It's been a quiet half week since we took Allison to college. We've heard from her often via email and phone and she seems to be doing very well. Meanwhile, I felt pretty good through yesterday when I did a little yard work, with lots of help from friends from church. I didn't think I was doing that much, but I seem to be paying for it today anyway. I had to take painkillers and anti-nausea medicine today. Sunday has truly been a day of rest for me today.

Empty Nest! Allison is now at college. I had three pretty good days in a row, though the long 5 hour ride was uncomfortable. Yesterday was my best day and I was even able to help haul Allison's stuff up one flight of stairs to her dorm room, though the effort really wore me out. She's all settled in and learning how to deal with problems on her own.

Odd weekend. I expected to feel very nauseous, but such has not been the case. Maybe it's the Kytril working, but I felt fairly well all weekend. Still, I was incredibly tired and didn't do much except sleep. Now Sunday night we're helping Allison pack for college. We'll be leaving tomorrow to take her to Southern Virginia University in Bueana Vista, VA, north of Roanoake.

Chemo Round 3 Done

My third round of chemo is done now and I feel more nauseous than ever. I took my first Kytril this evening and am still waiting for it to kick in. Dead tired too. Now I just need a few days to recuperate. Sometimes the cure feels worse than the disease.

Long, busy day. Spent much of it at Cancer Care. First I got a CT scan, then some routine blood work, then we met with Dr. Chay. We reviewed my new CT scan, comparing it side-by-side with the original taken back on June 16. My cancer is responding well to the treatments. The lumps in my lungs are either gone or much smaller, and my prostate is much smaller now, maybe the size of a baseball, and the organs around it can be discerned now. However my prognosis is about the same. I should start feeling pretty good a few months after I finish chemo, around the first of next year, and should continue that way for 6 months to a year. Then, short of a miracle, well, we'll see... I started my third round of chemo today, which went fine. Two more days this week followed by a nauseous weekend. This evening I took Allison to see a baseball game, about my last chance to do so before she goes away to college. My employer had reserved a block of seats for the game and I got to see a number of friends from work. Unfortunately, rain canceled the game before it even started. Guess my camping weather curse works for ball games too.

Back from camping. It rained most of the weekend. Of course, that always happens to me. It even rained in the Grand Canyon in June when we were there, something that NEVER happens. Anyway, we had a pretty good time. I didn't do much, mainly napped and read my book. Donna and Allison rode their bikes some - I opted out, for obvious reasons. This week: chemo and getting Allison packed for college.

Last Radiation Treatment!

I am home now from my last radiation treatment. I had 30 total: 22 wide area doses followed by 8 narrower "boost" doses. I haven't noticed too many side effects from the radiation - it seems like mine mostly come from chemo and the medications I'm taking. This has been a fair week so far - not much nausea or pain. I still don't have much energy or stamina - the slightest exertion wears me out. We are going camping this weekend, partly to celebrate the end of my radiation and partly because it's the last chance we have before Allison leaves for college in a couple weeks. I'm looking forward to relaxing and reading and getting away from it all for a few days.

New Improved Weblog

Today I decided to convert my homemade blog into a proper one. Below is everything that I had posted to the original website. And here is the latest news since my last update on 8/1. On Wednesday, Donna’s son Dean and his wife Hillary came for a visit. They brought their 2 dachshunds – added to our 2 Italian Greyhounds and 1 cat, we had quite a houseful – at least they all get along pretty well. Donna started her new job this past Monday – she’s a medical records clerk at Mission Hospital, the same place I get my radiation treatments. She works evenings, 2:30-11, which allows her to drive me to my various morning appointments. On Thursday, I had lunch with a couple of good friends from work. On Friday, I had some more blood tests and my counts are all pretty good – I should be able to resume chemo next week (8/15) without delay. This weekend I felt fairly good – no nausea and only moderate pain. No energy, though – the slightest activity really wears me out. Dean & Hillary left this morning so it’s pretty quiet around here again.

