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Jan 3, 2007! HAPPY NEW YEAR! Well, I'm home and starting to heal up a bit. As you probably know, I spent 9 days in the hospital (12/21-29) after a little "passing out incident." Seems I was in the bathroom peeing and, the next thing I knew, on the floor with Maria asking me if I was okay and what had happened? I didn't really know. I just remember feeling light-headed and then the lights went out. It turns out that I was having the same problem with retaining fluids that I had a few weeks ago. However, this time it was more pronounced and prolonged, since it was my second time around.  I can't tell you how frustrating it was in the hospital to have them take my BP lying down, sitting, and standing several times a day and see no change. Here's an example of what my BP's were generally running: Supine, 105/70; sitting 80/55; and standing (when I could) 55/40. They were giving me 4 liters of saline per day around the clock, but I couldn't retain any of it. Then they gradually weaned me off the juice and said that, when I could maintain a BP of 90 or better sitting, I could go home. I did that on the 29th. I've seen steady improvement since coming home, as was expected. Maria visited me one or more times each day in the hospital (an hour and 10 minute round trip) and often just sat there and watched me sleep. As boring as the stay was for me, it had to be equally hard for her though I know she'd never admit it.

Also while in the Hospital, I had quite a bit of discomfort from esophagitus resulting from the radiation. It only hurt when I swallowed, so I tried not to do much of that. Dr. S gave me what he calls "Magic Mouthwash," which is a combination of maalox, lydocaine, and benedryl. It helps with both taste and the pain. I am now mostly over the esophagitis and my appetite seems to be improving as well.  (Apologies for the creative spellings)

Finally, I have to mention the nurses and care-givers on the oncology floor at SW WA Med. Center. They are wonderful. Their care - to a person - was professional, responsive, and caring. They made the stay as pleasant and comfortable as it could possibly be under the circumstances. And what can I say about Dr. S? He saw me daily and kept me well-informed of my "progress," his concerns, and what he was thinking was going on with me. When I saw him yesterday, when I went in for a blood draw, he seemed happy and visibly relieved that I was doing better. Enough for now. Take care.

Jan 4, 2007  Still improving I think, although I cheated a bit and went in for a saline fix today since I had a couple of doctor appointments anyhow.  Dr. S. seems to be okay with how I'm doing, i.e., blood counts are coming back up and my weight appears to have stabilized (although at 33# less than when I started).  Although he did say I'm border line anemic, which was expected, and that it probably isn't going to get much better for quite a while.  He gave a me shot of Aranesp, which is supposed to stimulate the bone marrow to produce more red blood cells.  Anemia is when your red blood cell count gets so low that sitting up to watch TV makes you winded and tired.  If it's not better by spring, I'm sure my fishin' buddies will come over and clean my boat, change the oil, tie my tackle, launch the boat, pack my lunch......because that's the kind of guys they are.  Aren't you guys?.....Guys?

Also, I go in next Tuesday for a PET scan.  That's the one where they load you up with some radioactive stuff and see if and where it accumulates to determine if the tumor has stayed at home and shrunk up like a good little tumor.  After that, we will be able to plan the next steps - operation, more radiation, more chemo, or a combination.  I'm holding out for the best outcome.  Think good thoughts and take care.

Jan 15, 2007  Well, we just got back from seeing the Surgeon, Dr. S.  After reviewing the results of the Pet Scan, he said he didn't think he'd be doing me a favor by operating and said if it were him, he wouldn't do it.  While the tumor is mostly dead as a result of the radiation and chemo, there are three places, apparently on the periphery, where it is still alive.  The main tumor and the still viable parts are in places that are a tangle of nerves and vessels, including the aorta, making it very difficult to remove.  This is not news since this was his position from the start.  He said the operation would be difficult, risky, and without any guarantee that all of the tumor could be successfully removed.  Also, the recovery period of at least two months, besides being painful, would likely substantially delay any additional treatment with radiation or chemo.  So it looks like the surgery option is off the table although Dr. S. wants to meet with the radiologist that evaluated the PET scan and go over the results in more detail.  We meet with the radiation doctor on Wednesday and then with my oncologist on Friday.  We will be discussing the possibility of more radiation, including use of the cyber knife.  I'm guessing that I will get more radiation and chemo starting very soon.  The "good news" in all of this is that the main tumor was responsive to the treatment (sometimes they aren't), is substantially dead, and may be still dying off since the effects of the chemo and radiation are still working.  So, while we didn't get the greatest of news, neither was it the worst.  We are still upbeat and hoping for the best.  Maria and I should know a lot more by the end of this week.  In the meantime continue sending food, gifts, and money, and hold good thoughts for us.

