Round #2

Well, today I began my second round of the four scheduled 4 day chemo treatments which are in conjunction with my weekly one hour treatments. So far the side affects have been minimal with no signs yet of fatigue or nausea. The only prominent side affect was the acne type rash that Dr. Kukunoor said 1 in 10 people get and of course I got it! I should be so lucky in the lottery! After the initial treatment I felt the rash coming on and when I went and had the nurses at the chemo center look at it I was told that I was just having a reaction to Decadrol and that it would go away by itself. This was on a Friday when I should have also had a second one hour treatment but lo and behold no one ever mentioned that I was scheduled for this treatment even though they went into the computer and wrote down the rest of my appointments for the rest of the month for me. By Monday my nose was peppered with with white pockets of puss and black dried scabs from where the skin had blistered and bled. My entire nose was a deep red as if it was on fire and the rash spread up above my eyebrows and across my forehead and into my scalp and also down onto my chest. I called the nurses station again on Monday and this time when they saw my face they now determined that I had the rash I had told them about three days earlier. I was also suffering from mouth sores mostly located on the inside front of my lower lip and my tongue was extremly sensitive to any kind of heat. Even luke warm water would make my eyes water as if I had bitten into a hot pepper. Well the nurse gave me three precriptions, one for my mouth and two for the rash, one oral and one gel treatments. When I went to the Pharmacy to have them filled I was told that the they were out of the Gel and would not be able to get it until the foloowing day. This put me 4 days behind where I should have been had they acted diligently when I first contacted them the previous Friday. Needless to say I was not pleased by this and then to top it off when I went for my treatment the next Friday they finally realized I missed the treatment on the previous Friday and tried to cover themselves by saying that they probably bypassed that treatment because of the rash. This was a bogus claim because if it were true than I would've gotten the prescriptions on Friday instead of the follwoing Monday. You don't deal with the same nurse on every visit but I made it clear to the third nurse who gave me my treatment the neither of the two nurses on the previous Friday or Monday visits ever made a comment about bypassing a treatment or even that I had missed one. It was nothing more than them trying to cover themselves for this blunder. I had an appointment with Dr. Kukunoor on this past Wednesday and I made sure Dr. Kukunoor was aware of this. By now the rash is about 90% clear of my face but I still have red splotches on my chest but they do not itch like the ones that were on my face. Dr. Kukunoor wants me to continue with both the oral and gel prescriptions for the ramainder of the treatments to make sure the rash stays under control and for that I am grateful.
Todays bloodwork, drawn before the treatment began showed the majority of my counts to be below the low end of normal but they decided to go through with the treatment and I will get a booster shot on Tuesday when the fanny pack is removed to get my counts back up in the normal range. My WBC (White Blood Count) was 2.25 and the normal range is 3.70 to 10.1 and my RBC (Red Blood Count) was 3.90 and the normal range for that is 4.06 to 5.58. My Neutropenia count, another form of white blood cells was 1.57 and the normal range for those is 1.63 to 6.96. These cells turn into white blood cells and because the count was so close to normal this was the determining factor in going on with today's treatment. My Lymphopenia counts were .431 and normal for that is 1.09 to 2.99. This is another type of white blood cell. All of these are critical in the immune system in fighting off infections. My hemaglobin cout was at 12.3 and the normal range for that is 12.9t o 15.9 so I was pretty close there and there were about 4 other counts that were in the normal range but I don't have a detailed description of what they are or what they do and because they are in the normal range I'm not to concerned about them.
So other than that my eating is good, swallowing is better and energy level is good too. Dr. Kukunoor said that if this is as bad as it will gets, he said "Ill take it!" to which I replied to him,
"You can have it"" :)
Dr. Kukunoor did tell me that he spoke with Dr. Rodriguez who did the axillary dissection and they went over the operative report and Dr. Rodriguez said the the lymphnode that he wanted to remove for the biopsy procedure was wrapped around nerves and capillary tissues which prevented him from removing the entire node thru surgery. He removed as much of it as was possible. Dr. Kukunoor said that this is why he wants to be as aggressive as possible with the chemo and if after the treatment is done and the subsequent PetScan comes back clean than radiation to that area will be the appropiate follow-up. I asked Dr. Kukunoor what he meant by the PetScan coming back clean and he said the PetScans do not pick up microscopic cells, so as long as there are no other masses found elsewhere within my body at the time of the PetScan than this means it is clean and targeted radiation to the area will be the protocol to follow. When I asked Dr. Kukunoor as to how he would stage this cancer he said that the cancer in my neck was staged as a Stage 4B and he would now classify this as a Stage 4C. When I asked him which was worse he said the Stage 4C was worse because it had moved.
So now I have my friend for the next 4 days and then hopefully I'll return to normal. No hair loss as of yet but this is only the second treatment so if memory serves me well I believe it was at least two treatments last year before I saw the hair begin to fall out, so as the Zen Master in "Charlie Wilson's War" said, "We'll see!" I will close with that as I realize this was a lengthy post and there are more things I can go into to but this is enough for now. I will update probably next week sometime after Tuesday's pack removal.

