Ringing Out

Ringing Out

Ring This Bell
Three Times Well,
A Toll To Clearly Say
"My Treatments Done,
This Course Is Run
And I am On My Way!"

Sign above the bell in the lobby at Methodist Hospital Radiation Annex.

Yep, David "rang out" yesterday, real loud! I think it surprised him how loud! He had people sticking their heads out of offices! His main technican came out of the treatment room, people clapped and he actually smiled! He's a grinner, but teeth actually showed! Very exciting and more emotional than he thought it would be.
I baked cookies and we passed them out to the staff and both doctors. Rene surprised his dad by coming by and taking part in the bell ringing! Rene is the reason we had radiation at Methodist, he hooked his dad up, one of his customers is Methodist and he called and got it set up for us to see Dr. Butler. The doctors and staff were WONDERFUL! So caring and gentle, always asking how you are doing, you know they are interested in you as a person as well as a patient.
I suprised David by taking the day off and planning a day trip to Galveston. We sat on the beach, held hands, had a beer and watched the waves rush to shore. Nothing like a little quiet time with God and his wonderful creations. The Gulf of Mexico may not be as pretty as the California or Florida water, but the sound of waves crashing to shore sounds the same! His legs were "marked" with 3 blue lines, so he could be positioned in the same place every day for treatment. I took a picture of his legs with the gulf water washing his marks off, pretty cool! We had a pact at the start of this journey that he would always tell me what he was feeling and thinking...no matter what. He confessed to me that when I told him the plans for the day he got a little emotional.
Glad we can check this step off the list. Fatigue seems to be the only issue, and that will go away in about a month or six weeks. Having our friends and family walk the walk with us has been unbelivable! David got a card EVERY day from Phil, Sharon, Vickie and or Tuck. Don't know how they managed to time that, but it is was pretty amazing! He looked forward to the mailman everyday. I have no idea how many prayer lists he was on, but it worked! Thanks to everyone, we felt the love and prayers daily.
Can't wait for the family get together in May for his birthday celebration. Great idea Sharon! Never one to like being the center of attention, David is looking forward to seeing everyone. His second post surgery PSA test will be May 10th, and I know we will have more good news to celebrate!
Love to all,
Mom

Last meeting with Dr. Butler

Every Tuesday we meet with Dr. Butler to review the week, today was our LAST meeting! Day after tomorrow will be the 32nd and last radiation treatment! David had blood work done last week and the results were good. His white blood count is where it should be, no signs of infection. We were told his radiation beams don't go near any orgins that could be harmed by the radiation so they didn't expect any elevation in the white count (fighting infection from damage) He has never had any blood in the urine or problems with the flow of urine-this would also indicate infection. Dr. Butler was really please with the way David has progressed through the treatment plan. Fatigue is still a problem and David will continue feeling tired for about a month to 6 weeks. He comes home and takes a nap every day, but yesterday mowed the lawn when he woke up.
All the staff at Methodist are just fantastic, Debbie, our nurse today could not stop smiling as she went over the discharge papers. They are all so supportive and excited for your progress. I will post again Thursday with pictures of David ringing the bell announcing the end of his treatment. The bell is in the lobby, and when you finish treatment you ring it to give hope and encourgment to other patients. Kinda cool, when we started treatment David said he didn't think he would ring it, but he has since changed his mind and wants to shout from the roof top he is DONE!
The follow up plan-David has his 2nd post surgery PSA test scheduled for May 10th. We will have this done with Dr. Sukin and the results will be sent to Dr. Butler, we will see him for a follow up at the same time.
Love to all-Mom

David update

David and I had our regularly scheduled Dr. Butler meeting today. He is VERY pleased with how well David is progressing through the radiation treatments! Only 7 more and we are done! Mark it down, Thursday April 7th!

