Was hoping to find a clever/funny character to start update but my computer is ill. In a capsule, after doing a CT & PET scan, Dr. Cross was going to begin Cycle II Monday (3/2), hopefully with the same regimen. BUT. Henry became a real pesky problem. Either from inflammation, growth or position, he was causing Leenie intractable pain & had "to go". Dr. Scott Williams saw her MRI for the 1st time Friday & told us that the Cyber Knife (Just a name; NON invasive; no cutting; delivers precisely located radiation) was used only on smical nerve root #5 as it exits the spineall (grape to prune) size masses that are pressing on vital organs. Sooo, in that Henry inside was too lag for that, Dr. Pohar (radiated external Henry away) will perform Intensity Modulated Radiation Therapy - -IMRD - for which a major "plan" is required. Yesterday, Leenie had a simulated CT (not diagnostic) so they could take a myriad of measurements of her body, chest cavity, shoulder, arm, spinal colum and, of course, Henry. Now the engineers, dosologists & docs are feverishly working up a plan - minute by minute - of angles/doses for deliverance of radiation ONLY to Henry - 5 days out of 7 x 4 wks. It is hoped that he will shrink toward his center, thus beginning with pulling away from the spinal column and the irritation of cervical nerve root #5 and alleviating the pain/disfunction in her right arm/hand. But, as Dr. Cross said, malignant metastases don't tend to read medical texts so they don't know the best way to shrin k." If the last remaining tissue is small & still pressing on the nerve root, they could conceiveably use the Cyber Knife technique @ that juncture.
As to chemo, she will have a PET scan Monday & Dr. Cross will see us Tuesday afternoon - late to be sure it's been read - to share his findings, ie, is the disease progressing, stable or retreating. If the last, he will use the same regimen but will have to wait or find a drug LIKE gemsar b/c it can't be administered w/ radiation. The Platinum can but he'll make a call Tuesday re: just waiting until radiation is done & Henry a bad mamory. U nfortunately, these masses don't like being radiated & initially get inflamed, therefore larger. So Leenie will have more pain before she starts to get permanent relief. Dr. Cross has increased her pain meds/patch doses for the duration & she was just so much better yesterday, having slept through the night for the first time in wks. As we were leaving the hospital, they gave her a scrip which indicated that Dr. Pohar will start this Friday 3/6 instead of Monday, 3/9 so they are all working hard to create the plan sooner rather than later as Dr. Cross asked. Meanwhile, her wt & vital signs are stable, appetite is great and if the weather cooperates we'll be working on walks - first to the mail box, then across the sreet, and ultimately down to the point of our next door neighbors. Her cough is becoming more productive and the CAUSE is stasis, ie, sitting in bed reading all day, not more cancer in the lung fields. She's therefore a set-up for pneumonia and Nurse Ratchet says, to quote Jennie's 18 mo.-old Emma, "Nuh, nuh,nuh!". Today we organize the complicated schedules/transportation availabilities of the home-town crew, tomorrow I'll be with Peanut (Emma) while Leenie re-arranges her clothes (finally got bed & Mom's dresser moved so she can use those huge drawers) and Friday we begin. The treatments are uncomfortable b/c she must NOT MOVE or angles change. However, she'll a large part of the Rite Aid Pharmacy on board so we're hoping she sleeps. That's the schedule - TODAY. Could be entirely different after Friday's reaction, PET results, blood work (so far very good) etc. Keep those prayers coming. She will know when she can enjoy/benefit from a visit
Lorane
