More Radiation Today

This afternoon we head down to the hospital for more radiation on my husband’s spine.  The radiologist identified three spots that she feels will give my husband some relief from his pain, C6, C7 and T4.  There are the spots that will be radiated today.  As always there is risk especially when dealing with the cervical spine.  He will need to be medicated to ensure that he remains completely still on the radiation table.  The potential side effects include some inflammation to the voice box which will pass but may make his voice raspy for a bit, some swelling and tenderness in the areas radiated (this is an understatement, but we know that) and some nausea since T4 is near the stomach.  There are always the other possible side effects of paralysis or death.  Last night was not a restful one for either of us, but balancing the potential pain relief this seems the route to go.

There’s also a bit of a fear about the timing.  There will be disbelievers out there but anecdotally we’ve been told to try and avoid any sort of a procedure on a Monday or a Friday.  The focus of the technicians could be somewhat diminished.  And here we are going in as almost the last appointment on a Friday.  Somehow we will communicate this concern to the technicians carrying out the treatment.  To them it is a job, an important one, but still their work – to him it could be the difference between mobility or death.  Let’s hope we have the ‘A’ Team on this afternoon!

We continue to wait for the birth of our daughter’s first child.  She is due now.  She’s had a very good pregnancy and I certainly anticipate that her delivery will be just as good.  With the actual due date being Saturday, and the fact that she has started to have fairly persistent cramping, I suspect that we will see the wee bairn in the next couple of days.  This was and is one of the most important milestones in my husband’s cancer journey – to meet this grandson.  Barring no absolute disasters on the radiation table he will be doing just that.

CT Scan x 2

CT Scanner

CT Scanner

Tuesday of this week was CT scan day for both siblings, my husband and his sister.  Both are seasoned vets of the CT scan now.  When my sister-in-law was in the hospital over the last few months she must have had four scans at least.  My husband is now on his fourth or fifth related to his cancer.  Their appointments were, by happenstance, back to back at the same hospital.  I was the designated driver and so off we went.

Both were scheduled to have CT scans with contrast.  Both were instructed to take the oral liquid as well as have the contrast injected through a vein in their hand.  For those unfamiliar with a CT scan, a good overview is provided by the Mayo Clinic on their website as follows:

“A special dye called a contrast material is needed for some CT scans, to help highlight the areas of your body being examined. The contrast material blocks X-rays and appears white on images, which can help emphasize blood vessels, intestines or other structures.

Contrast material can enter your body in a variety of ways:

  • Oral. If your esophagus or stomach is being scanned, you may need to swallow a liquid that contains contrast material. This drink may taste unpleasant.
  • Injection. Contrast agents can be injected through a vein in your arm, to help view your gallbladder, urinary tract, liver or blood vessels. You may experience a feeling of warmth during the injection or a metallic taste in your mouth.
  • Rectal. A contrast material may be inserted in your rectum to help visualize your intestines. This procedure can make you feel bloated and uncomfortable.”  (Source: http://www.mayoclinic.org/tests-procedures/ct-scan/basics/how-you-prepare/prc-20014610)

After a previous CT scan with contrast my hubby was quite nauseous and vomited for the three days immediately after.  So he had decided to refuse to take the contrast completely.  After discussions with the nurses he was informed he could decline the oral but the injection was necessary and without it the radiologist would not do the scan.  One of the nurses reacted strongly to him declining the oral liquid and told him quite emphatically that vomiting was not a reaction.  Kinda funny when you think about it since vomiting is identified as a potentially minor to moderate reaction on a multitude of pages related to ICCM and barium and gastrografin contrast used for CT scans.  For example, Australia’s Inside Radiology provides this information:

“Allergic reactions almost always occur within minutes of the ICCM being given. However, 2 to 4 in every 100 people have a late reaction (up to 1 week but usually within 2 days) after an ICCM injection, consisting usually of an itchy rash, swelling of the face or nausea. These delayed reactions generally require only treatment of specific symptoms and they resolve promptly.

Minor

Minor reactions occur in about 3 in every 100 patients who receive low–osmolar, non-ionic ICCMs, which are the commonest contrast agents used in Australia for CT scanning and angiograms. These reactions include:

  • Flushing in the face
  • Nausea and / or vomiting
  • Mild itchiness

Almost always these types of reactions do not require any special treatment and generally take only minutes to go away.

