Tuesday, August 18, 2009

August 18, 2009 Who Do You Race For?















MY NAME IS BRETT TROIA and I AM A PROSTATE CANCER SURVIVOR!

Help me raise funds and awareness for The Prostate Cancer Foundation while competing in the IRONMAN FLORIDA on November 7, 2009.

Please follow the link below to donate to my cause; <http://athletes.kintera.org/2009triathlon/bretttroia?faf=1&e=2422136044> to visit my personal web page and help me in my efforts to support Prostate Cancer Foundation
Brett Troia is "raising awareness and funds to change the face of prostate cancer"

As you may be aware, I was diagnosed Dec 3, 2008 with prostate cancer. I have since had a robotic prostatectomy, been diagnosed cancer free and well on my way to a full recovery. This year I will be "racing for the cure" with Athletes for a Cure in the Florida IRONMAN Triathlon on 11/07/2009. In addition, I am committed to supporting the Prostate Cancer Foundation by setting a fundraising goal of $10,000 for prostate cancer research.
Prostate cancer is the most common non-skin cancer in America, affecting one in six men. Men are 35% more likely to be diagnosed with prostate cancer than women are to be diagnosed with breast cancer.

Athletes for a Cure, a program of the Prostate Cancer Foundation, is a new fundraising and awareness program to assist individual athletes in their quest to raise money for better treatments and a cure for prostate cancer. The Prostate Cancer Foundation is the world’s largest philanthropic source of support for prostate cancer research with a simple, yet urgent goal: to find better treatments and a cure for recurrent prostate cancer.
I am dedicated to this cause, this race and hope that you will support me in reaching my fundraising goal.





Monday, August 10, 2009

August 6, 2009 The "GREY AREAS"

All this was posted on the http://athletesforacure.ning.com/ website by a friend (and site creator) of mine Greta Rose Zagarino;

"Member Brett Troia, prostate cancer survivor and triathlete, is experiencing an important "grey area" among his medical team: as a young man of 41, what are the typical physical traits of an Ironman triathlete compared to those of a young prostate cancer survivor? His doctors aren't quite sure.

Can we get some important feedback from some of the IMers out there who DON'T have prostate cancer, so we can compare? Specifically, do male IMers regularly experience a decrease in potency and other physical misc. levels when their training is at a max level? This information will give Brett and his doctors really valuable information about his health, and may help other men out there with the same question. Could be good or bad news for him, and he needs to know.

This is a great opportunity to put this NING community to use. Thanks for your help and participation."

Here is another link for Prostate Cancer information, this includes PC survivors who chose the robotic prostatectomy with Dr. Vipul Patel, http://www.vipfriendsonline.com/bretttroia.html

Sunday, August 2, 2009

July 31, 2009 Who Do You Race For?

Athletes For A Cure wants to know, "Who Do You Race For?"

Here is my 1 min 30 second response....



video

Brett Troia was diagnosed on December 3, 2008 with Prostate Cancer and now he runs to raise funds and awareness for the Prostate Cancer Foundation.

MY NAME IS BRETT TROIA and I AM A PROSTATE CANCER SURVIVOR!Help me raise funds and awareness for The Prostate Cancer Foundation while competing in the IRONMAN FLORIDA on November 7, 2009.

Brett Troia is “raising awareness and funds to change the face of prostate cancer”

If you'd like to help me fundraise; Please join me in supporting a great cause as I compete in the Ironman Florida Nov 7, 2009: http://bit.ly/KyAZR

Tuesday, July 14, 2009

July 13, 2009 Where Have You Been?


Well let me start with a "Hello" and apologize that it's been so long since a post; 53 days to be exact.

Today, July 13 2009 is 14 weeks since surgery and I am thrilled to tell you that things are progressing along quite well. There is a lot of catching up to do so I'll do my best using bullet format.

- June 12, I had my first follow-up with Dr. Patel since the catheter removal, the visit went well; he was pleased with my PSA of 0.00, thought that my incisions healed up nicely, happy to hear I was training again but not so excited with respect to my "continence" or "dryness" percentages. The bottom line was, "Just do the exercises I told you to do, 300 kegels daily and things will get better" Dr. Patel didn't exactly tell me that I have been a disobedient patient through recovery but it didn't require much discernment.

- May 30, through much consultation, my wife's (Kim) approval, my friends 'The Peavy Persuasion" factor, Athletes For A Cure friends and some IRONMAN strings being pulled I accepted a "media slot entry" for the 2009 IRONMAN Florida on November 7. I began training June 1 (5 months from race day) and was provided with a "gift" from a very close friend of mine, he provided a training opportunity from a professional triathlete, Carole Sharpless. Follow the days up until the race on the IM counter on my frontpage.

- June 1, officially kicked off the training and fundraising to raise funds and awareness to change the face of prostate cancer. Help me raise funds and awareness for The Prostate Cancer Foundation while competing in the IRONMAN FLORIDA on November 7, 2009. As you may be aware, I was diagnosed Dec 3, 2008 with prostate cancer. I have since had a robotic prostatectomy, been diagnosed cancer free and well on my way to a full recovery. This year I will be "racing for the cure” with Athletes for a Cure in the Florida IRONMAN Triathlon on 11/07/2009. In addition, I am committed to supporting the Prostate Cancer Foundation by setting a fundraising goal of $10,000 for prostate cancer research.

Please follow the link below to donate to my cause;
Follow This Link http://www.kintera.org/faf/donorReg/donorPledge.asp?faf=1&e=2422136044&ievent=186390&supId=232476329 to visit my personal web page and help me in my efforts to support Prostate Cancer Foundation.

- June 9, had an opportunity to be interviewed by CURE Magazine regarding The New England Journal of Medicine report on PSA testing. For those of you that have followed my journey you that without PSA "testing early and often" for me we would not have diagnosed the prostate cancer yet. I was also asked by them to do a photo shoot for the article. The story should be in the FALL 09 issue of CURE.

- June 21, Father's Day, what a glorious day this was, a day to be THANKFUL for so much in life, GOD has blessed me with two beautiful girls and a wonderful wife. So much in life we take for granted until something so subtly reminds us. James 4:14. "You do not know what your life will be like tomorrow. You are just a vapor that appears for a little while and then vanishes away."

- June 21, I did it, I broke down and started a FACEBOOK page (well my daughter did it) for several reasons. I realize how AWESOME this blog has been (reaching over 4000 hits) for helping others with the same diagnosis and allowing friends and family to follow our journey. I want to use this cancer as an opportunity for outreach to help and inform others. If I can reach more people via FACEBOOK, then I'm all for it. If it increases my ability to reach people for raising funds and awareness then it makes sense. I feel that soon the blog will reach it's end and be available for those too come.

Here are my FACEBOOK and TWITTER links;

http://www.facebook.com/home.php?#/home.php?ref=home

http://twitter.com/bretttroia

As for my health; things are progressing, I do not have any issues to really report. I am training at full performance level for Ironman with no restrictions. With respect to potency I am approximately 80% (not requiring any medicinal assistance) and continence I am approximately 60% (not requiring any pads.) I continue to perform the prescribed 300 kegels per day and must be aware of urinary frequency required.

Thursday, May 21, 2009

May 21, 2009 Jeopardy





"I'll take prostate cancer for $1000 Trebek"

"0.00"

"What is Brett Troia's PSA level?"

Correct, I just received these results, dually confirming the pathology report from April 8, 2009. Brett Troia is "CANCER FREE" or should I say "cancer FREE," it doesn't deserve the CAPITALIZED emphasis.

As I mentioned several times before this is truly God's grace, compassion and glory. Thank GOD for my awesome medical team Dr. Vip Patel and Staff, Dr. Mike Jenkins and Staff, and Dr. Stephen Armistead and Staff!

I ask all of you to help me in my pursuit to raise funds and awareness while changing the face of prostate cancer. Please follow the link below to donate to my cause;

http://athletes.kintera.org/2009triathlon/bretttroia?faf=1&e=2422136044

(if the link is broken, please cut and paste into your web browser.)

