Radiation Spheres

The majority of my posts lately have been health-related. So boring! But, here is another one:
I had round 2 of my new chemo on Tuesday. The dosage this time was about 2/3 my previous dosage and I opted to use the patch (definitely helping, though I had a few usage issues which I think is preventing it from being as effective as it could be) to help with the nausea and also had an extra shot of atropine to help keep me from living in the bathroom. I don't have much of an appetite now, but I am able to keep fluids in my system, so that is a very good thing. I am tired, but not completely out of it like I was during round 1. I will have one more round next week and then I will take a break from chemo and I will start a directed treatment for the tumors in my liver.
As you know, the tumors in my liver a growing in size and number. They are now to the point that my liver function is out of the normal range. So, with the help and support of Dr. S., Tuesday afternoon (post chemo) Kelly and I drove down to Albany to meet Dr. Gary Siskin. He is an interventional radiologist and he will be part of a team that injects spheres of radiation into my liver to treat the tumors. The process is very cool, and the geek in me would like to regale you with how it works, but instead I will just tell you the spheres go under the trade names Theraspheres or SIR spheres and if you have insomnia, you can go check them out. (This is a pretty straightforward video of the process: http://www.sirtex.com/us/clinicians/about-sir-spheres-microspheres/mode-of-action/.)
I will go for a hepatic (liver) angiogram and trial run on 2/13. If that is successful ~ they need to be sure only a limited amount of radiation will leave the liver for me to be a candidate ~ then about 3 weeks later I will have the spheres injected into the more diseased lobe of my liver. About a month after than they will repeat the process for the other lobe. The side effects are described as flu-like, but due to the radiation I may not be able to be around the children for a few days (I will meet with the radiation oncologist on 2/14 and at that point learn more about that restriction). Two weeks after the second lobe procedure, I will be able to start chemotherapy again.
I feel good about this. I like the people involved, I like the fact I am on the schedule (no hemming and hawing and discussing with 20 other people), I love the fact it has a high success rate and a low incidence of side effects. Let's get this next phase started!

Quick Note

Kelly and I had a good trip to Johns Hopkins. My lead oncologist there reminded me a great deal of Dr. S in terms of his thoughtfulness and responsiveness to our questions. There were a few ideas put forth, but nothing set in stone. When things are ironed out a bit more, we'll talk about them. (No need to drag you all along on a roller coaster ride...especially one that often gets stuck!)

I have not been responding well to chemo - the side effects have sidelined me to the point that I slept 18 hours per day for a few days. My treatment this week was delayed because I was dehydrated and unable to eat. (I have lost about 25 pounds since Christmas. Of course...the one year I don't make losing weight a resolution!!!) I have been going in every other day for IV hydration and on Tuesday I will try chemo again, though at a lower dose. I am also going to try a patch to help with the stomach upset that my friend Courtney swears by - I am hopeful that it will work as well for me as it did for her husband.

Driving Miss Daisy

Turns out the first 24 hours post chemo were not too bad, but since then I have been having a rough time. The pill I started with to keep me from throwing up, caused me to throw up more often than not. The meds to keep my from living on the toilet were a joke. And please, do not offer me anything to eat.

In the midst of this (but without him being aware of the chemo side effects I was going through), Alex scheduled me for a pelvic ultrasound. For a pelvic ultrasound one needs to drink about 32 ounces of fluid 40 minutes before the scan. I willed myself to get it do and keep it down, and then I laid on the table and that was it. I lost it. The techs were so sweet they actually offered to have me come back in a little bit to try again. I passed, saying I would wait until things were sorted out. I figure I can only throw up all over someone's room once per day.

Dr. S changed and/or increased my meds to get me through this. I am showing some slight improvement, but not where I want to be. (Case in point: Kelly had to stop the car on the way home from church so I could throw up on the sidewalk. Yes, I am that classy.) The hardest part is that my head is now in a fog. I just fall asleep mid-conversation, for a long time, and soundly. I now have Kelly drive me places when I am on my meds...I honestly cannot imagine driving myself. If I plan, then I am okay (but run the risk of sneak side effects!) - it is quite a dance I am trying to learn.

Why Chemo is Scary

Chemotherapy is scary. Not because you might spend 3 days and nights in the bathroom, have your hair fall out, wake up in cold sweats, have dry eyes, suffer major fatigue, experience sore muscles, not want to eat, or no longer be able to feel your toes or fingers. It is because you don't know which, if any, of the side effects are going to apply to you.

Yesterday I dozed off for the end of my chemo treatment. I woke up and was soaked. My first thought: "I peed my pants!" (Spoiler: I did not.) The first thing I did was check my list of side effects - sure enough sweating was on the list, along with about 20 other possible side effects.

