Nope, My Life Ain't EZ

And now I have COVID. Diagnosed early Sunday morning at an ER. I'm feeling much better now, just 2 1/2 days later, but this infection has further delayed my first infusion to treat the melanoma until May 15th. This 14-day delay is due to the hospital's established medical protocol. 

Medical protocols are complicated things with lives of their own. They are established by committee with recommendations from the medics often conflicting with recommendations from the administrators, the accountants, the lawyers, and their insurance companies. Once in place, it's really difficult for an 'employee' medic (even more so for a contracted medic) to deviate from said protocols except in case of imminent loss of life or property. Our entire care for profit system has become a gigantic machine, accelerated by need and new discoveries and throttled by accountants, insurance companies, and lawyers. Once you are entered into the system for any particular need, you become an item on a conveyor belt. The system serves the 'typical' patient quite well, while serving the lawyers, administrators, and insurance companies even better. Less so for caring medics and those that don't quite fit into the mold. 

I've also applied to the Mayo Clinic Hospital in Phoenix to see if they want to take me on as a patient. Maybe I'll hear from Mayo next week. Same system, different machine.

And to make things more interesting, Glenda, my 73yo nearly blind and memory deficient wife, has a fever and fatigue tonight, so I'll probably have more to deal with to care for her tomorrow.

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. 

Aging isn't EZ, is it?

Today, I received my fourth positive cancer diagnsis--a malignant melanoma. This based on a biopsy collected upon surgical removal of a small skin lesion from the lobe of my right ear that was thought to likely be a benign Plyogenic Granuloma. Literature I've found from a quick internet search tells me that Pyogenic Granulomas are found to actually be malignant melanoma less than 1/2 of 1 percent of the time. Lucky me. Earlier cancer bouts in my life include cancer of the prostate in 2015, for which I had a high-tech robotic radical prostatectomy performed. And twice, I've had small squamous-cell carcinomas of the skin found and removed--one on my upper back in 2012 and another on the back of my right hand in 2021. This malignant melanoma is a different animal. The removal of the granuloma and the collection of the biopsy was done by a PA that cared for one of my earlier skin carcinomas and also does my routine annual head-to-toe skin checks. This particular lesion wasn't found in one of those checks--it just popped up on my ear a few weeks ago. Her clinic has referred me to Banner Health Oncology for further treatment and diagnosis. She explained to me that they would likely start with additional minor surgery on the ear looking to ensure 'clear margins' around the visible melanoma site, and would probably also want to do further diagnostic tests including blood work and a neck-lymph-node biopsy. If that is positive, it will likely lead to further treatment by radiation or chemotherapy. Right now, I just feel tired.