Summary: no bladder cancer, just "atypical cells" and surgery scheduled June 25. Had my followup visit with Dr. Hatcher. The nurse calls me and Judy in after a half hour wait, gives me the specimen cup. I tell her they're obsessed with urine around there. We get parked in a temporary then move to another room. Dr. Hatcher is buzzing around. We wait an hour, can you guess what my imagination is saying? He finally walks in and says good news, no bladder cancer, just atypical cells, they (pathology report) really aren't sure what it is. Could have had it for years, we'll just watch it. I tell him that's pretty dadgum vague. I guess his office will be my 3rd home and he compares it to an abnormal Pap smear. He says only a third of bladder cancers are associated with cigarette smoking. I quit 30 years ago for nothing. Judy says it's all due to drinking Sweet 'N Low but he says there's no evidence associating bladder cancer with saccharine. She says "yeah, right" and rolls up her sleeves. When Judy is peeved she rolls up her sleeves like she's gonna bust your head open on the schoolyard. Talk about telegraphing your punches!
Anyway he says they're booking surgery with the robot in June, research shows no difference in outcomes when spread with a 2 month window so a week here or there won't make a difference so I schedule after a planned family vacation to Texas to see relatives. He says there's no difference between Ft. Sanders and St. Mary's. I vote Ft. Sanders but the nurse says they do them on Mondays at St. Mary's and Thursdays at Ft. Sanders. She tells me the machine is newer at St. Mary's so I opt there since it's 4 days earlier and newer. I'm told it's a 23 hour admission so I go in Monday morning at 5:30 and I guess that means they kick me out at 4:30am Tuesday. Guess we'll have to call the police for an escort for Judy to go out to her car (rough neighborhood there) or get a few big guys to come and sit with us. Just some more preop, make an appointment with the anesthesiologist and take 1-2 weeks off. I'm betting on back to work July 5th.
Thanks to all those who're reading this, sent me emails and called and wished me well. I haven't shed one tear up until this second and now I'm moist in the lacrimal glands because I have never felt so loved in my life and I thank you. Lane
Thursday, May 24, 2007
Tuesday, May 22, 2007
Friday, May 18, 2007
Bladder biopsy/punch my ticket
Summary: Bladder biopsy done this morning, some good news. I went at 6am today to UT Hospital for a biopsy under general. As usual the staff is nice but interesting. The young woman (she looked 17) in admissions pushed the automatic door open to walk me to the cashier to pay may deductible (it's a business). Told her she looked strong enough to open the door. She said she didn't like to touch door handles. Must be fun to have OCD and work in a hospital. Perhaps she could be a telephone operator and avoid unclean appliances. Nurses were great. My male nurse was being shadowed by a nursing student and before wheeling me back to surgery turned to Judy and asked, "Don't you want to give him some sugar?" Thank God I'm in Dixie. We all laughed when he said he probably shouldn't use that line because he pulled it one time and the lady sitting by the gurney said she was the preacher's wife, not the patient's wife. I'd have still wanted some sugar but hey, that's just me.
I did get one or two pieces of good news. My chest x-ray was normal (no metastatic lesions apparent), EKG normal and my CBC, electrolytes and kidney functions normal. I noted they didn't do an alk phos to see if had bone mets and needed a bone scan as promised. I'll just do it myself on Monday. Helps to be a doctor.
Anyway Dr. Hatcher came out afterwards and told Judy he hadn't seen anything like my bladder in years, thought it might be something called plasmacytosis which is simply treated with antihistamines. Had some discomfort, suggested they give me a urinary analgesic pyridium and they thought that was a good idea. Gotta advocate for yourself.
I'm not sure how many punch biopsies they did in the bladder but between the prostate and the bladder if I had a ticket like Smoothie King or Pilot Coffee Club I could get a free supersize drink by now. I don't know what would be appropriate. Maybe $25 off my next test or surgery or an upgrade to steak instead of chicken.
