Medical Update: No News is Good News

I haven't posted a medical update in a while, because there is nothing new to report.

Everything is "status quo", which, according to my doctor, is what want.

Status Report:

Cancer: stable (not shrinking, not growing)

Chemo: continue current treatment:
Herceptin - once every three weeks
Navalbine - twice every three weeks
Zomera/Denosumab - once every four weeks

Pain: hip pain, back pain (severe, at times)

Pain Management: Optalgin (2-6 a day)

Tests: MUGA: coming up soon
CT: April/May ?
Skeletal X-Ray: April 15


Coffee-and-Chemo Dates: book now for July-August!


Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Glow in the Dark (Medical Update)

I am going to start glowing in the dark.

I just started my third radiation treatment to my brain.

Just before my son's Bar Mitzvah, in July 2009, I had a month of whole brain radiation (WBR). The tumors shrank; some disappeared.  Even after 6 months, some of the tumors continued to shrink.

Just before my daughter's Bat Mitzvah, in June 2010, an MRI revealed two new tumors.  I had stereotactic radiosurgery (SRS) on what turned out to be three tumors.  My recent MRI, showed that one tumor shrank, the other is stable. It also showed several new tumors... too many for another SRS. 

The radiologist, who did my intake last Sunday, recommended that we do another round of WBR;  she wanted to wait until this Sunday, so she could consult with the head off radiology, who was in Barcelona for a professional conference.  Moshe and I felt a little nervous about waiting, but we also felt good knowing that the department took the risks of this procedure seriously (particularly since the risks are elevated by repeating the treatment).

We came in on Sunday, and the radiologist was amazing!  She consulted with the dept. head before we even got there, gave us an update (basically, that the head agreed with their earlier decision), invited Moshe to ask the dept. head any questions he still might have, set me up for the simulation, and even for the first treatment!  Things moved much faster than I expected, but I am glad to have started treatment right away, especially after waiting the extra week for the head of the dept. to return.

So, I just finished the third day of radiation.  I will receive 18 treatments altogether.

This has impeded a bit on our holiday plans.

We, more specifically "I," will have to be in Jerusalem every morning, including Erev Chag, Erev Shabbat, and Chol HaMo'ed.

I have been having a tough time with this whole thing.  I am a bit devastated to have more tumors appear so quickly.

Quite honestly, I am scared.

I am trying to keep my chin up, but it is a challenge.  I just do not feel like saying "I am fine" when I am not, and I do not feel like explaining why I do not feel fine.

My emotions are extremely close to the surface these days.  I lose my temper more than I cry, but it would probably be healthier for me to cry a bit more.  I am feeling just a tad sorry for myself these days.

I have not even mentioned the hair thing....

Meanwhile, I am chugging along.  I even taught swimming today (and had great classes, if I do say so myself!)

I just wish I had a bit more energy, and I know that the WBR will knock me out and make me even more tired than I already am.

*sigh*

So, those of you who want to make a chemo or radiation date with me --now is the time!

(I was just kidding about the glowing part....)



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Medical Update: Radiation & Hip Pain

Background:

For a few months now, I have had some discomfort in my left hip. Recently, my hip has been hurting more. It bothers me a lot at night, when I am trying to fall asleep. Sometimes the pain is severe and it can be painful to walk or, in extreme circumstances, even to stand.

There is a concentration of cancer in my hip and, due to the increase in pain, the oncologist recommended radiation. He consulted with two top radiologist at Sha'are Zedek Hospital and then suggested that I meet with Dr. Vigoda, who is the head of radiology at Hadassah. Hadassah Ein Karem is the only facility in Jerusalem for radio-therapy.

Update:

On Sunday (Sep 16), my oncologist called me midday and said "Vigoda can see you today. Go now." So, I dropped everything, called Moshe and we went to Hadassah.

We were seen fairly quickly (only a half hour wait) by Dr. Sapir, who was young, very nice and smiled! Dr. Sapir consulted with Dr. Vigoda right away and then, to our surprise, arranged for me to have the "simulation" (where they determine the area to irradiate) and begin radiation immediately. We didn't have to wait, or come back two different times, or anything.

