The doctors ordered a blood test early this morning and discovered that his blood count (both red and white) are low. Therefore, they are in the process of giving him two units of blood, which will take about six hours to complete. He should be feeling somewhat better this evening with the full affect being realized by tomorrow.
At this point, we are unsure of when they will discharge him, but he may end up staying until the radiation therapy concludes on April 7.
Tuesday, March 31, 2009
Wednesday, March 25, 2009
Radiation Treatment
One of the biggest problems Dad has been experiencing is hip pain on the right side, which originated when he slipped (but didn't fall) when walking down stairs. He has an approximately 5x3 cm cancerous lesion in his pelvic bone, which has caused the bone to be compromised and is most certainly the cause for the pain. He has been having an increasingly difficult time walking.
After consultation with Dr. Weber on March 20 during the chemo treatment, Dad consulted with Dr. Wu, a radiation oncologist whom he had met briefly at the hospital during his first inpatient stay; the consultation took place on March 23. She recommended a radiation treatment plan to begin on March 24 consisting of 10 total visits on weekdays, concluding on April 6. This schedule was delayed by one day due to his admission to the hospital. Each visit will last about 30 minutes (most of which is prep time; actual radiation time is only about two minutes per visit).
The goal of the radiation therapy is to stop growth of the lesion in order to reduce the pain and hoprfully allow the bone to heal. He should begin experiencing some relief from the pain by the end of the treatment, but the benefits won't be fully realized for a few weeks after treatment has concluded.
Dr. Wu informed us that Dad's form of cancer, adeno carcinoma, responds well to radiation therapy. However, therapy for all of the lesions in his body is not an option because the dosage would be too much for him to tolerate. Radiation is recommended when there is only a primary tumor (i.e., if the cancer hasn't metastasized) or when there is a significant risk associated with a well-defined lesion. In Dad's case, the risk is fracture of the pelvic bone.
The only side-effect expected is some burning, itching, and dryness of the skin on the hip (front and back) where the radiation beam is to be directed.
After consultation with Dr. Weber on March 20 during the chemo treatment, Dad consulted with Dr. Wu, a radiation oncologist whom he had met briefly at the hospital during his first inpatient stay; the consultation took place on March 23. She recommended a radiation treatment plan to begin on March 24 consisting of 10 total visits on weekdays, concluding on April 6. This schedule was delayed by one day due to his admission to the hospital. Each visit will last about 30 minutes (most of which is prep time; actual radiation time is only about two minutes per visit).
The goal of the radiation therapy is to stop growth of the lesion in order to reduce the pain and hoprfully allow the bone to heal. He should begin experiencing some relief from the pain by the end of the treatment, but the benefits won't be fully realized for a few weeks after treatment has concluded.
Dr. Wu informed us that Dad's form of cancer, adeno carcinoma, responds well to radiation therapy. However, therapy for all of the lesions in his body is not an option because the dosage would be too much for him to tolerate. Radiation is recommended when there is only a primary tumor (i.e., if the cancer hasn't metastasized) or when there is a significant risk associated with a well-defined lesion. In Dad's case, the risk is fracture of the pelvic bone.
The only side-effect expected is some burning, itching, and dryness of the skin on the hip (front and back) where the radiation beam is to be directed.
Tuesday, March 24, 2009
Update for March 24, 2009
As noted in my earlier post, Dad was readmitted to Seton Medical Center this morning for severe fatigue. Tasha is staying at the hospital with him tonight.
His condition is largely the same as when he was admitted:
At this point, it's unclear for the underlying cause for his symptoms. Dr. Weber paid a visit late in the day today and indicated that the most likely explanation is the chemo treatment administered on March 20. The chemo drugs may need to be adjusted for the next application, which is scheduled for April 9. We will also have a discussion with him about the expected benefit of the chemo in general vs. the potential side effects.
There's no way to know how long he will be hospitalized, but my gut feeling is that it will be a minimum of three days.
I will be making more posts with further details regarding other aspects of his care.
His condition is largely the same as when he was admitted:
- He is extremely fatigued and needs help moving between the bed and the bathroom
- He feels cold even though his body temperature is normal
- He has not eaten and has no appetite
- He has taken some small drinks of water and has a saline solution hooked to his IV to hydrate him
At this point, it's unclear for the underlying cause for his symptoms. Dr. Weber paid a visit late in the day today and indicated that the most likely explanation is the chemo treatment administered on March 20. The chemo drugs may need to be adjusted for the next application, which is scheduled for April 9. We will also have a discussion with him about the expected benefit of the chemo in general vs. the potential side effects.
