![[Dattoli]](http://mywebpages.comcast.net/tdoherty/Dattoli.jpg)
The whole Tampa experience was top notch.If interested, please read on.
The whole Tampa experience was top notch.
If interested, please read on.
Below are all the very explicit details of my prostate cancer treatment by Dr. Michael Dattoli in Tampa, Florida using conformal 3-D external radiation combined with implantation of Pd-103 radioactive seeds into my prostate and of my recovery.
The photo was taken just 12 hours after the seeding.
After spending some time with the nurse going over my prescriptions to take after my release, I was released at 10:45am (Wednesday July 15) and was to be taken to one of the outside doors. My wife and I got to the apartment at 11:30am with the medicines I was to take for the next few days: Decadron (steroid anti-inflamatory), Trovan (antibiotic) Pepsid AC; I also decided that I had better take a daily dose of Metamucil to control constipation.
After I am gradually weaned off Decadron, then I'll begin Motron and Cardura (anti-inflammatory). Cardura (but NOT the Motrin) can be taken earlier jointly with the reduced Decadron dose if urinary flow is too slow. Cardura may give ankle swelling. If so, Hytrin or Flowmax are alternatives.
My diet consisted of no acidic fruit drinks (e.g. citrus) or caffeine or alcohol because all would further irritate my urinary pain.
Nothing that would irritate the bowels by not digesting well; e.g. seeds, nuts, whole grain cereals, fresh fruits (except ripe raw bananas, skinned apples), raw vegetables. Cooked vegetables are OK, but no potato skin.
Think bland: no sharp cheeses, no fried foods, no sharp cheeses. However, Dattoli is fairly loose with these restrictions, saying that some people do not have to change their diet. I am conservative enough that I will change to keep complications down.
Everything seemed to go OK until very early Sunday morning (5 days after seeding) when my urinary stream was extremely difficult to start, so at 4am I called the doctor's offfice. Dr. Dattoli, himself, was on call and called me back in 10 min. He prescribed an additional 4mg pill of Decadron and two 1mg pills of Cardura immediately to get things flowing again and to then move up the beginning of a daily 1mg Cardura by 8 days starting tonight. He was pleasant, knew exactly who I was and the details of my case and seemed wide awake. I hope I didn't pull him out of bed - I never thought he would be on call at 4am Sunday.
This is my 4th and last report (I hope), coming two months after my July 14th seeding by
Dattoli in Tampa.
My history of medicine consumption since my seeding is (for * see notes at bottom):
26 Daily Dosage in milligrams (2x3 = 2mg 3 times/day)
**rtb=rounded tablespoon (I included Metamucil in the above so I can use this chart to
check off when I take things. Metamucil is simply precautionary, but on the 2nd day after
seeding I was getting constipated and Metamucil helped, so I am continuing it.)
*NOTES
5 Su Jul 19: flow slow [per Dr. Dattoli phone call 4am] to increase flow take 1 4mg Decadron and 2 1mg Cardura now; begin nightly Cardura now instead of Mon the 27th.
12 Su* Jul 26 [Note: I was on 1mg daily of alpha-blocker Cardura to improve urine flow.]
On July 25, at 7pm after playing about 40 min tennis I experienced fatigue with an
irregular heartbeat (missed beats and extra beats). That evening at 11pm my blood
pressure was low (103/73; normal=?) and my heartbeat was high (100 vs. normal 52) and still irregular (dramatically shown while taking blood pressure). I then called Dattoli's office to see if the drugs might be causing the problem. Dr. Koval, on call, recommended stopping Decadron altogether (last pill was to be this morning 7/26) and discontinuing Cardura for that night. If urinary flow is a problem during the night, take 1/2 Cardura, then possibly dibenzyline. I immediately slept for 4 hours (vs. only 2 hours for each of the preceding several nights). When I awoke to pee, it was more difficult, but possible, so I held off taking any Cardura or dibenzyline for little longer.
At 8am Sun my heartbeat was regular, pulse 52, 115/76.
* Day 12 after seeding (Jul 26): After only playing about 40 min. of tennis, I became extremely fatigued with an irregular heartbeat (missed beats and extra beats). Several hours later that night, my heartbeat was still highly irregular.
