The liver ultra sounds did not show anything to be alarmed about. Judy is scheduled to next see the oncologist on Jan 20th and have her bile duct stint replaced on Jan 26th. However, this schedule will probably have to be advanced, as she is turning yellow again. She had a fairly good day a few days ago, but has since been in bed most of the time, including most of the day today.
Thursday, January 8, 2009
Wednesday, December 24, 2008
Wednesday - December 24, 2008
Lots of news, mostly bad.
Baking Soda Infusion - Judy did finish the 8 days of baking soda infusion and was sick most of the time, but felt it was worth it if it shrunk the tumors. The infusions did cause most of the back pain to go away, which was really helpful. The tumor markers went from 2,622 on Nov. 11 to 3,000 on Dec 23rd. But it is hard to tell what that really means, since they went from 1,000 to 2,622 (a 160% increase) during the prior two months that she was off chemo. In the prior two months they more than doubled and in the last 6 weeks they only increased by 15%, so maybe the infusions were helpful.
We did get the results of the Nov 25 CT scan on her abdomen and pelvis and chest and comparisons to the Jul 28 CT scan.
Liver - We learned that there was an 8 mm hypodensity within segment 6 of her liver, but that it did not increase in size and there were no new hepatic lesions. There was a mild amount of gas within the intrahepatic biliary tree within the left lobe.
Kidneys - The left kidney was not growing as fast as the right. There was a 10 mm lobulated lesion within the superior pole of the right kidney, which was unchanged. Bilateral extrarenal pelvises were present.
Pancreas - The previous 23 x14 mm hypodensity adjacent to the tail of the pancreas currently measured 15 x 10mm. The 13 mm left adrenal lesion was not changed.
Abdomen - There were numerous small lymph nodes within the retroperitoneum, celiac region and mesentery and there was also a general increase in size and number of lymph noes in these regions. The prior 15 x 8 mm left para aortic lymph node had increased to 18 x11 mm, the prior 23 x 10 mm portocaval lymph node increased to 23 x 13 mm, and the right iliac chain lymph node went from 13 x 7 mm to 17 x 9 mm.
Pelvis - There was a mild amount of free fluid within the pelvis, the uterus was filled with fluid and there was mild asymmetric thickening of the left aspect of the myometrium.
Back - Numerous blastic metastasis were again seen in the lumbar spine and pelvis. A few of these appear to have increased in size. For instance the 28 mm lesion within the L4 vertebral body previously measured 26 mm.
Heart - One mediastinal lymph node in the lower mediastinum anterior to the the descending aorta was 10.5 x 8.5 mm and is currently 12.9 x 10.3 mm.
Axillary Lymph Nodes - Many enlarged right superior and inferior axillary lymph nodes were present and increased in size.
Bones - Diffuse osseous metastatic disease involved the sternum, ribs and thorasic spine, but had not progressed since the earlier CT scan.
Blood Tests - Judy had three blood test results that were of concern to the oncologist. First, her Alkaline Phosphatase went from 298 to 961. The normal range for Alkaline Phosphatase is 39-120. Higher levels may indicate that the bile duct is blocked.
Second, her Aspartate Aminotransferase went from 80 to 131. The normal range for the Aspartate Aminotransferase is 8-35, with high levels indicating possible liver damage.
Third, her Alanine Aminotransferase went from 32 to 56. The normal range for Alanine Aminotransferase is 4-36, with higher levels indicating possible liver damage.
As a result of these significantly increased test results, the oncologist has ordered an ultrasound of her liver and scheduled it for Friday.
The last time we met with the oncologist she informed us that none of Judy's tumors were immediately threatening. So, this time I asked her what she actually expected Judy to die from. She said that it would likely either be a brain tumor or a tumor that would cause the liver to stop functioning. Based on the above test results and the absence of any indications of a brain tumor, it seems likely that a liver tumor will take her.
