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November
10
2019

November 10, 2019

I admit it...this is no picnic.
I think the euphoria just to wake up postop rapidly disappears when the anesthetic drugs and local wear off...with a vengeance. 
Biggest miscalculation was not sticking around UCLA an extra day just in case I needed something. 
Of course, problems always seem to happen with  physician patients. I didn’t disappoint. 

By the time we got the rental car and crawled down the 405 to Newport Coast, I was beyond ready to lie down. The extra 3 hours of waiting to get our condo was too much. Turns out, my catheter was blocked and the pressure was building up. Picture the scene in Monty Python’s “Meaning of Life” when Mr. Creosote eats one last dessert wafer and explodes. Worse still, drug stores don’t carry catheter supplies or irrigation saline and Orange County medical supply stores all close by 5 pm. Luckily, there was one CVS that had an irrigation syringe. I boiled water, cooled it in the freezer and managed to flush it out and get it draining again. A bush fix is as good as any of it works! No way I could have tolerated the 60 miles of LA freeway back to UCLA each way and I know how useless a trip to the local ER would have been. 

While today is a better day, I know I’ll feel better still once my bloated belly gets “going” again. 

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November
9
2019

November 08, 2019

So the surgery was considered a “success.” However, the final pathology including tumor margins and lymph nodes will take a week.  


Already, I am truly grateful for the good wishes from you all. They really helped me get through today’s surgery, the most challenging part of my eventual cure. 




I am already up and walking, eating, drinking tea (Earl Grey of course) and tolerating the postop pain with minimal meds. The fantastic care I received from the Prostate Cancer team at UCLA Ronald Reagan Medical Center under the directorship of Robert Reiter, MD (Stanford Medical school colleague and ski buddy!) exceeded my expectations. It has been such a relief to know I’m in the best of hands.




I will be released tomorrow but staying at the Newport Coast Marriott for another week until the Foley catheter is removed and we can return to Fort Lauderdale. Visitors are welcome-just call Natalie to be sure I’m not already down walking on Crystal Cove beach! There are few places on earth that decompress my brain so well. 




I am privileged to have so many wonderful people looking out for me. I thank each and every one of you! Hugs to all (feel free to come and collect them anytime—but only after the Foley catheter is out and the Depends™️ have been retired!)😂

November
7
2019

November 07, 2019

After 6 months in limbo, I’m finally on the way to UCLA get this thing out of me! I feel like a drug mule smuggling bags of swallowed contraband hoping to reach my destination without a deadly leak. 
The preop regimen includes clear liquids for 24 hours, a bowel prep similar to a colonoscopy (not too simple when flying cross country especially if the seatbelt sign is on!) and required preop Cialis which has produced so much acid reflux and headache that it’s “popular” effect is out of the question!
Still have one more doctor visit this afternoon but at least it’s followed by a 90 minute massage. That should help get me down off the ceiling especially having purchased an upgraded seat to ensure a relaxing flight and finding a dead TV screen....thank you Jet Blue—-NOT!


September
18
2019

September 18, 2019

As feared (and hoped?) a definitive diagnosis;
Prostate Cancer Gleason 7 (3 plus 4 for the savvy among you-better than 4 plus 3).  The biopsies were positive on all the MRI guided biopsies of the  most suspicious lesion. Kinda what I expected. The prior biopsy effort simply missed I guess. Bottom line: It will require a robotic prostatectomy after 6 weeks when the post-biopsy swelling has subsided. 

I’m planning to return to LA at that time for surgery and initial recovery so that a medical school colleague and former (and again future!) ski buddy, Dr. Rob Reiter, who runs the prostate cancer program at UCLA, can perform the surgery. I am in the best of hands with someone I trust and feel fortunate to finally have a plan. The last 4 months in limbo have been psychologically draining. 
I have no doubts about my eventual positive outcome- there’s an 85% chance of a cure. 
Not much else to say I guess. 
I’ll accept all virtual hugs— until I can get a real one. 


September
17
2019

September 17, 2019

What a day at UCLA Medical Center. 
I confess I feel far better than I did after my last prostate fusion biopsy at Henry Ford. I figured out that the Shingrix vaccination I received the day before is what did me in--it did the same number on me after dose number two a few weeks ago. Once I left the hospital yesterday, I only felt a little sore and have needed no meds other than the prescribed Cipro. Just hope my Achilles doesn’t rupture as with Cipro, "that's a thing."

But the procedure almost didn't happen. UCLA swapped doctors on me right before the procedure. I was quite surprised but had no choice as I didn’t fly 3,000 miles, take a week off of work to simply call it off, as annoyed as I was. The original doctor had promised enough IV sedation so that 
I'd snooze through the procedure. But because it was done without an anesthesiologist, the dosing was limited--and there was no local anesthetic gel or injection this time. I remained wide awake the whole time and felt it all. I had told the nurse that 5 mg. of Versed had barely touched me in the past—she gave me 3 mg. When it became clear I wasn't kidding, I was given a little IV Fentanyl and then a little Dilaudid, both of which did nothing to knock me out or change the sensation of a coring biopsy needle being deployed. On top of that, I was placed face down in the MRI with no pillow cutout to breathe through. Even Massage Envy knows better. This went on for 2 hours rather than the 45 minutes promised by the doctor I had scheduled with but it felt much longer than that. There were only 15 biopsies taken this time as opposed to 18 last time. But, each one required initial needle placement before going back into the MRI to check its position then back out to adjust it until properly placed (No "Clockwork Orange" in and out jokes please!). Then comes the double “snap” of the trigger when the specimen is taken. Picture a spear starting way down where the sun don’t shine then feeling it skewer you up to your navel—15 times! Two hours of that left me drenched. 

