Another Day

Posted by Roie R. Black on Mon 10 February 2014

Here we are, back at M. D. Anderson Cancer Center, visiting with more doctors again. And staring at more fish.

Fish tank

There are 63 fish tanks in this place. Apparently, they have a calming effect on patients in this place. Every waiting area has a tank. One aquarium place in Houston takes care of all of these things and similar setups at other hospitals and places around Houston and a few other towns as well (see what you can learn when you have time to kill, and free wifi in a hospital waiting room?).

Driving to Houston again

We are definitely not ready to tackle driving through Austin rush hour, then topping that off with Houston rush hour to get here for a morning appointment all in one shot, so we drove over Sunday evening. I managed to drive about half-way and we found a great little BBQ place in La Grange, Texas where no one except the staff was in attendance. We had an outstanding meal, actually we had at least a meal and a half, watched a bit of the Olympics, had to pass on desert, and I let Cheryl drive the rest of the way into Houston.

MY eyes started to de-focus as the sun went down, something I am dealing with more and more these days. he ophthalmologist explained that to us last week, it is due to the tumor pushing on my eye.

We arrived at the hotel around 8PM, in time to get a bit of work done and crash for the evening.

We got up early Monday morning, and had a nice (if somewhat expensive) hotel breakfast, then drove over to M.D. Anderson for the day's appointments.

Dental Oncologists

Our first appointment was with a dental oncologist. We first visited with her "Fellow" (another term" for a student who does the report writing before the real doctor shows up, and went over our history. After she got done, the actual doctor came in and looked over my mouth and teeth. Based on all the radiation and surgery I have been through, my remaining teeth and mouth are in pretty good shape. I do have some sores going on, but that is due to the long lasting effects of radiation, and that will heal over time.

We also went over things we can to to get a prosthesis constructed to fill in the gap caused by the surgery pulling out jawbone and teeth. We told her we would be glad to explore all of that once we got the cancer under control!

We left her office with a plan that we will explore after the more important plan has been explored first.

Radiation Oncology

The second appointment was much more important. Radiation was supposed to knock out the cancer that came back, but it failed to do that this time. I called Dr. Dzuik's office before this meeting and made sure he was back in town, and talked to his nurse, Dana, to make sure they were available to work with the folks at M. D. Anderson about what radiation had already been done.

Apparently, your body retains a memory of previous radiation, and you cannot radiate the same area more than twice. And they really do not like doing radiation in the same area more than once. Three times and tissues basically collapses. If there is new tissue in the area, things are better, and I do have new tissue in the area this time. We are fortunate in that even though I have had radiation twice, the two areas do not overlap, so actually, I may yet be a candidate for further radiation. That is if they can find a way to get to the new tumor that does not go through tissue that has already been radiated.

We signed a form that will allow M. D. Anderson to request the radiation images from Dr. Dzuik, and gave them the contact information. We left the appointment with hope that they can find a way to treat my new tumor as best as they can.

We felt pretty good about the prospects here. This is encouraging, but not definitive yet. We need to see what we can do with Chemotherapy, since it is the combination of all three treatments that will be the best bet.

Chemotherapy Onchology

The last appointment of the day was with the doctor who will be in charge of any chemotherapy we might go through. It is possible that chemo might shrink the tumor making it easier to do surgery. If the tumor reacts to the chemo, great. But if it does not react, they may miss an opportunity to do surgery, so all in all, they have to figure out the best plan.

Once again, we met with an assistant who took my history and looked me over before the real doctor came in. Since this is a research hospital, staffed by teaching doctors and students, this is the normal practice. When the real doctor came he, he was great. Turns out he is an ex-army doctor who spent time in Walter Reed in the D.C. area way back when I was first commissioned. We agreed not to hold it against each other that I went Air Force and he went Army.

He felt that my experiences with Chemo did not mean that I was not a good candidate for another round of Chemo this time. I did not have a full round of Chemo the first time, ant the back-up treatments, designed to keep you from experience nausea and other bad side effects are much better now. He was pretty sure we would be taking a stab at Chemo with my treatment plan. Enough so that he ordered the pharmacist to come in and go over the Chemo plan and all the side effects that were possible.

The doctor brought up the imagery they got last week, but I could not make out much of what I saw. It was obvious there was missing bone, but as far as the tumor was concerned, it all looked pretty much the same to me. Obviously, the doctor could make out the tumor, and he said it was intruding into the orbital (eye) area. Makes sense, since it is affecting my vision.

The hope is that Chemo will shrink the tumor so the surgery that is bound to happen will be easier to deal with and have a better chance of being successful (Yeah!). With a smaller tumor, there might also be a better chance that radiation can get in there and keep it from coming back. Everything builds in this plan, it seems. The one hard note in all of this was the simple fact that if we get to surgery, I might lose the left eye, since the tumor is so close to that eye. As it is right now, the tumor is pushing on the eye, causing double vision. It may be hard to remove it without causing damage to that area. Oh well, the loss of the eye is a small price to pay compared to the alternatives. I can live with that! I have friends who have lived long lives with only one eye. (Jim, if you read this, you are my new hero!)

As I recall from my first experience with Chemo, the side effects are many and varied, and in the extreme case, can be pretty severe! All I ever really got to in my case was a bad case of nausea, and the modern drugs are pretty good at knocking that out, so we are not too concerned about all of that for now.

As we left this appointment, we had an appointment set up for the first Chemo treatment one week from today. He wants me to stay over until the following day to make sure I do not have any bad effects from this first round. Then the plan is to do a follow-up treatment in eight days, then another treatment in 13 days, then repeat the whole thins three weeks later. With luck the tumor will show signs of shrinking by them, and they will determine if this is going to work. If so, they will continue. If not, well, they regroup and figure out a plab B. Hopefully, there will be a plan B.

Time to go home

After all of this, we were ready to go home. Cheryl and I walked out of the hospital to the parking garage feeling a bit more hopeful. This was the first time we heard positive news. They had a plan, even if it was not official yet. These folks were talking positive actions that might yet get this thing out of me.

Watch my purse!

I have been doing this for years!

Cheryls purse

Cheryl will walk away and tell me to watch this thing. I stare at it for a long period of time, hoping it will do a trick. It never does. Disappointment!

Oh well, maybe next time! One can always hope!

The down side of all this

If we have to do all of these treatments in Houston, which we might, it is going to really mess with my teaching schedule. I cannot teach a full load (actually an overload) and be in Houston as much as this might require. If we through in a major surgery, one that might cause me to lose an eye, well, this might be the end of my teaching career.

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tags: Cancer