Last week Dennis had a few (6) headaches at the base of his skull on the right side, and blurry vision a few times in his left eye. I sent an email to his NP letting her know what was going on, and also suggested to include a brain scan the next time he has his CT. She responded indicating that he needs a MRI in the near future. I'm so thankful he is getting a MRI instead of a CT of the brain–I believe this will be much more accurate. Yesterday there was a message on the machine informing us that Dennis will have his MRI on January 11th. Hoping for good news!
Wishing everyone a Healthy New Year!
December 31, 2011
December 10, 2011
Scan Update
Great news--Dennis remains stable!
This latest report did not contain any measurements, except for the slight decrease in the fluid collection that has been there all along. I always compare the latest scan to the previous one to see exactly what the changes are. No such luck with this report. I'll have to conclude that stable, in this case, truly means stable. No growth, no reduction.
Dennis will continue taking Votrient, and return in 6 weeks for his labs.
For those interested I'll include the findings.
Chest:
Enlarged destructive lytic mass at T3 rib is again demonstrated on the right. Several sclerotic foci in the thoracic spine are again demonstrated. These appear overall similar. Bony expansion at T6 on the left is similar. A small right middle lobe nodule is stable. No new suspicious pulmonary nodules are present. There is no new significant axillary, mediastinal, or hilar adenopathy.
Abdomen/Pelvis:
The liver is normal.
The gallbladder is normal in appearance.
The spleen is normal.
The pancreas is unremarkable.
The rt adrenal is normal. Nodularity of the left adrenal gland is stable.
The rt kidney is within norrmal limits.
The left kidney has been removed. The left retroperitoneal low density fluid collection anterior to the left psoas muscle is again demonstrated. It measures 5.3 x 4.4 cm, slightly decreased from prior exam of 5.6 x 4.8 cm but overall similar.
The pelvic viscera are unremarkable. There is no evidence for bowel obstruction. Previously seen thickening near the ileocecal valve is not present and likely represented under distention as described previously.
A fat containing lipoma in the left gluteus muscle is similar measuring 3 cm.
There is no significant abdominal or pelvic adenopathy.
Extensive bony metastatic disease in the lumbar spine and pelvis is overall similar.
Impression:
1. Stable appearence in diffuse osseous metastatic disease. Stable subcentimeter right lung pulmonary nodules.
2. Retroperitoneal fluid collection slightly decreased in size overall similar to prior exam, which may again represent a lymphocele.
This latest report did not contain any measurements, except for the slight decrease in the fluid collection that has been there all along. I always compare the latest scan to the previous one to see exactly what the changes are. No such luck with this report. I'll have to conclude that stable, in this case, truly means stable. No growth, no reduction.
Dennis will continue taking Votrient, and return in 6 weeks for his labs.
For those interested I'll include the findings.
Chest:
Enlarged destructive lytic mass at T3 rib is again demonstrated on the right. Several sclerotic foci in the thoracic spine are again demonstrated. These appear overall similar. Bony expansion at T6 on the left is similar. A small right middle lobe nodule is stable. No new suspicious pulmonary nodules are present. There is no new significant axillary, mediastinal, or hilar adenopathy.
Abdomen/Pelvis:
The liver is normal.
The gallbladder is normal in appearance.
The spleen is normal.
The pancreas is unremarkable.
The rt adrenal is normal. Nodularity of the left adrenal gland is stable.
The rt kidney is within norrmal limits.
The left kidney has been removed. The left retroperitoneal low density fluid collection anterior to the left psoas muscle is again demonstrated. It measures 5.3 x 4.4 cm, slightly decreased from prior exam of 5.6 x 4.8 cm but overall similar.
The pelvic viscera are unremarkable. There is no evidence for bowel obstruction. Previously seen thickening near the ileocecal valve is not present and likely represented under distention as described previously.
A fat containing lipoma in the left gluteus muscle is similar measuring 3 cm.
There is no significant abdominal or pelvic adenopathy.
Extensive bony metastatic disease in the lumbar spine and pelvis is overall similar.
Impression:
1. Stable appearence in diffuse osseous metastatic disease. Stable subcentimeter right lung pulmonary nodules.
2. Retroperitoneal fluid collection slightly decreased in size overall similar to prior exam, which may again represent a lymphocele.
November 26, 2011
Morning project
This morning I pulled up almost all the vinyl tiles from the bathroom floor. The perimeter tiles were easy to remove since they were all smaller than 12 x 12, but the full size tiles, that was another story. It was hard to get the putty knife under the tile, and when I did it would break in little pieces. Hmmm... I certainly didn't want this to be an all day project! Off to the computer for a search on how to remove self adhesive tiles. A few sites listed using your iron and a wet washcloth to heat the adhesive on the back of the tile, allowing it to peel up easily with the putty knife. It worked great! I was done in 2 hours!
November 25, 2011
A quiet Thanksgiving!
This year I stayed in North Carolina for Thanksgiving instead of traveling to New York to be with family. It's not that I didn't want to spend the holiday with my family, I just didn't want to travel. Thanksgiving is the worst travel time. It's a 12 hour drive one way, and the traffic is awful. Unless you leave very early on Sunday morning, say around midnight or 1:00 am, it usually takes 14 to 15 hours to get home.
Dennis has been in NY since the 16th. He goes every year at this time to hunt. Haylee really wanted to go to NY for Thanksgiving, so she took a flight up on Tuesday the 22nd. That left me spending Thanksgiving with the cat and the dog!! Another reason to stay home--it's not cheap to board the pets.
I'm enjoying my peace and quiet! Yesterday morning I cleaned out the front closet, and while my Thanksgiving dinner was cooking I put the contents back in. Funny how you can get so much more done when you don't have to worry about someone watching everything you're trashing. Translation: my husband's a pack rat and wants to keep everything. I didn't go crazy and trash too much, only about half a garbage bag!
As always, I am thankful for family, friends, and Dennis' health being stable.
November 20, 2011
Finishing and Decorating!
I'm taking on a major project, finishing and decorating the house.
Dennis and I built an addition on our house over ten years ago to transform a 765 heated sq ft bungalow style home into a 1400 sq ft. 2 bedroom home with a study. Our septic is only for 2 bedrooms, so our guest room/study has no closet to keep it legal. There is sooo much that needs to be done, and I'm tired of all the unfinished projects! I still have a plywood floor in my bedroom, and the soffit and fascia have never been done. How sad is that?
