Tuesday, December 9, 2014

Preventing Nausea in Chemo Round 2

Round 1 of chemo for Rudy was HORRIBLE!   He vomited for 4 days straight. Several things will be different about Chemo Round 2 and hopefully, the severe vomiting will be avoided.  That is the side effect that makes Rudy most nervous.



The first change - we are switching from Paclitaxel to Abraxane, which a a protein bound form of Paclitaxel.  This form is easier to "stomach".  The Abraxane will be taken in smaller doses every week, rather than a huge dose every 3rd week. That, too, may make it easier to tolerate.

Another difference is that Rudy is no longer on any pain medications.  Fentanyl was started the same day as Round 1 of chemo.  If it was a main culprit in the after-chemo vomiting, then we don't have to worry about that one on this round.

There will be some substantial anti-nausea meds given the day of chemo.  An anti-nausea med was used with Round 1 as well, but it didn't work against whatever thing Rudy was reacting to.  Since two things are being changed that could have been the cause of the nausea in the first place, hopefully, the anti nausea IV will not fail this time.

One other difference will be the medications used to treat any nausea that does occur.  When Rudy was having such a hard time after the first round, he was never seen by a doctor during any of the following days that we kept returning for fluids.  The nurses were left guessing and did the best they could.  They prescribed this and that and at one point he was taking 4 different nausea medications at one time and there were others previously tried still in his system. Two were oral, One was a patch.  Another was a cream.  We were told they each worked in different ways.  Their reasoning was that the combination would attack the nausea from many different angles.  That sounded good to us, so we followed instructions, desperate to do anything we could to help end the vomiting.

Dr. Thompson and her assistant, Stephanie, looked fairly incredulous about all of the meds he was taking for nausea.  They said that taking all of those together could have actually worked against him and prolonged the vomiting.  Hopefully, the preventative things being done will keep us from ever having to deal with uncontrolled vomiting again.

Monday, December 8, 2014

CTCA Day 3 The Plan

Our party card was full today!  Rudy, Linda, Nancy and I arrived before breakfast and got home just in time for supper.  We are sooooo tired.

We got so much information today that my head is spinning.

We started off in Pastoral Care.  The pastor was very, very nice.  We met with a couple of other medical folks who got more history and explained more of what was coming up.

Dr. Patricia Thompson


The meetings we had been most anticipating were in the afternoon.  We met the head of our team - Oncologist and Lung Specialist, Patricia Thompson.  We are in very capable hands.  She went over all sorts of things.

We'll do one more round of chemo similar to round 1, with a few adjustments to lessen the chance of nausea.  A number of other things will be done proactively to avoid nausea.  Hopefully, Round 2 won't leave Rudy sick as a dog for days.  AND, if there is a problem, CTCA is available to help 24/7.  Rudy can go over in the middle of the night if he needs to.  I sure hope that won't be necessary.  After round 2, she wants to rescan him to make sure this protocol is working.

Round 2 will most likely be on Thursday *IF* his white blood cell count has improved.  They are a bit low - probably from the number of days he was sick after Round 1.

There will be more things done in the next week.  He'll have a port put in.  He's getting another biopsy.  The first biopsy wasn't quite specific enough.  This time, they're going down his throat to get to the tumor.

Today, we were shown all of the recent blood test results and everything was explained in detail.  Then, 3 different doctors came up with plans to fix anything that was too high or too low.  Lots of the suggestions came from the naturopath and the nutritionist.  Rudy has some natural supplements to take and foods that will boost him back to better health.

Everyone we met with gave us typed summaries of all recommendations and things we discussed.  When a doctor meets with you at CTCA, they are usually accompanied by an assistant who is taking notes.  The notes are then printed out and you get a copy.  It's a good thing, because each doctor spends lots of time with you - usually 45 minutes to an hour.

There's more, but I'm just too tired to think.  Hopefully, I hit all the highlights in this post.  It was a very good day.   :-D




Saturday, December 6, 2014

Day 2 at CTCA

This morning was filled with more appointments at Cancer Treatment Center of America.  We are still in love.   I think it's an alternate universe and for some reason, the door into it has opened for us.

I knew we were lucky to get in, but I'm gaining a new appreciation of just how much of a miracle it is to be there.  I thought that only 40% of their patients could be local, but we found out yesterday it's just 35%.  Also, I have heard a number of examples of people who wanted in, but couldn't because the quota had already been met. They should have kept trying.  We didn't make the November cut, but we made it in December.  We only had to wait a couple of weeks - just in time for Round 2.

Another reason we are blessed is that CTCA is right here in our backyard -  minutes from our house.  Most patients have to travel to get here.  CTCA makes it fairly easy for out of town patients. They set up all the travel arrangements and they pick patients up at the airport.  Still, those patients are away from home.  If Rudy had had to travel, I might have had a hard time talking him into giving it a try.  Anyone who knows him, knows that the man hates to leave home.  Knowing what we know now, I'd say it's DEFINITELY worth traveling.  Even Rudy would recommend it.