Sunday, May 17, 2009

May 15, 2009 Intuitive Interview

During the 2009 World Robotic Urological Symposium in Orlando I was interviewed by Intuitive Surgical Inc. Intuitive Surgical designs and builds the da Vinci Surgical System, the breakthrough platform for robotically assisted minimally invasive surgery. The following caption is from the Florida Hospital website

"When Brett Troia was diagnosed with prostate cancer, he researched the best possible treatment for his condition and circumstances. He was referred to Dr. Vipul Patel by his physician, who performed a robotic prostatectomy on Brett on April 6, 2009. This interview took place just two days after his surgery."

interview url:

www.globalroboticsinstitute.com/en/urology-robotic-prostatectomy/testimonials/brett-troia

May 14, 2009 SENSORed

My name is Brett Troia and I am a prostate cancer survivor and I am having difficulties regaining continence. This is the first step, admittance, of my latest program, “ The Pelvic Floor Rehabilitation/Bladder Program.” Not really but it makes me laugh out loud. For those of you that have been following the blog I am 52 days since surgery and progressing along quite well.

This program is run by a bladder control expert (Bea) at the PC Urological Center who has assured me that she can he assist me in regaining control if I just trust and follow her directions. So I fully committed myself into her wise counsel. She asked if I had any inclination into what the program entailed, I explained that I was told that it might be a bit embarrassing and that it would be really fun.

The session is a series of steps;
1. Conduct a measurement of post-voiding residual urine and/or bladder capacity by ultrasound, retraining the bladder to empty
2. Anorectal manometry; this measures the strength/weakness of the pelvic floor muscles, allows the patient to visually see the baseline and progress at each session. Used to prescribe the correct amount of Kegel exercise.

3. Electromyography (EMG) testing to measure the electrical system of the pelvic floor muscles, these muscles contract by the way of electricity, visually monitoring if the muscles are relaxing or spasming.

4. Application of electrical stimulation to the pelvic muscles to strengthen and relax the pelvic muscles.

5. Instructions for completing a one day log of all voiding activity; to include measurement of each and any leakage throughout the day.
6. Instructions for daily Kegel exercises; contract the muscle and hold for 6 seconds, then relax the muscle for 6 seconds (this is one cycle). Repeat this cycle 4 times and perform this rep 4 times a day at least 3 hours apart.

What I did not tell you was that a rectal sensor, which is inserted into your rectum, completes steps two thru four. This is an imperative detail for those of you men that may choose the added benefit of the bladder program. Note; “it should not cause pain or discomfort!” Hmmm...discomfort really is all relative. The initial consult prescribes four sessions, once a week for ~60 minutes and then reassessment.

I should add that the experience although a bit intrusive and intimate does provide a glimmer of hope. Understand that this program is optional and that you could probably progress through these stages of incontinence on your own. Butt I'm a believer in seeking and taking all the "wise counsel" you can get.

Wednesday, May 13, 2009

May 10, 2009 TRI event weekend

Just a quick blurb from the Panama City, FL TRI weekend.

First and foremost HAPPY belated MOTHER'S DAY!

May 9, 2009

The Gulf Coast TRI (70.3) directed by Shelley Bramblett (an 'ol family friend) was May 9 on the beautiful Gulf Shores of PCB. I stood-by faithfully in all of my race support glory :) The race featured many of my local friends and the pro return of a family friend; Carole Sharpless. Carole returned after 19 months off, following a terrible accident during a training ride in Kona. She returned to the GCT and finished 3rd in the female pro category, a great return for a true athlete. As for my local TRI guys from "team proCURE" everyone finished safely. The PCB water kicked up for the swim start, while the wind blew on the bike course and the temperatures soared to 85 (with 87% humidity) for the 13.1-mile run. Did I mention that being in the recovery phase is great today?

I had an opportunity to visit with my Tallahassee fam, the Peavys and their friends while Sherrie Peavy once again endured the Gulf Coast Roast!





Sharpie and Kari







May 10, 2009

The KIDS TRI 2 event had 70 triathletes turnout for this Mother’s Day event. Race director Koren Kuna (another pal) from Kids Tri 2 provided flowers for the Mothers and will donate a portion of the entry proceeds to The FAN Club of Panama City, a women’s cancer support group.

Children from 5 to 10 years old completed a 100 yard swim, 3 mile bike, and a 1/2 mile run while the senior age group (11-15 years old) completed a 200 yard swim, 6 mile bike, and 1 mile run. Age group winner 9-10 girls Kari Troia brought home a victory today.

May 4, 2009 CROSS training

surgery: 28 days ago
blood flow: Levitra 3 times a week, 20mg
adult pads: as required, 4-6 per day
exercise: 2 mile per day walking, 300 kegels
follow up: 6 weeks (5/27 Orlando)
psa test: (5/14)

Great news; I have been cleared to begin exercise! Docs orders; take it slow, build-up to where you were prior to surgery and if there's any pain or blood (that is your body telling you too much too soon.)

CROSS training begins!

Where to begin, the spiritual CROSStraining; the emotions, the struggles, the talking, the support, the healing and the CROSS. I cannot begin to explain the range of emotions I have experienced during phase 1 "pre-op" and phase 2 "post-op or recovery." Last blog entry I began to experience some feelings of encouragement but over the past two weeks while my head felt right the disappointments continued. Honestly the problem is "I want control, I need control," this is my CROSS to bear and God in his infinite supremacy isn't ready for me to have control. (Ironic how control has specific meanings in this walk.) I believe that one of God's several messages is that this recovery process is about his timing and not mine. Again control. I just thank God that He recognizes us a fallible being and that He forgives us on a daily basis for our sinful nature.

The physical retraining has been slow for me; my earthly vessel is healed inside and out, my potency seems normal, while the continence is quite apparent drip-by-drip. Again "I want control, I need control," and it just isn't working out for me yet. I'm told it's takes time and that this too shall pass. I find it quite humorous that something so simple and trivial in the life of a healthy man has become some overbearingly consuming in the life of a "control junkie." No control for the one who craves control....lol. It really is irony at it's best. I cannot provide much clinical information except for an approximation of say 50% continence to date. I cannot leave home without extra pads.

So as I begin to retrain my athletic being; more struggles, more emotions and more walking. All the anxiety of the first bike ride, the first run and the first swim have been building. How would it feel on the bike seat, how would the gait be during the run and how would the stretching of each stroke feel. Interestingly enough the 43-mile bike ride was easy, the 45-minute swim was harder and the 6-mile run was excruciating. Did I mention that "I want control of my athletic recovery?" Again God showed me that I could have some of my normalcy back but it wasn't quite His timing for me to have it all back. I didn't nor wasn't prepared for how hard running (what just 29 days ago was second nature) would become. Accompanied by the searing Florida heat and humidity only makes it that much tougher.

As it feels like nothing is going right, I attempt to put it all in perspective, comparing it to Job who lost everything. Do I really have a right to whine. I mean I'm cancer free, I'm healthy, I have; an incredible wife, loving children, loving family, great friends, great church and a heavenly Father who loves me.

I guess I'm seeking that "AHA" moment that puts all of this into perspective for me, my family, my friends and you. If any of you see it or hear it, feel free to let me it on it. But until then I will continue to CROSStrain and wait on God's timing the best I can.

Tuesday, April 28, 2009

April 27, 2009 The Descent

surgery: 21 days ago
pain medicine: none
laxative: none
blood flow: Levitra 3 times a week, 20mg
adult pads: as required, 6-8 per day
exercise: 2 mile per day walking, 300 kegels
follow up: 6 weeks (5/27 Orlando)
psa test: (5/20)

Well, I 'm not sure where to begin, it's been two weeks since I've blogged and provided any update. I am not going to lie and tell you that it's been easy. It actually has been very difficult physically, mentally and spiritually.

I am continuing to heal physically, the physical exhaustion has subsided although I do tire easily. Internally all systems are back to functioning and the anesthesia effects are gone.

As for the urinary function; it has been a difficult few weeks, Friday (4/17) I woke feeling lousy, when I was urinating it felt like I was passing razor blades, obviously not good. I went to my general physician begging to urinate in a cup - the Bayer results showed traces of blood and bacteria present, looks like a urinary tract infection. I was prescribed Cipro for 5 days and they sent the sample to the lab for a culture.