My follow up appointment is Thursday, May 24th, will know more then and will keep this updated. Thanks for all the comments and emails and prayers. Thanks to my good buddy Diana Nelson, a fantastic public speaker, for loaning me the 4 CD set of Prarie Home Companion annual Joke Shows. I loved the one about the drag queen who went to the Catholic church. He told the priest, "Honey I love your gown and hat but did you know your purse is on fire?"
Lane
I did get one or two pieces of good news. My chest x-ray was normal (no metastatic lesions apparent), EKG normal and my CBC, electrolytes and kidney functions normal. I noted they didn't do an alk phos to see if had bone mets and needed a bone scan as promised. I'll just do it myself on Monday. Helps to be a doctor.
Anyway Dr. Hatcher came out afterwards and told Judy he hadn't seen anything like my bladder in years, thought it might be something called plasmacytosis which is simply treated with antihistamines. Had some discomfort, suggested they give me a urinary analgesic pyridium and they thought that was a good idea. Gotta advocate for yourself.
I'm not sure how many punch biopsies they did in the bladder but between the prostate and the bladder if I had a ticket like Smoothie King or Pilot Coffee Club I could get a free supersize drink by now. I don't know what would be appropriate. Maybe $25 off my next test or surgery or an upgrade to steak instead of chicken.
My follow up appointment is Thursday, May 24th, will know more then and will keep this updated. Thanks for all the comments and emails and prayers. Thanks to my good buddy Diana Nelson, a fantastic public speaker, for loaning me the 4 CD set of Prarie Home Companion annual Joke Shows. I loved the one about the drag queen who went to the Catholic church. He told the priest, "Honey I love your gown and hat but did you know your purse is on fire?"
Lane
Tuesday, May 15, 2007
Stop the weirdness
Summary: the cystoscopy went easy but the urologist doesn't know what he's seeing down there.
I have slipped through the wrinkle in time, fallen down the rabbit hole, been abducted by aliens or knocked into another dimension. I am being innoculated by rare and unforeseen events to the point that it is getting tougher to surprise me. For me to move past the numb stage will require some ordinariness.
I ran into a friend in the urologist's office who fortunately got better news than me. The nurse calls out "Mr. Cook" and I stand up but so does an elderly gentleman and she acutely spots him as the correct one. Later another nurse comes out and asks for Mr. Cook. I verify they mean Lane Cook. I met with Dr. Bruce Woodworth, the third urologist in the practice of three. They are all getting to know my bottom. He tells me there's a possibility of a middle lobe of the prostate growing into the bladder and they want to make sure if I have or don't have one. Miraculously I don't. I told him I just thought he was looking around the neighborhood. I dreaded the cystoscopy (tube run up the penis to the bladder). As was the case with the biopsy, the numbing gel was fine, had no pain. I once had a dentist do something in my mouth and say, "oh, shit." That was my last visit with her. So Dr. Woodworth says something like, "that's interesting." He says 1/3 of my bladder wall is red, doesn't look like cancer. He asks if I've ever had radiation treatment. I tell him never (must have been one of my alien abduction trips, I can't recall which one). And no I don't put laptops on my lap - they get too hot. He says it doesn't look like cancer, could be a telangiectasia (like those spider veins on the noses of old drunks) or plasmacystosis, hasn't seen this in over two years. "We need to biopsy these," he said. "Go right ahead, you're there," I say. He tells me that requires general anesthesia so I am given to conclude it must be quite painful. He asks again if I've had radiation. My memory is so-so but that's something you normally recall. So I'm going to have a detour. Before I make it out the door I find out he and Dr. Hatcher, my main urologist, are booking robotic surgery now in June (so much for my wish to get it over with soon) AND that UT Hospital decided to buy something other than the da vinci robotic surgery machine(probably something I'll use in the future with my luck) so I have to go to Ft. Sanders or St. Mary's hospitals. I plan on having my wife and step-daughter Christy (an RN) there to keep them from killing me off.
