post op review etc

Today marks exactly one week since the colon surgery and I feel pretty good. A little soreness when I move certain ways and general tiredness but all in all quite satisfied. I go back to have stitches removed and for a post-op consult on Thursday but from everything I read and am told by people who should know, I am way ahead of what is normally expected. And a silver lining – I lost 10 pounds and no longer wake up with an achy shoulder. I normally am a side sleeper but the surgery forced me to sleep on my back and I guess the way I was sleeping was messing up my shoulder.

One of those visually surprised by my progress was the Oncologist I visited today to discuss my prostate cancer. He couldn’t believe I had a colectomy a week ago and was up and about. His nurse immediately called over to Florida Hospital Deland and requested a copy of the pathology report from the colon polyp removed and I learned that not only was it totally clean but that they had also removed some lymph nodes in the general vicinity and those too were clean. He went through all the material with respect to my particular case and confirmed that it was very early, not an aggressive form, and that it was very likely 100% contained in a small area of the prostate. He said that if it were more aggressive they would start with a hormonal treatment but no sense in going there based on the information to date. The treatment I elected and he felt was the best choice was the Image Guided Radiation Therapy. With this treatment, the next step is to have 4 pure gold pellets imbedded in the prostate at the locations they planned to nail. They looked to me like cylinders less than 1/10” long and a few mils in diameter. Due to the recent surgery, he put off having the targets implanted until Feb 22. That’s an out-patient job similar to the origiinal biopsy – uncomfortable but not painful. A week after those are in place, I get a CT scan and temporary external target points applied -like 4 small ink dots – in my pelvic area. These are used to optically line up the radiation equipment. At the first treatment, the temporary targets are replaced with permanent tattoo’s. From the CT information, they create a radiation plan which shapes the radiation pattern to be used. This shaping is done with small motors that move rods in and out different lengths so that the radiation is actually patterned to my specific internal positioning. So they have control of both the source position and intensity and can create virtually any kind of radiation pattern. With the machine grossly positioned by lasers on the tattoos, it does a fine adjustment using the internal gold pellet targets. All of this is to make sure the beams go directly where they want them and kill as few good cells as possible. That lessens side effects and makes the process more complete and effective. The treatments start a week later – so that puts me into the second week of March. The treatments will be 5 days a week for 8 weeks. A treatment lasts about 15 minutes, start to finish. No pain, just like a chest x-ray. He said some people have side affects after a couple of weeks – all very treatable – but with the patterned radiation and Image tracking, the effects are much less than even 2 years ago.

The equipment is Varian state of the art equipment. There are only 3 such pieces installed in Fla right now so it’s great that I have good access to it in Daytona. As a side note, John Richardson, Tina’s dad, was a chief engineer kind of guy at Varian who designed and developed the tubes for this type equipment. I know that means it technically perfect so, how come he elected surgery for his prostate treatment? It’s a 40 minute drive from the house to the treatment center or they have a shuttle that will pick me up in Deland about 15 minutes from the house. Nancy talked to the driver and there are usually 4 passengers so it means having to wait around the treatment center. I’ll play that by ear but the place is nice – big screen flat panel TV in the waiting area, coffee, tea, pastries etc. It was interesting to see the interaction of the other patients waiting for their turn in the equipment. Like a club – they all knew each other and seemed to be enjoying the time. Nobody moaning around or doing regular doctor office things. I can see catching up on my reading, big time.

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