Just a quicky...

Just a quick and dirty cut -n- paste job from my Kidney-Onc List post to keep the ol' blog up to date...

--snip--

Hi folks,

Well, I just read through the report from my most recent MRI of my noggin.

There's some bad news but some good news as well..

Bad news first... The right Cerebral frontal lesion shows a "very slight" increase in size.

That's the bad news. Not too bad though, eh? Especially when compared to what my imagination had cooked up for me.

Those magic words, "NED" would have been more fun but this doesn't sound too bad, considering. I'll take it.

The better news:

There was a "slight decrease in size of the hemorrhagic left parietal lesion and no regrowth or recurrence of the left posterior parietal postoperative lesion.

(I'm not sure what this next part means or if it's good or bad...) multifocal small white matter long-TR hyperintense foci unchanged without contrast enhancement and without vasogenic edema.

(If anyone has a clue about that last paragraph, comments are more than welcome.)

No evidence for herniation or for midline structural shift

(not sure about the above line either..)

And saving the best for last: NO EVIDENCE OF INTERVAL NEW METASTASES (Yay me!)

So it seems like a fairly positive report, certainly better than I had been anticipating.

I still haven't consulted with any of my onc. docs regarding my recent CT or this MRI. If no one contacts me soon, I'll get on the horn and get after them. Or better yet, I'll sick my wife on them.. that'll get them moving if anything will... :)

Hang tough, fellow RCC warriors!

--snip--

Lazy damn doctors...

In about 1 hour, I'm driving down to Kaiser to get the written part of my MRI report. Scanxiety is at an all time high.

Apparently, Kaiser are just too busy to be bothered by having call and give their opinions so I have to go get the report myself and hope I can make some sense of it. As it stands right now, I don't even have any appointments set up with ant of my onc, docs.

Hey, maybe that means I'm all cured! ....or not.

I really dislike Kaiser's way of dealing with this sort of thing. (or, more properly, NOT dealing with it...)

Don't they realize that I might be just a little bit anxious to hear what they have to say about these latest CT and MRI scans? Sheesh!!

Oh well, I'll pass along the info as soon as I am able...

The Mask

"Pay me, I'll be your surgeon
I'd like to pick your brain..."

~ Blue Oyster Cult

So here are some pics of the mask that was used for my Whole Brain Radiation treatments. The mask used for the earlier targeted SRS (Novalis) treatments was very similar only much tighter and more uncomfortable.

Either one beat the hell out of the older method which involved a "halo-like" device which they apparently bolted directly to your head. This method is still used in some places, I'm told though I can't imagine why.

The marks you see on the outside of the mask are used to make sure your noggin is in precisely the same position between treatments. As I've mentioned before, the treatments themselves were no big deal, especially the WBR.

Basically, they lay you on the table, put your head into the mask and then fasten the mask to the table. Then they use the marks to position you properly.

Then it's zap, zap, zap... and that's about all there is to it.

MRI day

"Well I bumped inside the magic man
And he layed some tricks for me
He said, "You do need help my friend"
I whispered, "obviously"

He laid a spread of Jacks and Queens
And he bade me take my pick
But every face had your face
I cried out, "I am sick..." "

~ D. Roeser - P. Smith (Blue Oyster Cult)

Today is a big day for me. In about 45 minutes, I'm off to Kaiser for what may prove to be a crucial MRI scan of my brain. Hopefully, I'll soon know if both the targeted SRS treatments I received back in April and the more recent WBRT has done me any good or not.

The best news would be that all existing mets have been eradicated. This is not terribly likely but is not ungeard of either. If they've shrunk or even just become stable, well, even that would be cause for celebration.

If the brain lesions have grown or, worse, new ones have appeared... well, lets just say, that would suck in a big way. I don' think I need to say what that would do to my chances of overall survival.

I feel pretty good and am trying to stay positive but I have to admit, I didn't really know what "Scanxiety" really meant till now.

Unfortuately, this is Kaiser we're dealing with so I probably won't know any result till a week from today at the earliest. Be sure that I'll update here and on the List as soon as I know anything.

In the mean time, any positive vibes you may have to spare are more than welcome. And those of you with religious beliefs, well, if you don't mind sending out prayers for this old unbeliever, well, I'll gratefully accept those as well. I may need all the help I can get.

I don't need no doctor...

