Second Opinion

Mary and I just got back from Ann Arbor for our consult with the University of Michigan Cancer Center. It was a great trip all around and we are feeling particularly positive about our "second opinion" and some new opportunities for future treatment.  And to top that off, I just checked the pond in my yard and discovered that at least one goldfish has successfully wintered over under the ice.  And where there is one, there is bound to be others.

Our consult was Tuesday at 10am and rather than get up super early for a cross-state commute, we accepted an invitation from Mark and Susan Pearlman to come down the night before, have dinner, sleep over, and make it a leisurely 10 minute ride to the hospital after a nice homemade breakfast. Mark is a doctor at the very same Cancer Center and more importantly, he and Susan are the parents of Zack Pearlman, a dear friend of Alice in Los Angeles.  We quickly discovered that the whole Pearlman family loves Alice and were willing to extend that respect to Mary and I.  It made all the difference.  We were super comfortable in their home and with their company.  We ate good food, drank good wine, visited with Zack's Sister Allison and her spouse, Leanne (also friends of Alice) and had great conversation until bedtime.

Mark cancelled his morning meeting so he could make us omelets from the fresh eggs of their backyard chickens before heading off for work.  He advised us to get to our appointment early but to be prepared to wait.  We socialized with Susan and made the decision to come back to the house after my appointment to pack up. Well, we did not get there early but rather right on time. And no sooner than I finished a one-sheet questionnaire, my name was called and they took my vitals and ushered me into an examination room.  

We waited hardly a minute before we were welcomed by Dr. Manali Bhave (hope I got that name spelled right) who is in training with the center's senior esophageal cancer specialist, Dr Susan Urba. She took us through my cancer history, fixing some mistakes in the record and ultimately confirming that the choices that my doctors in Grand Rapids were making were right in line with what they would have recommended. Dr. Bhave possessed the gift of being able to type notes while she looked over her shoulder and talked to me. U of M had consulted on my case before and had a record of my cancer DNA which was compatible with successful trials with the drug, Ramucirumab, Dr. Krajewski was considering. After discussing options, she left and came back with Dr. Urba.

Dr. Urba started out by acknowledging that she had received a note from Dr. Pearlman mentioning our friendship and to give me her best care.  Of course she would do that anyway but it felt good to have the connection made.  She concurred with all the stuff that Dr. Mhave told us, recommending that we move forward with the recently approved cancer drug as a companion to the drug Paclitaxel that was started last week and went on to talk about getting me into a "phase 1" trial.  A phase 1 trial can only happen at a University hospital and it involves testing promising new treatments that are not yet approved.  This could happen only depending on open slots and after this current regimen is finished.  The nice thing about it is that it leaves me with more options should this current treatment be ineffective plus the opportunity to be part of scientific discovery for future patients with my cancer.  She thought my overall good health would be a factor in getting me into a study.  She said that someone who had lived three years with this cancer and that much chemotherapy she would normally expect to be brought in in a wheelchair.

We left feeling very good about future options.

We went back to the Pearlman home and had coffee with Susan.  We wanted to take her out for lunch but she was waiting for a delivery and had to pass.  We said our goodbyes and found a terrific Korean restaurant, Tomukun, right next to the Michigan Theater. And then it was back on the road. Two and a half hours and we were home.

Tofu Stew special with all the added "taste" extras

Tomorrow morning (Wednesday) I will see Dr. Krajewski and take on my second dose of Paclitaxel.  The new drug, Ramucirumab, will need to be approved by the insurance company so that will likely start next week.  I'm also hoping to get a new pain drug as Ibuprofen (which works great) is not a good pairing for gastrointestinal complications.  Unfortunately for the first time I am experiencing pain in the liver as one of my symptoms.

And winter seems to be waning so soon I can start getting a bit more exercise and revisit my fish feeding ritual.