Thursday, January 31, 2013

More tests on the horizon

We heard from Dr. Flaig today and he is going to order some more scans (to be done at the Cancer Center) so that he can compare them to the recent tests done in the emergency room and reassess the game plan. So it looks like we will be going up to Aurora in the next week or so.

In the meantime, Marshall has kept the pain at bay and has felt fairly good. He hasn't left the house, though.

Tanya will be here tomorrow night and that will be a bright spot in his birthday weekend.

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Tuesday, January 29, 2013

Wheelchairs, walkers, etc.

We learned today that we can probably borrow a wheelchair from the Rotary Club or the American Legion, but they may be from the stone ages. Since we are hoping he really won't need a wheelchair for quite a while, we may borrow one just to see how it works in the house and then return it and if he ever needs one, we can see how much they cost.

I did go ahead and order a walker, though, one with a seat and locking wheels. It also folds. He will be able to use that now just for more stability in getting around the house. Don't think insurance will pay for it, but at the moment we can afford it.

And I'm going to get literature from The Scooter Store.

I sent all of the emergency room records off to the oncologist today along with an email summarizing our visit to the emergency room and asking him what we should do going forward. We should hear back from him tomorrow or Thursday.

Marshall felt better today, but he stayed on top of the pain and that helped. Our moods have improved a little bit. Looking forward to Tanya's visit this weekend.

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Left hospital around 2:00AM

Marshall finally had the CT scan at midnight and we got the results around 1:00AM -- no hairline fracture. The emergency room doctor definitely feels like the pain is cancer-caused.

We left the emergency room around 2:00AM and Marshall was nauseous and sick most of the way home. Thank goodness the nurse gave us one of those disposable "buckets" to take with us because we were in my truck (ha)!

The emergency room doctor suggested that Marshall pretty much stay on morphine and laxatives for the rest of his life and that he get a wheelchair. Her reasoning for the wheelchair recommendation was that the more pressure he puts on that right leg (femur), the more pain he will have, and that if he uses a wheelchair the majority of the time at home he will be able to kind of "save" the leg to go out and about so he wouldn't be completely housebound. We are going to check on getting a wheelchair, or, better yet, a scooter from The Scooter Store! That would be way more fun for him to zoom around the house in than a wheelchair.

In the meantime, we will call the oncologist on Tuesday or Wednesday and let him know what the emergency room results were and see what he might have in mind. From all the message boards that I have spent hours and hours reading, it seems to me like a little radiation of the femur may be in order. Or it might be time for chemotherapy. And/or perhaps a change in treatment.

But we don't buy the idea of totally sitting home in a wheelchair downing morphine. Not just yet.
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Monday, January 28, 2013

In the hospital again

The oncologist returned our call this morning and advised that we go to the emergency room to try to figure out what was causing the leg pain.

It is almost midnight and we are still here. From the looks of the waiting room, it is definitely flu and cold season!

Marshall has had an MRI and an x-ray, after which the doctor came in and sat down and said she has ruled out a blood clot and she has ruled out sciatica. The tests showed scattered cancer spots in the thigh bone and the doctor feels the pain is caused by the cancer. She advised that Marshall start relying more heavily on the oxycodone and perhaps morphine. Marshall expressed a concern about becoming addicted and the doctor said we shouldn't worry about that. She said he has to deal with the pain and if the oxycodone controls the pain, then he should not worry about becoming addicted.

But she wanted to do a CT scan just as a precaution to see if there is a hairline fracture. Marshall is getting the CT scan right now. We will get to see the doctor one more time and then we will go home.

We will call the oncologist tomorrow to see where he wants to go from here.

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Sunday, January 27, 2013

Another day of pain

This was another day of leg pain for Marshall. He's using his cane and his knee brace. He took an oxycodone finally -- along with a laxative -- and that gave him about 5 hours of comfort. But when he went to bed he took a couple Advil because he wants to avoid the constipation that comes with oxycodone. He just can't win.

I went to town with Glenn (one of our fellow Pet Project volunteers) and we bagged pet food for a few hours for the upcoming Friday food giveaway.

