Overdue Update

Let me start by apologizing for not updating my blog more often. I just haven't felt up to over the past few weeks, but here it goes!
My 25 radiation treatments to my right axillary finished up on Feb 20th, followed by a quick trip back to Pittsburgh for a routine dental appointment, then back to Phoenix for a follow-up with Dr. Kukunoor, my oncologist. His exam did not address my right axillary at all, but rather the area around my collar bone and neck. He had asked me how my breathing was and then went on to say that the last CT scan I had in January revealed two spots that caught his attention. One was a nodule on my right lung and the other was a spot on the right side of my neck, which is the opposite side of where the cancer was originally spotted. Dr. Kukunoor stated that the spot in my neck could be from swelling or could be something other, and the spot on the lung was unknown. He told me he wanted to wait 3 more weeks before having a scan to see if these two areas changed in shape or size. I told Dr. Kukunoor that I did not want to wait 3 more weeks and wanted to have a scan done as soon as possible. He obliged my wish and set one up which was conducted this past Tuesday. It was a scan of the soft tissue of the neck and a full chest scan. Dr. Kukunoor called me at work yesterday (Wednesday) to give me the results and he said that there had been no significant change to either area and also attributed the spot on my lung to a form of pneumonia most likely caused by aspiration of food particles and liquids. I asked him just to reconfirm if this was good news and he said "Yes". I then went on to tell Dr. Kukunoor of relapse of difficulty swallowing and major swelling of my tongue. He had no explanation for the tongue swelling but did say that I could probably use another stretching out of my esophagus as the scar tissue was probably constricting that area again. I called the Dr. Gelzyad the G.I. who did the procedure last fall but he was reluctant to do it until I get another Endoscopy from my new ENT Dr. Hinni of the Mayo Clinic. I called the Clinic and was able to get an appointment for Thursday the 12th of March and if Dr. Hinni gives me the go ahead I will contact Dr. Gelzyad to have the procedure performed and get some from relief from eating and breathing. My tongue has also become very sensitive to heat both in the form of temperature and spiciness and me eating has been reduced to mostly things that require minimal chewing such as pasta, macaroni and cheese, yogurt, pudding and jello's. Everything else is just to difficult because my tongue seems to be filling most of my mouth. I have seen some significant reduction in the swelling over the last two days so perhaps things will return to normal soon. That's pretty much it in a nutshell for now and I will probably post another update in about two weeks after I see Dr.'s Hinni and Gelzyad.

Radiation to begin...........

Well, last Thursday I finally met and had my conulstation with my newest Radiation Oncologist Dr. Patrick Miller. The consultation went fine and even though I have already been through this I still had some questions and Dr. Miller was able to answer them all to my satisfaction. I fell very comfortable with him, although I must say that I was suspect when I first saw the location of the facility and the facility itself, not to mention it looked like Dr. Miller had slept in his shirt so the professional image was lacking. However, my suspicions were lifted when another patient in the waiting room, an elderly gentleman told me that he had done a lot of research of different facilities in the valley on the Internet and his conclusion was that this was one of the best. They were in their 20th year in the same location so I guess that's good for something.
Dr. Miller said I will probably receive 25 treatments versus the 30 that Dr. Kukunoor said I would receive and after some discussion about my work schedule they were able to accomodate me in such a manner as I shouldn't have to miss any work. The treatments will be Mon thru Fri at 4:15 p.m. and shouldn't take more than 10 to 15 minutes.
Today, Monday I went to the another facility over in Sun City, about 20 miles from where I live for a one time alignment session, to align my body using lasers to the radiation machine. similar to the same thing I went through last year. Later this week, after the "Plan" is developed I will go over to more closer facility for a "Dry Run" where they will do everything they will when the treatments start except for actually adminstering the radiation. Dr. Miller said aside from a little sunburn in the right axillary area I shouldn't have any other side effects.
So, I'm planning on the treatments starting on Monday January 19th and ending on Feb 23rd if all goes according to plan.
Aside from some facial and tongue swelling this weekend and a massive area of pain that flared up last night in the right axillary area, I'm feeling alright. I am concerned about the pain that flared up last night because on a large scale it is similar to the pain I had in my neck last year when I was first diagnosed. I saw Dr. Kukunoor last Wednesday when I was coughing up some bllod through my tach and it kept increasing and suring that visit I told him the right side of my neck was swollen and numb, he looked me over and said he didn't see any noticeable difference and left it at that. He did order a scan to check my lungs for blood clots but I have yet to hear from anyone regarding scheduling an exam. Apparently we are waiting on Blue Cross Blue Shield to give their approval, in the meantime I could die! Aren't insurance companies wonderful!

