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Jay Lake
Date: 2009-12-07 16:31
Subject: [cancer] Update on cancer, surgery and chemotherapy
Security: Public
Tags:calendula, cancer, health
This morning, calendula_witch and I went in for surgical followups, including post-operative consult as well as oncology consult.

We began with a fresh chest x-ray (about my sixth in four weeks), then met with a P.A. in in the Thoracic Surgery unit. The P.A. discussed my post-operative course, examined my surgery sites, removed the remaining stitches in the drainage wound, and discussed my ongoing healing. The chest x-ray looked good, with lungs properly filled out and no fluid inside them. She felt the swelling of which I'd been complaining wasn't a common side effect, but was within norms, and that the risks of draining it via needle (for example, of infection) outweighed the benefits of doing so. Otherwise she found my healing to be going quite well. She also mentioned that the pathology reports were 'as expected.'

She did write an additional Dilaudid prescription to tide me over through my tapering off period. She also provided me with a return to work authorization effective 12/14 for part time work, with no travel and no lifting, with a full time return to work authorization effective 12/21.

We then went down the hill to meet with the oncologist, followed by a session with her chemo nurse. The oncologist examined my surgery sites, recapped the discussion with The P.A., then reviewed the pathology. The bony nodule extracted during surgery was a calcified mass not found to be malignant, and the remaining nodules in my right lung are of no worry. The tumor was confirmed to be consistent with metastatic colon cancer. The oncologist thinks it's likely we've effected a surgical cure, but in order to be certain we do not have further metastases, is prescribing chemotherapy.

The course will be FOLFOX plus Avastin, as previously discussed. We reviewed the role of Avastin in this process. As the oncologist says, the science is unclear on treating metastases with Avastin. Successful adjuvant chemo (chemotherapy following surgical resectioning of primary tumor) is positively correlated with use of Avastin, and my situation is sufficiently analogous to that she and I both felt deploying Avastin would be an appropriate 'belt and suspenders' approach.

I will be receiving a port implant via day surgery, probably around 12/16. The surgery date will be confirmed in the next day or so. I will commence chemotherapy on Friday, January 8th. My courses will be every second Friday (unless rescheduled for some reason), with a pump being worn through the following Sunday, which they will teach me how to take out myself. This means that I may be able to miss as little as one work day out of every two week cycle, which I consider to be a good thing. I will also be having a chemo class on Tuesday, 12/15 with many of my family members and loved ones. I am encouraged to bring one or two people with me to each session.

We did discuss possible side effects, including the cold issues with FOLFOX, as well as the bleeding issues from Avastin. The side effect of most concern to me is the peripheral neuropathy, which can persist for up to two years after the chemo course concludes, and in some cases can produce permanent, minor damage to sensory and motor functions in the fingers and toes. We also talked about "chemo head", antinausea drugs and similar issues.

So, the net is that I'm having chemo, from January to June. I have a lot of logical fears, and some illogical ones, but the big kahuna of chemo fears is my dread of the mental blunting. The effects of "chemo head" scare me spitless. Add to this my concerns about the long-term effects of peripheral neuropathy, and I have plenty to keep me occupied. I will cope with these fears as I cope with everything, by running toward them and owning them. But that's the view today.

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Away Above the Chimney Tops
User: boobirdsfly
Date: 2009-12-08 01:07 (UTC)
Subject: (no subject)
I am in awe of your courage for sharing all this on here. I came here via Kyle Cassidy... There has been a lot of cancer in my family and in my close surroundings and I've been very afraid of it. Reading your journal is part of my journey to be less afraid. I'm training to be a therapist and my grandmother is dying from lymphoma at the moment (i hope to see her when i go to france for 6 days starting xmas day, but they don't know if she'll be around, they can't do chemio, she is too old - 90)
Anyway, thank you and I'm rooting for you with all this.
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User: twilight2000
Date: 2009-12-08 01:22 (UTC)
Subject: (no subject)
Bright Blessings on this journey!
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Somewhat Bent: Circle of Life
User: ladyallyn
Date: 2009-12-08 01:27 (UTC)
Subject: (no subject)
Keyword:Circle of Life
Well Wishes to you and Energy to you and all of your loved ones. It's a big adventure, but you live for adventure, right? :-)

~Best always
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Renegade Vagabond
User: khaybee
Date: 2009-12-08 01:41 (UTC)
Subject: (no subject)
I am very happy for you that this was a no surprises day.

