14 Month post Cancer follow up

Today is the 14 month post cancer follow up. 
Cancer.
That word still lingers in the back of our minds lurking as we continue to go through appointments with ENT, CAT scans, and mild scares from 'something showed up' we need another scan.

To...it was nothing.

However the good news is that Rich is doing better and he has this behind him. 
He also told the doctors that he wouldn't ever go through treatment again. I know he is solid in those thoughts. Chemo nearly killed him and he reacted so poorly to it. 

I'm hoping that our follow up visit will be another one where Dr. Witek slaps him on the back and tells him he is doing well.
We may have passed that magical one year date and now look forward to a 5 year prognosis.

Statistics show that if the cancer is to return, it will in the first year...or within 5 years.

So we still live with a cloud over our heads. However that cloud feels pretty distant at this time.

Follow ups and follow ups never end.

Archived Photo

One thing seems to keep leading to another.  We finally got seen by the surgeon who would do the 'eyelid' lift to increase Rich's vision.

After examining him and then calling in another doctor, the decided they wouldn't do any eye surgery until he saw Dermatology.  They poked and prodded around his face and asked many questions.

History of skin cancer? 

NO.

Anyone in the family have skin cancer?

NO.

A lot of sun exposure as a child?

YES.

Chemical exposures?

YES.

"We can't do the eye lid surgery until after dermatology does surgery on these multiple areas."

The doctors poked on his face some more and then their fingers brushed his forehead. 

"We may have to use all this nice excess skin to make skin grafts to cover up scarring. Dermatology will use the Moh's Method to take out the lesions and depending on how deep they are well, that will determine the scarring."

Rich shrugged.  I cringed.  I'd seen photos of the Moh's Method and well, it was not pretty but usually it healed up quite nicely.  Multiple spots? To not do surgery was inviting the cancer to spread and kill him.

I wondered how long had those spots been there?  Of course it wasn't something that a normal person would recognize as cancerous.

Cancer.

Hate hate that word.

We ended this appointment with a promise that Dermatology or Derm, would call and set up an appointment.

We are now one year an 12 days out of the Throat Cancer diagnosis.

More on that later.

Appointments and February Blahs

Rich still feels as if he has no energy and he is not really gaining any weight back.  This of course is a hard time of the year for him anyway.

Right now he is having the doldrums.  The overcast days have got him in a down mood.  Well, as he said. "I'm depressed.  I'm not getting better, I'm not getting my energy back."

When he is like this, there is no discussions to be had.  One just has to listen.  I can't point out to him that he is still alive and that he did have a great day out on Saturday when he went to an auction with the neighbor.

These things don't really matter much to him at this moment.  It is how he feels internally what matters.  He has stopped doing Tai Chi. I tried to get him to do it again.  But he just gives me the look.
He is supposed to be doing physical therapy but he has dropped the ball on that too.
  
I think part of it is that it is so muddy that doing anything outside right now is a huge chore.  When it was so cold two weeks ago, he had some trouble with doing things outside and breathing.

He has COPD and I think that the Throat Cancer and treatments may have made it worse.  That makes doing daily things a lot tougher. And unfortunately he feels that he should somehow be much better.

I have pointed out to him that he actually is doing more than he was pre-cancer.  But he can't see it.

I know once the winter blahs go away and the weather gets nicer, he will go into his 'spring' mode. At least that is what I am hoping.

We go for the CT scan and meet up with the Eye Doctor tomorrow.  I will ask the doctor how long of a recovery time he'll have with the eye surgery.  Rich is under the impression that he will be back at things the next day.

I am trying to be very positive for Rich and sometimes getting the dark look of gloom doesn't make it easy.
We take this time of year one moment at a time.
One foot in front of the other.

Visit with Rahim/ Chemo Oncologist

The blood labs turned out fine and Rahim basically met us with a follow up.
He let us know that he was scheduling a follow up CT scan that he thought should have already been done to the one done in Boscobel in August.