"I don`t need no doctor
My prescription tells me that
I don`t need no doctor
I don`t need no doctor

All I need is my baby
You don`t know I`m in misery

I don`t need no doctor
I don`t need no doctor

Well, the doctor said I need rest
He put me on the critical list
Keeping me safe from harm
All I need is her sweet charm

He gave me a medicated lotion
It wouldn`t do, woah yeah
My emotion, oh yeah

I don`t need no doctor
I don`t need no doctor
I don`t need no doctor"

~ Humble Pie

So I got the results back from last week's CAB (chest, abdomen, pelvis) CT scan . Looks like that shit is still growing.. The largest nodule is now up over 2cm. I'll have to check the previous scans but I believe this is the most growth I've had between my 3 months scan schedule.

Not the what I was hoping to hear but it could be worse, I suppose. AFAIK, my regular onc docs are either unable or unwilling to treat the lung lesions until my brain mets have at least stabilized (I'll know about that in about 2 weeks). Till then I guess it's RCC free-for-all party time in Joe's lungs... (Wheeee!)

Here's a cut-n-paste job from what I scanned off the report. As usual, much of it is greek to me but I'll get busy with google when I'm done here. I haven't talked to any docs yet about these results.

--snip--

DATE OF EXAM: June 28, 2007 NAME OF EXAM: CT chest, abdomen and pelvis TRANSCRIPTIONIST'S INITIALS: efs COMMENT:

CT examination of the chest, abdomen and pelvis was performed following intravenous and oral contrast. Transaxial CT images were obtained through the chest from the thoracic inlet to the lung bases.

Comparison is made with previous CT dated March 12, 2007. 2.5-mm thin sections through the chest were obtained. There is a 4.8-mm in size non-calcified pulmonary nodule within the posterior right upper lung field, near the major fissure and likely within the right upper lobe, slightly better seen on the current examination.

There is a stable 4.8-mm in diameter nodule within the right middle lobe and slightly enlarged non-calcified pulmonary nodule within the right lower lobe which currently measures 12-rnjn (increased from 10-mm) in its largest dimension. On the left, there is a lobular enlarging mass within the left lower lobe which currently measures 2.4 x 2.1-cm in its largest dimension. Adjacent to this is increasing linear density consistent with scarring or atelectasis. Increased linear scarring and atelectasis is also seen more anteriorly within the lingula.

There is no evidence of pleural effusion. No new parenchyma! nodules are seen within either lung. There is no significant mediastinal or hilar adenopathy. The heart remains normal in size. There is no pericardial thickening or effusion. The great vessels appear normal.

Transaxial images from the liver dome through the symphysis pubis demonstrate normal-size liver and spleen without focal mass. The patient is status post right nephrectomy. The left kidney enhances normally without evidence of solid mass or cyst. The pancreas and left adrenal gland appear normal. The patient is status post right adrenalectomy. No intra-abdominal or pelvic adenopathy or ascites is seen. Bone windows demonstrate no definite osseous metastases. The right eleventh rib has been partially resected.

IMPRESSION: -1) In comparison with the prior CT's of March 12, 2007, multiple bilateral pulmonary nodules, the largest within the lower lobes, have increased in size. Status post right nephrectomy and right adrenalectomy. Result SCHED FOR JUNE '07

--snip--

Panic attack!

"Climb to safety
After all that I've been through, you're the only one that matters
Climb to safety
You never left me in the dark here on my own
Climb to safety
Feel the water rising. Let me be your ladder
Climb to safety
I promise you'll be dry and never be alone

You call me on the phone, you say that it is crucial
You stick your fingers in your ears 'til they explode
I guess the business will be goin' on as usual
We must grab each others collar, we must rise out of the water
'Cause you know as well as I do that it's no fun to die alone

Climb to safety
After all that I've been through, you're the only one that matters
Climb to safety
You never left me in the dark here on my own
Climb to safety
Feel the water rising. Let me be your ladder
Climb to safety
I promise you'll be dry and never be alone

Climb to safety, safety
Climb to safety, safety
Climb to safety, safety
Climb to safety, safety"

~ Widespread Panic

No, not that kind of panic attack! This was the good kind...

I was able to go out last Sunday night to see Widespread Panic with my good friend.

I can't begin to tell you how good it was to get out of the house, hear some great live music and feel like my old self, at least a little.

It went very well. I had been worried that I'd get too tired or get one of my headaches but I felt fine though I did have take my cane along and sit down quite a bit to rest.

But it was a smallish venue and the sound was excellent no matter where you sat.. WP is not really a visual type of band.. it's more about the jams so sitting in the back was just fine.

I was dead tired by the time I got home but it was well worth it.. I've been tired before.. :)

I have to admit, I am not used to going to a show completely sober like that (I can't really drink alcohol at all now days) but it was no big deal. I spent so much of my earlier days partying like there was no tomorrow, I guess a little sobriety is probably a good thing.

Hearing live music that I love and thinking about something other than cancer for a few hours is the best sort of party anyway....