13 M* 27 [per Dattoli's call 10am, responding to fax] Since Cardura generally has more heart problems associated with it than the other alpha-blockers, Dattoli switched me to Flomax, but had to take both medicines for the next 7 days while I "loaded" Flomax. During this week of dual alfa blockers, my ankles and other parts of my body swelled up and I gained 20 pounds; the assumption being that this weight gain was mostly water.
18 Sa* 1: swollen ankles [per Dr. Dattoli phone call 10:30pm] decided that we would do nothing for now about the ankle and other swelling, he said that there was a medication that could easily solve the problem, but it would make me pee. He said I should keep my feet elevated whenever possible. This I find very difficult to do where I spend most of my time (at the computer).
21 Tu* Aug 4 Have gained about 20lbs to about 185; am extremely "puffy" in ankles and face and stomach as a result of massive water retention. Have stopped Cardura, and (hopefully) dibenzyline.
22 W* Aug 5 To control irregular heartbeat, began again taking 180mg Verapamil daily.
On 6/12/98, I discontinued taking Verapamil (for exercise-induced arrhythmia) due to PSA-related findings as described earlier. 45 minutes of tennis that night without major incident although slight irregular heartbeat (missed beats) immediately after playing (detected using a device that measures blood pressure with both visual and audio outputs). Have not needed dibenzyline since late Monday night. Last night after tennis, had diarrhea for the first time since SI
27 M* Aug 10 Severe irregular heartbeat after only 30-45 min. tennis. Did not play tennis Tuesday or Wednesday.
29 W* Aug 12 Frequent urge and hard to pee; up about every hour to pee; started taking 2 dibenzyline/day supplement to improve flow.
36 W* Aug 19 Because of continued severe irregular heartbeats when playing tennis, my cardiologist switched me from Verapamil to to a much stronger daily 200mg Pacerone (amiodarone). Since amiodarone requires a loading to first be effective, I took a quadruple dosage (800 mg) for the first 10 days.
39 Sa* Aug 22 Over the next 4 days added back to my diet, broccoli, salad with onions, apple, potato skins, red pepper, tuna sub, raison bread (no problems)
43 Th* Aug 27 Motrin prescription ran out on Tuesday morning, but the last two nights it was very difficult to urinate. Requested to go back on Motrin and the flow became better at night.
Day 46 after seeding (Aug 29): Since I couldn't play tennis due to a sore rotator cuff, I decided to improve my fitness and lose some weight by resuming a running program which had been dormant for several months due to hamstring, knee and toe problems. I started with a mile 1/4 run but couldn't run the whole way and had to walk 3 times and my total time was about double previous times. By Sep 10, I could run the course without walking, but my time was no better. However, throughout all these run/walks, my heartbeat was regular immediately upon completion of the run.
Day 61 after seeding (Sep 13): After today's run, I detected my first irregular heartbeat since switching to amiodarone, an anti-arrhythmic drug.
Day 63 after seeding (Sep 15): After today's run, I detected more irregularity in my heartbeat. If amiodarone is not working, I will need to switch to sotalol, another anti-arrhythmic drug. According to my cardiologist, this switch would require an overnight's stay in the hospital to avoid any adverse reaction.
Day 76 after seeding (Sep 28): After today's run in 10'38" (faster time since SI), I had no irregular heartbeats!
Day 77 after seeding (Sep 29): Radiation from seeds now less than 4.5% of original so I began taking again vitamins B, C and E and a mineral complex.