The 6 incisions are less painful except for the one above the navel where they removed the prostate, Monday (4/20) I woke to an infected incision, back to my general physician, he was concerned that the Cipro may not be strong enough and prescribed Levaquin for 10 days. Let me add that it has now become protocol for me that any drug or diagnosis must also be run through Dr Patel (Orlando) and Dr. Jenkins (Panama City), so it's a 3 doctor balancing act. Dr. Patel advised against any more medication and to see Dr. Jenkins for it. Jenkins inspected it (4/21) and suggested we watch it for a few days. So Monday (4/27) Jenkins felt it was subsiding and offered two options, watch it or drain it and pack it until it clears. I chose the watch it method, it could impact my run in 6 days.

During the (4/21) Jenkins consult we discussed my urinary control, as I looked at my urologist (and friend) who feels responsible for my current situation, I finally lost control and broke down in tears. I explained to him that I was so prepared for the surgery, the minimally invasive, faster recovery surgery, that I forgot how hard it would be on the backside. For the last 11 days since the catheter removal I have been fighting this minor problem I have with leakage. I am totally able to sleep through the night with no issues, no pads, waking up urinating fine. But during the day with increased activity it's like a "leaking faucet" In fact this is my new Indian name "leaky faucet." But I cannot tell you how the most normal function to a man (urinating) can become the most humbling thing I've ever experienced. It consumed me for 11 days and filled me with anxiety, impatience and frustrations. Until I met with Jenkins, another man who just reached out wrapped his arms around me and said he understood, he loves me and it will be fine. The surgery was amazing and it just takes time, your stress and anxiety is going to increase your recovery, you have got to find a way to relax. And by the way, Jenkins you're responsible for saving my life.

The plan is to manage, exercise and control the bladder over the next two weeks and if things do not get better then we will discuss the bladder control program at the urological center. Jenkins feels that the results would/should be the same but to let him know.

As for physical exercise, NONE for 4 weeks, this magic date is approaching (5/4) with much excitement and anxiety. What will that first stride be like? Will it hurt, will I run differently to modify my rebuilt bladder neck and urinary system?

As for medicine, the 100 mg Viagra caused vision problems and diarrhea (took it twice), switched to 10 mg Cialis, it caused the most debilitating migraines and leg cramps (took it twice) and now I have 20 mg Levitra. It is the last medicine they can prescribe to keep the blood flowing. I can tell you some promising news, during the non-medicinal periods the male function that is so important has returned. I won't provide too much detail but what is factored is whether or not it could be utilized for sexual functions. You have to provide a firmness scale of 0-10 with and/or without prescription meds. Remember this is all medicinal at this stage of the recovery process.

In the infamous words of my lovely wife, "You are cancer free, your able to have erections, what's a little wee on yourself."

Things are beginning to gradually get better;

I received a phone call from another prostate cancer survivor, Darren Ritch (4/23), he explained that all these things are normal and that the frustration, the anxiety, the leaking, all normal. He also said that because of my physical condition going into the prostatectomy that I am recovering much faster than he did and that it won't be long until these little speed bumps will pass. My friend Darren has been such an inspiration, his ability to share via blog and his compassion for others has been unbelievable.

I also received a phone call from Dr. Patel (4/20) asking me how I was, I think he could discern the anxiety in my voice, he said that the surgery was a success, now relax and heal.

God in his providence has filled my journey with many wise and inspiring resources. He has blessed me throughout, He was with me through surgery but when I needed him most these past two weeks I forgot about Him. I climbed Everest April 6th praying for his safety, but then I went running down that mountain thinking I had control again. I cannot help but listen to the repetitive lessons for me directly; CONTROL. Ironic that this is now my last hurdle, my last humbling of this trial, CONTROLLING my bladder. God is GREAT, He placed two scriptures in my life during my devotional (4/22);

Do not be anxious about anything..Phil 4:6

Cast all your anxiety on Him..1Peter5:7

In my descent down the mountain, through cancer, through recovery, I am back to having a sense of peace and feeling of ease. I feel like I have my head back on straight and the few days of darkness is gone and there is only light ahead in this trial. It is a trial that requires support; from God, friends, family and physicians.

Wednesday, April 15, 2009

April 13, 2009 Recovery Begins - Docs orders

surgery: 7 days ago

catheter removal: 3 days ago

pain medicine: tramadol every 6 hours for pain

laxative: docusate sodium 2 daily for 10 days

blood flow: Viagra 3 times a week, 100mg

adult pads: as required

exercise: 1 mile per day walking, 300 kegels

follow up: 6 weeks

At this point the physical exhaustion is still there sleeping 10-12 hours, the pain is starting to subside and become more localized in the incisions (muscles) and the pelvic floor, most of the anesthesia physical effects have subsided, still awaiting the bowels to activate.

The key is to stay hydrated, but mentally you want to control urine flow so obviously you are automatically drinking less, DRINK. Hydrate and manage your trips to the restroom, plan on one every 30-40 minutes. Attempt to stop and start flow while urinating as well. Be aware, if the urine flow stops either you're dehydrated or you may have blockage. If it is blockage notify your surgeon immediately, you will be reinstalling the catheter. If your urine becomes bloody, this is a key sign that you are doing too much, back down and rest. It is nothing to be too concerned with unless it is a measurable amount.

As for physical exercise, NONE for 4 weeks, I assume each patient may be different. No running, no lifting more than 5 pounds, no core exercise, no stretching, no sexual stimulation. The walk is prescribed for at least one mile per day, the more you are stationary the sorer and tighter you become. The kegels which exercise the pelvic are key for the urine control, 300 per day. This is not an easy goal to meet. I did this prior to surgery so I was somewhat prepared for the tenacity of these exercises, they become much different post-surgery.

As for medicine, down to 1 pain pill as needed, the laxatives are must at this point and the Viagra is prescribed to increase the blood flow in the surgical region. I must add that the Viagra is only for blood flow at this point, directions were explicit that if anything were to occur it was not to be utilized - cold shower - this is medicinal recovery time - 4 weeks.

Incision care, showering is fine, no hot tub, bathtub or swimming pools for 4 weeks. The incisions are sealed up with glue. I have four incisions for the daVinci robot, 1 incision for the removal of the prostate and 1 drain hole for post-op.

Using the restroom for bowel movements, DO NOT FORCE anything (not gas nor excrement), you do not want to stress your bladder reconstruction during the healing process. Just let the laxatives do their job, if you slowly lean forward and then sit upright, alternating this will assist the laxatives and bowels.

The key is to relax and incur as little outside stress as possible. Stress will become your worst enemy. And I promise you this is not only physically stressful but psychologically and emotionally as well. So you will need to find ways to manage the stress.

I don't anticipate that this phase is going to be an easy trial.

April 12, 2009 Family Reunion











After 7 days in Orlando we returned home the eve of Easter. We were reunited with our loving children and were able to attend Easter Service @ our home church (NorthStar Church, http://www.northstarpc.org/) I've attached a few images to show you how grateful, fortunate and blessed I am. God certainly has given me three of the most incredible gifts that any man deserves.

As we close out Phase 1 (pre-op stage) and head into Phase 2 (recovery stage) I want to thank all those that have been so instrumental through prayer, support and love. We couldn't have made it this far without you. We have had incredible friends, family, surgeons, urologists, pastors, survivors, prayer warriors, house sitters, this list goes on. I also want to thank those of you who have had the courage to share your stories through blogging; Darren Ritch, Michael Vinecki and family, Rabbi Ed Weinsberg, through awareness; Athletes for A Cure (Zagarinos), Prostate Cancer Foundation, and Livestrong. I'm sure I missed many more.

I feel that the blog lost it's way and became a story this past week, understand it was a story, our story. But I want us to get back to the facts dealing with prostate cancer awareness. My intentions will be to keep posting my recovery updates on a weekly basis for those of you interested and searching for some answers. I can tell you ahead of time that this will be based on the struggles of recovery for continence and erectile function (and we may have to be black and white in our blogging.) I promise to do my best in using appropriate and discrete language.


Monday, April 13, 2009

April 12, Easter Sunday

I want to apologize for the late posting, this should have been posted yesterday! I also want to shift the momentum of my condition to the condition of the cross.

The cross is consistent, conquering, powerful and rugged. The cross's power is life-changing for all those that acknowledge it.