I thought: "This is a first: a side effect and the chemo wasn't even done going in!" When Ruth, my nurse, came in I mentioned it to her and she asked: "...or it is the rubbery chair and 74 degree room?" I think she also kind of wanted to say 'duh,' but she is way too sweet for that. :)

So here I am, 24 hours after my first Irinotecan chemo treatment, faring fairly well. A few minor side effects, but ones I can manage. I like getting one 'cycle' under my belt - then I know the general pattern the treatments will follow, and I can plan around them a little better.

Strong body, weak cancer cells.



- Posted using BlogPress from my iPad

Tough Days

Ever since my stay in the hospital, I have been having a difficult time. I hadn't been feeling well for a few weeks before being in the hospital, and my hospital stay was a horrible experience and since then I just have not been myself.

I was admitted to the hospital for fluids and meds, in part because I had a horrible stomach bug compounded with severe pain in my abdomen and back. The nurse who admitted me, Chris, was fantastic. He helped me get settled, started my meds, checked in on me, etc. Sadly, he was only my nurse for about 6 hours.

Due to the pain medication I was given, I was not allowed out of bed without an aide. And a reminder: I was in the hospital, in part, for a nasty stomach bug. My first morning I buzzed for someone to come so I could use the bathroom. No one came. I buzzed again 10 minutes later. No one came. After 20 minutes, someone finally came. At that point I was nearly in tears, in massive discomfort, and feeling humiliated over the bathroom.  Later that day brought more of the same, my IV pump beeped for 25 minutes before someone came to turn it off (I was fighting a severe headache brought on by one of the pain meds), after I buzzed twice. I asked to take a shower. Four hours later I was brought towels. I asked for a bland diet when I was allowed solids. I was brought the regular meal. Meanwhile, the background noise in the hall was a staff member telling the patient in the room next door that HE WAS NOT ALLOWED TO GET OFF THE COMMODE. Over and over.

And all I could think was that when this gets really bad, when I am really sick...this is where I will have to be? These people are who I need to trust to care for me?

Then came Dr. Chan and all that crap, combined with the exhaustion brought on by some of my meds as well as the pain that stays with me each day, and I must admit to having some really tough days. A cancer survivor I know recently started a blog and part of it is about finding her sunshine. I am really struggling with that of late.

Nap time

I had my liver biopsy done this morning and all went well. My side is a bit sore this evening and my head is still a little fuzzy, but all in all I cannot complain. I was aware of the process, but sedated enough that it did not hurt and I willingly allowed the doc (another swimmer, by the way...swimming: the way to meet your dream healthcare team) to place a long needle through my side, repeatedly.

Results will be in early next week.

On Tuesday I start my new chemo. It sounds like the side effects may start during the treatment, so Kelly is going to work from home so he can drive me and be here...just in case. I am eager to get a treatment under my belt so I know what to expect for future treatments.

Then, on 1/22 Kelly and I will go to the liver clinic at Johns Hopkins in Baltimore for their advice/opinion. Working with them has been a terrific experience thus far, and I look forward to meeting everyone there in person.

I am beat...so off to bed I go to try to get some solid sleep. (And convince Kelly to get some sleep too!)

Next Steps

I have received quite a bit of flack for my lack of blog entry after my last posting. It has been a busy week sorting out what treatment option to pursue next and I have been feeling under the weather.

On Monday Kelly and I went to Boston to meet Dr. Chan. Her recommendation was a chemo combination that showed promise in Europe, but before signing off on that she wanted to talk to Dr. B again.
AUGH.

On Wednesday Dr. Chan called to tell me after talking with Dr. B she was changing her chemo recommendation. Just in case the cancer in the liver is related to the cervical cancer. (Quick refresher: No test I have gone through has ever shown they are related. In fact, every test has indicated they are two separate processes.)

I emailed Dr. S for his advice, and he felt the chemo change was okay, but he did wonder if an embolization would be an option worth pursuing (Dr. Chan was not in favor of an embolization).

My gut is telling me I need to pursue the embolization.

So...long story short:

1) On Thursday I will have another liver biopsy; in part to do another test to determine (once and for all...I hope) if the cervical cancer and tumors in my liver are connected.

2) I will start chemotherapy (irinotecan) soon. The side effects sound similar to what I have been through before. I am not 100% sure of the treatment schedule yet.

3) I am in conversations with the liver center at Johns Hopkins to get a second opinion to Dr. Chan's opinion. I will be talking with them again early in the week.

I am flying by the seat of my pants here. I am following my gut, and am grateful for the solid, clear counsel of Dr. S.