Posts Tagged ‘medical tests

18
May
10

Three Scans for the Price of . . . Three

But first, results from last week’s scan!

Good news all around – the largest tumor has shrunk from 9.4cm down to 7.9cm; several of the other tumors also have shrunk; and some that haven’t shrunk outside are becoming necrotic inside, which probably means that the Avastin is preventing the blood flow leading to them.

So, yay!

As well, at 2 months, what they’re really looking for is to make sure that the tumors aren’t still growing, but often what you see at that point is that they’re stable, neither growth or reduction. The shrinkage, therefore is actually very good news.

So, double-yay!

My spleen is slightly enlarged, which isn’t of concern yet – Doctor Medici says there are blood vessels leading from the liver to the spleen (I think this is how it went, chemo brain is to blame if I’m saying wrong, not Doctor M), and they can get a little congested. At any rate, it is possible that it is lowering my red blood count, and may in the future have an impact on whether I can continue with this chemo regimen; but for now we want to go with it for as long as my body will tolerate it, since it’s having such good effect.

I also have some pleural effusion in my left chest cavity – a build-up of fluid in the space between the lungs and the chest wall. I believe this accounts for the chest symptoms I’ve been having, and also for the anxiety attacks, which I’ve been having a bit more often. Dr. M. doesn’t believe that, but I do – I know my body, and I’ve associated the anxiety with the feelings of pressure or compression in my chest, and the feeling that I can’t breathe as deeply as I want; and that was before I knew there was something in there.

However, the thing that most concerned Doctor Medici was the swelling on my left hand from last week. He was concerned that there might be hidden heart damage or a blood clot in my arm that was causing edema, and so he wanted me to have a vascular ultrasound and an echocardiogram in the next couple days.

I went in to the infusion suite and had my chemo, and when I came out, Nurse K. had scheduled me for the ultrasound at 3 pm and the echoCG at 4 pm. Fortunately, our savior driver cousin Jeanette was able to stick around and take me back to the hospital, and even had some personal business there herself, so that all worked out.

The ultrasound was given by a student, and one of the staff doctor/technicians was there to walk her through it. I was hearing comments like “Where is this thingy?”, “Show me that thingy,” “Show me that thingy in color.” I was seriously wiped out from the chemo, and all I wanted to do as I’m lying there was sleep – surprisingly, I ended up feeling pretty rested after that, so maybe my steroid high was kicking in.

They ended up taking a close look at the port and its environs, and the doctor/technician asked me a lot of questions about it. They ran over into my other appointment by about 10 minutes, and were looking intently at the results of the scan when I came out of the room. I had to wait a few minutes for the next test, even though I was late; and while I’m in having the echocardiogram, the ultrasound doctor stuck his head in the door and said:

“I just got off the phone with Doctor Medici, and he wants her to have a CT scan this evening – we’re getting it scheduled now.”

I called Jeanette to let her know that she shouldn’t wait any more, but didn’t get hold of her, which I figured meant she was out in the waiting room. We finished the eCG, and while I was changing the eCG doctor went out to talk to the other doctor. When he returned he said that the CT scan was scheduled, and I should just head right over there. When I got to the lobby, sure enough there was poor Jeanette, waiting patiently – I really appreciate the fact that she took so much time out of her life to drive me around, and to wait so long, but I didn’t know how much longer it was going to be, and figured she needed to get home to her family. After she left I called Brian to fill him in, and have him pick me up after the CT scan.

Once I was over in the radiology department, I got in pretty quickly. Nurse S. asked me why I was there, and I had to confess that I didn’t really know. All I could do was speculate that the ultrasound had detected a possible problem in my left chest/arm area, but nobody had told me what was specifically being looked for (and yes, I did ask the eCG doctor, who was the only one there by the time I was done with that test, but he didn’t know anything about it, just that the scan had been scheduled and where I was supposed to go). So he (Nurse S.) went to talk to the CT doctor, and it turned out that they were scanning the left chest and arm to look for venous clots, as I had guessed. I was still confused with why they needed a new scan, since I’d just had one on Thursday last week, and it was after the swelling symptoms had been and gone; until Nurse S. reminded me that normal chest CT scans are done with both arms above the head, so the arm is not imaged. Ah, of course.