I go to do my preop bloodwork, EKG and chest x-ray. The pharmacy tech shows me her stuffed pigs that sing songs and laugh. Unreal. The anesthesiology resident witnesses to me and invites me to his prayer meetings in a hotel, tell me hundreds of thousands of people have been healed by prayer. And yes, they are charismatic. He asks me how I feel. He's a really nice guy. I should call him back and tell him to get out of anesthesia and into psychiatry. I also thank him and tell him he better be careful who he says those things to (religious) or some disgruntled person will turn him in. He acknowledges that. They get my blood, do my EKG, say I'm ready to go home. I remind them I have to have a chest x-ray. Oh yes, take this down the hall. The waiting room is packed. I sit on the floor and Judy sits in a love seat next to a young woman who starts coughing and tells the receptionist she's really sick. She looks like she has the flu. We turn away from her. They come out, stare at me and say, "his buttons are ok" and walk back in. I have no clue what that means. Then the tech comes out in a moment and comes and gets me. He tells me to lean against the plate. "What about my shirt" I ask and he says that's ok, my buttons are fine and won't show up. With my luck, the radiologist will diagnose me with 3 or 4 small button-sized tumors in the midline of my chest. I've just had a snake up my hooter so I tell him I'll take my shirt off. He doesn't care one way or another and snaps my picture. He never looks at my brand new orange arm band to verify that I am indeed Lane Cook.
So Friday morning at 5:30 May 18th I have the mystery lesions biopsied. Stay tuned. Probably asbestos fibers.
I have slipped through the wrinkle in time, fallen down the rabbit hole, been abducted by aliens or knocked into another dimension. I am being innoculated by rare and unforeseen events to the point that it is getting tougher to surprise me. For me to move past the numb stage will require some ordinariness.
I ran into a friend in the urologist's office who fortunately got better news than me. The nurse calls out "Mr. Cook" and I stand up but so does an elderly gentleman and she acutely spots him as the correct one. Later another nurse comes out and asks for Mr. Cook. I verify they mean Lane Cook. I met with Dr. Bruce Woodworth, the third urologist in the practice of three. They are all getting to know my bottom. He tells me there's a possibility of a middle lobe of the prostate growing into the bladder and they want to make sure if I have or don't have one. Miraculously I don't. I told him I just thought he was looking around the neighborhood. I dreaded the cystoscopy (tube run up the penis to the bladder). As was the case with the biopsy, the numbing gel was fine, had no pain. I once had a dentist do something in my mouth and say, "oh, shit." That was my last visit with her. So Dr. Woodworth says something like, "that's interesting." He says 1/3 of my bladder wall is red, doesn't look like cancer. He asks if I've ever had radiation treatment. I tell him never (must have been one of my alien abduction trips, I can't recall which one). And no I don't put laptops on my lap - they get too hot. He says it doesn't look like cancer, could be a telangiectasia (like those spider veins on the noses of old drunks) or plasmacystosis, hasn't seen this in over two years. "We need to biopsy these," he said. "Go right ahead, you're there," I say. He tells me that requires general anesthesia so I am given to conclude it must be quite painful. He asks again if I've had radiation. My memory is so-so but that's something you normally recall. So I'm going to have a detour. Before I make it out the door I find out he and Dr. Hatcher, my main urologist, are booking robotic surgery now in June (so much for my wish to get it over with soon) AND that UT Hospital decided to buy something other than the da vinci robotic surgery machine(probably something I'll use in the future with my luck) so I have to go to Ft. Sanders or St. Mary's hospitals. I plan on having my wife and step-daughter Christy (an RN) there to keep them from killing me off.