Allergies and fatigue are the only problems he is experiencing. I make him take a 2 hour nap every day, the dry hacking cough is getting out of control, keeping him awake at night. Last Friday the doctor gave him a prescription for something that in my opinion didn't work. Today they gave him codeine, hope it takes care of the cough. Weight is the same, blood pressure is great, no burning, no problems....feel VERY blessed! They have not done any additional white blood cell testing.

Not much of a update, but David is doing so good there is not much to report!
Love to all, thanks for the prayers, phone calls and cards.

Dancin' the Irish Jig!

May your blessings outnumber
The shamrocks that grow,
And may trouble avoid you
Wherever you go.
~Irish Blessing

I waited until today to do the weekly doctor update, not just because I'm Irish and like St. Patrick's Day but because today marks the HALF WAY MARK! David is officially 1/2 the way to completing the radiation treatments! 
Dr. Butler was out of the office Tuesday so we saw Dr. Grant. We had been told they might "add" sessions to the end of the treatment plan. I ask when they would make that decision, I was told by Dr. Grant that he thought Dr. Butler had already decided NO ADDITIONAL SESSIONS! (Needs to be confirmed next Tuesday with Butler)
The fatigue is about the same, David takes a nap everyday and can function okay. No pain, no other issues, no weight gain or loss. 
Spring Break was this week and we got to see kids and grandkids. We took Addy to the Woodlands to listen to music, and had a 1st Birthday party for Sophie. Billy went to treatment with David on Monday...regular stuff. Felt very good!
No blood work this week, but he will have a white cell count test next week.
Thanks again for all the cards, calls and prayers. Love you all.

White blood cell count

We met with Dr. Butler today for the weekly check up, they had done blood work last week to check the white blood cell count. White cells fight infection, he didn't give us the number, but told us they were good. David is doing fine, played a round of golf this week and last. He is starting to feel some fatigue, it is to be expected, and so far the only problem he is having. Today was the 10th treatment, and since we are shooting for a total of 32 that means he is about 1/3 of the way through.
Sarah came down last week and went with her dad to the Friday session. The nurses took her in the room and explained the machine and treatments to her. Jennifer and the kids are coming down this weekend, they are going to spend spring break here and at her parents. Billy just called, they are coming down Sunday for a couple of days. The cards and phone calls are great moral boosters, and the prayers are a wonderful comfort to us both. It only takes looking around the waiting room to know how blessed we are.

Dr. Butler meeting today

Every Tuesday after treatment David and I will meet with Dr. Butler to talk about how the week has been for him. Today was the first of those meetings, and we found out the number of sessions....drum roll please......32. They may add more, depends on how it looks towards the end. This was really good news because we thought it was going to be 37. So that's a WHOLE week less! David has gained one pound, and is not showing ANY signs of the radiation.
Depression is something I have been watching for, and some days I think he lets it get to him. Example: This weekend, I cleaned the garage, he was bringing me some stuff from the front porch and he saw the Christmas lights. He told me the thought crossed his mind that he may not feel up to decorating next year. And he wanted me to tell the kids he didn't want them to do it for him. Not that he won't be here to decorate, but that he won't feel like doing it. The other side of that, he is meeting with a woman he knows from work that her ex husband is dealing with 8 months of incontinence-he wants to help him by getting the guy to exercise. Depressed some days determined to help others some days.
Thanks for all the cards (Sharon, Phil, Vicki and Tuck) all the phone calls (kids and grandkids) and big thanks for all the prayers. Keep it up, I know he feels your love.

