Saturday, February 23, 2008

Follow up CT scan

My experience during the second round of chemo treatment was similar to the first. The day of and after the treatment I felt fine, but the following 5 days were uncomfortable. During this time I get fatigued easily and experience general aches and pains. Thus far my appetite has been great, but this round of chemo was difficult on my digestive system. After some research, I found certain nutritional plans are much easier (and healthier) for the body to process.

I have adjusted my diet drastically before. Just after the twins were born I was my heaviest, 265lb on my 6'6" frame.

At that time I decided that I didn't want my kids to see me as an overweight father. I cut my caloric input by 1/2 and did weight training exercises 3 times a week. I lost 40lbs in about 6 months.

I have kept the weight off by eating less than I used to, but I haven't utilized the healthiest diet. I tend to eat lots of processed foods, red meats, and refined sugars. I switched to diet soda when I originally lost my weight which helped reduce my caloric intake, but it's certainly not the healthiest way to hydrate.

For the last 2 weeks, I have switched to a vegetable focussed nutrition plan that has a moderate amount of lean white meat (to get me the appropriate amount of protein). This nutrition plan provides loads of nutrients, vitamins, and enzymes that my body can process much more easily. I don't know if this diet will help my fight against cancer, but it certainly can't hurt eating a diet full of foods that are natural provided for us (Genesis 1:29). In addition, I drink about 100 oz of water a day.

Deb and I went to Karmanos yesterday for my 3rd scheduled chemo treatment. We first met with Dr. Flaherty to discuss the follow up CT scan taken the week before. The oncology field uses results from the CT scan in conjunction with other indicators such as blood work (each of the 100+ cancers is different, but for liver melanoma one blood indicator is LDH, an enzyme that can indicate liver disease). A normal LDH level is 250. At my first consult my LDH was 800. By my second treatment it had fallen to 300. On Friday the LDH was just under 200. We took this as encouraging news.

The CT scans were a mixed story. The mass in my left lung (not known if it is cancerous) has decreased in size by 60%. There is also no evidence of fluid in my lung. The liver CT scan was a different story. The new images looked significantly different than the previous ones. On the CT scan report, the tumor is larger than before, but Dr. Flaherty thinks that the official measurements don't tell the whole story. Since all of the indicators of my health (i.e. energy, pain, sleep, appetite, blood work) have been improving, he feels that changing my treatment now based only on the liver CT results would be a knee jerk reaction. I agreed with him and elected to proceed with 2 additional chemo treatments.

My white blood cell count came back slightly low for the chemo protocol, but it was still high enough to adequately fight infections. This means that I will have to wait a week before getting my 3rd chemo infusion. Every day I realize more that this is going to be a long road for me. In a world that expects fast and quantifiable results, cancer doesn't fit. Faith and patience will be what gets me to the end of this road, wherever it leads.

Please keep me in your prayers for the chemo drugs to be effective over the next two treatments, that I'll avoid infections during this difficult time of the year, and that I'll keep hope and strength through this process. In addition, please keep Deb, the twins, and the rest of my family in your prayers. Cancer can be just as difficult for those close to it.

Thanks to everyone for your comments on my blog, as you have been sources of inspiration, joy, kindness, and love. It is comforting to know there are lots of people pulling for me.

Friday, February 1, 2008

Cautious Optimism...

As I write this entry, I am getting my 2nd chemo treatment at Karmanos. Since some time has passed since my last entry, I won't get to the meaning of the entry title until the end...

After being on medical leave for almost 2 months, I returned to the office the previous Tuesday (22-Jan). I had been in contact with my boss and a number of colleagues during my time away from work, so it felt like much less than 2 months had passed since I last stepped into the building. My first day back went better than I expected, particularly since I didn't know how fatigued I would be over a full working day. Many of my colleagues were glad to see me back in the office, interested in knowing how I was doing, and offered words of encouragement for my "climb."

I had enough energy after my first day of work to practice with my band, Inline5. For those of you who have not seen us perform (i.e. most of you), we are 5 engineers in Ford Research that don't mind embarrassing ourselves in public (everyone has lead vocals on at least 1 song). All kidding aside, we have a lot of fun practicing weekly and performing a few times a year. I have been the drummer in the band for 18 months, on an instrument I hadn't played since the 9th grade. Fortunately drumming is like riding a bike; no matter how long you are away from it, you can pick it back up quickly.

I thank the Lord that my side effects from the treatment have been relatively minor. When I went back to work I had developed a rash on the back of both of my hands. At my Thursday doctor appointment we found that it MAY BE due to the clinical trial drug I am taking. One of the common side effects of the drug is dry and itching skin. My oncologist's assistant had seen similar looking rashes before. She recommended an appropriate moisturizing agent and the rash cleared up by the weekend. My blood work showed that the platelets (blot clotting component) were in the normal range but the white blood cell count was low and would have to come up before my next chemo treatment.

Every morning since my first chemo treatment I have looked at my pillow and tugged at my hair to see if it was falling out. On Wednesday (23-Jan), 12 days after my first treatment, I was able to pull strands out easily. In my case, my hair didn't just fall out at once, but by Friday my hair was thinning out rapidly. 10 minutes after returning home from work on Friday I put the clippers on the lowest setting and removed what was left of my hair. It is a little ironic that this hair(less)style was the one that Deb didn't want me to do (before I started treatments, of course). My mother, who tells it like it is, prefers the bald look.

Deb's mom came to visit over the weekend. On Saturday I woke up with some pain in my upper left back that felt like a muscle strain. Deep breathing was difficult since I had acute pain in my back. Fortunately it did not feel like there was fluid in my lung. Deb and her mom took the kids sledding in the morning and shopping in the afternoon. I took it easy on the couch.

On Sunday our pastor at Genesis preached on being under pressure (Acts 16:16-32). Paul and Silas were preaching in Philippi. A slave girl, who was a fortuneteller (and money maker for her owners), pestered Paul to the point where he commanded the evil spirit out of her. Her owners, upset since they no longer had their profitable business, roughed up Paul and Silas and riled up others against them in the market square. The judges took the side of the mob and ordered that Paul and Silas be stripped and severely lashed in public. After the beating they were put in a cell that was the most secure in the prison. Clearly Paul and Silas were under pressure, more pressure than most of us will ever face in our lifetime. Instead of groaning or complaining about their situation, Paul and Silas prayed and sang hymns, which shocked the other prisoners. An earthquake caused all of the cell doors to open, releasing all of the prisoners. The guard who was supposed to prevent Paul and Silas from escape feared what would happen to him and prepared to commit suicide. Paul stopped him and led him and his family to salvation. I understand that prayer and singing hymns won't necessarily save you from pressure in your life, but Paul and Silas didn't know that the doors would swing open either.

On Monday I was back at work for my second week, getting settled into my office, and making progress on assignments that had been on the backburner since I went into the hospital. My back pain had subsided by Thursday and my breathing returned to normal. I also resumed exercising this week, a brisk walk for 30 minutes each morning on the treadmill.

And that brings us to today and "cautious optimism"... Before I could get my second chemo infusion, my oncologist had to ensure that my blood work met the requirements of the protocol. My white cell count climbed back to normal over the past week. This means that my bone marrow is healthy, important for me fighting infection. In addition, the enzyme level associated with the activity of melanoma in my liver dropped when compared to my initial visit before starting treatment. These findings, in addition to how much better I have felt the last 2 weeks, are positive results. I'm not through the woods yet, closer to just entering the forest. We won't have another CT scan done until mid-February, but we were warned that the scans might not respond in the same manner as the blood work. It is a long road ahead, but I'm hoping days like this outnumber the alternative.