The Pack is Back!

And no, I don't mean the Green Bay Packers! In an unscheduled but highly anticipated rematch of two heavyweight sluggers, this is a sanctioned 12 week bout between the "Polish Hammer" going up against "Mr. C". The first round got started last Friday with the "Polish Hammer" attacking "Mr. C' with a barrage of anticancer drugs, which similar to last year will go on for 4 days followed by a two week lull to allow the drugs to do their thing. In addition to this a diet of alkalizing foods will commence in an effort to bring the "Polish Hammer's" body Ph to a level that "Mr. C." will not be able to sustain itself in, along with a new round of herbal remedies supplied by my longtime ringside coach Mary Phoenik. Hopefully this 1-2-3 punch will be enough to deliver a permanent knockout blow to "Mr. C" and end this thing once and for all! I will continue to work and live as normal as life as possible for as long as possible during the next twelve weeks. Side effects will more than likely be the same as last year with a few possible new ones.
I will update this site as the rounds progress and see how the judges (doctors) score the rounds.
Stay tuned for my next update!

Rolling Along

Yesterday I met with Dr. Rodriguez for a follow-up to my axillary dissection that he performed on me two weeks ago to the very day. While there was still some swelling under my right armpit it had seemed to go down a little. Dr. Rodriguez again elected not to lance it as he feels it will continue to go down on its own buty advised me to keep a close eye on it and call him if I see any noticeable changes. It is all just fluid build up from the lymph nodes being removed.
After my appointment with Dr. Rodriguez I went bowling in my league and had one of my best nights since returning to the recreation in May. I had a 659 series on games of 222-171 & 266. I had the first 8 strikes in a row in the third game before leaving a 7 pin in both the ninth and tenth frames. I closed both frames with spares for a perfect game in that I had no opens. I then broke the news to my teammates of my recent developments and upcoming schedule of things to come. But like work I will continue to bowl as long as I can. Fortunately my cancer is on my right side and for those of who don't know it, I bowl lefthanded!!!!!!!!!!!
Today, October 1st I had an eight o'clock report time at Scottsdale North Hospital for a scheduled eleven o'clock procedure to have a port implanted in my chest in preparation for my upcoming chemo treatments. Everything went well and I was out of there by two o'clock. I was attended to by most of the same team that removed from previous port back in May and they were just as kind and gentle as before. It was good to see them all!
The port this time was placed opposite of the last one, this time being on my right side instead of the left and it was placed into a vertical vein instead of a horizontal artery so hopefully I won't have the complications I had last time with the port operating as efficiently as it should. I was awake during the whole procedure and felt no discomfort as they cut into my right jugular vein above my collarbone, which wasn't done last time. This was to insert the tube into the vein and then another incision was made below the collarbone to implant the port itself. The Dr. said she would be sure to make it even with the scar on my other side so that I would have a matching pair fo scars! For that I thanked her kindly!
After leaving the hospital I came home for about an hour and a half as I had an indoctrination scheduled for four o'clock at the chemo treatment center. This basically entailed going over everything that would take place, what drugs I would be given, what side effects I could expect and a detailed briefing of things that I could do to best prepare for the oncoming onslaught. Since I had already been through this once and really didn't need a lot of explanation the nurse said this was one of the easiest indoctrinations she had ever done!
My treatments will begin this Friday, and the good news is I will only have to wear the fanny pack for four days instead of five and since I'm off on Saturdays and Sundays this should minimize the amount of work time missed due to the problems that might arise while wearing the pack. Last year I wasn't working so it was easier to cope with as I usually didn't shower for the five days I wore the pack. I don't think my co-workers would appreciate it if I did that again and then showed up for work.
So, I will continue to work and bowl for as long as I can, keeping in mind the drugs will zap both my physical strength and immune system.
Well, the pain in my neck is starting to become noticeable so I will sign off for now and go take a "Happy Pill" and head off to bed.
Thanks to those of you who continue to follow my journey and for your continued prayers and well wishes. As always I appreciate them all whether made known to me or not!
God Bless you all!

Ready for another round!