I love and miss you.
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User: scarlettina
Date: 2009-12-08 02:18 (UTC)
Subject: (no subject)
With you in spirit--and in flesh if wanted.

Better to know all this in detail and understand what's coming; so many people don't or won't. Every post you make about this is a gift to everyone in your life. Education makes a difference and knowledge is the best defense.
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Michael Curry: alton
User: mcurry
Date: 2009-12-08 02:23 (UTC)
Subject: (no subject)
I'm glad that the day's appointments didn't bring any surprises, and your treatment team seems to have a plan going forward. I'll be thinking good thoughts for you as you start in on the next phase.
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User: dsgood
Date: 2009-12-08 02:39 (UTC)
Subject: (no subject)
Good luck!
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User: karenjunker
Date: 2009-12-08 02:51 (UTC)
Subject: (no subject)
Hang in there, dude. I'm voting for the clearhead version.
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Matthew S. Rotundo: Radioactive
User: matthewsrotundo
Date: 2009-12-08 02:58 (UTC)
Subject: (no subject)
As my man Neil Peart has said: "Adventures suck when you're having them."

Even so, I really like the sound of "not found to be malignant."

You'll beat this motherfucker yet.
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User: madrobins
Date: 2009-12-08 03:30 (UTC)
Subject: (no subject)
A day with no surprises is not a bad thing. Your courage and your candor is pretty awesome from where I'm sitting. Of course you're anxious. This is a scary process. But you have all the things you need to come out on the other side: courage, love, and good advisors.

Hang in there.
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Nisi Shawl
User: nisi_la
Date: 2009-12-08 03:34 (UTC)
Subject: (no subject)
Thanks for some good news, sweetheart. Love your head, toes, etc.
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User: cathshaffer
Date: 2009-12-08 03:55 (UTC)
Subject: (no subject)
Since the surgical cure didn't work last time, I'm glad you're going to have chemotherapy.

My mother has dealt with the peripheral neuropathy symptom for the past five years. It's actually something that comes on gradually and can be sort of managed. My Mom gets asked about numbness in her hands and toes at every appointment. If at some point it seems to be of concern, the doctor will switch her to a different therapy. So far, after thousands of doses of these drugs, all she has is a bit of numbness and tingling in her toes. It is really the least of her problems.

As for chemobrain, what I have heard and observed of that is that it is much more subtle than you fear. It seems to be just a condition of having a lot more "senior moments" than one is used to. One writer of my acquaintance had to rework her process a bit--keeping more notes on paper and fewer in her head. It's not a trivial concern, but I don't see it changing your personality or ruining your life--just a little adaptation and you'll be glad enough when you're passing milestones cancer free.

I wish you'd had some better news on the biopsy, but as always my thoughts and prayers are with you.
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User: e_bourne
Date: 2009-12-08 04:49 (UTC)
Subject: (no subject)
You and Mark should likely talk about peripheral neuropathy if you haven't already. About now, he's pretty expert. Since I only get to observe from the outside, what I see and what he feels may be skewed.

No one I know who's gone through chemo had any real problems with "chemo head" although tiredness was an issue. My sister had problems with bleeding, and her general recommendation was know someone who's a nurse you can call.

You are as well situated as one can be to get through this and on to the other side. We are all with you in spirit, and in person when necessary.
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User: lordslen
Date: 2009-12-08 05:35 (UTC)
Subject: (no subject)
Different type of cancer but my experiences are here http://lordslen.livejournal.com/
Chemo head is a fog that you can not see while in it but when you look back it's a well duh moment.
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User: seventorches
Date: 2009-12-08 12:25 (UTC)
Subject: (no subject)
Yes but...you on chemo brain still outclasses the rest of us. Happy to hear it's "good" news.
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Kari Sperring
User: la_marquise_de_
Date: 2009-12-08 12:53 (UTC)
Subject: (no subject)
I empathise. I'm never had the chemo, but I lost 2-3 years to psychiatric medication. I came back from under the blunting. And you are indomitable. We have faith.
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A large duck: wagon
User: burger_eater
Date: 2009-12-08 14:05 (UTC)
Subject: (no subject)
Good luck.
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oracne - Victoria Janssen
User: oracne
Date: 2009-12-08 15:50 (UTC)
Subject: (no subject)
I'm keeping you in my thoughts.
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User: mcjulie
Date: 2009-12-08 16:03 (UTC)
Subject: (no subject)
"Good luck" seems like such an understatement, how can I say "Good luck" times a million?
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