October 19 – We saw Dr. Z. today and he talked about the last lab tests and PET scan. It wasn't bad news, but then it wasn't great news either. Her RBCs are holding at 3.24, her WBCs at 7.3 and her hemoglobin at 10.5. Two of the three are a bit low, but not so low as to be worrisome right now. The doc said that we showed continued progress, the tumor was reduced and its metabolism had slowed. That was not exactly a “you are cured.” The last time I saw him he said we would be starting a new regimen of one treatment a month. This time after discussion with his assistant he had us back on a three week schedule, so if one has an imagination one might think that the results are not as good as the doctor had hoped for. I have no proof of that, but I had really looked forward to just having treatment once a month. On the bright side, he did eliminate Carboplatin, the drug that he said did the most damage, but we are still on the Avastin and the Alimta. Cathy will get her next treatment in two weeks. I mentioned that she was a little light-headed from time to time and he found a slight murmur in her heart and has scheduled an EKG for her. If it isn't one darn thing it is another.
I think next time I am going to have to pin Dr. Z. down and find out exactly why we are doing this three-week schedule instead of the monthly one he first mentioned. We would have had 12 or 13 more chemo treatments and then done. Now it is more like 18. At $26,000 a pop those extra weeks are very expensive
October 24 – Cathy had a blood test for her regular doctor today. At least once a year they have to check and make sure that the cholesterol drugs are not damaging her liver. Tomorrow she has an EKG to check that murmur they heard last week. The following day we see Dr. D. to hear the results of the latest lab tests. Next week she goes back on the chemotherapy.
October 25 – I got Cathy up at about 0630 and we were at the hospital by 0730 for the EKG. It went fairly efficiently and we were out of there by about 0800. This morning I got an email from the lab we were at yesterday and they wanted to know what I thought about their service. I told them that if they want to have a computer system to make appointments, and I have a confirmed one for 0800, then I expect a needle in the arm at 0800. If it takes another 25 minutes to get service, then they should junk the entire system because clearly nobody is paying attention to it. I don't think they will ask my opinion again. Still, they asked so I told them.
October 26 – We saw our general practitioner today and he gave Cathy a clean bill of health. Her RBC was holding steady at 3.3; her cholesterol was down to 142; her triglycerides and sugar were fine and in general he was happy. Because her BP tends to be a bit high in the morning and she takes three blood pressure pills in the morning and one in at night, he decided to change it to two pills early and two pills late. Other than that, he has nothing to say and asked her to come back in three months. He wants her to take a flu shot but we never take them. He said we should talk to the oncologist next week and see what he says.
November 2 – Things have been quiet. It is now eight weeks since the last chemotherapy treatment and Cathy has not had any real pain or problems. She is still light-headed on occasion, and we shall find out today if that is a heart problem. The last EKG should clear that up.
Her blood pressure seems to be under control. We have balanced her drugs and now every time I take her blood pressure it is normal. She now takes Amturnide in the morning; Atenolol at night; and Kapvay both in the morning and at night.
Today she will take the first of the reduced chemotherapy treatments; Avastin and Alimta with the Carboplatin eliminated. We need to know if the other chemicals are reduced or the same. We also need to know why she is back on a three-week regimen instead of the four-week regimen the doctor first recommended. Finally, we need to know if she is still looking at a year of treatments or less.
Her blood pressure is just about what it was last week. Her WBC is 7.9, her RBC 3.12 and her hemoglobin 10.4. The treatment with just two drugs took only 90 minutes.
November 4 – Two days after the latest treatment and Cathy shows no signs of distress. It is still early, but it appears that removing the Carboplatin might have gotten rid of the worst of the after-effects.
November 8 – Cathy has done surprisingly well after the last treatment. There doesn't seem to be any bad effects at all. Yesterday, for the first time in weeks she was tired in the afternoon and napped for an hour. That might be from the treatment last Wednesday or maybe she was just tired. However, the good part is that we can live a regular life and go anywhere or do anything without worrying about some problems from the treatment. After the past several months that is quite a relief.
November 11 – Cathy had a slight nosebleed again this morning. I was hoping we were done with them, even though the very first thing on the drug “problems” list is nosebleed. I am tempted to take her somewhere to see if they can cauterize it, but I suspect of the drugs cause it the nose will just open somewhere else.
November 17 – I called a local ENT specialist trying to get an appointment for Cathy. Apparently the doctors are making more than they can spend down here because nobody ever called us back. There was also an article in the newspaper saying that the FDA wanted to disapprove Avastin for breast cancer because they did not believe that it decreased the size of the cancer or helped in the quality of life. Of course, Cathy has lung cancer not breast cancer, but we will have to bring this up at our next doctor’s visit.
November 23 – We are back from the oncologist. The entire chemotherapy ran about 90 minutes on the button. This is much better than the 3-4 hours we were doing during the first series when we were getting a third drug (Carboplatin). I asked about the Avastin which has been declared of no value against breast cancer, but the doctor said it was still certified for lung cancer.
Cathy was tired this time and I cannot tell if it was the treatment or just the normal stress of the doctor and the Thanksgiving holiday. As soon as we came in the house I ordered her to bed for no less than one hour. Hopefully she will awake with renewed energy.
It is funny how much extra time we spend together now. In the old days we were both independent and if she went to the doctor she went by herself. Now, because I want to know exactly what is going on with no chance of error in communication I go to every visit with her and that adds up to a few extra hours a week.
I pinned the doctor down today and got some straight answers. Her lymph nodes are all clean. The big growth in her lung was originally about 2.1 inches in size and now it is .8 of an inch. The doctor said that she was in "partial remission." I replied that I thought remission was the absence of all cancer. He said that was correct but if the growth has shrunk more than 50% they call it "partial remission." That sounds like a silly misuse of the term, but I guess I will go with it. We will continue treatment every three weeks and do another PET scan in maybe 3 months.
Her blood work was OK. Not great, but her white blood cell count was 4.8 which seemed low to me but the lab says is within normal range. The red blood cell count was 3.03 which was low (3.80 being the normal low) and her hemoglobin was 10.1; normal being 11.7. I guess there is no immediate need to think about another transfusion, but we will have to keep a close eye on it.
So, we seem to be moving right along. We are apparently winning the battle against cancer, but it may just be a temporary victory. Who knows?
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