Exhale...

We got up this morning and left the house in the snowstorm at 8:30 for a 10:00 appointment with Dr. Urban.  It is usually a 40 minute drive (or less), but this morning it took us an hour and 15 minutes to get there.  (By the way, Whitley County and Columbia City do a much better job of plowing than Allen County and Fort Wayne...just sayin')

As soon as we got out of the car, we heard a loud beeping coming from everywhere in the parking garage.  As we approached the door to enter the building, people started coming out.  One woman, who obviously works there, said "We have to stay out here.  That is the fire alarm"

So we got back in the car a hoped the building would not burn down.  It didn't.  We went in within 10 minutes and since the weather is so bad and some people couldn't make it for their appointments, we went right back to see the doctor. 

And the results of the PSA blood test...which everyone has been waiting to hear...the PSA is undetectable.  (That is the perfect result in case you are wondering)

So this will be my last post for a while.  He does not have to go back until September which is when I will post again.  He will have another PSA test before that appointment and hopefully it will still be undetectable.  The PSA is the indicator now to show that he is cancer free.

Thanks again to everyone for all your support and prayers through the last couple of months.

Waiting...waiting...waiting

As many of you saw, Geoff went to Terre Haute over the weekend for the girls basketball state finals.  He said that went well, but he was pretty tired at the end of the day. 

He is also pretty much back to work.  He goes in every day and stays until he gets tired.  Yesterday he was there until about 1:30 and is up and around now (6:57am) and getting ready to go in.  Things are getting back to normal.

And now the waiting...yesterday he went in for his post-op PSA blood test.  (He says it is the best blood test he has had because he didn't even feel it!  Good job Mrs. Perez)  Tomorrow is the BIG day...he has an appointment with Dr. Urban at 10am.  He will find out if the PSA number has fallen.  It doesn't matter if it is zero yet (but that would be nice) as long as there is a downward trend.

I will post the results of the visit tomorrow. 

Getting Up and Around

This has been a pretty good week.  Geoff has gotten a lot of work done at home so he has been keeping busy.  He has also stepped up his activity a little.  He is up walking around the house for 10-15 minutes every hour.

Wednesday, Jennifer (CCHS principal) and Lyle (CCHS assistant principal) came over for lunch and had a little meeting about boys sectional and some other important topics.  I think he was glad to see someone besides me for a little while.

He accomplished his goal of going to the last home boys basketball game on Friday night.  I came home and picked him up to get him there in time for the varsity game.  We lost:-(  Thanks to Lyle for making sure he had a soft chair to sit in for the game.  Thanks also to all those who came over to visit at the game.  And to the cheer block for recognizing his presence at the game.

Today, we spent about two hours walking around the Home and Garden Show at the Coliseum...then he came home and took a nap.  And he RARELY takes a nap.  He says to his good buddy Tony (who loves to take naps) that maybe it is a practice he should take up.

The plan right now is to go to work on Monday for a couple of hours.  If that goes well, he will gradually increase his hours till he is back full time.

Quiet Week

This week has been a quiet week.  Geoff was feeling pretty good Tuesday and walked quite a bit around the house (inside of course).  Perhaps he overdid just a little because Wednesday was not a very good day.  So he rested all day Wednesday.

The only venture outside this week was to his primary care physician to follow up on the blood clot and the xarelto.  He is to continue the xarelto until this prescription runs out, taking two a day.  When this prescription is done, he will take it for three more months but only once a day.  He was also tested for anemia.  The doctor will call him if he is anemic and let him know what to do.

His favorite thins is that he is to continue wearing the compression hose until he goes back to his PCP in mid-March.  And his very favorite thing about the compression hose is that I washed them for him yesterday with a bunch of kitchen towels.  I washed them all on the "sanitize" cycle.  As some of you may know, my kitchen is red and I have some new dish drying mats that are also red and have never been washed...until yesterday...with the white compression hose.  You can guess the rest.  But he is a good sport about it...after all "only real men can wear pink"

The goal for this week...go to the varsity game on Friday night and continue as possible with paperwork, scheduling and upcoming sectional arrangements for transportation, etc.

Progress

This was a pretty good weekend.  On Friday, our friends Deb and Tony, drove us to our girls basketball sectional game at Bellmont against Mississinewa.  This was Geoff's first venture out of the house except for his doctor appointment last week.  He made it through the whole game but was not very comfortable.  So he decided one game for the weekend was enough.  (We are not counting this as going back to work...just an outing:-)

He feeling pretty good, but is anxious for things to get back to normal.

