Relief

• Outpatient surgery at Big Barnes to place a stent in my left ureter

When I woke up after surgery, I immediately felt relief from the pain that I'd been feeling, a good sign that the surgery went well and/or that I was well medicated. Dr. D was able to place the stent and assuming I don't have any problems with it, I'll see her again in a few months to have it removed and replaced. I did get a handful of new prescriptions to take home with me and that felt a little overwhelming. Dr. D took a sample from near the kink to culture to make sure that there is not an infection, but one of the prescriptions is a precautionary antibiotic just in case. Now it's just about recovering and waiting to meet with Dr. T on Tuesday to talk about what is next.

Hydronephrosis

This morning I got the phone call that we knew was coming some day, but the one we didn't ever want to get. Dr. T called to talk to me about my scans and it's not good. There are new tumors in new locations and growth and ugh, it's all bad news. Additionally, Dr. T said that we have one problem that requires immediate attention, hydronephrosis. Basically, a tumor is pressing on the tube (ureter) that runs from my left kidney to my bladder. It has caused a kink and the tube has ballooned up behind the kink. It is probably the cause of my back pain and it is not allowing my left kidney to drain properly.

• Appointment with Dr. D in the CAM building at Big Barnes

Dr. T's office set up an appointment for me right away this afternoon with a urological surgeon. There aren't a ton of choices for this problem. For a patient with advanced cancer, one option is just to deal with the pain and ultimately possibly lose function in that kidney. This surgeon however agrees with Dr. T that trying to put in a stent is another possible option for me. It would be an outpatient surgery under anesthesia to place the stent into the ureter. If during the surgery, the stent isn't able to get past the kink, a third option would be to have a tube placed from the kidney out my back to an external bag. So, let's hope the stent can be placed without any problems. The stent will have to be replaced every 3-4 months through further outpatient surgeries. If chemo could shrink the tumor that is causing the pressure, there is a possibility that a stent wouldn't be needed forever. But, one thing at a time.

Dr. D talked about admitting me to the hospital tonight but based on my preference to be at home, she sent me on my way and scheduled my surgery for first thing tomorrow morning.

Stent and external tube options:

   

Que sera sera

• CT/MRI scans at the Barnes West County Imaging Center

I have been having a lot of back pain and problems with nausea and some vomiting, so I'm pretty concerned about today's scans. I took a nap in the hammock this afternoon though and that always helps to relax my nerves a little.

Go!

I woke up feeling okay this morning so we headed to Forest Park to participate in the Go! St. Louis 5k. We walked a lot, and even with that, it was probably near the limit of what I am physically capable of right now... which is both frustrating and satisfying at the same time. I get frustrated by the fatigue and pain that come with cancer and treatments, but I'm also satisfied that I continue to push myself to stay active and keep moving. My goal was to finish in under 40 minutes and we barely missed that, but we finished. And we had fans too!

Feed me Seymour

• Bloodwork and appointment with Dr. T at Siteman South County

We're going to give my body some time to recover from the radiation treatments. I'll have scans and a Guardant blood biopsy in 3 weeks and the results will shape our plans going forward.

Some good news is that my ANC is 1.2, which means that it has remained stable since my final hospital blood draw a couple weeks ago. It's still technically low but this appears to be my new normal.

Some bad news is that I've lost a couple more pounds. Dr. T mentioned that he could tell just by looking at me. So I need to do a better job of getting calories in. Sometimes with how my body is feeling, it's just the last thing I want to do.