Cathy was released from the hospital tonight. Although she screened negative for Hepatitis A, B or C from her 1/15/09 blood draw, the infectious disease doctor called in on Cathy's case seems to think the recent elevation of liver enzymes was due either to:
"Hepatitis" as a reaction to the medication designed to combat THRUSH, Flucazanole OR
Yeast / Candidiasis in her liver [thrush migrated there]
So, fun for us, we will be administering the same intravenous anti-fungal medication she has been receiving while in the hospital the last 2 or 3 days. Thankfully, our insurance provides for Home Health Care that will get us set up for it and instruct us how to do it.
Our "matriarch" is tired from inability to sleep in the hospital, dried out in her mouth / nose from the dry hospital air and now eating quite well again! Her liver enzymes are coming down, WBC is up and should continue to rise through lack of chemo the last two weeks and for the foreseeable future and platelets are well into normal range.
Another prayer concern is that Cathy will not get chemo until her liver enzymes are under control. This cancer has been aggressive and fast growing, we hope and pray that the cancer will be held in abeyance while her enzymes retreat.
Wednesday, January 20, 2010
Monday, January 18, 2010
What a day - renewed hope!
With rising liver enzymes, jaundice and concerns of Hepatitis or liver failure [signs looked to the former, fears "imagined" the latter], today has been quite the rebuttal. And we praise God for answered prayers!!
The day started with another blood draw at the chemo station since Cathy's blood from Friday, 1/15 was still inadequate to allow for therapy. Results came back with a solid 3.6 well above the cautionary point and platelets exceeding 200 [160 being the low point of "normal].
The next stop was to meet with Dr. Bayer and get the full results from the liver enzyme and tests for hepatitis. Cathy was negative for hepatitis A, B or C and the cancer marker even ticked down slightly! However, many of her already significantly elevated liver enzymes more than doubled. The CT scan from 1/13 could reveal any clues, Cathy can't get MRI scans now, so Dr. Bayer had Cathy admitted to the hospital for more tests and to be seen by a gastroenterologist and infectious disease doctor. The concerns being a possible blockage causing the increased enzymes. Chemo was not administered and won't be until the liver enzyme conundrum is deciphered.
The intake procedure, subsequent scans [EKG, X-ray and ultrasound] and visits by doctors was done with remarkable precision and timeliness. Both doctors, as well as Dr. Bayer, suggested the Flucazanole for THRUSH may have contributed to these elevated enzymes and the ultrasound did not indicate any blockage. Additionally, blood drawn today showed one of the key enzymes even retreated between last Friday and today ... and Cathy took her last Flucazanole this morning! If subsequent tests on Tuesday, 1/19 show enzymes continuing in a decreasing fashion, Cathy will be released from the hospital and will not need and ERCP procedure to be done.
This sure looks like great news and should allow chemotherapy to resume sometime soon. HOWEVER, with weekly chemotherapies resuming, the concern is now focused on a way to keep Cathy's WBC from degrading to the point that she gets THRUSH again as the treatment [Flucazanole] may be as disquieting as the ailment!
For now, the patient is resting [as best possible] in the hospital and we'll fight tomorrow's battles with renewed optimism! Praise be to God for answers to many faithful prayers!!
The day started with another blood draw at the chemo station since Cathy's blood from Friday, 1/15 was still inadequate to allow for therapy. Results came back with a solid 3.6 well above the cautionary point and platelets exceeding 200 [160 being the low point of "normal].
The next stop was to meet with Dr. Bayer and get the full results from the liver enzyme and tests for hepatitis. Cathy was negative for hepatitis A, B or C and the cancer marker even ticked down slightly! However, many of her already significantly elevated liver enzymes more than doubled. The CT scan from 1/13 could reveal any clues, Cathy can't get MRI scans now, so Dr. Bayer had Cathy admitted to the hospital for more tests and to be seen by a gastroenterologist and infectious disease doctor. The concerns being a possible blockage causing the increased enzymes. Chemo was not administered and won't be until the liver enzyme conundrum is deciphered.
The intake procedure, subsequent scans [EKG, X-ray and ultrasound] and visits by doctors was done with remarkable precision and timeliness. Both doctors, as well as Dr. Bayer, suggested the Flucazanole for THRUSH may have contributed to these elevated enzymes and the ultrasound did not indicate any blockage. Additionally, blood drawn today showed one of the key enzymes even retreated between last Friday and today ... and Cathy took her last Flucazanole this morning! If subsequent tests on Tuesday, 1/19 show enzymes continuing in a decreasing fashion, Cathy will be released from the hospital and will not need and ERCP procedure to be done.
