Rick on BCG

So we went in to see the urologist, Dr. Lilly, for Rick's surgery follow up and to hear about the pathology report. Here's Rick:
From the Tabletop Diary:
“May 7, '09, Thursday
Doc Lilly confirmed that it is/was definitely bladder cancer. Good news is it's treatable without chemotherapy or radiation. The treatment is intravesical by immunotherapy which means a live bacillus (bacteria) called Calmette-Guerin (BCG) is placed inside the bladder with a catheter and left there for two hours. The bacteria seek out and destroy the cancer cells while the body seeks out and destroys the bacteria triggering the immune system to attack cancer cells. Pretty slick, however, like any immunization, it causes a low-grade infection in the body and you feel like crap for a day or so.
A nurse loaded me up and within 2 hours I started feeling like crap. After I peed it into the toilet, I was instructed to add 2 cups of household bleach to the water and flush after letting it cook for 20 minutes. I get to do this for the next six hours and drink lots of water in between.
I'll go in every week for the next five weeks for a repeat of the treatment; then I get 6 weeks off followed by a biopsy to look for cancer cells. If they find some, they repeat the treatments; if not, I get some time off before the next checkup.
Yes, this is long term treatment – from two to five years or, at my age, perhaps for the remainder of my life.
Also, treatment with BCG is not without risk. There have been instances of bleeding, clotting, high fevers and even hospitalization. In rare cases, death.”

And here's Mary:
Whew. Have you noticed how many medical treatments end their descriptions end with, "Oh yeah, and you might die?" But if you don't get the treatment, the disease will have its way with you, so you go ahead and have the treatment.
Rick will be going back in to be filled up with BCG every Friday morning for the next five weeks. "So," he said to me as we walked out of the elevator at the Arnold Pavilion,* "no vacation this year." He'll be using his vacation days for BCG treatment and recovery. Hey, we never go on vacation anyway.
The good news in all this is that the cancer had not invaded too deeply into the bladder wall. Doc Lilly said the stage was T1. Those of you conversant with cancer stages know that cancer is rated in stages 0 through 4, 0 being the least advanced and 4 being the most advanced. Afer Stage 4 you have "recurrent."
The not so good news is that it is a "high grade," or aggressive, type of cancer, but it is treatable, and Rick has started treatment.
*The Arnold Pavilion is one of the many large buildings that are part of the main campus of Swedish Hospital up on First Hill, above downtown Seattle, also known as "Pill Hill" because of its high population of hospitals and medical offices and facilities. Swedish is a sprawling collection of buildings, and if you get sick in Seattle you're likely to spend time there, unless you belong to Group Health, Seattle's legendary HMO.
The other nearby hospitals on First Hill are Harborview, the county hospital; and Virginia Mason Hospital, which is now affiliated with Group Health. All of these hospitals take up a few blocks of space. Going a little farther east from Swedish you come to what is now called the Swedish Cherry Hill Campus, formerly Providence, a Catholic hospital. Cardiac care is done at Cherry Hill, and that's where I had my angiograms.
Another Catholic hospital, founded by Mother Cabrini, was absorbed into the main campus on First Hill some years ago. Hospitals are like oil companies and newspapers: they consolidate into larger, and fewer, entities.
The main Group Health campus is north and east on Capitol Hill.
I arrived here in 1972, so these are the hospitals I know about. I know there were more, but they were before my time. There are other hospitals in Seattle: Highline, down in Burien; the Ballard campus of Swedish Hospital in, naturally, Ballard, and formerly the Ballard Hospital; and Valley Medical down in Kent. Those are the big ones I know about in or near the Seattle city limits. I'm sure that is an incomplete list.
They are all rabbit warrens, mazes of halls and floors and elevators and sky bridges.
Much of the Arnold Pavilion is devoted to cancer treatment, starting with the Swedish Cancer Institute on the ground floor. The Arnold Pavilion is also where you go for mammograms, ultrasounds, and other tests and treatments, not necessarily having to do with cancer. It is connected by skybridges with the main Swedish hospital building to the south, where Rick had his TUR last week, and to the Nordstrom Tower to the west, another complex of medical offices.
So that's it for today.
Tomorrow I go in to the Sleep Medicine Associates and talk about how great my CPAP machine is and how nice it is not to be dying in my sleep anymore.
Every day in every way I understand more deeply that joke that "old age ain't for sissies."

Today's photos are of the purple rhododendron blooming in front of the house, and Rick back at work on his cartoon strip, while recovering from BCG treatment.