Normalizing

This might seem a bit weird, but of the many things that have happened in the last couple of weeks, my new stoma and urostomy pouch system have been the least concerning of it all.

I've now had three home visits with nurses at Fraser Health (our Health district). All were excellent, all watched me do a complete "bag change" and all offered some tips to make it quicker and more secure.

It really is simply a different way of doing things, and I can see myself comfortable with it in a few weeks.

I no longer have to get up and go pee at night.

What's caused more consternation is the pain/itching of the axe wound I have below my navel. It's not so bad sitting still, but rubs and itches when I walk, and it's really hard to find a comfortable position when I sleep. It's also awkward when I MMA fight.

I neglected to fill the prescription for Tylenol-3's they gave me when released from the hospital - because I'm a man and can suck it up.  Wrong.

The other irritation I have is injecting myself with Lovenox every night until March 29. I know, I know, diabetics have to do this every day, but it still sucks! (Lovenox is a derivative of heparin, a blood anticoagulant.)

I'm walking more and more each day, and can feel the energy starting to come back. I'm driving again (doc said that the only concern he had was opioids and narcotics - as soon as I was strong enough and off the drugs I'm good to go), and I can put my shoes and socks on myself. I'm a big boy!

So onward and upward. Gotta get strong to start the next phase - I think it will be Nivolumab. We'll know more April 8 (meeting with Dr. Noonan at BC Cancer).

Pathology Results. Doug 4.3?

I was called into my surgeon (Dr. Wong) yesterday to get my staples and stents removed from the RC surgery (radical cysectomy) I had on Feb 29. He also had pathology results from the surgery.

As it turns out, a couple of minutes before I arrived he was called in to emergency surgery at RCH (next door), and had only seconds to see me.

So all the pathology results I have so far were lying flat on my back while he took the staples out. This story may change in the next day or two if I get more information out of him.

OK - so the pathology. I was originally diagnosed with Stage 2 MIBC (muscle invasive bladder cancer) in August 2023 with no evidence of spread. I had 4 rounds of GEM-CIS chemotherapy (Oct-Dec '23) before RC surgery.

The surgical pathology results were that the bladder was completely removed with nice margins surrounding the tumor(s). Same with the prostate and seminal vessels. But one of the eight removed lymph nodes removed showed cancer. So this now has to be reclassified as Stage 3.

EDIT: I did hear from him. Cancer was very aggressive, and had entered the fat layer of the bladder, although when it was removed it appeared completely contained. The actual tumor was about 2cm. To put this in perspective, Dr. Wong had removed the entire tumor in August. It had grown to this size in six months, in the middle of chemotherapy.

Wong is now referring me back to my oncologist (Noonan - I thought she quit!) for immunotherapy. I believe the therapy will be Nivolumab. So while this is not good news, I'm spinning this that having immunotherapy at this stage is probably a good thing. Without the lymph node being affected, I'd go into a monitoring program. This way, regardless of what is actually going on, I'm getting the immunotherapy. Wong may have removed all of the cancer. But maybe he didn't.

ANOTHER EDIT: Got a call today (3/14/24) in to see the Oncologist on April 8.

Doug 4.2

 A little housekeeping.

• Doug 4.0 diagnosis
• Doug 4.1 chemotherapy
• Doug 4.1 radical cysectomy

And I'm Done?

It's Friday, March 8th, and I was released from the hospital this morning.

We arrived at Royal Columbian Hospital at 6:30am on Thursday, February 29 - surgery was slated for 8:45am. I was wheeled into the OR at 8:44am (I asked what time it was because I'm that kind of a guy). 

It took about 20 minutes up front to have the anaesthetist install an epidural. He told me as he's trying to jab something between L2 /L3  (or was it T3 /T4) that I have minor scoliosis. Who knew (certainly not me)? Anyways, lights out about 9:15am on Thursday. 

(The reason they give the epidural is to ensure that the entire mid-section of your body stays completely anaesthetised during the surgery. Apparently it's very simple and reliable. It also prevents the screaming when you wake up mid-procedure.)

I wasn't there when it happened, but Dr. Wong called Laura about 12:20pm and said he was done, and happy with the results. So a little over 3 hours. 

Although the hospital was super busy, the care and attention I got was outstanding. I left with a bag full of supplies, a couple of prescriptions, a handful of to-do's, and some Halloween candy. 

I look pretty good, and it only hurts when I blink. 

We will have pathology back on the bladder, prostate, lymph nodes and seminal vessels (all the stuff they removed) in another week. I'll write another update then, with the plan moving forward (surveillance, more treatment, buying a round-the-world cruise on a credit card).

Home and feeling good...