Zapping Session #21 – Week Update

This morning’s Zapping Session #21 was canceled because of equipment issues—a make-up session will be added at the end—but the rest of this week’s zapping sessions were quite routine across the board, with a minor issue on Monday.

In addition to having to have a full bladder, you also have to have an empty rectum. Despite having had a bowel movement just prior to the session, the CT scan revealed a little stool left behind. That concerned the technicians, so they called the radiation oncologist over to see if they could proceed with the zapping. He gave the green light after evaluating the size and positioning and we completed the session as usual. That was a first. Glad to see that the imaging safeguard in place is working.

I had a different set of technicians zapping me this week and the one seemed to be a bit more persnickety about my bladder status, which I appreciate. She gave me some updated guidance on how to make sure my bladder was full. In essence, she said to make sure to drink water throughout the day so that my body is hydrated (especially in our warmer weather). Otherwise, if I’m not hydrated, when I drink the liter of water in the morning, it gets diverted to where it’s needed in the body first rather than to the bladder. Makes sense.

Based on that, I’ve actually started drinking water after each time I empty my bladder—even in the middle of the night—and that seems to have helped keep me closer to a full bladder (after only one day of using this method).

Yesterday’s session was the fastest yet: 23 minutes from leaving my house to being back in my house. The patient who’s normally ahead of me on the schedule was done, and not more than a few minutes after I checked in, I was on the table getting scanned for positioning.

That really makes me appreciate the fact that I am able to use this facility and not the other one offered up. The other facility is 18 miles / 29 km from home and, depending on the the time of day and traffic, it could take 35 to 60 minutes to get to, plus there could be delays at the entrance gate to the military base the hospital is located on. Managing bladder timing under those circumstances would have been a nightmare.

On a positive note, my fatigue has been noticeably less this week than last, and that’s a good thing. That just means that I have more energy to run to the toilet more frequently. 😂 The frequency is a bit annoying and even limiting.

I find that it’s a little challenging to go out and play immediately after the zapping session unless I could guarantee that a toilet is available on relatively short notice. After surging my system with water in the morning, I find that I’m emptying my bladder three or four times in the first two hours or so after the session ends. Once that water is purged from my system, I get back onto a more normal schedule of emptying my bladder every two hours or so, give or take.

Now, it’s off to the barber shop without fear of having to bust out of the chair and run to the toilet. I hope.

Enjoy the weekend and be well!

Thank You!

If you’ve read more than three posts on this blog, you already know that I’m a numbers guy. Well, on 29 July 2022, this little old blog that was created to share updates with family and friends has just surpassed a quarter million views from over 40,000 visitors.

Never in my dreams did I think this blog would have such a reach, so thanks to each and every one of you for following along and offering your insights and support.

With gratitude, —Dan

Zapping Session #16 – Update

This morning’s session had an unexpected surprise. At the end of the session, the technician told me that my bladder was “borderline” not filled enough, and I found that to be really odd. I used the same bladder-filling timeline and technique this morning that I’ve been using all along. She encouraged me to practice over the weekend.


I met with the radiation oncologist on Tuesday, which was unusual because our normally scheduled meeting day is Thursdays. He told me he was going away for a few weeks, and I asked him where he was going. Long story short, his wife is from Germany and they were going to visit her family in a town that was about an hour from where my grandfather was born. Also, his wife studied at Würzburg, and my cousin is a professor and doctor at the university hospital in Würzburg. Small world.

During the meeting, I mentioned that the side effects were beginning to kick in more, and he commented, “Yeah. You’re at the dosage level where they typically start showing up.” I thought that was interesting because I never considered there to be a dosage threshold for side effects. It makes perfect sense though.

Fatigue

The fatigue is really kicking in now, although it happens in waves of varying amplitudes. For example, after yesterday’s session (Thursday), I was energetic enough to stop by an event at my former employer and just hang out for a few hours and see how everyone was doing. By mid afternoon, I was a tad tired (70% on my internal “battery”) but was able to keep going through the afternoon, past dinner, and into the evening.