My first project will be redecorating the main bathroom. Yesterday I purchased an unfinished mission style table to be used for towels/storage since my bathroom has no closet. Haylee really liked the table when she saw it. Personally, I think she wants it for her bedroom! I also looked at shower curtains and found a few that were okay, but nothing great. I'll look again today while we are out Christmas shopping for the nieces and nephews.
I'm really excited to get back to work on the house!! It's been way too long!
Dennis and I built an addition on our house over ten years ago to transform a 765 heated sq ft bungalow style home into a 1400 sq ft. 2 bedroom home with a study. Our septic is only for 2 bedrooms, so our guest room/study has no closet to keep it legal. There is sooo much that needs to be done, and I'm tired of all the unfinished projects! I still have a plywood floor in my bedroom, and the soffit and fascia have never been done. How sad is that?
My first project will be redecorating the main bathroom. Yesterday I purchased an unfinished mission style table to be used for towels/storage since my bathroom has no closet. Haylee really liked the table when she saw it. Personally, I think she wants it for her bedroom! I also looked at shower curtains and found a few that were okay, but nothing great. I'll look again today while we are out Christmas shopping for the nieces and nephews.
I'm really excited to get back to work on the house!! It's been way too long!
November 7, 2011
Time Change... Ugh!
Up at 3:30 this morning!
I love that it will now be lighter in the morning, but this time change really messes me up. I usually wake up at 4:30 - 5:00, so I knew I would be awake around 3:30 - 4:00. I tried to go back to sleep, but that didn't happen, so at 4:15 I got up and made coffee. I love how people say you get an extra hour of sleep. Yeah, only if you actually fall back asleep!!
I hope it doesn't take too long to get back on track!
October 30, 2011
College Campus Tours
My daughter, Haylee, is a junior in high school, and we are now starting to tour college campuses. Yesterday we attended UNC Charlotte's open house. The campus is beautiful, and Haylee really liked it. I also think she likes the idea of living near/in a big city. Before touring UNCC her number one choice leaned towards ECU, which we will be touring on November 12th. Now she's not so sure about ECU. She's also interested in UNC Wilmington, which we will tour on December 3rd.
Yesterday she kept saying she didn't know if she wanted to be a Pirate, a Seahawk, or a 49er! After she tours the other campuses I hope her choice will be easier!
Yesterday she kept saying she didn't know if she wanted to be a Pirate, a Seahawk, or a 49er! After she tours the other campuses I hope her choice will be easier!
October 25, 2011
Normal Labs
Dennis had his labs done yesterday and the results are normal. I did notice 2 items flagged with a "L". RBC was 4.40 (range 4.50-5.90), and Absolute Lymphs 1.1 (range 1.5-5.0). I'll have to check Google University to see what these numbers mean. More good news, Dennis has gained 6 pounds! It must have been all the brownies he ate while at his moms this past week.
His next CT scan will be on December 2, with the results, labs, and Zometa infusion on December 5th. I'm glad there will be one more scan this year since the start of my insurance year will change from March 1st to January 1st. Unfortunately, this means I'm screwed out of 2 months since I hit my out of pocket maximum. We will have an information session about our insurance today, and I have a few questions about our prescription drug plan. Needless to say my monthly insurance premium will be increasing AGAIN, along with my prescriptions and co-pays!
Insurance - it's a love / hate relationship!
His next CT scan will be on December 2, with the results, labs, and Zometa infusion on December 5th. I'm glad there will be one more scan this year since the start of my insurance year will change from March 1st to January 1st. Unfortunately, this means I'm screwed out of 2 months since I hit my out of pocket maximum. We will have an information session about our insurance today, and I have a few questions about our prescription drug plan. Needless to say my monthly insurance premium will be increasing AGAIN, along with my prescriptions and co-pays!
Insurance - it's a love / hate relationship!
October 9, 2011
Grandfather Mountain
Yesterday was absolutely gorgeous out, and I decided to take a trip to the mountains to view the fall foliage. The leaves are just starting to peak in the higher elevations. I traveled north on 421 to Boone, picked up 221/321 to Blowing Rock, and hopped on the Blue Ridge Parkway towards Grandfather Mountain, which was my final destination.
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| Panoramic view from the Blue Ridge Parkway before the Linn Cove Viaduct. |
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| Viaduct straight ahead! |
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| View from Grandfather Mountain |
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| View of the mile high swinging bridge on Grandfather Mountain. |
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| Trail from the lower parking lot to the swinging bridge. |
It was such a beautiful drive I might have to do it again next week during peak!!!
October 2, 2011
2011 Coleman Classic
This year our Coleman Classic Golf Tournament was held on Sunday, September 25th. We had thirty-five golfers participate, and about fifty people who came out and purchased a plate of food for our cause. It was a great time, and we were lucky the weather cooperated. It didn't rain until 8:30 that evening, right when we were leaving.
So, let's get to our final dollar amount. Drum roll please...
We raised $1600 for kidney cancer research!! How awesome is that?!
So, let's get to our final dollar amount. Drum roll please...
We raised $1600 for kidney cancer research!! How awesome is that?!
All proceeds from our fundraiser will be donated this week to the UNC Cancer Center, for Kidney Cancer Research.
Thanks to all who donated!
September 18, 2011
Searching...
for direction.
There's a lot going on in my life at the moment, and it's a bit overwhelming.
Taking it one day at a time...
There's a lot going on in my life at the moment, and it's a bit overwhelming.
Taking it one day at a time...
September 15, 2011
Staying Busy!
Last month I took a trip to NY to pick up Haylee. On the return trip we planned a few stops. We went to Philly, and then to DC, returning home the day before she went back to school. We were around the DC area when the earthquake hit, but we were in the car and never felt it. I was a bit disappointed that I missed it.
I continue to run, but it's not consistent. My last run was on Saturday. The days are shorter now, and I no longer run in the morning before work since it's dark outside. The temperatures are cooling down, so I will be able to run after work, and not overheat.
Dennis had his scans on September, 9th and we saw the nurse on September, 12th for the results. Dennis remains stable. He will return in 6 weeks for labs, and return 6 weeks after that for scans.
The 2011 Coleman Classic Golf Tournament will be held on September, 25th. This is our Kidney Cancer Research fundraiser with the proceeds given to the UNC Cancer Center. I hope we have great weather that day, and lots of people!!