My Original Weblog

Thursday, June 29, 2006 - This is a log of my battle with cancer. This doesn’t mean I no longer want emails, phone calls, or visits – I enjoy and appreciate all three. Please keep in touch. For starters, I’m going to give a chronology of my illness to date:
· January 31, 2006 – Routine physical including prostate exam and blood test. Nothing unusual detected and my PSA count was very low.
· May 8, 2006 – Over the preceding week I had noticed a change in my urinary functions: weak stream and a feeling of never getting completely emptied out. Went back to my family doctor, got another prostate exam, and still everything seemed normal. He prescribed an anti-biotic in case it was a urinary tract infection.
· By this time I was feeling pressure in my pelvic area, making it uncomfortable to sit. I worked from home several days because my recliner is much more comfortable than my chair at work.
· May 17, 2006 – Continuing to have urinary problems. Went to the bathroom a dozen times while getting ready for work. I even drove to work, but turned around and went back home without even stopping. Went to my family doctor again and this time he described my prostate as large, hard, and lumpy. He extended my anti-biotic prescription and referred me to a urologist. He also ordered another blood test to check my PSA count (it was still very low).
· May 18, 2006 – Urologist confirmed that my prostate was large, hard, and lumpy. He extended my anti-biotic prescription for another two weeks and recommended an ultrasonic exam and biopsy.
· June 1, 2006 – Ultrasonic exam and biopsy – not fun – prep included a Fleet enema and the exam itself was quite uncomfortable. The doctor took 18 samples for the biopsy.
· June 4, 2006 – Flew to Arizona for vacation. My mother and brother live there in Prescott and Prescott Valley, respectively.
· June 6, 2006 – In addition to urinary problems, I was having a lot of bowel problems. I stopped taking the anti-biotic, thinking it might be causing that problem. It wasn’t helping and I had only a few doses left anyway.
· June 8-9, 2006 – Donna, Allison, and I hiked to the bottom of the Grand Canyon. We descended nearly 5000 feet on the 7 mile South Kaibab trail and camped at the bottom. Next day we climbed a couple thousand feet in 5 miles on the Bright Angel trail and camped at Indian Garden. On the final day, we climbed the remaining 3000 feet in 4-1/2 miles. It was a very successful hike and I came away with little more than sore muscles.
· June 10, 2006 – I couldn’t urinate – nothing more than a trickle. The pressure and pain continued to build until finally around 4 PM Donna took me to the emergency room. They inserted a Foley catheter into my bladder. This was very painful due to the usual sensitivity of that area coupled with the pressure of forcing the tube through my prostate past the restriction. Over the next few minutes most of a liter drained into the bag. But I still felt a lot of pressure in that area.
· June 11-12, 2006 – I spent most of the rest of our vacation in bed. The pressure in my pelvic area made it almost impossible to sit up right in a chair.
· June 13, 2006 – I didn’t see how I’d ever manage a van ride to Phoenix followed by two plane rides. We went back to the emergency room where, after a brief checkup, they gave me a prescription for pain medication. Trying to salvage something from the last half of our vacation, we took my mother and brother out to dinner that evening.
· June 14, 2006 – Flew home – everything went fine.
· June 15, 2006 – Saw my urologist and got results of biopsy – all 18 samples were positive, they were all cancerous. He prescribed more pain medication, ordered a CT scan, and referred me to a cancer specialist.
· June 16, 2006 – CT scan of my torso.
· June 21, 2006 – Went to Cancer Care of Western North Carolina. The doctor showed me the CT scan and pointed out the many little cancerous spots in my lungs, and one in my liver. My prostate, normally the size of a walnut, was 9.5 cm in diameter, about the size of grapefruit. The diagnosis: small cell cancer of the prostate and lungs. The prognosis: incurable. Left untreated, I would die in 6-12 months. With aggressive, invasive treatment, I might last 5 years. We agreed to a middle ground where I would get chemotherapy and radiation, with the goal of shrinking the prostate to relieve my pain and allow me to enjoy the last 2-3 years of my life. More pain medication and a referral to Mountain Radiation Oncology.
· June 22, 2006 – my birthday – 49 years old. Visited Mountain Radiation Oncology (MRO). Agreed to start radiation as soon as possible. Got a CT scan of my pelvic region so the doctors would know exactly where to aim the radiation. They drew several targets on me for reference.
· June 27, 2006 – my mother’s birthday – 81 years old. Went to Cancer Care where we received a detailed explanation about chemotherapy. Chemo is systemic - it is administered through an IV and goes throughout the body. It works by killing fast-growing cells like cancer. Unfortunately, those are not the only fast-growing cells in the human body: so are stomach lining cells (hence the nausea) and hair follicles (hence loss of hair). The chemo helps in my prostate, lungs, and liver.
· The treatment room was a pleasant surprise. Instead of some depressing little cubicle, it’s a large room with about 14 recliners for the patients. One wall is all glass looking out into a small garden area with a little waterfall. There is a corresponding waterfall indoors giving the illusion that it’s part of the outside waterfall. There is a baby grand piano in the room which people may play.
· June 27, 2006 – Went to MRO where they put me on the radiation machine, but they only took some X-rays to further help with the alignment. They drew even more targets and outlines on me. Working in conjunction with the chemo, the radiation kills the cancer cells in that region. It will do nothing for my lung cancer. The main side effect is supposed to be fatigue.
· Though these treatments will kill much of the cancer, it will come back and eventually kill me.
· June 28, 2006 – first radiation treatment. This is done in a very uncomfortable position - I lie face down on a “belly board” which allows my belly to hang into an opening which helps get my intestines out of the way. I have to drop my pants to my knees – I imagine I’m quite a sight lying there. Good thing I’m not modest (my radiation technicians are both female). The good news is that it takes only a few minutes. I get four shots, one each from my front, back, and left and right sides. The bad news is I get 20 treatments over the next 20 working days. One down, 19 to go.
· June 28, 2006 – first chemotherapy. They put in an IV and gave me four different medications: Ondansetron and Dexamethasone Sodium Phosphate followed by Carboplatin and then Etoposide. I get three days of therapy this week, then after 17 days off I’ll come back for three more days. Since therapy takes over two hours, I brought my laptop computer and watched a DVD movie which really helped to pass the time.
· June 29, 2006 – I guess they were right about the fatigue because I had my best night’s sleep since all this started. In fact, I also feel the best I’ve felt since June 9. The only other side effects are a slight metallic taste in my mouth (Carboplatin has platinum in it), dizziness, and constipation. The latter has been a problem ever since I started taking pain medications, back on the 10th. Back to Asheville for more radiation and chemotherapy. It almost feels routine already.
And that brings you up to date. I actually wrote all this during my chemotherapy. Please check back periodically for updates. Calvin

