Wednesday, April 25, 2012

Rump roast anybody?

Yep, they cook my ass on a daily basis.  No salt, pepper, garlic, or rosemary, so it probably isn't very tasty, but the good folks at the Providence Radiology Oncology center have the pleasure of microwaving my butt for breakfast Monday through Friday.  Today was my 15th treatment out of 28. 

The treatment itself is quick and painless, a couple of minutes in the waiting room, I give the nurse the password to let me in to the treatment room, drop trou, and lay down on the little cot like bed of the machine.  It takes the nurses a couple of minutes to position my ass exactly how they want it, then they leave the room, close the huge (8 inches thick) door, buzz buzz, whir, buzz buzz, whir, buzz buzz, pull up pants, and go home.  The total time spent in the office is usually less than 15 minutes, and the whole trip there and back home again usually takes less than 45 minutes.

However, it doesn't take long for the burning to start.  One might describe it like taking a hot fireplace poker up the butt.  Or, looking at it in a slightly different light, one might say that it feels like wiping with 50 grit sandpaper (or maybe a wire brush).  Needless to say, it doesn't feel good.  So, I take vicodin, and I smear viscous lidocaine on my ass.  The drugs knock the pain back to a manageable level, and if it is a good day, I'll start to be mostly pain free by two or three in the afternoon.  It seems like I do still need some drugs to knock the pain totally away, but I can reduce my dosage for the rest of the day/evening.

I have also been experiencing some irritation of my bladder and urethra.  It's not at a "why does it hurt when I pee?" level yet ... just uncomfortable.  Unfortunately, I seem to have to pee a bit more often too.  And, I've had a couple of bouts of diarrhea, but that is probably caused as much by the chemo as by the radiation.

Effects seem to be cumulative, so Sunday and Monday are my best days.  Thursday and Friday are my worst days.

Monday, April 23, 2012

The Plan

It took about 10 days for my doctors to get a plan in place and under way.

3/26/2012 - got out of the hospital.

3/29/2012 - let my surgeon look up my butt ... he needed to see the tumor for himself.  And, whoa! spur of the moment he wants to operate the next day to put a power port (for chemo injection) in me.

3/30/2012 - get up at 5 something in the morning to be checking in to the outpatient surgery wing at Providence by 6.  See the doc for something like two seconds somewhere around 8, then it gets all fuzzy and I'm out cold until 10.  I'm a little fuzzy here, but I'm pretty sure that they put me in a wheelchair and Camille pushed me down to the Radiology Oncologists office.  The fog cleared pretty quickly and, we talked with Dr. Wang-Chesebro for a while.  She laid out the radiology part of the treatment plan to me, and sent me on down to her nurse torturers who took some pictures of my butt (you might think that this is your great opportunity to find some noodie pics of Jes, but alas it wasn't so much fun ... they stuck something up there so they could get some contrast pictures of my tumor.)  The doc came back to tell the girls where to put my tattoos.  Yep, they put tattoos on you so they can put the gun in exactly the same spot every day.

4/3/2012 - back at the outpatient procedure desk at 6 am again.  They need to put a marker on the cancer spots in my liver.  This is so they know what part to take out in the small chance that my tumors shrink up to almost nothing in the two months that I will be having chemo/radiation treatments before the surgery.  And, they need you awake for this one ... they do give you drugs, not enough to knock you out, just enough to make you mostly forget about the big needle they are sticking between your ribs.

4/5/2012 - is the first day of treatment.  Camille needed to be in the office this day, so my friend Nora came and hung out with me while they got me set up with a pump that will be giving me little doses of poison for the next month or so.  She also got to put a few pieces into the puzzle that they have in the Radiology waiting room while I was off getting cooked for the first time.

So, the plan is like this ...

28 days of radiation.  The first 25 days are at a somewhat reduced/routine level, and, it sounds like they turn up the volume for the last three days.  Radiation treatment is Monday - Friday only, so my ass gets a break on Saturdays and Sundays. 

Concurrent with the radiation treatment is chemo.  I get the pleasure of hauling around this little pump that every couple of minutes puts a drop of something called 5-flourouracil (aka 5-FU) into my power port.

Take a break for about a week.

Two cycles of FOLFOX.  Here's where they add some more drugs into my chemo cocktail.  My understanding at this point is that this cocktail consists of 5-FU, Oxaliplatin, and Leucovorin.  A cycle of FOLFOX goes something like this: the oxaliplatin and leucovorin are administered in the oncologist's office, and the 5-FU goes home with me on the pump for two days, back to the office to turn in my pump for the next 12 days.  So, two cycles will be four weeks, and then ...

Take another break ... 4 weeks this time.

Now it's time for surgery ... this is a major surgery ... cut off half of my liver, and take out a chunk of my rectum and colon.  Recovery should be 4-6 weeks.

There ain't no rest for the wicked ... back to the chemo routine for another 10 cycles of FOLFOX.  (That's 5 months folks.)

And, of course, that's if everything goes according to plan, and I don't have any complications that slow things down.

Friday, April 20, 2012

Where the story starts

I learned that I have cancer on March 24, 2012.  I had been experiencing some escalating GI discomfort over the previous couple of days, and a brief visit with my primary care doctor had me in the emergency room which lead to some tests chief of which was a flexible sigmoidoscopy which found a large tumor in my rectum.  The doc took some tissue samples to verify that the sucker was indeed cancerous, and nobody was surprised when the tests came back a few days later confirming that it was cancer.

So, it was off for more tests and pokes over the next couple of days.  CT scan showed two small lesions on my liver that they needed to get a tissue sample on.  Good times?  Right.  And, yes, the spots on my liver are cancerous too. 

It was also over this long weekend in the hospital that I met my team of doctors.  I can't say enough about how happy I am to have this group of people working on my ass.  So far, I have five docs ... Dr. Jeremy Holden is the fellow who stuck the scope up my butt and found the big tumor, Dr. Todd Crocenzi is the oncologist who is overseeing my chemo regime, Dr. Alice Wang-Chesebro is the radiology oncologist who is in charge of pounding my ass with radiation, Dr. David O'Brien is the surgeon who will cut the tumor out of my ass, and Dr. Ron Wolf is the guy who will cut it out of my liver.

And the good times ... they're only starting.