With no music playing (I cannot operate without music in my own OR) at least my internal boom box kept me sane replaying excerpts from Saturday night’s Earth, Wind and Fire concert at the Hollywood Bowl. "Partying up" with Mary J. Blige and Nas there tonight will supply me with more musical distraction before I have to focus on the results coming back Wednesday afternoon. Glad this part is over. 

Off to brunch at the Santa Monica Urth Café--perhaps they have an “Urth, Wynd, and Fyre” special omelet?

 

September
16
2019

September 16, 2019

Round Two begins. 
Quick recap:
Had 14 sets of prostate needle biopsies read as benign in May. But, a subsequent genetic marker test looking at 3 (Confirm MDx) on the specimens showed 2 specimens each had a single positive out of the three checked for—i.e. only 2/42 tests were positive. That corresponded to an 11% chance of a significant lesion on repeat biopsy but a 30% chance of a low grade lesion. Far better than the initial 85% chance of a significant lesion from the MRI readings.
Hence, after 4 months, and a PSA still 12.4, more biopsies are needed to try to get a definitive tissue (histologic) diagnosis for grading and staging. 
This time it will be done while in a “wide-bore” MRI (referring to the diameter of the machine— not the orifice involved or its post procedure condition!)🤣

Most bizarre is to know that the only definitive result would not be a good one, but equivocal results leave me again in limbo. So not sure what I’m hoping to hear....



May
23
2019

May 23, 2019

HOLY COW!!
I WON THE LOTTERY-better than the lottery!!!
On the way to the Detroit airport to fly home, the Urologist called me to say that even though they had specimens definitely from within the PI-RADS 5 lesion, which are over 85% likely to be malignant, all 18 biopsies appeared BENIGN!! 
I’ll need another PSA in 6-8 weeks after the biopsy swelling decreases and maybe another MRI fusion biopsy from the front to get a different angle on the lesion if the PSA goes up again. Thankfully, they would do it in the OR under anesthesia.  I’d rather have a full prostatectomy than go through the same approach again without it. In retrospect, the pain was absolutely worth it!!! At least I can now recover from my back surgery without a double whammy. But, I am still gonna make it my mission to nag everyone to get routine preventive health care. I’m up to 17 people who told me they already heeded my advice! 

I truly love you all for your outpouring of care and support. The last two weeks would have be unbearable without it.  But my heart goes out to those who are still in the midst of their own health battles.

May
22
2019

May 22, 2019

Parental Advisory:
Prolonged Full “Backal” Nudity
Mature Content
Inappropriate Language 
Sexual Violence
Really bad humor!

Wow! Rough day finally getting my prostate biopsy. 
Went to the drug store yesterday to pick up Bactrim for antibiotic prophylaxis. The CVS in Royal Oak, MI had the Shingrex vaccine which we could not find anywhere in South Florida. So Natalie and I both got it. By bedtime, my left deltoid felt like Mike Tyson had punched it which woke me up at 4 am along with a splitting headache. Having not taken any pain meds after my L3/4 discectomy since the day of surgery just 1 week ago, I did take a Percocet in anticipation of the procedure and to help the headache. Before the procedure, the additional injected antibiotic (gentimicin) was not given IV but into the right buttock where all my pain had just been relieved by the disc surgery. It was almost as bad! Then, despite topical anesthetic gel, AND WITH NO SEDATION WHATSOEVER,  it took at least 10 minutes (which felt like an hour) to “place” the ultrasound probe to visualize the prostate and inject 20 cc of local—and yes, it goes in where the sun don’t shine!  Then it had to be moved all around to “fuse” the mapped MRI with the ultrasound. After that, I will definitely NEVER commit a felony— I know I wouldn’t survive even 1 night in prison!

It gets better; With the first needle biopsy of my anterior lesion (the more concerning of the two) where anesthetic couldn’t reach, and without any warning, I heard and felt the bang of the biopsy gun, kind of like a staple gun. I practically jumped off the table only anchored to the bed by the ultrasound probe shoved up my rectum! And since I had moved, the fusion procedure had to be repeated. Guess the judge gave me a life sentence (hopefully!). At least the next 17 biopsies weren’t as bad. But the sweat dripping from every pore forced me to cling to the edge of the table like Charlton Heston clutching his rifle in his (now) “cold dead hands.”

Five hours later, the local has long since worn off. So, combining the shoulder pain from the Shingrex “jab,” a still splitting headache, lumbar incisional pain and muscle ache from last week’s surgery, right buttock throbbing from the antibiotic, and pain all the way from the biopsy site way down to what could only be equated with post amputation “phantom limb pain” from my circumcision 58 years ago, I took 2 more pain pills and had a great nap! 
All in all, I’d rather have spent a day riding Disney’s “It’s a Small World After All” instead! That’s real punishment. And I apologize because now you’re hearing that in your head, aren’t you?
Heading home tomorrow as it’ll be up to a week before the full biopsy results are posted. So that’s all for now!