Friday, June 30, 2006 – Another good night’s sleep, thanks to the fatigue caused by my therapies. I didn’t feel quite as well today as the preceding couple of days - the nausea was a bit worse. Allison was my designated driver today, giving her a chance to see what I’m going through and to give Donna a break. She played the piano for a while during my chemotherapy. I’m done with chemo for a couple of weeks now. In case you want to send us email, I’m still using my work email calvin.dimsha@thermo.com. To send to Donna, use ddimsha@charter.net. Calvin
Saturday, July 1, 2006 – This weblog has generated a lot of thoughtful, concerned emails. I won’t be able to answer most of them personally, but I do appreciate every single one. I never knew I had so many friends in the world. Today was not a good day - a new problem popped up. Since I was a teenager, I’ve had varicose veins in my left leg. They are ugly, but have never caused me any more problem than occasional itching and brief pain. Today they are causing excruciating pain. I wrapped the leg with an Ace bandage to help support the veins, and it helps a little with the pain. The fatigue and nausea continue to plague me. I spent most of the day in bed. On the plus side, my prostate must be shrinking because I don’t feel as much pressure in that region. If it weren’t for the leg pain, it would probably have been one of my better days. Calvin

Monday, July 03, 2006 – My varicose vein pain continued yesterday and last night. Late this morning I had an ultrasound which confirmed I have blood clots in the leg. Beyond the pain, there is the risk that a clot will move to my heart or brain. They put me on blood thinners: Coumadin and Lovenox – the latter I have to give myself by injection. This won’t do anything about the clots I already have – my body has to get rid of them on its own – the goal is to prevent future clots. Calvin