Easter is a season of promises fulfilled and promises waiting to be realized. It's about the cross, it's about the resurrection and being resurrected.

The Easter story is a message of hope, a message of Jesus conquering the grave, which means His followers can too.

God promises 3 types of life; changed life, abundant life and eternal life. For us we have most certainly experienced changed life (which is a daily struggle), we are certainly living in the abundant life (God has blessed us in so many ways) and the eternal life is just an instant away.

This season has certainly given us many reasons to rejoice in the resurrection of our Savior. We hope and pray that all is well with any person that may come in contact with this blog. If you have any questions regarding just how God has guided us through our experiences or any questions directly regarding treatment, surgery or recovery please feel free to contact us through the blog or via email. troiabj@knology.net Brett & Kim Troia

Saturday, April 11, 2009

April 11, 2009 he has risen indeed (a fitting pun)

After a relaxing afternoon at the pool with good bladder control, we thought, "Man, this is going to be a piece of cake!" By 11:00 that evening, we were having second thoughts, actually Brett was thinking - fearing, cringing at the thought, - "It would really stink if I have to have the catheter put back in." From about 5:00 p.m. until 11:00 there was no urge to empty the bladder, and no success when he tried. He began to worry, anxiety roars it's ugly head again. I am sure his stress was not helping. Blockage only occures in about 5% of the cases and since he had been going earlier in the day, I felt that he would be ok and knew that he needed to relax. Very easy for ME to say. I remembered the PA at Dr. Patel's office telling us that sitting in a warm bath may help. He sat in the tub for a few minutes - frustrated so he didn't stay long. I did my best to get him to relax, but found myself falling asleep. Brett took his medicine and went to sleep pad free. Next thing I knew it was 2:00 and Brett woke me up to tell me he was going "potty". Yeah!!!!! Actually, this was the second time he had gone. (He was also experiencing other things that you men out there can relate to - the natural male functions with early morning urinations - yeah baby!) Things are looking good. :) Baby New Year is making progress! Relieved, we both went back to sleep. From that point on, he went two more times before we got up at 7:00. I'm so proud of him - AND the awesome thing is that he has excellent bladder control and very little leakage. But, wait, there's more. We were lieing in bed watching a movie and off he goes to the bathroom. Yes!!! He finally had a movement, six days later! He's such a big boy! The moment was a monumental as Allison's and Kari's first bowel movement in the pot! Seriously though, he has to retrain his muscles as his body adjusts to the removal of the prostate. He is doing remarkably well. His stress is his worst enemy.

We're waiting to see what the weather is going to do. It's very foggy - zero visibility - so we haven't decided if we are going wait for the fog to lift and get a little pool time in or just hit the road back to Panama City. I'm not sure exactly what the drive home has in store for us. I anticipate a lot of pit stops!

April 10, 2009 Walnut

Meet "Walnut," a gift from one of my very best friends. Ken found this little fella, shaved him down, bandaged him up and sent him to Shingle Creek to be with us. I must admit he is appropriately named, I lost one and gained another. Thanks Ken, you always are able to find the positive and humorous spin in things.

Friday, April 10, 2009

April 10, 2009 Home Free

The morning was filled with a lot of anxiety and waiting, more anxiety and more waiting. Brett's past experiences with the removal of foreign objects has not been pleasant - wicked bladder spasms. So the thought of removing the catheter was bitter sweet -really making him anxious. Having to wait at the hospital for the cystogram was torture! He felt nauseous, his hands and nose were freezing, and was loosing the color in his face. Not a good scene! Not even my humor could distract him! Apparently, "they" were behind - like that never happens. Finally an end to the wait and off to X ray he goes. Good news, the bladder reconstruction is good - no leaks present. Next stop, Dr. Patel's office. Unfortunately, we had to wait there too. Yep, you guessed it, more anxiety. Now, he's really freaking out! I tried everything to keep him distracted. While he lie on the table looking so fashionable in his hospital gown and socks I examined his incisions (they look good by the way), I examined his ears, eyes, mouth, nose, and checked his lymph nodes. That worked for a few moments. Next I played with his toes and sang, "This Little Piggie" and had to laugh when I got to the last one who went wee wee wee all the way home. Oops - sorry Brett! My bag of tricks was about empty. At last, a knock at the door and in walks the nurse. Let me tell you, she was GOOD. She was talking to him and asking him questions, and unbeknownst to Brett, removing the catheter all at the same time. He didn't even feel it! No bladder spasms, no nothing! What was all the anxiety about! I told him he would be fine! Dr. Patel's visit was the grand finale. He expects Brett to recover much, much more quickly than the average patient and I so do I! He will need to refrain from physical activity for at least four weeks and follow up with a visit to Dr. Patel in six weeks. So it looks like we are HOME FREE! What a blessing!

April 10, 2009 Back to Reality - Phase 2

Although the circumstances for our mini-vacation were not the greatest we sure have had a wonderful week together. We have spent a lot of quality time; walking, talking, holding hands, being intimate. Something that we seem to take for granted in our busy hustle bustle lives. Another lesson learned, make time for those most important to you. But as our time of recovery ends, we must get back to reality, so.....

We are headed to Celebration this morning for a cystogram (a leak check of the reconstructed bladder and urethra) and hopeful removal of the catheter. I cannot lie, I am feeling a bit of anxiety this morning based on my historical physical reactions with bladder spasms. Kim also wanted to remind me that with the removal of the catheter comes a whole new set of issues, at this stage mainly continence and then of course erectile function. So we will manage one goal at a time, one day at a time, one prayer at a time.

Thursday, April 9, 2009

April 9, 2009 Recovery Room View
































This is the view from our Rosen Shingle Creek recovery room and an early morning photo of my 4:30 am walking attire.
Kim and I again want to Thank You ALL for your love, support and prayers throughout. We also want to thank you for your comments on the blog, we really look forward to reading them.

Wednesday, April 8, 2009

April 8, 2009 Cancer FREE

Today's update start's with a blessing, the pathology report is back and Brett is cancer FREE. The report showed 15% of the prostate being cancerous, a gleason score of 6 and the margins as zero. Both Dr. Patel and Dr. Jenkins were quite suprised with the percentage of cancer. You would expect 15% in someone much older than 41. Brett's prostate wouldn't have made it to 60, so the prostatectomy was definitely the best way to go!

Although we had a great day with great news, the 3:30 a.m. start was not very promising. Brett woke up with a lot of discomfort and was feeling pretty low. As he lied on the couch absorbed in his discomfort he was definitely feeling the effects of his surgery - finally feeling the "cancer". As you know, he never had any symptoms of the cancer growing inside. Although I could sympathasize with his discomfort, I had to remind him that it could be much worse. At one point I told him to suck it up and move on. What you are feeling right now is only temporary. With that said, we were off on our 4:00 walk. We cruised the halls of the 11th floor for about 30 minutes and then went back to sleep. The next time we woke up, he had a better attitude and a craving for a Chick-fil-A biscut and a cup of coffee with his urologist (Panama City doctor). So we were off, but not before a quick call to Dr. Patel's assistant just to let her know we would at the symposium. Long story short, Dr. Patel invited us to watch a live case at the symposium. So here we are - in the conference room at the World Robotic Urology Symposium eating parfait and watching a live prostatectomy in Chicago. Dr. Patel introduces us to the crowd and asks Brett if he wants to ask the surgeon performing the procedure any questions. As the surgery is being performed, all of the conversation between the surgeon in Chicago and the panel of doctors at the symposium is heard by all in attendance. Pretty darn cool. Next, we were off to see the DaVinci system up close and personal. The manufactor had a system on display and Dr. Patel let us try it out. Brett was in the surgeon's seat and I was in the seat of the assistant. There was a tray with several objects on it located where the patient would be. We were able to pick them up and pass them off to each other. It was so darn cool. I must admit, I was a bit shocked when we turned around and saw the crowd that was gathered behind us - cameras and video cameras galore! After a few photo opps, a rep for the manufacture of the DaVinci system wanted to interview Brett. So, off we go to another break-out room for the interview. They interviewed Brett for about 10 -15 minutes and then brought me in as well. While this was going on, Dr. Patel got the text message regarding the pathology report. What a great way to end the morning.


Tonight Leslie and John (sister and brother-in-law) came over for dinner. We ordered room service and watched a movie. Leslie has made our "comfort and care" package absolutely awesome!