Moreover, though he told us that it would take about half an hour to get the results of the simulation , the results were ready in less than 15 minutes and then I went straight to the first radiation treatment.

The treatement only takes 5-10 minutes. It's amazingly fast. But I need to go every day.

On Monday, I went in and there was only one other person there. It took longer to park, than anything else!

But today, Tuesday, I arrived about a half hour later and waited almost two hours! That was exhausting. Luckily, my friend JB took me and we had plenty to talk about. (working/staying at home/ADD/kids...)

I will receive radiation for 10 days. During this time I don't get chemo. But, the way it falls out, I only miss one week of chemo, because next week was an "off" week. Oh well, no vacation this time.

Anyway, I just finished day 3 of radiation.

Hopefully the pain will go away soon....

Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Medical Update -- Markers & Pain

My apologies for not providing this update sooner.

My markers are down!

Really down.

For months, my markers were on the rise. And they were climbing high! That, combined with a significant and steady increase in pain, was the main indicator that my previous chemo regimen was not working.

Almost as soon as I started on Taxol (in December), my markers started coming down.

About a month ago, they finally reentered the "normal" range.

The most recent tests indicated that they were still in the normal range, and even lower than the previous results.

This is great!

Regarding pain, things are a little less clear cut. At first, the Taxol seemed to have a substantial effect on my pain as well. For a brief period, I stopped taking pain killers regularly. The respite did not last long. Significantly, when I did need pain killers, I still needed to take both Optalgin and Algolysin.

These days, in addition to back and hip pain, I have pain in my lower rib cage, increased sensitivity in both shoulders, and pain in my neck.

Currently, I take pain medication 2-4 times a day. Occasionally, I need to augment the pain meds. Usually, half a Percocet is enough.

I still do not like taking drugs.



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

CT & Ultrasound -- Medical Update

I have been so overwhelmed with the flu, that I realize I forgot to update you about the important stuff. (Actually, I did not realize it, until a million people kept asking me about the results!)

The CT did not reveal any new developments. The radiologist did see a "hint" of something on the liver, so we checked that out.

I did an ultrasound. The radiologist did not see anything worrisome.

So, for now, I seem to be doing well.

Recently, my pain seems to have gone down a bit, so that is also a good sign that the new chemo is working.

The oncologist wants to do a PET scan, eventually, but not now. Apparently, you have to be off chemo for at least 2-3 weeks before doing a PET. The oncologist does not want to stop treatment at this point.

I just started my fifth cycle of treatment with the Xeloda and Tykerb.



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Medical Update: August 2007

I promised to let you know when I know more….
So I hope that this will be an easier way of letting you all know what is going on with me....


The outpouring of love and support from all of you was absolutely amazing!

I finally got the results that I am HER2 positive. As soon as I got the results, I felt calmer and more in control. Now we could determine and start treatment!

I began treatments two weeks ago, Thursday July 26 (11 Av), with vinorelbine (Navalbine). It made me itchy! This reaction is noted in the research, but it is uncommon (lest anything about me be common!).

I couldn’t tell if the vinorelbine made me tired because they gave me this super duper antihistamine to counteract the allergic reaction (that caused the itching), and the antihistamine knocked me out!

Last week, on Wednesday, I got Herceptin for the first time and then the vinorelbine. The drugs are administered via IV, and the doctors always introduce one drug at a time, to see if it causes a reaction. At first, Herceptin is administered very slowly, to give the body a chance to adjust. Eventually, it will just take an hour and a half to get the Herceptin. But this time it took four hours! They had to go slower than usual because… it made me itchy! But when it went slower, it was okay. The vinorelbine made me itch again, but not as badly as the first time. So I didn't take the anti-histamine until the evening. This way, though I was tired, I wasn't completely knocked out.

This Wednesday, I'm getting a new drug, to prevent further deterioration of my bones. I'm actually in a clinical trial, so I am either getting Zomera or a new drug called Denosumab. Participating in the trial is a win-win for me. The Zomera is the next generation drug of its kind, and is not covered by the health funds. And the Denosumab is a new drug which is not even available on the market. So, either way, I'm getting a better drug than I would have gotten had I not been in the study.