Today, though, was a considerably different story. As soon as I was done with the session at 10:15 a.m., I ran and bought groceries, had lunch, and by 11:45 a.m. my internal “battery” was down to about 20% and I was napping until about 2:30 p.m. Hard. Even now, as it’s approaching 4 p.m. as I’m writing this, I feel as though my battery is about 50-60% charged even after the nap.

I may attribute part of the fatigue to my urinary frequency, because it’s definitely increased through the week.

Wednesday night into Thursday morning, I had to empty my bladder just twice. Last night, I had to empty it four times. That’s four sleep interruptions that would contribute to the fatigue.

The doctor did offer to put me on Flomax (Tamsulosin) to relax my bladder and hopefully reduce the frequency. For now, I declined his offer because at some point years ago (perhaps even before I was diagnosed), I had been prescribed Flomax and I recall that it wasn’t a very positive experience with its side effects (extreme dizziness).

Urinary Frequency

As you saw in a previous post, I was using a spreadsheet to track when I was emptying my bladder, but that was cumbersome to use, especially logging an entry in the middle of the night. I found an app called “Simple Time Tracker” that has a widget that I can have on my phone’s home screen, and all I have to do is tap it to start recording when I go to the toilet and tap it again when I’m done. It automatically records the date and time, and that’s all that I’m after. (The only downside is that I can’t export the data to my spreadsheet.)

Between 1 a.m. and 4 p.m. today, I’ve made eleven trips to the toilet, and my only fluid intake was about 1.5 liters of water before the zapping session and another 0.5 liters of soda after the session. It’s not like I’m consuming a high volume of liquids to have me going so often.

Irritation

My skin irritation remains about the same and applying moisturizing lotion does help. But now I have a general constant mild burning sensation in my urethra and hints of it starting in my rectum. It doesn’t hurt to urinate (yet), but the burning sensation is mildly annoying right now. I also think the irritation in my urethra is triggering my brain to empty my bladder when I really could probably wait a while longer without incident. I’m guessing it will likely worsen as the cumulative dosage increases.

Emotions

For one of the first times since starting the hormone therapy, I found myself to be a bit on the emotional side this week. I’m guessing the fatigue contributed to that, too. I’ll leave it at that for now, and I may write about it separately in the days ahead.

Summary

After Monday’s session (1 August) I’ll be halfway through the treatments. If the side effects stay at the current level, that can be manageable. If they get worse, I guess I’ll just have to suck it up and power through them like the countless thousands of radiation patients before me.

Enjoy your weekend!

Day 4,273 – Fatigue Fatigue?

Okay. If this keeps up or gets worse, the fun will definitely be over. <sarcasm font>

Friday’s zapping session went amazingly well. From the time I closed my garage door, drove to the facility, got zapped, drove home, and opened the garage door it was 27 minutes. Total. We’re in the groove.

The kicker came in the afternoon.

My energy level just dropped to near zero and I went into a Rip van Winkle-like sleep for the whole afternoon. Not good. Even after the long nap, I was still pretty lethargic in the evening.

This morning (Saturday) was a different story. I was pretty energetic and worked on organizing my home office up until about noon. But about an hour into it, my energy level hit a brick wall and I was horizontal on the sofa again for a nap that lasted about ninety minutes.

The nap gave me a second wind of energy, but just a few short hours later around 6:30 p.m., I was dragging anchor again. (I’m powering through it right now as I write this so I’m not up all night because I napped this evening.)

I’m sure it’s a combination of the hormone therapy (started twelve weeks ago), the radiation, and the fact that I’m running to the toilet two to four times a night that’s causing all this. I’ve even started going to bed about two hours earlier than normal to try and make up for the sleep deficit through the night.

So, yes, I’m fatigued by the fatigue. I won’t say it’s incapacitating because I have pushed myself through a few low-energy sessions, but it is having an impact on my routine. I can only imagine what it will be like in three to five weeks if it keeps up like this. Sheesh! But, on the positive side: No hot flashes!

Monday’s session will be the one-third mark for the treatment. I guess that’s something to celebrate.

Be well!

Zapping Session #9 – Quasi-Fail

At the start of this adventure, I set a goal to not have my bladder interfere with a session. I failed that this morning.

I pretty much followed my normal drinking schedule to fill my bladder for the session, but I could tell driving into the parking lot that this was going to be a close call. They called me back to the zapping room pretty much on time, but there was another prostate patient wrapping up his session, so I had to wait another ten minutes. As I waited, I could feel the pressure in my bladder getting even worse.