I go to do my preop bloodwork, EKG and chest x-ray. The pharmacy tech shows me her stuffed pigs that sing songs and laugh. Unreal. The anesthesiology resident witnesses to me and invites me to his prayer meetings in a hotel, tell me hundreds of thousands of people have been healed by prayer. And yes, they are charismatic. He asks me how I feel. He's a really nice guy. I should call him back and tell him to get out of anesthesia and into psychiatry. I also thank him and tell him he better be careful who he says those things to (religious) or some disgruntled person will turn him in. He acknowledges that. They get my blood, do my EKG, say I'm ready to go home. I remind them I have to have a chest x-ray. Oh yes, take this down the hall. The waiting room is packed. I sit on the floor and Judy sits in a love seat next to a young woman who starts coughing and tells the receptionist she's really sick. She looks like she has the flu. We turn away from her. They come out, stare at me and say, "his buttons are ok" and walk back in. I have no clue what that means. Then the tech comes out in a moment and comes and gets me. He tells me to lean against the plate. "What about my shirt" I ask and he says that's ok, my buttons are fine and won't show up. With my luck, the radiologist will diagnose me with 3 or 4 small button-sized tumors in the midline of my chest. I've just had a snake up my hooter so I tell him I'll take my shirt off. He doesn't care one way or another and snaps my picture. He never looks at my brand new orange arm band to verify that I am indeed Lane Cook.
So Friday morning at 5:30 May 18th I have the mystery lesions biopsied. Stay tuned. Probably asbestos fibers.
Saturday, May 12, 2007
The Bad News
Friday, May 11, 2007 - I get a call from Dr. Hatcher. He tells me I have moderately fast growing prostate cancer. I'm numb with the news. I call my wife Judy and she asks if I'm joking. I assure her I am not and that Dr. Hatcher will meet us at 6pm this evening. I drive home in a hypnotic state, unemotional.
We hug a lot and make plans to go. I've pretty much decided to go with a radical prostatectomy. We watch a couple of videos on the da vinci robotic surgery:
http://www.intuitivesurgical.com/products/da_vinci_video_overview.aspx
http://www.sharpmedialibrary.com/documentary_2005/Robert_and_Rita_HIGH.wmv
I've heard bad things about radiation, burns to the rectum, how salvage surgery afterwards is not easy nor effective.
We go and meet Dr. Hatcher. I'm reassured by his reputation, his Duke University and Massachussett's General Hospital residencies. Dr. Mounger says he is a fine surgeon. So do several others.
He tells me I have a Gleason score 7 (the lower the better) and stage 1B. Good news-it's only on one side. Bad news-looks like it's growing into the left nerve supply so it will likely have to come out. So much for nerve-sparing surgery. I have to have a chest x-ray and lab studies (alk phos, CBC) to rule out metastasis but no bone or PET scans for now. We discuss lots of numbers, percentages. He seems to focus more on incontinence and ED than death rates, assures me if we get it all I am essentially cured. I ask how many he's done - he's done over 2,000 radical prostatectomies, over 100 of the robotic ones. I ask him if it was him would he go to Vanderbilt or Hopkins. He says maybe a year ago but not now, they have the same outcomes. He said he saw two men in followup this week: the man who had the radical had taken 4-5 hydrocodone and the man with the robotic surgery had taken no pain pills at all. I have to spend the night in the hospital, there 2-3 days, home for 1-2 weeks with a foley catheter in, have to have a cystoscope (the news just keeps getting better and better). Says I'll be 99% in two weeks. Unfortunately supplemental testosterone is never again an option.
Fortunately Judy is a great support, has always stood by me and this is no exception.
We tell the kids. My son is scared, "I've already lost one parent to cancer." His mother was way too optimistic for her metastatic breast cancer so my attempts to reassure him fall on deaf ears.
My daughter asks if they gave me a certain number of years to live and I said no and mention total cure if they get it all. My aunt who is 90 cries and cannot speak. My brother tells me to hang in there and take supplements. Lots of support from friends, office staff. Diana offers to come back early from vacation and I tell her no, I'll need her later. "May you live in interesting times" is the old Chinese curse.
