Patient is a 40 year old white male.
5'-5" tall 160 lbs.
No unusual medical history and no GP
Smoked 1 pack of cigarettes a day for 25 years.
No history of cancer in the immediate family.

October 31, 1998
Visible blood in urine.
No pain with urine other than the initial shock of seeing
bright red blood.  Blood only lasted for two voids,
after that nothing.  All urine normal until February 1999

February 17, 1999
Second episode of blood in the urine.
This time there were small pieces of tissue in the blood.
I had two bloody voids with tissue and then all clear again.

April 3, 1999
First trip to the urologist. (I had a history with the urologist due to vasectomy)
Dr. thought I might have a kidney stone and set up an IVP for April 9, 1999.

April 19, 1999
I got the news today, IVP showed bladder cancer.
Scheduled TUR.

April 27, 1999-TUR
Arrived at hospital at 5:00 AM
Surgery at 7:00 AM   Awake at 1:00 PM
Dr. removed two tumors: one the size of a half dollar
the other the size of a quarter.
Dr. confirmed, non-invasive.
Pathology graded them Ta stage II/III
Dr. did three biopsies in the bladder and two
from the colon.  All pathology negative on biopsies.
Most uncomfortable thing about TUR surgery was the catheter.

August 23, 1999
TUR follow-up cystoscopy.
New tumor found.  Scheduled second TUR.
(four month time frame between checkups was my fault)

September 24, 1999 Second TUR
Arrived hospital noon into surgery at 2:00 PM awake at 3:30 PM
Drank two cups of juice, voided once and was home by 5:00 PM
This one went much easier that the first, because
I woke up without a catheter and went home the same day.
The Dr. found three tumors this time.
All of them about the size of a dime.
All superficial (no pathology on these tumors due to size)

October 11, 1999 – First BCG treatment
Tried catheter without anesthetic -- didn't work ( I'm a wimp )
Installed anesthetic -- worked much better.
Instillation lasted about 4 minutes.
First Void                11:20  AM  No pain, no tissue, urine clear.
No noticeable effects at all.
Second Void                12:30 PM slight yellow color to urine
no pain or anything unusual.
Third Void                3:30 PM urine clear.  No pain, although
at the end of urination I had this weird gurgle feeling
like the pump just didn't have enough fluid to work. 
Sensation lasted about 5 seconds.
Fourth Void                5:30 PM urine clear.  No pain.
Gurgle feeling again at end of urination for 3 to 5 seconds.
All subsequent voids today were normal.

October 12, 1999
Nothing to report. All voids appear normal with no pain.
(wonder if gurgle feeling yesterday was "bladder farts"?
 from air induced into the bladder during treatment.)

October 13, 1999 thru October 16
Nothing to report.  all voids appear normal with no pain.

October 17, 1999
Nothing to report.  All voids appear normal with no pain.
Note:      The first week of treatment seems to have been a non-event
                I have gone on with my regular routine and have noticed no ill effects
                or inability to do as I wish.

Monday October 18, 1999 – Second BCG treatment
Dr. confirmed that "bladder farts" are from air induced
during the process.
All went well.
First Void                 11:15 AM
Void appears normal. No pain.
Second Void                12:30  Void appears normal
Had bladder farts again.  (these things kind of tickle)
Third Void                 7:45 PM   Appeared "ginger ale" in color
also had same color spot in underwear.  No pain.
Felt run-down this afternoon, could be medicine
could be weekend of "serious" fishing.
Fourth Void                10:50 PM  Appeared "ginger ale" again
also had some "red" tissue in the urine.

October 19, 1999 – October 22, 1999
Nothing to report.  All voids appear normal with no pain.

October 23, 1999 – October 24, 1999
(I went to a concert last night.  Drank a LOT of beer
had massive headache most of the day but no noticeable aftereffects)
All voids appear normal with no pain.

Monday October 25, 1999 – Third BCG treatment
All went well.
Nurse noticed that urethra seemed a little narrow.
(more difficult than normal insertion of catheter)
First Void                 11:00 AM
Void felt normal. No pain. Although I did notice
what seemed like a small piece of tissue in urine.
Second void                12:00 noon
Void felt normal.  I did notice small amount of blood
at very beginning of void.
Third void                5:30 PM since noon all voids have had slight burning
upon urination.  Some bloody spots in underwear.
I have felt run down most of the afternoon but nothing
too uncomfortable.
Fourth void                8:00 PM slight burning upon urination.  No more blood
spots but do have stain in the underwear.
One small piece of tissue in urine.
Fifth void                9:10 PM  No burning or blood this time
One small piece of tissue in urine.
(by tissue , the best way to describe this stuff is that it kind of
looks like the blood vessels in very early stage chicken embryo.
red and clear in color and like an unraveled filament.
Approx. 3/16 to 1/2 of an inch long)