When he wrapped up his session, they called me back to the table and I told them we were in the “danger zone,” so they put an absorbent pad on the table just in case. As I sat on the table, I realized that I wasn’t going to make it and made a mad dash to the toilet, getting there just in the nick of time. And, because once I start emptying my bladder, I can’t stop in mid-stream and only partially empty it. It’s all or nothing. My bladder was empty.😡

The technicians had me stay in the area, drink some more water, and wait while they mapped the next patient. About twenty minutes later, I was back on the table, absorbent pad still beneath me, and we zapped away. By the time we were done, I was making a second mad dash to the toilet because my bladder was filled to capacity again.

In the end, the session was completed successfully.

Watch “Biochemical Recurrence Post-radical Prostatectomy” on YouTube

I stumbled across this presentation in my YouTube feed and even though it’s about 10 years old, it contains a lot of good information for those with an increasing PSA after radical prostatectomy.

It gets into:

  • Biochemical Recurrence definition
  • Value of regular vs. ultra PSA tests
  • Survival
  • Imaging (again, dated because this is 10 years old)
  • Identifying good candidates for salvage therapy
  • Salvage RT toxicities and success rates

The video is about 52 minutes long, and the presenter shares information in an understandable way for us patients.

Zapping Session #7 – Canceled

This was interesting… About half an hour before my scheduled zapping time, I received a call saying that their Death Ray machine (my term, not theirs) was down and they needed to cancel today’s session. “We’ll just add it on at the end. See you Monday at your normal time.” Alrighty then…

That will take me to 31 August to wrap it all up, assuming there aren’t further hiccups.

Zapping Session # 6

I started my zapping sessions a week ago today and wrapped up my sixth session this morning.

Practicing filling and holding my bladder the week before the zapping started has paid off. I’ve been successful at filling and keeping a full bladder for every session. Although, on Tuesday there was a delay with the machine of about twenty minutes and I nearly had a bladder explosion on the table. That was cutting it a bit too close.

Every week, usually on Thursdays, I meet with the radiation oncologist to review how I’m doing and to discuss any side effects and answer any questions. That’s good.

As far as side effects are concerned, there are a few already popping up.

I’m not sure that it’s actually from the radiation yet, or simply because of the need to keep a full bladder, I am finding that I’ve been emptying my bladder more frequently. I mentioned that to the nurse, and she asked how frequently. I pulled out my phone and opened my log, looked at the numbers, and told her.
“You’re keeping a log??? I wish more patients did that!” (It’s good to be a nerd at times.)

It’s taken me a few days to get in the habit of documenting every time I pee, so that’s why you see so many incomplete entries on the first few days.

I’m also beginning to sense some skin irritation (itching, mainly) at the zapping site. It’s very mild and intermittent right now, and may increase over time. The irritation seems to be most prevalent within the first few hours after zapping. I guess it’s like a sunburn—it compounds itself as you go along with little time to heal in between. The doctor said that I could apply a moisturizing lotion after being zapped, but definitely not before being zapped.

The final side effect that’s beginning to take root is fatigue. I’m not sure that it’s actually from the radiation yet, or the fact that I’m peeing frequently through the nights, interrupting my sleep, or a combination of both. A little nap in the afternoon works just fine.

The radiation oncologists and the technicians both confirmed that they check that my bladder is sufficiently full and my rectum sufficiently empty on their scan before they start zapping to minimize any collateral damage. They said that if I wasn’t properly prepared, they’d tell me to get off the table and drink more water or poop. That’s reassuring to me.

I have to admit that it’s a tad annoying to have my retirement non-schedule interrupted by having a structured routine again. I was really getting used to not having to commute or show up to the office at a certain time every day. 🙂 Of course, I shouldn’t complain much because the whole process—driving there, waiting, zapping, and driving back—takes less than 45 minutes. Heck, yesterday, I was through the whole thing in exactly 30 minutes.

I have to admit, too, that I’m being a bit more cautious when going out in public with BA.5 COVID cases on the rise. I continue to wear my mask and am a bit more judicious in determining whether I want to go out. I know that radiation doesn’t necessarily compromise your immune system, but the last thing I need is a week or two delay in zapping if I came down with the virus.

