The Pam and Jerry Fields' Blog Page

Medical Update

The latest medical news is not good.

On Wednesday, March 3rd, I went to the Mayo Clinic in Rochester, Minnesota, for two appointments. The first was to get an MRI of my prostate; the second was a doctor consultation to determine a course of treatment.

Mayo Clinic main entrance (Mayo Clinic photo)

The MRI indicated a possibility that the cancer may have spread into the pelvic area lymph nodes and seminal fluid canals. The results were not conclusive, but due to my high PSA reading the doctors think this is likely. As a result, the Proton Beam Therapy I had hoped would be the preferred course of action is not viable.

Instead I have opted to use Brachytherapy, or internal radiation therapy. This involves use of radioactive ‘seeds’ implanted for a short time in the prostate. External radiation will also be part of the treatment.



There are two version of this Brachytherapy, low-dose long term implants and temporary, high dose implants. The later are inserted for 5 – 15 minutes at a time and are then removed. General anesthesia is used for the procedure. I will be going the high dose route as the doctors think I am a good candidate for this type of treatment. The high dose implant and removal will be followed by external radiation treatments extending over 5 weeks, give or take.

In addition to the radiation I will be on one or two prescription drugs and injections to lower my testosterone levels, which helps discourage cancer development. I will be taking across-the-counter calcium tablets and vitamin D supplements to help offset the effects of the radiation. The first of the injections happens this coming Monday, March 8th, following a blood draw that will set a baseline for treatments to follow.

Pam will accompany me for the initial implant in April, as I will be sedated and not really fit to drive home after the procedure. Otherwise I can take the follow-up shots and treatments on solo trips. Many of the subsequent treatments can be scheduled at the Mayo Clinic satellite office in Austin, Minnesota, which is a half-hour closer to Elma than the main Mayo Clinic in Rochester.

The first implant will take place in late April and the follow-on treatments should be completed within 5 or 6 weeks after that. The lowered testosterone will continue for up to 18 months with PSA level checks every 3 months or so. The long-term prognosis, overall, is good.

However, there are side effects to deal with — loss of energy and loss of muscle mass mainly. There can be other issues as well but most clear up within a few days or weeks. It will not be a good time but the treatments are necessary. I’ll just have to deal with it as well as I can.

And face it…this is not like lung cancer or brain cancer. “Keep the big picture in mind” was the advice of the doctors and that is what I hope to do.

It does mean my summer plans will have to be modified; attending my annual motorcycle rally in Colorado will probably not happen this year, but the middle and end of the summer should still be productive to some extent. It remains to be seen how well I tolerate the treatments and side effects.

So Wednesday was (pardon the pun) kind of a bummer. I had hoped for a better outcome. We were mentally prepared for a non-invasive cancer program due to the CT scan results at Mason City, then the Mayo folks starting using the phrase “aggressive cancer” right away when describing the MRI scan. However, on the bright side, the MRI did not require the insertion of a probe, for which I was most thankful.

A side note:

If you have never taken an MRI, the machine is very loud. I was provided ear plugs and head muffs to keep the noise to a minimum. The process includes a lot of tones, beeps, and other noises from the machine. My session took about 50 minutes as 2 scans were completed, the first being a ‘normal’ scan and the second, aided by a chemical infusion, was a ‘high contrast’ scan. The doctors ( I had 2) showed us the results of the scans in their consultation session, but a layman can’t ‘read’ the outputs very well. When the doc points to a gray blob and says “this is the prostate” you just have to take it on faith. Anyway, with the check-in, preparation, actual scan, and release, the appointment took about 2 hours and 20 minutes, much longer than I had anticipated.

Back to our regular programming.

Pam is working on the west wall of the library, which is the wall containing pocket doors leading into the nook and bathroom. I will have before-and-after shots of the wall when completed, but for now Pam has the brown edging done and two coats of white paint down. Next comes the grosgrain ribbon border around the ceiling and above the door.