October 26, 1999
Everything appears like it's back to normal.
No blood, no burning and only slight staining
in the underwear. (does not appear to be blood)

October 27, 1999 – October 31, 1999

November 1, 1999 – Fourth BCG treatment
Fourth BCG treatment.  All went well.
Didn't have narrow urethra problem this time
First Void                 11:00 AM
Void felt and appeared normal. No pain.
Slight blood spotting of underwear through the afternoon.
Nothing seemed out of the ordinary the rest of the day.

November 2, 1999 – November 7, 1999
Nothing to report.  All voids appear normal with no pain.

November 8, 1999 – Fifth BCG treatment
All went well.
First Void                 10:45 AM (couldn't hold it the full 2 hours this time)
Void felt and appeared normal. No pain.
All remaining voids felt and appeared normal.

November 9, 1999 – November 14, 1999
Nothing to report. All voids appear normal with no pain.

November 15, 1999 – Sixth BCG treatment
9:00 AM Sixth BCG treatment.  Same old same old.
First Void                 11:05 AM
Void felt and appeared normal. No pain.
All remaining voids felt and appeared normal.

November 16, 1999
Nothing to report.
All voids appear normal with no pain.
This will  be the last entry unless anything
happens between today and December 16
Follow up poke & peek is on that day.

December 8, 1999
I am having very frequent needs to urinate.
Sometimes as often as every thirty minutes.  And then, just a trickle of urine.

December 16 1999 – Peek and Poke
Dr. found one papillary TCC tumor and some red areas in the bladder
Scheduled third TUR for December 28, 1999 to remove tumor and do biopsies.
Frequent need to urinate seems to have subsided.
I have also noticed that after the poke & peek that my sexual stamina has decreased.
By decreased I mean to the point that I last about thirty seconds after I achieve penetration.
My wife just loves this but she doesn’t say anything except ask the Dr. what might be causing this.

December 28, 1999
Arrived at the hospital at 11:00 AM for surgery
Woke up after surgery at 2:00 PM  and was released at 4:00 PM after having to pass 200 ML
(this was the first time I had to pass a specific amount of urine to go home after TUR surgery)
I did notice that this was the easiest TUR from which to recover.  I  really did not experience any pain, except when I urinated, and then it was only for two days. (I did not take any pain meds after the surgery)

December 31, 1999
Sexual staying power is back.

January 6, 2000
TUR follow-up visit with the Dr.Pathology report on the Papillary TCC was Ta grade I/IIIBiopsies were all negative.

I asked the Dr. about the sex thing and he said that he didn’t know of anything he did that might have caused or stopped the problem I was having. We did agree that since my tumors have all been the low grade non-invasive type that we would wait. Three months till the next poke & peek to decide any further course of treatment. So with that good news I will not be making further entries until after my April 2000 Follow-up Poke & Peek.

August 10, 2000
Follow-up Poke & Peek All Clear.

February 5, 2001
Follow-up Poke & Peek found one (3mm pap.)Will schedule TURBT for the last part of February 2001. After removal we will discuss BCG maintenance therapy.

February 23, 2001
Fourth TURBT Arrived at the hospital at 7:00 am
Dr. removed one .4 cm grade Ta stage 1 Papillary TCC.
Was home on the couch at 12:30 pm

March 2, 2001
TURBT follow-up
Dr. and I discussed using maintenance BCG and decided
that since I was getting my Poke & Peek's (P&P) every 3 months
and all my tumors have been Ta stage 1 we would hold off on the BCG
until I have another reoccur. We feel that (with respect to Dr. Lamm)
since ALL my tumors have been low grade and the frequent P&P we will
hold off on the BCG maintenance for now.

June 11, 2001
Poke & Peek (P&P)
I AM CLEAN !!!!
.....and with that, I will post again when I have something to add.

March 28, 2002
This was the first time the Doctor allowed six months
between a poke & peek. The result was ALL CLEAR.
The Doctor does want me to stay on a six month schedule
for five years and if all is still clear we go to a one year schedule after that."


To be continued............

April 4, 2003
Hello everyone,
It's been awhile since I've posted because I haven't had much to say but I had my P&P yesterday and everything looked "perfect". I've been over 2 1/2 years without a reoccurrence (time to have a small
party)

Much thanks to this list and the Dr's we can get to listen!

Gary in Dallas
Gary's BCG Diary