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Saturday, January 26, 2013

The pain has returned

For the past two days Marshall has had pretty bad pain in his right leg making it difficult for him to even walk. I got him a knee brace to help stabilize the leg and he also has one of those 4-legged canes which helps a lot. The Advil wasn't really doing much but, silly me, I was only giving him the recommended dose. After talking to others, we have increased the Advil dose tonight and we'll see if it helps.

I consulted Dr. Google again and found a few sites that indicate that after radiation treatments pain can come and go for a month, maybe even two months, so Marshall is not sure whether to get a doctor appointment or tough it out and see if it lets up. We'll play it by ear. One of the sites I found explained it this way: Radiation kills the targeted cancer cells but those cells don't immediately leave the body. It takes them a while to break down and work their way out and during that time there can be intermittent pain. I like that explanation because you can actually almost visualize the cancer leaving and kind of "kicking and screaming" on its way out! But I don't know if that's really what's causing his present pain.

There is nothing worse than seeing a loved one in such pain for an extended period of time and not be able to do a darn thing to make it better.

Friday is his birthday and his daughter is coming for 4 days (Feb 1 to Feb 4) and he is looking forward to that. I hope he feels good enough to make it a nice visit. I plan to sneak out and play with some friends while Tanya is here!
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Thursday, January 24, 2013

My birthday

Today I got another year older. I promised myself I wouldn't ever do that again, but the birthday witch always seems to win. Thank you to all the people who sent me birthday greetings by email, Facebook and Snail Mail. I enjoyed every bit of it!

Anyway, we went to breakfast and spent a quiet day at home. Marshall is still getting pretty fatigued by early afternoon. And today he had a little leg pain -- not sure if it's cancer related or just simply lack of exercise. You can't help but let every little ache and pain take on more importance than it probably should.

He took some Advil and in an hour or so he felt better.

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Tuesday, January 22, 2013

Not much to report

Yesterday we went to Pueblo and did a bit of shopping and then had lunch like we used to do. So pleasant. But by the time we finished lunch, Marshall's energy level had dropped so that I had to drive home. But still, that is very very good. The hormone treatments that kill the testosterone are always going to cause fatigue but the radiation added some fatigue on top of the fatigue. The radiation fatigue is almost gone now and he'll be left with the regular cancer fatigue. (Are you following that?) So the fact that he wakes up in the morning with some energy is just wonderful.

Today we went to town (post office, bank, etc.) and then had lunch and came back home. He took a nap and I searched for ways to keep busy. My job has been slow the past week, so I am reduced to organizing cabinets and cleaning out closets. Ugh.

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Sunday, January 20, 2013

Home alone

Yes, today I am home alone while Marshall is out on his trike.  This is what we've been waiting for.  The pain is gone and the side effects of Thursday's treatment are gone and the colitis appears to have settled down and his energy levels are up.

I am home happily doing a little work and a little eBaying and he is happily out and about.

And tomorrow we plan to go to Pueblo and have one of those normal days that we used to have -- running errands and going to lunch.

Boring and normal.

Friday, January 18, 2013

The morning after....

This morning Marshall woke up with aches and pains and was having trouble walking -- all side effects from the Lupron and Xgeva injections he got yesterday. He doesn't remember, but he gets these side effects after every treatment. So he needs a few days of resting and taking Advil and he will get back to normal. There goes that bike ride he was going to take tomorrow if the weather was nice!

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Thursday, January 17, 2013

Report on today's visit to oncologist

We went up to Denver last night and got a hotel room at the Spring Hill Suites (directly across from the hospital). The rooms are really great and they give a nice discount for cancer patients of the University of Colorado Hospital. But even though it's great to get the special rate, I can't help think what Fred always says about getting senior citizen discounts: "I'd rather be young and pay full price." Well, we would rather Marshall NOT have cancer and pay full price at the hotel!!

At any rate, this morning our first appointment was at 8:50AM -- lab work. Then our appointment with Dr. Flaig was at 10:00AM. The PSA has gone up a little more -- it's now 13.2. A little depressing, but Dr. Flaig was not too concerned.

