Zapping Session #25 – Update

This week’s sessions went well for the most part.

Tuesday, though, was a close call. As I was getting ready to leave the house, my brain was telling me to empty my bladder—soon. I debated whether to follow my brain knowing that I’d likely delay the zapping session because of emptying my bladder ten minutes before or just head off to the appointment hoping that I could hold it.

Death Ray Machine

Luckily, the technician came out within a minute of me scanning my barcoded check-in card and asked if I was ready. I told him, in a somewhat panicky voice, that I was more than ready and we had only a few minutes to get this done before the dam burst. We made it happen, and I was trotting out of the room to the nearest toilet, making it there by a matter of seconds before having to let it all out. Too close for comfort.

Thursday’s session wasn’t as fast, but had me on the brink and pretty much sprinting out of the treatment room to the toilet. Again, too close for comfort.

This morning’s session (Friday), the pendulum swung in the complete opposite direction. Despite following my normal fill-the-bladder routine, I could tell that I was nowhere near ready to get zapped. They skipped over me and took not one but two patients for their sessions as I waited for my bladder to fill. After the second patient, I hopped on the table, still a little uncertain about my bladder fullness, but the scan showed it was filled sufficiently to go ahead with the treatment (about 70%).


I met with the radiation oncologist on Monday and we talked about the fatigue and urinary frequency. Once again, he offered Flomax and I declined. However, Monday night and into the entire day Tuesday, I was emptying my bladder every sixty to ninety minutes, day and night. That gets old, fast. After my session on Wednesday, I spoke with the nurse, gave in, and requested the Flomax prescription.

The Flomax seemed to help that very first night, getting me down to two trips to the toilet. Last night was about as good with only three trips.

But, as I mentioned a few posts ago, I didn’t have a positive experience with Flomax the first time I tried it years ago, and it seems to be kicking me in the butt again by adding more side effects on top of the ones I’m already experiencing from the Eligard and radiation.

Of the listed Flomax side effects, I seem to be experiencing drowsiness, headache, body aches, and faster heart rate. Yippee.

Yesterday, my first full day on Flomax, I was exhausted the entire day (as if the fatigue from the radiation wasn’t bad enough…). I also had a low-grade headache throughout the day and just felt blah. The one that concerned me the most was the heart rate.

I monitor my blood pressure and pulse each morning and, since March, my resting pulse has been averaging 66 beats per minute. This morning, it was 88 bpm; yesterday, it was 74 bpm. That sudden uptick concerned me, so I spoke with the nurse about it this morning and she reassured me that it wasn’t a real problem, but something to keep an eye on if it keeps increasing.

I’ll continue with the Flomax for now because they say it can take five or so days for it to really settle into your system. But if these issues continue or intensify, we’ll have a discussion about continuing on Flomax.


On a more positive note, I did manage to join a friend for lunch on Wednesday and that went fine, with preventative runs to the toilet just before entering the restaurant and just before driving home. By the end of the lunch, though, I was fading fast and was ready for a little siesta at home.

At this point—compared to how I was doing last winter when my only concern was a rising PSA—I can tell that I’m on the “treatment is worse than the disease” roller coaster. I know that many of these side effects are supposed to subside within a few months after treatment ends, and I’m looking forward to that happening. In the meantime, ten more sessions / two weeks to go!

On that note, I’ll wish you a happy weekend! Be well.

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.

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!

Day 4,251 – Experimenting

The engineer in me is alive and well. In preparation for starting salvage radiation therapy next week, I’ve started experimenting with the timing and volume of water needed to have a full bladder at just the right time.

The instructions I was given were to drink a liter of water and have completed doing so by 30 to 45 minutes before my scheduled appointment time. Because I can’t drink an entire liter in one shot, I give myself about 30-40 minutes to do so. I also created two rating scales (purely subjective, of course).

The first rating scale is the sense of urgency that I have at the scheduled start time of the zapping. I use a scale of 1 to 10, with one being, “I got this,” to ten being, “Get outta my way I’m gonna to pee in my pants!!” The second scale is an estimate of volume when I finally do empty my bladder. (During my mapping, we had to wait because my bladder wasn’t full enough.)

For reference, my zapping appointments are scheduled at 9:45 a.m. I figure that I’ll have to hold my bladder until at least 10:15 a.m. to allow for getting me aligned and get through the actual zapping itself.

Yesterday, my first experiment day, I started drinking at 8:45 a.m. and had consumed the full liter by 9:15 a.m., 30 minutes before the scheduled zapping start time. At 9:45 a.m., I rated my urgency at a 5 and, interestingly, I was able to not empty my bladder until 10:45 a.m. However, I was surprised that the volume was lower than I expected it and rated it a 5 (out of 10). I suspect that would have delayed the zapping a bit.

Today, I started drinking a little earlier at 8:35 a.m. in hopes of having a more full bladder. I stopped drinking at 9:10 a.m., 35 minutes before the scheduled start time. At 9:45 a.m., I rated my urgency as a 7 and had to empty my bladder at 10:15 a.m., with a higher volume output than the day before (also rated a 7).

DateStart
Drinking
Stop
Drinking
Urgency
at 9:45 a.m.
Need to
Empty
Bladder
Volume
30 June8:459:15510:455
1 July8:359:10710:157

I’ll continue to do this up until the start date to try and zero in on the perfect timing so the zapping goes as smoothly as possible once it starts next Thursday.

Yes, I’m a nerd.

Be well!

Day 4,236 – Mapping Completed

This morning, I got my first tattoos as part of the mapping process.

The whole thing went quite smoothly. My appointment was at 10 a.m., so I started downing a liter of water around 9 a.m. to make sure that my bladder was full. I may have consumed it a little slower than I should have, because when I was on the table, the technician said my bladder wasn’t quite full enough so we waited a few minutes to let my kidneys process my intake.

The cool temperature in the room accelerated my desire to run to the toilet to let all the water out, but I was able to hold on until the scan and tattooing were completed. But not by much.

The actual zapping will begin on Thursday, 7 July 2022 and go for seven weeks, which should put the end on 24 August if I counted days correctly while waiting. That means I have a few weeks to play before being tied to the zapping schedule.

Be well!


The photo is somewhere in central Kansas as storms were brewing. I didn’t see Dorothy or Toto. 🙂