Baking Soda Infusion - Judy did finish the 8 days of baking soda infusion and was sick most of the time, but felt it was worth it if it shrunk the tumors. The infusions did cause most of the back pain to go away, which was really helpful. The tumor markers went from 2,622 on Nov. 11 to 3,000 on Dec 23rd. But it is hard to tell what that really means, since they went from 1,000 to 2,622 (a 160% increase) during the prior two months that she was off chemo. In the prior two months they more than doubled and in the last 6 weeks they only increased by 15%, so maybe the infusions were helpful.
We did get the results of the Nov 25 CT scan on her abdomen and pelvis and chest and comparisons to the Jul 28 CT scan.
Liver - We learned that there was an 8 mm hypodensity within segment 6 of her liver, but that it did not increase in size and there were no new hepatic lesions. There was a mild amount of gas within the intrahepatic biliary tree within the left lobe.
Kidneys - The left kidney was not growing as fast as the right. There was a 10 mm lobulated lesion within the superior pole of the right kidney, which was unchanged. Bilateral extrarenal pelvises were present.
Pancreas - The previous 23 x14 mm hypodensity adjacent to the tail of the pancreas currently measured 15 x 10mm. The 13 mm left adrenal lesion was not changed.
Abdomen - There were numerous small lymph nodes within the retroperitoneum, celiac region and mesentery and there was also a general increase in size and number of lymph noes in these regions. The prior 15 x 8 mm left para aortic lymph node had increased to 18 x11 mm, the prior 23 x 10 mm portocaval lymph node increased to 23 x 13 mm, and the right iliac chain lymph node went from 13 x 7 mm to 17 x 9 mm.
Pelvis - There was a mild amount of free fluid within the pelvis, the uterus was filled with fluid and there was mild asymmetric thickening of the left aspect of the myometrium.
Back - Numerous blastic metastasis were again seen in the lumbar spine and pelvis. A few of these appear to have increased in size. For instance the 28 mm lesion within the L4 vertebral body previously measured 26 mm.
Heart - One mediastinal lymph node in the lower mediastinum anterior to the the descending aorta was 10.5 x 8.5 mm and is currently 12.9 x 10.3 mm.
Axillary Lymph Nodes - Many enlarged right superior and inferior axillary lymph nodes were present and increased in size.
Bones - Diffuse osseous metastatic disease involved the sternum, ribs and thorasic spine, but had not progressed since the earlier CT scan.
Blood Tests - Judy had three blood test results that were of concern to the oncologist. First, her Alkaline Phosphatase went from 298 to 961. The normal range for Alkaline Phosphatase is 39-120. Higher levels may indicate that the bile duct is blocked.
Second, her Aspartate Aminotransferase went from 80 to 131. The normal range for the Aspartate Aminotransferase is 8-35, with high levels indicating possible liver damage.
Third, her Alanine Aminotransferase went from 32 to 56. The normal range for Alanine Aminotransferase is 4-36, with higher levels indicating possible liver damage.
As a result of these significantly increased test results, the oncologist has ordered an ultrasound of her liver and scheduled it for Friday.
The last time we met with the oncologist she informed us that none of Judy's tumors were immediately threatening. So, this time I asked her what she actually expected Judy to die from. She said that it would likely either be a brain tumor or a tumor that would cause the liver to stop functioning. Based on the above test results and the absence of any indications of a brain tumor, it seems likely that a liver tumor will take her.
Saturday, December 13, 2008
Saturday, December 13, 2008
Well, we didn't get the tumor site baking soda injections ... but we did get baking soda infusions directly into her porta-cath. We were supposed to get infusions daily for eight days. Judy got real sick and experienced severe tremors before the initinal infusion of 3 mg's of baking soda and Vitamin B complex, but we went ahead anyway. That first evening she felt fairly well. The next day she took the second infusion of 6 mg's of baking soda (again with B) and got really sick that night, including worse tremors. They lasted about an hour. The next two days were skipped ... the first day the DO wanted to research the possibility that the infusion might be causing the tremors and the second day he was ill.
The next day (Friday) we went back for a 3rd infusion of 12 mg's of baking soda and protien. Judy got real sick again and ended up being in bed most of the day on Saturday, with terrible nausea. She called the DO at home and he prescribed ginger root and peppermint tea. It seems unlikely that she will be able to continue these treatments, as the protocol calls for the baking soda amount to be doubled each time and be 100mg's on the final treatment.
