Seeing my doctor again Tuesday

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compiler
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Date Joined Nov 2009
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   Posted 6/12/2011 8:45 PM (GMT -6)   
Unfortunately, I have been ill since about 10 days after my SRT ended. I still have a nasty cough deep in my chest that comes and goes but keeps feeling irritated. My body temperature remains very low (96.8-98, generally 97.3-97.6 when for me it is usually 98.6-99). The fatigue has been miserable. Some days it is okay but then I am active and the next day it's bad again. Also, when I am active the temp goes down.
 
All this is very unusual and has been going on for 2 1/2 weeks (good thing I didn't go to KC -- I was supposed to go to grade AP papers). I thought the fatigue was due to SRT, but I am not sure. This may just be a "simple" upper repiratory virus. But previous infections generally involve a fever!
 
It will probably be time for a chest x-ray and assorted blood tests (counts, thyroid, etc.).
 
I am so tired of doctor appointments. I remember when my father was ailing as he entered his 90's. His biggest complaint was the myriad doctor appointments. I seem to be out in front on that score.
 
Oh, well...
 
Mel
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .Biopsy 11/30/09. Gleason 4+3. Age: 64. Surgery: Dr. Menon @Ford Hospital, 1/26/10. Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- yes.. PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06; 1/4/11-0.13,3/1/11--0.27. SRT completed 5/13/11

Sleepless09
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Date Joined Jul 2009
Total Posts : 1267
   Posted 6/12/2011 8:52 PM (GMT -6)   
Hi Mel,

Sorry to hear about your being ill.

about four weeks ago I was hit with something that had me laid up in bed for near a week. I still can't believe how hard it hit and how drained I was. I think there must be a really nasty virus making the rounds. It will be interesting to hear what your doctor has to say.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  

compiler
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Date Joined Nov 2009
Total Posts : 7197
   Posted 6/12/2011 8:59 PM (GMT -6)   
Well, we know the big fear-- WILL THEY FIND A SUSPICIOUS SPOT?
 
Never ever would have thought that with this type of illness -- before PC.
 
Crazy!
 
But I'd like to get a handle on this. I want to work out. I have done some brisk walking. My wife and I did about 4 miles yesterday...I felt ok then but today the fatigue hit this afternoon!
 
 
 
Mel

142
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Date Joined Jan 2010
Total Posts : 6891
   Posted 6/12/2011 9:27 PM (GMT -6)   
Mel,
 
The really difficult part of the fatigue for me is that it is only almost predictable. And, when someone at the office coughs, I wind up that night with a fever.
 
The daily part is easy, but if I miss that early afternoon cat nap, I have no clue when it will hit, or how hard.
 
I can't say I think much about what the doc might find.
 
Hope you get better.

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 6/13/2011 8:52 AM (GMT -6)   
I42:
 
We shall see. It does feel a lot like the pneumonia I had many years ago.
 
Mel

compiler
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Date Joined Nov 2009
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   Posted 6/13/2011 9:03 AM (GMT -6)   
True.
 
Would blood work show this?
 
Mel

JNF
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Date Joined Dec 2010
Total Posts : 3655
   Posted 6/13/2011 9:38 AM (GMT -6)   
My white count droppped quite a bit during radiation and I understand that is to be expected. I get checked again next week. Fortunately, I did not get fatigued from radiation, nor have I had any illnesses since stopping radiation nearly six months ago.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard shot and daily Jalyn started on 10-7-2010.
IMRT to prostate and lymph nodes 25 fractions started on 11-8-2010
HDR Brachytherapy December 6 and 13-2010.
PSA <.1 and T 23 on 2-3-2011.
PSA <.1 on 4-7-2011
Second Eligard shot on 4-7-2011

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 6/13/2011 11:05 AM (GMT -6)   
JNF:
 
Can you elaborate?
 
Is the WBC supposed to pick back up over time?
 
Mel

142
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Date Joined Jan 2010
Total Posts : 6891
   Posted 6/13/2011 12:00 PM (GMT -6)   
Mel,
 
As we've discussed before, both my white and red cell counts fell far below minimums during RT. It is just at a year later now, and the red is at the low end of the normal range, white is just below the bottom of the normal range.
 
They should both get back to normal "within a year" per my GP. I'll find out for sure at my next blood work in October.
 
 
My RO said they were not normally impacted (LOL).

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 6/13/2011 1:14 PM (GMT -6)   
My RO I think said this doesn't happen. Obviously...
 
Anyway, not sure about my situation.
 
I know I seem to be getting sicker.
 