Today, I called the office of Dr. Francisco Rodriguez, who last week performed an axillary dissection of my right armpit area. The call was to tentatively schedule a follow-up to that procedure and also concern over swelling and tenderness in that particular area. I was told that the Dr. would see me later that same afternoon. After arriving at the office and a short wait I was visited by Dr. Rodriguez and greeted with the abysmal, "I have bad news or you". He went on to say that the pathologist report had come back only yesterday from the dissection and it showed that the cancer was now present in that area and that I should get a hold of Dr. Kukunoor as soon as possible. He did say he attempted to contact Dr. Kukunoor himself, but Dr. Kukunoor was on vacation. Needless to say I was somewhat at a loss as to what pertinent questions to ask, but Dr. Rodriguez basically said that surgery was not the answer due to the complexity of nerves, muscle and other tissues in the area but that I would require further treatment. He did not go into detail as to whether this would involve another round of chemo, radiation or both so I'm sure Dr. Kukunoor will discuss this with me when I meet with him in the near future. Aside from the tenderness and swelling in that area and I have no other pain except for my ongoing swallowing issues and I'm not sure if that is tied into this or not. So again, I will post more as things develop but this is where it stands right now!

Busy Week

Well, this week was a very busy week as far as Dr. appointments and procedures were concerned. It started on Monday with a Barium Pill Swallow study that was conducted at 8:30 a.m. at the Scottsdale North Hospital. It was about a 20 minute procedure in which I was given Brium liquid to swallow followed by a Barium pill. A visual screen was placed where I as well as the Dr. could see where the two items went and it confirmed what I had been saying all along. The liquid Barium was going into my lungs and the pill went no further than the base of my tongue and stuck there. Attempts to move the pill along by drinking water failed and I ended up having to cough it back up. It was not that large of a pill!
Tuesday, I had an Axillary Dissection performed on my right armpit area to remove lymph nodes that had illuminated during my last two PetScans and were deemed metabolically active. This was done at Paradise Valley Hospital and I was there from 9:00 a.m. until 4:00 p.m. mostly due to the prep work and tests that had to be done before the procedure and about two hours for the sedation to wear off. I'm still a little tender in that area but there is no major pain. I did go to work the following two days ignoring the instructions to give 24 hrs for the anethesia to wear off, and I regret not following the instructions as I suffered severe headaches and nauseau toward the end of my shift on the first day back. I did feel better the second day though.
Friday, at 6:00 a.m. again at Scottsdale North Hospital I had an Endoscopy and Dilatation of my esophagus by my GE Dr. Bradford Gelyzad. The dilatation was done not with the expandable Donut I had been told about previously, but rather with two tubes of different diameters that were inserted into my mouth and down my throat to expand the esophagus. I was coming out of the sedation during this procedure because I remember seeing the rust colored plastic/rubber hose and remeber the Dr. speaking to me, but I don't remember feeling anything at all. I had a bite block in my mouth, which was placed there for the Endoscopy and made insertion of the tube easy for the Dr. Swallowing later in the day was noticibly easier in that food would not get hung up at the top of the esophagus, but being that my tongue is still swollen, chewing and eating in general is still difficult and aspiration through the trach persists. I should have a follow-up with Dr. Gelyzad sometime with the next 10 to 14 days for a follow-up.
So aside from awaiting the Pathologists report on the Axillary Dissection and the follow-up with Dr. Gelyzad nothing else to report on at this time. Hopefully the swelling in my tongue will go away with time as all of this is being attributed to Radiation side effects, and I'll be able to return to a normal diet. Until then eating will continue to be a struggle and great discomfort but I know it is important in maintaining my overall well-being. The majority of my diet will probably continue to be of the liquid type for the short time being, until these side effects subside.
My next posting will probably be when I get the results back from the Pathologist.

