Re: Dr. Myers Appointment On Friday

May 2, 2012

Could you please post your PCa history again. Can't remember ;-).

May 2, 2012

Thank you GENERALYour preferred name: JackiePatient’s name or nickname: ElgieYour relationship to him: WifeLocation/Country: USAAge at Diagnosis:56Patient's general health: Good/ lower back arthritis Very painfulIs there any family history of breast or prostate cancer? NoneDOCTOR'S INFORMATIONDate of DRE:??? Diagnosed November 2003 DRE positive or negative: Positive(It is positive if the doctor felt something)Stage given at time of DRE: Stage lll (T3 N0 M0) This Stage was last updated in 2004(The doctor stages the disease at the time of the DRE)PSAPast PSA history: (5 years if available)PSA when found 6.3PSA before Radical ProstatectomyNov. 10 2003 6.3After Radical ProstatectomyApril 26 2004 0.3Post SurgeryMay 4, 2004 0.3May 25, 2004 0.3Nov 2004 0.2Post RadiationMay 2005 0.04Nov 2005 0.1June 2006 0.1Jan 2007 0.3July 2007 0.5March 2008 0.8Sept 2008 0.9March 2009 1.15Nov 2009 1.93June 2010 2.6Jan 2011 3.9July 2011 5.9Dec 2011 0.51BIOPSY INFORMATIONDate of Biopsy: January or February 2004Gleason

score assigned by local pathologist: 3 + 4 = 7 with focal pattern 5, Tumor site Right and Left portions of the prostate gland 4 core needle samples on left compromising 80% of specimen, Right biopsies negativeGleason score assigned by expert pathologist: (If slides sent for second opinion)OTHER TESTSBone or CT scans: (results) July 2011 cancer in pelvic area in boneEndorectal MRI or ProstaScint: (findings) ???Other

Blood tests: (findings) Has been anemic on and off for a few years. At

one time they prescribed Iron. Nothing prescribed for anemia last 3 years. OTHER DOCTORS CONSULTED and their opinions, advice or findings.Urologist - Radical Prostatectomy, 38 IRMT treatments, watchful

waiting, Bone Scan show pelvic cancer in bone, Casodex 2 weeks and Elgiard and come back in 6 months. Radiation Oncologist: 38 IRMT treatments ended October 2004Medical Oncologist: Going for 1st visit Medical Oncologist, Dr. Denmeade & Nurse Practitioner October 11, 2011 Had 1st Appointment at s Hopkins Medical Oncologist Dr. Denmeade & Colleagues Megace

40 mg prescribed for hot flashes. Advice from these doctors was to have a psa in 3 months, 6 months and to come back to them or other Medical Oncologist after the 6 month psa and decide the next steps to take. The Doctors said there are about 10 more treatments after the Eligard. Other: For the last month a recent red lined half moon rash above eye and in middle of forehead. Prominent at different times. No consistence. Appears at will. TREATMENT HISTORYHistory

of treatments and results in chronological order since diagnosis, including pathology results after surgery if applicable, and additional info if initial treatment failed.Urologist -April 2004 Radical ProstatectomyIRMT 38 treatments ended October 2004Watchful waiting until July 2011Bone Scan July 2011 show pelvic cancer in boneAugust 2011Casodex 4 weeks August 2011 Eligard and come back in 6 months January 2012 s Hopkins Appointment. PSA low enough to hold off on Eligard Shot. Re-evaluate in 3 months. OTHER INFORMATIONNovember

2011 He is experiencing hot flushes.... day and night, many aches and pains, is feeling very weak, tired (sleeps most of the time) and simply doesn't feel good at all. He Is also having problems with his memory.November

15,2011~My Bf is so very tired every day and is finding it more and more difficult to get out of bed each day. He feels so very miserable since about a month after the Eligard. He is so tired of feeling so bad.

Within the last month and a 1/2 moon red line has appeared on one half of his forehead and eye. I am hoping to get any input as we won't have an appointment until April of 2012.November 17, 2011~The results

from the blood work for my husband today shows that his triglycerides are over 550. He use to be 200's. We are not sure why because he eats a good diet. We have to inquire if the Eligard has caused this. His blood count is 11.5 which he usually is around a 13.5 . The doctor wants us to

check the triglycerides in 3 months again and check the blood count in a

month. As for the red mark on his face and eye..........they gave him a

fungal cream prescription. We have to follow up with the Family doctor in 4 weeks. He also increased his Cymbalta from 30 to 60 mg a day. We will continue working toward getting to Dr. Meyers for a 2nd opinion. We

have also started him back on Soy milk and soy products. Sure hope this

helps him.December 2011Heart Doctor Appointment - Heart Monitor, Stress Test = Irregular heart beat / Increased Carvedilol / 2 weeks later Heart Monitor / Carvedilol stopped Irregular Heart Beat

Increased Carvedilol to 12.5 twice a day. Heart is beating 55. Strong and no longer enlarged as was previously........10 years ago. Follow up

in 6 months. January 11, 2012 These are test that are lower, higher or have changed since last blood draw even if I do not know what some are... Triglycerides have dropped dramatically to 152 with new

blood work/ Good cholesterol at 265 High / HDL 112 / Vitamin B-12 187

/ and received a B-12 shot once a month for now / Total Protein is low

6.20 / Glucose 102 / BUN 27 High / BUN/Creatinine Ratio 25 High / AST(SGOT) 58 High / PSA 0.51 / RBC 3.42 Low / HGB 11.8 Low / HCT 35.2

