Tuesday, June 2, 2009

What's Up With the Doc 59? - Phase Number Next

First, what's up with my neck - I met with the spine surgeon yesterday and he's confident that the structural stability of my spine is fine. The tumor is growing, is causing more pain, and is threatening my vertebral artery (probably not a huge deal, but you never know). If it continues to grow it could (and probably would) threaten the nerve root exiting at that level and, eventually, my spinal cord. So all are in agreement that something should be done about it. Choices are real surgery and stereotactic radiosurgery. While there is some really amazing stuff going on with actual vertebral body replacement surgery, everyone is in agreement that my life expectancy is not long enough to warrant the huge hit that my quality of life would take with that kind of major surgery and recovery, so radiosurgery it is. I have a treatment planning CT scheduled for Tuesday in New Haven and the treatment itself will be the 18th or 19th.

Next, never let it be said that I don't know my oncologist. Today was the post-scan, figure out what we're doing visit. First we talked about pain control because pain is the thing that is most threatening to my quality of life at the moment. He is perfectly comfortable managing my pain until (and if) I need really huge doses of oxycontin or morphine, not likely to be the case with me for quite a long while. For now, I'm to continue the Ibuprofen and start taking 5 mg of oxycodone whenever. If I get to the point where I'm regularly taking 20 mg or more a day we'll start oxycontin. I'm cool with that plan and plan to start with bedtime oxycodone because probably a decent night's sleep will help me during the day. Then we got to the heart of the matter - what next for the cancer? He is perfectly in agreement with me that it makes no sense to undertake any challenging treatment at this point. The cisplatin/taxotere was the last shot at trying for a significant response. Now it's just whatever we can think of to control disease without making me feel awful. He wants to go to Navalbine - 10 minute infusion weekly for three weeks, off one week, then repeat ad infinitum. Even his chemo nurse says this one is easy. Major problem is usually constipation, which, with starting opiates at the same time, I'll have to be fairly aggressive about preventing.

I have been really good about not asking prognosis questions but I couldn't help myself today. He wouldn't make any predictions. He said that he knows I like to plan ahead a little bit (Emma was with me and rolled her eyes all the way into the back of her head at that understatement) but that experiences are so varied it's impossible to give any idea whatsoever. He told me that 25% of people admitted to inpatient hospice are discharged! He also said that things tend to go more quickly with people who give up and I made it clear that there are way too many things on my "I want to be there for..." list for me to ever give up and give in. So we left it at Navalbine and Zometa next Tuesday and we'll see how it goes.

So, there's a plan in hand that makes sense to me. Philip turned 15 yesterday - cake was had by all. End of year orchestra and jazz ensemble concert is tomorrow night. Hannah takes SAT II Saturday and it's Emma birthday. Lindsay is coming up and the two of them are going to trip the light fantastic. Monday is Philip's trumpet recital and Tuesday is the end of year concert band and wind ensemble concert. So look for something next Wednesday reporting on all these events and the first Navalbine treatment.

Love to all,


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