Wednesday, July 23, 2014

Apparent progress

Preferring to goldfish pond or CT scans?  Well, both really. 

The pond seems to be supporting at least some fish for a reasonable amount of time.  I added ten more a while back and I have only pulled out two dead ones.  There are about 5, distinctive fish that I can tell are getting larger and they regularly play in the bubbler, darting in and out of the bubbles seeming to be having fun.  Algae is now growing and I decided to let it grow because I think plant life is healthy for the environment.  It is harder to see the fish anywhere but in the froth of the bubbler.

I had a CT scan last week Monday.  It was supposed to be the Friday before but I forgot to take one of my pre-meds for allergy to dye contrast and I made the mistake of telling them that.  They rescheduled the procedure but not before I had drunken a bottle of barium and taken a heavy dose of Benedryl that made me foggy for the rest of the day.  But Monday scans went easy and yesterday I got the result: Stable.  No change in size, most importantly, no growth.  The blood tests that accompanied the scan showed the "tumor marker" figures still dropping.  That is very good news.  The liver tumors are producing less and less of the growth pattern that activates the marker.  This is not a surprise to me because I feel a healing in my gut.

I'm back on chemo this week but I'll have an extra week off because I will be heading to Seattle August 2-10.  One more dose at least as soon as I get back.

Friday, June 13, 2014

Speeding summer blues


It's June.  One of the things I hate about June is that it is suddenly July and summer is half over.  I still need to exchange all the long sleeve flannel shirts in my closet for the short sleeve madras shirts hanging in the transitional closet in the basement. Oh, to be able to slow down time and savor the warm months!

I guess I should be leading with the boring, predicable results of the transesophageal echocardiogram (TEE) .  They were negative as expected.  My heart is in good shape and not the source of any stroke.  It was a relatively short and easy procedure.  Mary accompanied me.   I was given Versed, the drug that makes you sleep, or at least forget everything that happened while you were quasi-awake.  I was really a little afraid because I was told I would need to be awake enough to swallow an ultrasound probe.  I remember getting the spray that anesthetizes the throat but the rest, fortunately, is a blank.  They decided to use a pediatric probe because of my messed-up esophageal anatomy and the possibility of some narrow passages.

With WMCAT over and my summer threatening to turn into autumn, I jumped into a couple of seasonal home projects.  Number one was getting the pool open.  That was easily accomplished by hiring a teenager to mop out the winter detritus and a pro to get all the mechanics going with all the proper maintenance tweaks that I otherwise might overlook. It always feels good to have a bubbling pool with clear water instead of a gaping hole littered with 8 months worth of tree debris. The second project was to finally convert that concrete, kidney-shaped, cracked wreck of a potential pond into a similar but functional pond that holds water, goldfish and maybe a turtle or two.  I had attempted this a couple times before in previous using self conceived methods for patching cracks that seemed to make sense to a person who knows nothing about these sorts of things.  This time, after powerwashing I invested in the over-priced pond-certified products that guarantee success; primarily, three coats of fish-safe, rubberized paint.  It looked fantastic!  But would it hold water?  I could barely stand to wait the prescribed curing period.



The good news is that it holds water.  The bad news is that it kills goldfish in relatively short order.  I first tried three grocery store "feeder" goldfish.  They cost 28 cents each but still they represented a life in my hands.  They seemed so happy, exploring every inch of the pond, separating and regrouping in a  mini-school.  I watched them for a couple hours.  After several hours break, I came back to find them all belly up.  It was devastating!  I talked to a friend who has worked in a pet store for 15 years and she offered to test the water.  I brought in a sample and it passed all the tests with flying colors.  We speculated that I might have gotten sick fish or maybe the city water was too fresh and full of chlorine, that now had clearly evaporated.  She picked out 4, extra-healthy-looking and pretty "feeder" goldfish that I would be rescuing from a fate of being fed to pet piranhas. At the same time, Marlee brought home from school two large goldfish from her teacher's pond.  They already had names so there was a bit of extra pressure there to succeed.  This time, I followed a temperature adjusting procedure of floating the bags of water in the pond for 20 minutes.  Once again, it was a joy to see them go from their claustrophobic little containers to the sprawling Ponderosa in my back yard.  My friend Dave Hast was with me to witness.  Four hours later, the little goldfish were dead.  One more hour and the big ones were lying upside-down on the bottom.  All I can figure is that the slotted concrete blocks i had placed in the bottom for raccoon shelter had been impregnated with some kind of poison during their  tenure as lawn tripping hazards.  So my plan is to pump out the water, remove the bricks, rinse out the pond, refill it, add some water plants and try again.  Any fish lovers want to try and stop me?

