Sunday, June 25, 2017

Saturday, December 25, 2010

Fwd: Kris, Dave, and the Lumps: Chemo round 4, Cycle 5

Sorry Duane, had an email address snafu... almost lost yours but it's fixed now... well, until the next snafu. :)

Dave

Anything can be accomplished with the will to do so... nothing can be accomplished without it!
"...the blank sheets are IBM property, but they do serve the purpose of keeping execs busy trying to understand them." - Kilroy
"Do not come in early! Do not stay late! There WILL be overtime!" IBM Manager BCRS
In reply to the question 'how can we get along' an IBM manager replied: "I would not change any decisions I've made in the past two years, I am not changing, I am not going anywhere, deal with it!", obviously a woman of compassion.

Friday, November 26, 2010

Kris, Dave and the Lumps: Chemo Round 4, cycle 3 and 4

Friday, October 1st Chemo, nothing spectacular (which is good news).  Ongoing issues with nose bleeds and we have titrated the issues with constipation.  Still working on the issues with constipation after the treatment but we think we have a line on it… taking a Senekot early in the day, and one before the treatment, then one the next day.

 

Saturday, October 2nd Ok, too much Senekot, need to cut back.

 

Monday, October 4th Parb-inhibitor and again, everything went without a hitch.    This marks the end of cycle 3

 

Cycle Four:

 

Friday, October 15th Full Chemo again today.  Blood pressure keeps cruising downward and the Dr. is halving Kris’ dose of anti-hypertensive drugs.  She’s noticed that she gets nose bleeds starting a few days after the infusion and lasting until about 4 days after the round is done.  Nothing major, just annoying.

 

Monday, October 18th Kris noticed her scalp aching over the weekend but we have no evidence of hair falling out… waiting and watching.  The only real issue is the clash between timing on this, winter (so I can’t right the bike as much) and the chemo schedule.  We’ve been doing the treatments at the end of the day, both to avoid losing time at work and so that I can attend as much as possible between volunteering at the high school and my evening class.  Unfortunately, with winter coming on we need to figure out how to manage logistics so we can both get to where we need to be when we need to be there.

 

Friday, October 22nd Full Chemo again and everything is going smoothly.  At this point Dr. Moran just had us stop the Anti-Hypertensives as Kris’ blood pressure is back to normal levels (or lower).  We think we have the constipation figured out at this point.  One Senekot just before treatment seems to do the trick and keep things… ahem… flowing nicely.

 

Next cycle will be shifted to starting Monday then going Thursday-Monday-Thursday as Thanksgiving got in the way.

 

Don’t forget: krisanddavehart.blogspot.com for all of your catching up needs… yes, I’ve noticed it’s again infected with adds from folks I know nothing about.  I’m clearing them out with fair frequency and asking the administration to help get rid of this.

 

Thursday, October 21, 2010

Kris, Dave and the Lumps: Round 4, Chemos 3 and 4 and Cycle 2

Friday 1-Oct-2010

The infusion itself went well but Kris is drained at the end of the infusion.  That night we rested with Iron Man II and went to bed early.  As before things seemed fine Saturday.

 

Monday 4-Oct-2010

The infusion went well.  Kris seemed chipper and fine (which is a departure) when I left her (I have class Monday nights and we time it so I can be at the infusion, however I can’t stay through the whole process).  This is a departure from the norm, and a good one.  Her blood pressure is actually fine at this point.  The systolic is still a bit higher than I wish, being about 80, but in the overall it’s fine.

 

Cycle 2.  Okay a bit of clarification.  I am using ‘Round 4’ to mean the fourth time Kris has been diagnosed with cancer.  In previous notes I was using ‘Chemo 1’ for the first infusion but she would typically have an infusion every three weeks.  Now she has three week cycles in which she will have four infusions: Friday, Monday, Friday and Monday.  Thus From here on out I’ll use ‘cycle’ to mean which set of four infusions she’s on.  This note covers infusion three and four of cycle 1 and infusions one and two of cycle two… confusing enough?  Well, if so, I’m sorry for the confusion but it’s what we are doing.

 

Infusion one: Friday 15-Oct-2010

Again, all is quiet.  We keep having to warn the nursing staff to NOT use the automated BP monitor as it always seems to add about 20 points to Kris’ BP.  We are very well known  by the staff now as we are always playing games that cause them great curiosity… as well as the other patients.  Kris seemed less tired after the infusion but wasn’t up to her normal speed.  We spent the night quiet and bed early.

