Is extending life always the best choice

limpndamp said:

spinal fusion
David,

I can speak to spinal fusion, because I had the c4/5; c5/6 vertebrae fused about 3 years ago (a few months before being diagnosed with PCa). I had severe spinal stenosis. The discs were bulging into my spinal cord. The doc told me I was a fender-bender away from being paralyzed. In fact, if I did not have the fusion surgery, I probably would be paralyzed in 5 to 10 years. Although my ability to turn my head is only slightly restricted, I can honestly say that I am completely satisfied with the outcome. The loss of flexibility and no pain versus the pain prior to surgery was an easy trade-off. I would do it again without hesitation.

I, too, was recently diagnosed with chronic kidney failure. Stage IIIa. We are in a "wait-and-see" mode, trying to limit the advancement by proper diet.

My approach to all this (including PCa) is to separate each disease and treat it on it's own. My neck (and arm) are pain free; my PSA is nearly undectable; and I'm trying to eat healthier.

limpndamp said:

spinal fusion
David,

For more information, do a web search on "cervical discectomy with fusion".

I only had the C4/5; C5/6 discs removed, although it was first suspected that the C3/4 would also need to be removed. My doctor, a neurosurgeon, said that the MRI sometimes makes things look worse than they actually are. He said he would make the decision about the C3/4 when he went in. In addition to an MRI, I also had a myelogram (sp?) which is a procedure where you are face down on a tilting table, a dye is injected into the lower spinal canal, and the table is tilted so your head is closer to the floor so the dye goes toward your head and xrays are made. This supposedly gives a better result than the MRI. I think my doc said he would not operate with having the myelogram results with him during surgery. This procedure was surprisingly pain free (other than the position I had to put my head during the test aggravated the bulging discs). It probably only took 15 minutes to complete as an outpatient. A numbing agent was used at the injection site. I don't remember having any side effects from this procedure. I drove myself to it, and home afterward.

As for the spinal fusion surgery, it also was relatively pain free. There is about a one to one and a half inch incision on the lower neck. The discs are removed, vertebrae bone is ground away to make room for a piece of cadaver bone to be inserted in place of the disc. A metal plate that spans the vertebrae which had the discs removed is screwed into the vertebrae. It makes for quite an interesting xray!!

My recovery couldn't be easier. I spent one nite in the hospital, and wore a neck brace for one day. Lifting was limited to something like nothing heavier than a cup of coffee for several weeks. The doc said, on a scale of one to ten (most painful), recovering from neck surgery is about a two; whereas lower back surgery is a nine. I think I was off pain meds two days after surgery.

I would recommend you find a good neurosurgeon if you are going to have the surgery. An orthopaedic surgeon could do it, but considering the proximity to the spinal cord, I wanted a neurosurgeon doing it.

As I said before, I would not hesitate to have this done again.

texhutch5 said:

Quality of life
David,
I'm with you on not wanting emotional replys. I was 47 when diagnosed with all 12 biopsy needles positive with gleason 7-9s. My PSA before surgery was 34 and after my two month follow up, it shot to 188. My urologist staged it at the time T3A. I was told to start treatment or die. So I had the robotic surgery and after the two month follow up I started injections of Lupron. All I could find on the internet was the standard message found on almost all medical websites, or people wanting to give hope and cheer. I wanted to know what really happens, and what men go through with the disease and treatments. I appreciated the few men that shared their actual experiences. So far, I have survived for five and a half years since treatemens began. After consulting five different oncologist, including one at MD Aderson in Houston, they all agreed that hormone blocking was the best for me. So I have been suffering from the effects of very low testosterone for over five years. My PSA still remains undetectable, so I haven't needed chemo. The main thing that concernes me about your situation is you DJD. The hormone deprivation has caused me severe osteoporosis. So far, I have had two fractures in my heels, making it difficult to walk. My lower back is in constant discomfort. And my once muscular arms are resembling my grandma's. When your testosterone is close to castrate levels, you will start losing bone very quickly. You will also start losing muscle mass and energy, making exercise difficult.For the bones, I have taken Zometa and Alendronate, with little success. If you are experiencing depression, the hormone deprivation will probably make it worse at some point. Currently I am taking Cymbalta to combat pain and depression...it helps a little, but thats all. Things got so bad lately, that my oncologist agreed to give me a treatment holiday. I am off of the alendronate and didn't have my scheduled Eligard shot. We are going to let my testosterone rise and carefully monitor my PSA...hoping that this will improve my quality of life. It gave me a psychological boost so far, and am hoping to feel normal soon. I have done a lot of living in the past five years, and don't have regrets for treating the cancer as I did. My advice to you is to talk to your orthopedic surgeons about the impact that hormone deprivation would have, should you have to go this route. And if you are told you need hormone deprivation, try try try to talk the doctor into intermittent treatment. Which means after your PSA is brought down to undetecable with hormone treatment, then let your testoterone recover for as long as you can before getting your next treatment. If you can do this, you might be able to treat the cancer and still have a good quality of life. I hope this helps.

ralph.townsend1 said:

Death
Shipjim

I can relate on everything you said about life sentence and death which is the final answer. We should never fear death for the pain is gone and our friend's move on. :-)

My heart is sadden for your loss of your son, I hope there is some joy in remembering him!
My prayer's are with you!

God bless

Swingshiftworker said:

No Guns For Me!
Well, I don't think I'm going to die from PCa BUT I've already decided that, if it comes down to it, I'm going to seek out legal euthanasia where ever it is most convenient to arrange it.

I've watched older people in my family gradually die while ill and bed ridden. It's not pretty. My mother -- who will be 99 years old this coming Jan 5th -- is in the same situation. Frankly, I don't think human beings are meant to live that long and when they live beyond the point that they can care for themselves and truly "enjoy" life (not just exist), it really calls into question the premise that "life" MUST be preserved over all else.

If I become chronically ill and pain or bedridden and become nothing more than a burden and hunk of meat that has to be fed and cleaned like a baby, I will definitely want OUT!!

That said, I wouldn't use a gun. Guns are VERY messy. I'm a retired law enforcement officer. I own lots of guns AND I've seen the effects of them. If you commit suicide w/a gun, you won't have to see or clean up the mess but it won't be pretty. I don't want to go out that way either.

I'd prefer a peaceful sleep in a calm and loving environment in the company of the few people who care about me and who will take proper care of my remains. So, if I don't go "naturally," that's the way I'd "prefer" to go.