Moderate

Moderate reactions consist of severe or prolonged vomiting, a generalised rash, or swelling of the face, mouth or throat, making it harder to breathe and swallow. These reactions often need drug treatment and occur in less than 1 in 1000 people.”  (Source:  http://www.insideradiology.com.au/pages/view.php?T_id=21#.VK7NJ2B0ycw)

Anyway the CT scan was necessary and both he and his sister went ahead with the injection but not the oral drink.  I spoke with our nurse from Oncology and advised her what had transpired and she indicated that the CT scan with the injection should be sufficient and as a precaution to give my husband a couple of antiemetics (anti-nausea pills) to stay ahead of any potential reaction.  Today is Thursday and he appears to be on track which is a good thing.  He sees his Oncologist next week to find out the results of the CT scan as well as a shoulder x-ray that was taken during the same visit.

My sister-in-law, however, is at the being of her journey.  She had her CT scan on Tuesday, her picc line was inserted on Wednesday, she has the visiting nurse coming today to do a flush on the picc line, and tomorrow she has her chemotherapy education session and blood work in anticipation of her first chemo treatment next Wednesday.  Her treatment cycle has been determined as every two weeks for the next six months.  She has a great attitude going into this.  Just put your head down and push through, every day puts her closer to the end of the treatment.

Needless to say we are still feeling our way through this whole process, thankful to family and friends for all their support and assistance in oh so many ways.

Christmas Passed

Daphne the Christmas Pooch!

Daphne – All dressed up for the occasion.

So we are through part one of two for the holidays.  Christmas is now over and we have New Year’s to get through.  This new phase in our lives has meant some significant changes to how we “do” Christmas.  In years past we would go carolling up and down the street or get together with friend’s at our house, their house, it changed from year to year.  We’d have a nice Christmas Eve dinner – usually surf and turf, drink Bailey’s and watch The Christmas Story.  We go to bed late, and get up late the next day.  Christmas Day would be turkey with all the trimmings and generally people arriving throughout the day for appetizers, drinks, carol singing, dinner and later on games.  We’ve always been sure to take pictures and plenty of them.  This year was a much different affair.  We managed to do a bit of a drive around our city to look at the Xmas lights on Xmas Eve, my husband and I along with his sister, two of the kids and two couples that are dear friends of the family.  The next day we had more family, including our two grandchildren, stop by but it was for a few brief hours, no meals, no games, no drinks.  The only consistent thing from years past is that we took pictures, and lots of them.

My husband had a poor response to the Zometa infusion and it took him down for about 8 days.  Today, the 28th, is the first day he has had an appetite and been able to participate in conversation with the family.   It was just bad timing for the reaction to the Zometa, but it did make me realize that I had slipped a bit on my research on recommended treatments.  If I had read up on Zometa and chatted through the side effects with my husband prior to commencing the treatments I doubt he would have opted for it.  This is what WebMD states regarding Zometa Intravenous under Common Side Effects:

The following side effects are associated with Zometa intravenous:

Common side effects of Zometa intravenous:

  • Bone Pain –  Severe
  • Feeling Weak – Severe
  • High Blood Pressure – Severe
  • Low Amount of Magnesium in the Blood – Severe
  • Low Amount of Phosphate in the Blood –  Severe
  • Low Amount of Potassium in the Blood –  Severe
  • Trouble Breathing – Severe
  • Backache –  Less Severe
  • Chills –  Less Severe
  • Chronic Trouble Sleeping – Less Severe
  • Cough – Less Severe
  • Diarrhea – Less Severe
  • Dizzy –  Less Severe
  • Feel Like Throwing Up  – Less Severe
  • Fever – Less Severe
  • Fluid Retention in the Legs, Feet, Arms or Hand – Less Severe
  • Head Pain –  Less Severe
  • Incomplete or Infrequent Bowel Movements – Less Severe
  • Inflammation of Skin caused by an Allergy – Less Severe
  • Joint Pain –  Less Severe
  • Low Energy – Less Severe
  • Muscle Pain  – Less Severe
  • Throwing Up  –  Less Severe
  • Urinary Tract Infection –  Less Severe

Click on the link if you want to see the other side effects listed under Infrequent or Rare.  There is also a good site in the UK that I often refer to when looking up this type of information, Patient.co.uk.; it provides suggestions on how to deal with the side effects.

