We came up to the hospital yesterday so that Marshall could go to the Rocky Mountain Lions Eye Center. They couldn't find anything definitive wrong with the eyes, so they set another appointment for next Thursday for him to have a thorough retina examination.
So we spent the night at our favorite hotel, the Spring Hill Suites, and had a nice evening just kicking back.
Today was the regular 2-week lab work and checkup with the nurse practitioner, Kathryn. The best news is that the PSA has gone down even more and it is now 1.04. That is so exciting.
His iron levels are coming up again, which is really good, so we will continue the iron supplements until it gets back up to normal.
His Vitamin D levels are getting low again, so they will be starting him up again on 50,000 units of Vitamin D a week for the next 24 weeks to bring those levels back up. We mentioned that it was odd that his vitamin D would be so low when he gets a lot of sunlight. She said she is not at all convinced with regard to the correlation between sunlight and vitamin D production in the body.
With regard to the petechia/purpura on his arms, she said that is probably caused by the prednisone and that, while it is annoying, it is not harmful and he shouldn't worry about it.
The varicose veins on his legs are not concerning her at this point, but we will keep an eye on them and monitor them. The varicose veins could be causing some of the leg pain he's been having.
She said that if the restless leg syndrome continues to get worse, she will prescribe Gabapentin for him. (Tricia, I mentioned that you gave us your bottle of Gabapentin and she seemed to think he could use that if necessary, so thank you.)
We mentioned that he's been having some leg pain that is reminiscent of the bone pain he had before and she said that if it was bone pain from the cancer, it would not be intermittent, it would be constant, so she was confident it was not the cancer.
Marshall asked her for her opinion about what was happening with the cancer in the bones -- if he could be considered in remission. She said that the term remission isn't really used any more except in very limited cancer situations. It is not used in prostate cancer that has metastasized. But she is confident that the tumors are being starved and thus are not growing. She said that's what all of the test results tell her.
And she's not sure what is causing the nausea, but she wants him to try to not take the anti-nausea pills unless he absolutely has to. Easier said than done.
But then she saw one of the tests that indicated he was severely dehydrated again and that concerned her. She did not want him to leave on his motorcycle trip today without being hydrated, so he had to stick around until 3:30 to get hooked up to an IV for several hours. She stressed to him again that he needs to get 60 or 70 ounces of water a day.
She wants him to see his primary care physician on Monday when he gets back to check the kidney function and if it isn't back up to par by then, she wants him up at the hospital ASAP in order to do an ultrasound of the kidneys to see if anything bad is going on. She feels confident that he is just dehydrated from not getting enough water and that he will be back up to par by Monday but she wants to be sure we stay very much on top of this.
I asked her whether drinking coffee could cause dehydration and she said absolutely. She said that for every cup of coffee he drinks, he needs to have two glasses of water -- one for the water he should be drinking and a second glass to make up for the cup of coffee. So Marshall may cut down on coffee.
He is due for another Lupron (hormone) injection and Xgeva (bone strengthener) injection and he'll get that next Thursday.
One of Marshall's childhood friends was in Boulder this week so he came over to the hotel to spend a few hours with Marshall this afternoon. That was a special treat.
I think that sums it up.
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