Progress already? Sept 27

Mom had her first post-chemo follow-up with the oncologist this morning. We don't yet have the blood test results, but the doctor felt under her armpits for the obvious lymph nodes he found on his first visit (two weeks ago).  

It seems hard to believe, but he didn't feel them today. I even hesitate to report this, fearful it could put us on a roller-coaster. But we will TAKE it with a happy heart.  

Treatments (updated)

Question from the audience was: How many treatments will she have, and what time frame?

Treatments will be every two to three weeks. The usual spread is three weeks, but she is getting "mini-CHOP" (smaller dose) and the oncologist could put them closer together. He will watch how she is doing and how the blood tests look. A patient usually receives six treatments.

Get your flu shot

Please get your flu shot. Not only to protect yourself:

If you are going to be visiting Mom, PLEASE get vaccinated.  She is immune-compromised, and she can't get the protection.

Please, please, protect yourself and Mom.

I have masks here!!!

She's home

Ready for home

Fun visits yesterday from Rhonda, Judy, Missy, Rhea.  Mom was too out to remember, but we took pictures as evidence. Missy nearly had me ROFL.

Chemo went well without immediate effects.  Still sleepy this morning, but Mom perked up quite a bit this afternoon.

All the lines are out, except for the port access, no fluids running. The on-call weekend kidney doctor seemed to think she could go home at any time.  So perhaps tomorrow. I'll need to do some grocery shopping! 

Now I'm off to catch Max to Orenco Station.

Drip drip drip

Chemo's running. Well, technically, the immunotherapy Rituxan is an anti-body. She had a bunch of pre-meds to prevent side effects so she's pretty sleepy.  The real chemicals will come next.

Tomorrow she will get an injection of Nulasta to support white cells.  They want to watch her, and said MONDAY will probably be when she goes home.

Diagnosis and treatment plan

We got confirmation of what we already knew: Mom has lymphoma.  The type is large (or diffuse) B-cell. It is an aggressive lymphoma but also is treatable.

The treatment will be "CHOP," where each letter is a certain chemical. The "P" is prednisone,which she started on Tuesday. I think the round of chemo will be tomorrow and she will go home Saturday. The doctor is starting with about a two-thirds dose to have less stress on the kidneys, and can increase in the next round if it seems safe.
Chemo will be every three weeks, and progress is monitored primarily through blood tests.

With the treatment, the doctor (who is wonderful) is guessing a 35% chance of full remission, but most likely suppression of the lymphoma with an improvement in her quality of life, and with more time to do some things, and see people, which are important to her. (If she did not have treatment, she would only have a couple of months to live.)

We talked a lot, and will talk more in the morning, about side affects and how those side affects are either prevented or treated.

More later, but I needed to get this posted.

Diagnosis longer?

Crud, the surgeon during follow-up today said the biopsy results could take up to five days.  I'm still hopeful the 24-48 hour estimate comes through.

But the internet: bless it, says results of "flow cytometry" could take 10 days.  

She's awake, on prednisone

It's a nice morning for Mom so far. After three (or four, really) procedures the last two days, she's able to eat (last night wolfed down broth, Jell-o, and juice); the sedation has mostly cleared her system.

The port placed near her left shoulder looks really good, and she's not having any pain.

I asked the surgeon how big the node was: if you make a circle with your two hand, pointers touching each other and thumb tips touching each other, then slide right point tip down to the last joint of left pointer, and same with the thumbs, that's about the size she made.  Normal size? Touch those four finger tips together, about the size of a dried bean.

They started the steroid, prednisone, last night, to take five days. It's a pretty big dose (80) so she may become jittery.  And, the doctor said, ravenous like a bear in a campground!

Port in, biopsy node out

Mom now has a port (or "catheter port") near her left should, and as long as it doesn't give out, there is good access for fluids.  It took longer than expected as the doctors first routing choice ended up being "teeny tiny veins." But it is in.

The easier part was pulling a node.  Remember, 24-48 hours before we know anything.