Brian was waiting for me as soon as I was done, and we came home and made dinner, and were hanging a couple new pieces of artwork on the wall when the phone rang.

Dr. Medici was calling to let me know that the ultrasound doctor had detected some apparent slowing of bloodflow into the arms, which seemed as if it was coming from the middle of the chest; this is why Dr. M. requested the CT. The CT however, didn’t detect any clots or other problems, so unless the eCG results come back with something odd, everything seems as it should.

So that is the story of my big medical day, and My Three Scans.

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14
May
10

My Least Favorite Rollercoaster

Well, one of the topics we discussed with Dr. Medici on Monday was progress scans on the chemo regimen. He said that it had been nearly 8 weeks, and since we were rescheduling the chemo, why not do them this week?

I was floored, as I understood that scans happened every 3 months – Brian was under that impression also, but he said he remembered hearing 2 months originally, but then everything he heard after that was 3 months.

Apparently we were so shell-shocked in the first meeting with Dr. Medici, just finding out that the tumors were indeed cancer, that what we missed/got confused about is that with a new chemo regimen scans are performed at 2 months, and then each succeeding 3 months as long as you’re on that regimen. And once you switch to a different chemo regimen, you have a scan at 2 months, then each succeeding 3 months. The tricky part is if the 2-month scan shows that the disease is progressing, you get switched to a new regimen, so you’ll have a scan in another 2 months.

At any rate, I jumped at the chance to have scans 4 weeks earlier than I was expecting, because the waiting is the hardest part (how petty of me ;-} ). So I had a scan on Thursday morning early.

Late Tuesday afternoon, his nurse called with the results of my CA 15-3 tumor marker blood test results: the number was down by nearly half – excellent news, yes?

Maybe. There isn’t a specific correlation between the amount of tumor marker in the blood and the size of tumors that is true for every person. For instance, when I had my recurrence, I had a tumor that was a little larger than the largest of the original tumors, and my CA 15-3 was somewhere around 9 or so. We did not check my tumor marker with the first set of tumors, since I had the surgery before I ever met with the oncologist, so I can’t say what it was at that time. But 9 is a perfectly acceptable “normal” level, one that an oncologist would expect means there is no tumor.

My prior tumor marker level at my latest oncology followup was 10 (I believe that was in July, but it might have been November, I’ve lost track of specific dates). And when we measured it at the time of diagnosis in March this year, it had soared to 1622. Knowing that there’s at least 1 tumor of nearly 4 inches diameter, other, smaller tumors, and multiple lesions on the liver, that seems to indicate aggressive growth in a short timespan.

But does the halving of the tumor marker mean that the tumors themselves will be halved in size? Probably not, although it is likely a good indication that the chemo is having some effect on the cancer. Dr. Medici says once we get a few scans and tumor-marker measurements, we should be able to figure out *my* personal marker-level-to-tumor-size correlation. It would be awesome if it was 1:1.

So why the rollercoaster?

I’m still adjusting to the idea that I have a terminal disease, which is pretty depressing.

Yet the hope that springs up when I’m told that the tumor marker is down is hard to repress. If we knew what that *meant*, it might be that I have every reason to hope that there has been significant progress; it also might be that it only means that the chemo is good at killing off the tumor markers in my blood, but not good at killing off tissue-bound tumors.

But of course, statistics don’t lie. It’s just that you never know where your position in the stat table is, until something actually happens.

So I’m trying to maintain a balance between hope and statistics – it’s a thin line, and it’s hard to keep your footing.

We’ll find out Monday what the results of the scan are, and there’s 2 out of 3 chances that I’ll remain on my current regimen – if there is progress in shrinking the tumors, or if there is no change in the size, I’ll continue as is; but if there is growth, we’ll be switching me to a new regimen.

Dr. Medici will hopefully have the results soon enough this afternoon to be able to make that decision, because if I’m continuing the same regimen, I will have chemo on Monday. If it’s changing, I’ll have chemo Monday only if he is able to get the new drug in on time.