Thanks to all for all the cards, phone calls, food, snacks, thoughts and prayers.  Thanks to all Geoff's "crew" for keeping things going at games while he is not able to be there.  And thanks to the other administrators and others at the high school for taking over wherever they can.

First Post-op Visit

Today was the first post-op visit with Dr. Urban.  The news was all good so far.  He is now free from his "little buddy" (the catheter) and he is extremely happy about that!

The pathology report was good...actually better than expected.  The Gleason scores turned out to be lower than originally thought but treatment was still necessary even at the lower scores.  They dropped him from a stage 3 to a stage 2 so that was also better than expected.  Dr. Urban said the disease was significant and was glad he went ahead with the surgery.

No further treatment is necessary at this time.  The first true test will come mid-March when he has his first post-op PSA.  The goal is to have a VERY LOW score, even zero.  He will find that score out at his next appointment March 19.

I was thinking of having a pool...who can guess the first day he will be back at work, not counting ball games?

Home Again

INR report today 4.0...so guess who came home today!  I went to the hospital and picked him up to bring him home about 10:00am.  He was very happy to be home.  He is no worse for the wear...seems to still be doing well but has a little backache from the bedrest (not being able to move around)

The doctor decided to prescribe Xarelto instead of Coumadin for a blood thinner.  With Xarelto, there will be no blood tests.  He will be on the blood thinner probably 3-6 months.

We go back to the surgeon this Wednesday for diagnostic testing and the pathology report. 

Geoff thanks everyone who has sent cards, flowers, food, treats, books, magazines, crosswords, well wishes and prayers.

Progress

Today was a good day.  The INR is up to 1.8 so the doctor thinks he will be coming home tomorrow.  He is definitely ready!

Bedrest

Today is the first full day of bedrest.  The only reason he is allowed up is to use the restroom.  One of his former students popped in for a minute today and said he was amazed...he has never seen Mr. Penrod still for so long.

Mr. Penrod is definitely not enjoying being still for so long, believe me!  The good news is, the swelling in his foot and leg has gone down tremendously.  To my untrained eye, I would say he has no swelling at all.  That is a very good sign that things are improving.  But the indicator that the medical people are looking at is the INR.  I asked what INR stands for and the person I asked could not remember what the N stands for but it is "International 'something' Ratio".  Some other medical people reading this blog may be able to fill in the "N" for us.

What it is...it indicates how well the blood is clotting.  The lower the number, the more it clots.  The goal is to have it not clot so much so they want the INR to 2.0-3.0.  This morning, Geoff's INR was 1.0

No one can say how long it will take to get up to 2.0.  Everyone reacts differently...some people change quickly, some slowly.  It appears Geoff's number will be changing slowly, but who knows!?

So, he is getting a shot of lovenox (twice today) and a pill of Coumadin (1 today at 5:00)  Another blood test in the morning will determine how much Coumadin tomorrow.

His attitude is pretty good, really.  He is disappointed that this happened because he was doing everything the doctor said (as far as walking, etc) and he is getting bored, I'm sure.  He was glad to have a few visitors today (besides me:-)

So, just hoping for positive change in the INR tomorrow!

Setback

Geoff was doing very well.  He was up and around a lot, not taking much pain medication and feeling pretty good.  The only weird thing to happen was his left knee was very sore yesterday.  He called someone from FWO and asked about it and he said to watch for swelling in the calf and foot.  Well, today there was swelling in the calf and foot and his leg was pretty hot below his knee. 

He called Dr. Urban and described his symptoms.  Dr. Urban suggested he go to the local ER.  They did an ultrasound and found that he has a blood clot behind his left knee, which is his artificial knee.  The doctor told him they could treat it at home or in the hospital.  The treatment can cause some bleeding.  He decided since it is behind his artificial knee, he would stay in the hospital. 

He had a blood test in the ER and a shot of lovenox and a pill of Coumadin.  He is on bedrest and will continue with the blood tests and blood thinners.  I don't know how long he will be in the hospital for this.  I guess it depends on when the blood clot is gone.

Home

Well, from 5:30 yesterday morning till 5:30 today, time just seemed to fly!  Of course Geoff doesn't recall much from 7:08am on from yesterday, but he does remember some.  Needless to say, he feels like he lost a whole day.  And now we are home!