First Treatment

David had his first radiation treatment this afternoon. We don't know how many sessions he will have until we meet with Dr. Butler on Tuesday. This week his treatment times are all afternoon, hoping next week he can be moved to morning sessions. They told us it was important to keep him at the same time everyday, don't know why. He will also be kept on the same machine, and have a CT scan done prior to every treatment. According to David, no pain (the balloon isn't comfortable-but doesn't hurt) start to finish time is about 20 minutes, including scan.
I am going to be able to take him twice a week, and he feels comfortable he can manage the other 3 trips.
David has said he might start posting, so you may get another update. If not I'll post what Butler tells us Tuesday.
Thanks for all the prayers we feel them.
Mom

David's "markings"

I wanted to share with everyone a little humor as we travel on this prostate journey. This will also explain why we won't see David in his trademark blue jean shorts for awhile.
I knew that the mapping appointment yesterday would result in David "being marked" with a sharpie, so he could be lined up in the same position for every treatment. I was not in the room with him when he was marked and didn't see what was done to him until last night as we got into bed. I was under the impression when the doctor said "small marks"  that the marks would be 1/4 inch or so. Not really! When he got ready for bed last night I was exposed to this REALLY big bright blue X marking the spot on his bottom! The shock of it made me laugh, and I couldn't stop! Then he climbed into bed and I saw his legs! 3 neon blue lines on each leg! He won't be wearing shorts for fear that his "markings" might be taken as "gang tats!" Bless his heart! We both were laughing so hard we had tears running down our face!
Love you all-Roena

IMRT Imaging today

"To have and to hold from this day forward, through sickness and health......."
I was reminded of this today on the eve of our 31st wedding anniversary. Not for the obvious  reason that David is getting ready for phase two of our prostate cancer journey, but rather for the underlining reason I go with him to his appointments. We were discussing the test today on the way home and it became clear to me that alot of the information goes in one ear and out the other. Case in point, he has to have a balloon catheter inserted for every radiation treatment. This was explained by Dr. Butler at our first meeting with him. The purpose is to "recreate" the prostate and its position. Once the prostate was removed the bladder, colon, and other orgins shift into the void left behind. The balloon becomes a make shift prostate and lifts the organs out of the way. This is done so the radiation can hit the prostate bed without doing any damage to the healthy organs. News to David! He had not realized any of this....and that's why I go...and am so blessed to be able to calm his fears in ways I never imagined.
The test today was to map his prostate region. A special "bean bag" was made just for him, a large air mattress looking thing that was molded to fit around body. He was marked with a black sharpie to line him up in the same position for the treatment. Very small marks on the backs of his legs, they will be remarked over the duration of his treatments to keep him in the same position. Several CT scans were done, some with the balloon some with out.
I was able to go back to the room with him at the start of the test, but had to leave once they started. The nurse was telling him what to expect and when his treatment should start. She said we might get the call as early as this Friday to start on Monday! What makes IMRT so different is the carefull planning using 3D computed tomography images in conjunction with computerized dose calculations to determine the dose intensity and pattern. Once Dr. Butler comes up with the plan, we will know how long the treatment will last. Could be as few as 24 or as many as 42 sessions. Another positive about IMRT is that it is a far more precise, higher and more effective dose of radiation and causes less damage to surrounding tissue. It works more slowly making the toxicities do less damage to surrounding "good" tissue.
Before you all start thinking I am working on my degree to become a doctor, I should explain I take notes and come home and do research!
David did take some prescription meds to calm him down today. He was worried about the balloon, and when the nurse called it a "catheter" I thought he might run out the door! So, being dopie helped him get through the unknown. We left feeling much better, nothing hurt, everyone was nice and he is ready to get this next round going!

