On Wednesday we met with the oncologist to discuss the CAT scan results and the next steps. That conversation seemed to me somewhat more clearly serious than the report I had received second-hand from Steve after the doctor's initial telephone call. That is to say, the doctor reiterated that in the upper part of the body the tumors seem shrunk/less active--but this time he speculated that most of the "credit" for that improvement probably still goes to the radiation. And the "cancer activity" in the abdominal region (including liver and lymph nodes) was described as continuing growth of the tumors there --so, he said, we need to "change our strategy" with the chemo, since it's not making headway against the target growths—which are "still not under control." The MUGA scan showed normal heart function, so stronger chemical treatments were not contra-indicated by that test. Then he said (again) that before going ahead with any chemo, he always asks the patient whether he *wants* to go ahead with a harsher treatment. And Steve said that yes, he did, in the hope that his continuing and recently-increased abdominal discomfort could be lessened by such treatment.
So. The new chemo regimen is a three-drug combination, two of which are infused once every three weeks. We had the first (four-hour-long) infusion Wednesday. The nurse had to change arms for the IV partway through, because the arm was tingling, burning, and showing redness. The second arm didn't get that way by the time it finished, and the redness in the first arm did subside, so the nurse said he thought everything was okay but we should contact them if there was a problem. The third drug is taken orally, two tablets in morning and three in the evening every day throughout the treatment. Swallowing them Wednesday evening didn't go well, so we've switched to grinding and dissolving them and putting them into the feeding tube via syringe. Disappointingly, Steve has continued to feel quite nauseated and to have recurring episodes of dry heaves (no productive vomiting, since he doesn't have any food in his upper stomach) since we got back from the chemo late Wednesday afternoon. I emailed the doctor about this Thursday evening, and he called Friday morning to suggest coming in for an additional anti-nausea infusion. Since I was at school, our home health aide drove Steve to the Infusion Center for that treatment, and the episodes stopped while the infusion was actually going on (several hours)—but have restarted since then. He has a spell every 4-5 hours (including being awakened during the night by it) and feels nauseated pretty much all the time between spells. We don't know how long to expect this may go on (just first few days after a treatment? or for the duration of this regimen?). Unfortunately but unsurprisingly, this condition keeps him from being able to take any significant amount of food by mouth (so he's losing weight again) or to drink much in the way of fluids (so he's pretty dehydrated also). Altogether not a promising situation.
So. The new chemo regimen is a three-drug combination, two of which are infused once every three weeks. We had the first (four-hour-long) infusion Wednesday. The nurse had to change arms for the IV partway through, because the arm was tingling, burning, and showing redness. The second arm didn't get that way by the time it finished, and the redness in the first arm did subside, so the nurse said he thought everything was okay but we should contact them if there was a problem. The third drug is taken orally, two tablets in morning and three in the evening every day throughout the treatment. Swallowing them Wednesday evening didn't go well, so we've switched to grinding and dissolving them and putting them into the feeding tube via syringe. Disappointingly, Steve has continued to feel quite nauseated and to have recurring episodes of dry heaves (no productive vomiting, since he doesn't have any food in his upper stomach) since we got back from the chemo late Wednesday afternoon. I emailed the doctor about this Thursday evening, and he called Friday morning to suggest coming in for an additional anti-nausea infusion. Since I was at school, our home health aide drove Steve to the Infusion Center for that treatment, and the episodes stopped while the infusion was actually going on (several hours)—but have restarted since then. He has a spell every 4-5 hours (including being awakened during the night by it) and feels nauseated pretty much all the time between spells. We don't know how long to expect this may go on (just first few days after a treatment? or for the duration of this regimen?). Unfortunately but unsurprisingly, this condition keeps him from being able to take any significant amount of food by mouth (so he's losing weight again) or to drink much in the way of fluids (so he's pretty dehydrated also). Altogether not a promising situation.
We had planned to drive down to Silver Spring this weekend to visit with Melissa and attend her Cathedral Choir concert, but have had to give up that plan. Presently (Saturday morning) Steve is sleeping in his recliner. I haven't administered his morning medicines yet, but I'm unwilling to rouse him from an apparently comfortable rest to do that. (This is one significant difference between home care and hospital care…) I'm pretty sure that whatever good the meds may do, it won't be worth more than the sleep.
Sorry to post such a less-heartening report, but that's the news from here. Thanks again to all of you for your ongoing support—your thoughts and prayers and the continued sprinkling of cards and emails and visits all help Steve's always-strong spirit keep as upbeat as possible.
--Carol
