Judgment Day #9 All Clear, and Technology Rocks! - September 8, 2011

First the great and awesome news: Judgment Day #9 came and went with an ALL CLEAR now marking 39 months cancer free!  God is indeed good, all the time!  Of course, trials are not out of the picture, so try to enjoy the following VERY LONG blog posting about the good, the bad, and the ugly of today's Judgment Day!

Trying to get work done the day before a Judgment Day and trying to relax in preparation are pretty much mutually exclusive pursuits.  What will easily make the whole relaxation side impossible is a call from the front office staff at the Urology Clinic informing me that my second (of three) upcoming BCG treatments, optimistically and aggressively scheduled and planned last March, would need to be changed.  Could I possibly come in the afternoon instead of 8:30 in the morning.  Undeniably I could have done so, and even more certain was the fact that I would NOT be doing that!

Just to remind all of you, I do plan these things out in advance for a reason.  The longer in advance, the more likely the chances of getting the earliest appointment in the morning, late in the week.  We want this for two reasons: A) The sooner you start the sooner it is over with for the day; and B) Now that American businesses are all employee-hostile, I have to use "Vacation" days to cover any medical time off, so Friday is the very best day.  BGC treatments are a two day ordeal with the first day consisting of a two-hour holding period followed by a six-hour special handling period, and then add two to six hours for full system flushing and urinary symptoms to dissipate.  The night and next day are consumed by exhaustion, body aches, and "general malaise."  So you want early in the day to get to the end of both Day 1 (to sleep) and Day 2 (to be mostly back to normal) as soon as possible.  And you want late in the week to spread the recovery time over a Saturday and consume only one "Vacation" day.  Worst vacation ever, so logical to minimize it.

Let me recap and paraphrase the friendly phone call for you:
Chirpy female voice: "Hi, this is xxxxxxx, from yyyyyyy Urology Clinic."
 Me: "Hello."
CFV: "I see you have a BCG appointment with Liz on September 23.  She will not be available that morning, so would you mind coming in the afternoon instead?"
Me: "Yes."
CFV: "So would 2:00PM work for you?"
Me: "No."
CFV: "You are not available?"
Me: "You should have one of these BCG treatments yourself."
Slightly less chirpy FV: "Pardon me?"
Me: "If you had any idea what you were requesting, you would never have called me in the first place."
CFV: "Well you see Liz has surgery that morning and won't be available until the afternoon."
Me: "Not my problem"
CFV: "I'm sorry?"
Me: "Look.  There is a 12 hour recovery period from a BCG treatment.  Having it at 2PM means that the soonest I can even think about going to bed is 2AM on Saturday.  Is that what you are sorry about, or is it the fact that I cannot have any food or drink for 16 hours while I wait for Liz to finish her morning business and a leisurely lunch?"
Not at all chirpy FV: "I'll have someone else call you back."
This is annoying on so many levels.  The only reason I had Liz scheduled at all was because Dr. Hopkins does surgeries every other Friday, and I was trying to save a "vacation" day!  Someone did indeed call me back, and we explored a few options, none of which were acceptable.  It was down to 2PM, take it or leave it.  I hung up and began stewing, fuming, cursing, and nearly spitting.  I bent a few ears of innocent by-standing coworkers, who were sympathetic (and probably afraid not to be).  A few hours later, I talked to another coworker, TK, whose business (and perhaps her life in general) is about solving problems and getting things done.  We reviewed the options, and came up with two slightly less awful alternatives. 
1) Have the BCG after the cystoscope or the next day, ruining some pre-existing dinner plans as Treatment #1, then do Week 1 and Week 3 as scheduled for treatments #2 and #3, skipping Liz's busy morning.  Problem is that the scope does enough trauma to make BCG ill-advised without several days to recover.
2) Skip Liz's busy morning and delay the treatment until Week 4.  Problem there is that puts recovery right on top of our 28th wedding anniversary.  One could surmise that after the first 26 or so these get to be a matter of routine, but females will often disagree!
3) Suggest to the doc during Week 1 that he give us the BCG and catheter and we do the BCG at home for Week 2.  Probably all kinds of legal and regulatory reasons why that won't work, but I was prepared to be stubborn about it!