This sure looks like great news and should allow chemotherapy to resume sometime soon. HOWEVER, with weekly chemotherapies resuming, the concern is now focused on a way to keep Cathy's WBC from degrading to the point that she gets THRUSH again as the treatment [Flucazanole] may be as disquieting as the ailment!
For now, the patient is resting [as best possible] in the hospital and we'll fight tomorrow's battles with renewed optimism! Praise be to God for answers to many faithful prayers!!
Sunday, January 17, 2010
Long Overdue [2 of 2]
The events of this past week warrant a post all their own, so strap in! January 11 proved to be, almost on queue, another week without chemo [it seems the story is the same every third week]. Cathy's WBC was at 0.9 [again, normal is 4.1 - 10.9]. Additionally, Cathy experienced excruciating THRUSH in her throat again, almost immediately following the last dose of Flucazanole from her prior bout with THRUSH - but this is just one more result from such low WBC. Because the Dr and nurses all thought Cathy looked strong, and she is such a good patient and can rebound on her own, Dr. Bayer elected to avoid the cost [and PAIN] and forego the Neupogen shots.
Not knowing why he did this and [with the incorrect misunderstanding about previoius transfusions], I contacted the Dr. on Tuesday for clarification. I also mentioned that Cathy and I had compared the last three "liver panels" against the original blood draw from 9/14. While some of the key liver enzymes had come down slightly over the last 6 weeks or so, they were all SIGNIFICANTLY higher than those from 9/14 and one key measurement went up.
Dr. Bayer had been on some task that took him away from seeing patients for several weeks, so after we hung up he reviewed Cathy's liver measurements. He called me back within 2 hours on Tuesday to suggest a new CT scan ASAP and another blood draw on Friday, 1/15. En route to the CT scan on Wednesday evening, Cathy mentioned some new symptoms she had noticed that were abnormal. By Thursday when the Dr. called to inform us of the CT scan results [no new growths, but no reduction in the size of the tumor in her liver], Cathy also informed him of her jaundiced eyes and skin - signs of additional compromise in her liver.
Full results of Friday's blood draw should be known by our late AM chemo appt on 1/18. These last few days have been very difficult not knowing what else is wrong with Cathy's liver and if this will affect her ability to continue with chemo. Amidst all the fatigue [so UNlike Cathy], I did see some strength from her for a short period this afternoon and it gave me hope that we can still address these issues.
The goal is to get Cathy to the point that she can receive the "PARP inhibitor" that is in final testing now. The test is going so well that our Dr. is optimistic it may receive FDA approval by mid-summer '10. We have, to this point, opted against getting in the test as there's a 50% chance she would get the chemo and placebo instead of the chemo and PARP inhibitor and there are vastly different and apparent results that all can see, even though it is a double blind study. Please pray with us to this end. Thanks for caring, encouraging, helping and praying.
Not knowing why he did this and [with the incorrect misunderstanding about previoius transfusions], I contacted the Dr. on Tuesday for clarification. I also mentioned that Cathy and I had compared the last three "liver panels" against the original blood draw from 9/14. While some of the key liver enzymes had come down slightly over the last 6 weeks or so, they were all SIGNIFICANTLY higher than those from 9/14 and one key measurement went up.
Dr. Bayer had been on some task that took him away from seeing patients for several weeks, so after we hung up he reviewed Cathy's liver measurements. He called me back within 2 hours on Tuesday to suggest a new CT scan ASAP and another blood draw on Friday, 1/15. En route to the CT scan on Wednesday evening, Cathy mentioned some new symptoms she had noticed that were abnormal. By Thursday when the Dr. called to inform us of the CT scan results [no new growths, but no reduction in the size of the tumor in her liver], Cathy also informed him of her jaundiced eyes and skin - signs of additional compromise in her liver.
Full results of Friday's blood draw should be known by our late AM chemo appt on 1/18. These last few days have been very difficult not knowing what else is wrong with Cathy's liver and if this will affect her ability to continue with chemo. Amidst all the fatigue [so UNlike Cathy], I did see some strength from her for a short period this afternoon and it gave me hope that we can still address these issues.
The goal is to get Cathy to the point that she can receive the "PARP inhibitor" that is in final testing now. The test is going so well that our Dr. is optimistic it may receive FDA approval by mid-summer '10. We have, to this point, opted against getting in the test as there's a 50% chance she would get the chemo and placebo instead of the chemo and PARP inhibitor and there are vastly different and apparent results that all can see, even though it is a double blind study. Please pray with us to this end. Thanks for caring, encouraging, helping and praying.
