One more day

Dr. Mullin came in at about noon to talk about his conversation with Dr. Porubcin. They both felt that the best course of action is to increase the daily dose of Lovenox to 70 ml as mom continues with the chemo treatments. Dr. Porubcin didn't think that mom's port in her chest had anything to do with the blood clotting.

Dr. Mullin couldn't say what caused the episode/reaction of what was making all of her blood vessels in her head dilate, other than maybe a clot did get loose and cause some problems - but the good thing is that it resolved itself. Just as clots clot; sometimes clots dissipate themselves too.

Believe it or not, one of mom's best friends, Nancy Craig, had her knee replaced yesterday and is staying in a room right down the hall. Mom has been down there a couple of times to check on her and say hello.

So mom will be able to go home tomorrow. I think it's best she stay another night as well. Just because she doesn't feel as bad as yesterday doesn't mean that nothing else will happen. There's still the issue of the small fluid buildup in her abdomen, the doctors aren't sure what is causing it (other than the cancer). Hopefully with the new round of chemo, the cancer cells will be killed off, and the fluid will subside. I guess we will know that in a couple of weeks after some more treatments are out of the way.

Overnight in hospital

Mom has developed blood clots again in her lungs, so she's going to spend the night tonight at Hammond Henry. Earlier today she was feeling short of breath and then she had an episode where she felt like the blood was rushing to her head, so she called Dr. Mullin's office and went in to get some blood work done and get a scan - and the clots showed up on the scan.

The nurse gave her an extra shot of Lovenox (the clot preventative) so that will help prevent more clots and then hopefully start to break up what is there.

There was some discussion about whether or not her port is causing some of these clots since this is the second time around.

The scan also showed some fluid buildup around spleen and pelvis area - but no tumor anywhere. The fluid buildup isn't a good sign but at least there's no mass anywhere.

Tomorrow Dr. Mullin and Dr. Porubcin will talk and figure out the best approach. She will probably go home tomorrow afternoon but they wanted to keep an eye on her tonight.

Post chemo

Mom said she is feeling OK today - other than she woke up with a headache overnight. Nurse Marty said that this was a common side effect with this particular treatment - headaches - so that is nothing out of the ordinary. One of the other side effects that Nurse Marty said was common was constipation... and I'm not going to ask mom if she is constipated so we'll just leave it at that.

Marty is one of my favorites - I see her from time to time in Longview Park across from my house. She walks her dogs over there and we always have discussions about rescuing animals and such. Her niece is a huge animal advocate and frequently fosters dogs and is also a big pit bull fan too. That's always a plus in my book. 

Tomorrow we'll see how mom feels - she reminded me that the second day after chemo is tougher than the first day after chemo, so we'll see what happens. 

Back in the chemo room

The round of chemo went very well today - mom was done in about 45 minutes and we were out of there in less than an hour. The nurses didn't have any trouble with her port and they were able to access it right away. They gave her the Topotecan and another bit of some other drug to curb the nausea. She can take some of her other nausea medication if she wants to later - all and all she felt fine although a little tired after we got back home. She doesn't have to go in tomorrow for the neulasta shot so this process is easier on her system that the last time. She won't have that much hair loss either.

I looked up in my notes from last year because I remembered that the first oncologist, Dr. Konda, talked about using Topetecan as well. I had written down that his strategy was also to go three weeks on and one week off with the treatments. At the time, her CA125 count was at 2500 (on 3/26/09) so in some respects she is kind of right back where she started, which is disheartening, but today the nurses felt that she should respond well to the drug and hopefully we'll see that in the lab work in the next couple of weeks.

We didn't hear anything about the scan she had done last Friday, hopefully we'll hear about that in the next day or two to rule out any growth areas. If there are no growth areas that is a good thing. Her treatment next week is on Tuesday.

More chemotherapy

Mom had another blood count done last week and unfortunately the CA125 count went up again to 1900. Dr. Porubcin was disheartened by the high number, but advised that the best thing to do was to start chemo again with the drug Topotecan. In some respects this drug is a good option as it has minimal side effects and mom doesn't have to go through the "cocktail" of meds before starting treatment... so no need to take steroids, benedryl, emend, etc. That is at least a good part. The drug (topotecan) should be able to kill the cancer and bring the CA125 number down.

Dr. Porubcin ordered another scan of her midsection and she will have that done Friday morning. They may be able to detect where (or if) the cancer is collecting somewhere. The last scan she had in July didn't show anything because the number was so low, however this time may be different.

Nonetheless, the fact remains that the cancer is growing.

She starts treatment next Monday, and will have it weekly for three weeks. Then she will have the fourth week off, and then start the cycle again... so three weeks chemo, one week off... etc. for four months at least. The treatments only take an hour.

Dr. Porubcin told her to stop the Tamoxifen too.

We talked a little bit about the Cancer Research project in Iowa City. The project is using the carboplatin and taxol, along with Avastin, for the treatments. Dr. Porubcin felt that regimen was a little harsh and didn't think that mom was up for that and making all of the trips to Iowa City. I agree in a way and want to try the Topotecan route right now. At least we can act on that pretty quickly and get her in for treatments next week.

No one thought that her cancer would come back so quickly - but then if cancer was so predictable then more cures would be available. The only thing she can do is stay one step ahead and with all of this attention from Iowa City doctors and Trinity doctors and nurses, she's in good hands.

Mom talked with Sherrie (nurse) at Dr. Porubcin's office on Monday, and she (Sherrie) is going to check into the chemo research project that is being conducted in Iowa City. Mom may be a good candidate... but having Sherrie call and ask the right questions is the next step. 

For now Mom is going to stay on the Tamoxifen. Hopefully that will keep the count from going any higher. Her next blood test is in four weeks and then after that will have a visit with Dr. Porubcin to talk about more options. 

In the meantime fingers are crossed - hopefully she won't start having symptoms otherwise.

Cancer counts

Mom went in for another blood test this week and Dr. Porubcin's office called her Friday to tell her that the CA 125 was over 1200 - which is extremely high given the time frame. The last time the count was over 200 which was high to begin with in the first place. The doctors were concerned a month ago but also said that they don't treat "the number" necessarily.

Well now "the number" is high and she needs to look at some options. Dr. Porubcin put her on Tamoxifen - a drug that is mostly used for breast cancer patients, but there has been some success with ovarian cancer patients. It blocks the estrogen activity and prevents the cancer cells from binding to some sort of protein. It has the potential of reducing the original cancer... so in theory it could potentially inhibit her cancer or at least keep the counts from skyrocketing up any more. 

She wants to talk to Porubcin's office some more. I'm sure the doctors in Iowa City will have some information as well, so we will be doing a lot of talking in the next week to see what the next step is going to be.