Since I last posted in April many things have happened and they have mostly been good. Heart problems have been front and center so I’ll start with that.
My heart failure (HF) treatment required three months of total rest starting on January 3rd and during that time I lost a lot of weight, mostly due to muscle loss. It left me weak. I started to rebuild in the gym, but you know, it’s a long haul. I’ve had “breathlessness” as a problem since 2018 and both of my shoulders have their own problems. I can’t lift a lot of weight and I have to find a pace that keeps me moving without having to stop and catch my breath. Things improved, and I also started to walk again. The big win for me was to start cycling. Even on an e-bike, my first few rides were one or two miles around the neighborhood, and it required the use of a throttle, which kept the bike moving while I rested my legs or went up steep hills. That improved too and I now ride without use of the throttle, with the exception of starting from a dead stop. Year to date I’ve done 30 rides, logging 436 miles, and now I don’t consider it to be a ride unless it’s ten miles minimum. My current goal is 35 rides and 500 miles, but it’s gotten cold and I’m not as tough as I used to be.
We’ve taken our first vacation in two years, driving to Montreal and staying for five days. We were walking 4 or 5 miles every day and it was hard, but it was also an improvement. We’ve had a few other local trips, staying 1 or 2 nights. There was a mid-summer visit to the emergency department of my favorite hospital due to unusual pain in the flank. It was not heart related, but I was stuck there for 12 hours and they would have admitted me if I didn’t fight against it. The cause of the pain was not determined, so I left the hospital with the same problem that sent me there. However, some CT imaging studies showed significant pleural effusion in the left lung. This led to a thoracentesis procedure on week later. About 400ml of fluid was drained from the left lung cavity. I’ll return to this shortly.
While we were sitting in the ED waiting room I spied a mouse running around in the corner of the room. Harmless but unexpected. There was a security guy in full uniform so I told him about it, thinking that the mouse might upset some of the other patients. He summoned a couple of maintenance people and then he got curious while waiting for them. He accumulated a small crowd of fellow employees as he cautiously approached the corner. The mouse appeared! The guy shouted and leapt up onto a chair. One of his colleagues laughed and said there was no danger. Mr. Security said that mice can jump and he didn’t want to be attacked by it. It was pretty funny to see this full grown man in a police uniform dancing around on the furniture to avoid a mouse. Great entertainment for everyone in that end of the waiting room.
Overall the summer was wonderful. I missed the previous summer entirely due to 18 weeks of chemotherapy. This year I had very few summer doctor appointments and was far healthier. Last week I had a follow up echocardiogram and it shows that everything has remained stable since April. This is good news because the result in April showed a huge recovery to “normal.” With the help of a drug regimen, my heart apparently remains mostly normal. My next meeting with the heart doc is in early November.
Now back the thoracentesis. This was ordered by my mesothelioma doctor. He pointed out that the CT images from the emergency department showed growth of two small spots on the left chest wall. This is the advance of pleural mesothelioma. He recommended a process called cryo-ablation to kill the nodules. He also told me about a small clinical trial that has shown some success with at least one other mesothelioma patient. The treatment is immunotherapy, where DNA is extracted from the patient, modified, amplified, and re-injected. I think this is the future of cancer treatment, so I have tentatively agreed to enter the trial, given that mesothelioma is uncurable and has returned to invade my left lung. This coming Thursday, October 22nd, both nodules will be biopsied for DNA analysis and then destroyed with cryo-ablation. It’s a low risk, minimally invasive outpatient procedure, but it happens in the operating room under general anesthesia. The unique operating suite is very high tech. I might post about it next week, assuming all goes well.
Also lurking in the background is stage 4 prostate cancer. This has been treated since 2010 and knocked back repeatedly, but my PSA level is rising once again. The next treatment will be androgen deprivation therapy (ADT), which I have experienced in the past and I have to say, it’s pretty awful. It’s a major downgrade for quality of life. Why treat all of these different cancers, feel like shit, and then die? For now I am not in any treatment, which is rare for someone with stage 4 PC. My oncologist prefers to hold off on treatment and monitor the PSA level every two months to see how quickly it changes. The rationale is that I’ve taken a beating from other cancers and treatments. I still need more time to re-build (something impossible to do on ADT) and to enjoy life. It’s a balancing act based on quality of life, and ADT may become a reality. Time will tell.
Long post, and it’s a lot to absorb.
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