Thursday, February 26, 2009

What's Up With the Doc 42? - Up and Down

The Up:

Lindsay and I had an absolutely delightful weekend at Canyon Ranch. We watched a couple of movies together plus the Oscars, ate some delicious and healthy food, had a couple of really restorative treatments, and mostly just enjoyed each other's company. I have to specifically describe something I did called a "Remineralizing Bliss." This all occurs in a massage room on a heated table with the lights low and soft new age music playing. It started with an exfoliating scrub all over. This was washed off with warm towels followed by a dry scrub. Then I got covered with lavender oil and wrapped in warm towels. While I was wrapped she did foot and scalp massages. The oil was wiped off with warm towels and then she did a full body massage with remineralizing lotion. I told her that, if it did nothing else for me, she gave me 100 minutes of feeling physically well (no pain, no nausea) and completely at peace that I could go back to during the many times that are not so comfortable.

I've been sleeping much better in the last week or so allowing me to start the day with more pep and optimism.

The Down:

I continued with daily fevers through Monday. I was able to use my medications to time things so that I usually only had 2 or 3 hours in the afternoon when I felt the need to be in bed under covers and felt well enough for dinner by the time that rolled around. I took a dose of Ibuprofen at 7 pm on Tuesday and by then had had no temp greater than 98.6 for 24 hours so didn't take any more and, brilliant as I can sometimes be, didn't realize until I was really miserable at work at about 3 pm on Wednesday that I should check my temperature, at which point it was 102.1. So I'm back on regularly scheduled fever reducers. The right sided abdominal pain hasn't been too much of a bother.

Along with the fever and abdominal pain I've been having problems with a poor appetite, filling up really quickly and some epigastric fullness and discomfort. By the first of the year I had gained about 13 pounds since starting chemo. Before we left for Canyon Ranch I had lost 4 of those since the first of the year. This morning the scale tells me I have lost 5 more in the last week. Not so good, since whatever the reason for these symptoms (tumor necrosis - good, Alimta side effects - not so good, tumor progression - really bad) I know that when a real weight loss spiral begins it can be very difficult to stop. So I asked Robert to pick up some Ensure for me and called the doctor. He thinks this is all Alimta side effects (boo!) and has been leaning toward stopping the Alimta and switching to something else since LAST cycle's fevers. We agreed that, rather than waiting until March 17 for the next scan, we'll get one Tuesday morning BEFORE the next Alimta and make our decision about what to do when we see the results (that day, so no delay in Alimta if the scan is good). So -- significant reduction in tumor size we go ahead with Alimta and keep working on symptom management. No significant change or progression we quit Alimta and figure out what's next.

I'm also finding that I'm having more and more trouble dealing with the typical difficult worker's compensation patient - the bread and butter of my specialty. I have so little patience for symptom magnifiers and people who are trying to find any way not to work and have someone else pay them. I think I'm going to have to start some meditation or something because it's starting to take a toll on me emotionally. Any suggestions welcome.

I think that's about it. Hannah and I are off for Rochester tomorrow. Her team is seeded #1 in her age division! Monday I work clinically, Tuesday I start with the CT scan, then get my thumb injected, then see the oncologist. I'm scheduled to work clinically Wednesday and Thursday, off Friday, and then work clinically Saturday and Sunday. I'll update after I see the oncologist on Tuesday.

Keep the good energy headed my way.



Catharine said...

Per your request, a suggested meditation:

CD#2 in Dr. Andrew Weil's Mindbody Tool Kit contains about a 25-minute guided imagery/relaxation exercise that is one of the easiest and best I've ever used. No tensing of already tight/sore muscles. No special deep breathing that reminds me of the pain in my chest, side, and back. Just a wonderful voice with directions to trust the intelligence of my various muscle groups and give them permission to relax. Then, a gentle and brief exercise of going to and enjoying a favorite place. It is worth a try.

Sending caring thoughts your way.


Nick said...

Good luck on tomorrow's scan. Regarding putting up with symptom magnifiers, yes, that was hard for K. And it's hard for me now when I think about what K went through with so little complaining. But...the most significant thing I learned was greater empathy and the need for us to be kind to one another. I still have lower tolerance for some things, but I try, try to remember we never really know what others are going through. Especially don't let your reaction to whingers affect your own health. Again, bueno suerte manana.