Wednesday, July 5, 2006 – Enjoyed the 4th as well as I could. We had some corn-on-the-cob for lunch, then some grilled steaks later. I should mention that I’ve been losing weight, about 20 pounds so far. It’s a combination of the fear of constipation and simply not being hungry. The nausea lately isn’t helping either. Donna is amazed that I keep asking for smaller and smaller meals. I’m the guy who used to eat a big meal, have seconds, then be back an hour later snacking! Well last night I overdid it, that steak dinner was so tasty - I was a little miserable last night from all the food. We got to see some fireworks last night, right from our front porch and back deck. We could see the Weaverville fireworks, but also lots of “private” shows in the neighborhood. Today was a pretty good day. I slept well again. The pain in my left leg is still there, but it’s bearable. I had my radiation treatment today, the 4th so far, and met with my radiation doctor. It was the first time we’ve discussed removing my catheter – I have very mixed feelings about that – I dread ever having to get another one put in. The morning’s activities, mild though they were, wore me out and I napped most of the afternoon. Calvin

Friday, July 7, 2006 – TGIF – even though I’m not working now, I still enjoy the weekends – no therapy, no trips to Asheville. Yesterday was one of my not-so-great days. I started out feeling lousy, then the afternoon wasn’t so bad, but then I had so much pain in my pelvic region last night that I couldn’t get to sleep until well after 3AM. Also the blood clots in my left leg continue to be very painful. I had blood work done yesterday and I’m about where they expect me to be, i.e. some of the numbers are out of the normal range but are explainable by my therapies and medications. Calvin

Saturday, July 8, 2006 – Slept pretty well last night. Pain was bearable today, though I’m ready for the blood clots in my leg to break up and go away. I even managed to putter in my basement workshop for a few minutes this afternoon. Someone suggested I add a picture of myself to this website so here it is. This is from last month when we hiked in the Grand Canyon. It sure seems like a long time ago now. A lot has changed since then. Calvin

Monday, July 10, 2006 – Not much new to report. I had my 7th radiation treatment this morning. I continue to have my ups and downs with pain – had a bad spell mid-afternoon today, but the rest of the day was pretty good. The blood clots are a lot better. I had more blood work today – my blood is still too thick so I have to continue taking the Lovenox shots and they increased my dosage of Coumadin. Speaking of which, it’s time for my evening meds. Calvin

Wednesday, July 12, 2006 – Ditto (except for the blood work). The news keeps spreading. I’m hearing from people I haven’t heard from (or in some cases even thought about) in years. It’s been good. Give me time and I’ll get all the emails answered eventually. Calvin

Thursday, July 13, 2006 – Finally something new to report: I’m losing my hair. When I started chemo they told me to expect some thinning, but so far nothing. Then this morning I was scratching my head and when I looked at my hand there were a dozen loose hairs in it. I showed Donna by yanking out a handful of hair. After my shower, there was a nice little pile of hair at the drain. Maybe it’s time to get that crew cut. Donna’s brother Rick and his family drove up from Atlanta today for a visit. Unfortunately, it was NOT one of my good days, pain-wise. It got progressively worse throughout the day until, by evening, it was almost unbearable. I kept taking pain killers until I finally got enough in me to overcome the pain and was able to get to sleep. Calvin

Friday, July 14, 2006 – I felt a bit better today than yesterday, but the pain is still there. It never goes completely away. My hair continues to fall out (Donna says I’m shedding). We went to Cancer Care this morning to have blood drawn again. They’re checking my INR to see if/when I can quit taking those Lovenox shots. Unfortunately, my ratio is still way too low, so I have to continue the shots plus they’ve increased my Coumadin dosage again. Maybe next week… Calvin

Sunday, July 16, 2006 – A fair weekend only. Plenty of pain and plenty of pain killers. My hair is really coming out now, not just from my head but my beard and mustache too. I had thought it wouldn’t bother me, but now that it’s happening, it does. I guess I’ll wear a hat out in public, at least until I get used to the idea. I spent most of the weekend resting, though I must confess that I took the lawn tractor out for a spin around the back yard Saturday. I was feeling like such a useless slug and needed to do something useful. I paid for it later with extra pain. Calvin