Tuesday, April 7, 2009

April 7, 2009 Recovery











We have been discharged from Celebration and returned to our honeymoon "recovery" destination, The Rosen Shingle Creek.

I look forward to my room service meal, it will be my first real food in 60 hours. I don't look forward to some of the medical issues ahead; no bowel movement for 4-5 days (+ the previous 2), some possible swelling in the male anatomy based on the catheter, abdominal soreness at the incisions and overall discomfort from the catheter until friday morning. I'm mainly dreading the bladder spasms and flank pains, excruciating discomfort.

We are scheduled for the Cystogram @ 9:30 Friday morning followed by the catheter removal provide there are no leaks in the reconstruction of the bladder to the urethra.

April 7, 2009 Baby Steps










We have come a long way in 12 hours, thanks to the outstanding care I was able to get at least 5 hours sleep and controlling the bladder spasms. I woke Kim up at 4:30 am and wanted to walk, we walked 20 laps down and back which was a huge feat compared to 12 hours ago. Due to the anesthesia I made it 1/2 the way down the hallway and experienced vertigo, the nausea, the shakes, the drop in heart rate and blood pressure and sweating. I had two issues to contend with vomiting (knowing how much that would hurt) and fainting (knowing how much more that would hurt.) All in all it was pretty humorous after the fact, my nurse gave me kudos for the determination to not do either of the aforementioned and making it back to the bed safely.

Dr. Patel just made his rounds at 5:00 am, he said, "everything looks great, take it easy, it's not a race anymore." He provided sound directions of light duty for a minimum of 4 weeks; no lifting, no jogging, but light stretching.

The nurses just removed the drainage port, it was a bit uncomfortable on the way out and led to instant bladder spasms again. Thank goodness for the Toridol injection, it seems to subside the pain and spasm within minutes.

We expect to be discharged about 10:30 and headed to Shingle Creek for the remainder of our honeymoon, this is the first time we have never been away from our children for longer than 2 days. We miss our little angels immensely but know that they are in good hands and being well taken care of.

Most important of all, thank all of you for your prayers they were certainly felt and heeded. God was in control and has provided Dr. Patel with such a gift to promote peace and healing in this broken world.

Monday, April 6, 2009

Surgery Day Photos















April 6, 2009 Post Op

It's been a long day - definitely a good day - but a long and emotional day for Brett. Luckily, we were "surrounded by a great cloud of witnesses", family, friends, and hospital staff. God's presence was definitely felt.

The producer and his film crew were in the hospital lobby awaiting our 5:15 a.m. arrival. After some brief paperwork, Brett was off to prep for surgery. He had a few "race day jitters" but, heck, who wouldn't? Once his local urologist (and personal friend) showed up, you could see his relief; he was now at ease and was soon off to the OR. Mike was here for the symposium, but his first order of business was to observe Brett's surgery. As sister Leslie and awesome friends, Jeff and Bonnie, and I patiently waited we got updated texts from Mike in the OR. How awesome is that! Surgery was absolutely flawless - as good as it gets! You can't ask for better than that! Once out of recovery, Brett was rolled into his VIP room on the fourth floor. He was greeted by awesome nurses who took wonderful care of him. I can't put his feelings into words, but I am sure he will blog about it when he's got the energy. Like I said, we were surrounded by a great cloud of witnesses...

How's he feeling. He's hungry, very hungry. No food since Saturday night! He can start having solid food in the morning. Within the last hour or so, his bladder has started to spasm. Not fun - a lot of sharp pain and discomfort. It's difficult seeing him in so much pain knowing there is nothing I can do. Hopefully the meds will kick in and help ease the pain. The nurses say it usually subsides after the first twenty-four hours. He's been up for two walks. The fist one did not go so well. The combination of nausea and dizziness took its toll and he almost face planted. After five hours, he was up again. This time was much better, but a second nurse followed close behind with a chair to catch him just in case! Hopefully he'll be able to get some sleep tonight. The doc will be here bright and early in the morning and we are anticipating discharge by noon! We'll be off to the hotel to relax - by the pool of course!

April 6, 2009 Surgery is over!

Surgery was flawless - perfection from start to finish!
Brett is still in recovery so I have not seen him yet. He was bright eyed and bushy tailed this moring and had a great attitude.
We'll update later!

April 6, 2009 Ironman FL 09


All of you, many thanks for all your love, prayers and support the last 120 days since the prostate cancer diagnosis. Today is what we've been training for and tomorrow brings new challenges. Today is our first Ironman FL.

Saturday, April 4, 2009

April 5, 2009 Perspective

To the cross I look. To the cross I cling. Of its suffering I do drink. Of its work I do sing. On it my Savior, both bruised and crushed, showed that God is love, and God is just.

At the cross You, beckon me, draw me gently, to my knees and I am, lost for words so, lost in love I'm, sweetly broken, Holy surrender!

What a priceless gift: undeserved life have I been given through Christ crucified. You've called me out of death. You've called me into life. And I was under Your wrath, now through the cross, I reconcile.

At the cross You, beckon me, draw me gently, to my knees and I am, lost for words so, lost in love, I'm sweetly broken, Holy surrender! At the cross You, beckon me, draw me gently, to my knees and I am, lost for words so, lost in love, I'm sweetly broken, Holy surrender!

In awe of the cross I must confess, how wondrous Your redeeming love and how great is Your faithfulness!

At the cross You, beckon me, You draw me gently, to my knees and I am, lost for words so, lost in love, I'm sweetly broken, Holy surrender! At the cross You, You beckon me, draw me gently, to my knees and I am, lost for words so, lost in love, I am sweetly broken, Holy surrender!

Yeah, Yeah! Broken for You...I'm broken for You, my Lord. Jesus...All that's left, ooooo I am sweetly broken.

Sweetly Broken..Jeremy Riddle

Sweetly Broken Video




Friday, April 3, 2009

April 4, 2009 Medically Speaking

The medical nomenclature of my upcoming surgical procedure is called, "nerve sparing robotic prostatectomy - athermal retrograde early release of the neurovascular bundle"

below are some you tube links if your interested;

http://www.youtube.com/watch?v=FtlhMIBhh2I

http://www.youtube.com/watch?v=wQP8Upe1Ot8

http://www.youtube.com/watch?v=sSp9Dp-OlCc

Thursday, April 2, 2009

April 2, 2009 Reflection


As the torrential rains fell on the Panhandle of Florida today I was forced to spin on the Cadillac of all stationary bicycles, "The Spinner NXT." It was actually designed by a BMW engineer who had comfort, speed and climbing in mind. Manufactured by Star Trac the Spinner NXT is the top-of-the-line in indoor cycling bikes. It truly is a great ride for an indoor workout, the only stationary that you can really get out of the saddle and climb for real.

The downside of the ride was I had to stare at myself the whole time in a wall mirror, interestingly enough the image never changed whether I was seated in the arrow position, the seated climb or out of the saddle.

So during my ride my image was based on my reflection, which led me to wonder;

"What AM i reflecting?"
"What AM i reflecting to others throughout this trial?"
"What AM i reflecting to God throughout this trial?"

Hopefully I have reflected strength, courage, understanding and perseverance through my faith in Christ Jesus. James 1:2 reads, Consider it pure joy, my brothers, whenever you face trials of many kinds, because you know that the testing of your faith develops perseverance.

As I continued to climb I wondered if people actually listen more to someone with a trial, a crisis or a diagnosis of cancer, like my cancer becomes a megaphone? People are watching the testament, people really want to know what holds us together when the storms come. So how does one maintain and reflect the hope, faith and belief in our God?

Throughout each pedal stroke and every bead of sweat it kept coming back to me that it's not about me and all about HIM and my life counts most when it counts for HIM.

We should all consider our reflection.

Wednesday, April 1, 2009

March 30, 2009 Dahlonega Retreat



We just returned from an AWESOME weekend of relaxing in the Appalachian foothills of Dahlonega, GA. Some very good friends of ours invited us to spend the weekend away at their family cabin. We got to hike, eat, play games, eat, laugh, eat, fellowship, eat...etc. More importantly we got to just BE. Sometimes it takes the calmness and quietness of nature to really see God, the hustle and bustle has a tendency to crowd him out when we need him most.