"Just to be diligent," is what he said.
The August CT scan had some 'things' in it that should be looked at again.

Um.  I don't like that.  But I recall asking the attending doctor at the ER what exactly did all the techno stuff mean?

His answer?  See the VA and have a bone scan also scheduled.  This was the doctor that had seen us 9 months before the VA caught the throat cancer and had said to Rich...get ENT to see you ASAP.

Okay, so I'm not going to obsess over another scan.  Rich has already said if there was more cancer to deal with in the future, we would only treat it with Palliative Care and nothing else.

So far things are good, the basal skin cancer will be removed next month and we see a doctor this month to check on the floaters in his eyes.

The stroke has affected Rich's eye - brain co-ordination and he is supposed to doing home assignments exercises for that.  He does it when he feels like it.

Too busy to take 5 minutes or 10 minutes a day for it.  I'll have to insist on more Tai Chi if I can too.  He has dropped the ball on that.

So here it is 13 months from the day he came home and said the word Cancer.  
He is doing pretty well I think ... and so do the doctors, for going through a very rough regime of treatment and all of the things in between that he went through.

However, Rich thinks he isn't doing as well.  His weight has stayed fairly stable.  Up and down a few pounds with each doc visit.

Onward.  Let this March be a much better one.  Eye surgery and at the end of the month?  Remodeling begins!

Skin Cancer around the Eye and CT scan ordered.

I found a message on my cell phone.  It was Dr. Rahim from Oncology.  He left me a detailed message that he had ordered a CT scan of Rich's abdomen "as a precaution" and because he is detailed.

In August we'd gone to the ER because of stomach pain that was intense.  The doctors at Boscobel thought it was a blockage and did a CT scan.  The doctor who had dx'd Rich's throat cancer the August previously was there and gave us the print out of the CT. He wanted me to give it to Rich's provider and his oncologist.

I asked him what it all meant.  The lesion on the adrenal gland? The remark by the doctor who read the CT?  What was the "nonspecific sclerotic density in the right iliac bone, that should be further evaluated by a nuclear medicine bone scan?" At the time I worried when he said that could indicate the beginnings of bone cancer.

See you live in fear of someone finding something...anything once a diagnosis of cancer has been reached.  

Rich's diagnosis of having nodules of skin cancer around his eyes in several spots was alarming to me.  But he did his male stoic thing and shrugged it off.  He did say however, that the locations caused the eye doctor to be concerned enough to schedule biopsy and surgery to take them off and while they were at it, they would nip his upper eye lids which sag and block almost 30% of his vision.

He has been feeling run down the past few days and I did try to explain to him that subzero weather was hard on those who have COPD and who have had radiation treatment.  

"Where did you read that?"

"Well honey, it was actually in the audio that I took with our first meeting with the oncologists."

Sad note.  We lost Mona yesterday, our eldest hunting hound.  Good note.  I still am waking up next to Rich each day and for that I am grateful.

Another 13th Visit

Just when you thought it was safe to go back into the waters...

Rich went to his Dental appointment as was scheduled.  During our short two visits to Palliative Care, Rich had complained about 'floaters' in his eyes.

Dr. Loconte didn't give it a thought, they seemed more concerned about his overall well being.  Let's just say that Palliative Care is a good thing, but it didn't work out for Rich very well.

After his Dental appoinment, Rich walked over to see the Eye Clinic. He thought he'd see if he could get an appointment to see an eye doctor about the floaters.  They seemed to really bother him quite a bit.

As luck would have it, an appointment opened up and 'could he please wait for the doctor?'  Rich agreed, it was rare that you ever got in on a same day at any clinic at the VA.

The UW eye doctor showed up and listened to Rich's complaints.  Rich's eyes were dilated and examined.  He told Rich about the floaters.  If they got worse or he saw flashes of light, he was to 'get in' immediately. 

Then he asked Rich if he'd had any family history of skin cancer.

