Second CT Scan and Ninth Chemo

June 7, 2014

Normally, you would have already seen a blog update from me, as I tend to write them just before the next session, and per the schedule, I should now be in the middle of the tenth chemo session.  However, we did not start the tenth session on Wednesday (June 4) as scheduled and it has been pushed to next week.  I'll get into that in a bit, but there's a lot that's gone on in the past two and a half weeks since I last wrote.

First, the ninth chemo session started on Wednesday, May 21st. My Dad brought me into the clinic for this session, as Karla was home with baby Graeme. Like all sessions, before it started, we met with either my doctor or nurse practitioner (in this case it was Nina the NP) to discuss how the previous session went, whether changes were needed, etc. This discussion was more significant because we would also discuss the results of the CT scan I had undergone the previous week. Karla was dialed in through the cellphone. Unfortunately, the results were not as great as the first CT scan. There was some slight regrowth in the tumors (7%) which Nina indicated was actually a positive result, as this showed the chemo had maintained stability over the tumors since the previous session (anything under 20% is considered stable). I don't think Karla and I could quite bring ourselves to look on this as positive, but we do understand the situation I'm in - there is very little chance that the tumors in my body will be eradicated, so the point of the chemo sessions is to keep the tumors at bay, either shrinking them or at a minimum, holding them steady(and thus prolonging my life). So, this is not bad news, more 'meh' news.

There are numerous different chemo regimens that can be used against the cancer, and what we are pursuing is just the first of those regimens.  There are many more in reserve, so to speak.  This regimen was going to come to an end soon in any case, before one of the drugs (Oxalyplatin) did permanent damage to my nerves (the neuropathy side effect I have discussed in previous posts). I had actually been feeling the neuropathy more prevalently in recent weeks. So, Nina's recommendation was to scale back on the dosage of the Oxalyplatin for this session but to continue with the current regimen for this session. So I got hooked up to the different IVs, and then after completing the on site infusion, went home and completed the three day home infusion.

One thing we noticed as the days progressed is that the fatigue I had been experiencing seemed to be a lot worse. I was waking up unrefreshed, and by lunch time, was almost out of gas.  An afternoon nap couldn't really bring back my energy, and I was going to bed immediately after dinner.  This was becoming exceedingly frustrating for me, as it was getting harder to put in a full day of RSI work, let alone have anything left for my family.

A quick aside here - during this session, Karla's brother Chris and his family came up and paid us a visit from New Jersey. They stayed at a nearby hotel (they have five children so there was no way all of us could have stayed in our small house) and came over each day to visit.  It was great to see them again, as Isla had never met her cousins on the DeGaetano side. It was definitely an experience for her, having to share her toys with others, and there were a few blow-ups!  Chris and his wife Jill have done an amazing job raising the five kids, ranging in age from 2 to 11 years old. We all went and visited the newly opened Legoland in Boston. Probably more age appropriate for kids 7-14, but it was definitely an experience. Chris and Jill went back to Jersey on June 1.

Normally by this time, I'd be feeling really strong, but the fatigue has only gotten worse. My friend Ron was coming over for dinner on Tuesday, June 3, and I was hoping I'd have the energy for his visit.  But Tuesday turned out to be a really weird day, side effect-wise.  At 9:30, I took some Ibuprofen and started with some cold sweats early on.  These subsided and by lunch time around 1PM, it was like a switch got turned on and I had some energy again, like a normal day before the next chemo session. I cranked out some RSI work over the next four and a half hour, but then got really cold and shivery and no amount of blankets could cool me down.  So Ron's visit consisted of me being under blankets the whole time having shivery conversations.

June 10

I picked up the blog a few days later, as I was quite fatigued over the next few days and a number of things happened.  I went in the for the 10th chemo session on June 4, but unfortunately had a bit of a fever approaching 101% degrees, so no chemo this week,  The doctor felt it would be better to wait a week and in the meantime, see if the could isolate my fatigue.  So we spent the rest of Wednesday getting blood cultures, loading up on IV fluid and being rescheduled to next Wednesday for the 10th session.

Unfortunately, when we got back home, my fever went up again.  Karla called Dr. Wolpin and he recommended going to the hospital.  So we loaded back up into the car and drove downtown to the Brigham. I would be on my own here, as Karla and I did not want to bring Graeme into the emergency room.  Luckily, Dr. Wolpin had called ahead and I was seen very quickly.  I hate the Emergency room as it is like a petri dish of injuries, disease, illness, etc. and I just tried to keep myself separated as much as possible.  I had a private room quite quickly.

They took more tests, blood and vitals, and my fever had come down.  I also had a chest x-ray to make sure I did not have pneumonia.  All tests were negative but they decided to keep me over night just in case.  Probably one of the worst sleeps since baby was born, constant noise, and being woken up every few hours for vitals or bathroom break.  Overnight, Jamie decided to come down from Ottawa for a few days to provide support which was welcomed, especially if I needed to go back to hospital.  I was cleared to leave around ten, but traffic was so bad that Karla wasn't able to get me until around noon.  Finally home, quite fatigues in early afternoon so went straight to bed.  Jamie made it down, and provided major support over the next few days.

My fever did go up a bit over the next few days, but after consultation, with NP Nina, we decided to stay home over weekend and then come in on Monday for next attempt at chemo.  Unfortunely, still had a fever so pushed off chemo until Wednesday the 11th.  Instead we did another CT scan to see if tumors were the cause of my fatigue.  So spend most of the day at the clinic and drove home for dinner.  Still feeling fatigue on Tuesday, but drove in Wednesday for next chemo.

I'll describe things further in my next blog, as we actually did move forward with the next chemo on the Wednesday.

Talk soon.

Andrew