So that's it for the medical summary. In a few months, I will get tested again to see how the cancer is responding to the treatments.

With love and optimism,
RivkA

The State of My Liver: inconclusive (Medical Update)

We did a CT of my liver . 
Results:  Inconclusive

We did an MRI of my liver.
Results: Inconclusive


We did a PET CT of my liver.
Results: Inconclusive

We did a liver scan of my liver.
We do not yet know the results.

Some of the blood work regarding liver functionins is also a bit suspicious.

Still, nothing is conclusive yet.

Remember, a year and a half ago, when I discovered tumors on my brain and I freaked out about brain mets?  One of the things my oncologist emphasized was that tumors on my liver would be far more scary.

Not to worry, I am still not freaking out.

Another thing my oncologist emphasizes is that we do not deal with "what ifs."  We will not decide how to handle my current medical situation, until we know what it is.  So, until we know the facts, we wait.

Meanwhile, we have had a few harrowing days.



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Medical Update --Markers

I haven't quite figured out the marker thing yet.

CA 125 seems to be "my" marker.

CA 125 is often linked to ovarian cancer, but not exclusively.

When I was diagnosed with mets, in the summer of 2007, my CA 125 was 56.7 (high).

Five and a half weeks into treatment, my marker dropped to 32.2 (normal).

Two months later, at the end of October, it was down to 23.7 (normal).

At the end of December, it was 26.1 (still normal).

Then, in February, the numbers began to fluctuate:
5.2.08 -- 35.6 (high)
4.3.08 -- 32.5 (normal)

Then, in April, the numbers slowly and steadily began to climb up:
29.4.08 -- 47.0 (high)
10.6.08 -- 68.7 (higher than when we started)
1.7.08 -- 71.9
19.8.08 -- 102.1
2.9.08 -- 120.9

The diagnostics seem to indicate that my treatment is effective.

So why has my CA-125 count has been rising for months now?

No one knows why.

We have done all the tests:
CT -- everything looks the same
MRI -- we really needed to check my liver, and discovered that it looks even better than expected.
Ultrasound -- a few months ago, there was something strange near my left ovary. It did not "look like cancer," but I needed to follow up on it. I did an ultrasound this past Tuesday... there is nothing there anymore.

I met with a gyno-oncologist. (I bet you did not know there was such a thing! I sure didn't)

My gyno-oncologist (GO) only has clinic hours on Tuesdays, so I waited for a "free week" to go spend the morning at a different hospital, Hadassah Har Zofim.

Moshe came with me.

The GO was present for the ultrasound (as was some other woman, in addition to the technician). I might have minded the "invasion," if it weren't for the fact that I was anxious about the growth and the fact that all three agreed that nothing was there anymore. I mean, if something was still there, one of them would have seen it, right?

Anyway, after the ultrasound, we had to go to the GO's clinic.

Moshe had an important meeting at work, but he wanted to be at my meeting with the GO, since I don't remember anything these days.

Even though the doctors were running a bit late (because the department who schedules these appointments seems to be unaware that there is a staff meeting every Tuesday morning....), we (read: I) thought Moshe could still make it on time to his work meeting.

I was supposed to be the first patient to see the doctor.

Moshe, being infinitely more pessimistic, expected something to come up. It did. The doctor took another patient in before us, because they had a brit that morning.

By the time we were inivited in, 45 minutes later, I was completely anxious, and knew that Moshe would be late. The doctor, sensing my anxiety (you'd have to be blind to miss it), offerred to meet with us later, at our convenience. I was so aggitated, that I was ready to come back another time. Luckily, Moshe was cool-headed and assured the doctor that it would be alright, and we should meet now.

The GO suggested that we leave the tension outside, so that he can give me all the time and attention that I needed.

It was hard to release the tension, because my rising markers made me tense to begin with, and that was why we were there!

But I was impressed, yet again, with the doctor's gentle and concerned manner.

In the end, we also spent at least 1/2 an hour with the doctor. He spoke with us in detail, and also consulted with my oncologist.

The bottom line, there is nothing to do at this time.