Heartbeat Diary from Tennis and Running Activities:
*************************************************************
Tom Doherty http://mywebpages.comcast.net/tdoherty
I am 57, athletic, in excellent health; live Wilmington DE
PSA = 4.0 (10/94), 5.0 (12/97)-->sextant biopsy 2/6/98 found
prostate cancer on left side; right side not cancerous
left side: base 21% cancerous, mid 47%, apex "suspicious"
Gleason = 6 (3+3) for left base and left mid; Stage = T1c
prostate size = 37.6cc (2/98); DRE & ultrasound = neg
PAP=2.1 (ref=0-2.5 on 3/98);
Casodex (3/19/98+); Lupron/mo (3/27/98+)
endorectal MRI (4/2/98) = no extracapsular spread (size=28cc)
PSA = 1.4 (4/24/98), 0.2 (6/9/98) [all PSA by Hybritech]
testosterone = <15; liver function normal (6/9/98)
discontinued Verapamil 6/12/98 due to PSA-related news
conformal 3D EBRT (7/2-7/21/98)
82 Pd-103 TheraSeeds implanted 7/14/98
Anti-inflammatory: Decadron (urinary) to 7/25 (4mg3x to 2mg1x); then 400mg Motrin
100mg Trovan (antibiotic), Pepcid AC (to lower acidity)
Metamucil/Crangrape and "Anusol" suppositories option 7/16+ (daily)
biweekly Cortenema enema (anti-inflammatory ): start 7/20
start daily 1mg Cardura (for urine flow) 7/19 to 8/2;
10mg dibenzyline (as needed, normal = 1-2/day); now 1/day
0.4 Flomax 2x/day (for urine flow) since 7/27
Due to irregular heartbeat: restarted daily 180mg Verapamil 8/5,
switched to Amiodarone 8/19 (800mg for 10 days, then 200mg)
8-9/00: cut 0.4mg Flomax & 200mg Motrin from twice/day to once/day before bedtime. *************************************************************
Anti-
Urine
Urine
Urine
Anti-
Anti-
Anti-
Anti-
Total
Day
Jul-
infla
flow
flow
flow
bioti
acid
infla
infla
Meta
Sleep
After
Sep
Deca-
Car-
Flo-
diben-
Tro-
Pepcid
Mo-
Corte
mu
Seeds
Date
dron
dura
max
zyline
van
AC
trin
nema
cil
1 W
15
4x3
100
10x2
2 Th
16
4x3
100
10x2
rtb**
3 F
17
4x3
100
10x2
rtb
2
4 Sa
18
2x3
100
10x2
rtb
2
5 Su*
19
2x3
1
100
10x2
rtb
3
6 M
20
2x3
1
100
10x2
1
rtb
2
7 Tu
21
2x2
1
100
10x2
rtb
2
8 W
22
2x2
1
10
10x2
rtb
3
9 Th
23
2x2
1
10x2
rtb
2
10 F
24
2
1
10
1
rtb
2
11 Sa*
25
2
10
10
rtb
4
12 Su
26
1
10
rtb
4
13 M*
27
1x2
.4
10
400x3
1
rtb
5
14 Tu
28
1x2
.4x2
10x2
400x3
rtb
15 W
29
1x2
.4x2
10x2
400x3
rtb
16 Th
30
1x2
.4x2
10x3
400x3
rtb
4
17 F
31
1x2
.4x2
10x1
400x3
1
rtb
4
2nd Half
Life:
18 Sa*
1
1
.4x2
10x2
400x3
rtb
6
19 Su
2
1
.4x2
10x1
Verap
400x3
rtb
5
20 M
3
.4x2
10x2
-amil
400x3
1
rtb
21 Tu*
4
.4x2
180
400x3
rtb
22 W*
5
.4x2
180
400x3
rtb
6
23 Th
6
.4x2
180
400x3
rtb
24 F
7
.4x2
180
400x3
1
rtb
25 Sa
8
.4x2
180
400x3
rtb
26 Su*
9
.4x2
180
400x3
rtb
27 M*
10
.4x2
180
400x3
1
rtb
28 Tu
11
.4x2
180
400x3
rtb
29 W*
12
.4x2
180
400x3
rtb
30 Th
13
.4x2
10x2
180
400x3
31 F
14
.4x2
10x2
180
400x3
rtb
32 Sa
15
.4x2
10x2
180
400x3
rtb
33 Su
16
.4x2
180
400x3
rtb
34 M
17
.4x2
180
400x3
rtb
3rd Half
Life:
35 Tu
18
.4x2
180
400x3
rtb
Amiod-arone
36 W*
19
.4x2
200x4
400x3
rtb
37 Th
20
.4x2
200x4
400x3
rtb
38 F
21
.4x2
200x4
400x3
rtb
39 Sa*
22
.4x2
200x4
400x3