Tuesday, July 18, 2006 – I was supposed to start my second round of chemotherapy today, but my white blood count was too low. There’s a drug they can give to stimulate the bone marrow to produce more white blood cells, but they can’t give it to me because I’m also getting radiation therapy. The only other option is to delay chemo for a week and see if my count comes up. On the plus side, my INR is now high enough that I can stop taking the Lovenox injections. We met with Dr. Chay at Cancer Care, discussed my pain problems, and he increased the dosage on my pain medications. Calvin

Thursday, July 20, 2006 – My best day in a long time. Less pain today, easily controlled by my medications. Calvin

Sunday, July 23, 2006 – Friday was another pretty good day, though not quite as good as Thursday. Allison drove me to my radiation therapy. Yesterday I started having pain again and never left the house. I slept a lot, read, and watched some TV. Today started out much the same, but at this time (early afternoon) I’m feeling a bit better. We’re going to grill some steaks for Sunday dinner – I need the protein to build up my blood so I can resume chemotherapy. Calvin

Monday, July 24, 2006 – A pretty good day. Before my regular radiation treatment, they did a new CT scan of my pelvic region. To get a better image of my bladder, they injected contrast into it via my catheter. Yet another new and interesting experience. We again talked about removing the catheter and I am hopeful that it will be this week. That would be a big morale booster for me. Calvin

Tuesday, July 25, 2006 – According to the CT scan they did yesterday, my prostate is “noticeably smaller.” Instead of being smashed up against all the surrounding organs, they’re starting to see some separation and some tissue in between. The plan is to take out my catheter tomorrow. I can’t wait, but at the same time I dread it. After six weeks, I just hope everything still works down there, if you know what I mean. Then, over at Cancer Care, they drew blood and my counts were all up. They proceeded with my second round of chemo which will continue tomorrow & Thursday. As usual, that is making me nauseous and fatigued. I slept the rest of the afternoon and don’t expect to have any trouble sleeping tonight. Calvin

Wednesday, July 26, 2006 – A good day, a milestone day: the catheter is GONE! I was surprised how much it hurt to remove it, but it was nothing like having it inserted, and the pain passed quickly. So far everything seems to be working normally. It’s a strange feeling after six weeks of relying on that thing (since June 10), but I’m adjusting quickly. Like riding a bicycle, I guess – you never forget how. I also had my regular radiation treatment followed by chemo. I was VERY nauseous all day, despite lots of anti-nausea medication, but overall it was a wonderful day. Calvin

Thursday, July 27, 2006 – Catheter-free for over 24 hours now and everything is working fine. I wore Depends underwear to bed last night (TMI?) just to be safe, but didn’t have any “accidents.” Today was my 20th radiation treatment, but it looks like we’re going to continue a bit longer. They’re going to “refocus” the radiation on my now-smaller prostate and up the dosage to really zap those old cancer cells. Also today was my last chemo session in this second round. Now I’ll need to weekend to recover from the side effects. I continue to be nauseous, but at least haven’t thrown up any. Calvin

Sunday, July 30, 2006 – Friday was a pretty good day. I wish I could say the same for the weekend, but it has been lousy. I’ve been terribly nauseous and have spent much of the weekend in bed. Here’s hoping for a better week ahead. Calvin

Tuesday, August 01, 2006 – A couple of better days. Most of the nausea has gone away. Still some pain, actually some pretty bad pain this morning, but it got better as the day progressed. I got a new prescription for an anti-nausea medication called Kytril – thank goodness for health insurance – the list price for 10 pills was $600 but with insurance I only paid $25. I’ll be saving those for my very worst days, probably right after my next round of chemo. My radiation today was the start of my “boost” phase where they have narrowed the beam due to the reduced size of my tumor. They have me scheduled for 7 more treatments, but I don’t know if that will be the end of it. After radiation, I had an enjoyable lunch with some of the guys from my department at work. Calvin