August 14, 2011
Couch to 5k - week 2
Yesterday I did half of my week 2 - second workout before it started to rain. I went back out later that morning to finish, but in the process I aggravated something in my calf. I massaged my leg, trying to work out whatever it is, and will try again tomorrow morning. While out today I stopped by the library and took out a book on running. I need to read about form, and what I should be doing to avoid injury. The last thing I need right now is to get hurt.
July 31, 2011
Couch to 5k
I'm so over how sedentary I've become!!! Today I have officially started Couch to 5k, with the goal of running my first 5k in October. Besides ending my couch potato lifestyle -- this will help me firm up and increase my overall health. Sounds like a win-win to me.
I ran across this article by Mary Meehan today and thought it was a good fit with todays entry. Enjoy!
I ran across this article by Mary Meehan today and thought it was a good fit with todays entry. Enjoy!
July 19, 2011
July 17, 2011
Day trip to Wrightsville Beach
As I watched the weather during the week I decided we were going to Wrightsville Beach on Saturday. The beach is only a 2 1/2 hour drive from my house, so it's a great day trip destination. Parking can be a nightmare so you need to arrive early. To get a good parking spot I suggest you arrive around 9:00 am. Our timing was perfect. We landed a great spot in the parking area near Johnnie Mercer's pier.
It was an absolutely gorgeous day! You couldn't ask for better weather. The temperature was in the high 80's with low humidity, and winds at 10 mph. The ocean was rough, and a little cool when we arrived, but had calmed down, and became warmer during the day. The waves were nice, which was an added bonus for the surf event going on down the beach from where we were.
After 5 hours of sun and surf, it was time to go. We had purchased a day parking pass, so as we were leaving we gave the pass to the person who was waiting for our parking spot. It felt good to make someone's day a little nicer.
I'm already looking forward to our next beach trip!
It was an absolutely gorgeous day! You couldn't ask for better weather. The temperature was in the high 80's with low humidity, and winds at 10 mph. The ocean was rough, and a little cool when we arrived, but had calmed down, and became warmer during the day. The waves were nice, which was an added bonus for the surf event going on down the beach from where we were.
After 5 hours of sun and surf, it was time to go. We had purchased a day parking pass, so as we were leaving we gave the pass to the person who was waiting for our parking spot. It felt good to make someone's day a little nicer.
I'm already looking forward to our next beach trip!
July 9, 2011
Scan Update
Good news. Dennis remains stable with a slight improvement (-.3 cm) in his third right rib and left pelvis, and his labs were normal. He will continue taking Votrient and go back in 4 weeks for lab work. Dennis was having issues with vomiting and diarrhea, so he had his medication reduced to 600 mg. I hope and pray the drug continues to work at a reduced dosage. It has only been a few weeks since this reduction, but so far so good. Dennis returns for lab work on August 1st.
June 12, 2011
Airport parking
Friday afternoon I had to pick up my Aunt Sherry at the airport. I arrived early and went through the hourly parking line to get my parking ticket. I grabbed the ticket from the ticket dispenser, and placed it in the dashboard gauges area as I always do every time I get a ticket for a parking garage. This works great in my car, but not so much in Dennis' truck. As soon as I released the ticket I watched it disappear. CRAP! (not my exact words) I tried to pull the plastic dashboard out enough to get my fingers in there and feel around for the ticket. No luck! I couldn't feel the ticket, and was afraid to pull too much on the dash in fear of breaking it! Now what? I explained to one of the guards at the door what happened and asked what my options were. He was a very nice gentleman, and after showing me the flight board to check on the planes arrival time, and pointing out the area where my aunt would be arriving from, he suggested I check at the information desk. The ladies at the information desk put me in touch with the parking department, and I explained what happened. Since I didn't have my ticket I was informed I would be charged a lost ticket fee of $17. The normal parking charge is a dollar an hour, and I was wasn't even going to be there an hour. I was not a happy camper. I had about 5 minutes before the flight arrived, so I went back out to the truck to try again. I felt up under the steering wheel area, but there was no way I would be able to reach up very far. I pulled again on the plastic dashboard and was able to get a few fingers in there and feel around, the whole time hoping the dash wasn't going to break, or squish my fingers if I lost my grip. I finally felt the ticket, pulled the dash out a little more to get a grip on it, and pulled it out. Whew, what a relief! My fingers were a bit sore, and I did have an indent mark for about a half hour from pulling on the dash, but hey, parking only cost a dollar!!!
June 11, 2011
I'm still employed!
Yesterday truly sucked at work. It was awful hearing throughout the day who they let go. Unfortunately, it seems they are releasing long time employees and that doesn't sit well with me since I've been there for twenty years. I know of at least sixteen they let go. Two were from my department. I also heard of three people who put in their notice. Since I wasn't very busy yesterday I took the time to go through my work area and box up all my stuff. There wasn't much, everything fit in a 11 x 17 box. When my time comes it will be a fast exit!
June 10, 2011
Layoffs...
Here we go again!!
It's been 7 months or so since the last round of layoffs. Layoffs started yesterday, with more coming today. I heard about forty people will lose their job.
Work's going to SUCK today!!!
June 5, 2011
Hummingbirds
Last week I enjoyed watching the hummingbirds in our yard, and was lucky enough to get a few pictures. I stood very close to the feeder and use the zoom just to get these shots. Wow! For such a small bird those wings sure do make a lot of noise. I could always hear the birds before I could see them!
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| Ahhh... the feeder all to myself. |
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| Hey! Where did you come from? |
May 29, 2011
Lab Reports
Dennis' labs were normal, and he will continue to take Votrient at full dose. After the awful side effects he had last weekend there was talk of possibly lowering his dosage. This was the first major episode of side effects since being on the medication. Dennis didn't feel too well on Saturday and skipped his meds Saturday night. He wasn't any better on Sunday, but did take his medication. Monday morning he couldn't eat, and couldn't keep water down. It was awful to see him so sick and not be able to help. He forced down water to stay hydrated, and by the end of the day was able to eat a little, very little. Dennis was able to eat more on Tuesday, and by Wednesday he was back to feeling "normal". The new "normal", you know, post cancer diagnosis normal. If Dennis has another episode like that, he's to call the nurse immediately.
Another area of concern is his eating. When he's on the meds food doesn't taste good and he doesn't eat enough. He also has a "full" feeling even when he's not full. He had the same issue with Nexevar. Dennis needs to pack on a few pounds. Well, more than a few. At this last checkup his weight was 148. Being sick right before his doctor visit didn't help, as I'm sure he lost 5 pounds over those few days! The nurse suggested making milkshakes using ensure or boost as the liquid. As long as it's chocolate, it shouldn't be a problem. Chocolate is his favorite food group!!!
