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I think I last posted an update on my father's prostate cancer before the first specialist visit, so let's play catchup. Last Friday was the visit to the medical oncologist at Emory, Dr. Kucuk, where we expected the word to be "do hormone suppression therapy, which should slow this down enough for something else to kill you before it does". But surprise! (and I guess this is why you go see specialists), he said "you're healthy and strong--get this thing out of there". With a few hints of "it's an aggressive form of prostate cancer, and you really don't want it to spread to your bones...that would hurt. Badly."

So Dr. Kucuk consulted with his colleagues about the various removal options suitable to the patient, and the referred Daddy to Dr. Nieh, a urologist, for possible cryosurgery. We pleaded hardship for the travel back and forth to south Georgia, and got a double-booked appointment for today instead of one 2 weeks off. (And waited less time than we did with Dr. Kucuk.)

After hearing Dr. Nieh discuss how it would work, the chances for complications, and all that, the cryosurgery still seems the best option to remove the prostate and the cancer, though the TURP procedure that uncovered this cancer makes things a little more difficult. The possibility will remain for some cancer cells in the urethra, which is not touched by the freezing. Post-surgery monitoring will be hard, as this tumor is not producing much PSA (not all prostate cancers do, it seems). However, it seems like a good shot at eliminating the problem, without too many negative effects on Daddy's quality of life.

The surgery scheduler was out until Monday, but when she calls we'll be scheduling for sometime in April, to give time for things to heal completely from the TURP. Meanwhile I'll drive Daddy home tomorrow.

For those who want to get into serious TMI territory, here's an Emory page on cryoablation of the prostate. Avoid this if you have an aversion to needles, or are male. <g>
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My father is here this weekend, and my older brother should be arriving around midnight. (Daddy sees the oncologist tomorrow morning.) The cats find the various rearrangements at time interesting, other times frustrating.

The unfolded sofa bed behind me has kept Fish and Fred interested all evening.
The closed door to the 'guest wing' frustrates all of them, but especially Agatha when she bumps into an unexpected 'wall'.
Disruptions led Agatha to re-discover an old favorite spot--the cabinet under the bar sink in the laundry area, which stays toasty warm when the furnace is on thanks to the vent arrangement.
Luggage on the floor of both the guest room and the study--both fascinating (Fish and Fred) and a hindrance (Agatha).

Older brother just arrived...time to let him have the room.
nlbarber: (Agatha)
My father will come up here Wednesday for the oncologist appointment on Friday. My sister-in-law will go get him, then I'll take him home either Sunday or Tuesday--Monday being out because I have a conference call at work. That means Agatha's comfy nest area she's been using since she went blind must be dismantled--it's the guest bathroom. At a minimum the litterbox that pokes into the main floor area by the bathtub has to move. The basket she sleeps in under a furnace vent probably needs to go too, as that infringes on the area where you would stand in front of the sink. The food and water dishes can probably stay if pushed further back beside the toilet--but there might not be much point in it if she stops spending time in there.

Today's task was moving the litterbox, along with the puppy pad that it sits on to catch when she pees over the edge of the box (nearly 100% of the time, I think). After debating putting it in my bathroom (really no room at all), or perhaps in the laundry room blocking the coat closet door, I decided to try it in the Cat Room despite that being the location of the other 2 boxes. I moved the box, induced Agatha to walk to the Cat Room by herself, gently pushed her towards the box so she could smell it, then put her front feet in it, too. She of course stepped out immediately and left to go back to the cat basket in the guest bathroom. You can put a cat in the litterbox, but you can't make her use it...

Despite that initial reaction, so far this seems to be a success. The puppy pad was peed on sometime during the day, and neither the floor nor the bathroom rug were. Tomorrow I'll decide if I'm going to try to shift the cat basket. That will be harder on her--it's not the only place she sleeps, but it's the most common. And the second most common is a spot in the guest bedroom, which will be off limits to her (at night at least)while Daddy is here. She'll just have to move down her list of favored sleeping spots for a while.
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Actually, I got home Thursday--older brother is in Moultrie with Daddy until Sunday, when we hope he will feel OK about being on his own. The oncologist appointment has been set for January 30, and sister-in-law will probably make the down-and-back trip to bring Daddy up here for it. I must finally get the guest room cleaned up again....