 

Kris has noticed that her bowels are in a sort of rebellion because of this chemo.  She’ll not go for about two days after the infusion and then she has difficulty going as she’s blocked up.  This round of chemo, we tried using a laxative twice a day for the days following the infusion, through Sunday night.  This helped but after the initial movement, things went a little too well.  We titrated so that Monday she took a laxative an hour or so before the infusion, another after the infusion then one more the following day.  This helped as she was able to… move… easily and more readily after the chemo session but things are still a bit too, um, facilitated.  So, we’re going to do one before and one after next time.  Our thinking is that the chemo is causing the initial blockage but everything else seems fine.  By taking the laxative before chemo, we are counteracting the formation of that initial blockage.  Yeah, this is a minor thing but something I want anyone else to be aware of if they should ever need to go through something like this… and they plan is for no one to have to go through it!

 

Infusion two: Monday 18-Oct-2010

Everything went smoothly.  Some of the issues I covered in the ‘squeamish’ paragraph above.

 

For those that don’t know, this is copied at: http://www.krisanddavehart.blogspot.com should you want to catch up or keep up.

 

As always, thank you for your thoughts and well wishes… they keep us going.

 

From: David Allen Hart [mailto:David.Hart@Colorado.EDU]
Sent: Wednesday, September 29, 2010 5:40 PM
To: 'David Hart'; Reed_Ann@stvrain.k12.co.us; bjc-ops@comcast.net; bobby4th@yahoo.com; bacotton@us.ibm.com; christapie@gmail.com; alexande@us.ibm.com; lieder@us.ibm.com; ccompton@us.ibm.com; ottmar@us.ibm.com; 'Duane Calvin'; eclectic-wave-kks@cox.net; eclectic-wave-rs@cox.net; geralyn@us.ibm.com; wogordon@yahoo.com; totosato@cox.net; inettles@us.ibm.com; jpk@us.ibm.com; jaydunk@cox.net; cannonj@us.ibm.com; beggly2001@yahoo.com; joecthulhu@aol.com; jmaron@us.ibm.com; kchart45@aol.com; kitkat@us.ibm.com; krishart@us.ibm.com; LindaRandall61@aol.com; carlisle-1@comcast.net; marilynwiddifield@peoplepc.com; markdean@us.ibm.com; MaryWarren@cox.net; mcmillan@apo.nmsu.edu; miragrig@us.ibm.com; bellivea@us.ibm.com; mccordp@us.ibm.com; pettitdp@msn.com; fahey@us.ibm.com; rrangel@us.ibm.com; lsubelle21@yahoo.com; restep@us.ibm.com; guderian@us.ibm.com; RMNUNEZ@us.ibm.com; sanatk@us.ibm.com; sdakins@us.ibm.com; shazmira1@yahoo.com; carlisle3@verizon.net; swinch@us.ibm.com; stevey@us.ibm.com; themancalledbear@yahoo.com; wramsey@us.ibm.com; whispermoran@yahoo.com; wwphx@yahoo.com; dahart1.krisanddavehart@blogger.com
Subject: RE: Kris, Dave and the Lumps: Round 4, Chemos 1 and 2

 

Thursday 16 Sep 2010

Got word that we were accepted into the trial.

 

Thursday 23 Sep 2010

Due to scheduling constraints we had to have our Dr’s visit today though the first infusion is tomorrow.  Everything seems go though Kris still has issues with her tongue from the Ixempra in the last bout.

 

Friday 24 Sep 2010

First infusion went well though there was some confusion about needing tests… they’d been done with the Dr’s visit on Thursday.  Because it’s a trial, they took Kris’ vitals before the infusion, BP, heart rate, temp.  Then again after the infusion.  We were alarmed because her BP was 120-ish over 70-ish the day before, and after the infusion it was 140-ish over 95 (or there about).  The nurse consulted with the Dr. and his take was ‘wait and see’.  Long and short is that it’s not an immediate concern but something we need to monitor.  Kris also complained about body aches and tiredness, basically flu like symptoms.  This is one of the side effects that are normal for this course of drugs but it’s not pleasant.  When we went home we just laid down on the couch and rested.

 

Saturday 25 Sep 2010

Kris feels fine so the flu-like symptoms are not pleasant but aren’t lingering either.

 

Monday 27 Sep 2010

With this treatment, Kris has infusions Fri-Mon-Fri-Mon then a week off and repeat so, back at the Cancer center.  The nice thing is that it’s Panera Bread day on Mondays.  A local Panera bread donates quite a bit of bread to the cancer center so Kris took a loaf of raisin bread (and snuck off with a load and a small baguette for class).  Infusion went well save that again, her BP shot up.  This time the nurse brought around an old fashioned cuff and checked it and rather than being in the 140s over 90s, it was 130s over high 70s, or something close to it.  Long and short is that we think the new fangled machine which is nicely automated is running a bit high.  Also the flu like symptoms were pretty bad again this time.

Wednesday, September 29, 2010

RE: Kris, Dave and the Lumps: Round 4, Chemos 1 and 2

Thursday 16 Sep 2010

Got word that we were accepted into the trial.