More later. Lane
We hug a lot and make plans to go. I've pretty much decided to go with a radical prostatectomy. We watch a couple of videos on the da vinci robotic surgery:
http://www.intuitivesurgical.com/products/da_vinci_video_overview.aspx
http://www.sharpmedialibrary.com/documentary_2005/Robert_and_Rita_HIGH.wmv
I've heard bad things about radiation, burns to the rectum, how salvage surgery afterwards is not easy nor effective.
We go and meet Dr. Hatcher. I'm reassured by his reputation, his Duke University and Massachussett's General Hospital residencies. Dr. Mounger says he is a fine surgeon. So do several others.
He tells me I have a Gleason score 7 (the lower the better) and stage 1B. Good news-it's only on one side. Bad news-looks like it's growing into the left nerve supply so it will likely have to come out. So much for nerve-sparing surgery. I have to have a chest x-ray and lab studies (alk phos, CBC) to rule out metastasis but no bone or PET scans for now. We discuss lots of numbers, percentages. He seems to focus more on incontinence and ED than death rates, assures me if we get it all I am essentially cured. I ask how many he's done - he's done over 2,000 radical prostatectomies, over 100 of the robotic ones. I ask him if it was him would he go to Vanderbilt or Hopkins. He says maybe a year ago but not now, they have the same outcomes. He said he saw two men in followup this week: the man who had the radical had taken 4-5 hydrocodone and the man with the robotic surgery had taken no pain pills at all. I have to spend the night in the hospital, there 2-3 days, home for 1-2 weeks with a foley catheter in, have to have a cystoscope (the news just keeps getting better and better). Says I'll be 99% in two weeks. Unfortunately supplemental testosterone is never again an option.
Fortunately Judy is a great support, has always stood by me and this is no exception.
We tell the kids. My son is scared, "I've already lost one parent to cancer." His mother was way too optimistic for her metastatic breast cancer so my attempts to reassure him fall on deaf ears.
My daughter asks if they gave me a certain number of years to live and I said no and mention total cure if they get it all. My aunt who is 90 cries and cannot speak. My brother tells me to hang in there and take supplements. Lots of support from friends, office staff. Diana offers to come back early from vacation and I tell her no, I'll need her later. "May you live in interesting times" is the old Chinese curse.
More later. Lane
The leadup
April, 2007. I want to know why I'm tired a lot, want to take a nap in the evenings. I get my testosterone checked and it's in the toilet. It was borderline a year ago, now it's time to do something. I go in for my annual DRE and PSA prostate exams. My physician, Danny Cox says ok to start the testosterone gel. Five days later he calls and says he doesn't like my PSA and Free PSA, wants me to see Paul Hatcher, urologist. I actually argue but am a good patient and go. A year ago my PSA was 2.4. It came back 2.7 but repeat showed 2.4. I schedule an appointment. Before my appointment I check my PSA again. 2.7. I'm still optimistic.
May, 2007. I see Dr. Hatcher. He tells me he can feel a ridge on my prostate which Dr. Cox didn't feel. He recommends a biopsy. I hear scary things (pain) about this but also reassurance.
May 9, 2007. I see Dr. Hatcher's partner Dr. Jay Mounger. Funny guy, older, quit doing most surgery, just does biopsies. He uses a local anesthetic and grouses and tells jokes. "If it hurts, you don't have enough Novacaine!" he says. The next day I see two fellows who've had biopsies by other docs in the last year with no anesthetic. How cruel.
May, 2007. I see Dr. Hatcher. He tells me he can feel a ridge on my prostate which Dr. Cox didn't feel. He recommends a biopsy. I hear scary things (pain) about this but also reassurance.
May 9, 2007. I see Dr. Hatcher's partner Dr. Jay Mounger. Funny guy, older, quit doing most surgery, just does biopsies. He uses a local anesthetic and grouses and tells jokes. "If it hurts, you don't have enough Novacaine!" he says. The next day I see two fellows who've had biopsies by other docs in the last year with no anesthetic. How cruel.
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