May 17, 2011 Update

We saw Trevor the PA at Dr. Nichols office. He had some interesting insights on Dad’s health issues. After describing Dad’s health status before the biopsy and his status now, he did seem to agree that the information we could have determined from the tests was not worth the procedure. His feeling is that a bone marrow biopsy is needed and the two main diseases that could be determined from that are not treatable, so why bother.

Dad’s wound is healing nicely. The HH nurse yesterday had to use the wooden end of the Q-tip to get the wicking material in. Tonight we remove the wicking material for good and see what happens. The HH nurse is scheduled for tomorrow morning and I’ll be there to see if we might be able to discontinue that service. Dad is anxious to get back to tennis and with the nurse coming M-W-F that is difficult. The PA prescribed one more week on antibiotics as insurance against another abscess.

On the anemia front, while Dad’s numbers are low, they are not catastrophic. If they do get low enough for him to have a transfusion, then a nephrologist (kidney specialist) would prescribe epoitein(?), a hormone to stimulate the bone marrow to produce more red blood cells. The PA’s feeling was that the anemia is caused by Dad’s renal insufficiency. We will monitor Dad’s Red Blood Cells and kidney functions every three months. As for future doctor visits, he has one with Dr. Chang near the end of the month. No more with Dr. Nichols (unless the wound starts acting up again) for three months.

We got to spend some time in conversation while waiting for the doctor. Dad says he is eating well. He is feeling good and wants to get back to his routine. I think he is looking forward to living and not constantly going to the doctor. He is looking forward to the Boston trip in the fall. And, as a by-the-way, feels that Boston Rob did a great job on Survivor and deserved to win the million bucks.

Love,

John

Feb 1, 2011 Update

Attached are the notes from yesterday’s doctor visit. You will see that he ordered several blood test again, the main one rechecking the kidney. He is also checking on dad’s anemia and if it is too low he will order a blood transfusion for dad.

Dad is primarily concerned with his control problems and told the doctor that the stream is better sometimes, but that the frequency is not. The doctor told him that it might take time for the swelling to go down and see some improvements in the frequency.

He reviewed all his medications and told him to continue all the prescription meds.
Dad was given a cream for the rash on his back, but the doctor was unsure as to what caused the rash.

The doctor also told dad that he has swollen limp nodes about 1 inch around. These were detected on the CAT scan they did of his kidney a few days before his surgery. The doctor told us that to evaluate them they would have to open him up from his belly and work their way to the back to biopsy them, they are located near his back, but there is no easy way to go in from his back. If it is cancer, then the chemo treatment would have to be sever to have a chance of killing them.

The doctor also discussed his anemia stating that they would like to go into his bone marrow in his thigh to see why it is not making enough red blood cells.

Dad refused both procedures and told the doctor, fix the frequency problem first and we can talk about what is next.

We did talk dad into trying a sleeping pill at night to see if he can sleep better. Dad wrote down every time he got up the night before his doctors appointment and it was at least once per hour. He did try 1/2 pill last night and said it wasn’t much better, but he didn’t get up until Tom went over at 9:45 am and did have a 2 1/2 hour period where he didn’t wake up.

Dad’s next steps are:- Blood test again the week of Feb 28th.- Drs appointment on March 7th at 2:45 pm with Dr Nichols- Follow up with Dr Chang on April 25th at 11:40 am.Tom, let me know if I missed anything.

Love to all,

Bill