She was very very sleepy this morning after the colonoscopy, and was just really starting to be alert about an hour before the port-biopsy procedures started.  I'm hoping she gets to sleep well tonight. 

If all the doctors agree, they will start a steroid tomorrow (kidney doctor wants to watch it carefully). 

Scopes Sept. 19

Yesterday's and today's scopes did not locate a source of bleeding. Docs decided the levels are not critically low; they are working to schedule her in for biopsy this afternoon. Please remember we won't have results for 24+ hours.

Poor Mom hasn't eaten in a long time.

Biopsy delayed

The biopsy is delayed. She had an endoscopy today to try to identify some blood loss, but no problem was seen from the throat to stomach. So tomorrow will be a colonoscopy; biopsy Wednesday at earliest. 

Lots of visitors yesterday, which Mom loved. Brother Bill and Joan; aunts Judy and Susan; old friend (from age 14!) Charlotte Clunas; Vicki and Bill Zurcher; Julie and John Gillette. WOW!!!

Biopsy scheduled

Biopsy will be tomorrow, Monday. I don't know how long to get results. 

Calcium better:10.8
Creatinine unchanged
In balance: potassium, magnesium, phosphorous

Cardiac okay; calcitonin - September 16

Fairly quiet day with two items of note!

Cardiac clearance for surgery won't be a problem.  I forgot she had a stress test just two weeks ago, but in my defense we had never been told the results. Which are good, clear!

Mom is starting on calcitonin for four days; it is a hormone that acts to reduce blood calcium.   No more calcitonin for our young lady, it made her sickly. 👎

So: after surgery (probably Monday) to get a lymph node for biopsy, Mom can be started on a steroid to help the kidneys PLUS provide some action against the alleged lymphoma. They can't start the steroid now because it would interfere with the biopsy diagnosis. 

Nice visit today from cousin Jeri and her family. 

She's feeling everybody's positive vibes, thank you.

Mom (Bette Jackson) - A journey begins? 9/15/2017

The alleged lymphoma.

That's what we're calling it for now.  Mom's hospital oncologist says we do not diagnose based on the radiology report. We look for the pathologist's report.

Based on a CAT scan today, Mom has multiple enlarged lymph nodes: arm pit, mid-torso, abdomen, groin areas. It does NOT appear to be a recurrence of the "easy" colon cancer she had several years ago, which would show up differently.

So now the task is to determine which of the many kinds of (alleged) lymphoma she's facing. But let me just relay her words, "Let's kick it."

The oncologist's preference is to have a surgeon remove a node from under the armpit. Yes it is a surgery but he is looking at this as being the better diagnostic over a needle biopsy, to get a better sample.  First she has to get clearances from cardiology.  Now that it's the weekend, we're also looking at Monday at the earliest (in my words, to get the "A Team" back in the building). I am very okay with a few more days to get the stress on her kidneys down to an even better level.

I was satisfied with Dr. Scott.   He may have already spent more face time with Mom than Mike got with Dr. Bud Pierce during Mike's entire treatment time.

BACKGROUND
Mom had shingles in May and just never seemed to get her strength back. By mid-August she hit a low when she fell (no injury) and did not have the strength to get herself up.  August 26 I took her to the emergency room for severe weakness, confusion, loss of appetite, thirst, plus the beginnings of some odd Neuro issues (slight tremor, couldn't hold her phone, couldn't hit the correct buttons). They rehydrated her for a couple of days and sent her home. The following weekend was Labor Day Weekend and we repeated another two-night stay. Ten days later the doctor didn't like the follow-up blood work so ordered her to admit to the hospital again through ER. So she is on her third night's stay as I type. 

There are a few more details, but not important to repeat here.  

UPDATE PLAN
I will post updates here.  Feel free to call/text/email if you have questions (no calls after 9pm or before 7am please). I may post the answer in this blog, as other people may have the same question. 

The last time I used the blog it seems the "comments" section wasn't working. I'll see if I can fix that, but not a big priority right now, sorry.