Neither the GO nor my oncologist recommends checking out my ovaries laproscopically. There is no indication that the GO would find anything. And, given my weight and medical history, including 6 abdominal surgeries, resulting in a lot of scar tissue and adhesions, the surgery would not be simple. Not to mention that I've had 3 serious post-op infections in the past....

So, what do we do about the rising markers?

Nothing.

Just "wait and see".....

Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

MRI - Good News! (Medical Update)

"Can the radiation make the tumors go away?" I asked, first to my oncologist, then the radiologist, then the head of radiology.

I was devastated by the discovery of brain mets. I could not accept that the brain mets would not go away.

"Sometimes the tumors shrink from radiation," I was told, with reservation.

"But can they be totally destroyed?" I persisted.

"Rarely," I was told, by caring doctors who did not want to give me false hope.

The main goal of the radiation was to stop the tumors from growing any further.

That was not good enough for me. I prayed every day, during my five minutes of radiation, for the radiation to completely destroy the tumors.

Well, the tumors might not be 100% gone, but they have certainly lost some of their power!

We have not yet received the written report, but the images look a lot cleaner! We only saw one or two "shadows," only one of which is still a remnant of a tumor, according to my doctor's analysis (though he is the first to acknowlege that he is not a radiologist).

My doctor, upon reading the report, sent me the following message right away:

got the report of your MRI and the improvement we thought we saw is REAL.

This does not mean that I am done with brain mets. Like the bone mets, brain mets never goes away. Still, I doubt anyone expected such good results.

Thank you all so much for your prayers!! God is listening!!

I cannot think of a better way to start the new year!



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

CT -- Medical Update

On Sunday, I did a CT of my head, neck, chest, adbodment, and pelvis.

There is no written report yet, but it seems as if everything is ok -- meaning there is nothing new.

The CT is done without contrast, however, which means we do not see everything so clearly.

The radiologist did see a "hint of something" on my liver. My oncologist does not think it is something to worry about, but he is sending me for tests, just to be sure. I have to do an ultrasound this week.

Meanwhile, there are also tumors on my lungs. Apparently they have been there all along.

They are tiny, about the size of an "o" but they are there, and there are almost ten of them. I thought the tumors on my lungs were gone.

Apparently, the Navelbine (first chemo I took) shrunk them, but did not eliminate them.

My oncologist says that tumors shrinking to that size, and staying that size, is practically the same as if they are gone. It does not feel the same to me.

"Good as gone" is not "gone."

I want the tumors to be gone.

I hate cancer.



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Medical Update: Two Down -- Now What?

So, I have just "used up" my second chemotherapy.

I will not be receiving treatment tomorrow. Instead, my doctor is squeezing me in for an appointment, so we can determine what my next treatment will be.

This past week, I noticed the chemo (Taxol) affected my hands more than I realized. In addition to a loss of dexterity, I lost much of the strength in my fingers. I find it very difficult to open up a bag of nuts or chips. I have to ask my kids to do it for me. I also have difficulty opening bottles and need to use a grip to give me added strength. Usually, I just give the bottle to someone else to open.

My hands feel more or less the same as they did last week (pudgy), and I do experience periodic tingling in my fingers and hands.

My grip is affected and I constantly feel like I am about to drop things. When I had to put eggs away in the refrigerator, I was so careful, lest I inadvertently drop an egg and have to clean up the gooey mess. (It is yucky, just thinking about it!)
My hands are definitely not so happy. I do not see an improvement from last week to this. I do not want to risk this becoming a permanent condition.

I would not be happy if my hands felt like this for the rest of my life.

That was really the deciding factor in finishing with the Taxol
My tongue is also still not happy, but it is better than it was. At least I feel that it is improving.
My feet are still bothering me, but I cannot tell what discomfort is coming from the inside. They are so swollen, and so very uncomfortable.

I saw my GP, about my cough and about my feet. He still thinks the cough is caused by acid reflux. He put me on a stronger anti-reflux medicine (Pantoprazole) for the next two weeks. I am wondering if the reflux will lessen when I get off the Taxol, and if that will affect my cough.

He also sent me for a chest x-ray, an EKG, and an Echol (which I already did for my oncologist). I think everything is normal.