I also accomplished my goal of getting my 83-year-old dad back on motorized wheels.  We delivered a 50cc scooter to him and after a brief practice ride,  followed him in a car to his local haunts.  It felt like a success.  His balance is still great and he can't get into too much trouble at a maximum of 25mph.

Chemo continues to be a drag on my energy levels but I am grateful that the side effects are minimal. Blood platelet levels continue to drop but not to serious levels yet.  One side-effect of that is that I am subject to bleeding and bruising.  I have some pretty sweet bruises commensurate with my klutziness.  I also have about 8 days where ice-cold food and beverages are somewhat uncomfortable.  I'm seeking out as much cold beer or ice cream as possible for the remaining days before the next infusion.  The nausea is only slight and I still have my glorious locks of hair and robust appetite.

Tuesday, May 27, 2014

Summer vacation

Dr. Scott led with the good news at this morning's appointment:
"It's working!"
The chemotherapy is effective according to the results of last Friday's CT scan.  All the liver tumors are shrinking. But at the same time the toxicity is high and he had to cancel this morning's infusion because my blood platelet count was too low to treat me.  So I get another week off chemo.  It may mean that I am now one week on and two weeks off.  I guess I'll take that even though I am anxious for the drugs to do their work.

Still one more hospital test next Monday; a trans-esophageal something or other.  They will induce sleep and put some scanner down my throat to look at my heart to make sure that the source of my stroke is not originating there.  This was ordered by the Neurologist, Dr. Santos.  Dr. Scott suspects the stroke was triggered by migraines. But the heart must be ruled out.

My classes at WMCAT ended last week and I have to say that it felt just like that old feeling from grade school at the beginning of summer vacation. But it was bittersweet saying goodbye to the kids.

Time to work a little travel into my schedule.

Monday, May 19, 2014

Stroke

It was a weird week last week.  I was having visual problems and lightheadedness that I chalked up to migraines.  That may still be the source of the visual symptoms but the problems led to an MRI on Friday and I just got a phone call telling me I had a stroke.  Must be a very small one because I don't seem to have stroke symptoms but it means getting back on a daily aspirin regimen.

When I had my appointment with Dr. Santos, the Neurologist/ Ophthalmologist, to see why large fields of vision were disappearing, he ran a battery of tests that indicated the possibility of something in the brain.  The fear was that it would be a brain tumor from metastasized cancer.  There was an unexplained spot on my retina and a visual field test that hinted something was not right.  He ordered the MRI, this time at the Lemmen Holton Cancer Center (part of Spectrum Health) so I was able to do some comparison shopping.  Their MRI machine seemed smaller and less frightening and they didn't offer music (a ridiculous salve for the loud MRI noises) and they did offer a cool blindfold and an array of snacks at the end.  I think points go to Lemmen Holton.  A "wet read" was ordered, which meant my Dr. would get results within the hour.

Somehow, Dr. Santos was unreachable and I waited all evening for the call.  Finally at 10:30pm the phone rang it was Dr. Mohr, a partner of my primary care physician, Dr. Hazle. When they couldn't reach Dr. Santos, they bumped down to the next guy on the list and since Dr. Hazle was not the guy on call, it was bumped again to Dr. Mohr, who I guess I would say I like based on our conversation.  He did not blurt out the results.  He said he did not know me and wanted first for me to set up the story as to why I was having an MRI.  After hearing my story he said, "Well I guess this is good news".  No tumor.  The bad news being that I'd had a stroke.  The further good news being that I did not have any horrible stroke symptoms or evidence of permanent damage.