PetScan Follow-up

Well, this past Monday I went for my quarterly PetScan, and all went well as this is usually a routine procedure. My blood sugar tested normal, it has to be in order for the injection they give you to do it's job and I was there for about an hour and a hlf.
On Friday, I had a follow-up to the PetScan with my Arizona Oncologist Dr. Kukunoor. Dr. Kukunoor said that the PetScan was an overall good report with no signs of any activity in the neck and throat area, however there was concern over an area of illumination in my right armpit area. This was seen in the last PetScan but was deemed insignificant at that time, due to its minimal size. The most recent PetScan now showed this illumination to have more than doubled in size and also changed its shape which concerned Dr. Kukunoor. A physical examination of the area also revealed a firmness in the tissue that was not consistent with that on my left side. Dr. Kukunoor told me that the illumination is measured by what he called an SUV (I can't remember what it stands for) but that it went from a 2.9 reading to a now current 7.0. Dr. Kukunoor said he wanted to have the tissue biopsied to determine for sure what it is. He set me up with a surgeon, Dr. Francisco Rodriguez, with whom I will meet this coming Thursday Sept 4th for a consultation to explain my options and answer any questions I might have. Then a date will be set for the biopsy. Dr. Kukunoor, as is his usual protocol, wants this done very quickly, and he set up a tentative follow-up appointment to see me on September 29, which could get moved up depending on the test results from the pathologist on the biopsy. Be sure and stay tuned!
I also discussed with Dr. Kukunoor my recent degradation in my ability to swallow, both solids and liquids. Over the past month to a month and a half I have had a steady decline in the ease in which I am able to swallow with most food getting caught at the top of my esophagus and my having to cough it back up in order to get it down. I knew it was a problem last month when I was back home and my Dad, a notorious slow eater was finishing his meals before me! That was telltale sign for sure! Dr. Kukunoor said the swelling could be occuring due to the radiation, to which I was somewhat puzzeled, being that radiation eneded over eight months ago. Dr. Kukunoor assured me this was not unusual, and he again placed an order for me to see a gastroenterologist, so that I can have my esophagus examined to determine if in fact it is closing up. If that is the case then a procedure that Dr. Straka had talked to me about months ago would probably take place. This would involve the insertion of an expandable donut being inserted into the esophagus and expanding the donut to stretch out the scar tissue to open up the passageway. I will probably be contacted early next week by the Gastroenterologist to schedule an appointment.
So things are still not all settled and the upcoming weeks should be interesting to say the least. I will contiue to post updates as I receive results.

The Latest

Well, having returned from a fabulous vacation back in Pittsburgh from August 5th through August 20th and seeing both my dentist and ENT Dr. Straka, here is the latest update.
My dentist appointement with Dr. Edward J. Dengel went fine, with no signs of cavities and or decay of any kind. This is important as my condition of "Dry Mouth" can promote bacteria and cause numerous problems if not taken care of daily. This include flossing, cleansing with a water pik and the ususal brushing of the teeth, gums and tongue. X-rays also showed no signs of any imminent problems.
My appointment with Dr. Straka was routine as well, with the exception of my describing to Dr. Straka how swallowing for me has become more difficult over the last several weeks. Dr. Straka did reduce my trach tube once again from a #6 to a #4 but recommended we leave this one in for a period of one to two years, mostly as a safeguard to keep an airway open in the event of some unforseen swelling such as I'm experiencing right now. Although this swelling does not affect my breathing at this time. Dr. Straka did order a Barium swallow study and it was determined that some foods particularly liquids are going in to my windpipe but no explanation was given as to why except that the little flap of skin that is supposed to prevent this is weak and not doing its job to a 100%. The speech therapists who were present during the swallow study had no recommendations for exercises, only to eat a diet of softer foods and thicker liquids to help prevent the foods from going down the wrong tubes. They also querried me as to whether or not I had had a recent cold or if any other changes had occured in my lifestle. I told them of my recent change to the South Beach Diet to try and improve my eating habits and also of a liquid supplement that my Master Herbalist Mary Phoenik had recommended I take that aids in celluar reconstruction. That supplement consists of juice from the Mangosteen fruit and it has yet to be determined if my swelling in the throat can be attributed to that or not.
This coming Monday I go for a PetScan and will review the results of that with Dr. Kukunoor on Friday the 29th of August. I will speak to him about my swallowing issues as well and see what he has to say about that.
My vacation home could not have been better, the weather was fall like and we did not turn the air conditioner on once the whole time I was home. Dad and I played a few rounds of golf in order to tune up for the Polish Falcons Golf Tournament and I shot 4 consistent 9 hole rounds of 46-46-46-42, and struck the ball better than I ever have. Following the tournament I shot a 39-47 round at Glengarry Golf course near Latrobe with my brother-in-law Darren. Dad was all golfed out by then but we did manage to get in one more round out in Ohio at Copeland Hills where again I played very well, but I can't remember my scores.
I got to see a lot of old friends at the Falcon Golf Tournament and enjoyed the two day affair. We also attended on Pirate baseball game with my sister Cathty and her family on Sunday. It was a beautiful sunny day abd a good crowd was onhand but sad to say the Buco's lost:(. But it was nice to spend the afternoon at the park.
Aside from that we did some yard work down in the woods behind the house trying to take back the land from the onset of Kudzu, which like cancer will kill if not killed first. I seem to have taken on a great obsession to rid our property and that of the neighbors of this creeping vine that will cling to and kill just about anything in it's path.
My next planned trip home is the weekend of September 6th to participate in the Polish Falcons District IV golf tournament to be held at Harmony Ridge (formerly Ambrdige Golf Club) of which Dad is the Tournament Chairman.
I will post another update after getting the results of my upcoming PetScan.