The CT that I did before Pesach also appears to be normal. The areas of the bone tumors appear bigger, but this is also consistent with the extra bone density caused by the bone strengthening drugs (Zomera/Denosumab).

My markers are normal, so we are not worried.

I am doing an MRI in a few weeks and I will do some sort of full body scan so we have a baseline before starting with the new drug.

And, of course, that is the big question now: to which chemotherapy will I switch?

The two drugs my doctor is considering are Taxotere and Xeloda.

He told us to check them out on the internet. We did. Moshe spent most of today reading up on these drugs and some other derivatives of Taxol.

We did our homework.

We have lots of questions for when we meet with the oncologist tomorrow.



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Medical Update -- Second Opinion

"Why are you here?" asked the oncologist.

"My doctor wanted me to get an expert opinion," I responded.

"What nonsense; he's an expert in his own right," she muttered under her breath.

So, I explained that my doctor wanted someone with a fresh opinion, from another hospital, who would examine my case from an unbiased perspective.

That, she found tenable.

Her analysis does differ somewhat. She notes that:

1. all my markers have been rising steadily(not just the CA-125). That, coupled with my increasing pain, indicates, without doubt, that there is "progression of disease."

2. the CT report does not indicate that the cancer has been eliminated from my liver. After the second report, noting that the lesion is smaller, all following reports note "no change."

3. though there is no evidence of disease on the MRI, since there is no previous MRI with which to compare the results, they are inconclusive. Perhaps with this type of imaging, no evidence would have been apparent, even in the beginning.

4. there are lesions evident on the CT, that could be tumors.

She recomments switching treatment.

I expressed my concern that I have already "used up" one of the drugs that are appropriate for my cancer.

She assured me that there are still plenty of drugs left in the "arsenal" and that there is a lot of research these days about HER2 breast cancer.

The uncertainty is disconcerting.

But we are just talking about changing treatments.

Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Medical Update -- Doxil, Weight Loss and Herceptin

Started Doxil today.

We have not received approval yet, but are optimistic that our supplemental insurance will cover the treatments.

Meanwhile, a few of our many angels covered the cost of today's treatment.

So we wrote a check to the hospital and I received my first treatment.

At one point, I felt a tightness in my chest and midsection.  The nurse slowed down the pace of the IV. The pain lessened, though I still felt a tightness in my chest, in the area of my sternum.

The pressure did not increase when the nurse raised the rate again, but I still feel the tightness in my chest now (almost 7 hours later).

My next dose of Doxil is in a month.

My oncologist advised me not to expect to feel a difference in pain until then.  I hope he is wrong.

Lately, I have had to take half a Percocet at night, in order to alleviate the pain enough for me to fall asleep.  I wake up in the morning, earlier than I want, from pain.  I do not want to take a whole pill, because I do not want to be a zombie in the morning!  I am back to taking pain killers (2 Optalgin & 2 Algolysin) as soon as I get up, and every four hours thereafter. 

My appetite has not yet returned fully.  I only have a few more kilos left to lose (4.7 to be exact).  When I get down to 70 kilos, I will have to do something to make sure that I do not lose too much weight.  I always said:  If I have to eat a high calorie diet, I will just eat ice cream all day.  I might need to stock up soon....

I also need to do some sort of exercise.  I know I do not move enough during the day.  I lost all this weight, yet I still feel like I have to drag myself to go anywhere.

Good news for today:  My health fund approved coverage of Herceptin!
 


 
Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

A Pain-Free Window and Another Miserable Night (Medical Update)

Despite yesterday's crazy, drugged-up, day at the hospital,  I managed to rest for an hour before leaving to give my presentation in Elazar.

I am pleased to report that I felt great during my presentation, and the talk was excellent (if I do say so myself).  I spoke for about an hour and then opened the floor for questions.  Many women actively participated, asking pertinent and insightful questions. Even after the evening officially ended, women came up to ask additional questions and share some more personal thoughts.

I had prepared an outline for the evening's talk, to give to the organizers.  I usually do not plan out what I am going to say in such detail.  The outline really helped me to focus my presentation, and the messages I wished to convey.

