Meet My Radiologist

Daily Quote: "Dr. Sheehan was diagnosed with prostate cancer in 1986. By the time it was discovered it had spread to his bones. For seven years he lived with the cancer, and 'made every day count.' He was a runner to the core and he would not let the cancer change that. He ran until his legs could no longer carry him. Through it all, he remained true to himself, continuing to write about his experiences. This time it wasn't about running, it was about dying. Going the Distance was his last book. It was published shortly after his death."  --from GeorgeSheehan.com, http://www.georgesheehan.com/welcome/bio.html

I'll need to re-read the book "Going the Distance" during my own cancer fight as to keep me motivated to push myself forward.  Dr. Sheehan is a great role model for me!

Today is the first day I meet my Radiologist, Paul K. Treadwell;  I read his bio at the 21st Century Oncology website, which stated:

Paul K. Treadwell, MD, Board Certified in Radiation Oncology, received a Bachelor of Science with honors from the University of California. He graduated from medical school at the University of Nevada with a Cerficicate of Distinction in Surgery. He did his residency at the University of California, Irvine. During his residency Dr. Treadwell received the American Cancer Society Clinical Fellowship Award and served as Chief Resident for two years.
Before relocating to Las Vegas, Dr.Treadwell was the Associate Head of Radiation Oncology at St. Joseph Hospital and Children's Hospital of Orange County and was a Clinical Professor in Radiation Oncology at the UNiverisity of California, Irvine. Dr. Treadwell is a member of the American Medical Association. Dr. Treadwell's special interests include breast and gynecological cancers and Hodgkins lymphoma.
He is a member of the American College of Radiation Oncology (ACRO).

Hi bio gave me confidence he was competent enough to be one of my Knights in my struggle to beat cancer.  His photo was obviously taken when he was much younger, as the man has grown heavier and grayer. 

The following is a gist of my consultation with Dr. Treadwell at 21st Century Oncology at 8:00 a.m. on March 30th.  Completed several pages of paperwork.  Was taken to a very small room where the doctor's assistant took my blood pressure.  A few minutes later Dr. Treadwell entered and sat down across from me and was rather blunt about my throat cat scan, that I have squamous-cell carcinoma.  He proceeded to check out my lungs with his stethoscope.  After my quick checkup, I asked what will be my treatment? The chemo-radiation treatment will take about eight weeks and consist of 40 treatments.  Dr. Treadwell stated that the success rate of the chemo-radiation treatment is about 75-80% and much better than the alternative of cutting out my tongue, which I readily agreed!



He strongly suggested that I take a medical leave of absence from work as the treatments are very tough, the last three weeks of treatment are particularly difficult.  Unfortunately, I can't afford to take that much time off from work and told him I prefer to struggle through the process of working and taking treatments.  Trying to deter me he mentioned a previous patient who was a security guard in tremendous physical condition rippling with muscles who also wanted to work during the treatment weeks, but eventually had to quit his job as the treatments were just too tough for him.  He didn't realize that his little story sounded like a challenge to me, and had me repeating that I was not going to take a leave of absence from work.

I mentioned that I work from 12:00 p.m. to 12:00 a.m. and my treatments must be in the mornings.  He stated their are no guarantees when the treatments are scheduled.  Oh well, the treatments only take 15 minutes, not including the waiting room time, I could visit the radiologist when I'm working and treat it like a lunch break...I wish the doctor's office wasn't so far off the Strip.

The side effects during chemo will be that my saliva will be thicker, will need to eat through a feeding tube and I will not be able to taste for four months! 

I asked when do we start my treatments.  I had several projects before treatment:

(1) Need dentist approval as to not have any root canals exposure...the radiation could eat my jaw and teeth resulting in partial or total removal of my jaw.  The dentist also has to retrieve for me a flouride brace (I have no clue what it is) and will use the flouride for the rest of my life.

(2) Southwest Medical will need to provide me a feeding tube and will need instructions on how to use and clean it.

(3) I must have a PET Scan as to see if my cancer has spread or if cancer is still isolated above my neck.  I have a PET Scan already scheduled for April 1st at Steinberg Diagnosic.

(4) Approval from my HMO, which sometimes takes two weeks!  My insurance does like to drag things.

