Tuesday, December 25, 2012

Timeline

How did I get here in this position, writing this journal? I never really considered myself like Superman, the title just seemed to fit. In terms of super powers, I always felt a little more like Wolverine, sans the claws and metal skeleton. It was his ability to withstand pain and heal from injury that I somewhat identified with.

As a small child, I frequently got tonsillitis and eventually had my tonsils removed. Later, as I got into secondary school, I became a frequent allergy sufferer and had outbreaks of hay fever turn into a sinus infection 2 or 3 times per year. Other than these bi-annual events, I almost never had to go to the doctor and after getting surgery for a deviated septum a few years back, these events have become even less frequent.

I rarely got a cold, though sometimes my allergy outbreaks were difficult to distinguish from a cold, and I've only had the flu a couple of times in my life despite never getting a flu shot.

The only real exception to all of this was a time in 6th grade when I came down with a mystery illness that was never fully diagnosed. The going theory is that it was some form of mono, but I never really had all the standard symptoms of mono. This kept me out of school for the greater amount of a month, then it was gone and I got back to normal never to see any kind of relapse or recurrence.

My point in all of this is that, for the most part, I don't get sick, and when I do, it rarely impacts my ability to function. In my adult life, I've rarely had to take sick days off from work and have never had to use them all to cover an actual illness. I don't contract those illnesses that go around each year and on those rare occasions when I do get sick, I usually recover pretty quickly. I've also never been one to let illness stop me from getting things done. I've never been able to just lie down and relax when sick and unless I've got something potentially contagious, I usually go to work anyway or go ahead and get things done around the house pushing through the illness.

Even when I had the surgery for my deviated septum, the doctor told me to stay home and take it easy for 3 days. That barely lasted through the first afternoon. Working in IT afforded me the ability to get things done from home and, being outpatient surgery, I was home by noon and checking my email by 2:00. I worked most of the next day, staying home only to spare my co-workers from the sight of the drainage tubes that were protruding from my nose, and those came out earlier than they were supposed to.

So, with all of that said, how did I get here? Back in the summer, I had some back pain for a few days after doing some moderate yard work over a weekend. That, in itself, was not unusual, but what was unusual was that it lingered for the better part of a week and the regular tylenol and advil treatement didn't really help, especially overnight. My wife had some left over Vicodin from her gall bladder surgery, so I took those and the problem went away after a few days. I found it odd, but didn't think much about it, especially since it went away. A few weeks later, it happened again. Then I started getting odd random pains, primarly at night when going to bed. One night it would be in my left leg, the next night in my right. One night in my lower back, another in my upper back or neck. It was odd, but over the counter medication would take care of it one way or another and the pain would go away. Eventually, the pain settled in my back and became more chronic. Tylenol and Advil were able to relieve the pain, but it was having to take them regularly, several times per day, every day, so I went to see a Chiropractor.

The Chiropractor started treatment, making adjustments, with a lot of cracking, and some stretching exercises to follow at home. The treatments seemed to help, but the pain would inevitably come back. The pain moved my neck and stay there. I would wake up in the morning with a stiff neck. At one point, it was so stiff I couldn't move it at all without pretty severe pain, so I went to see my family doctor, who gave me some muscle relaxers and sent me to a physical therapist. The physical therapist applied some heat treatments and the same exercises that the Chiropractor had. Between the three, my neck loosened up after about a week, but kept coming back to a lesser degree. The pain started wandering again, and seemed to lodge between my shoulders frequently.

Because I work sitting at a computer all day, both my doctor and chiropractor assumed that it was probably caused by repetitive stress and poor posture, so I started taking steps to improve that problem. I purchased an adjustable desk for work that allowed me to alternate between sitting and standing while at the computer. I purchased a lumbar support pillow and made adjustments in my car seat and chair at work. I made an effort to sit with better posture and work with my iPad at eye level by propping it up on a lap pillow. I did the stretches and exercises as directed. All of that seemed to help, but the pain kept coming back or never really went away and I was still taking Tylenol and Advil alternately around the clock.