It was a very nice retreat with no worries, no timeline, no schedule and no commitments. A great way to connect and start the 7-day countdown.


Thursday, March 5, 2009

Mar 1, 2009 Seaside Chill


Today was the Seaside ½ Marathon, quoted as being the coldest and windiest race we have ever experienced. The 5:45 am arrival greeted us with darkness, 39 degrees (30 degree wind-chill) and 20 mph NW winds (in your face the first 6.55 miles.) The weather severely impacted the pre-race routine; it became stay as warm as possible until the “gun” goes off.

Once all 2300 of us were off and running things began to get better, we were running and the blood eventually started to flow. Several of my friends competed, but the most exciting story was my wife Kim competing and finishing her first ½ marathon (2:33.28) while I finished with a pb of 1:46.15. The Seaside ½ is a great venue, with a great pre and post race finish but this year was cut short due to the weather.



Wednesday, February 25, 2009

Feb 25, 2009 Interesting News Articles Released

Doctors back wider consideration of prostate drug

http://www.ajc.com/services/content/health/stories/2009/02/25/prostate_cancer_doctors.html


Breast Cancer Mutation Raises Prostate Risks in Men
Certain mutations in the genes may indicate which men are at risk of more aggressive cancer.

http://www.prostatecancerfoundation.org/site/c.itIWK2OSG/b.4992459/k.EBDC/Breast_Cancer_Mutation_Raises_Prostate_Risks_in_Men.htm?msource=feb09np1&auid=4543142

FundResearchNow.org is a website produced by America's prostate cancer organizations to give you the tools to email, write, call or meet with members of Congress to impress upon them the importance of Department of Defense funding for prostate cancer research.

http://www.fundresearchnow.org/site/c.grKIIYPGIqE/b.4918309/k.BED1/Home.htm

Tuesday, February 24, 2009

Feb 23 2009 What are you training for?

This seems to be the most commonly asked question lately. While most of my friends are training for the upcoming Seaside ½ Marathon followed by the Gulf Coast Triathlon I happen to be training for the biggest all-around trial of my life to-date, it not only encompasses the physical, but the mental and the spiritual. With 40 days to go until surgery I don’t feel completely prepared.

The past two weeks have been a bit trying both physically and mentally. Although I am training for the Seaside ½ Marathon as well (and my wife Kim will be doing Seaside too) the mileage has really increased for me. The week of Feb 7 I logged 49.4 miles (this included the Pensacola Bridge-to-Bridge 15k) and the week of Feb 14 I logged 37.7 miles (plus 71.0 miles on the bike.) but who besides my Garmin 305 is really counting? My daughter Allison asked me what I was running from? Out of the mouths of babes! So I attempted to explain it using the analogy of the Lipitor commercial. Do you remember the commercial with the skier slaloming down the double diamond expert run while traversing moguls with the “cholesterol number” affixed to his back? No matter how fast he was skiing or how quick he cut or what type of aerial he maneuvered that number was still there and there was no escape. Until he used Lipitor then he was able to reduce it and maintain it, so they said. Well no matter how far, how fast or how long I run the Cancer is still there. Don’t misunderstand me the LOVE OF RUNNING exists but ultimately it is acting as a release mechanism for something much bigger. I guess I’m monitoring my vital signs, the elevated heart rate, the shortness of breath, the beating in my chest, the feeling of throwing up in the heat of the sprint, the perseverance – it all reminds me that I am alive and well?

I won’t forget the phone call from my friend and urologist, Dr. Jenkins (Mike), “this is the hardest call I’ve had to make, but the results came back positive, you have prostate cancer.” Yes Brett, you have Cancer, at 41, in relatively great shape, religious about physicals, in-tune with your body, IT DOES NOT DISCRIMINTATE. It doesn’t matter who you are, you are not invincible and you are not in control. But the difficulty this past few weeks seems to be that I have no symptoms, not one, just an elevated PSA (2.0) number and dually confirmed positive lab results for one of twelve core samples testing positive in black and white on paper. No pain, no suffering, no physical confirmation. You see I know that they are out there in hospitals awaiting their radiation, their chemo, their lab, their latest results, suffering, struggling and not knowing what lies ahead for them. Will they live or die? I am thankful, grateful, praising God that Mike was aggressive, that I have been diagnosed early, that I have no symptoms and that I have been placed in the hands of the World’s finest surgeons. But I cannot help but feel like I’m cheating Cancer. I know this sounds crazy? I’m not asking for symptoms, the sickness, the side-effects, the long suffering – but just trying to rationalize it.

So I RUN! It helps, but when I look over my shoulder, still there, I look in the mirror, still there, I step on the scale, still there and I check the Garmin, still there. So there it is, as I try to release this to you. I guess I’m scared, scared of the lack of control in the situation, that this surgery; the removal of the affected prostate and the recovery of my physical functions (that we men take for granted: urinating and sexual function) will be based on the precision of my surgeon and the healing following my surgery. I realize I have taken the advocacy into my hands and by God’s grace been provided with a great team of doctors and supporters. So I cannot be any more prepared except for ensuring we are prayed up.

I cannot say enough about my reliance on my family, friends and complete strangers. My support network has become unbelievable; my wife and kids, my family, my closest friends, my church, other churches and people within the cancer kinship. The response and communication from this blog has been awesome (I thank Paul Peavy, Darren Ritch and the Vinecki family for transparency and their inspiration in it.) I can’t explain to you or measure the source of strength to someone diagnosed with Cancer to personally know someone facing the disease or that has survived. The shared experiences are empowering. It has really shown me the genuine goodness, kindness and love in people, another lesson built by design for me.

My running list of lessons learned to date (note to self: these are ALL areas in which you struggle):

1. you are not in control – God is

2. it’s not about you – it’s about Him

3. people are genuinely good, kind and loving

Lastly, if any of you are interested in more information dealing with Prostate Cancer, these 3 sites are full of great hope, great inspiration, great perseverance and great research;

1. Michael Vinecki http://www.michaelvinecki.blogspot.com/

2. Darren Ritch http://www.darrenritch.blogspot.com/

3. Darren http://www.prostatebiopsyblog.com/

4. Rabbi Ed Weinsberg http://http://www.conquerprostatecancernow.com/


Feb 16 2009 Ultrasounding the Stone

Just a follow-up to the kidney stone, today we conducted a routine ultrasound after the kidney procedure. The report shows the kidney and bladder look normal with no abnormalities, but the kidney stone is there (and in-place.) Dr. Jenkins said he searched for it during the ureterscope procedure and couldn't’t locate it, but here is a nice black and white photo of it on the ultrasound (kind of like that first baby image.) The status is, we are not going to concern ourselves with it at this point and everything looks good for surgery.

Monday, February 2, 2009

Jan 22 2009 Instent Removal

Just to close out my kidney stone adventure, the stent was removed Thursday the 22nd by my urologist with some minor discomfort, but the after effects were as painful as could be. Within a few hours of removal my bladder went into “spasms” and my right flank (kidney positioning) was pulsating, the offsetting pains were enough to lay me out on the bathroom floor for a few hours wrapped in heating pads and consuming Lori-tab. In all honesty, this was my first ever experience with true internal bodily pain.

You all know what “they” say though, “Pain is weakness leaving the body!” Is that true for all scenarios (including medical) or just endurance athletic events and just who are "they?"

The troubling part about the whole experience this past week is that my 6mm stone is still housed in my right kidney somewhere unbeknownst to any of us.

Wednesday, January 21, 2009

Jan 21 2009 Hanging by a THREAD

Monday turned into a seek and destroy mission with nothing shocking to speak of, correct, no shock waves occurred. An early arrival at the Bay Medical surgery center, general anesthesia and a ureteroscope. It was deemed necessary to pass a small fiber optic instrument called a ureteroscope through the urethra and bladder into the ureter then into the kidney. My urologist was unable to shock or remove the kidney stone due to it’s placement outside the collection area (and its encapsulation.) Apparently it is my 6mm stone to keep and will not be going anywhere.