Hate it or hate it, you gotta love chemo when your life depends on it. . .

04
Feb
09

February 4, 2009

Update on me: nothing much different – more tired, more pain in my left lung, but no fever or coughing. The pain is due to accumulation of fluid, but I believe that the antibiotic is causing more activity in the lung, thus more fluid, so it probably isn’t a bad sign. If it continues to get worse (it’s still at a fairly low level in spite of the increase), I will, of course, call the doctor.

And my feet feel sweaty. Go figure.

Update on Robin: His various blood and lab tests came back mostly normal – there are a couple things that are off. His cholesterol is 561 (normal is 324 or below), and one of his thyroid numbers (I think it is the T4) is at 4.2, normally 4 or lower. The vet is processing another thyroid test – if he turns out to be hypothyroid, that could explain the high cholesterol (this is a dog who has *never* been given people food, and is actually on a weight control diet (thus less fat) already). The vet seemed to think that it might explain the problem with his hind end, although he seemed dubious about that.

He doesn’t think it was a seizure of any kind.

So until we get the next test back, we don’t really know if there are more diagnostics in the works or if we will end up treating him for hypothyroidism, and waiting to see if the problem recurs.

And that’s about all I know (or feel capable of knowing, right now, at least). Time for another nap.

03
Feb
09

February 3, 2009

Well, it’s only Tuesday, but already we’ve had more drama than necessary this week.

Last Thursday, I realized that I was coming down with a cold, so worked from home on Friday, and tried to take it pretty easy on the weekend. I already had plans for Saturday morning (a class on learning how to use my new sewing machine’s spiffy functions, which are indeed way cool), so I went to that.

Then on Sunday Carrie, James, Brian, and I went to brunch at Petite Provence on Division, which, not so coincidentally, just happens to be next to my most favorite bead store ever, Beads at Dusti Creek. So of course, we sent the boys home and spent a couple hours browsing and chatting – I really went to visit the ladies, because I haven’t been in for a long time, and miss seeing everyone. Sweet Calla was there, but sadly, nearly everyone else except for Eric, and most importantly Beau, were not. But we had a great visit with Calla, and Carrie found some great stuff for a new project.

I’m on a stash diet this year – I have enough beads, fabric for quilting, and yarn for knitting to last me for way more than a year (at least at my present level of output), so I’m only going to work from items in my stock. Of course, if I don’t have any findings, or need batting for a quilt, or don’t have the right set of needles for a knitting project, I will do what I have to do to make sure I don’t have a pile of UFOs on hand, but otherwise, NO purchasing new beads, fabric, yarn.

At any rate, I made it out of Dusti’s without actually buying anything, and oddly enough, without the usual “Oh, but just think what I could make with *this*, and it won’t be here the next time I come back, so. . .” temptation. It was fun to look at stuff, and I definitely saw things I would like to make projects with, but I didn’t even have to talk myself out of anything. Weird.

Of course, that might be because I wasn’t feeling up to par – my cold and left-over chemo side-effects from the last infusion on the 23rd had me pretty tired, and after I got home, I lay down for a two-hour nap. I had no problem sleeping Sunday night, either.

I woke up Monday morning to a pain in my calf, which lasted for a few minutes; and before that pain passed, my left lung all of a sudden felt like it was being compressed, and I felt like I was breathing through cotton. I could feel mild pain in my back underneath my shoulder blade. When I stood up I was a bit light-headed. Crap. These are similar symptoms to what I felt when I had my pulmonary embolism.

I called the oncologist, and, as I expected, he sent me to the ER. It was very busy, so probably the first hour was spent in the waiting room, although they did give me an EKG while I waited (sounds sort of like a service for the busy professional – EKGs and ultrasounds WHILE YOU WAIT!). Once I was in a room, they drew some blood and hooked me up to an IV. Annoyingly, they had to poke me in the arm rather than use my port, because the contrast agent they use for CT angiograms cannot be put through the kind of port I have. Apparently there is something called a “power port” that is specifically designed for taking that kind of abuse (hey – if a bloody plastic apparatus can’t take it, how are my precious organic VEINS supposed to handle it, huh?).

