Saturday, 30 June 07
Multiple concerts today in Austin, the conclusion of the week-long UT Band Camp. We had left home yesterday amidst a heavy downpour. More rainfall has been received in June 2007 than any other June on record in North Texas.
After the concert, Kathy, Aaron, Aimee, Aric and I went to Schlitterbahn Water Park in nearby San Marcos. Here we went down the "Rapid River" and gigantic slides. Each ride on the slide requires a trek of 51 stairs, and with each step I am fighting the tumor, climbing more than 400 stairs for the eight rides I took. Good exercise for anyone, especially a guy on chemo, to keep blood clots from forming in the legs.
Friday, 29 June 07
My 23rd post op MRI was performed today on a GE 3T (tesla) machine in Dallas. My review of the film suggests that the tumor is still lurking about, although it has not grown and is still not visible to me in the side views and back views. There are three factors that complicate this layman's analysis. (1) the scale factor used to print the images from today differs from that of the previous scan, and (2) the general quality of the 3T images today are inferior to the 1T images from ISI on 6/1/07 and (3) the pic attributes on the ISI images suggest that they were collected on 5 mm slices with a 2 mm skip, while the other facility's images seem to indicate a 3 mm slice on a 0.3 mm skip (I cannot decode the geek speak on the film).
A review of the softcopy of the images on CD suggests that the tumor has perhaps shrunk, but I cannot tell because the contrast agent used at ISI (19 cc of Magnavist) produced a much brighter default contrast image around the eyes and skull compared to the rest of the brain than the agent used at the Dallas imaging facility (20 cc of Optimark). I can adjust the brightness of the images, yet I am unable to form any definitive opinion. My best guess: tumor remains, but lacks progression. The Radiologist's report is due Monday morning.
Monday, 25 June 07
Today was supposed to be a Carboplatin chemo infusion, but we need to wait one week for two reasons: first of all, the standard treatment is to wait four weeks after the 1st infusion, then perform a MRI to verify no tumor progression (if the tumor has grown during the past month, we will hit it with a different chemo) before receiving a 2nd dosage of Carboplatin. Today makes only three weeks since said first infusion. The 2nd reason to wait one more week is that my platelet count, while evidently still marginally acceptable, has dropped to 81,000 per microliter, so we need to give my system another week to recover. Other CBC measurements are good, and in fact the red cells and hemoglobin have increased since the last week.
The MRI on Friday will be performed using "3T" magnetic field strength equipment in place of the standard "1T" machine. There are only a few such facilities so equipped in the United States, so I am told. The use of the 3T apparatus will provide greater resolution to more accurately determine the status of the beast (reported to be 6 mm x 6 mm x 3 mm in the most recent radiologist report), even though both 1T and 3T MRI images are generated based upon 5 mm slices and 2 mm steps.
Sunday, 24 June 07
Kathy, Aric and I drove Aaron and Austin to band camp at UT in Austin in our Ford E150 Hi-Top Conversion Van (15 mpg highway), then returned to Argyle late this evening, I'm always "in" on road trips.
Saturday, 23 June 07
Time to mow the yard, a non-trivial task, since four weeks have elapsed since the last cutting, and since we have had much rain in North Texas in May and June, resulting in growth of perhaps three feet in many places. The 18 hp Murray riding mower, the 5 hp Murray push mower, the Stihl edger and the Stihl blower were needed. There is only one thing to do after working in the yard for more than five hours, skipping lunch in the process and taking just two breaks for water: Bar-B-Que! And so we did to top off a satisfying day of labor and refueling.
Friday, 22 June 07
Aric and visited Ryan today, a boy of 11 years who has a number of disabilities. Frequent readers of this blog will recall Ryan's Hat Trick from October 2006.
Wednesday, 20 June 07
I drove my Trans Am to work today, in honor of a special group of colleagues and business associates. It seems fitting to have the TA at the site of this offsite design review.
Tuesday, 19 June 07
My CBC results came back favorable today. All four categories are down, but still acceptable. I am told that that it is entirely possible for all readings to be back up next Monday, when I receive the next Carboplatin chemo.
Monday, 18 June 07
Today is an Avastin infusion, preceeded by the Saline solution, Aloxi and Decadon, as before. The CBC machine was out of comission, so the results will not be available until Tuesday. Since Avastin is not chemo, CBC information is not needed. The Carboplatin is on a 3-4 week schedule and the Avastin is a bi-weekly application.I brought a book to read, but didn't even crack the paperback, due to the uplifting conversation afforded by two friends also receiving treatments today.
Sunday, 17 June 07
Father's Day, my fourth such celebration since tumor removal. I got everything I asked for: grapefruit juice, 1% milk, "Lemon Chills," pudding and the paperback version of Foxe's Book of Martyrs. I also received sissors, pens, and six rolls of transparent tape (I often complain that I cannot find office supplies around the house), a very nice "Executive Leather" chair and a double DVD of Led Zeppelin in concert from 1970-1979. Stairway to Heaven is classic Zeppelin, a well-known song. I find classic rock to be both interesting and artistic, but there is a real path to heaven to consider.