Right after the presentation, on my way out, I experienced a sudden, new, intense pain, in my upper abdomen, on my right side.  It hurt me to breathe.  I could barely stand up straight.

It felt like a gas bubble was caught underneath my ribcage and I did not know how to relieve the pressure.  The pharmacist had warned me that the pain medications could cause constipation, which I understood to be at the root of this new pain.

As soon as I got home, I collapsed into bed.  Lying flat on my back was the least uncomfortable position.  Turning onto my side caused excruciating pain.  Two hours after I first fell asleep, I woke up from the pain. I could not fall back asleep, the pain was unbearable.

I wrote an email to my doctor then spent an hour in the bathroom.  I managed to relieve at least some of the pressure, but it was not fun to be up in the middle of the night, feeling so much discomfort.

I felt pretty miserable.  It took another hour or so to fall into a fitful sleep.  I did not sleep well.  The pain kept waking me up.  Each time, I had to concentrate on breathing slowly and shalowly, so I could relax my body enough to fall asleep.

When morning finally came around, I still hurt. 

I went to the doctor, who examined my abdomen and agreed with my evaluation.  He prescribed a laxative and gave me a shot for the pain. 

By the time I finished at the doctor's office, the pharmacy had already received my order for the new pain patches.  My mom picked up the new patches, which are 50 mg of Fenta (instead of 12), and I put one on right away. 

The new patch seems to be working.  I took one Percocet when I woke up this morning, but, besides that shot in the doctor's office, I have not needed any further supplements to the pain patch.

I still feel abdominal pain on my right side, but it is significantly less than this morning's pain.  I am cautiously optimistic that I will feel better tomorrow.

Tomorrow is my mother's last day of this visit.  It would be nice if we could do something fun....



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Medical Update (Doxil + Herceptin)

Between trying to manage my health and trying to plan a simcha (celebration), we are all at our wits end!

We have had lengthy discussions with three oncologists regarding my upcoming treatment.

My main oncologist recommends Doxil.*

The oncologist with whom we had a phone consultation made several recommendations, all involving Herceptin.

And our semi-local "second opinion" oncologist (who is in the Tel Aviv area), with whom Moshe always insists we meet before beginning any new treatment, agreed that I should switch to Doxil + Herceptin. 

She also said that, according to the current (and new) laws, both should be covered by our health fund.

We are not finding the health fund so forthcoming.  We are challenging the health fun.  At the same time, we are applying to our supplemental insurance for coverage of the Doxil.  The supplemental insurance won't cover Herceptin, because I took that drug before I signed up for coverage.

Meanwhile, my markers are shooting through the roof, but we know there is progression, so no one is getting all excited about that.... except Moshe and me.  And I am so scared about what has been going on inside my body since my last tests showed progression. 

We just cannot play this waiting game.  So, we are looking into funding the first few treatments on our own (with help, of course).

Once we get approved for funding, we should be reimbursed.... ("should" being the operative word)

Meanwhile, I am in pain, and sometimes the pain can get quite serious.

Like now, when my hip hurts so much that I cannot sit, or lie, comfortably, and my thigh muscle is having some sort of electric spasm!

My head is exploding with all the things I have to do tomorrow!!!

Our daughter's Bat Mitzvah is THIS SHABBAT!!

She will be reading ALL of Parhsat Balak at our women's Tefillah group! 

I am so proud of her!!!



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

* Doxil was developed in Israel, by Prof. Alberto (Avraham) Gabizon, who is currently the head of oncology at Sha'are Zedek.  (See # 69 and # 70 in this list of Gabizon's professional publications)

Medical Update -- fingernails and chest pain

OK, so I want to clarify something here: my concern over blue nails is not "cosmetic."

I have to ice my fingernails and toenails to keep them healthy. If they turn colors, that is NOT a good sign. If they are not well, they are in danger of infection or falling out or both. Not a pretty sight, and not something that a little nailpolish can fix.

Today, I met with my oncologist and asked him if the cold pack gloves and slippers were really necessary. He said they were mandatory (for all the reasons mentioned above).

They are not fun, but now that I know what to expect, I can deal with it a bit better.