Another 4-1/2 hours and one CT scan later, the doctor told us that I had pneumonia. Brian and I looked at each other, pumped our fists, and yelled “woo hoo!” – pretty sad when having pneumonia is a good thing, but ya gotta admit that it is *much* better than a pulmonary embolism.

Even more exciting is that this means we don’t have to take me off the Avastin. It can cause bleeding problems (either clots or hemorrhaging in extreme cases), so if I’d had a PE, we would have had to stop it.

Finally got home (via Dairy Queen for my first meal of the day, and a consolation Heath Bar Blizzard) around 5 p.m., had a nap, read, went to bed. I’m on antibiotics for two weeks, and the doctor says I can go back to work by Friday. Of course, Friday is supposed to my next chemo, so I have a call in to the oncologist to find out if that’s still a go or not. I *really* do not want to delay the chemo. I want to get it over with!

I woke up around 2:30 a.m. this morning with an upset stomach and a killer headache. I got up at 3, had some broth and crackers, and sat in my recliner reading until 4. Since my stomach was better, but my head was still killing me, I decided to nap in the recliner for a while rather than go back to bed and risk waking Brian with my restlessness.

Around 7:30, Robin, who had been sleeping behind my recliner, started thrashing around, woke me up from a fairly sound sleep. I jumped out of the chair and went around to see what was the problem – he couldn’t stand up, his hind legs weren’t working. I calmed him down, ran my hands over his back and hind legs, but didn’t seem to have any pain reaction. Got him on his front legs, then lifted him onto his hind legs, and he was able to walk but not steadily – his rear legs kept collapsing. I got him over onto the carpet, and sat with him for a while, calming him down again, then tried standing him up again. It looked like it was mostly his right rear leg that was the problem.

I woke Brian up, who took him to the vet – they didn’t have an open appointment until 3 p.m. this afternoon, so Robin will be there all day. Since Brian has to go in to a client’s site this afternoon, hopefully our neighbor will be able to pick Robin up.

So that’s been my fun couple days so far. Woo hoo!

10
Sep
07

September 10, 2007

After a wonderful weekend at the coast, Brian and I got home Sunday afternoon, and after greeting a very happy-to-see-us dog, got back into the routine (the cats were pretty ho-hum about our return).

Today, the doctor contacted me with both bad and good news. The bad news is that the additional mass in my left breast is cancer; the good news is that the mass in the right breast is not. This means that I will definitely have to have a mastectomy on the left, because of the positioning of the cancerous lumps; as well as the impracticality of doing two lumpectomies as far apart as these two masses are, being a multi-focal cancer, it is probably more aggressive and that makes it more likely that I could expect a recurrence were we to do lumpectomies. The doctor still wants to do an excisional biopsy of the mass on the right, but unless I choose to go the route of having a prophylactic mastectomy (removing the breast as a preventative measure), it would be minor surgery; either it or the prophylactic mastectomy will be done at the same time as the left-breast mastectomy.

I asked the surgeon about getting a test done to see if I carry the breast cancer genetic markers, as it would be helpful to know in making a decision about what to do on my right breast – because of my family history, it seems like a good possibility that I have at least one. Apparently it takes 4 – 6 weeks to get the results back, and since we’re hoping to have my surgery scheduled for no later than September 28, I will either have to make the decision to proceed on the bilateral surgery without that information, or plan another surgery if the results come back positive. Without one of the markers, I have a 20% chance of developing cancer in the remaining breast, but if I do have one or more, the chance shoots up to 80%. I’m leaning toward the bilateral mastectomy option, at least in part because I don’t want to have to go through this again. There are so many things I want to do, places I want to visit, and especially, people I want to spend time with – why waste part of my life by having to go through cancer and its attendant rigors a second time? Brian and I will discuss it with the surgeon when we meet this Thursday – hopefully she’ll be able to add some clarity to the decision-making process.

In the meantime, my mission (with no choice but to accept it ;-} ), is to set up appointments to meet with plastic surgeons and decide who I want to do the reconstruction (I’m definitely planning on having a permanent installation – I don’t want to have to look for body parts when I get dressed in the morning!) . Then it is just a matter of finding a time when the two surgeons’ schedules coincide to do the surgery.