0.1 PSA

David and I met with Dr.Sukin today for the results of his first post surgery PSA test. Happy to report is was a 0.1. This is the number both doctors had told us to expect, but knowing a high number would mean the cancer was still growing at a rapid rate made the wait for the results very hard on David. I said David, but it was hard on me too! Seeing him worried is rare, he hides emotion very well.
Dr.Sukin was REALLY pleased with the incontinence. Some men have this haunt them the rest of their life, David has had it under control since Christmas. This is important because the doctor wants him at the best posssible level before starting radiation.
A radiation treatment facility is part of Dr. Sukin's practice, Urology Specialists. He gave us the information to look into going there for David's treatment. Willowbrook Radiation Oncology Center is much closer to where we live, and one of a few radiation centers in the Houston area using RapidArc™ technology to treat cancer. RapidArc™  delivers a complete radiation treatment with a single 360° rotation of the treatment machine around the patient. The entire tumor receives a precisely targeted dose of radiation and the entire process takes less than two minutes - 1/6th the time of more standard treatments. Since Dr. Butler, the Head of Radiation with Methodist in Houston was the pioneer and first to use this approach to treatment we are going to continue with the plan to have the treatments at Methodist Hospital. David is scheduled for the "mapping" portion of this next week. MRI CT Scans and something called Computer Tomography. The appointment is next Tuesday the 15th. I'll have more then.
Love you all-Roena

Terms and Doctors

I am going to start with a little information to everyone-medical terms and doctor names and treatment descriptions. That way when I refer to something everyone will know what I am talking about.

Dr Steven Sukin is the Urologist/Surgeon that did David's surgery in October, he is head of Robotic Surgery for St. Lukes Hospital. David had what is called DaVinci Robotic sugery instead of open surgery. 5 small holes instead of one big incision. Overnight stay in the hospital-healing time cut in half.

Dr. Brian Buler is the head of Radiation/Oncology at Methodist Hospital. He will be doing the radiation treatments. We were able to get in to see him because Rene pulled some strings with Methodist-they are one of his customers-he called the PR person for the hospital and got it set up. This guy is responsible for cutting edge technology with radiation. Was the first doctor in the world (yes THE WORLD) to do IMRT at Methodist in 1994. We have seen him twice, and I expected to be passed off to another doctor, just because he is so busy.....but hasn't happened yet! Would like to know what Rene's PR person said to him! VERY thankful to Rene for doing this for his dad. I know we are in the best possible hands for this next step.

IMRT is Intensity Modulated Radiation Therapy, and is done for all types of cancer treatment not just prostate. 40 beams of radiation will target the area, the machine will circle around and deposit the radiation avoiding the good cells. Different than external beam radiation.

PSA prostate specific antigen. A blood test that indicates adnormal cell activity. Normal number is 4, David's increased from 2.5 to 10.4 in 5 years. Not a cancer indicator, one of the most "false positive" medical test around. For that reason if numbers are high, it is normal to retest. And do a DRE.

DRE digital rectal examination (the "bend over" test men hate) Dr. Sukin found a knot when he did David's. That's why he scheduled a biopsy the next day. When the biopsy was done, 12 samples were taken and all 12 showed cancer.

Gleason score is a rating of the number of cancer cells found within the core samples from the biopsy. 10 is as high as they go. David's score was 8 in ten of his samples and 7 on the remaining two. This indicated what Dr. Sukin called aggressive prostate cancer. (many men have prostate cancer, not all is aggressive, making the different treatments so varied)

Now for the update!
David will have his first post op PSA test on Monday. We meet with Dr. Sukin on Wednesday for the results. They wait 3 months after the surgery for all the cancer cells to settle back down. We are expecting the number to be 1 or below, because the cancer had escaped the prostate we know it won't be zero. The following week on the 15th we go back to Houston and Dr. Butler to start the mapping for the radiation. MRI's and CT scans will be done with the information plugged into a digital program to map out the areas to deposit the radiation. (Dr. Butler worked with gaming technology software to come up with this approach) David will be "marked" with little tattoo marks so they line him up the same way every time. It will take about a week to 10 days to get the plan put in place. Once that is done David will start the program. The plan will also determine how many treatments he gets (37 to 42). Looking at Monday thru Friday for 6 to 8 weeks. More on that as it happens.
Roena

First Post Op PSA Test

I ask Sarah to set me up a blog site to communicate with everyone and keep you all "in the loop" about the upcoming treatments This is the first post and also a test to see if I can post something you all can read. If it works, I'll fill you all in on the next blog.
Mom