I went in to the office on Friday morning for a meeting, postponed at my request from Tuesday when I was on my way to Moultrie. It should have taken about an hour--maybe less. But with the guy running it, it took 2 and a half hours, and ended without anyone having action items or any sort of timeline for the next steps. So glad this guy isn't my supervisor!

Today was much more fun. I Jazzercized this morning (boy, I'm going to have to work at getting back in shape....and the JazzerThon is next month), went to the grocery store, then called younger niece over and we made Triple Ginger Cookies. Ours spread out more than Heidi's and the first batch was a little underdone...but these are really good if you're a ginger lover. We're also working on the right amount of salt to sprinkle in with the turbinado sugar for the coating to get that little sweet/salty bite we both like.

Tomorrow niece will return to make her birthday cake, one of 3 she generally gets every year. There's the devil's food cake her grandma makes on or near the actual birthday (Dec. 30), while she's in Arizona visiting. Then there's a 'family' birthday cake, and a cake for her birthday party. Tomorrow's baking will be the family cake, but niece has chosen a pie: Grand Canyon Pie from Beranbaum's Pie and Pastry Bible. It's a chocolate cookie crumb crust, a layer of bittersweet ganache, a layer of fresh raspberries, a layer of chocolate chip whipped cream, all topped with cocoa meringue 'boulders'. Supposedly the effect will be the layers of the Grand Canyon. I just finished baking the cocoa meringue--the rest will be tackled tomorrow.
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Generally good news: Daddy's bone scan was negative, providing pretty good evidence that the prostate cancer has not spread. (Older brother says prostate cancers are most likely to spread to bone.) The post-procedure PSA dropped significantly from Daddy's routine check a few months ago, which could mean that most of the tumor was removed during the procedure or that the tumor is very undifferentiated (which is bad--more likely to spread) and not producing PSA.

The urologist wants to send him to an oncologist for treatment recommendations, and Daddy told him he'd prefer to go to Emory, a major teaching and research facility. (Emory is 10 minutes from me and my younger brother in Atlanta.) Urologist did not have a referral to hand for an Emory oncologist but said he would get one in a week. He also wants to get the actual tissue slides back from the pathology lab he uses (which is in Cleveland) so those can be taken to the oncologist at the consultation.

So, we wait on the referral, and also discuss needs for support here. Older brother is speculating that the treatment suggestions will be either "do nothing and watch" or a hormone-suppression therapy that involves a shot every 4 months. Neither of these would force a move to the Atlanta area where we could provide more constant support for trips back and forth to doctors, etc.

I'm headed back to Atlanta tomorrow, as planned.
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Gee, it's been a week since I posted...I'm shocked. Things remain rather upside-down-ish.

I drove back to Moultrie today after an extended weekend in Atlanta--I went home Friday afternoon when younger brother was well on his way to swap places. He stayed until today (he'd initially planned to come home Sunday or Monday) as Daddy didn't feel comfortable spending the night alone. Tomorrow is the appointment with the urologist to talk about options for treating the cancer, and older brother the doctor will be here in time to go with us. He (older brother) had to see patients today, so is catching a flight that will get him to Atlanta about now (9 PM) and then rent a car and drive down.

My weekend in Atlanta had lots of cat-snuggling time (but I'm still In Disgrace for leaving them repeatedly), only one Jazzercise session, lots of errands, some reduction of the accumulated home paperwork (but no work on the taxes--guess I'll have to make the January estimated payment just to be sure), a brief fit of nesting manifested as cookie-baking (Jay Lake's ginger chocolate chip cookies as spotted on [ profile] kristine_smith's LJ), some visiting time with sister-in-law and the kids including playing Can't Stop which just arrived from Thought Hammer, and a MiniLoisCon with [ profile] mbernardi, [ profile] filkferengi and spouse, [ profile] ann_mcn, Dawn and her mom, and Matt. [ profile] mbernardi was on this side of the pond for GaFilk, which I passed on in favor of all the aforementioned activities plus some good alone-time needed for this introvert's sanity.