We go back to the Wellness Center on Monday and the oncologist on Tuesday. Guess we will have to see what each says.
The next day (Friday) we went back for a 3rd infusion of 12 mg's of baking soda and protien. Judy got real sick again and ended up being in bed most of the day on Saturday, with terrible nausea. She called the DO at home and he prescribed ginger root and peppermint tea. It seems unlikely that she will be able to continue these treatments, as the protocol calls for the baking soda amount to be doubled each time and be 100mg's on the final treatment.
We go back to the Wellness Center on Monday and the oncologist on Tuesday. Guess we will have to see what each says.
Wednesday, December 3, 2008
Wednesday - December 3, 2008
We had quite a time over Thanksgiving! All of our children and grandchildren were here and we actually got a complete family picture! It was exhausting as the guys played video games all night and the kids and moms were up fairly early the next morning. The nights that no video games were played, we often stayed up and talked much on the night. It was also total chaos, as the house was strewn with toys and sleeping arrangements and the garbages were always overflowing. It was so good to have them here, but the peace and quite are so wonderful now that all are gone! We can actually get a good nights sleep again.
Judy finally got the results back from her CT Scan and learned that the tumor she most worries about (the one at the base of her pancreas) actually shrunk a little. If this tumor invades the pancreas it will cause extreme pain and signal the beginning of the end. Unfortunately most of the other tumors had grown some.
Dr Randy Roberts at the Soli Wellness Center in Layton (near Ogden) said that she had progressed well during her first month of the plethora of wellness treatments, but that she still had a long way to go to be at her best. So, we contracted for another month of treatments! We expect to treat there at least another two to four months. Unfortunately none of these costs are covered by our health insurance.
One of the treatments that she received was a detoxifying foot bath. She was so impressed by it that we actually bought the machine so that she could do it at home more than once a week. We are also considering doing baking soda injections at the site of the tumors in her back that are causing the most pain. We think we have identified a local DO who will do them, though of course the Huntsman Cancer Center is discouraging this approach as there are no double blind studies supporting this therapy. However, there is a doctor in Europe that has some successful patient histories with this therapy ... but he is the only one publishing results at this time.
Judy finally got the results back from her CT Scan and learned that the tumor she most worries about (the one at the base of her pancreas) actually shrunk a little. If this tumor invades the pancreas it will cause extreme pain and signal the beginning of the end. Unfortunately most of the other tumors had grown some.
Dr Randy Roberts at the Soli Wellness Center in Layton (near Ogden) said that she had progressed well during her first month of the plethora of wellness treatments, but that she still had a long way to go to be at her best. So, we contracted for another month of treatments! We expect to treat there at least another two to four months. Unfortunately none of these costs are covered by our health insurance.
One of the treatments that she received was a detoxifying foot bath. She was so impressed by it that we actually bought the machine so that she could do it at home more than once a week. We are also considering doing baking soda injections at the site of the tumors in her back that are causing the most pain. We think we have identified a local DO who will do them, though of course the Huntsman Cancer Center is discouraging this approach as there are no double blind studies supporting this therapy. However, there is a doctor in Europe that has some successful patient histories with this therapy ... but he is the only one publishing results at this time.
Sunday, November 16, 2008
Sunday - Nov 16, 2008
We have three types of news this week. The good news is that the oncologist said that Judy is not in immediate danger of dying, thus they have agreed on no additional chemo at this time, since she continues to feel better and better while off the chemo.
The intermediate news is that Judy is having more and more back pain, presumably from the cancer in her spine. Even though the cancer in her lymph nodes is not hormone responsive, the oncologist said that when it metastasizes to the bones it often is. So they have put her on monthly hormone injections on the outside chance that they can slow the cancer growth in the backbone a little. Unfortunately she got quite ill after the initial injections. We do not know whether the injections caused the illness, or if it was caused by something else ... like getting overly tired.
