BCG Rounds 2 & 3 and Other Updates - 5 November 2012

 It's been almost 3 weeks since my final BCG treatment of the last maintenance series, and I have been remiss in updating the blog with data and details.  I must emphasize that moderating my fluid intake and adding Gatorade as an electrolyte replacement has made an enormous difference in dealing with the side effects.  My "drink more, then drink more still" strategy definitely created more problems with electrolyte loss than it solved by flushing the bladder.  I target about 1.5 - 2 quarts of fluid (black tea at room temperature for me) per hour after the first two hours to continue until major symptoms cease - sometimes well after the 6 hour special handling period.  I intersperse mouthfuls of Gatorade beginning at about 3 hours after instillation, targeting about 2 quarts of Gatorade consumed across the time period.  I also sip a little more Gatorade during the night, and pound down at least half a quart upon arising the next day.   Net result is lower symptoms, lower duration, and less total discomfort.  I no longer need to plot a "misery index,"  as the net misery is now less than it has been for the past 2 years.

I found Round #2 to be about the same as last year, and, after making some adjustments in timing and amount of Gatorade, found Round #3 to be EASIER than last year.  Keep in mind that the reduced symptoms may be due to the short interval (5 days between #2 and #3), or due to my adjustments, or both.  In any case I am glad it's over and I am fully recovered just 2 weeks later - much sooner than ever before.  The detailed results are found in the charts below, not for the squeamish!  The corresponding tables from the previous round last year (and the year prior) may be found HERE.

BCG Round 2 of 3 - Click to Enlarge
BCG Round 3 of 3 - Click to Enlarge

During the final two treatments I was joking with Dr. Hopkins about skipping one.  Much to my surprise, he said that he was not fully convinced it was necessary to continue maintenance further.  I asked about high grade cases like mine, but he was not prepared to go into details.  Instead we scheduled an office visit in 6 months (April 2013) for him to review my case, updated PSA blood test, and the terrible DRE check of the prostate growth.  He has noted over the last 4 years that my prostate has been getting larger, but not too concerned because of low PSA.  I suppose at that time we will discuss the merits of continuing BCG maintenance.  Dr. Lamm is most insistent about doing maintenance BCG, but he proceeds at far smaller doses (down to 10% or 1% of a normal dose), while I have held steady at 33%.  Not sure where this will go, but I think I will proceed next October with another maintenance series, if for no better reason than my insurance will cover it, perhaps for the final time.  Dr. Hopkins also mentioned possibly doing only one or two rather than three doses.  Dr. Lamm demands 3 doses, although at the lower concentrations.  

I suppose we shall see on April 16.  Seems an appropriate day - after getting financially raped by the IRS on April 15, I will get physically molested by the doctor a day later.  It's amazing what we pay governments and doctors to do to us...

Click to Enlarge

1 comment:

Randi said...

As always, it is great to see a new blog entry. My husband had his two year cysto today with Dr. Lamm and will start another 3 week maintenance BCG treatments on Friday. Then hopefully just a cysto at 6 months and a whole year BCG free! Your blog is so helpful and we appreciate it so much.