Another Quick Update

Been quite a week, as I related earlier. The latest news is that SoCal has accepted the referral for the IFN/IL2 therapy.

Note, that does not mean that I will be getting the therapy, only that they will consider the request. Before I really hit the winnowing process there are some tests that have to be done. First, I have to have a Treadmill Stress Test. This is where they make you runn your butt off, and take a bunch of electrocardiograms while you do it, The aim is to see if you have any cardiac disease. My test will be a bit different, as the Orthopaedic Oncologist does not want me running--he wants to keep the stress on my left femur as low as possible, so I will have a pharmacologicic stress test..Currently scheduled for next Friday, so more to report then. I will also have to undergo a Pulmonary Function test--they will see how much air I can move and how well my lungs function--before the referral will be formally accepted. But hey, one step at a time. Assuming that I pass the tests, I will then have to travel to SoCal for the full consultation. One step at a time.

For now, things are going well. The chest pain gets better every day, and the nausea/vommitting from the weekly chemo infusions has not started up...yet.

Have a good weekend all, and Go Cardinals! Remember, it is the little things that matter to those around us.

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Sleepless in Castro Valley

Just a quick update while I wrestle with insomnia...I received a phone call from the Cyberknife folks late yesterday afternoon--tip for others out there: trying to locate items in a newly remodelled Safeway while noting appointments and talking on the phone does not work. I must have cruised the same aisles three or four times while trying to do both. I guess my sister in law is right, that Y chromosome prevents multi-tasking!

It seems that I have an 0800 appointment this morning (nothing like a timely warning) for the simulation and target scanning; then treatment appointments for Monday and Tuesday. Of course, the follow up email from the Treatment Coordinator has to confuse all of that, as it also mentions a treatment appointment on Friday. Not very confidence building. Ah well, all I know is that Robin and I will be at the Cancer Center at 0800 to sign in and start the day. The Treatment Coordinator tells me that today's appointments will last about 4 hours, so I think I'll bring my netbook along and surf. Yes, Stanford has free WiFi for the public to use.

Other news from the trenches: The various docs have finally agreed, and I am back on the Sutent as of yesterday morning. Too early to tell what the side effects will be this time around, other than nasty indigestion at 0330 in the morning.

Well, time to see if the Zantac is working and try to get back to bed. But first I'll have a bit of a snack as I am not supposed to eat anything after 0400 today (part of the preparation for the morning CT and MRI scans). Gotta keep the weight up...

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A Day at Stanford and Mailing List Update/Information

Robin and I spent the day at Stanford Hospital yesterday for the CyberKnife consult. The Neuro folks had billed this as a treatment appointment, but evidently SUH had other plans... As is par for a teaching hospital we had to wade through a group of Fellows and R3's before we saw the physician of record for the consultation. The treatment plan that we agreed to is for a return visit for creation of the face mask (assists in beam targeting) followed by final/targeting imaging by CT and MRI. Then we would go home for a day and return on day three for the actual therapy. The final number of treatment visits is yet to be determined, but it will probably not be more that three visits.

I heard from RWC late last Friday about the full spine MRI results: the only lesion noted is at L1, and it is larger than on the first MRI. There is some extension now into the surrounding soft tissue, and RWC thinks that traditional radiation might be beneficial--I am not convinced of this. I would prefer the CyberKnife team look at the scans and determine if they can address the lesion; so I have pushed the RWC team to refer the lesion to SUH, rather than telling me that they (RWC) think it is too large for the CyberKnife.

On other fronts, I have received a few mailing list requests from people who are already enrolled in the Google Group. Note: The mailing list and the Google Group are one and the same. I am only using the group for the mailing list features which offer more flexibility than the Blogger web site. Long story short, if you are receiving blog post updates then you are on the list and do not need to resubmit your name. If you are not recieving update emails and are on the mailing list then you should just leave a comment in the blog and I will try to figure out what is happening.

Well, time to get moving and accomplish things. Today is our Wedding Anniversary and I need to start acting like it!

Take care and be well. Read more!

Treatment Plan Update

Well, went in today for a few things. The day actually started yesterday afternoon with a call from the MRI folks--they were trying to get me in ASAP for the special Closed MRI that Stanford needs before the CyberKnife therapy next week. There was bit of confusion, because my records now read "claustrophobic" so they try to do everything with me under the "Open MRI", rather than in the older "Closed MRI". You know, the coffin tube. So around and around and around with the schedulers until I got frustrated and just called the Neuro Science team and asked them to kick some butt. Boy did they. Seems the NP and the MA from the NS team got frustrated as well, so they pulled in their Chief to raise a little cain. Next thing I know I got a call at 1045 this am from the MRI trailer asking when today would be good for me! Showed up at 1130, right into the coffin tube, and the special MRI scans were done. Oof, 3 mm cuts instead of the usual 5 mm cuts. Took a Long time. Gotta love that Xanax. I actually fell asleep for the last 20 minutes or so of the scan!

For those across the pond: think of an MRI (or a CT of that matter) as taking planar views (cuts) through a structure. For many of these types of scans the cuts are spaced every 5 mm. They can be done top to bottom, side to side, etc. Taking 3 mm cuts effectively doubles the number of "pictures" so it takes longer and has the advantage of offering better views for some tasks. Also, the Closed MRI truly looks like a tube, you slide into it instead of under it. The main advantage is that the spatial resolution and detail are much greater. The Open MRI is like lying between two huge metal pancakes with open sides, but the spatial resolution and detail is decreased. Much more comfortable though.

After the MR we ate a great Vietnamese lunch (Pork Bo Hue and Shrimp paste sticks: spicy pork soup and shrimp paste rolls on a stick), then raced back to the Hospital to have the staples out and a surgical consult on removing the "barometer" lesion at the back of my scalp.

The staples are now out and replaced with SteriStrips (why bother? The strips are stuck to the hair and not the wound. Not like they are doing anything). The wound looks great and is healing well.

The general surgeon will have me back on 10/9 to remove the barometer lesion. It is currently at 1.5cm x 1.5cm x 0,5cm, as I measured it on the MRI. Gotta love electronic records, I have a disk of today's MRI so I used it to examine the scalp lesion dimensions and extension. Much easier than trying to use my fingers at the back of the head.

Recup from the craniotomy continues to go pretty well. I managed to walk up to the kid's school after dinner tonight, and only needed a brief rest on the way back. Maybe by next Monday I can start bringing Sheba along again for the evening constitutional. Still foggy at times, but that is to be expected. Boy was the drive down to Hayward a rush! First time driving myself since the surgery, so a bit different (Robin was golfing in the hills, no cell phone coverage!)

Got the pathology results from the crani, they look a bit odd and are being sent out for a second. But, they did show persistent necrosis (death) in the tumor, so the chemo did have a good effect.

The current plan is to restart the chemo about 28 days post operatively, no calendar in front of me, but that would be around October 17 or so. Looks like we get to take the family vacation at Fort Bragg with me still able to eat. Woo Hoo!

Steroid taper starts today at 0600 hours! Yes, 4 more days and I can drop this crap!

The next posts are going to deal with technology issues, I have had some questions from family and friends, and I have some questions for all of you, so I am going to do a roll-up review and cover all of them at once.

Be Well.

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