It still might just be a nasty virus (but possibly infected due to messed up immune system).
 
Mel

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 6/14/2011 11:23 AM (GMT -6)   
Update:
 
Saw my doctor today. He did do a chest x-ray and that was perfectly normal.
 
He then had me do a bunch of lab tests (counts, thyroid, mono, etc.). He said the counts data should be in tomorrow.
 
Based on information gleaned on HW, I suspect the counts may show some abnormality.
 
He also prescribed zithromax as it might be a bronchial infection (but probably isn't!).
 
Mel

Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 6/14/2011 2:27 PM (GMT -6)   

Mel:

Let's just look at it is only an infection and think positively about your results from the tests.  IMO your immune system was  left in a weaker state after radiation and there are some nasty chest "bugs" circulating everywhere. Think positive my friend.

Jack


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 6/14/2011 3:47 PM (GMT -6)   
Well, the major symptom here is this horrible fatigue. It has gotten worse and I am really not able to function too well. I'm too tired to do anything. Fortunately, I don't have to do anything this week.
 
I'm going to start the zithromax tomorrow on the long shot that it is a bacterial infection.
I'm going to first wait until I get the blood test results, although he did not say to wait.
 
Mel 

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 6/15/2011 12:54 PM (GMT -6)   
More frustration. I got the results of a battery of tests.
All are within the normal range with one glaring exception.
Here are some results with the normal range, and the exception:
WBC 5.9 [4.8-10.8]
rbc 4.68 [3.6, 6.1]
hemogl. 15.3 [14-18]
hematocrit 44 [42-48]
OK, there's more. But on the WBC Differential, it lists:
Lymphocytes at 18 % with normal [25-45]
My doctor says this is not significant. My reading seems to indicate that this is a problem.
All the other figures are normal. Is this insignificant? It would seem to explain my problem.
I also called my RO. My RO (his nurse) says none of this has anything to do with the SRT and the 18% is not significant. Based on past responses to any complaints, I am not surprised at the RO response.
 
However, 18% seems a lot less than the minimum of 25%. I am not convinced this is insignificant and it certainly fits with my symptoms.
 
 
 
 
 
Mel

Tim G
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Date Joined Jul 2006
Total Posts : 2286
   Posted 6/15/2011 1:52 PM (GMT -6)   
Mel,

What most docs look at is the absolute numbers of white blood cell subcategories, not so much at the percentage.

Your total WBC count is 5,900 per mm3, so at 18%, your lymphocytes are 1,062 per mm3. Normal values for this (reference range) are about 1,000 to 3,500 per mm3. In other words, your lymph count is low normal.

Take care and hang in there!

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 6/15/2011 4:21 PM (GMT -6)   
Tim:
 
Actually, after reflection, that's what I was thinking.
 
Here's what I wrote a friend, using the numbers on the report:
 

> Also, applying some mathematics, maybe that 18% is not significant. Here's
> why.
>
> My WBC is 5900. Normal is 4800, min. The lowest normal lymph. is 25%. If I
> apply this to 4800, then the lowest number of lympho. to be normal is 1200.
> If I take 18% of my 5900, then that is 1062. That is subnormal, but not way
> way off. So, maybe it is not significant?
>
 
If we go with the 1000, better yet.
 
But, still, no explanation of why I am sick and why the low body temp.  Hopefully, this will just dissipate. I am going to wait a week before trying the antibiotic (no evidence of a bacterial infection, and Zithromax has a new black box warning about dire intestinal problems and as part of the warning they specifically mention using Z with a viral upper respr. infection).
 
Mel
 
 

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3655
   Posted 6/16/2011 7:44 AM (GMT -6)   
Mel,

My wife and I were each going through radiation at the same time (her second time). Our separate rad oncs both said that radiation can have an adverse effect on white and red blood cell formation and that it is normal to see these levels drop a bit. They both said they will rebound after the radiation stops. In my case the docs are not concerned and I have a blood test each six months. My wife has more frequesnt checks (every two months) as she also had chemo therapy which hits blood cell formation very hard.

Before tx my WBC was high outside normal (13 or so) and post treatment it was low normal (4 or so). I am hoping the next reading is at least in the mid range normal.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard shot and daily Jalyn started on 10-7-2010.
IMRT to prostate and lymph nodes 25 fractions started on 11-8-2010
HDR Brachytherapy December 6 and 13-2010.
PSA <.1 and T 23 on 2-3-2011.
PSA <.1 on 4-7-2011
Second Eligard shot on 4-7-2011
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