I’m relieved to finally be able to move ahead on this, although it’s helped me with learning to be more patient – a good thing, but something I’d rather have acquired through, say, my knitting or my quilting!

Julie

07
Sep
07

September 7, 2007

Hi y’all –

So Tuesday and yesterday I had my MRI-guided biopsies, and discovered that I’m a real wimp when it comes to the sedative they give – the nurse said it has a half-life of 6-8 hours, but it was well over 24 hours before I felt back to normal. Unfortunately, I seem to have developed a tolerance for the local anaesthetic – fortunately, I have a high tolerance for pain, so it wasn’t too bad.

For those who were as confused as I was about how they do an MRI-guided biopsy, it involves taking images with the patient in the coil, moving the patient out, sticking things into the patient, moving the patient back into the coil to make sure the things are positioned properly and moving the patient back out of the coil (repeat this step as necessary), and sticking more things into the patient in order to take things out of the patient. Fortunately, I only have vague memories of all the moving and poking – I really only noticed things if they spoke directly to me (they always put a hand on my arm when they spoke to me – Brian suggested that perhaps they were communicating via bone conduction).

The really weird part is that after they got me out of the machine and moved into another room where they bandaged me up and gave me all the follow-up care instructions, I can remember all of that – every word. I remember Brian stopping at the vet’s to pick up pills for April before we went home. I remember getting out of Brian’s car, trying to avoid the mirror on *my* car because it was parked too close. After that, I only know that I made it upstairs onto the bed because that’s where I found myself this morning. I pretty much slept without moving for 14 hours straight – I briefly surfaced at 5:00 a.m., but didn’t notice that I was still in my clothes.

The results from the first biopsy should be available today, but my doctor isn’t, so I won’t know anything until next week. Since it won’t really change anything except how extensive the surgery will have to be, and whether I have chemotherapy before or after the surgery, I’m not stressing (at least, not so far – maybe there’s more Xanax left in my system than I think!).

We’re heading off to Newport for a couple nights in celebration of Brian’s birthday (Thanks, Steve & Ellen, for the use of your place). Robin doesn’t get to go, but he does get to stay with his good friend Jasmine (Thanks, Sharon & Gary). The cats are going to enjoy the peace and quiet – after our house guest Augie the Dorkie (that’s half-Dachshund, half-Yorkie) left the other day, they were thinking that Robin (too big to get into their hidey-holes) was looking pretty good, but then they started remembering that he’s still a dog, and thinking that he really doesn’t need to check their ID every time they walk through the room.

Anyway, I’ll post an update next week as soon as I have results. Take care,

Julie

29
Aug
07

August 29, 2007

They (whoever “they” are) always say that no news is good news – but in this case it’s just exactly that – no news.

I went in for my ultrasound-guided biopsy today, and in spite of being able to see on the MRI films where the suspicious spots are supposed to be, the doctor couldn’t find either of them with the ultrasound. Of course, there was a lot of time spent looking, and then the staff helped me set up my appointments for the MRI-guided biopsies – one is on 9/4, and the other is on 9/6. The very kind and sympathetic nurse practitioner who is my liaison at the imaging center (and who was the one who helped get today’s appointment moved from its further-out date) put me on the “fast track”, so that I didn’t have to wait to get in – it might have been another two weeks otherwise.

So far, everyone I’ve dealt with has been extremely helpful, and compassionate, as well. It seems as if it would be easy for someone who deals with cancer patients every day to start treating patients as if they’re just another body – I haven’t seen that at all yet. Even when I expressed my frustration strongly today (I didn’t pitch a fit, although it was tempting ;-} ), the doctor and the nurse practitioner both were more concerned about making sure that I got in to have the MRIs right away than defending the system.

So there’s the news, such as it is. More waiting. I will probably know something around September 11 or 12 – I have to schedule a follow-up with the surgeon after the results from the 9/6 MRI are available. I expect that appointment will solidify the surgery/treatment plan.

Julie




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