An early Christmas Gift!

Well, this past Friday I had my last Chemo treatment finishing my 12 weeks of Chemotheray and today I met with my Oncologist Dr. Kukunoor to review the results of my CatScans I had shortly after Thanksgiving.
Dr. Kukunoor read through the report rather quickly and many of the terms I could not comprehend but the bottom line is that it was an overall good report. Dr. Kukunoor said the the scan of my neck area showed enlargement of the lymph system and when I asked him if that was good, Dr. Kukunoor responded with, "That is terrific!" The scan of my chest and abdomen showed no new areas of cancerous tissue and the tumor in my right axillary has responded to the chemotherapy and shrunk to the point that Dr. Kukunoor now wants to radiate the area to remove any microscopic cells that may be lingering about. Neither the CatScan nor PetScan can pick up these micrscopic cells if they are there. The radiation treatment will consist of 30 daily treatments that shoukld last no longer than 5 minutes, far less than the 35 treatments I went through last year that lasted anywhere from 15 to 20 minutes. I asked Dr. Kukunoor about side affects of radiation and he said that because of the proximity of the area to be radiated side affects should be few if any at all, again unlike my neck area which was packed with many vital tissues from the esphoagus and windpipe to salivary glands and the voicebox.
Dr. Kukunoor said he wants to wait about three weeks before the treatments begin so that puts me at about mid-January. In the meantime I have an appointment on Dec. 30th to meet with a radiation oncologist and also a dermatologist to examine side affects I am currently suffering from the 5FU and Urbatux drugs that I have been receiving. Overall though, Dr. Kukunoor said I was doing extremly well and he said he will see me again in two months. I did at the end ask Dr. Kukunoor if I would be able to indulge myself into an alcoholic cocktail every now and then and he gave me the green light, so at least the Holidays will be filled with more than one kind of Spirit!
I wish you all a very Merry Christmas and the Happiest of New Year's filled with Love, Joy and most of all Good Health! Thanks for your continued prayers and as always I sincerely appreciate each and everyone of you!
May God Bless each of you!
Tom

Halfway Home......but

Well, today I met with Dr. Kukunoor who did a physical examine of my right axillary and said the newest tumor seemed to be a bit smaller so he wants me to get a scan, specifically a CT Scan so he can get a better idea as to how much the tumor may have shrunk. The scan is scheduled for December 1st, the day I return to Phoenix from my Thanksgiving vacation back in Pittsburgh. Depending on what the scan reveals, the chemo treatments could be extended beyond the initial 4 to up to as many as 7 total. As long as it can be determined the Chemo is working and the tumor is shrinking, those will be the determining factors.
Everything else was fine as far as my vitals were concerned and overall I feel extremly well. My eating has returned to almost normal (Thanks God, just in time for Thanksgiving) and hopefully it will stay that way.
During Fridays treatment session, my blood counts came back much improved over the prrevious weeks numbers. My WBC was up to 4.31 and NEU was 3.28. The HGB came in at 10.8 and HCT was 31.0 and PLT was 211. The RBC was 3.48, still a little low there.
The weather was beautiful after I got out of my appointment around 10:30 a.m. so I went over to Stonecreek golf course and hit 51 balls on the range after putting for about 20 minutes. I wanted to play 9 holes but the course doesn't offer a 9 hole rate and after hitting the 51 balls I was too tired to play 18 so I went home for a restful afternoon.
I get my third all day treatment this Friday, and then carry the fanny pack for the next 4 days and then I will skip my next one day treatment as I will be home and Dr. Kukunoor said that I will just get that treatment when I return to Phoenix, so I get a little break there and hopefully I will feel as normal as possible for the 11 days I am at home.
So, my next update probably won't be until after the Thanksgiving Holiday, unless something warrants otherwise!
I wish everyone a safe and enjoyable Thanksgiving with family and or freinds and hope you cherish the time spent with those closest to you. I know I will!
God Bless you all!

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!