When I woke from anesthesia I found that the doctor left me a gift, a thread, six inches hanging from the normal channel. "Doc where are you? You forgot something here!" I then learned that it was connected to a stent which was to remain in-place 3-4 days, a small hollow tube placed in to keep the channel open. The removal of said stent can be completed by just pulling the thread? "Are you kidding me? Hey doc you put it in, you’re taking it out."

This has been one of the most painful experiences to-date, it feels like my lower back (right kidney) has been bruised and battered. A lot of heat and a few Loritab are helpful, I can only imagine what the stone passing or the shock wave feels like. My analogy is compared to the "google earth" vehicle driving a street near you to capture images, well the doctor drove around my kidney doing the same thing, kind of like the "magic school bus."

Doctors do not always know what causes a stone to form. A person with a family history of kidney stones may be more likely to develop stones.

For more info:
http://kidney.niddk.nih.gov/Kudiseases/pubs/stonesadults/

Sunday, January 18, 2009

Jan 18 2009 Extracorporeal Shock Wave Lithotripsy?

Tomorrow morning we physically begin phase one of preparations for April 6th, the demolition of a 6mm kidney stone in my right kidney. This "little" burr showed up during the Dec 17th CT scan of the abdomen and needs to be taken care of prior to the prostatectomy, the concern is that it could come loose and try to pass during post surgery recovery. The last thing we need is this "little meteor" obstructing the restructuring of the urethra to the bladder while fitted with a Foley catheter for 6-7 days. We consider this a preemptive strike.

So Dr. Jenkins is going to use a little shock and awe, high energy shock waves are passed through the body and used to break stones into pieces as small as grains of sand. Because of their small size, these pieces can pass from the body along with the urine. The patient lies on top of a soft cushion or membrane through which the waves pass. About 1-2 thousand shock waves are needed to crush the stones. The complete treatment takes about 45 to 60 minutes.The key is that he can actually see it on a x-ray and that it resides in the collection area of the kidney otherwise we are going to have to use "the normal channel."

The "normal channel" you know, no man's land, where everything is meant to flow down and out, not up and in. The medical term is Ureteroscopic Stone Removal, for stones found in the lower part of the urinary tract, the doctor may pass a ureteroscope (a hollow tube-like device) up into the bladder and ureter (through the normal channel.) A basket-like device may be passed through the tube to grasp and withdraw the stone.

Although the procedure is fairly common any procedure requiring general anesthesia and a hospital gown make me a bit uneasy.

Saturday, January 17, 2009

Jan 12 2009 Marathon Angels


So most people ask "How was it?" It was an awesome challenge. It was an awesome experience. It was a first of many new experiences for me this year.

It was not only a physical challenge but a psychological and spiritual challenge. For those of you who have never run 26.2 miles (like myself) around mile 20 the mind and the body decide that they are separate entities not working in unison. The mind tells you that you've had enough, the heart rate jumps to 187 bpm, the body becomes cold and chills with goosebumps while the legs continue to labor forward. Each mile was significant so walking was not an option for the remaining 6.2 miles. I finished the race set before me in 4 hours and 19 minutes, with joy, pain, tears and ice packs.

When the marathon began at 5:50 am under a full moon and 57 degrees I stood alone anxious and praying amongst 20,000 runners. At that point the prayer was simple, God please be with me (and the all the runners) throughout this marathon and help me complete it for your glory, without stopping and without injury. I made a quick decision to join a 4:15 goal "pace group" led by an energetic Clif gal from Pennsylvania named Marie (the angel of inspiration.) I ran with this group through the Magic Kingdom, Grand Floridian and the Animal Kingdom until mile 20 where I was, yes, dropped. Although I managed to complete Disney Studios, the Boardwalk and Epcot to finish just 4 minutes behind them with Marie waiting to greet me! I met some peers along the way; Luke from Miami, Jose from Bal Harbour, Erin from Lakeland, Marsha from Fayetteville and Kathleen from Ohio, all of these angels played a roll in my accomplishment.

The ironic story I want to share is about Kathleen from Ohio who sauntered in around mile 12.5, we discussed my current diagnosis and the upcoming challenges. It turns out that she works for a cancer unit in Ohio where Dr. Vipul Patel was prior transferring to the Global Robotics Institute and that she knows him well. Kathleen stated, "you couldn't be in the hands of any better surgeon, he is the best there is, I am going to call him and tell him we met on mile 13." We spoke some more until she jogged off to support other marathoners along the route. I am convinced that Kathleen was the angel of assurance.

The highlight of the morning was the chance to meet, greet and kiss Minnie Mouse. Not only did I receive this awesome Mickey Mouse medal but I had face time with Ms. Mouse.

It was truly a great venue and an incredible adventure.

Saturday, January 10, 2009

Jan 10 2009 Are you Goofy? The Disney Marathon!

It is the eve before my first Marathon; I am currently at the Rosen Shingle Creek anxiously awaiting the 0315 wake-up call for a 0550 race start. Although I should be fast asleep at this point I figure I can still get 5 hours asleep if I stop the coffee now. Sleep has really become overrated for me this past month.

With retrospect into the 26.2 miles I’ll attempt to run tomorrow I again look at it as I look at my recent diagnosis, a challenge to overcome. Tomorrow will be a morning of reflection not only from the past but also for the future, I am told to expect a battle throughout the run physically, mentally and spiritually. For some who don’t partake in this endurance craze they would ask “Why?,” for those running, all 23,000 entrants, each would give you a different answer.

I’m personally running for all those who cannot run from the cancer, running for the cure. My goal is not to win this race but to run with perseverance the race marked out for us. We all have the passion to compete we’re just wired that way, but it’s more about accomplishment, purpose and heart. I plan to focus on my relationships throughout the run tomorrow, 26 to be exact; I am going to try to dedicate each mile. I’ll share a few of those specifically with you, mile 1 God, mile 2 Jesus, mile 3 Holy Spirit, mile 4 my incredible wife Kim, mile 5 my first gift from God Allison, mile 6 my second gift from God Kari, mile 7 my beautiful sister Leisa, mile 8 my closest friend and sister Leslie, relatives, friends…and mile 25 all those cancer patients and survivors.

Although this event is not a fundraiser of sorts for cancer, it will be, in my heart. I am planning a second Athletes For A Cure Triathlon in Sep 2009, which will be an opportunity for ALL of you to support the fight of prostate cancer specifically with proceeds going directly to the Prostate Cancer Foundation, http://www.afactri.com/. I will post the actual Brett Troia fundraising website soon. This is a great venue for a great cause.

I want to THANK all of you for your emails and support since the posting of this blog. I need to tell you that I’m a bit embarrassed with the fact that I’m posting this blog, I want you to understand that truly the blog is not meant to be about me, but about HIM, all those that know HIM, those that don’t know HIM and those that will come to know HIM. It’s for those yet to be diagnosed and those already diagnosed. I don’t claim to be a doctor, a pastor, a surgeon, or anyone even worthy of posting a blog, just someone trying to remain faithful and help others through it.

Thursday, January 8, 2009

Jan 8 2009 Treatment Options

Jan 8 2009 Once diagnosed the frenzy of researching prostate cancer with respect to treatment options is imperative.

I want to provide two thoughts;

1. Become proactive, be your own advocate, do the research, ask the questions, seek second opinions, interview doctors, cancer patients, cancer survivors; this is your life at stake.

2. Ensure the websites you visit are legitimate i.e. http://www.prostatecancerfoundation.com/, http://www.americancancersociety.com/, http://www.conquerprostatecancernow.com/, www.cancer.gov/cancertopics/types/prostate, www.webmd.com/prostate-cancer/default.htm

Don't discredit the blog sites, they can be very helpful when it comes to actual cancer survivors experiences.