What evaporated was all hope of relaxation, deep breathing exercises, or a decent night's sleep.  I forced myself to do one deep breathing set before midnight, and caught about 4 hours of fitful sleep.By morning I was too exhausted to be frustrated, had a nice breakfast and shower, and did some deep breathing practice.  It really does work and really does help.  Did a few more sessions in the car during our 50 minute drive to the clinic.  By the time I arrived, I was as calm as a summer breeze.  Processed in with minimal hassles and was shown to the exam room. I delivered my urine sample and returned, my gaze immediately drawn to the VERY new, very high tech instrument on the exam prep table. I asked the nurse, Is this the new narrow-gauge scope?  "Yes," she replied, "It's even smaller than a catheter!"  While she was not quite right (victim of a Boise State education - it's a football school now), it was exactly the size of a 14 gauge French catheter, and SIGNIFICANTLY smaller in diameter than the old scope.  It also required the use of a very big high-res monitor.  This was enough to make me forget all frustrations for sure.  One of our Bladder Cancer frat buddies, Ben F. in Louisiana (aka Mobile Biohazard Man), used one recently and declared there was no recovery period at all.  This baby was the latest from Karl Storz in Germany, and it looked to be a major improvement.
Dr. Hopkins breezed in quickly and, after the usual pleasantries, he got right to work. There was a bit of confusion getting the monitor turned on, but then we were off to the races, and...


Well, almost nothing.  But nothing compared to past experience.  This Storz endoscope ROCKS!  There has been very minor recovery pain at the very tip end of things, but really nothing.  After cleanup and dressing, I joined the Doc at the scheduling table and we looked at options.  With the low invasion factor from the new scope, Option 1 above moved into first position, and we pursued it.  The problem was that he advised against today, and the Doc was not planning to come in the next day.  But he relented and agreed to come in at 10:30 (which we both know will be 11 or 11:30), but still preferable to 2PM or later.  And BCG starts 1 week sooner.  Still skipping the Liz week, so ending as originally scheduled on September 30.  And now many hours later I can assure you that the smaller scope is absolutely the way to go!


TK said...

The power of positive thinking that problems are opportunities for creativity! And I throw in a good dose of emphatic prayer.

Sometimes the timing of good news (new equip) is oddly amazing. At any other time, your appreciation of this equipment probably wouldn't have been as great. Though it still looks like a modern torture device.

Here's to a Happy Anniversary

Deb said...

I haven't written you in quite some time so you may not remember me. My husband was diagnosed with bladder cancer in November 2007 and your blog helped him through his treatments, etc. - tremendously!!! He coudl actually relate to what you were going through so it made it "not quite so bad". Anyway - he has now passed the three year cancer free mark and we're looking at "buying the celebration cake" in a couple more years! OF course, he still has to have the cystoscopy every three months but hasn't had to undergo BCG treatments for a year now. Looking at this scope - I sure wish HIS doctor would get one like this! Anyway - congratulations on your wonderful results!!!!

Steve Kelley said...

Thanks to both TK and Deb. Trust me, readers, this narrow-gauge scope is the difference between 90 seconds of torture followed by 36 hours of pissing fire, and 90 seconds of discomfort plus not much. I think I still would have been as excited about it!

Rapid Iq said...

Congratulations Steve...I remembered your scope schedule..n was anxious...Happy for you!
Have a great time ahead!

El Calígrafo said...

Hola Steve !
Sería interesante saber sobre la hidratación con aporte de electrolitos.
¿Ayuda a tolerar la BCG?
Saludos !

Steve Kelley said...

Translation of Sebastian's comment:
Hi Steve!
It would be interesting to know about hydration and electrolyte intake. Does it help to tolerate BCG?

My response:
I need to collect more data, but it seems that there may be a connection. I will know more after my 3rd BCG in 2 weeks.

Mi respuesta: Es necesario recopilar más datos, pero parece que puede haber una conexión. Sabré más después de mi tercera BCG en 2 semanas.