roto rooter

Tomorrow will be the procedure on her trachea. There is a tumor there that is growing rapidly and making it very difficult for air to get into the left (I think) lobe of her lung, so they're going to cut part of it out tomorrow. The formal term for the procedure is "rigid bronchoscopy". Originally, they were planning to put a stint in, but apparently there is a danger of those migrating, and since it expands after insertion, a migrating, expanding stint in the throat seems, well, less than ideal. So, partial tumor removal only, and hopefully after that we'll see a big improvement in her ability to...breathe!

Second radiation went well today, but the pain is a lot worse.

First round of radiation done!

So Mom had her first radiation appointment this morning at 10am. She gets to bring in a CD of her choosing during each of these appointments, so that's kinda cool. She'll be there every Monday thru Friday this week and next, around that time, for a total of 10 radiation treatments. After that, we'll begin chemo. Also, this Wednesday she will have the stint inserted in her throat (or around there...), and later this afternoon she's meeting the surgeon, Dr. Park, who will perform that procedure. This Friday is a follow-up visit with Dr. Piatanza. Clancy comes Monday!

Radiation delayed until Monday

Okay so I'm working through my anger/frustration right now but, argh, because of some administrative glitch (they couldn't get in touch with the doctor to approve the films) they weren't able to do radiation today and have postponed until Monday at 10am.  Mom has reacted in a much more zen, calm manner than me, so I guess that's good.  More soon. 

Tattoos, needles, scalpels and radiation

Hi.

Mom's getting her first dose of radiation today, in about 20 minutes (at 3pm EST). At her planning appointment yesterday she got some small dots tattooed on her neck and shoulders, so that they can direct the radiation to the exact right spot and minimize damage to other tissue. For those who were horrified by this image, you'll be glad to hear that she doesn't have to wear a face mask--just a little chin strap.

Today's other big news is that they have decided to put a stint into her lung next Wednesday, to make her breathing easier. This is great news, as we were thinking that they would treat that with more radiation or just wait for the chemo to do its thing. Hooray for mechanical solutions. So the two things that are bothering her the most--her neck pain and her labored breathing--are being treated first.

She also has a new blood thinning medication (to treat the blood clot in her leg), that she must inject daily. Whee.

We are making plans to get out to New York again sometime soon. Anyone want to do a New York-San Francisco apartment trade?

Bone scan done - prep today - radiation tomorrow

So yesterday Mom had a bone scan at Sloan, which was yet another test to more carefully specify where they need to target radiation in her neck (these people are seriously THOROUGH!).  She also had a CT scan last Saturday to do this.  Hopefully all tests are done now - at least for the immediate future.  

They injected her with some radioactive isotrope thing yesterday at 1 and then at 5 they did the actual bone scan.  Today she will go back to Sloan for a preparatory appointment for the radiation that starts tomorrow.  They'll run a simulation with her, so she really knows what to expect.  You can check out the simulation program here.  The radiation appointments (as Jenn said, 10 in a row on business days) will occur at the same time every day, with the same technician.  So that's cool.  Even adults need consistency.

Katrin comes to town tomorrow to stay with Mom for I think 6 or 7 days, and then Clancy will be here March 3rd, so yayyyy!  I have a concert at my church job Sunday afternoon that Mom's gonna try to make, but regardless, we will still have our annual Oscar Night celebration. 

quick update

Janet's last day of work was today, so now she can focus her attention on her new full-time job.

This week, that will be: a bone scan on Wednesday, a planning session with the radiology oncologist (there's probably another "ogical" in there somewhere, forgive me) on Thursday, and her first radiation session on Friday. She'll continue to have radiation for 10 (business) days in a row, and then will commence chemotherapy, once every three weeks.

More soon!

Sloan Kettering = Rolls Royce of cancer care

We are, for the first time in a long time, hopeful and excited.

Even walking in the building this morning, it was apparent that this place ROCKED. Everyone we encountered at Sloan Kettering was caring and sweet, looked us in the eye and didn't for a second assume they knew anything about Mom's situation before really hearing about it.

So after checking her in and taking her vitals, they brought us back to the examining room (which had its own private bathroom and a nice round table with four chairs). Several minutes later we met Mom's doctor, Maria Pietanza. WE LOVE HER. She asked Mom about 300 questions, including asking for the whole history of her pain, where it hurts, when it hurts, etc. etc. She examined Mom, said she wanted to take a look at the films again, and then would come back so we could discuss treatment.

When she came back she said, "So the first thing we need to do is get rid of your neck pain."

YAY!

She told us that radiation is the best way to do that, so we made the first available appointment with Dr. Alice Ho, the radiation oncologist (that appt turned out to be Monday morning at 10am). Mom is also getting a CT scan tomorrow which will allow them to target the exact spot in the neck needing radiation - woo!

Pietanza told us that chemotherapy controls the disease, stops new metastases, shrinks tumors and prolongs survival. We like all of these things. Systemic treatment is needed and she wants to start with a combination of carbo-platinum, taxol, and avastin. She will also have supportive medication to bypass some of the side effects (and we will be seeking out fabulous scarves).

The radiation will go on for ten days at a time (once a day), after which we will begin chemo. So chemo should start in about two weeks. When it starts, the chemo will occur once every three weeks and normally goes for six cycles. After two cycles of chemo they will do a test to see if the "cocktail" is the right one for Mom.

This doc chucked her former pain meds, and now she's on:

• oxycodone for pain
  
• steroids to take down the swelling in the neck/kill the wheezing
  
• antibiotics to counteract the chemo's pending effects on the immune system (good cells and bad cells all go out together)
  
• anti-nausea pills
  
• cough-suppressant (major)
  
• and ya know...laxatives

After the doctor left, a nurse came in and talked to us, explained in detail which meds to take when, and said sternly "Nobody should be sitting at home in pain, so if you're in pain, tell us."

YEAH!

Today her head actually bopped to the music as we sat eating in PJ Clarke's, and tonight she has been sitting up, having impassioned conversations. SUPER CHATTY! The neck pain is markedly better and the wheezing has almost gone away altogether.