The consultation only took about 15 minutes and then I went immediately to the gym and ran six miles (at 6.0 mph, 1% grade) on the treadmill before work.  Called my dentist and made a consultation appointment for Monday, April 4th, 9:15 a.m.  It was an exhausting day, but feels great that I'm finally beginning to start my fight against cancer.

My next post will be about my PET Scan.  Bare with me, I'm a little behind due to time restraints.

Result of Neck Cat Scan

Daily Quote: "Ninety percent of cases of head and neck cancer (cancer of the mouth, nasal cavity, nasopharynx, throat and associated structures) are due to squamous-cell carcinoma. Symptoms may include a poorly healing mouth ulcer, a hoarse voice or other persistent problems in the area. Treatment is usually with surgery (which may be extensive) and radiotherapy. Risk factors include smoking and alcohol consumption." --Wikipedia

Finally received the results of my Neck Cat Scan that was at Southwest Radiology on March 23rd, which was taken before my biopsy result.  Friday, I'll have a full body Pet Scan, which will show if the cancer has spread to my lower lymph nodes and/or other organs.  The following is the result of my Neck Cat Scan:



CT NECK WITH CONTRAST
CLINICAL HISTORY: Benign neoplasm of tongue.
COMPARISON: None.


PROCEDURE: Following the uneventful administration of intravenous
contrast material, CT images are obtained from the skull base through
the aortic arch.


FINDINGS: Lung apices are grossly clear. Slight degenerative changes
are seen in the spine. Dental hardware is seen. There is mucosal
thickening along the inferior aspect of both maxillary sinuses.
Visualized mastoid air cells are clear. The parotid glands,
submandibular glands and the left thyroid lobe are unremarkable. There
is a partially calcified cystic and solid nodule involving the right
thyroid lobe on image #69, measuring 10 mm. There is uniform
enhancement of the great vessels of the neck. There is focal nodular
thickening along the base of the tongue towards the right side of the
vallecula on image #37, measuring 3.2 x 1.8 cm. Bilateral abnormal
lymph nodes are seen in the jugular chain region, zone II on the
right, measuring 2.3 x 1.5 cm and left side on image #34 measuring 1.7
x 1.4 cm.

IMPRESSION:


1. Focal soft tissue thickening and masslike area along the vallecula
centered towards the right side. In addition, there are multiple
abnormal jugular chain lymph nodes along the zone II bilaterally.
These are worrisome for malignant neoplasm, recommend further
evaluation.


2. Mucosal thickening is seen along the maxillary sinuses bilaterally.


3. A 1 cm partially calcified nodule along the right thyroid lobe.
Recommend dedicated evaluation when clinically appropriate or
comparison to a prior.

Ran after work on my gym's treadmill at 12:15 a.m.  Easy run, six miles on the treadmill with a 1% grade, which was done at 6.0 mph (10 minute miles.)  No heart rate monitor.  It's very tough to run after work as the stressful 12-hours driving a cab on the Strip takes alot out of me, but I do feel a sense of accomplishment afterwards, like I have at least some control over something!

Hill Repeats

Daily Quote: "'Life, on the Line: A Chef's Story of Chasing Greatness, Facing Death, and Redefining the Way We Eat' (Gotham Books, $27.50), by Grant Achatz and Nick Kokonas: Grant Achatz had already won acclaim as one of America's top chefs when he was diagnosed, at age 33, with advanced cancer of the tongue. The recommended treatment was devastating: A surgeon would remove his tongue, lymph nodes and a portion of his jaw. There would be chemotherapy and radiation, and still his chance of survival would only be 50 percent." --by M.L. Johnson, The Associated Press, updated 3/3/2011

The above quote doesn't exactly give me warm fuzzy feelings about my own tongue cancer, although at this time I don't know how advanced my tongue cancer, I should read Achatz story as to understand my own possible therapy and struggles. 

Today I finally ran Hill Repeats, which was done at my gym's treadmill.  The first two miles was at 6.0 mph with no grade, then 4 x .25 miles at a 5% grade, 6.3 mph.  Recovery intervals a .25 mile with no grade and at 6.0 mph.  Finished with a two mile cooldown at 6.0 mph and no grade.  Average heart rate: 159 bpm, cardiac drift during the repeats 173 bpm.  Note, my maximum heart rate is 188 bpm.

I called Steinberg Diagnostics and left a message on their answering machine.  Still no word from Steinberg Diagnostics about setting an appointment for my pet-scan.  Should visit the doctor's office tomorrow as to physically set an appointment.  Wednesday is my first appointment at 21st Century Oncology to see Dr. Treadwell.

Base Building, March 21-27, 2011

Daily Quote: "If you were healthy and at a good weight when you were 25, there's almost never good reason to be significantly heavier than that.  Even if you've tacked on muscle -- which, come on, is usually not the case -- the extra weight is almost certainly making you slower, not faster.  As runners, we already live in ways contrary to accepted beliefs on what aging is supposed to be like, so why not take that attitude toward weight as well?" --Scott Douglas, Running Times Magazine, "Scott's Original Miscellany" March 2011, pg 52.


This week I returned to base building and increasing my mileage...I returned to running with a vengenance as I was chasing away many negative demons from my thoughts.  I'm gradually transferring my runs to after work rather than before work, I need my mornings for doctor appointments and future treatments.  The transition from running at 10:00 a.m. to my new schedule of 12:30 a.m. is difficult as I'm pretty exhausted after working a 12 hour shift as a cab driver...but I must keep myself motivated to stay fit and strong for the upcoming cancer battles.

My weight today is 175.2 pounds on my six foot frame! I'm so close on reaching my goal of 170 pounds!!

I ran a total of 40 miles, which is the most weekly miles this year!   Due to my discovering that I have cancer, my goal of building my base mileage to 60 mpw may not be realistic, but I'll strive to improve as much as I can with whatever life throws at me.  Last week I had to change my Rest Day to Tuesday as I had to wait for doctor appointments approval.  My changing my running schedule for after work should solve those issues in the future.  I didn't have time to squeeze in swimming last week, and may have to drop swimming from my future routines...swimming is just too time consuming as to dress and redress in time for work.

All my runs last week were at an easy aerobic pace of 60-70% of my maximum heart rate, which for me is around 9-10 minute miles.  I wanted to do one session of hill repeats, but lacked the energy to attempt it.  Maybe next week I'll do hill work?!?


Monday: Easy Run, 6 miles.
Tuesday: Rest Day
Wednesday: Easy Run, 5 miles, Upper body weight circuit training.
Thursday: Easy Run, 6 miles.
Friday: Easy Run, 5 miles. Upper body weight circuit training.
Saturday: Easy Medium-Long Run, 12 miles. Cycling, 30 minutes.
Sunday: Easy Run, 6 miles.
Total Weekly Mileage: 40 miles.

My next doctor appointment is next Wednesday at 21st Century Oncology for 8:00 a.m. when I meet Dr Treadwell for the first time.  No, I didn't make up that name, he is Treadwell...sounds like a good omen if you're a runner!!

Bad News.

Daily Quote: "Become a student of the sport.  It ruins none of the magic of self-discovery to learn that thousands of others have gone before you and experienced every challenge and joy that you have.  Take advantage of the lessons others have drawn from their mistakes so that you don't have to repeat them." --Scott Douglas, Running Times Magazine, "Scott's Original Miscellany" March 2011, pg 51.

Yesterday, during work, I received a cell phone call from my Ear, Nose, Throat specialist, Dr. O'Donnel, in regards to the results of the biopsy of my tongue.  I have cancer.  Since I was driving my cab at the time of the conversation we both felt I should call his office this morning.  I called his office and couldn't reach him, therefore left a message and currently waiting for his call. 

Also yesterday, Southwest Medical Radiology finally called my home answering machine in regards to scheduling my throat cat scan.  Called their number, and they put me on their answering machine, left a message and waiting for their call too.

Appears I won't be running this morning as I wait for phone calls.  Will need to leave for work by 11:20 a.m.  This week is a busy cab week due to the large "Concrete World Convention" as well as hordes of students on spring break.  I'm physically and emotionally exhausted.

I'm still in a bit of shock and have thousands of questions to ask my doctor.  It doesn't seem fair does it?  I'm a healthy weight, never smoked, exercise regularly and now I have cancer....most of my family smoke like chimneys, are obese, have a variety of unhealthy habits, yet they are o.k.

Since I'm waiting, I'll start googling "throat cancer" and begin my new battle...