We left the hospital about 3pm after getting instructions for all the gadgets he has attached to him for the next week or so.  Geoff is doing well.  He has been up and around since he got home.

He cannot drive for at least a week.  He goes back to the doctor on Wednesday, Feb 12. He will then get the pathology report.  After a while, they will do a PSA test.  He hopes to fail that test (by getting a zero on it).

Stayed tuned for the next episode.

Up and Around

The morning has started off well.  Geoff got up, out of bed about 6:30 and took two laps around "the circle".  He doesn't seem to have much pain.  He is using an "On Q" to help with the pain.  It delivers the pain med right to the area of the surgery rather than through an IV.  He is much more awake using that than having to have the pain meds through the IV.  He is still on a clear liquid diet until they tell him he can have some regular food...hopefully that will be soon.

The doctor should be in sometime this morning and give him a plan for the day.  The snow is coming down pretty good.  Whitley County is under a travel watch right now.  So...looks like it will be slow driving home when we get to leave.

Geoff says to thank everyone for thoughts, prayers and words of encouragement.

In the Room

At about 3:00 Geoff was admitted to his room.  He is resting comfortably and looks pretty good.

He is on clear liquids today so he just had some water and a popsicle a little while ago.  I'm sure he will be glad to get regular food tomorrow.  And tomorrow he should be up walking around with the goal of going home in the afternoon.

Thanks to everyone for all your positive thoughts and prayers. 

Day of Surgery

The surgery is over!

I just met with Dr. Urban for a post-op report.  Since the right side of the prostate was not affected, they did not take as wide a margin from that side but took more area from around the left side. 

The prostate was not abnormally shaped which means the disease is all microscopic.  The lymph nodes around the prostate looked normal so no lymph nodes were removed.  The surgery went as expected.

If all goes well, he will be able to go home tomorrow.  Hopefully the weather will allow us to go home.

Day of Surgery #1

It is now 8:18 am.  We have been at the hospital since 5:30.  Everything has gone right on schedule.  He met with the anesthesiologist and the surgeon at about 6:45.  They started the anesthesia and took him back to the operating room at 7:08.  The surgery is scheduled for 7:30 and should take about 4 or 4 1/2 hours then recovery for 1-2 hours. 

More info will follow.

All the Details

Everything has been scheduled. 

Pre-op tests have been scheduled for Monday, January 27.  These include blood tests and an EKG.

Then the surgery is scheduled for Tuesday, February 4.  The location is Parkview North on DuPont.  He is to check in at 5:30 am.  The surgery should last about four hours.  Then he will be admitted to the hospital for an overnight stay.  If all goes well, he will be home the next day.

Post op visits have been scheduled about a week later.

He is planning on being out of his office between two and four weeks, depending on how he feels during recovery.  After a few days, I'm sure his computer will be home with him and he will be available by email and phone.  (He's such a workaholic:-)

Continued thoughts and prayers are appreciated.

The Big Decision

Geoff has made his decision.  He will be having surgery.  He has made contacts with the doctors and if all goes well with the scheduling, the surgery will be Feb 5.  I  will confirm this in the next post.

Dr. Urban, the Surgeon

Today, we went to talk with Dr. Urban.  We were there over an hour and he gave a lot of good information. 

Geoff went into the appointment thinking he was going to ask if he could go ahead and make the appointment for surgery.  I think this is a case of the more information you have, the harder it is to make a decision.  It takes a while to sort everything out.  Needless to say, we left without making an appointment for surgery.

Dr. Urban explained that there are three indicators of a high risk (for recurrence) patient.  One indicator is when there is an obvious tumor growing and the prostate is oddly shaped.  The second indicator is if there has been spreading of the cancer outside the prostate.  The third indicator is high Gleason scores.  Unfortunately, Geoff falls in the high risk category because of his Gleason scores.  For this reason, while surgery is not contraindicated, Dr. Urban feels that radiation may be the better choice because it covers a broader area.  With surgery, there are limitations to how much tissue they can remove.  Surprisingly, he said they would not remove any lymph nodes because they feel it is better to leave the lymphatic system "intact" so to speak.  They look around at the lymph nodes to see if there are any that look abnormal, but feel it is better not to remove them, especially if radiation is a possibility as a second treatment.

Dr. Urban pointed out that with Geoff's high Gleason scores, there is a one in three chance that the cancer WILL NOT recur.  With radiation, there is a 50-50 chance.  If he does the surgery and there is further treatment indicated, the odds do not change.

