2005 - Pneumonia & By-Pass Surgery

05-Jan-05
PSA = 3.26

03-Mar-05
PSA = 3.39

23-Mar-05
PSA = 4.29, Free PSA = 0.18, PSA Ratio = 0.04

28-Mar-05
Dr Seward - given cough syrup for persistent cough
START Tussionex 1tsp q 12 hrs prn

04-Apr-05
To Stevenson Mem. Hosp Emergency. Dx: Pneumonia
START BIAXIN 250mg 2tabs bid

05-Apr-05
Nauseated and vomiting - suspect conflict with Biaxin & Tussionex
STOP Tussionex

14-Apr-05
STOP BIAXIN -lungs appear clear

14-Apr-05
First meeting with Cardiac Surgeon Dr. Richard Bauset, MD, FRCS(C)

26-Apr-05
PSA = 4.58

27-Apr-05
Pre-Op Clinic at Southlake

11-May-05
STOP Ketoconazole. Saw Dr Tannock (drop-in to clinic) stay on HC

11-May-05
STOP ALL SUPPLEMENTS EXCEPT VIT C
STOP Aspirin
START PMS Amiodarone 200mg t.i.d.

18-May-05
STOP PMS Amiodarone
18-May-05 Bypass surgery scheduled -patient in hospital, IV started of 100mg Cortef - stretcher on the way - Cancelled due to emergency patient.
Rescheduled June 2nd

25-May-05
PSA = 7.26
START PMS Amiodarone 200mg once daily

02-Jun-05
Arrive at Southlake Hospital for by-pass surgery @ 5:45am. Told it was cancelled AGAIN - this time because surgeon was in O.R. all night and still there. He had also cut his finger and it was infected. Rescheduled for June 9th

09-Jun-05
STOP PMS Amiodarone
Triple By-Pass cardiac surgery successfully undertaken. Veins salvaged from both legs medial groin to knee.

10-Jun-05
Taken from ICU to cardiac floor in A.M. Nursing care Excellent at Southlake.

14-Jun-05
Discharged home.
START Altace 2.5mg once daily
START Metropolol 62.5mg b.i.d.
START ASA 81mg enteric once daily
Re-Start CORTEF (HC) 10mg b.i.d.
START Lasix (for leg swelling) 20mg once daily
Re-Start Vitamin Supplements

15-June-05
Visiting Nurse changed leg bandages, checked all wounds.

16-June-05
Visiting Nurse removed half the leg staples & rebandaged.

16-Jun-05
Phone conversation with Dr Ian Tannock; agreed to reducing HC gradually as long as no symptoms. Also will book BMD (July 18th) and has postponed our meeting with him until July 27th.

17-Jun-05
STOP Cortef 10mg b.i.d.
START Cortef 5mg b.i.d.

17-Jun-05
Dr Seward (GP) - Requested blood Work

18-Jun-05
Visiting Nurse: Remaining Staples removed, wounds left unbandaged.

23-Jun-05
PSA 12.56 - Lupron shot that evening.

24-Jun-05
Dr. Seward:
START Cephalex 500mg for incision infection in legs.
STOP Cortef 5mg b.i.d.
START Cortef 5mg once daily in A.M.

30-Jun-05
Dr Seward
STOP Altace 2.5 mg daily
START Altace 5.0 mg daily
STOP Metropolol 62.5mg b.i.d.
START Metropolol 25MG b.i.d.

01-Jul-05
STOP Cortef 5.0mg daily
START Cortef 2.5mg daily

04-Jul-05
STOP Cephalex 500mg - infection appears healed and Gord beginning to be more active.

07-Jul-05
START Graviola 450mg q.i.d. (4 times daily) Not prescribed by physician!

08-Jul-05
STOP Cortef 2.5mg daily
START Cortef 2.5mg every other day

08-Jul-05
Dr Hess - Cardiologist EKG all well! Booked Echo Cardiogram Aug 18 before final discharge!

15-Jul-05
STOP CORTEF.

18-Jul-05
BMD at PMH - Tannock's verbal "You have the bones of a young man" not given any written report. Report sent to Dr. Robert Joss at St Michael's.

21-Jul-05
PSA = 10.15

26-Jul-05
Discovered lump at side of right leg incision, about the size of an egg, soft, not painful.

27-Jul-05
PSA= 8.39
Dr Tannock @ PMH. Gave permission to retry Casodex.

28-Jul-05
START Casodex 50mg daily

07-Aug-05
STOP Graviola (Temporarily out of stock)

10-Aug-05
REHAB Stress Test. Had to stop due to legs giving out - no chest discomfort. Cardiologist in attendance concerned about cholesterol levels. Looked at lump on incision and thought it was a collection of blood from surgery that it would dissolve over time. (It is already smaller than when first discovered.)