rtb
40 Su
23
.4x2
200x4
400x3
rtb
41 M
24
.4x2
200x4
400x3
42 Tu
25
.4x2
200x4
400x2
rtb
43 W*
.4x2
200x4
rtb
44 Th
27
.4x2
200x4
400x2
rtb
45 F
28
.4x2
200x4
400x3
rtb
46 Sa
29
.4x2
200
400x2
rtb
47 Su
30
.4x2
200
400x2
rtb
48 M
31
.4x2
200
400x2
49 Tu
1
.4x2
10
200
400x2
rtb
50 W
2
.4x2
10
200
400x2
rtb
4th Half
Life:
51 Th
3
.4x2
10
200
400x2
52 F
4
.4x2
200
400x2
rtb
53 Sa
5
.4x2
200
400x3
54 Su
6
.4x2
10
200
400x3
rtb
55 M
7
.4x2
10
200
400x2
56 Tu
8
.4x2
10
200
400x2
rtb
57 W
9
.4x2
10
200
400x2
58 Th
10
.4x2
10
200
400x2
rtb
59 F
11
.4x2
10
200
400x2
60 Sa
12
.4x2
10
200
400x2
61 Su
13
.4x2
10
200
400x2
rtb
62 M
14
.4
200
400x2
63 Tu
15
.4x2
10
200
400x2
64 W
16
.4x2
10
200
400x2
65 Th
17
.4x2
10
200
400x2
rtb
66 F
18
.4x2
10
200
400x2
67 Sa
19
.4x2
10
200
400x2
5th Half
Life:
68 Su
20
.4x2
10
200
400x2
69 M
21
.4x2
10
200
400x2
70 Tu
22
.4x2
10
200
400x2
71 W
23
.4x2
10
200
400x2
72 Th
24
.4x2
200
400x2
rtb
73 F
25
.4x2
200
400x2
74 Sa
26
.4x2
200
400x2
75 Su
27
.4x2
200
400x2
76 M
28
.4x2
200
400x2
77 Tu*
29
.4x2
200
400x2
Anti-
Urine
Urine
Urine
Anti
Antiar
Anti
Anti
Total
Day
Jul-
infla
flow
flow
flow
bioti
rhyth
inflam
infla
Meta
Sleep
After
Sep
Deca-
Car-
Flo-
diben
Tro-
Amio-
Mo-
Corte
mu
Seeds
Date
dron
dura
max
zyline
van
darone
trin
nema
cil
(hrs)
Time (min)
Blood
Heart
2.Blood
2nd
Heart
Date
Tennis
Pressure
Pulse
beat
pressure
Pulse
beat2
Comments
Aug
11
115/81
66
reg
NewLondon NH
148/85
64
NewLondon NH
Aug
12
none: 4am
125/93
61
NewLondon NH
40 min: 8p
120/82
75
tennis to 6:30p
Aug
13
hard tennis
115/77
84
irr
127/90
90
irr
4p: very irreg
to 3:30p
115/99
85
irr
115/99
85
irr
10p: very irreg
Aug
14
9 games:2p
130/86
73
9pm
Aug
18
none
133/81
62
5pm
Aug
26
139/85
82
reg
20min bike
Run
Aug
29
12'
145/90
87
reg
Walk 3 times
Sep 1
11'25"
118/78
100
reg
Walk 3 times
Sep 3
11'07"
reg
Walk 3 times
Sep 4
12'
157/91
86
reg
Walk 3 times
Sep 6
11'45"
150/79
108
irr
162/86
88
Walk 2 times
Sep 8
11'50"
148/79
107
reg
150/73
90
Walk 3 times
Sep 10
12'41"
142/77
91
reg
Walk 4 times
Sep 12
11'06
152/78
128
reg
166/82
101
no walk
Sep 13
11'37"
138/37
103
irr2
143/95
83
irr4
no walk
Sep 15
11'30"
152/69
93
irr2
Sep 17
11'30"
136/81
82
reg
Sep 18
11'19"
142/74
107
reg
Sep 19
11'25"
139/61
105
irr1
130/75
84
irr1
3rd pulse reg: 82
Sep 21
11'21"
167/144
122
irr2
156/92
84
irr3
3rd pulse reg: 82
Sep 22
bike 30'
113/73
83
irr3
118/68
65
irr5
3rd pulse reg: 82
Sep 24
bike 30'
124/68
83
reg
Sep 24
10'48"
168/74
100
irr1
Sep 27
bike 30'
126/74
85
reg
Sep 27
10'58"
168/74
84
reg
Sep 28
10'38"
146/81
81
reg
For additional details see
Stages of My Seeding Experience:
External Radiation (Conformal 3D-EBRT) and Preparation for Seeding,
Brachytherapy (Implanting 82 Palladium-103 Seeds),
Post-Seeding EBRT,
Recovery Complications, Medicines and Heart Concerns,
My Doctors and
Overall Summary
Visit the SeedPods web site at http://www.prostatepointers.org/seedpods
to learn even more, and to ask your own questions.
Tom Doherty's Home Page