Shipley: The Bladder Saving Guru

February 1, 1997: Shipley: The Bladder Saving Guru

Early Saturday morning, I received a phone call from Dr. Shipley, which we almost missed!!! However, since I already had his office number, I called back immediately, and the nurse relayed the message to him, for he called back a few minutes later.

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The conversation revolved around likely candidates for the Shipley approach, which combines chemotherapy and radiation therapy in an effort to save the bladder. He explained how his protocol involved four weeks of chemotherapy combined with radiation, followed by four weeks off. At the end of the second four week period, a cystoscopy is performed to look for the presence of tumors. If tumors are found, the radical cystectomy is recommended. If none are found, another four weeks of chemotherapy and radiation are applied and the bladder is followed up with cystoscopy examinations every three to four months. Subsequent local superficial growths are handled with intravesical chemotherapy using BCG or mitomycin, in which the chemotherapeutic agents are instilled directly in the bladder.

Dr. Shipley discussed how they like to work with patients who have had all the tumor removed with TURBT, as his success rate increases when this is the case. As I wasn’t sure if Dr. Neuwirth had resected all of the tumor, my hopes were a bit dimmed. He even mentioned that they sometimes use cystoscopy and transurethral resection two or three times to make sure they got all of the tumor.

This conversation gave me some hope. He even stated that I could come to Boston for a consultation with himself, along with Dr. Kaufman and Dr. Heney. Shipley referred to Marin General Hospital as, “The other ‘MGH’!” and mentioned the names of Dr. Francine Halberg and Dr. Patrick Bennett. Dr. Bennett had trained with Dr. Shipley and his team of oncologists and urologists and Shipley regards him as his protégé. So the next obvious thing was to speak with Dr. Bennett.

I had originally phoned Dr. Bennett when he was on call just after my surgery to ask him what to do about my back pain. He was quite helpful then, and during the conversation I had with him after speaking with Shipley he was also very nice and understanding. He told me what I already knew about the Shipley approach in that it worked best with all of the cancer resected, but that he would have to discuss my case with Dr. Neuwirth.

This was the day of many visitors and phone calls from well-wishers. For example, J. D. brought us dinner from Kitty’s place and brought me a copy of Andy Weil’s book, Spontaneous Healing, which I have been reading ever since. Late in the evening, Dr. Rossman phoned me to tell me that he had spoken with Dr. Gullion, Dr. Keith Block (from Evanston, IL), and John Boik, author of an excellent book on cancer research and alternatives.

TURBT

January 27, 1997 – First Hospital Stay, Continued

My refusal to sign the operation afforded me another whole day of waiting. In the morning, I had visits from Dr. Belknap and Dr. Neuwirth, both of which were very helpful in pointing out the pros and cons of the alternative anesthetic methods, but I still hadn’t made up my mind. I wanted to speak with an expert.

Dr. Neuwirth tried to prepare me for the best case scenario, which would involve complete resection of the bladder tumor followed by quarterly inspections with a cystoscopy and possibly coupled with chemotherapy agents inserted directly in the bladder. I found this discussion rather informative, but would have preferred a more accurate reading of my tumor.

Since my daughter was ill, my wife couldn’t be with me the whole time, so I spent the day receiving phone calls and visitors, and listening to classical music, and Dr. Rossman’s tape. Since I couldn’t eat or drink, my thoughts continually turned to food, especially when my roommate ate his meals. In between time, I continued my meditation and visualization practices, which kept me from getting to anxious about the ensuing operation.

At around 3:00 P. M., my wife returned to the hospital, just in time for the meeting with the anesthesiologist. His name was Christophe Dannello and he was very nice. He carefully explained the various options, and with his guidance, I decided to go with the epidural.

TRUBT
Transurethral Resection of Bladder Tumor (TURBT)

Around 6:30 P.M., they came to wheel me off to surgery. I grabbed Dr. Rossman’s tape and headed off to the operating room. I was given a sedative intravenously and placed on the table. A moment later, a small needle was applied to my lower back and I was turned over and placed into position. The oxygen feeder was placed in my nose and my legs were positioned in place for the surgery.

Then… I was gone! I woke up in the recovery room and spent what seemed like only fifteen minutes there. I was taken back to my room and my wife was with me for the next half-hour or so. Then she had to get home to the children, so there I was, lying flat on my back with a catheter in me. I started to feel pain from the epidural and was given “candy” – vicodin. This controlled the pain.

I proceeded to do my “mind story” and had a fairly good night sleep until I was rudely awakened for vital signs around midnight. Luckily, the rest of the night was uneventful, even though I was leaking blood through my catheter.

First Hospital Stay

Barcelona Hospital

January 26, 1997 – Superbowl Sunday!

I woke up around 8:30 in the morning and called Dr. Belknap. I got his answering service and called the physician on duty, Dr. Jacoby. He set me up for an appointment at 10:45 on a Sunday morning! I then proceeded to phone Dr. Belknap at home, and he assured me that seeing Dr. Jacoby was the right thing to do.

After taking a urine sample, which, by the way, looked more like a blood sample, Dr. Jacoby examined my prostate gland and left the examination room to call the urologist on call at Marin General Hospital (the other MGH!) who happened to be Dr. Neuwirth. Dr. Jacoby strongly recommended that I head off to the hospital so that Dr. Neuwirth could run some tests to see what was causing all this blood.

Barcelona Hospital
Barcelona Hospital – Photo by Jerome Freedman, 2015

We arrived at the emergency room of MGH at around 11:30, armed with a bag containing the urine sample, in perfect time to meet Dr. Neuwirth. Can you imagine not having to wait four hours in the waiting room! He walked away with the bag and returned in less the 10 seconds. “I want to admit you and do some tests,” he said.

After that, in short fashion, I found myself in a typical hospital gown, lying in bed with an IV started in my left wrist. In less than an hour I had X-rays, a CT scan, and an intravenous pyelogram, or IVP, which is an x-ray evaluation of the urinary tract. All of these tests were expected due to the excellent coverage of the hematuria web page.

The results were not favorable. From the CT scan, it was obvious that I had some kind of tumor at the base of the bladder and therefore a cystoscopy was necessary. This was to be scheduled as soon as possible, but actually would never take place on Super bowl Sunday! What medical team would be willing to give up their Sunday evening, anyway?

So there I was, back in my bed, just in time to watch the Super bowl. By then, the phone was ringing off of the hook, and my friend, Dr. Rossman came to visit me to look into my condition. He is an outstanding physician in his own right and specializes in interactive guided imagery, and acupuncture. He brought with him a new guided imagery tape for pre-operative patients in which he collaborated with Stephen Halprin. I also had a few other visitors, including my sister and her husband, my son, and another good friend. I think the gentleman I was sharing the room with was getting fed up with all of the phone calls. I knew I had a tremendous support group behind me. This, by the way, is one of the important factors in helping yourself to a speedy recovery – having a support group of people who love you unconditionally.

After everyone left, I settled down and listened to Dr. Rossman’s tape. This helped me to relax and visualize some long range goals, such as playing tennis four days a week once again. With meditation and visualization techniques, I was able to sleep most of the night, barring interruptions from nurses who wanted to suck more of my blood.

One interesting thing that happened that night was that one of the nurses wanted me to sign my operation consent from. After reading it over, I decided that I needed to speak with an anesthesiologist first, in order to determine whether I should go with a general anesthetic or an epidural. The nurse said that he would get one up to my room, but one never came. The next nurse on duty also tried to get me to sign, but I still refused. It took them until 3:00 P. M. the next day for one to come, and I missed an opportunity for a 9:00 A. M. surgery.