11-Aug-05
Saw Dr Seward who confirmed lump as a haematoma - not to worry.

16-Aug-05
PSA= 6.69; Free PSA= 0.37; PSA Ratio= 5

18-Aug-05
Echocardiogram

22-Aug-05
START Graviola 450mg q.i.d.

01-Sep-05
At Rehab managing treadmill for 1 hour at 4kms/hr

08-Sep-05
Dr. Seward knows about Graviola; Pleased with downturn in PSA.

14-Sep-05
PSA= 6.09

15-Sep-05
Stop Graviola to assess Casodex activity

30-Sep-05: - Saw Dr. Seward (GP) for prescription renewals; Told to stop iron and start a multivitamin pill containing iron. Also told that cholesterol was "right on target". Cardiologist report on Echocardiogram (Aug 18th) showed some leaking at the Aortic valve. Needs to get a medicalert bracelet and inform dentist that he needs antibiotic pre-medication before dental work.

10-Oct-05: - We finally got to speak with Dr Hess (cardiologist), who assured us that Gord's minor Atrial leakage was a non-issue and could carry him over the next 300 years! That was a huge relief.

11-Oct-05: - Podiatrist during regular visit this morning showed some concern over the swelling and some redness and heat in Gord's right ankle. As usual, Gord had not seen fit to mention this, assuming it was the normal post-operative healing going on We had put in a call to the Cardiac Surgeon's office because we had yet to get a follow-up date to see him. When the receptionist called back with a date, I asked about these symptoms and she gave me the number of the cardiac floor at the hospital and the names of the nurses there to ask for. The receptionist on the floor put it to the nurses and they suggested Gord see the GP and if he cant get an appointment to go to a walk-in clinic. By the time I had this information, Gord had headed to Newmarket for his Tuesday Rehab. I called him there and told him what was said and told him to ask the nurses there if he should do rehab or if there was a doctor there to look at the ankle. They barely looked at it and sent him home without allowing rehab. Meanwhile I tried to get his GP - receptionist there said he was fully booked Tuesday and Wednesday and to go to emergency - so when Gord got back from Newmarket, we headed to the local hospital ermergency. A nice female doctor with a lovely European or Spanish accent saw us and gave us a great sense of relief - NOT a DVT!!! (Deep Vein Thrombosis) but possible beginnings of cellulitis. Keep it elevated, keep wearing support hose - keep up with the rehab and watch it closely! Tempest in a teapot!

11-Oct-05: PSA=6.64; Free PSA= 0.41; PSA Ratio= 6

20-Oct-05: - Gord complained of pressure in his chest on about the third lap of Rehab today. He did not want to stop however, so we slowed the pace and kept going and it appeared to dissipate and he finished his requisite 35 laps. I am a bit discouraged about this - thought the surgery had taken care of this symptom.

24-Oct-05: - Asked for PSA results (See Oct 11th above) at Dr Seward's office to be prepared for Oncologist visit on Wednesday. Casodex not working! PSA rising.

26-Oct-05: - To Princess Margaret Hospital. Lab. results pending. After 2 hour wait in the clinic, was seen by a Dr Joseph instead of Dr Tannock. Confering with Dr T. they want to wait for next local PSA to see if continued trend upward using same (SMH - local) assay. If further elevated, come off Casodex again. Told oncologists about the Graviola result. They have no problem with Gord taking it, "if you think it helps you" Gord is waiting until next PSA before re-starting it.

27-Oct-05: - Saw Cardiac Surgeon, Dr. Beauset in Newmarket. He agrees with cardiologist that the atrial leakage is minimal and not a worry. Noted still oedema in legs; suggested diuretic, but again normal for post-op by-pass. Discharged.

28-Oct-05: - Dr. Seward: Gord given Flu Shot and Rx for Hydrochlorathiazide 12.5mg daily.

29-Oct-05: - START Hydrochlorathiazide 12.5mg daily

08-Nov-05: - PSA = 7.78

10-Nov-05: - Saw Dr Arts - neurologist - 6 month check-up/ no neurological problems

15-Nov-05: - Dr Seward: BP good 130/??? - given Pneumonia Shot; oedema in legs
improved - continue hydrochlorothiazide. Told PSA result of Nov 8th above. Blood lab
requisition to check electolytes.

15-Nov-05: - STOP Casodex - Informing Dr Tannock's office

15-Nov-05: - START Graviola 900mg b.i.d.

06-Dec-05: - PSA = 7.70. Extra bloodwork requested; all results "normal" as usual we do not see the records.

07-Dec-05 : - Saw Dr. Tannock at Princess Margaret Hospital. He again re-iterated Gord has "SLOW" disease, has no other hormone manipulation to offer, yet does not want to start him on chemo either as it may impact his present QOL. We decide to relax, enjoy Christmas and see what 2006 holds for us.