Another area of concern is his eating. When he's on the meds food doesn't taste good and he doesn't eat enough. He also has a "full" feeling even when he's not full. He had the same issue with Nexevar. Dennis needs to pack on a few pounds. Well, more than a few. At this last checkup his weight was 148. Being sick right before his doctor visit didn't help, as I'm sure he lost 5 pounds over those few days! The nurse suggested making milkshakes using ensure or boost as the liquid. As long as it's chocolate, it shouldn't be a problem. Chocolate is his favorite food group!!!
Dennis' next CT scan, oncologist visit, and Zometa infusion will be in 6 weeks, on July 7th. We're certainly hoping and praying to hear more good news about shrinking spots!!!
As you enjoy this holiday weekend, please take the time to reflect on its true meaning. Memorial weekend is not about sales, a day off of work, or the start of summer. It's about those that made the ultimate sacrifice for our freedom.
May 15, 2011
Abstracts...
Sometimes I wonder about abstracts, or maybe I just don't understand them. A few days ago I read an abstract, Early experience with targeted therapy and dendritic cell vaccine in metastatic renal cell carcinoma after nephrectomy. Maybe it's just me, but I found the whole study questionable. For starters, the study only involved 2 male patients with metastatic RCC, and there was no mention as to where their metastatic disease was. How can only 2 people in a study be conclusive?
From the abstract:
Sunitinib (50 mg per day) was given for 4 weeks, followed by radical nephrectomy after two weeks. DC vaccine was initiated immediately after surgery and repeated monthly. Sunitinib was restarted daily after 2 to 3 weeks of surgery with a 7-day interval every 4 weeks.
Results: Follow-up in these patients at 9 and 10 months demonstrated a stable disease in both, as shown by imaging and clinical findings, with no further treatment required.
Conclusion: The immune response obtained with DC vaccine combined with the antiangiogenic effect of sunitinib and the potential benefits of cytoreductive nephrectomy in advanced disease could represent a new option in the treatment of metastatic RCC. Further prospective trials are needed not only to elucidate the ideal dosing and schedule, but also to better define the proof-of-concept proposed in this report and its role in clinical practice.
The abstract never mentions the length of the study. How long were they on Sunitinib after the radical nephrectomy? It only mentions they had a 7 day break every 4 weeks. The DC vaccine was given monthly. For how many months? The follow-up was at 9 and 10 months. They both were stable, with no further treatment required. And... Sorry, but this abstract is lacking information.
I love the last line in the conclusion. Further prospective trials are needed not only to elucidate the ideal dosing and schedule, but also to better define the proof-of-concept proposed in this report and its role in clinical practice.
Obviously!!
Update: I found the original abstract, and it did answer a few of my questions. Here's the link to the original.
From the abstract:
Sunitinib (50 mg per day) was given for 4 weeks, followed by radical nephrectomy after two weeks. DC vaccine was initiated immediately after surgery and repeated monthly. Sunitinib was restarted daily after 2 to 3 weeks of surgery with a 7-day interval every 4 weeks.
Results: Follow-up in these patients at 9 and 10 months demonstrated a stable disease in both, as shown by imaging and clinical findings, with no further treatment required.
Conclusion: The immune response obtained with DC vaccine combined with the antiangiogenic effect of sunitinib and the potential benefits of cytoreductive nephrectomy in advanced disease could represent a new option in the treatment of metastatic RCC. Further prospective trials are needed not only to elucidate the ideal dosing and schedule, but also to better define the proof-of-concept proposed in this report and its role in clinical practice.
The abstract never mentions the length of the study. How long were they on Sunitinib after the radical nephrectomy? It only mentions they had a 7 day break every 4 weeks. The DC vaccine was given monthly. For how many months? The follow-up was at 9 and 10 months. They both were stable, with no further treatment required. And... Sorry, but this abstract is lacking information.
I love the last line in the conclusion. Further prospective trials are needed not only to elucidate the ideal dosing and schedule, but also to better define the proof-of-concept proposed in this report and its role in clinical practice.
Obviously!!
Update: I found the original abstract, and it did answer a few of my questions. Here's the link to the original.
Dick's Last Resort
For those of you who can't read the hats - mine says I'm not wearing any panties, and Dennis' says I'm wearing her thong with an arrow pointing to me. Too funny!!!
May 14, 2011
Scan Report
The April report showed shrinkage in a few areas. Chest: There is improvement of the RUL subpleural groundglass opacity, measuring 6 mm, previously 9 mm. The 4 mm RLL subpleural nodule was unchanged. Bones: The right third rib measures 4.8 cm x 2.5 cm, previously 5.3 cm x 3.4 cm. The left pelvic lesion measures 4 to 3 x 2.2, previously 4.1 cm x 3 cm. The right 3rd rib and left pelvic reference lesions exhibit interval decrease of its soft tissue tumor component. Impression: 1. Osseous metastatis disease in the right third rib and the left pelvis which shows improvement compared to prior study. 2. Interval improvement of RUL ground glass opacity.
Okay, so there is shrinkage as listed, BUT what about the other areas of bone. No news about the 6th rib and no news on T7 or T8. It's a small improvement, and I consider his cancer stable with this latest report. Honestly, I was hoping for a better response from this drug. Hopefully, the next report shows even more shrinkage!
The side effects from this drug are mild, but he still has issues with eating. Food doesn't taste good, and sometimes just the smell makes it were he doesn't want to eat. He had the same thing happen when he was on Nexavar. I just hope he doesn't lose as much weight as he did when he was on that drug.
Okay, so there is shrinkage as listed, BUT what about the other areas of bone. No news about the 6th rib and no news on T7 or T8. It's a small improvement, and I consider his cancer stable with this latest report. Honestly, I was hoping for a better response from this drug. Hopefully, the next report shows even more shrinkage!
The side effects from this drug are mild, but he still has issues with eating. Food doesn't taste good, and sometimes just the smell makes it were he doesn't want to eat. He had the same thing happen when he was on Nexavar. I just hope he doesn't lose as much weight as he did when he was on that drug.