Long Overdue [1 of 2]
For those who might still be following, I'm sorry for the delay in updating. Though our holidays were much more low key & "abbreviated", most of what was done was done by me so its been busy.
To update, Cathy received her chemo on 12/14, but again on 12/21 her White Blood Cell [WBC] count was too low to get chemo. During Cathy's original bout with cancer in fall of '08, Cathy received Neulasta to help her body create sufficient WBC to keep her on the schedule of chemo every other week - but using Neulasta does not allow for chemo on a weekly basis as Cathy is doing now. So on 12/21, with her WBC count at 1.1 ["normal range of 4.1 - 10.9], Dr. Bayer scheduled Cathy for daily Neupogen 12/21-12/23 . This stuff brings up the WBC but at the cost of flu-like symptoms and BONE PAIN. Tough trooper that she is, Cathy felt the pain the evening of 12/21. The evening of 12/22, however, was AGONY. Cathy lamented that she just couldn't do it again on 12/23. Although the "stand-in" Dr. ordered Cathy to have the shot, the nurses who know my wife's resilience insisted on taking blood labs first - praise God she was at 5.6, didn't need to get the shot, and had an extra day to recoup for Christmas.
We enjoyed time with family and friends for Christmas and the New Year. Cathy once again had consecutive chemo on 12/28 and 1/4 and we marched into the New Year. We hope your Christmas, like ours, was joyful and filled with the love of family and friends at the celebration of our Lord's marvelous birth.
To update, Cathy received her chemo on 12/14, but again on 12/21 her White Blood Cell [WBC] count was too low to get chemo. During Cathy's original bout with cancer in fall of '08, Cathy received Neulasta to help her body create sufficient WBC to keep her on the schedule of chemo every other week - but using Neulasta does not allow for chemo on a weekly basis as Cathy is doing now. So on 12/21, with her WBC count at 1.1 ["normal range of 4.1 - 10.9], Dr. Bayer scheduled Cathy for daily Neupogen 12/21-12/23 . This stuff brings up the WBC but at the cost of flu-like symptoms and BONE PAIN. Tough trooper that she is, Cathy felt the pain the evening of 12/21. The evening of 12/22, however, was AGONY. Cathy lamented that she just couldn't do it again on 12/23. Although the "stand-in" Dr. ordered Cathy to have the shot, the nurses who know my wife's resilience insisted on taking blood labs first - praise God she was at 5.6, didn't need to get the shot, and had an extra day to recoup for Christmas.
We enjoyed time with family and friends for Christmas and the New Year. Cathy once again had consecutive chemo on 12/28 and 1/4 and we marched into the New Year. We hope your Christmas, like ours, was joyful and filled with the love of family and friends at the celebration of our Lord's marvelous birth.
Monday, December 7, 2009
We'll take it !!
Cathy's pre-chemo labs came back on November 30th showing her blood too degenerated to allow for chemotherapy. The Dr. and staff didn't seem flustered as a result and suggested the extra week off may do her some good and allow her to gain strength and her blood to rebound sufficiently to receive her scheduled "nab paclitaxel + Avastin". Cathy did show a bit more energy and we fed her a fair amount of beef on Saturday and Sunday to help.
The "pinch hitter" [not our regular oncologist] made a comment to Cathy today to the effect of, "Well this is a happy story" with regards to Cathy's response to her chemo. She DID get her dual chemo today and evidently [we haven't seen them], her abnormally high liver markers are continuing to come down! The "exit strategy" / maintenance regimen has not been discussed with us [perhaps it's just way too premature], but today we are very heartened by Cathy's response and the medical community's view of her progress.
Cathy had declined the steroids administered prior to her chemo the last two treatments but today's nurse wasn't aware of this change. So before Cathy and her sister noticed, she had received nearly 1/2 of the steroid ... Cathy was full of life this evening! Getting sleep as a result is still yet to be determined. Cathy is SUCH A TROOPER. She is fighting so valiantly and we appear to be seeing results as a result of her spirit, the faithful prayer of so many, the Lord's favor and chemo sufficient for the task. Thanks for your loving support and prayers.
