The most important part is, of course, the continuing efforts of her doctors to help cure SWMBO.
This is a very long, involved and technical discussion. If you are not intrinsically concerned about the background and current status of SWMBO's battle for survival, I urge you to stop reading now.
Okay, for the information of the few remaining readers, we'll continue with the description of the November SWMBO Report.
_______________________
To recap, on July 29, 2008, SWMBO was diagnosed with Lung Cancer. She doesn't smoke, but that is not a requirement for contracting this particular brand of Cancer. The good news, she doesn't smoke. Nor do I smoke in her presence, except incidentally outdoors where the smoke is carried away from her.
Being a non-smoker, her chances of survival are much better than the usual lung-cancer case. Her lungs are clean of tars and nicotine deposits, she is generally healthy and in good physical condition. She has ever been careful to observe a good regimen of healthy food and exercise.
She found the fest Oncologist within reasonable distance; in this case, it was the Seattle Cancer Center in Northern Washington State ... 300 miles, a five-hour drive away.
Her primary Oncologist, Dr. Cunningham, determined that she had a single tumor in the upper quadrant of her right lung. This is different from her local Oncologist who had determined (incorrectly) that she had two tumors, one in each lung (both considered "inoperable" because they are loath to cut out a tumor lest they miss something and, in the process, spread the infeection.) This simple correction in diagnosis moved her from the "Type Four" (no hope) to "Type One" (perhaps manageable) categorization.
Her Seattle doctor prescribed a new drug, Tarceva, which is "... a targeted Cancer treatment for second-line advanced for Non-Small Lung Cancer (NSCLC) ...". This medication had previously been prescribed after all other tratments had ceased working, but recently has been designated as the drug in choice for an otherwise-healthy Lung Cancer case, which perfectly described SEMBO's situation.
It worked for several weeks, until in mid-October SWMBO experienced sudden and dramatic mood-swings and an obvious decrease in energy and Oxygen acquisition.
A consultation with her doctor in Seattle resulted in the conclusion that the Tarceva was no longer working. Her Oncology team, in consultation, determined that she should immediatly dicontinue the Tarceva treatment and stat an intensive program of Chemotherapy.
SWMBO was required to take WEEKLY treatments of Chemotherapy, including (among other drugs) Benedryl ... an antihistimine (makes it easier for her to breath without coughing much), and a 'cocktail' of heavy-metal compounds such as Platinum which are deadly poisons, but intended to actually kill the tumor.
For the first few weeks there were a number of bad reactions, including extreme emesis (vomiting) which is generally acknowledged to be a common reaction to this kind of Chemotherapy.
SWMBO's drug treatment has been adjusted to treat various kinds of secondary side-effects of the primary drug treatment. She has been prescribed and anti-emesis drug called "EMEND", which has stopped the violent regurgitation commonly associated with anti-cancer chemotherapy.
Also, she has been severely debilitated by the drugs. She has no energy, is often unable to concentrate. She must sleep with a nasal oxygen feed, which causes irritation in the nasal passages and especially a slow-to-heal sore on her upper lip where the oxygen feed rests. She cannot move around without a portable oxygen source. She cannot go out shopping without cotton gloves and a filtration mask, because after the fourth treatment her immune system is severely debilitated and she is particularly subsceptible to secondary infections. If she catches a cold while shopping for food, it could quickly become a life-threatening illness.
I mentioned earlier that she is receiving infusions of these cancer-killing 'cocktails' on a weekly basis. Because she is (other than the Lung Cancer) so healthy and strong, her Oncologist has determined that she would respond well to a weekly infusion. This is notably different from the usual Chemotherapy schedule, which is one treatment every FOUR weeks.
The usual reaction to treatment is a first-day feeling of euphoria, caused by the supporting drugs. The second day is an almost 'normal' day; not euphoria, but a general sense of well-being. By the third day, the sense of well-being is gone; day-to-day sensation is one of sickness and no energy. By the sixth day, she is beginning to recover, and by the seventh day she may be able to get out of bed and move around with no great and particular sensation that she is unable to function.
In the usual case, the following three weeks until the next infusion are difficult, but endurable.
For SWMBO, there are no 'following three weeks'; she begins the cycle immediately, and the reaction to the chemotherapy is greater ... more extreme ... every week.