That said, they are downright unpleasant.

On a happier note, I did not experience any chest pain from the Taxotere today. The drip was fairly slow, so that might have had something to do with it, but I do not know. In any case, I am cautiously optimistic that I will not experience any more pressure.

Chemo day was long today (9:40 am - 4:20 pm), but much better than last time!



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Medical Update: MRI and PET CT -- Results

It turns out, I tend to hear what I want to hear. 

Twice now, I thought tumors were gone, when they were not.

So, today, I sat with my oncologist, to understand what is going on in my body.

The bottom line: my cancer is under control.

I still have tumors in my brain, my lungs and all over my skeleton. 

Thank God, there is currently no evidence of disease in my liver. (At least I got that one right!)


Both the MRI and the PET CT show the tumors in my brain are continuing to shrink.  The shrinking may be a continued effect of the WBR (Whole Brain Radiation) or from the Tykerb/Lapatinib (which seems to cross the blood brain barrier) or both. 

The PET CT also confirmed that:

1. the tumors in my lungs, which are tiny, are stable
2. the tumors in my bones are stable
3. my liver is clear

Overall, the news is good.

Stable is good.

I still wish it would all go away.



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Medical Update -- Xeloda vx. Taxotere.... and the winner is....

We arrived a few minutes late... and there were no parking spaces... so we parked right in front of the hospital, in the spaces reserved for taxicabs. Who says there are no advantages to having cancer? With a tav neichut (handicapped parking permit) you can park almost anywhere!

We went in, paid and sat down to wait...

When my Second Opinion Oncologist (SOO) came out of her room, she was surprised to see us.

"I did not expect to see you;" she said softly.

When we said down in her office, she continued, "You did not need to come. I sent you an email..."

I explained that we, particularly Moshe, had more questions for her.

She repeated what we have heard before, both from my regular oncologist and others as well: there is no 'right or wrong' answer. Even though Taxotere is an excellent, and effective, chemotherapy, she does not like it so much because of its toxicity. She prefers Xeloda, which has much fewer side effects. That said, she understands why my oncologist recommended Taxotere, and agrees that it makes sense to try it.

She did suggest that if we do choose Taxotere, a full dose should be administered once every three weeks. My oncologist recommended that I receive the Taxotere weekly (1/3 of a dose per week), like I received the Taxol. Spread out, the side effects are less severe. My SOO ceded that the difference in efficacy was not that significant.

(She quoted a study that compared Taxol weekly, Taxol once every 3 weeks, Taxotere weekly, and Taxotere once every 3 weeks. She said that Taxol weekly was the most effective, followed by Taxotere once every 3 weeks.)

When our meeting ended, the SOO told us "there is no reason for you to come to me again; you have an excellent oncologist."

Then, almost as an afterthought, she added, "except, perhaps, after Tykerb. There are several new drugs that are coming out for HER2 cancers."

She suggested that when the time comes, her hospital might be involved in research that will be relevant to me.

As we left, she repeated that we can email her with questions and that we can rely on the judgement of my oncologist. Then, again, softly, she wondered that we had come.

I wondered if I had missed some sort of subtle message when we spoke on the phone. I do not think so. I just think she thought it unnecessary, and thought that was clear. I think she was being sensitive to the fact that it costs so much money to sit with her.

Nonetheless, as we walked out, Moshe expressed his relief at having gotten our SOO's opinion. He noted that had we not gone, he would have spent his nights, laying awake in bed, wondering if we had made a mistake about my treatment. When you look at it that way, we did not waste our time or money. It was worth it for his peace of mind.

And, just so we would take full advantage of being in Tel Aviv, we went out to China Li, a nice Chinese restaurant in Tel Aviv.



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

CT -- Medical Update

The CT report was short and to the point:  no change.

No change = stable = good news.



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Medical Update -- Side Effects of Taxol

Tired all the time

Split nails

Feet are tingly

Left foot is a little numb, especially around the toes and the ball of my foot

Menopause 10 years too soon, including HOT flashes and night sweats

Keep getting colds

Hair is falling out (slowly)


I could post about all of these things, but I thought I'd sum it up for now....



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA