Chemo treatment 2.8 down, no April foolin'...

This tough week continues but I have a better idea why since getting back the results of the CT scan from Wednesday morning. Dr. Chen and I went over them at the Thursday treatment. First off, the CT scan certainly wasn't informative as the PET scan would have been but it did have some favorable news. In comparison to the PET/CT scan from January 4th, there is nothing there to indicate cancer progress and maybe even indications of continued positive treatment. Without getting a qualitative cancer metabolic activity score (SUV), its hard to say how much real progress has been made. It appears that some of the distant bone metastasis sites have improved but its unknown if there is still cancer activity happening in those areas. However, we can say with certainty that my brain, spleen, liver, kidneys, and colon remain free of cancer lesions. The lesions on some of my ribs and spine also seem to have improved, but again its hard to say without the metabolic activity score. It also appears that cancer growth in my right lung has receded a bit. But, the pleural effusion in my right lung has increased in size, going from 9 mm in thickness in January to 31 mm in thickness now. This would explain my trouble with breathing and increased wheezing and gurgling. In addition, I have a small, developing pleural effusion in my left lung. Dr. Chen explained the biggest trouble with this is that the pleural space, that is the space between the lung and the sack that surrounds the lung, is negative pressure helping the lung expanding when inhaling. As the space gets filled with fluid, it becomes positive pressure which works against the lung expanding causing the breathing trouble. Also, as I take deep breaths, the push of the fluid causes pain to both the lung and the sack. If left untreated and it continues to grow in size, it could eventually cause the lung to collapse. So what to do? When I first went to Swedish last September to drain off the heart fluid and diagnose the cause of the pericardial effusion, xrays showed a large pleural effusion on my right lung causing my breathing problems and keeping me on an oxygen feed for a few days. The pulmonologist gave me a lasix water pill that effectively treated the problem. Within a day, I was off the oxygen mask and onto a nose feed. So Dr. Chen has put me onto the same pill to see if that will drain it off. He kinda has his doubts but the alternative is to surgerically drain it so its worth a shot to see if the pills will work. In addition, I am on another antibiotic in case the fluid buildup is a result of an infection. Another possible cause of the fluid build up is my lymph system not keeping up with the drainage of the mucus waste created from the cancer cells and some healthy cells getting destroyed by the chemo, this is if I understood Dr. Chen correctly. What this tells me is I need to better help my lymph system along by staying well hydrated and getting more excercise.

So while the CT scan wasn't as informative as a PET scan would have been, we were able to get some info. Basically, we still see positive progression against the cancer and thus will stay the course with the same chemo regement for the remainder of this cycle. Then we will try for another PET scan to decide how to go about the next cycle. We were also able to figure out the breathing problems and get treatment going for that. Dr. Chen says we can use ultrasound to check in on that in a week or two.

The rest of the treatment went well. The vitals looked good with bp at 134/72, pulse was up at 92 bmp, blood O2 was 97%, and weight steady at 201 lbs. The lounge was full so George gave me one of the private rooms with a bed. As I walked with him through the hall, both Krystina and Daravan sais I looked flushed and asked if I was running a fever. George said my temp was good but Daravan wanted to check again before jacking me into cool IV beverage. Again, my temp was fine. So she hooked me and and took the blood samples. That's when Dr. Chen came in to go over the CT scan and give me the exam. My blood counts came back still looking good and so on came the premeds and Avastin. When I got hit with the benadryl, it was like a rush of relief for the first time. My breathing opened up, my natural skin color returned, my cough went away, and besides feeling sleepy, I was feeling better. The benadryl cleared up the allergies I have been suffering from. Bingo! According to Daravan, I then slept through most of the chemo treatment. She said I was out like a light and even though she would come in and change IV bags, I never woke up. I did come too right when the last of the chemo was finishing off. A few minutes later, she came in and was surprised to see me awake. She told me I slept through the whole thing. She then got me unhooked and I left feeling a bit refreshed.

So besides getting my water pills yesterday, I stalked up on benadryl. Now I have to go out and get that antibiotic Rx filled...