 

Thursday 23 Sep 2010

Due to scheduling constraints we had to have our Dr’s visit today though the first infusion is tomorrow.  Everything seems go though Kris still has issues with her tongue from the Ixempra in the last bout.

 

Friday 24 Sep 2010

First infusion went well though there was some confusion about needing tests… they’d been done with the Dr’s visit on Thursday.  Because it’s a trial, they took Kris’ vitals before the infusion, BP, heart rate, temp.  Then again after the infusion.  We were alarmed because her BP was 120-ish over 70-ish the day before, and after the infusion it was 140-ish over 95 (or there about).  The nurse consulted with the Dr. and his take was ‘wait and see’.  Long and short is that it’s not an immediate concern but something we need to monitor.  Kris also complained about body aches and tiredness, basically flu like symptoms.  This is one of the side effects that are normal for this course of drugs but it’s not pleasant.  When we went home we just laid down on the couch and rested.

 

Saturday 25 Sep 2010

Kris feels fine so the flu-like symptoms are not pleasant but aren’t lingering either.

 

Monday 27 Sep 2010

With this treatment, Kris has infusions Fri-Mon-Fri-Mon then a week off and repeat so, back at the Cancer center.  The nice thing is that it’s Panera Bread day on Mondays.  A local Panera bread donates quite a bit of bread to the cancer center so Kris took a loaf of raisin bread (and snuck off with a load and a small baguette for class).  Infusion went well save that again, her BP shot up.  This time the nurse brought around an old fashioned cuff and checked it and rather than being in the 140s over 90s, it was 130s over high 70s, or something close to it.  Long and short is that we think the new fangled machine which is nicely automated is running a bit high.  Also the flu like symptoms were pretty bad again this time.

Saturday, September 11, 2010

Kris, Dave and the Lumps: Round 4

Wednesday September 1st

Kris had her follow up PET scan which Dr. Moran ordered after the final chemo treatment

Friday September 3rd

Kris and I went to see Dr. Moran (our oncologist). The nurse gave us a copy of the pet scan results and it was not a good read. There were several areas of ‘uptake’ or areas in which the dye is being picked up and absorbed readily. The dye is designed to be something cancer cells want to eat, so a lot of ‘uptake’ means you have areas that are suspicious. The verbiage was careful to point out that it could be a lymphatic reaction to a chest cold, but that this was not at all likely. The fact is that Kris has had a nagging cough for about two weeks now. Unfortunately, I’ve associated this cough with cancer since she’s had a cough like this for no apparent reason at each occurrence. The areas of concern are three lymph nodes in her neck. The largest of which is just under her mandible… read: just below her jaw… and on the left side. The largest of which is about 2 cm. There was very minor uptake in other locations like the umbilicus but the Dr. who wrote the notes was not concerned by these (based on what was written).

Dr. Moran came in and confirmed what the document said. He was cautious and obviously did not want to cause a panic but did order a biopsy and return visit.

Wednesday September 8th

Kris and I went in for her biopsy. This was a needle biopsy and the pathologist actually didn’t need much material to get the sample he needed (this was nice). Long and short is that after about an hour we were on our way with a Band-Aid and orders to ice the area. Kris tried the ice and, being Kris, hated it (it hurt more than leaving it alone!) so she abandoned that idea.

Friday September 10th

Back to see Dr. Moran and the biopsy confirmed that we have cancer again. He said that he’d need material from a full biopsy to confirm which strain of cancer it is but given our history the odds of it not being a recurrence of the breast cancer she’s been fighting all along are extremely slim. He offered two courses of action:

Radiation treatment

Yes, I know, she’s had her lifetime treatment of radiation. However, that ‘lifetime’ dose is in the chest area and we might even argue that it’s localized to the area of her left breast. Because of this we can treat the cancer in her neck with radiation. The downside is that this will leave scarring of the tissue which will mean a sore/stiff neck and likely will affect her salivary glands leading to dry mouth. If done before surgery, this will hamper the surgery.

Surgery

This would be what it sounds like. They go into the neck and remove the affected lymph nodes. He cautioned that back in the day this surgery was rather deformative but things have improved. I read this to mean that it’s still deformative just not as bad as it was. It would also leave Kris with a stiff neck and some loss of motion.

Kris mentioned having seen an article on The Dr.s about a new treatment for melanoma which causes the immune system to help with attacking the cancer. Dr. Moran indicated that this had sparked a memory and excused himself to check on something (with Beth). Beth is the cancer centers liaison with trial procedures/medications. They have a new drug in trial which is a parp inhibitor and works specifically with triple negative breast cancer. Turns out Kris is a good candidate for this trial. The drug is in stage three testing which means that they are done with double blind, control group, tests in which some folks receive the drug under test and others do not. Further, we were told that the drug is expecting FDA approval as late as January so I feel that this stage of testing is really to get more statistical data on its effectiveness and of course when it’s not indicated. We were also that this is to make the drug more widely available to patients until FDA approval.

