November
19, 2020 - The COVID Year
Well, the February
checkup went okay. My testosterone level
went back down below 30 and my PSA went up to .08. Since then my PSA has gone up to .10 then .15
each of the remaining quarters. Of
course I was hoping for less, but I am not in a state of panic yet. I guess I won’t be going off Lupron for the
foreseeable future.
My diet has
suffered thanks to COVID, but I also have some new rules on exercising thanks
to Kathe.
Pandemic
Right after I wrote
my last blog entry, we started to learn about the coronavirus. We were scheduled to go on a cruise in early
March. We decided to take our chances
when we heard the cruise line was taking precautions. We were screened verbally, our temperatures were
taken before boarding and were told to be very careful about hand washing,
getting close to people, etc. The cruise
line and most passengers were taking it seriously. We were on board when the president had his
first major press conference showing his reaction to the virus (that it was
like the flu and was totally under control).
I immediately knew the country was in trouble. I was expecting the more typical reaction of
past presidents which would have been throwing all available resources at this
serious potential public health problem.
We left the ship on March 15th after cruising the Caribbean,
expecting some screening at Customs and Immigration. There was no screening whatsoever. We headed home from Ft. Lauderdale, stopping
at Costco on the way wearing our masks.
There was an armed guard at the door and people were social
distancing. There was no toilet paper!
We totally isolated
ourselves for the next two weeks. Since
then have gone out no more than twice per week to pick up supplies. In the early days we did curbside pickups and
then, out of frustration because the pickers couldn’t read our minds for things
like substitutions, I have been going off-hours to Walmart to do the shopping
while always wearing a mask. It has been like that for the past 7 months. We have had very occasional outdoor social
distance gatherings with the neighbors we see as treating this seriously, while
avoiding those that seem to think they are invincible. We do walk the dog regularly. We now only have one dog, having lost our
Winky in September to what we think was a stroke.
In April I had some
congestion, so I had a COVID test. It
was negative, so I chalked it up to allergies. That said, I have a belief that
one of the things we always take when we think we might be exposed to people
with colds or flu has given us a small level of protection against the
virus. This is Grapefruit Seed Extract
(GSE) which has properties that help fortify the immune system. We take 10 drops in water once or twice per day. We do this especially when we travel. As a result we seldom get the dreaded “travel
cold”. You might want to check this out.
Diet
and Exercise
With spending so
much time inside it has been tough to stay on the no sugar/low carb diet. I crave more snacks than normal and there is
so little I can eat that is low carb. I
end up eating way too much containing sugar substitutes and way too many
processed foods. To make matters more
challenging, Kathe is on a diet that is way too high in carbs, so I am fending
for myself a lot. I know this has not helped my fight against rising PSA. The good news for Kathe is that she has lost
15 pounds since the beginning of the year.
In past posts I had
mentioned my chest pains that no one seemed to be able to explain, even after a
stress test and other attempts at diagnosis.
I also had another problem with being “regular” as well. On a positive
note, thanks to my primary care doctor, I took him up on a suggestion to eat
100% bran cereal instead of oatmeal for breakfast. Both problems have seemed to go away, so I
think it may have been a combination of constipation and heartburn that led to
chest pains. 100% bran is great!
As for exercise, Kathe
and I now have a rule that we can’t watch TV unless we have exercised that
day. This has forced both of us to
exercise more. I am doing weight-bearing
exercises and stretching and she is doing aerobics. I also walk the dog at least an hour per
day. We have had our days without TV,
however.
UTI
In April I had an
experience I had in the past. I had a
blockage in my urinary tract that was excruciatingly painful. I tried to get an emergency appointment with
a local urologist without success, then with my primary care doctor without
success, so I ended up in the emergency room where thankfully I passed a
clot. This relieved the pressure and
pain. The diagnosis was a Urinary Tract
Infection (UTI). I started a course of Bactrim
antibiotic with that stuff that turns urine into major staining agent (Cystex). I finally got an appointment with my primary
care doctor and he switched the Bactrim antibiotic with one he said was much
stronger (levofloxacin). After about 4
levofoxacin pills I very painfully pulled a tendon in my left arch while
walking. Only then did I read that insert
that came with the levofloxacin . It
warned against tendon pulls! I
immediately stopped the levofloxacin and went back to Bactrim.
Anyway, I was
hoping that my May PSA rise in May was connected to the UTI. When my PSA went up in November, I ruled the
UTI out.
What’s
Next?
I have to get back
to a better diet. At the same time it is
becoming time to get a new PET/CT scan to see if anything is happening with my metastases. I know I have a low PSA, but because I have
always had a low PSA, things could be happening in there. I have been having some strange pains
recently in my cranium and chest where I know I have mets.
I would like to get
one of the new PSMA PET/CT scans that hasn’t been FDA approved. My doctor back in San Diego told me he
thought he could get me into UCLA to have a PSMA scan, but I don’t live there
anymore and there is COVID to consider. From
my research the next closest available PSMA scan would be Johns Hopkins in
Baltimore. Boy, is it hard to find
things like this out!
I can get another
Axumin scan which I have found by attending a seminar is in the same
sensitivity ballpark as PSMA.
Unfortunately my hospital in Charleston doesn’t do Axumin scans, but I
am told that a more local hospital in Savannah does do them. The challenge will be how to get the right
contacts and the prescription to get the full body scan. I am requesting the results of my last Axumin
scan from San Diego in the meantime.
Note: The most available PET/CT
scan is far too insensitive to be of use to me.
In the Axumin
seminar they said that the sensitivity is such that they can reliably find mets
when the PSA is above .79 and even when it is as low as .50. Mine is .15, so there is a question as to
whether, even with my classically low PSA, it is too early to be able to see
anything with the scan. I really need to
talk to an expert radiologist about this.
My last scan was done when I had a PSA of .03 and the result was “no new
growth”.
That’s enough for
now…