When discussing treatments you have six options;

watchful waiting
In watchful waiting, you get no treatment, but you see your doctor often. If there's no sign the cancer is growing, you continue to get no treatment.

radical prostatectomy
Radical prostatectomy is a surgery to remove the whole prostate gland and the nearby lymph nodes. There are two options the open surgery or the daVinci robotic assisted surgery.

radiation therapy
There are 2 types of radiation therapy. In one type, called external beam radiation therapy, radiation is given from a machine like an x-ray machine. In another type, radioactive pellets (called "seeds") are injected into the prostate gland. This is sometimes called seed therapy or brachytherapy. The external beam therapy option has an alternative method called “proton therapy” www.floridaproton.org/, www.protonbob.com/proton-treatment-homepage.asp

hormone therapy
The purpose of hormone therapy is to lower the level of the male hormones, called androgens, which are produced mostly in the testicles. This is because androgens, such as testosterone, help the prostate tumor grow.

cryosurgery
liquid nitrogen freezing of the cancer

In our research there were only two options for us; surgery or external beam radiation. So I will attempt to explain our decision. Here is our argument; we have the option to remove the cancer from my body for good, using cancer and cure in the same sentence vs. treating a cancer with the ability to kill it but still having to monitor the PSA, the DRE and possibly follow-on biopsies while both treatments can/could have the same side effects. What quality of life are you seeking? We opted for the surgery utilizing the daVinci system and seeking out the best surgeon for the procedure.

I would never attempt to provide advice to any other prostate cancer patient on what treatment would be best for them. It is all based on the individual’s situation regarding cancer stage, patient age, health and quality of life thereafter. So take control and you make the decision.

Jan 1 2009 The New Year with New Challenges


Jan 1 2009 So ultimately the New Year begins with New challenges…now knowing that I am not in control. I believe Louie Giglio says it best “I AM NOT BUT KNOW I AM” confusing as it sounds it’s quite simple. But for an A-type, Obsessive Control type and an ADHD person like myself the concept is hard to engage. We are not in control of our lives or our health, we simply have the free will to make our choices hopefully based in a God knowing - God loving - God fearing manner.

I am not a resolution type guy, but I do know that this year will be different in many ways. I wish all of you the best and appreciate all your prayers, calls and cards.

I plan to challenge this cancer within and use it for God’s glory.

I have always loved Hebrews 12:1
Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles, and let us run with perseverance the race marked out for us. Let us fix our eyes on Jesus, the author and perfecter of our faith, who for the joy set before him endured the cross, scorning its shame, and sat down at the right hand of the throne of God.

Dec 31 2008 New Years Eve Day consult

Dec 31 2008 After spending the past five days on the beach in Cocoa me, my wife and children made the trip into Orlando for the visit with Dr. Patel. As we pulled into the Florida Hospital at Celebration I must ad the resort style appearance was quite appealing…

Florida Hospital was the first institution in Central Florida to offer the da Vinci® robotic radical prostatectomy in 2004. Dr. Vipul Patel is Medical Director of the Global Robotic Institute at Florida Hospital, and has personally performed the most robotic prostatectomies in the world. Dr. Patel leads one of the world's most experienced teams which is renowned for providing excellence in patient outcomes with respect to cancer control, urinary continence and maintenance of sexual function.

I should add that the anticipation of this consultation was much worse than the biopsy, although nothing was taking place today my anxiety level was maxed out. I am thankful that Kim was able to be with me, her presence was calming and reassuring. We were greeted very warmly and processed through admissions with much efficiency, although I did have everything organized and ready for processing. If Dr. Patel were to offer surgery tomorrow I was ready. We waited in the exam room for about 15 minutes which provided ample time for my A.D.D. to kick-in and I searched the entire room, the overhead cabinet was full of Depends, my mood quickly calmed.

Our first interaction was with Geoff Coughlin, MD a medical fellow of Dr. Patel’s that has been with him for over two years. Dr. Coughlin had reviewed my chart and had begun to explain the surgery, recovery and effects in detail. He answered a majority of our questions before we ever asked them. (I have provided his answers in red)

We had prepared a list of questions for our consult;

After reviewing my labs, family history, age and physical condition what is your recommendation for treatment? Surgery

Do you feel I am the right type of patient for a radical prostatectomy utilizing the daVicni robotic system? Absolutely, a prime candidate based on my physique, my age and the fact that I have a small prostate.

Do you believe with my cancer that by electing surgery we can successfully cure me from prostate cancer? Yes, after surgery you should have a PSA level of 0.

What are my chances of recurrence provided a successful surgery outcome? Would any chemotherapy or radiation be required? A minimal chance of recurrence, almost nil.

What is the success rate of surgery? The success is that you will forget you ever had cancer. For ages 55 and below we base it on the return of continence and erectile function.

Based on my age and physical condition what should I expect for the return of continence and erectile function? Continence within 3 weeks and erectile function within 3 months, we would be surprised if the rehab would be any longer for your situation.

How long should I expect to be out from; Work? Approx. 1 week Running? Approx. 4 weeks Biking? Approx. 12 weeks Lifting? 30 days no more than 10 lbs.

What determines the amount of time the catheter will be required? Approx 5 days. It will be removed following a cystogram. A cystogram is where contrast is injected into the bladder via the foley catheter then an x-ray of the bladder is taken in search of any leaks.

What would the timeline be for registration, surgery, release and returning to Panama City? We would require you stay for approx. 7 days following surgery, 24 hours after the removal of the foley catheter.

Would you require follow-up appointments or release me to my urologist? It is the choice of the patient, appointments at 30, 60, 90 days and then throughout the following year.

If you were diagnosed with prostate cancer tomorrow what treatment would you elect? I never asked this question, it was pretty apparent. Although I did ask Dr. Jenkins this question. Surgery.

Dr. Coughlin added that he has worked in various facilities across the world and that Dr. Patel is one the finest surgeons currently performing this procedure. Dr. Vipul Patel has personally performed the most robotic surgeries in the world, and is one of only two surgeons to have performed 2,000 robotic prostatectomies.

Next we met Dr. Patel; our first impression was what a humble and gentle man. He was more than willing to answer any remaining questions, concerns or hesitations.

1. We discussed the issues with early detection in men and how the PCP is handling PSA, more important he noted that any PSA is suspect, but over 1 is evident of some abnormality.

2. We discussed family history, I shared the Troia MD Anderson Cancer Tree, and he noted that with my brother’s prostate cancer and my diagnosis that most definitely my brothers, cousins and nephews would develop prostate cancer at some point.

3. Dr. Patel explained that all I am reading and researching doesn’t necessarily apply to me with my age and health considerations. There is not a lot of data available for men in their early forties. I personally used this website to gauge some of my information http://darrenritch.blogspot.com/ and an excellent book by Rabbi Ed Weisenberg called Conquer Prostate Cancer Now http://conquerprostatecancernow.com/

4. We then discussed possible surgery scheduling; he noted that he will not operate within 8 weeks of biopsies due to the bleeding and trauma (so that pushes it to Feb 1.) Next his schedule is booked through March, so I asked him if he had any “live case” coming available. For those of you that don’t know, a live case is the live robotic radical prostatectomy performed by Vipul Patel, MD while being fed into the World Robotic Urological Symposium 2009 held in Orlando, FL April 6-9. He told us that he had one available April 6 2009. So we elected to secure that spot on his schedule. http://www.globalroboticsinstitute.com/en/urology-robotic-prostatectomy/world-robotic-urology-symposium

5. We also discussed my past athletic venues, mainly the Athletes For A Cure Triathlon (2008 Orlando, FL) and my upcoming Disney 2009 Marathon (Orlando Jan 11 2009.) He was excited to hear of my involvement and even mentioned that maybe we might work together in unison with some future events. Lastly Dr. Patel shook our hands and said, “See you in three months and come back in good shape.” He doesn’t realize that I will use that as motivation to be in the best shape possible for me, I will treat this next 90 days as if I were training for another endurance event, my most important ever, one that could alter my life and my family’s lives forever.

6. So I guess that makes me a Prostate Model of sorts, either a model prostate or a prostate model.

Here is an excerpt from an email my wife sent her work associates…

“I can't begin to put it all into words, but let's just say, he will, without a doubt, be in the hands of the best the world has to offer! Long story short, his surgery is scheduled for April 6 - the Monday we return from spring break. The World Robotic Urology Symposium will he held in Orlando beginning April 6. Brett's surgery will be the "live case" for the symposium - telecast to the venue for hundreds to see. As it turns out, Dr. Jenkins will also be in attendance and was ecstatic when Brett told him that he was going to be the live case for the symposium. Our next mission will be for Dr. Jenkins to try to find a way for me to sit in on the telecast of Brett's surgery! How darn cool would that be! Patients usually are released from the hospital 24 hours after surgery but are asked to remain in town for at least a week post-op..” Kim Troia Jan 1 2009