Another miracle is that the Newnan CTCA was built just in time for Rudy.  I know that's silly.  It's helping many other people - around 2000 at any given time, but it feels like it was built and made ready just for Rudy.  It was meant to be and we feel truly blessed.

My Current Favorite Quote

We met some wonderful patients today.  Cancer patients seem to have an incredible clarity about life and what's important. They almost have a different look about them.  A few of the patients we met today were young - in their 20's. Age didn't matter. They had that same clarity.  They were all kind and positive and patient. They move slower and not just because they are sick.  I really can't imagine anything more rewarding than working with these people.  I told Rudy that he, too, seemed to have that look.  He has changed.  I don't like the disease, but I like the new Rudy. We are closer than we've ever been.  Unexpectedly, we are really happy, too.

The doctors and nurses we saw today were top notch and very positive. CTCA really seems to attract the best staff.   The pulmonary specialist showed us our scan and took us thru it, bit by bit, explaining everything.  We had never seen the actual scans before.  Out in "the real world", they just don't show patients very much.

The Mind-Body doctor was very good and Rudy was really taken by lots of what the doctor had to say.  The Mind-Body specialist makes sure patients understand how being happy, even in the midst of a gloomy situation, can increase the odds of a good outcome.  CTCA has lots of tools and resources to help patients stay happy.  There's something for everyone.  Everyone at CTCA buys into this idea.  In fact, I'd say it's at the center of everything they do.  It's why everyone is so happy and nice.  They know how important it is for their patients.

When we were leaving the cafeteria today, Rudy went out slightly ahead of me.  He had to wait a minute and a nurse he'd never met saw him.  Rudy smiled at her and she walked over and gave him a big hug.  Rudy loved it.  He talked about it several times thru the evening.  That woman really moved him.  As we walked out, he said he had no doubt he was going to do well.  It only takes a moment to connect and have a profound effect on someone.  Why don't we all do that more often?

Thursday, December 4, 2014

Rudy Update Dec 4 - CTCA

Today was so full that I hardly know where to begin.  I guess I'll just go in chronological order.

We had our first appointment at Cancer Treatment Center of America.  Rudy and I got to CTCA early so we sat in the lobby and just took it in.  It's like a huge swanky hotel.  It was very busy - tons of people going here and there.  The wild thing - every single person (patients and workers) were smiling.  I'm not exaggerating.  Ask Linda and Nancy.  It continued thru the day - every person we met was positive and happy and enthusiastic.  I really felt like we were in an alternate universe.

Rudy met with 5 people (or maybe more)  today and each one asked more questions than anyone we've met with so far.  They gathered lots of history -Rudy's history, his immediate family and extended family.  They were thorough.  

They were also organized.  OMG!  I have a DELUXE binder with everything I need to know and everything is organized with tabs and card holder pages and more.  If I want to look something up, I'll be able to find it easily.

Everyone we met said if we have questions, call them.  I have most everyone's number.  AND we can call over there 24/7.  If Rudy has trouble on a weekend, we won't be in a random emergency room being seen by someone who doesn't have access to his records.  Everything Rudy needs in regards to his health will be taken care of in this one facility.

We had a tour of the infusion room.  It's not one big room with all the patients.  There are large individual private rooms with TVs.  And Rudy can have guests.  They also have a nice porch so if someone gets tired of being cooped up inside, they can relax outside.




The whole facility felt more like a hotel than a medical facility.  

The cafeteria food was very good.  95-98% organic.  Much of it local grown.  http://www.180degreefarm.org/
This farm also sells produce at the hospital - market style - on Tuesdays.  This family has a child who was diagnosed with cancer at age 4 and they did a 180 degree change in their lifestyle and eating (hence the farm name).  Their child is now 12 and fine.  Apparently, the family really knows their stuff about fighting cancer with food and is very willing to share.

I am always a little nervous eating out.  I can't be sure what people have done to the foods that I may not be able to tolerate.  You'd think salads would be safe, but many places dip their lettuces in a solution to keep the leaves looking fresh longer.  Also, having dressing out is a big risk.  I took a gamble today and was just fine.  YAY!!!!!!!!!!!!!   Now, I won't have to pack my lunch on long days.    That'll be so nice.

I know I must be leaving stuff out.  The bottom line - we were all bowled over and feel like we're in very good hands.

Once home, we had something sad to deal with.  Our very old dog (17 or 18 years old), Lulu, had to be put down today.  She had a stroke overnight.  When we got up this morning, her feet were turning under and she was having a very hard time staying upright.   My sweet dad went with me to the vet. Lulu had been diagnosed with an aggressive form of leukemia and told she would likely only live another month or two.  That diagnosis was three years ago.  She lived a good long life, so we're trying to focus on that.

Late this afternoon, after Rudy took a nice nap, he wanted to go for a spin in his new Challenger.  I went along and boy, was that fun.  I've never been one to care much about cars as  long as they were safe and reliable, but I have to say, it was really fun riding around in this one.  Rudy made sure to test the power a few times.  It definitely has way more get up than anyone would need.  I felt myself being thrown back in my seat on several occasions (and Rudy never broke the speed limit).   

So that was our day.  

We'll be back over at CTCA for more meetings tomorrow.

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