I think that took Rich by total surprise.
"Nope."

The doctor said that he was scheduling Rich for a biopsy in a few weeks as he had skin cancer under his eyes. These areas would be removed as cancer near the eyes was not a good thing and they didn't want it to spread to his sinuses nor his eyes.  He told Rich what kind of cancer it was called and that ... he the doctor was 99% certain that these spots were cancer.
And by the way his drooping eyelids would require surgery as they were blocking at least 30% of his vision.

When Rich got home, he walked in the door and said "I saw an eye doctor today, they are going to do surgery on the lids so I can see better and did you know I have cancer under my eyes?"  He paused and thought a moment.
"I think he called it 'Eye Cancer Lymphodemia'."

I shook my head and said, "I doubt that is what it was called!"

Then I did some research and found the spots that Rich was talking about.  Indeed when I compared them to Basil Cell Carcinoma 'on the face and below the eye' I was surprised.
Indeed I could see it plainly.

And we wouldn't have had a clue except for a cancellation on the 13th.

Now we have another wait and see.  Another cancer diagnosis that happened on the 13th of all dates.

However this cancer...if it is Basil Cell Carcinoma and it has not spread deeply into the tissues, has a 99% survival rate of 5 years or better.

And so it goes.

6 Month follow up and CT scan

December 17th.

The long drive to Madison seemed to take forever.  We listened to the radio and commented on how wet our winter was so far. We talked about just about anything and everything but what we were going for.

A follow up CT scan 6 months after the last radiation treatment.

It seemed long ago, yet such a short time ago. Was this going to be fine?  I don't know what Rich thought because he didn't seem to be worried about it.

Both of us were in a fairly positive mood.  The long day at the University of WI Hospital didn't really excite us much.  We found the lab and got the blood work. We found the cafeteria and both of us had great lunches.
UW Hospital of Madison is one of the most frustrating places to get around in. Nearly every first time to ... well, even us after 35 some visits, sometimes have to ask for help to get from one place to another.

Finally we were in the waiting room for Radiology Oncology.  I recall our first wait there.  Scared to death of the unknown that was to come.  Frightened and nervous.  I wasn't frightened now, to say I as not nervous would be an overstatement.

I was just hoping for good news as was Rich.  We'd found that doing Tai Chi together had really helped his overall feeling and general attitude.  He was better than when Dr. Witek saw him in September when Rich still felt exhausted from the treatments.

His name was called and we went into Witek's exam room where his Medical Assistant took his vitals.  Rich's weight was pretty good. It was 179.  He'd started cancer treatment at somewhere in the 190's.  But the weight loss had actually come after the treatment stopped.

Rich hadn't seen it himself, but he'd been more active around the farm and of course not having all of his teeth and the saliva issue had curbed his appetite some.  Over the past few months, his weight had settled right around the 178 or 9 lbs.  

The hair he'd lost was coming in. In back where the tomography targeted radiation had caused a complete loss, the hair was coming in black and curly.  A startling difference to his mostly silver straight hair. His goatee was black on one side too.  I thought it was pretty cool how one side of the mustache and goatee had come back in such a dark contrast.

Dr. Witek walked in and turned on his heel to face Rich.  
"Good news man! It is all good, nice and clear CT scan!"
Rich grinned, I felt all the air go out of me and felt joy.

Dr. Witek asked about Rich's vision and mentioned that the CT scan in September after the PET scan had shown a significant stroke in the occiptal lobe of the brain. 

Rich waved his hand and said things were better. He was doing Physical Therapy for that and Tai Chi for overall balance and besides, it made him feel relaxed and good.

We inquired about his wedding and Dr. Witek grinned and began to show us photos and talk about his wedding.  It was a very happy moment between Dr. and Patient.

He examined Rich and then made a time for follow up. He stated that Rich had had enough radiation for a while and the next visit should be in April and no CT scan.

It was the most beautiful Christmas Gift we could have gotten.