The "pinch hitter" [not our regular oncologist] made a comment to Cathy today to the effect of, "Well this is a happy story" with regards to Cathy's response to her chemo. She DID get her dual chemo today and evidently [we haven't seen them], her abnormally high liver markers are continuing to come down! The "exit strategy" / maintenance regimen has not been discussed with us [perhaps it's just way too premature], but today we are very heartened by Cathy's response and the medical community's view of her progress.
Cathy had declined the steroids administered prior to her chemo the last two treatments but today's nurse wasn't aware of this change. So before Cathy and her sister noticed, she had received nearly 1/2 of the steroid ... Cathy was full of life this evening! Getting sleep as a result is still yet to be determined. Cathy is SUCH A TROOPER. She is fighting so valiantly and we appear to be seeing results as a result of her spirit, the faithful prayer of so many, the Lord's favor and chemo sufficient for the task. Thanks for your loving support and prayers.
Saturday, November 28, 2009
Too much fun? Too much to eat?
Perhaps we overdid it taking Cathy to the Rockford area for Thanksgiving to be with her family. The food and warm fellowship were excellent as always and not something Cathy or the rest of our small family could stand to miss. But in light of how comprimised Cathy has felt since returning it sure makes me second guess staying too long or Cathy indulging too much [extra pressure on her liver causing extra pressure on her lungs]?
On Friday we finally reviewed her labs from Monday's chemo. They weren't good: platelets below 100 and other factors above or below norms. It caused me to do some more internet research about Triple Negative and I was smacked into reality at just how pernicious this cancer is. Stories of other triple negative breast cancer patients with similar stories to Cathy's: faithful, young, vibrant, healthy, active women inflicted with this insidious stuff. Please continue to pray for her strength, response to chemo, the doctor's wisdom, timely medical advances and God's overarching grace and mercy.
On Friday we finally reviewed her labs from Monday's chemo. They weren't good: platelets below 100 and other factors above or below norms. It caused me to do some more internet research about Triple Negative and I was smacked into reality at just how pernicious this cancer is. Stories of other triple negative breast cancer patients with similar stories to Cathy's: faithful, young, vibrant, healthy, active women inflicted with this insidious stuff. Please continue to pray for her strength, response to chemo, the doctor's wisdom, timely medical advances and God's overarching grace and mercy.
Sunday, November 22, 2009
WOW!
"WOW!!", Dr. Bayer exclaimed while feeling Cathy's abdomen during last Monday's chemo appointment. He followed that up by facetiously saying, "We don't even need to have a CT scan". Evidently the swelling in Cathy's liver has noticeably receded. Cathy then asked if she could have her chemo [got both the nab-paclitaxel and Avastin this time] sans the steroids. Dr. Bayer, knowing his model patient is tough, in tune with her body and capabilities, and able to take the "risk", agreed.
Since it had been 11 days since Cathy's last chemo and she felt strong, she skipped the steroids feeling they caused side effects worse than any perceived benefit, and she proved quite perceptive - she slept better after the chemo, exhibited none of the "shakes" she had after previous chemos and was unfazed by the chemo's nasty effects until about Wednesday afternoon.
Tonight Cathy felt she may have regressed a little bit but I think it's due to the increased activity she has exhibited over the last 3 days and the protracted time she has avoided the oxygen [generator or mobile backpack unit]. Cathy's voice is stronger, aforementioned energy and activity increased and resolve renewed. She ate quite well today, too!
Tomorrow brings another chemo [nab-paclitaxel only] and we hope the side effects will be minimized so Thanksgiving with family can be maximized, for we have MUCH to thank the Lord for. We wish you dear and faithful "followers" a blessed Thanksgiving as well and thank you for your prayers, cards, letters, phone calls and support in so many ways.
Since it had been 11 days since Cathy's last chemo and she felt strong, she skipped the steroids feeling they caused side effects worse than any perceived benefit, and she proved quite perceptive - she slept better after the chemo, exhibited none of the "shakes" she had after previous chemos and was unfazed by the chemo's nasty effects until about Wednesday afternoon.
Tonight Cathy felt she may have regressed a little bit but I think it's due to the increased activity she has exhibited over the last 3 days and the protracted time she has avoided the oxygen [generator or mobile backpack unit]. Cathy's voice is stronger, aforementioned energy and activity increased and resolve renewed. She ate quite well today, too!
Tomorrow brings another chemo [nab-paclitaxel only] and we hope the side effects will be minimized so Thanksgiving with family can be maximized, for we have MUCH to thank the Lord for. We wish you dear and faithful "followers" a blessed Thanksgiving as well and thank you for your prayers, cards, letters, phone calls and support in so many ways.
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