Base Building, March 14-20, 2011

Daily Quote: "Multipace training is, of course, the key to top performance regardless of your target race distance.  But that's not the only reason to regularly do all sorts of workouts, from long runs and basic speed sessions to slow recovery runs and tempo workouts.  There's no better way to keep your running interesting than to have peaks and valleys of intensity and duration woven throughout the weeks."  --Scott Douglas, Running Times Magazine, "Scott's Original Miscellany" March 2011, pg 49.

A week of waiting on my throat condition.  Last Monday morning my Ear, Nose & Throat doctor, Dr O'Donnel, had taken a small piece of the lump from my throat for a biopsy, I haven't received the results of the biopsy so far.  I had also scheduled a CAT scan for my throat area, but Southwest Medical is still awaiting for approval from my HMO.

I'm currently 175.8 pounds on my six foot frame.  Not much of a weight loss last week, which I'm not surprised as I reduced my training, but kept eating approximately the same amount of food.

Last week was a recovery week, when I reduce my weekly mileage and intensity as to allow my body to recuperate.  I strive to have a recovery week every fourth week of training.  My mileage was only 23 miles last week and also eliminated the exhausting and time consuming swimming from my routine.  I'll probably add swimming back to my crosstraining next week.

All my runs last week were at an easy aerobic pace of 60-70% of my maximum heart rate, which for me is around 9-10 minute miles.  Next week I plan on adding a hill workout to my weekly routine.


Monday: Easy Run, 3 miles.
Tuesday: Easy Run, 4 miles. Upper body weight circuit training.
Wednesday: REST DAY
Thursday: Easy Run, 3 miles.
Friday: Easy Run, 4 miles. Upper body weight circuit training.
Saturday: Easy Run, 6 miles. Cycling, 30 minutes.
Sunday: Easy Run, 3 miles.
Total Weekly Mileage: 23 miles.

Base Building, March 7-13, 2011

Quote: "It's not uncommon to go to bed thinking, 'Darn, I should have run today.'  It's not common to go to bed thinking, 'I shouldn't have run today.'"  --Scott Douglas, Running Times Magazine, "Scott's Original Miscellany" March 2011, pg 49.

Last Wednesday I registered for the 2011 Rock n Roll Las Vegas Marathon due to the special promotion for the "Largest Night Race in the World Announcement"...I paid $121 for my entry fee; last year's registration was $145.  The marathon starts at 4:00 p.m. on December 4th and runs under the Las Vegas Strip's neon lights!  The cut-off time is four hour and thirty minutes, which will make this more elitist than the Boston Marathon; I'm not too concerned about the cut-off time as I should be able to finish in the 3:30-3:40 range.

Thursday received this short note from my primary care doctor, Kyra Norris, MD, regarding my fecal globin stool test: "I have reviewed your results and wanted to provide you with an update.  Thank you for choosing Southwest Medical Associates.  The following test(s) are within the normal range: fecal globin stool test (presence of blood in the stool.)  The result(s) will be discussed in more detail on your next appointment."  I don't know how presence of blood in my stool is within the normal range, but doesn't appear to alarm my doctor, hence I'll keep pushing forward with my exercising.  I'm no longer coughing nor spitting up blood, but do have a constant small dull ache in the back of my throat, undoubtedly due to the small lump near my larynx.  I also have a small nodule in my right lung, which appears to be normal.  I guess my old age is catching up to me.

My weight today is 175.9 pounds on my six foot frame!  I'm so close on reaching my goal of 170 pounds!! 

Last week I ran a total of 33 miles, which is the most weekly miles this year!  My mileage base is still being built toward that 60 mpw goal that I have set for myself, I should be able to reach that base mileage by Fall, just in time for marathon training.  I was still able to maintain my weight lifting and cross training too, but I felt extremely tired last week and should consider having next week as a cut-back or recovery week.

All my runs last week were at an easy aerobic pace of 60-70% of my maximum heart rate, which for me is around 9-10 minute miles.

Monday: Easy Run, 4 miles. Swam 20 laps.
Tuesday: Easy Run, 5 miles. Upper body weight circuit training.
Wednesday: REST DAY
Thursday: Easy Run, 4 miles. Swam 25 laps.
Friday: Easy Run, 5 miles. Upper body weight circuit training.
Saturday: Easy Medium-Long Run, 10 miles. Cycling, 30 minutes.
Sunday: Easy Run, 5 miles.
Total Weekly Mileage: 33 miles.