The bad news is that during the last two months (that Judy has been off chemo and feeling better and better) her cancer marker has more than doubled. The presumption that we are making is, that while her general health is getting better and better, her cancer tumors are also getting bigger and bigger.
At this point we are assuming that she probably has less than a year left. However, our focus is going to be on helping her feel as well as she can for as long as she can vs extending her life at the expense of feeling poorly all of the way to the end.
The intermediate news is that Judy is having more and more back pain, presumably from the cancer in her spine. Even though the cancer in her lymph nodes is not hormone responsive, the oncologist said that when it metastasizes to the bones it often is. So they have put her on monthly hormone injections on the outside chance that they can slow the cancer growth in the backbone a little. Unfortunately she got quite ill after the initial injections. We do not know whether the injections caused the illness, or if it was caused by something else ... like getting overly tired.
The bad news is that during the last two months (that Judy has been off chemo and feeling better and better) her cancer marker has more than doubled. The presumption that we are making is, that while her general health is getting better and better, her cancer tumors are also getting bigger and bigger.
At this point we are assuming that she probably has less than a year left. However, our focus is going to be on helping her feel as well as she can for as long as she can vs extending her life at the expense of feeling poorly all of the way to the end.
Sunday, November 9, 2008
Sunday - Nov. 9,2008
Judy is getting stronger and stronger. She felt well enough to attend all three meetings this Sunday. She has also been going to physical therapy and is making good progress. They are working on her overall physical well being and also on her lympathetic arm. The arm is going down and is no longer causing her as much pain as before!
Jerry had a not-so-good week. His rectal bleeding came back a couple of times, but went away on its own and he is doing better now. The considerable loss of blood has made him even more tired than his heart condition. He probably exacerbated the problem with a 60 day colon cleanser he bought over the internet and did not quit using until after the bleeding restarted following the cautery. He got his flu shot like a good guy and now has a cold, with heavy sinus drainage, a fever blister and even more shortness of breath. However, he made good progress getting the garage cleaned out, the shelving set up and even repainted the garage floor with some paint Steph and Derek had left over. He should be able to get Judy's car in within the next week or so. (The floor paint has to dry a week before you can put a car on it.) So, Saturday will mark the accomplishment of a big Fall goal for Jerry.
Jerry had a not-so-good week. His rectal bleeding came back a couple of times, but went away on its own and he is doing better now. The considerable loss of blood has made him even more tired than his heart condition. He probably exacerbated the problem with a 60 day colon cleanser he bought over the internet and did not quit using until after the bleeding restarted following the cautery. He got his flu shot like a good guy and now has a cold, with heavy sinus drainage, a fever blister and even more shortness of breath. However, he made good progress getting the garage cleaned out, the shelving set up and even repainted the garage floor with some paint Steph and Derek had left over. He should be able to get Judy's car in within the next week or so. (The floor paint has to dry a week before you can put a car on it.) So, Saturday will mark the accomplishment of a big Fall goal for Jerry.
Monday, November 3, 2008
Monday, Nov. 3, 2008
Judy has been off chemo for almost two months and is feeling somewhat better overall. Though I don't think that the cancer has shrunk during this time. She does not seem to have any interest in going back on the chemo, but we will see when she meets with her oncologist again in a week or so.
Jerry spent the last 24 hours in the University Hospital trying to determine what was causing his heavily blooded stools. They did find an Arterio-Venous Malformation during his colonoscopy. (You can Google AVM for more information.) This malformation is when there are no capillaries between an artery and a vein. The blood just recirculates, without feeding the cells. Usually it is not a problem, but ocassionaly the vein ruptures. This is what caused the bleeding in his stools. They cauterized the rupture and told him that he was good for several more years.
Jerry spent the last 24 hours in the University Hospital trying to determine what was causing his heavily blooded stools. They did find an Arterio-Venous Malformation during his colonoscopy. (You can Google AVM for more information.) This malformation is when there are no capillaries between an artery and a vein. The blood just recirculates, without feeding the cells. Usually it is not a problem, but ocassionaly the vein ruptures. This is what caused the bleeding in his stools. They cauterized the rupture and told him that he was good for several more years.
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