March 27, 2011
The colors of spring
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This past week the weather was beautiful with temperatures reaching into the eighties. Everywhere I look there are splashes of color; purple wisteria, yellow daffodils, and white dogwood blossoms to name a few. I have really enjoyed watching the trees come to life this week as the buds have started to open, and everything is turning green, and I mean everything. Lots of pollen in the air leaving a greenish yellow film everywhere. Last weekend I finally put my bird feeder up opting for a spot near the bay window, so I could watch them from where I sit in the living room. It took the birds a few days to find it, and they are now happily munching on seeds. Well, I thought it was a good spot. Yesterday I moved the feeder to the side yard due to the unwanted bird #@*! on items in my front yard, mainly my car and the plastic lawn furniture. I hope this solves the problem. If not, the feeder will be moved again. Unfortunately, our wonderful spring weather has disappeared. Today will be rainy with temperatures in the mid thirties. It was nice while it lasted, and I'm looking forward to those eighty degree temperatures returning soon.
March 16, 2011
Awesome...
Someone pinch me! I can't believe the drug company will be suppling us the Votrient for free. Thank you to Rachel, the financial assistance gal at the hospital. Dr. Rathmell, who might have had some pull with the drug company, and GSK!!!! You're Awesome!!! The drug will arrive tomorrow, so Dennis will only miss one day.
Dennis had labs on Monday, which were normal, and a visit with Mary, our NP. Boy, was she mad when we told her what was going on. She mentioned something about gouging out someone's eyes at the insurance company, but I told her she had to get in line behind me! Patricia, one of the trial nurses we had when Dennis was first diagnosed, stopped by to say hello as well. She's soooo nice, and always makes time for us.
I'm still waiting to hear about what happened with my insurance. We were offered two plans - gold and silver. We were told the gold plan was the same coverage we had. It's bad enough the deductible went up, and the cost increased about $100 a month, but to find out it didn't cover a drug anymore just about put me over the edge. Kathy from HR is doing her best to find out what happened, and has CC me on the emails to the insurance company. I hope we hear something soon, and that no one else has to go through this.
Dennis had labs on Monday, which were normal, and a visit with Mary, our NP. Boy, was she mad when we told her what was going on. She mentioned something about gouging out someone's eyes at the insurance company, but I told her she had to get in line behind me! Patricia, one of the trial nurses we had when Dennis was first diagnosed, stopped by to say hello as well. She's soooo nice, and always makes time for us.
I'm still waiting to hear about what happened with my insurance. We were offered two plans - gold and silver. We were told the gold plan was the same coverage we had. It's bad enough the deductible went up, and the cost increased about $100 a month, but to find out it didn't cover a drug anymore just about put me over the edge. Kathy from HR is doing her best to find out what happened, and has CC me on the emails to the insurance company. I hope we hear something soon, and that no one else has to go through this.
March 12, 2011
A place for me
I've started this blog so I'd have a place for my thoughts and feelings as our family deals with kidney cancer. We have a caringbridge page for Dennis that's used to update our family and friends on his condition. If you want, you can visit his page by clicking here. I write updates about his health, his treatments, when he has scans, side effects, etc. Most times I don't include my true feelings because I don't want to use his site as place for me to whine, vent and complain. It's not about me, it's about Dennis. Also, I don't want our family and friends to worry about me due to something I write on his site, and I know there's a few who will. Honestly, I don't want to deal with the phone calls and prying questions which will result from me offering too much info.
At the moment we're still waiting for information about assistance for Votrient. The last we heard was talk of 50% or free. Uh, free please! We need to know soon since Dennis only has enough pills to last through Tuesday. He has labs Monday so I hope to hear something during the visit.
I finally talked with someone in HR Thursday afternoon. She knew I was upset since I was on the verge of tears, but thankfully I kept it together. She talked with someone from the insurance company but she didn't sound hopeful. Unfortunately, I probably wont hear anything different than what I already know. To make matters worse there's another kidney cancer drug that's on the tier 4 list, Afinitor. I'm so pissed off about this. If we can't get assistance for either Votrient or Afinitor, that's two drugs he wont get to take unless it's in a trial. Sutent is a tier 3 so I'm guessing that would be the next drug if we can't get assistance.
Sucks to learn you're underinsured!
At the moment we're still waiting for information about assistance for Votrient. The last we heard was talk of 50% or free. Uh, free please! We need to know soon since Dennis only has enough pills to last through Tuesday. He has labs Monday so I hope to hear something during the visit.
I finally talked with someone in HR Thursday afternoon. She knew I was upset since I was on the verge of tears, but thankfully I kept it together. She talked with someone from the insurance company but she didn't sound hopeful. Unfortunately, I probably wont hear anything different than what I already know. To make matters worse there's another kidney cancer drug that's on the tier 4 list, Afinitor. I'm so pissed off about this. If we can't get assistance for either Votrient or Afinitor, that's two drugs he wont get to take unless it's in a trial. Sutent is a tier 3 so I'm guessing that would be the next drug if we can't get assistance.
Sucks to learn you're underinsured!
March 10, 2011
It's always something!!!
Tuesday night I received a phone call from the specialty pharmacy billing department. They called to question my cost of the next shipment of Votrient, which would be $6059.18. My calendar year benefits were just renewed in March so I thought maybe it had not gone through yet. My plan is 10/40/60 so for the last two months I've only had to pay $60 for each refill of Votrient. We put the drug on hold until I could see what was going on with the insurance because if they send it I'm responsible for the full price on the bill. After I got off the phone I looked up my benefits on line and saw this:
Specialty Pharmacy Drugs: Your co-payment is 100% of the medications total cost.
I guess this applies to tier 4 drugs, since Votrient is on that list. It would have been nice to know this information. We were told the insurance would be the same as what we had. Apparently it's not! I guess the plan should have read 10/40/60/We're not paying for that one. To make matters worse I have a $100 deductible and they added that onto the cost. Excuse me! How about adding that to something you'll actually cover. I did send an email to HR asking if they recalled any information about this change in our prescription plan.
Anyhow, I went on line and downloaded the GSK co-pay help form and faxed it along with my 2010 tax return yesterday. I should hear something today about what kind of help we can receive.
It's always something!
Specialty Pharmacy Drugs: Your co-payment is 100% of the medications total cost.
I guess this applies to tier 4 drugs, since Votrient is on that list. It would have been nice to know this information. We were told the insurance would be the same as what we had. Apparently it's not! I guess the plan should have read 10/40/60/We're not paying for that one. To make matters worse I have a $100 deductible and they added that onto the cost. Excuse me! How about adding that to something you'll actually cover. I did send an email to HR asking if they recalled any information about this change in our prescription plan.