Finally, on November 8, 2012 two things happened that changed everything. I had an appointment with the Chiropractor the previous morning. Both he and I agreed that something wasn't adding up since the pain was not getting any better, so he ordered an MRI of my lower back to see if I perhaps had a bulged disc. I had the MRI done after work the next day. That same evening, I woke up about an hour or so after going to bed with severe pain in my back, neck and leg. The Tylenol and Advil didn't help at all and I went through the night in pain, with no sleep. The next morning, I asked my wife to take me to the doctor.

I was able to get in to see my doctor for a same day sick visit that morning. While I was there, just as he entered the examination room, a nurse came in and said that there was a call for him from my chiropractor. He took the call and came back into the room. The radiologist who did the MRI had called the chiropractor directly, which was unusual as he would normally just send a report over. The radiologist had called because he saw lesions on my spine that he thought could be an indication of cancer, possibly multiple myeloma. My doctor examined me, and then sent me out for a blood test, urine test, and CT scan. He also referred me to an oncologist for examination. This was the beginning of a dizzying whirlwind that covered the next several weeks.

I went straight from the doctor's office to get the blood test and pick up the supplies for the urine test. Apparently the urine test required me to collect it over a 24 hour period and would determine whether multiple myeloma was present or not. I scheduled my CT scan for first thing on the following Tuesday and got an appointment with the oncologist for later on that same Tuesday. In the meantime, he gave me a prescription for Vicodin to deal with the pain.

Tuesday, November 13, I got up and went to get the CT scan first thing in the morning. My appointment with the oncologist was for 11AM. By the time of my appointment, he had already received the results of my CT scan. He said that it showed that I had an enlarged prostate and that the blood test had shown my PSA level was high. He then referred me to a Urologist. Because my wife was scheduled to have a C section on the following Monday, he was able to get the Urologist to see me that afternoon. The meeting with the urologist was basically a consultation. He explained that a biopsy of my prostate was needed in order to determine whether it was enlarged due to cancer or for some other reason. Because of the time pressure we were under with my wife's scheduled delivery, he was able to schedule the biopsy for Thursday morning. Both doctors seemed fairly sure that the results would come back negative due to my age, the lack of standard symptoms for prostate issues, and the fact that my PSA level was relatively low even though it was elevated.

The next morning I had the biopsy. The urologist said that it would take a few days to get the results back and wanted me to schedule an appointment for Wednesday. I explained that Wednesday wouldn't be possible because that was likely to be the day my wife and baby would be coming home from the hospital. We left it with they would call me when the results were available so and we would coordinate from there.

Monday, November 19, my wife gave birth to a beautiful baby girl. My pain stayed under control during our time at the hospital. It was a welcome uplift after the previous week's events. The next day the Urologist called stating that they had the biopsy results back, however, due to the Thanksgiving holiday, the earliest that I could get in to see him was the following Monday. I went ahead and called the oncologist as set up an appointment with him for the same day.

Monday, November 26, I went to the urologist and he informed me that the biopsy results were positive for stage IV prostate cancer and that it had likely spread to my bones. I was in a bit of shock and disbelief. I didn't have much of a reaction. I wasn't even sure how to react. He explained that because it had spread, surgery was not an option and we would have to treat it with hormone therapy. He then gave me a prescription for some pills to take over the next 2 weeks in preparation for the hormone therapy (Lupron).

That afternoon, I went to see the Oncologist who went over it with me again and then ordered a bone scan to determine how much the cancer had spread. When the scan came back, it showed that it was pretty much everywhere and here we are today. My treatment, for now, consists of monthly injections of Xgeva plus bi-annual injections of Lupron. In the meantime, I have a Fentanyl patch and Vicodin to manage the pain, daily doses of stool softener and Miralax to manage the constipation caused by the Fentanyl and Vicodin, and twice daily calcium supplements to strengthen my bones.

It was a lot to deal with in a short amount of time, but I am grateful that my health coverage allowed things to move that fast without having to deal with a bunch of bureaucratic referrals and pre-approvals. I feel fortunate that I was able to go from diagnosis to treatment so quickly. I know there are other plans out there where that would not have been the case. For now, we just endure and see what the future brings.


1 comment:

  1. Hi there, I was reading up on few of your posts and had quick question about your blog. I couldn't find any contact info and was hoping you could email me back when you get the chance, thanks!

    Emily

    ReplyDelete