Which brings us to the current month.
Last week SWMBO took her second treatment in her home town. Three of the five weeks required an all-day drive to Seattle, which her sister (The Saint) was willing to accept as the driver. Bless her heart!
This Friday, SWMBO drove herself the five minutes from her home to the local hospital, and was able to drive herself back as well.
But there were problems, which weighed heavily on her mind.
After the previous Friday treatment, when she went to the pharmacist to pick up her current round of prescription refills, the pharmacist informed her that they could not fill the EMEND (anti-nausea) prescription because her insurance carrier refused to pay for a refill more frequently than once every 23 days. This was based on the usual once-in-four-weeks schedule of Cancer Chemotherapy treatments. They were either unaware of, or chose to ignore, the fact that she was receiving infusions every week rather than every four weeks.
Her Seattle Oncologist started negotiations with her Insurance Carrier to explain that the 4-times more frequent prescription was necessary, but the communications were slow and exclusive of the patient.
She couldn't really afford to just pay for the medication herself, because the cost is $220 for one week's medication.
And she couldn't do without it; before the new EMEND medication was available, she lost her voice due to dramatic and uncontrollable emesis.
We talked it over, and finally by Thursday we decided that we would have to pay for the vital medication ourselves, and hope that later we could try to submit a claim to her Insurance carrier after the (hoped-for) successful negotiation betweet Oncologist and Insurance Carrier.
In the meantime, last Monday SWMBO had all of her hair shaved off her head.
She was already pulling the hair off by the handsfull, and she decided that there was no reason why she should chance plugging up her bathtub drain with the hair. Her eyebrows were almost completely gone, too.
So she had her head shaved. I went to the store and bought her a handful of soft (non-scratchy), warm caps so she could keep her head warm. Also, "Spicy", the wife of The Hobo Brasser, knitted some wool-felt hats for her. These are soft, non-irritating, and stylish. Also, warm!
In the meantime, her Oxygen Supply Company installed a humidifier attachment to her overnight Oxygen Generator system, so her nasal passages wouldn't be irritated by the infusion of oxygen. They also provided a non-flammable lubricant so that she could protect the delicate nasal passages, and her Oncologist prescribed a steroid which would help prevent irritation.
When I picked up her prescription on Wednesday, I was pleasantly surprised to discover that the only bill was the $20 co-pay, rather than the $220 full-cost.
Saturday we picked up her two latest prescriptions, designed to help her resist the nasal irritation.
I watched her while she took all of the medications this morning. I couldn't count the number of pills she took. These are apart from the cough syrup needed to keep her from coughing every time she changed her position ... sitting down, lying down, standing up ... everything (including talking, and laughing) makes her cough.
The VERY good news is that before her Friday Infusion, she received another thorough check-up from her local Oncologist.
Her weight is the same as last week, if not a bit better. She's not losing weight, which is a good sign.
Her Blood Oxygen is up, which means that her lungs can supply oxygen to her blood better. Another very good sign.
The size of the cancer tumor in her lungs has not changed, which means it is not growing.
Her blood-pressure is 'Normal', always a good sign.
Indications that she is responding well to treatment include:
- We went shopping for groceries yesterday. She was gloved and taking oxygen from her portable tank, but she know what she wanted (stuff that I would starve rather than eat!) and was able to spend 40 minutes in a store without needing to stop for a rest;
- She is enjoying her surroundings, and we worked a crossword puzzle. She took phone calls from family an Spicy, and enjoyed them;
- A co-worker visited her at home today, they had a pleasant one-hour conversation. I didn't eaves-drop, but she reported that they had "a nice chat";
- She received a catalog of wigs and caps for chemotherapy patients during her last treatment .... we discussed what wigs and special caps she might purchase ... she was alert, vivacious and interested;
- We rented and watched the animated movie "Kung Fu Panda" ... one private vice is that we enjoy animated cartoons such as "Shrek" ... we both enjoyed the movie, and she /we laughed out loud all the way through.
If you care at all, I hope you will join me in welcoming this very positive SWMBO Report.
Our girl is coming back.
I'm always said she was a fighter. I hope I've managed to convery that I also believe she is a Winner.
Next year, we'll see you in the Rifle Pitts at Dundee.
She's going to kick your ass.
No comments:
Post a Comment