Anyhow, I went on line and downloaded the GSK co-pay help form and faxed it along with my 2010 tax return yesterday. I should hear something today about what kind of help we can receive.
It's always something!
March 8, 2011
Getting up to speed
Awesome game! UNC kicked Dukes butt 81 - 67 and won the ACC regular season title!! Woooo, hooo!
OK, back to Dennis' cancer journey...
On June 17, 2009 Dennis had a follow-up with Dr. Esther, and a consultation with Dr. Rosenmen to discuss having radiation to his femur. Well, they had an opening and started radiation that day. The following day we met with Dr. Rathmell and discussed how Dennis will proceed with treatment. Since Dennis was having radiation he had to delay the start of his systemic treatment, Nexavar, until after the radiation was complete. Also, after his last radiation treatment he will start his first intravenous infusion of Zometa. Zometa is a bisphosphonate that is used to reduce or delay complications from bone metastases or bone lesions.
June 25th was the last radiation treatment, and the first Zometa infusion. All was well until the next day...
We were leaving for New York and Dennis was sick. The Zometa gave him flu like symptoms, and somehow he pinched a nerve in his leg causing him a lot of pain. He was absolutely miserable. We're talking capital M miserable. It was so bad that I told him he needed to not make everyone else miserable for the 12+ hour ride. He ate pain pills like they were candy, and slept most of the trip. Thank you Lord!!
Dennis started Nexavar on July 6th. My insurance at the time was 30/70 and we still would not be able to afford the cost of the medication. I wrote a hardship letter and we were accepted to receive the Nexavar paying only 5% of the 30% I would normally have had to pay. I was floored by the cost of the cancer drug. I can't imagine having to decline treatment because you can't afford it. Thank God some drug companies offer no cost, or a reduced cost of their drugs. I have no idea how many patients are accepted into these programs, but at least for some it's an option and there's hope. Dennis had a few side effects from the drug; High blood pressure, weight loss, diarrhea, and tender feet. He was very lucky to not get HFS. Hand Foot Syndrome (HFS) is when you develop blisters and sores on your hands and feet. I've read about others having this, and to the extreme. Some couldn't even walk it was so bad.
Dennis continued having CT scans, and a Zometa infusion every 2 months. He also had another bone scan in August. All reports came back stable. He continued taking Nexavar until about the 3rd week in February of 2010. The medication was stopped due to his hernia surgery scheduled for March 1st. The hernia surgery went well, he healed nicely, and after his visit with the oncologist on March 22, 2010 he was aloud a hiatus from the systemic treatment. Taking a break from treatment was needed. Dennis lost quite a bit of weight while on the drug, and honestly, he looked awful. That night I read over his report and saw the T8 was stable in appearance. WHAT!!! This is why I ask for the reports, so I can go over them at home and compare the information from the previous reports. I can't stress enough how important it is to ask for copies of the reports. Of course the T8 was not mentioned on any other scan so I questioned it. The Dr. went back through Dennis' scans and did find the small spot on his vertebra and explained that some spots are so small that not every radiologist points out every spot when they write their findings.
The next scheduled CT in May included having his head scanned. He had a few really bad headaches, and of course the first thing I thought was it had spread to his brain. It's amazing with even the smallest ache and pain my mind thinks the worst. The scan revealed he does in fact have a brain, and it appeared normal. Are you sure? Awesome news! One less thing to worry about. No spread to his brain. He also had another bone scan with the results being stable. He was aloud to continue his hiatus from systemic treatment.
Dennis' July scan revealed another spot on his vertebra, this one at T7. It was listed as increased in size from prior study, but in the impression area it was listed as new. ?? Dennis was also having increased pain in one of bone mets. It was recommended that he have radiation to that area. While having radiation to the rib, the radiologist also zapped the T7 spot even though it wasn't bothering him. The radiation worked on the rib pain.
The September scan showed slight growth in his bone mets and in the lung mets. The growth was in millimeters and Dennis asked if he could continue to stay off the meds. The Dr. agreed, and Dennis was allowed to extend his hiatus for another 2 months.
December's scan showed more growth. The report impression was: 1. Interval development of innumerable new round densities throughout the axial skeleton which represent progression of osseous metastatic disease. Focal masses in the left pelvis and right anterior third rib have shown mild interval growth. 2. Minimal increased size of right upper lobe and right lower lobe nodules. Dr. Rathmell discussed Votrient (pazopanib) as the next treatment drug for Dennis. Of course he was thrilled to start treatment again, NOT. Since it was deer season Dennis decided to start the drug in January. He was afraid of the side effects, so wanted to wait until the season ended. He started Votrient on January 15th. So far the side effects have been mild compared to Nexavar. His blood pressure increased so he went back on his second BP med, his hair is starting to come in white, and he has had vomiting. Although, he has now started to take anti nausea medication when he takes the Votrient, and that seems to be working.
On February 14th he went and had labs done, and had his infusion of Zometa. We met with a NP who was very nice. Dennis and I really liked her, and we will see her again on March 14th when he has his labs done again. We were lucky to get the Zen infusion area. It's the area that has less traffic and its very quiet.
We certainly hope this drug will shrink the tumors and help with the bone mets, too. Dennis has his next scan in April, and we're hoping for an awesome report!
Well, you're up to speed on the cancer journey...
OK, back to Dennis' cancer journey...
On June 17, 2009 Dennis had a follow-up with Dr. Esther, and a consultation with Dr. Rosenmen to discuss having radiation to his femur. Well, they had an opening and started radiation that day. The following day we met with Dr. Rathmell and discussed how Dennis will proceed with treatment. Since Dennis was having radiation he had to delay the start of his systemic treatment, Nexavar, until after the radiation was complete. Also, after his last radiation treatment he will start his first intravenous infusion of Zometa. Zometa is a bisphosphonate that is used to reduce or delay complications from bone metastases or bone lesions.
June 25th was the last radiation treatment, and the first Zometa infusion. All was well until the next day...
We were leaving for New York and Dennis was sick. The Zometa gave him flu like symptoms, and somehow he pinched a nerve in his leg causing him a lot of pain. He was absolutely miserable. We're talking capital M miserable. It was so bad that I told him he needed to not make everyone else miserable for the 12+ hour ride. He ate pain pills like they were candy, and slept most of the trip. Thank you Lord!!