Jan 17, 2007  Although the PET scan report said that there were several areas of the tumor that took up the radioactive marker, Dr. H did not seem particularly concerned about them.  He said the radiation will continue to do its thing for some time and he didn't think a couple of the "bright spots" were cancer but possibly an artifact of the radiation.  He would wait to see the result of another scan that I will have to have in three months.  I'm going to be a regular visitor to the scan machines for the foreseeable future (Sorry Blue Cross).  The scan they did the last time was call a "PET-CT Fusion."  It allows integration of the CT tissue scan with the radioactive uptake picture so it's apparently more powerful than either of them by themselves.  The scan report also noted a "small focus of abnormal tracer accumulation...Small metastatic focus is not excluded but would be unusual."  This spot coincided with a small lump under the skin on my side that has been somewhat sore for a week or so.  Therefore, we will need to have a biopsy of it.  Dr. H said if it is malignant, then we can either remove it or radiate it as appropriate.  It sounds like it wouldn't be that difficult a procedure because it's just under the skin in a clump of my widely distributed fat.  Maria and I are going to push to get the biopsy as soon as possible.  The good part is the scan didn't show any spread to any of my few remaining vital organs.  Maria and I are anxious to get all this medical "stuff" done for awhile so I can focus on feeling better and we can again socialize with our friends, and do some traveling and fishing this summer.  Next report after the visit to Dr. S on Friday.  Take care and enjoy the snow.

Jan 17, 2007 Yes, we are optimistic. I think the news was more good than bad, though I lay awake for several hours in the middle of the night last night, trying NOT to worry about that new spot that lit up on his side. Dr. H didn't think it was in a lymph node, so that was a relief! Though he still tires quickly, John's been feeling better and I can see a definite improvement in his energy level. When he's better, I'm better! :-) He even had fun driving the new car to the doctor's appointment today. It handled great in the snow and ice. The snow driving was his first time back behind the wheel since his last round of chemo, so I know it's an indication that he's feeling more like himself.

Jan 18, 2007  Dr. Ss, the Surgeon, called me this morning and asked if I could come it today for the biopsy of the "marble" on my left hip (see Jan 17th entry).  I said sure, so Maria and I hopped in the "ol' Highlander" and headed in.  He dug in and got it out and sewed up in about an hour.  I'm home now and feeling okay, but will probably start to hurt in awhile.  We should have the lab reports back on Monday or Tuesday.  We're keeping our fingers crossed that it's something (lord knows what?) besides a tumor.  Dr. Ss said it would be unusual for it to be one in that location but, I'm nothing if not unusual, so we'll see.

Jan 26, 2007  Well, I assume you just read the general update page so I'll try not to rehash that here.  The surgeon, oncologist, and we were all a bit surprised that the biopsy came back positive for the same type of cells that were found in the original tumor.  The lump was on my left flank near the hip bone and was in the middle of the little (okay, large) roll of fat, sometimes referred to as "love handles."  The surgeon removed most or all of it.  This is good and bad.  I'll explain in a minute.  Dr. S said that, since the tumor was able to metastasize to that location, it was 1) borne by the blood and 2) able to grow under the adverse conditions of the Cisplatin that I was getting.  So, while the PET scan did not show any other locations, that does not preclude the possibility that there are some, but not large enough to show up yet.  Neither does it necessarily mean that there are others.  Dr. S had planned on doing another round of chemo at this time - with or without the current circumstance - and with a different chemo.  The reason was that, if there were Cisplatin-resistant cells, they might effectively be treated with the new chemo. The fact that the tumor on my side was largely removed precludes using it as a measure of the effectiveness of the Docetaxil.  However, if another pops up over the treatment period, that could be a clue.  I will be getting three Docetaxil treatments, one each Friday starting today.  Then I get the 4th Friday off and then three more, ending about March 9th, if all goes well.  Then we will do another PET/CT fusion scan and see what the story is.  We are thinking positively and hoping that I will get a break for a while to recover so we can enjoy the summer and fall.  But, more chemo is not out of the picture and if that's to be, then we'll just have work our play around it.

I have to admit that the news Thursday night about the biopsy came as quite a blow to Maria and me.  We did some crying, a lot of talking, and some speculating.  But then, "we got over it."  After all, it is what it is, and brooding or worrying is not good medicine and neither is it a good way to spend whatever time we might have together, be it one year or 20.  It was a setback, yes, but no more than that.  In fact, Maria commented that the positive part of this whole cancer thing is that one of us hasn't been suddenly taken, as too often happens, without the opportunity to have expressed our love and our wishes to each other, to my kids, and our friends.  You know, to say those things that we all have plans to say..... "someday before we die."  We get to do that!  And if it turns out to be a false alarm, I expect we will not be harshly judged by the recipients for the imposition.  And so much the better.

So, as I said in the General Update, we are positive and upbeat and will continue to live life with gusto and to enjoy the kids, Maria's wonderful parents, our great friends, and especially each other as much as humanly possible.  We are looking forward to doing things and traveling with friends, including a possible quick trip to California to visit Maria's folks, a Tofino, B.C. fishing trip this May, the big Buoy 10 party in August, a fly fishing extravaganza through Montana this fall, Chinook fishing at our cabin in October, then the holidays and whatever other wonders the year might hold for us.