The Martyrs book is a story in a story. Turns out this book had been sitting on the book case in our home for a year or more. Kathy merely pulled it off of the shelf, placed it in the gift bag and gave it to me again! Take stock of your belongs, you might just find what you are looking for. And I am serious about the first two items described above. I am the only person in the family who likes grapefruit juice and 1% milk. This was a great father's day.
Saturday, 16 June 07
Kathy, Aric and I made a road trip to Waco to attend the concert that signified the end of the Baylor band camp for Aaron and Austin.
Friday, 15 June 07
A road trip to Tyler is the order of the day, in my 1999 Ford Taurus (28 mpg highway). A time for family, for memories, for honoring a friend. A day of fellowship and kinship.
Thursday, 14 June 07
No major fatigue issues or anything else from the chemo infusion of 04 June 07. My prayer pager wake up call came at 5:30 am early this morning! Also, the drama of our female cat's cries for a boy cat resumed yesterday (see the April news page). We have had several cats over the years, but none that carry on like Savannah. We simply must get her spade after this subsides again.
Wednesday, 13 June 07
Another good night's sleep - the Decadon steriod must be out of my system. My appetite has also returned to normal (from being above normal), also indicative of the recession of the steriod. I have no nausea and am back on the Polyethylene Glycol, so everything's good. I have been using the prayer pager in place of my alarm clock; I receive a "777" page most mornings around 7:15 am.
Monday, 11 June 07
My CBC results came back favorable today. In fact hemoglobin levels are high, but okay, probably due to the iron supplements I have been taking. Watching the blood flow from my arm to the collection tube is a 1/x event, meaning things have been turned upside down. I used to faint occasionally when exposed to such sights. No reason for this behavior, other than fear, but fear of what? All I know is that the guy who could not help but stumble at blood draws now does not experience such drama. I can only attribute this victory to direct divine intervention, replacing my fears with His peace.
Is there any doubt that fear is a real and powerful opponent? Fear can literally make one sick, with butterflies in the stomach and nausea, headaches, loss of sleep, etc. And yet fear is hard to release. A healthy respect for dangers that can physically or emotionally harm a person is important (things such as electricity, firearms and machinery), but for my body to panic and shut down at the sight of blood when I was in middle school and even as an adult is just plain fear for fear's sake.
Sunday, 10 June 07
I drove Aaron and Austin to band camp at Baylor in Waco, with Aimee riding shotgun just because. A long day, a great day. Kathy and Aric returned from Maryland with advice about future travel: the cheap airfare has drawbacks and use the public transportation system, rather than trying to drive. Andrew and I had reached similar conclusions last summer when we journeyed to St. Louis.
Saturday, 09 June 07
I took our van into the shop today to check the wheel alignment in preparation for a road trip on Sunday to take two of our sons to band camp. Kathy and Aric are in Maryland watching American Bald Eagles, and Andrew is working at AquaKids, so I rode my vintage Schwinn bicycle back home from the shop. A hot sweltering day today in Texas, but I am glad to have the gift of energy and strength to accomplish this 3.5 mile ride (mostly up hill, or so it seemed!)
Thursday, 07 June 07
Again, this morning I awoke without any nausea, but with an appetite. Next event will be a nurses check on Monday, during which we will only check my blood. If all's well, the next round of Carboplatin will be performed on Monday, 25 June 07. I appreciate the outpouring of support these past few days.
Wednesday, 06 June 07
The second part of the first round of the new chemo treatment was administered this morning, and consisted of the following:
Saline solution, 500 cc to establish the IV and clear the line
Aloxi, 0.25 mg to suppress nausea
Decadon, 10 mg to further supress nausea
Avastin, 445 mg anti-angiogenic agent that attempts to cut off blood flow to tumor cells
I asked a nurse about the possibility of a port, not knowing how long my veins will hold up to all of the pokes. The answer is that the entire staff anticipated that the chemo will obliterate the spot and long term chemo will not be needed. If sustained infusions are needed, then the need for a port can be explored at that time.
Dr. Stark-Vance stopped by the chemo room to see us and the other folks in the room. She handed me three pictures from the Legacy Brain Foundation event from last month. I added two of the photos to the existing collection. We also heard a few songs by ApologetiX on her iPod.
Tuesday, 05 June 07
This morning I awoke without any nausea, with an appetite, yet I slept for only six hours last night, probably due to the steroid given to me yesterday. I have no complaints. We will whip this miserable traitor again, by the grace of God again. Please note the use of the pronoun "we." I cannot do this alone. There is a team involved, and the team is cross-functional, consisting of immediate family, extended family, coworkers, church family (several), neighbors and medical. But you are also on the team. Even if we have never met, you have become part of the team simply by reading this posting. What can you do? Well, please pray and call my Prayer Pager, entering your Zip Code at the beep. These pages provide significant encouragement and always seem to arrive at just the time I could use a little boost. I have already received several new Zip Codes.