This would be another round of Chemo with Gemzar and another drug as well as the drug under trial. Kris already has experience with Gemzar. Gemzar (and the other drug) are considered standards of treatment for this cancer. One issue with this is whether or not the insurance company will cover us for this treatment. We think the odds are good that they will since this is stage three of testing and the underlying drugs that the test drug are taken with are ‘standards of treatment’. What I mean is that it’s a risk that has some data behind it so that the insurance company can quantify it and I expect that they will sign off on it. Another issue is that we will be enrolling in a lottery. If we win, we get the drug. We don’t get the drug until we win. Until then, we do get treatment of the two baseline drugs. Beth has not, yet, seen a case where someone has not received the drug but it can happen. This is essentially the drug companies way of controlling how much demand they have versus how much production they currently have, or so we were told.

Dr. Moran said that it might be a few months before we know if the drug is effective in our case or not so I asked him outright what the risk in waiting for a positive treatment is. He was careful in his reply but he indicated that he feels safe that we run no more risk with this course than with either of the other two. Put another way, he said that if the cancer were to express itself in another organ, it would do so no matter which course we take. His words were then ‘the cat would be out of the bag’.

For the record, we can’t enroll in this trial unless we are stage 4. Dr. Moran still feels that this is local but, as with the last occurrence, we can’t really call it stage 3 anymore. Long and short is that technically we have stage 4 cancer but it’s kind of grey. During his reply to my asking after the risk of waiting for treatment (doing the trial) he gave an example of the cancer expressing itself as liver cancer and there would be no arguing with that being stage 4 cancer. This reoccurrence, as with the last one, is so localized that it sort of sits between a 3 and a 4.

Monday, August 9, 2010

Kris, Dave and the Lumps: Round 3, Chemo #17 (and others)

Chemo #17… last round!

First to catch up. Kris went virtually blind in her right eye some weeks ago. It started while she was out on her daily walk on a Friday and the ‘blindness’ is much like a film of oil on her eye. We initially thought that it was due to sun block getting into her eye or into her contact lens. She changed out lenses and things seemed to get better. The following Tuesday it returned. The next Friday we went to see an optometrist and he suggested rinsing with eye drops. He found no evidence of macular degeneration, corneal detachment or anything that we were most worried about. That following Saturday (a week on now), it got markedly worse. She rinsed her eye with a hand held spigot we have on one of our tubs for about 15 minutes and that seemed to help but not by much. The following Monday we saw the optometrist again and he referred us to an ophthalmologist. The eye Dr. found a small tear in the macula with an associated fluid pocket. They said that this could be from high blood pressure (and this fits from due to the spike she had when suffering one of her migraines) or she might’ve had a cold which affected this region of the eye. Long and short is we have this damage but don’t know the real cause. They asked her to wait two weeks at which time they would inject dye and get a better picture of what is going on.

Meanwhile, Chemo #16 was scheduled in this time frame. Dr. Moran said that a rare side effect of Avastin is damage to the eyes and could lead to blindness. We will suspend treatment until we know more. After the answer from the Ophthalmologist, we rescheduled for the following Thursday and had infusion #16 (uneventful) based on their diagnosis of the problem. In short, they decided that Avastin wasn’t directly the problem and it was safe to continue with it. Point of fact, the eye Dr. said that they might well use Avastin for this problem with the eye!

When we went back for the test of Kris eye which included the dye, the Dr. found no sign of leakage which indicates that this is likely not related to blood pressure (so much for my theory). He concluded that it must be a hereditary thing and prescribed a drug he has had success treating this problem with. As a coincidence, Kris father Gerry was visiting and he too had a similar event back in the ‘80s which caused him to retrain which was his dominant eye. For the record, Kris is doing fine and sees well enough to function though not as well as she did before this event.

Chemo #17.

We saw Dr. Moran and conferred with him over the drug that the Ophthalmologist had prescribed. Dr. Moran knew of no reason not to take that drug along with the Avastin… especially since this was the final installment of Avastin. He did order a Pet Scan to occur between now and September so that he can review that scan the first week of September. We are back on the post chemo/treatment treadmill of scanning and watching to make sure that Kris is clear of cancer.

“Do not come in early! Do not stay late! There will be overtime!” Anon… for now.

When I asked 'someone' how we can get past a communications issue I received the reply "I would not change any decisions I've made in the past two years. I am NOT going to change. I am NOT going anywhere. Deal with it!" She'll bee anon, for now.