Dennis started Nexavar on July 6th. My insurance at the time was 30/70 and we still would not be able to afford the cost of the medication. I wrote a hardship letter and we were accepted to receive the Nexavar paying only 5% of the 30% I would normally have had to pay. I was floored by the cost of the cancer drug. I can't imagine having to decline treatment because you can't afford it. Thank God some drug companies offer no cost, or a reduced cost of their drugs. I have no idea how many patients are accepted into these programs, but at least for some it's an option and there's hope. Dennis had a few side effects from the drug; High blood pressure, weight loss, diarrhea, and tender feet. He was very lucky to not get HFS. Hand Foot Syndrome (HFS) is when you develop blisters and sores on your hands and feet. I've read about others having this, and to the extreme. Some couldn't even walk it was so bad.
Dennis continued having CT scans, and a Zometa infusion every 2 months. He also had another bone scan in August. All reports came back stable. He continued taking Nexavar until about the 3rd week in February of 2010. The medication was stopped due to his hernia surgery scheduled for March 1st. The hernia surgery went well, he healed nicely, and after his visit with the oncologist on March 22, 2010 he was aloud a hiatus from the systemic treatment. Taking a break from treatment was needed. Dennis lost quite a bit of weight while on the drug, and honestly, he looked awful. That night I read over his report and saw the T8 was stable in appearance. WHAT!!! This is why I ask for the reports, so I can go over them at home and compare the information from the previous reports. I can't stress enough how important it is to ask for copies of the reports. Of course the T8 was not mentioned on any other scan so I questioned it. The Dr. went back through Dennis' scans and did find the small spot on his vertebra and explained that some spots are so small that not every radiologist points out every spot when they write their findings.
The next scheduled CT in May included having his head scanned. He had a few really bad headaches, and of course the first thing I thought was it had spread to his brain. It's amazing with even the smallest ache and pain my mind thinks the worst. The scan revealed he does in fact have a brain, and it appeared normal. Are you sure? Awesome news! One less thing to worry about. No spread to his brain. He also had another bone scan with the results being stable. He was aloud to continue his hiatus from systemic treatment.
Dennis' July scan revealed another spot on his vertebra, this one at T7. It was listed as increased in size from prior study, but in the impression area it was listed as new. ?? Dennis was also having increased pain in one of bone mets. It was recommended that he have radiation to that area. While having radiation to the rib, the radiologist also zapped the T7 spot even though it wasn't bothering him. The radiation worked on the rib pain.
The September scan showed slight growth in his bone mets and in the lung mets. The growth was in millimeters and Dennis asked if he could continue to stay off the meds. The Dr. agreed, and Dennis was allowed to extend his hiatus for another 2 months.
December's scan showed more growth. The report impression was: 1. Interval development of innumerable new round densities throughout the axial skeleton which represent progression of osseous metastatic disease. Focal masses in the left pelvis and right anterior third rib have shown mild interval growth. 2. Minimal increased size of right upper lobe and right lower lobe nodules. Dr. Rathmell discussed Votrient (pazopanib) as the next treatment drug for Dennis. Of course he was thrilled to start treatment again, NOT. Since it was deer season Dennis decided to start the drug in January. He was afraid of the side effects, so wanted to wait until the season ended. He started Votrient on January 15th. So far the side effects have been mild compared to Nexavar. His blood pressure increased so he went back on his second BP med, his hair is starting to come in white, and he has had vomiting. Although, he has now started to take anti nausea medication when he takes the Votrient, and that seems to be working.
On February 14th he went and had labs done, and had his infusion of Zometa. We met with a NP who was very nice. Dennis and I really liked her, and we will see her again on March 14th when he has his labs done again. We were lucky to get the Zen infusion area. It's the area that has less traffic and its very quiet.
We certainly hope this drug will shrink the tumors and help with the bone mets, too. Dennis has his next scan in April, and we're hoping for an awesome report!
Well, you're up to speed on the cancer journey...
March 5, 2011
The start of our cancer journey
My husband, Dennis, was diagnosed with kidney cancer on April 3, 2009. Months before he would sneeze, grab ahold of his ribs, and wince. I asked what was wrong and he kept replying that he thought he had cracked ribs, although he could not remember doing anything that would cause cracked ribs. A few weeks later the pain started to ease up so we thought whatever was going on was healing. About a month later Dennis was kicking/pushing snow out of the back of his truck and thought he pulled a groin muscle. At this same time the pain in his ribs returned. A few days later Dennis comes into the bedroom, pulls up his shirt and shows me a bump on his left side. Hmm... that's not normal. You need to see a doctor right away.
Dennis saw his doctor and she sent him to have a chest x-ray. The radiology report indicated a large, rounded soft tissue opacity in the right lateral midlung, with an approximate diameter of 6cm. This opacity is adjacent to the lateral chest wall on the right, and overlies the posterior right fifth through seventh ribs. This opacity is not appreciated on the lateral view. There is no evidence of a rib fracture or osseous rib lesion. The left lung is clear. There is no evidence of an effusion or pneumothorax. Cardiomediastinal structures are within normal limits.
IMPRESSION: Large, approximately 6 cm soft tissue opacity within the right lateral midlung suspicius for a neoplasm. Correlation with CT of the chest is recommended.
The only opening the hospital had for a CT scan was that night but Dennis had to work, so they scheduled a CT chest w/contrast for the next morning.
The report from the April 3, 2009 CT scan.
IMPRESSION:
1. Large exophytic left renal mass (6 cm), incompletely visualized, is consistent with renal carcinoma.
2. Expansile right third rib mass, most consistent with metastatic disease.
3. Indeterminate pulmonary nodules, which could reflect metastatic disease.
Dennis called me at work and gave me the news. He was choked up when he told me, and I hated that I wasn't there when he heard the news. After that, the day was a blur. I honestly don't know how I kept it together.
On April 9, Dennis had another scan, a CT of the abdomen w/ contrast. We also had an appointment with Dennis' urologist, Dr Nielsen, and his oncologist, Dr. Rathmell to discuss the radiology reports and the available options. The recommendation was to have a laparoscopic nephrectomy. We were also presented the option of a clinical trial of sorafenib for 5 weeks before the nephrectomy. Dennis entered the clinical trial and was scheduled for a PET/CT, and a whole body bone scan.