Low / MCV 102.9 High / MCH 34.5 High / Glucose 102 / Steroids for about a week for eczema on arms and legs....started to help and now getting back to worse. Using Elecon cream daily. Switched from Elecon

cream to another cream. Eczema got much worse and is now healing somewhat. Follow up with Family Doctor every month. January

28, 2012 Elgie has gone from one extreme to the other with his sleeping & well being. He was sleeping and tired previously and then he couldn't sleep and now for the last 4 days he is sleeping better

and feeling better and it's almost time for the next shot. It seems like it took about 4 1/2 months to start feeling better after the Eligard. March 21, 2012 Feeling okay but still very tired. Back has been much worse. Taking much longer {2 hours} to loosen up in the a.m.

PC Digest : viewtopic.php?f=14 & t=6479 (¯`v´¯).`·.¸.·´ ¸.·´¸.·´¨) ¸.·*¨)(¸.·´ (¸.·´ .·´ ¸ JackieTo: ProstateCancerSupport From: djmarchand@...Date: Wed, 2 May 2012 20:25:12 +0000Subject: Re: Dr. Myers Appointment On Friday

Could you please post your PCa history again. Can't remember ;-).

May 3, 2012

Jackie wrote:

> Leaving tomorrow to drive to VA for Elgie's appointment with

> Dr. Myers. Wanted to know if there are any specific

> questions we should be asking.

Hello Jackie,

Here are some suggestions. This is far from an exhaustive list,

but they're what occurred to me after reading Elgie's history

that you posted.

- What are the likely causes of all of the nasty symptoms that

Elgie has been experiencing?

Go through each one - tiredness, aches and pains, weakness,

memory, blood work, heart problems.

- Are there ways to alleviate them?

Exercise? Most men on ADT find exercise to be essential in

combating weakness and tiredness and joint pain. It helped

me tremendously when I was on ADT.

Different drugs instead of Eligard?

Note: It looks like it was a mistake to give Elgie enough

Eligard to last 6 months. A better plan would probably have

been to give enough to last one month, so that if things went

wrong a change could be made in one month instead of six

months. I think that Elgie's next prescription should be for

a shorter term dose.

- What are the likely causes of Elgie's feeling better?

Adapting to the drugs?

The drugs wearing off? (I suspect that's the main reason.)

- What is the right treatment for PCa in light of Elgie's heart

problems?

Dr. Myers has said that he has more patients dying of heart

disease than PCa, and he is very conscious of the issues

regarding hormone therapy and heart disease. He's also big

on heart healthy lifestyles.

- What diet, supplements, exercise, etc. should Elgie use?

Ask him for a recommendation for any books or websites on

this. Making a few notes in a consultation can't give you

the comprehensive information you can get from a book.

- Where should Elgie get follow on treatment?

One of the issues you will need to decide upon is whether to

switch completely over to treatment by Dr. Myers, or just to

see him for an evaluation and consultation while continuing

to get primary treatment at Hopkins or elsewhere.

I suspect that Dr. Myers knows a lot of the Hopkins doctors

and can suggest someone there to see if necessary. It's

certainly a well regarded hospital and I'm sure they have

some excellent people.

You may have financial/insurance questions to ask in this

regard, and Dr. Myers may have some sort of business or

office manager who can go over the issues with you in more

detail.

Make a written list of all your questions so that you don't

forget any of them.

Consider bringing a recorder to the meeting and certainly take

good notes. One of you might make notes while the other talks.

Don't be shy about asking embarrassing questions, for example

about sex or emotional issues. You're not going to ask anything

that Dr. Myers hasn't heard a thousand times already and he's not

going to think even a tiny amount less of you for asking. He's

going to treat all questions in a straightforward and objective

manner and he may be able to help. If you have such question,

write them down on your list too.

Don't hesitate to say, " Hold on, let me finish writing this

down before you go on " , if that's what you need to do, or to ask

questions like, " Did you say ...? " , " What was the name of that

(drug/disease/condition/doctor/supplement) again? " I think

doctors like to see their patients be serious about writing down

the advice they're getting and not just nodding their heads and

forgetting it all by the time they get home.

You can also try searching Google for " what questions to ask the

oncologist about prostate cancer " . Most of what you get will be

useless because most of the websites are giving advice to people

who just been diagnosed, not gone through as much as Elgie has.

But you might pick up something useful.

I hope this helps and I wish the best of luck to both of you.

Alan

May 3, 2012

Thank you so very much Alan. We are excited, nervous, apprehensive & other emotions at this point. We are so greatful because you forget so many things when you're all of these things. 15 hours and counting down..... (¯`v´¯).`·.¸.·´ ¸.·´¸.·´¨) ¸.·*¨)(¸.·´ (¸.·´ .·´ ¸ Jackie To: ProstateCancerSupport From: ameyer2@...Date: Thu, 3 May 2012 16:47:51 -0700Subject: Re: Dr. Myers Appointment On Friday