Marshall had started out on Lupron (hormone therapy) early in the diagnosis back in April, and when it didn't knock the PSA down to undetectable by October, Dr. Flaig added a daily Casodex pill, which is supposed to block cancer cells. But he had told us that Casodex can do funny things. In quite a few men, when Casodex is added to Lupron, it brings the PSA down. But in some men, like Marshall, the Casodex doesn't do the trick -- instead of blocking the cancer it starts feeding the cancer -- so they discontinue the Casodex.

Now here's the interesting part: Dr. Flaig says that they have observed a phenomenon that in approximately 30% of the men who don't respond to the Casodex, when the Casodex is withdrawn the PSA shoots down to undetectable. The researchers can't figure out why, but now when they withdraw the Casodex, they wait 6 weeks and re-check the PSA again before they move on to other treatments. Dr. Flaig says he has seen this in quite a few patients, but the best one is a patient from Nebraska who this happened to and after withdrawal of Casodex, this gentlemen has now stayed in "remission" for more than 2 years.

So we are now in that 6-week wait-and-see period. We have stopped the Casodex and we go back on February 28th for another test to see if Marshall falls in that 30% of men. Cross your fingers!

Marshall got his Lupron injection today as well as his Xgeva injection, we went back to the hotel and had lunch and then headed home.

Marshall was a little tense yesterday and today but for the most part he stayed very upbeat. He feels good, no pain, and his energy levels are improving. Dr. Flaig says that the way Marshall feels is a big part of the equation here, so the fact that he's been feeling so good is an indicator of no cancer activity, which is good.

Here are a few pictures of the Anschutz Cancer Pavilion. It's a very pretty, peaceful place.

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Tuesday, January 15, 2013

Heading to Denver tomorrow for next oncology visit

Marshall's next appointment is Thursday, so we are going to head up there tomorrow, get a nice hotel, go out for a nice dinner (or, if he is too stressed out in anticipation of seeing the oncologist, order a pizza in our room), watch TV and cuddle.  Our dogsitter will spend the night here with our boys.

On Thursday, there will be lab work to see where the PSA is at this point and then we will see Dr. Flaig to discuss treatment going forward.  If the PSA is indeed going up as we were told when Marshall was in the hospital at the beginning of the year, then Dr. Flaig will probably start a new treatment plan.  That's what's got Marshall a little stressed out.

Then he will get his next Xgeva shot (bone strengthener).  And then we head back home.

So stay tuned for the report Thursday night.

Sunday, January 13, 2013

Sub zero temperatures

Marshall woke up feeling good again today -- well, actually, I woke him up, but still, he was feeling good!

I got up around 7:00 AM to feed the dogs and realized that we didn't have any running water, so I woke Marshall up! We checked our thermometer and the low last night was 14 below zero. So I ran into town and bought a bunch of bottles of water and some Purel and Baby Wipes.

While I was gone, Marshall reached a plumber and he actually showed up (that's kind of rare down here in Westcliffe). He was here for about 4 hours and spent a lot of time in the crawl space under the house. He tells us that the door to the crawl space was ripped off, not sure if an animal did it or if the heavy winds we've been having did it. So he thawed the pipes out, heat-wrapped some of them that weren't already wrapped, and he fixed the door to the crawl space.

When he left, the guy from Department of Wildlife showed up because of our call asking how to get rid of skunks in our garage. He checked it out and said the first thing we should do is dip rags in ammonia and spread the rags all thoughout the garage, leaving the side door open a little bit so the skunk(s) can escape. I will do that tomorrow.

If that doesn't work, he said we will need to trap them. I can't wait.

So it was a long and busy day and except for a little drop in his sugar levels, Marshall handled it all very well. Normalcy. Yay!

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Saturday, January 12, 2013

Broncos lost

Marshall woke up feeling good again! Just some minor intermittent pains that will probably always come and go.

So other than the Broncos losing today, this was another really good day.

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Friday, January 11, 2013

Better days are here again

Wednesday was another bad day.

But on Thursday morning (yesterday), Marshall woke up feeling good. What a great morning. So we decided I could be gone for a while, so I took my friend Mary up on her offer to drive me to Denver to pick up our car which we had to leave there back in December when Marshall was not able to drive it home.

Mary and I had a great day, catching up with each other's lives on the drive to Denver, and then stopping at the Morrison Inn (in Morrison) for lunch. It was a fun outing, plus we got our car back home. It isn't good to be back here in the mountains with only one vehicle.

I got home around 8:00PM and Marshall was still feeling really good with a higher energy level than he's had in ages.

This morning he woke up feeling good again and we decided we would go to breakfast. We went to town, had breakfast and ran a few errands. It felt so NORMAL!! We got home around 1:00 and he was exhausted but still feeling good. He has a slight pain in his hip, but I think we need to resign ourselves to the fact that there will probably always be some intermittent pains from time to time. And at this point, Advil seems to cover that nicely.

He's lost about 15 pounds in the past few weeks, but his appetite is coming back. We've been paying closer attention to his sugar levels, too, and he is making sure to stay hydrated.

Two good days. I love it.

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Tuesday, January 8, 2013

Another visit to the clinic late today

The clinic called us this afternoon and asked if Marshall could come in today rather than Thursday for the results of the lab work.

That worked well for us since Marshall was still experiencing debilitating stomach cramps and said he was "feeling strange." So we got to the clinic around 3:45 and he was feeling worse and worse. He was sweating and was cold and clammy and pale. They put an ice pack on his neck and started taking his vitals. His sugar was very low and he was dehydrated.

So they took him to the back and hooked him up to intravenous fluids (with some sugar) for about 30 minutes. The doctor felt that this might even help with the stomach cramps.

When we left, Marshall was truly feeling better. They also gave Marshall an antispasmodic medication to try if the stomach cramps get bad again.

I had read about aloe vera juice for stomach cramps and asked the doctor about that. He said it works for some and not for others. But it would be worth trying.

So we are home again and he is still feeling better. Hope this is a new trend.....

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A quiet Monday & Tuesday, except for Coco

We went to the clinic yesterday and had the lab work done that the hospitalist ordered (we go back Thursday for the results) regarding the low white blood cell count. Then we ran a few errands and came home. Marshall was feeling a bit better but still lots of cramps from the colitis.

We got home and got settled and then let the dogs out. I saw Coco come back to the door to be let in and as I started to open the door I saw that he had an animal in his mouth. Turned out to be a RAT!!!!!! A very big rat! My sweet little loving baby Coco with a rat in his mouth. And he refused to drop it.

I got the heebie-jeebies and started yelling and poor Marshall had no idea what was going on. But as bad as he feels, he made it outside and convinced Coco to let go of the rat (which was dead, by the way) and Marshall disposed of the rat. Marshall said Coco meant the rat to be a gift for me. Ugh. I can't believe I almost let Coco back in the house with a very large rat in his mouth.

So I called Coco "Rat-Mouth" the rest of the day and there definitely weren't any kisses. Marshall says that's what a hound like Coco is supposed to do and I'm messing with his male psyche by not approving. EEEWWWWW!

Today he is still battling stomach cramps. We are going to ask the doctor Thursday about aloe vera juice

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Sunday, January 6, 2013

Everything is status quo....

Marshall is still feeling pretty lousy -- he has been suffering with the colitis all weekend.  It's kind of ironic that the radiation treatments seem to be slowly but surely alleviating the pain in his lower spine but they are trading that pain for the pain of colitis.  And if he thought the hormone therapy treatments caused fatigue, the radiation doubled the fatigue.  He can't win.

But he seems to me to be just very slightly better.  We took a little walk out to the garage and back today and when we got back in the house he was exhausted!  However, he is regaining his appetite, so that is a good thing.  And the food is staying down, another really good thing.  The stomach cramps aren't as severe, either.  I hope it continues.

Tomorrow we go to the clinic for blood work to check his white blood count to be sure it's coming back up.

Friday, January 4, 2013

Glad to be home

Marshall is very glad to be home but he is very tired and was a little nauseous today (I'm sure the nausea is from the colitis). I had to run to Canon City to fill some prescriptions for him and he stayed home and rested. He is still a bit groggy from all of the morphine he got in the hospital. Happily, he hasn't needed any pain medications since he's been home.

He has an appointment on Monday to get lab work done so that his white blood cell count can be checked again. I did a little quick research and learned that the white blood cell count can get a little low from radiation treatments so I'm guessing that's what caused it.

Then we have an appointment on Thursday (the 10th) with his primary care physician to go over all of the things the hospitalist recommended. Here's a funny story: when the hospitalist released Marshall from the hospital, he gave us prescriptions for fast-acting morphine, as well as three different laxatives. He stressed that Marshall MUST take these every day several times a day. It sounded like overkill to me, but he insisted.

Today when I went to get the prescriptions filled, the pharmacist said he wanted to talk to me. He wanted to know why the doctor prescribed so many laxatives. I said I didn't know. The pharmacist said he was reluctant to fill the prescription because he couldn't imagine a scenario where that many laxatives would be called for. I agreed with him. We will talk to primary care doctor about that on the 10th.

We heard from the oncologist and even though Marshall had the PSA test done at the hospital, Dr. Flaig has decided to do it again when we see him on the 17th just to double check and I am so glad he's doing that. It may not end up showing any different results but my research with "Dr. Google" tells me that it is possible under certain circumstances to get an elevated reading. And to my way of thinking, Marshall has gone through so darn much in the past two weeks that there are a gazillion things that could possibly cause an elevated reading.

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Thursday, January 3, 2013

Home again!

Wednesday was a day of trying to stop the pain and also to stop the nausea and allow Marshall to eat solid foods again. And in the afternoon we got the results of the lab tests showing that his PSA has risen to 12.3, kind of depressing. We were hoping so much that it would have gone down after being on the Casodex for these past few months. That news put Marshall in the dumps for the rest of the day.

We contacted the oncologist and he made an appointment for Marshall to come and see him on January 17th to "regroup" and see what the best treatment option is now. In the meantime, we wait and see if the radiation treatment brings relief of the back pain.

Today I got to the hospital around noon and Marshall had been unhooked from the monitors and the IV and they were just seeing if he did well enough on his own to come home. We took a "vigorous" 2-minute stroll around the nurse's station and ordered lunch.

The hospitalist visited in the afternoon and said Marshall could go home but that he had a low white blood cell count and he wanted to have that checked out again. We will call our primary care physician to get blood work done on Monday to check the white blood cell count. The hospitalist also wants Marshall to be on a daily regimen of morphine and laxatives. When we call Dr. Bliss about all of this tomorrow we will make an appointment to go over it all with him as well.

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Wednesday, January 2, 2013

Marshall is back in the hospital

Marshall was admitted to Parkview Hospital this afternoon after spending the last few days with extremely bad stomach cramps, no appetite, a loss of 10 pounds in 6 days, constipation and generally feeling bad.  

The emergency room doctor ordered a CT scan and she diagnosed colitis and started him on a 14-day antibiotic. Then Marshall was seen by the hospitalist who said it is not infectious colitis, it is radiation colitis. He says Marshall couldn’t possibly be constipated because since he hadn’t been eating, there wasn’t any stool present to eliminate.  He is going to keep Marshall on the antibiotic, but not for 14 days.. While he was on the way to the hospital in the ambulance, his back -- which had not had any pain for three or four days -- started hurting again and by the time he got to the hospital it hurt a lot. They gave him quite a bit of morphine which sent him to la-la-land but didn't help the pain, so they then tried Dilaudid, which took the pain level from a 10 to a 5. Dr. Shah said that he could not continue Marshall on this drug because it is too powerful and in the end is not the right choice. Instead he wants Marshall to keep experimenting to find the right mix between morphine, oxycodone and laxatives. (Marshall and I are hoping that in the coming days, the pain will lessen on its own because of the radiation and painkillers won’t be needed, so we’ll see.) They are going to keep Marshall in the hospital for two or three days for observation.  Marshall and I did a bit of crying tonight. 

So now we have to cancel our appointment with the oncologist this Thursday. The doctor at Parkview says they will order the tests we would have gotten on Thursday (PSA and Vitamin D levels) and we'll just have to ask our oncologist when he wants us to schedule another appointment to get the bone strengthening shot.