I did make it to the office for almost a full day yesterday (left an hour early to do Jazzercise before the MiniLoisCon), and 3 hours today for a conference call. I also agreed to come in on Friday morning for a local database management meeting--I'm driving back to Atlanta Thursday as older brother will be here through Sunday, and given how little time I'm managing to put in, I think sacrificing part of my Fridays Off is OK.

Before I go I hope we can have a discussion about what help Daddy needs after Sunday and how to get it for him. The cancer treatment decisions will affect the "what help is needed", too, of course.
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The day started out with a run to the urologist's office to see if the catheter needed to be re-inserted. Thankfully, no--despite Daddy's bladder getting very distended and painful overnight, he eventually persuaded it to let go of enough fluid to get comfortable. Looks like exercise is essential to keeping that system working while the bladder continues to build muscle tone.

Weather was providing some background excitement, as a good stiff wind blew most of the day. Before I got up the dead dogwood by the driveway toppled over (and was sawn up by city crews by mid-afternoon, wow!). An excursion to the grocery store needed a slight detour around the block where one of the senescent water oaks that line a lot of the city streets had toppled, taking out a slab of the sidewalk and a power pole or two. It's supposed to be windy again tomorrow, but not that cold--high about 69.

What kept me busy the rest of the day? Laundry, a trip to the post office with BookMooch mailings, two grocery store runs (I could get more efficient about this, but I keep thinking short-term), fixing soup and Reubens for lunch, cooking Penne With Chicken, Mushrooms and Asparagus for dinner and a fruit crumble for a semi-indulgent dessert. The pasta was OK--needs a little more punch somehow, perhaps from a significant increase in garlic. The fruit crumble was wonderful. Officially it was an Almond Fruit Crumble from Small-Batch Baking, using a Granny Smith apple and a half a cup of blueberries as the fruit. The recipe supposedly serves 2, but it fed me, my father, and my cousin Cecil with more than any of us though we should have.
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My younger brother returned from his visit to in-laws on Thursday, and drove down to Moultrie Friday night after visiting his office and collecting some files. I left Saturday morning for home. Now I'm packing to go back--brother has a jury duty summons for Wednesday. I have to take (well, lead) a conference call tomorrow from 12-2, but then will leave my office, throw the suitcase into the car, and hit the road.

Tomorrow morning is the appointment for taking out my father's catheter--brother will deal with getting him there and back, and will either stay with him until I get there or if things are doing well, leave earlier knowing I'm on my way. I'll be there until at least Friday, I think, and probably will be back next week for the next doctor's appointment where test results and treatment options will be discussed. Older brother the doctor is flying down for that, too.

The cats will be upset--they haven't gotten over their upset from last week, in fact, and are clingy and demanding. I have managed quite a list of chores in my 57+ hours at home (so far), but the cat-reassurance task is fated to be incomplete.
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I'm still in Moultrie helping my father, who still has a catheter as the result of a Dec. 19th procedure on his prostate. Today we went back to the doctor's office (we thought) to have the catheter removed. Instead the doctor gave us bad news: the pathology report shows cancer, and it's a very aggressive form. (Gleason 9, if you know the scale.) Daddy had prostate cancer 14 years ago which was treated successfully--this looks to be a very different beast.

We're still in the information gathering stage. Tomorrow we'll go out to the hospital so he can have a bone scan done, and at the doctor's office today they drew blood for a PSA. His last PSA wasn't elevated, and if it still isn't that reduces the treatment options. We see the doctor again in 2 weeks to discuss all those results. My older brother the doctor will try to get here for that appointment.

And just to add to the aggravations, the catheter doesn't come out until next week...


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