Back to our situation and nope, we definitely would have considered other holistic ways to enhance his bones rather than infuse them with a bisphosphonate.  There is plenty out there too – therapies like mind body healing, osteotapping, Tai Chi, Xi Sui Jing; a wide range of supplements and dietary supports.  We just need to get through New Year`s and then settle back into a routine where there is time to do the much needed research.

Today Was a Decent Day

The title of this painting is "The Musicians".   With all that chemo splashing around in his veins, it will be interesting to see what his next painting looks like!

The title of this painting is “The Musicians”.
With all that chemo splashing around in his veins, it will be interesting to see what his next painting looks like!

For the first time in weeks it seems, today was a decent day.  It started off a little rocky, there was some nausea, but as the day progressed my husband started to visibly improve.  He knew that today had to be heavy on the proteins.  The chemo has gone through him and wiped out all his blood cells so he needs the protein to rebuild.  The toxins from the chemotherapy also still need to be flushed out – so a day that would also be heavy on fluid intake.  He was game.  By mid afternoon he was starting to perk up.  This was a good thing.  His taste buds are still off – at dinner tonight he informed me that most of the food I served him was a little “off” but since it didn’t seem to bother me, he ate the food anyway.  This was quite funny really – the two big culprits were white rice and water.

He’s busy painting a submission for an art exhibition right now – which is another good thing.  We’ve rigged up an arrangement where he can keep his left leg elevated in deference to his blood clot and still paint at an easel.  The clot is still very apparent and his leg is still very swollen.  By the end of the day his foot is smooth and shiny and his ankle is completely puffed up.  Despite the swelling the pain has begun to subside which suggests he is well on the way to recovery.  Not out of the woods completely but hopefully close.

There’s always a hitch though.  On the 20th of this month he goes for a CT scan.  There are three potential outcomes: 1) the chemotherapy is not working; 2) the chemotherapy has managed to stop the progression of the cancer, and 3) the chemotherapy has managed to reduce the presence of some of the existing cancer.   He told me tonight that the chemotherapy has taken a significant toll on him physically and mentally and that, depending on the outcome of the CT scan, he has decided that he may take a break from the treatment.   I know that when he starts to feel better, like he is now, he’s loath to go back in for another treatment.   It’s important that he have a sense of control in his own wellbeing, and also the knowledge that he can and will feel better.  There will be much more conversation in this regard prior to the 20th but for now there will be no more dialogue on this topic – decisions will be made after we get the CT scan results.

The sun shone today in more ways than one.

Post Chemo Treatment 3 – Day 2

It’s been two days since my husband had his third chemo treatment.  His response after this treatment has not been as severe as after his second treatment.  I have to say the second treatment must have been distorted by the developing blood clot and thrush.  So far this treatment appears to have been better, however, it is still too early to tell.

Yesterday my husband was able to take a litre of hydration given over the course of 5 hours.  Today he was not so lucky.  When the visiting nurse arrived to set up the drip his blood pressure was remarkably high, we felt it was too high for him to take the hydration.  He’s had heart issues in the past and the saline solution might put too much strain on his heart.  We opted to forgo the treatment for today and try again tomorrow.  This meant that we had to focus on getting him to drink around 2 litres of clear fluid on a day when he felt quite nauseous.  The day is almost over and I am afraid we have missed the mark by between 1/2 to 3/4 of a litre.  The visiting nurse will come by in the morning so we have to hope that his blood pressure is at a more respectable rate.  The hydration is key to flushing out the chemo drugs and improving how he feels.

The blood clot continues to be a concern in his leg.  The swelling is still significant, however, it has not moved to any other area of his body as far as we can see.  He was not able to get much exercise in today at all.  He has very low energy and feels under the weather – which is normal for this point in the chemo cycle.  So a day where very little was said or done but where he has managed to get a lot of rest.  Tomorrow is a new day.