When you pray, the following is suggested:
Thank for Lord for bringing me this far (40+ months post op)
Pray for strong blood counts - that my system holds up so I can continue to take the chemo
Pray that the MRI on 29 June 2007 will be truly clean, that the spot found on 6/1/07 vanishes, and that no new spots develop
Page me (972-321-0088), entering your Zip Code at the beep, followed by the "#" key
Monday, 04 June 07
Today is my 40th month anniversary of the removal of the brain tumor. Today is also the Oncologist appointment to review the report from the Radiologist from this past Friday. For the past 21 scans, the official reports have been "no signs of tumor progression, or tumor recurrence," or similar verbiage, but today I learned that both the Radiologist and Dr. Stark-Vance (Oncologist) have identified a spot at the edge of the original tumor bed that is thought to be tumor recurrence.
There was no time to waste, so Kathy, Dr. Stark-Vance (vsv) and I went into the war room shortly Kathy arrived with 30 pounds of MRI film (all previous scans). We reviewed selected scans, explored all of the options, including a PET scan, gamma knife and surgery, even removal of the entire Right Parietal Lobe (!).
A review of prior MRI film suggests the return of the tumor in late January 2007 or perhaps earlier, but its reappearance is so gradual and feeble that it managed to elude everyone's attention. until last Friday. But even now, the tumor is so small that it doesn't show up in all three MRI planes (top, side, back). The first tumor displaced more than 59 cubic centimeters (3.79 cubic inches); this one is a mere 0.108 cubic centimeters (0.007 cubic inches), about 550 times smaller than the first tumor.
At the end of the meeting, having verified acceptable CBC levels we opted to switch to Carboplatin chemo and Avastin. The discussion then proceeded along these lines ("vsv" is the doctor, "jdk" is you know who):
vsv: When do you want to start?
jdk: now
vsv: can't do now. How about tomorrow at my Dallas Office?
jdk: now in this office in Ft. Worth
vsv: I can admit you to this hospital (Harris Methodist) and get the chemo done tonight
jdk: sounds like a possibility
vsv: you could be released by 2 am from the hospital
jdk: let's do the infusion right here, right now
vsv: we need three hours for the first round. It is too late in the day
jdk: let's do the treatment right here, right now
vsv: we can do half now and the other half in Dallas tomorrow, or the other half back here on Wednesday
jdk: great!
Unlike the initial intrusion of the beast, the way forward against it this time did not require as much research, because Kathy and I were not starting from scratch, not knowing anything about brain tumors, or treatments, or survivors, or what doctor to use. Kathy and I are already up to speed and could make good solid decisions immediately.
So I received the following agents and solutions via an IV in the early hours of Monday evening, within three hours of being told of the beast's return:
Saline solution, 500 cc to establish the IV and clear the line
Aloxi, 0.25 mg to suppress nausea
Decadron, 10 mg also to supress nausea
Carboplatin, 700 mg chemo that targets fast growing cells, such such as tumors (and unfortunately good but fast growing cells as well)
The Avastin will have to wait until Wednesday, not enough time tonight in Ft. Worth to do this.
Dr. Stark-Vance and her nurse assistants fully expect the next scan (29 June) to be truly clean. I share in her optimism and hope, as do my family and friends. After this, the gbm might attempt to raise its periscope from time to time searching the horizon for targets of opportunity, but we will be listening for it and will dispatch destroyers after it each time. As before, this is a total war. There will be no prisoners taken, no mercy shown, no holds barred.
Sunday, 03 June 07
I have been conducting an experiment for the past several weeks and am now pleased to report that my hypothesis has been validated: the male of the species has two advantages: retention of the same hair style for decades and the sporadic use of vintage After Shave can both be embraced with no adverse societal consequences. In fact, no one will even notice when you pile your hair to the right instead of the left where it had been since 1975. Immediate family, extended family, coworkers, friends, telemarketers, neighbors, family pets, visitors to this website - all are safely inoculated from major changes in conservative hair configurations. Christmas gifts from 1982, such as Old Spice, can continue to be used on those rare occasions when just being street legal is not enough, again without comment from anyone on the planet.
Saturday, 02 June 07
Two stops for the Trans Am today; first at the 1st annual Argyle Car Show and the other and the Sonic Car Show in Denton. Several surprises at both events. For instance, how is it that my Trans Am wins 2nd place for cars in the "1970s and 1980s" category in Argyle, but then at Sonic, I receive a plastic coffee mug while a dilapidated truck from the 1950s that is not even painted is awarded a top 10 trophy?
Friday, 01 June 07
Today is my 22nd scan (21 MRIs and 1 PET) since brain surgery in February 2004. The MRI looks clear to me - the report will be received Monday.