That wall will not get the art deco treatment of the east wall but will be decorated with posters and wall art. Complicating the work is the now-unused shell of an electric wall heater. The casing of the heater is not flush with the plaster; it sticks out just a bit and Pam is trying to find a way to work around it. Wall plaster in the library is very dry and fragile; Pam doesn’t want to take on a major sheetrock repair. (Pick your renovation battles.) So, a poster or large photo will eventually cover the area and, when we leave, the next owners will have to decide how to handle the old heater box insert.

Well-above normal temperatures have arrived, resulting in the rapid melting of our accumulated snow. I think NE Iowa will experience more storms before spring really arrives but it’s good to be able to take the dogs out without having to put on their cold-weather coats (offset by muddy paw prints in the laundry room). The outdoor cats have been more active outside the catio and I have been able to putz with several small projects in the garage. The warm weather is extending into next week’s forecast so should be with us for several more days.

Overall, the week had ups (warmer weather) and downs (MRI results) but not much in the way of photogenic moments, for which I apologize.

Photo Archive

This week’s photos are scenics from the Pacific NW and rural settings in that part of the country.

Rural Oregon
Sunset silhouette of a farm
Tug “Vancouver” on the Columbia River, Mt. Hood in the background, near Portland, Or.
Fishing boats at anchor, Whidbey Island, Washington
Log float on a river in Oregon

That’s it for now. Thanks for looking in!

Pam’s Penny

Cancer. Here we go (again). Yes, Hank, it’s the “same-o same-o” treatment for prostate cancer now as when you survived it in the past. It ticks me off that cancer research seems to be more-or-less stalled on chemical and surgical treatments. I was hoping the Proton Beam would be an improvement, only to have that potential pulled out from under.

At least the Mayo Clinic keeps extensive electronic records in the online medical database (Epic). None of the Iowa clinics so far do this; it’s a huge headache making sure medical providers are all functioning with the complete patient profile. Mayo makes the fourth clinic location Himself has visited (Austin, MN for the radiation will make that five) and there have been three different medical groups involved — Howard County Medical, Mercy One, and Mayo. It’s a billing and information mess.

Regarding ongoing renovations here at 702 Main, re-evaluation of timetables will need to accommodate both the upcoming cancer treatment schedule and the health impact of those treatments. I suspect I will need to concentrate on more projects I can complete solo.

Be well. Happy Trails.

3 Comments

  1. Becky

    As you say Jer, the big picture is the one to keep in mind at all times. I was sorry to hear the proton beam therapy was a no go, so I guess you’ll need to rely on the tried and true and be thankful there actually IS a tried and true!

    So, does this mean you are gonna bust a$$ until late April? What’s your mind-set? Take it day by day? Have high energy vs low energy supplies on hand? I’m curious.

    I have a feeling you will tolerate this well. I dunno – just a feeling. And if there are bumps in the road you can always read or take a nap. Neither are bad options in my mind!

    Onward and upward Jer! You can do this!

  2. Jerry

    Becky:

    Thanks for the note. At this point I am still a bit numb to the most recent turn of events so will take it day-by-day. The only supplies I have put aside are the doctor recommended supplemental calcium tabs and Vitamin D pills.

    Yes, we will get as much done as we can before the late April procedure. That part does not bother me as much as concern over the follow-up radiation treatments which will create the biggest side effects. I hope I tolerate these well but will just have to wait and see. The doctors recommend sticking to my regular routine as much as possible including physical activity.

    Naps are good!

    I will also get acquainted with the local library which I have not yet visited. I am sure I will use their resources, and there are always YouTube videos.

    I may or may not get out to The Lot in Colorado this year, but if I do it will probably be late in the summer and just for a visit, not to get any real work done.

    Should be an interesting several months upcoming.

    Jer

  3. Becky

    Day-by-day is a good philosophy. Many times we worry about things that never happen… I’m really good at that.

    I was not able to find the specific Cussler book you recommended but there are several others available. I will get back to you if I listen to one.

    At least the weather is cooperating!

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