There's no way to know how long he will be hospitalized, but my gut feeling is that it will be a minimum of three days.
I will be making more posts with further details regarding other aspects of his care.
Readmission to Hospital
We are currently in the process of getting Dad readmitted to the oncology ward at Seton Medical Center. He is extremely fatigued and has experienced a marked decrease in appetite over the past 24 hours. He slept poorly last night and suffered from diarrhea at about 4:00 AM. We came to the hospital for his first radiation treatment this morning, which has been postponed until he is feeling better.
I will do my best to post more updates regarding his care soon, including plans for radiation therapy and pain management.
I will do my best to post more updates regarding his care soon, including plans for radiation therapy and pain management.
Sunday, March 15, 2009
Update for March 15, 2009
Apologies for not posting for a week. A lot has been going on; for now I will post a high-level update and provide details in the next few days.
- My sister, Tasha, arrived here on Tuesday, March 10 from Hawaii. She will be staying for about a month.
- We consulted with another oncologist, Dr. Ruth Marlin, on Tuesday, March 10. That consultation was not for a second opinion so much as a complement to Dr. Weber's care and in fact we were referred to Dr. Marlin by Dr. Weber. I will post details of that visit once we receive a copy of her report.
- Dad had a rough week since my last post, hitting his low point on Tuesday, March 10. His fatigue, pain (head and hip), and mouth sores have been the primary concerns. We consulted with Dr. Moskowitz (his attending physician at the hospital) on Friday, March 13, primarily about pain management. He has suggested some changes in the pain medication, which will be be trying this week.
- Dad's next chemo session is scheduled for Friday, March 20.
Sunday, March 8, 2009
Chemotherapy Drugs and Treatment Details
The drugs Dr. Weber has prescribed for Dad's chemotherapy include the following:
The first two are standard chemo drugs and the third attacks the blood vessels of the tumor.
In addition to these drugs (which are all administered intravenously during the actual treatment), Dad is also taking Decadron orally for four days around the chemo (day before, day of, and two days after) to prevent the rash that can occur as a result of the Alimpta. There is one final pre-treatment drug that he is given in the office called Kytril to reduce nausea.
As explained by Dr. Weber, the plan is to complete one round of treatments, which consists of three visits at three week intervals:
After the third treatment on April 10, they will run a CT scan to see how the cancer has responded to the first round of treatments. If spread is either stopped or even countered, this will be considered success and they will continue with the same drugs. If the drugs prove to be be ineffective, Dr. Weber will adjust them in an attempt to find an effective solution.
The first two are standard chemo drugs and the third attacks the blood vessels of the tumor.
In addition to these drugs (which are all administered intravenously during the actual treatment), Dad is also taking Decadron orally for four days around the chemo (day before, day of, and two days after) to prevent the rash that can occur as a result of the Alimpta. There is one final pre-treatment drug that he is given in the office called Kytril to reduce nausea.
As explained by Dr. Weber, the plan is to complete one round of treatments, which consists of three visits at three week intervals:
- February 27
- March 20
- April 10
After the third treatment on April 10, they will run a CT scan to see how the cancer has responded to the first round of treatments. If spread is either stopped or even countered, this will be considered success and they will continue with the same drugs. If the drugs prove to be be ineffective, Dr. Weber will adjust them in an attempt to find an effective solution.
Saturday, March 7, 2009
Update for March 7, 2009
Over the past couple of days, Dad has had many ups and downs. He has not felt as bad as his worst nor as good as his best and there have been many fluctuations. His symptoms include:
- Fatigue: Sometimes he can hardly sit up or keep his eyes open, other times he is able to walk a half mile with me. He rests by lying down on the couch and closing his eyes but not always sleeping. His mental acuity seems to correlate inversely with his fatigue.
- Sleeplessness: The Ambien seems to have been helping but his sleep is still disrupted several times each night. He rarely stays in bed for more than 6 1/2 hours. He naps a few times a day although sometimes he just rests.
- Headaches: His headaches have been quite bad, even relative to his baseline, which was pretty severe to begin with and has been for years. He continues to describe them as being more on the top of his head rather than the back or sides, which is more the norm for him.
Thursday, March 5, 2009
Medications
Below is a list of the medications Dad is currently taking. We are also tracking dosage, frequency, etc. but for purposes of the blog I will just post a list. Let me know if there are any questions about any of them. There is a mixture of prescription and over-the-counter drugs.