A bunch of new tests have been added to this Friday's CT scan looking for the source of the clot. The doctors say I am too young to be having a stroke and it is undoubtedly related to cancer.  I still feel light headed but am somewhat relieved that this is my last week of classes.

Wednesday, May 14, 2014

Chemo update

I really feel like this regimen is working.  The poking pains in my liver region have subsided and my "tumor marker" blood tests are heading in a downward direction.  I seem to have a pattern of a bad week (when the chemo is administered) followed by a good week in terms of nausea and temperature sensitivity but neither symptom has been too terrible.  So I would say the glass is half full.  The temperature sensitivity, it turns out, seems only to be for cold.  Ice water or any chilled food or beverage triggers a "pins and needles" sensation on my tongue and throat but it is short lived and fairly tolerable.  Still, I'm staying away from ice cream during week one.  The same sensation is felt in my fingers when I reach into the refrigerator or freezer.  So glad that West Michigan temperatures are finally spring-like.

I'm not sure that this is related to chemo or not but I am experiencing an uptick in what I am being told are migraines; specifically a rare type called Hemiplegic Migraine.  The good news is that I am not getting much of the debilitating headache side of the symptoms; a few pangs at most.  But I am getting the visual aura effect where I see bright flashes and a jaggy, crescent shaped distortion in my vision.  At other times it manifests as numbness on my left side or blind spots.  Yesterday for a couple hours my left peripheral vision disappeared.  It happened to come on while driving and could not see the on-coming lane of traffic without physically turning my head 90 degrees to the left. This morning, briefly the vision just below center focus disappeared.  I could read a line of type but not anticipate the next line.  A couple weeks ago it was the center focus so I could not see faces or read anything.  Very strange!  But the effect fades away and everything is normal again.  I'm sort of old to be experiencing migraines for the first time in my life but there are stranger things.

My teaching job ends in a couple of weeks and I have a ton of work to do to finish up.  It will be a bit of a relief and I hope I will be freed up to do a bit of travel during my good week.  Abby just moved to Ithaca, New York this week for a new start so perhaps a drive to the Finger Lakes region is in my near future.
Abby with packed car and bicycle attached to trunk, ready to embark.



Friday, April 18, 2014

Bringing back the fanny pack

 I wanted a stronger chemo.  After I could start to feel the fingers of cancer under my ribs, I just wanted those cells to die.  On Tuesday after infusing the first chemical, the second was inserted into a battery operated pump and hooked into my port for slow infusion-- 46 hours.  I had to carry it around in a fashionable fanny pack and report back on Thursday to have it removed.  This happened like clockwork.  I heard the "all-finished" alarm going off while sitting in the chemo lounge waiting for my nurse.  I did not recognize the sound and wondered where it was coming from until the nurses zeroed in on me.  Taking it off only took moments and then I was back on the street.  It was not that bad... until Thursday night.  The nausea struck hard and is continuing as I write this on Good Friday afternoon.  I think it is a good thing that I feel this sick because it tells me the chemo is working.  I'm glad to have the day off from work because all I want to do is lie down.  No chemo next week because this is an every other week regimen.  Hope to get some relief!

Tuesday, April 8, 2014

Ice cream and hot shower binge

Chemo was cancelled today because Dr. Scott wants to upgrade the regimen. "I'm not doing enough for you." he said.

The report from last Friday's CT scan confirmed what I suspected; the liver lesions are still growing and multiplying in the right lobe of the liver.  I had a gut feeling. Literally.

Inspired by a recent talk from Memorial Sloan Kettering Esophageal Cancer guru, Dr. David Ilson, Dr. Scott wants to try me on a combination of Oxaliplatin and Fluorouracil (5-FU). The former is similar to what I am used to but the latter has some new side effects and a new delivery system.  The side effects are mainly temperature sensitivity.  No hot or cold foods or drinks, no hot showers or reaching into the freezer.  It is delivered over 46 hours so it will involve an electric pump hooked to my port that I will take home with me for a couple of nights.  These sound very unpleasant but one of the problems I had with the last regimen was that I was not feeling it enough.  I did not have the sense that it was killing cancer, and that proved to be the case.

So I'm off to get some premium ice cream and hot fudge.  I've got a week to enjoy these pleasures.