So that’s my first week/six sessions of zapping under the belt. Thirty-three more to go.

Be well!

Zapping Session #1 – Done!

Just a quick post-zapping session post…

My appointment was at 9:45 a.m. and I arrived at the facility at 9:30 a.m. and met a friend who was there to provide a distraction and moral support—it was great to have him there.

I checked in and had about a ten minute wait before I was called back to the zapping room. There, the technicians explained what was going to happen and had me lie down on the table. We had a little challenge getting me lined up initially. I’m 6′ 1″ / 185.5 cm tall, and all of my height is from my waist up, so I had to scoot up on the table to get aligned.

They told me to wear gym shorts or sweat pants—something easy to pull down without metal (i.e., zippers) or items in my pocket. They put a sheet over my private parts, had me pull down my shorts to mid-thigh, and lined the lasers up on my new tattoos.

After that, they went into the control room and slid me into the machine. I stayed there for a good five minutes or so as they evaluated the fullness of my bladder (just right) and my positioning. They adjusted the table a few millimeters, all under the radiation oncologists supervision, and he gave them the green light to zap away.

The head of the machine rotates around the table, first in one direction and then in the opposite direction, buzzing as its delivering the radiation. That lasted probably around 5-8 minutes or so. It’s not like being in an MRI or CT scan tube at all. No need to feel claustrophobic.

As soon as they were done, they moved the table back to the start position, I got up, and walked out and hit the nearest toilet to empty my bladder. Easy-peasy. All totaled, including the drive there and back, I was gone about an hour.

The only surprise that I had was the paper copy of my zapping schedule that they handed to me. They have me scheduled for 39 sessions instead of the 35 that I thought we were doing. That has me ending on 30 August 2022. No biggie, I guess.

Lastly, they gave me a little ID card with a barcode on it and I simply scan it to check in for all my future zapping sessions.

I’ll have to admit that, a few days ago, I wasn’t all that emotionally worked up about this, and even this morning I thought I was pretty okay. But I can tell now just from the tension releasing from my body right now, I was far more worked up than I thought I was. The subconscious can do some weird things.

Going forward, I’ll probably not post about this after every session, but only when there are noteworthy things to report (like shorting out a multi-million dollar machine if I pee all over it or if/when the side effects start kicking in).

I need a nap. Or a beer. 🤣

Be well!

Day 4,255 – Green Light for SRT

I’m good to go to start my salvage radiation therapy on Thursday. Yippee. <sarcasm font>

You may recall in my last monthly update, I commented that I was having a dull ache in my testicles and groin. I really wanted to ensure that something weird wasn’t going on. Unfortunately, I experienced my first bit of a run-around with the VA Medical Center. After nearly a month of back-and-forth with the office and schedulers, I was able to see the urologist this afternoon.

In a nutshell, she did a physical exam and determined that there was no hernia. I can proceed with SRT Thursday.


I’ve continued my bladder-filing experiment through the weekend with mixed results. Again, I’m scheduled for zapping at 9:45 a.m. and I’m trying to be able to hold my bladder to at least 10:15 a.m.

Saturday, I had a complete fail—I couldn’t hold anything past 9:30 a.m., 15 minutes before my scheduled start time. Not good. Hopefully, I get this sorted out and what’s in my bladder will be sufficient for the zapping.

DateStart
Drinking
Stop
Drinking
Urgency
at 9:45 a.m.

(1-10)
Need to
Empty
Bladder
Volume
(1-10)
30 June8:459:15510:455
1 July8:359:10710:157
2 July8:309:0589:306
3 July8:459:15410:107
4 July8:409:15410:255
5 July8:309:15410:405

Regarding Eligard / hormone therapy side effects, I’m not complaining. Fatigue remains the prevalent side effect. Luckily, no hot flashes yet and, surprisingly, I can still achieve an erection and orgasm to about the same level as before the Eligard. (A bit more effort is required.)

I’m not sure how much I’ll write about the actual SRT once it gets started. I’ll probably stick to the noteworthy items along the way. Let’s hope it does the trick with minimal damage along the way.

Be well!