Dr. V (his urologist) and Dr. Urban talked this morning before Geoff's appointment.  Dr. V told Dr. Urban he thought Geoff was a good candidate for surgery (further confusing the issue:-)

So...no decision at this point...maybe tomorrow

Radiation Information

Today was Geoff's visit with Dr. Trenkner (I think that is how it is spelled).  He is the radiation doctor.  This was mostly an information gathering visit.

First he met with a nurse who got all his history and physical information...you know the questions...any family history, do you smoke, what medications do you take, etc. 

Next Dr. T came in and talked for quite a while.  He said with Geoff's Gleason scores being 8's and 9's, radiation would be a good option...but so would surgery.  Basically, both options are open to him right now and Dr. T didn't really commit to which one would be better.  He said, of course, he believes in the radiation so he would have no reservations about recommending the radiation.  The regimen would be...

Hormones would be administered first for about two months to "kill" all the testosterone.  (Testoterone is the culprit that promotes prostate cancer growth)  Then radiation treatments would begin daily, Monday through  Friday, for 39 treatments, or about 8 weeks.  Then, because the Gleason scores are 8's and 9's, the hormone therapy would continue for 18-24 months.  PSA tests would be administered on a regular basis.  There are some side effects but most likely not lasting.  On occasion, the side effects become chronic, but not very often.

If he chooses radiation first, then the option of surgery is off the table.  Apparently there is not much room "in there" to work for the surgeon and once radiation is completed, the prostate sort of attaches to the bladder (it all kind of gets cooked) and the prostate could then not be removed.  I'm not sure what the recommendation is, then, if there is a recurrence.

While remembering that Geoff's CT scan and bone scan were clear, Dr. T's concern was that with the high Gleason scores, there is a higher chance of metasteses and/or recurrence.  For that reason he seemed to lean more toward the radiation, but stressed that BOTH treatments were acceptable (almost equally acceptable, it seemed).

Geoff asked about surgery with follow-up radiation.  Dr. T said that would be indicated if there were any afftected lymph nodes or any cancer noticed outside the prostate.  

After talking with Dr. T, a patient advocate came in and gave Geoff all kinds of information about cancer support groups and organizations.

So...the first visit is done.  Tuesday, Jan 14 will be the first visit with the surgeon.

Reschedule

Dr. Urban's office called today.  (Dr. Urban is the surgeon)  Geoff's appointment with Dr. Urban has been rescheduled for Tuesday January 14.  So, he doesn't have to wait too long...that's a good thing  :-)

Blizzard 2014

Dr. Urban's office just called and they will be closed tomorrow.  Dr. Urban is the surgeon that Geoff was supposed to see tomorrow. 

So the first Dr. appointment will be Thursday with the radiation doctor.  Dr. Urban will call Tuesday or Wednesday to reschedule.

Introducing "Life's An Adventure"

Greetings Friends and Family

This is to introduce the blog where you will be able to read any news about Geoff.  Most of you know, but some may not, that Geoff has been diagnosed with prostate cancer.  He has had the biopsy and is now ready to go on two doctor visits next week to decide how to proceed. 

He will see a surgeon on Monday and the doctor who would do the radiation therapy if he decides on that.  At this point he is leaning heavily toward the surgery, but will talk with the radiation doctor just in case there is a compelling reason to change his decision.

According to Dr. V...his urologist...the diagnosis came very early and the prognosis is good.  He has had a bone scan and a CT scan and all is clear in both those tests so it has not spread.  The only other possibility would be if the lymph nodes have been affected.  Dr. V says he doesn't feel that is likely, but will know for sure after the surgery.

A little prostate cancer lesson for all...they judge prostate cancer by what is called the Gleason score.  A Gleason score of 2-6 is a slow growing cancer.  A Gleason score of 7 is medium growing and a score of 8-10 is a fast growing cancer.  There were 8 samples taken on the left side and 8 on the right side of the prostate.  All samples on the right side were benign.  On the left side, 7 out of the 8 were determined to be cancer.  All of the samples that were cancer had a Gleason score of 8-9.  Because of the scores of 8-9, some kind of treatment is necessary.  In cases where the Gleason score is in the slow growing category, sometimes treatment is not necessary.

That should have everyone caught up that didn't know anything about all this.  This has all happened since Thanksgiving so things have moved rather quickly and we thought this would be the best way to keep everyone updated.

More news will follow as we know anything.

Geoff and Nicole