Once a day, taken in the morning:
Once a day, taken in the morning:
- Stool softener and laxative
- Magnesium
- Vitamin B6
- Aspirin
- Finasteride (generic for Proscar)
- Centrum Silver
- Folic Acid
- Lovaza
- Niaspan
- Flomax
- Zolpidem (generic for Ambien)
- Mucinex DM
- Vicadin
- Fentanyl (generic for Duragesic)
- Nexium
- Dexameth (generic for Decadron)
- Rhinocort Aqua
Update for March 5, 2009
Dad's first chemo treatment took place at Dr. Weber's office on Friday, February 27, 2009. It took about three hours to administer and he felt no ill effects when in the office or for a few days afterward.
On the evening of March 2, he misjudged the bottom of the stairs when walking down and nearly fell. As a result, he experienced some pain just below his right hip near the top/back of his thigh.
On the evening of March 3, he suddenly felt extremely fatigued, sleepy, and cold and also experienced a severe headache on the top of his head in spite of having put on a new fentanyl patch earlier that day. He went to bed somewhat early and slept for at least six hours straight; this is the most continuous sleep he has gotten for the past several months. He continued to have the same symptoms in the morning, with a break when he felt better for an hour and a half mid-morning, during which time he took a shower.
He and Bette had appointments with Terry Grenchik at 2:00 PM on March 4, at which time he consulted with her about the hip/leg pain and the fatigue and heacache. She gave him a prescription for a muscle relaxant (which has not been filled) for the pain and suggested that the other symptoms are likely a result of the chemotherapy and/or cancer.
I consulted with Dr. Weber on the phone late on the 4th and he agreed that Dad's symptoms could be a delayed response to the chemo and didn't think there was anything else we should be doing at this point.
On the evening of March 2, he misjudged the bottom of the stairs when walking down and nearly fell. As a result, he experienced some pain just below his right hip near the top/back of his thigh.
On the evening of March 3, he suddenly felt extremely fatigued, sleepy, and cold and also experienced a severe headache on the top of his head in spite of having put on a new fentanyl patch earlier that day. He went to bed somewhat early and slept for at least six hours straight; this is the most continuous sleep he has gotten for the past several months. He continued to have the same symptoms in the morning, with a break when he felt better for an hour and a half mid-morning, during which time he took a shower.
He and Bette had appointments with Terry Grenchik at 2:00 PM on March 4, at which time he consulted with her about the hip/leg pain and the fatigue and heacache. She gave him a prescription for a muscle relaxant (which has not been filled) for the pain and suggested that the other symptoms are likely a result of the chemotherapy and/or cancer.
I consulted with Dr. Weber on the phone late on the 4th and he agreed that Dad's symptoms could be a delayed response to the chemo and didn't think there was anything else we should be doing at this point.
First Post
The purpose of this blog is to keep track of Dad's health, cancer treatments, reactions, etc. Below is a brief summary of the events leading up to where we are today.
Dad and Bette stopped in for a visit to San Francisco on February 12, 2009 on their way from Hawaii back to Missouri. The original plan called for them to leave San Francisco on March 4. On the evening of February 19, Dad felt very ill and hardly slept, with various symptoms ranging from indigestion to fatigue. On Friday the 20th, I took him to see our family doctor, Terry Grenchik (who is actually a nurse practitioner). Based on her concern about pneumonia, she sent us to the emergency room at Seton Medical Center in Daly City, California. A chest x-ray showed a mass in his right lung, which prompted more tests and his admission to the hospital. He remained in the hospital until his discharge on February 26. During his stay, he was diagnosed with stage four lung cancer, which had spread to the lymph nodes in the chest and several bones. The primary mass is near the top of his right lung. While in the hospital he began consultation with Dr. Robert Weber, an oncologist, and began chemotherapy on February 27.
Future posts will be to track how he has been feeling, progress with his treatment, medication he is taking, etc.
Dad and Bette stopped in for a visit to San Francisco on February 12, 2009 on their way from Hawaii back to Missouri. The original plan called for them to leave San Francisco on March 4. On the evening of February 19, Dad felt very ill and hardly slept, with various symptoms ranging from indigestion to fatigue. On Friday the 20th, I took him to see our family doctor, Terry Grenchik (who is actually a nurse practitioner). Based on her concern about pneumonia, she sent us to the emergency room at Seton Medical Center in Daly City, California. A chest x-ray showed a mass in his right lung, which prompted more tests and his admission to the hospital. He remained in the hospital until his discharge on February 26. During his stay, he was diagnosed with stage four lung cancer, which had spread to the lymph nodes in the chest and several bones. The primary mass is near the top of his right lung. While in the hospital he began consultation with Dr. Robert Weber, an oncologist, and began chemotherapy on February 27.
Future posts will be to track how he has been feeling, progress with his treatment, medication he is taking, etc.
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