Only time will tell if it's EZ

 April 26, 2023. Mesa, Arizona. 

Well, I start Immunotherapy at MD Anderson in Gilbert, AZ on Tuesday, May 3, 2023. Time will tell.

Quick Changes May Be EZ for Some

 April 24, 2023. Mesa, Arizona. 

Home from my pre-op appointments at MD Anderson. Glenda and I spent from 7:30am until 1:00pm at the hospital. I am not happy.

At the meeting with the radiation oncologist, we went over their procedures and discussed all the options there, but the doctor said that after reviewing my case with the immunology and surgery oncologists, his opinion was that radiation may be a adjunct to surgery--after surgery--but, depending on what they found, may not be needed at all--so no restraining mask preparation or practice sessions at this time.

I had my lab work drawn and my EKG done, then we had a nice light lunch in the cafe.

At the meeting with the surgeon (who is my case manager) he confirmed that surgery, for me, was agreed by their tumor board to be the first best action. We discussed all aspects for a half-hour or so. He answered questions for Glenda. We agreed to keep May fourth as the date for my surgery, with a 7:30am show time.

As he prepared to leave he decided to give my ear and the area around it a last cursory examination. After a quick look he got out a flashlight and gave it a second look at which point he said, "Oh, my." Then he got out his camera, took a couple pictures and sat back down. Verdict: my melanoma is being very aggressive and has visibly worsened in a few days. I knew that. He said that perhaps two months of immunotherapy prior to surgery would be prudent after all. I'm to leave the 4th on the calendar for surgery for now, but he's meeting with the immunologist this afternoon to discuss. So, again, we wait for a call

...but this now seems most likely: 8-12 weeks of immunology treatments followed by surgery, followed by reassessment at that time for adjuvent radiation therapy and then an additional year of immunology therapy regardless of yes or no on radiation. I shouldn't need a driver for immunology therapy, but I should have had one for the drive home today as I was not in a good mental state to be driving.

I missed an exit.

Twice. 

More of EZ’s Saga

At my first appointment at MD Anderson Cancer Center in Mesa. My extraordinary run of luck seems to be continuing as I've been directed to exam room #13 to await the doctor.

This morning at MD Anderson went much as I expected. It took about an hour to get 'registered' as a new patient, complete a lengthy medical history, and for them to verify my Medicare and Tricare for payment for services. Proving that my lucky streak (except for the lottery) continues, I was escorted to exam room #13. Was seen by the doctor in just a few minutes. He reviewed my medical history with me in detail, examined the spot on my ear, and went over the information forwarded from my dermatologist who removed the original growth. He then went over the plan of confirmatory diagnosis with me. They will obtain the biopsy slides from the lab that did the original to examine in their own pathology lab. On 11/17 I will have an EKG, lab work collected, ultrasound of my neck and head soft tissue, and then see the doc on 11/21 for a pre-op visit. Assuming all goes well to that point, I then go off Eliquis and NSAIDs for a week and on 11/29 be at MD Anderson before 7:00 a.m. (nothing by mouth after midnight) to have neck/head lymphatic gland mapping (a three-hour non-invasive process), followed at 11:30 with surgery to remove additional tissue from the ear lobe and the sentinel lymph gland (one or more glands) for biopsy. This is supposed to be out-patient surgery, local anesthesia only, so I should be home by 3 or so in the afternoon.

If the removed ear tissue shows clear margins and the lymph glands are negative for melanoma, I will only need routine follow-up afterward. If not, we'll go to the next stage to discuss immunotherapy, chemotherapy, radiotherapy, or some combination of the three.

I will need someone to stay with Glenda on the 29th, as I have to be there early and stay most of the day (at least) and I'm not comfortable leaving her alone that long. Writing this up in detail has been good for me just to make sure I know and understand all this activity.