The following day Dennis had the PET/CT. The day didn't start off very well. He was poked way too many times as they tried to find a vein. He also had to wait an extra hour before they could start since he had milk in his coffee, a big NO, NO. The only new information from the PET was a hypermetabolic focus involving lateral left 6th rib. Unfortunately, the day didn't end well either. Dennis found out he was allergic to the contrast. His hands started to blister and by the next day he couldn't stop itching. I felt so bad for him.
Around April 12th Dennis started the clinical trial of sorafenib. The trial was to evaluate shrinkage before surgery. Dennis tolerated the meds well, and he could feel them working. All his spots were sore for a few days.
There is focal uptake in the right 3rd rib, corresponding to osseous findings on the CT of the chest and worrisome for osseous metastatic involvement. There is a subtle, elongated focus of increased radiotracer uptake along the anterior aspect of the fourth right rib, which is not visualized on CT, but suspicious for metastatic involvement. There is also increased uptake within the 6th left lateral rib, corresponding to findings on PRT/CT and worrisome for metastatic involvement. Within the pelvis, there is increased radiotracer uptake within the left sacroiliac joint and the right proximal femur. No CT or PET/CT correlation. The areas are suspicious for metastatic involvement.
Good grief, more bone mets!! At least we know where all the pain was coming from. What he thought was a pulled muscle in the groin was really pain from the femur. What, another scan? Dennis went for a AP+LAT of the right femur on April 20th. By now with all the scans I'm surprised he isn't glowing green!! The findings were a 11.4 x 3.5 cm lytic lesion seen in the proximal right femur, concerning for metastatic involvement, and worrisome for impending fracture.
Ok, it's April and turkey season. Dennis is out walking for miles unaware that his femur is close to breaking. At his next appointment he mentioned how much walking he was doing and his oncologist then told him of the dangers along with setting up an appointment with Dr Esther, an orthopedic oncologist. Hmm... would have been nice to know that little tid bit of info earlier, don't you think?
On April 24th we met with Dr Esther and went over the planned surgery. Dennis was to have a steel rod put in along with having endovascular surgery the day before to cut off the blood supply to the tumor in the femur. After looking at the x-ray of the femur we were amazed it didn't break. He really was lucky considering he fell a few times while out hunting, and stepped into a deep hole that actually jarred his leg. Dennis had his bionic leg surgery on April 30th, and was released 3 or 4 days later. He still has some pain were the screws were put into the hip, but he deals with it.
Dennis had his laparoscopic nephrectomy on May 18th. His whole family came down from New York. His mom, brother, sister, and 2 nieces. All went well with his surgery and he was able to leave in a few days. His incisions healed nicely, and he was getting around pretty well in a few weeks. Soon after his family left his cousin Pete came down for his treatments at Duke. Pete had Glioblastoma Multiforme Grade 4, and unfortunately lost his battle Sept. 13, 2009. Cancer Sucks!
Before the nephrectomy Dennis had another scan to see if the sorafenib worked on shrinking the tumor. It did! The tumor shrank a little more than 1 cm, and he wasn't even on it for very long due to the unexpected surgery on his femur.
At the June follow-up with his oncologist it was determined that since we knew the Nexavar/sorafenib worked Dennis would continue taking it, and have scans every 2 months. We also received a copy of the pathology report.
Renal Cell Carcinoma, Clear Cell Type
Fuhrman Grade 2
T1b, Nx, M1
Well, that's enough for tonight. I've got a UNC-Duke game to watch! Go Tar Heels!
Dennis saw his doctor and she sent him to have a chest x-ray. The radiology report indicated a large, rounded soft tissue opacity in the right lateral midlung, with an approximate diameter of 6cm. This opacity is adjacent to the lateral chest wall on the right, and overlies the posterior right fifth through seventh ribs. This opacity is not appreciated on the lateral view. There is no evidence of a rib fracture or osseous rib lesion. The left lung is clear. There is no evidence of an effusion or pneumothorax. Cardiomediastinal structures are within normal limits.
IMPRESSION: Large, approximately 6 cm soft tissue opacity within the right lateral midlung suspicius for a neoplasm. Correlation with CT of the chest is recommended.
The only opening the hospital had for a CT scan was that night but Dennis had to work, so they scheduled a CT chest w/contrast for the next morning.
The report from the April 3, 2009 CT scan.
IMPRESSION:
1. Large exophytic left renal mass (6 cm), incompletely visualized, is consistent with renal carcinoma.
2. Expansile right third rib mass, most consistent with metastatic disease.
3. Indeterminate pulmonary nodules, which could reflect metastatic disease.
Dennis called me at work and gave me the news. He was choked up when he told me, and I hated that I wasn't there when he heard the news. After that, the day was a blur. I honestly don't know how I kept it together.
On April 9, Dennis had another scan, a CT of the abdomen w/ contrast. We also had an appointment with Dennis' urologist, Dr Nielsen, and his oncologist, Dr. Rathmell to discuss the radiology reports and the available options. The recommendation was to have a laparoscopic nephrectomy. We were also presented the option of a clinical trial of sorafenib for 5 weeks before the nephrectomy. Dennis entered the clinical trial and was scheduled for a PET/CT, and a whole body bone scan.
The following day Dennis had the PET/CT. The day didn't start off very well. He was poked way too many times as they tried to find a vein. He also had to wait an extra hour before they could start since he had milk in his coffee, a big NO, NO. The only new information from the PET was a hypermetabolic focus involving lateral left 6th rib. Unfortunately, the day didn't end well either. Dennis found out he was allergic to the contrast. His hands started to blister and by the next day he couldn't stop itching. I felt so bad for him.
Around April 12th Dennis started the clinical trial of sorafenib. The trial was to evaluate shrinkage before surgery. Dennis tolerated the meds well, and he could feel them working. All his spots were sore for a few days.
On April 17, Dennis had a whole body bone scan. We were starting to feel like regulars in the scan area of the hospital, and the café as well. At least we weren't on a first name basis with anyone. You know you're spending too much time at the hospital if they shout your name when you walk in. Anyhow, here's the findings of the bone scan using the PET/CT 4/10 and the CT chest 4/3 for comparison.
There is focal uptake in the right 3rd rib, corresponding to osseous findings on the CT of the chest and worrisome for osseous metastatic involvement. There is a subtle, elongated focus of increased radiotracer uptake along the anterior aspect of the fourth right rib, which is not visualized on CT, but suspicious for metastatic involvement. There is also increased uptake within the 6th left lateral rib, corresponding to findings on PRT/CT and worrisome for metastatic involvement. Within the pelvis, there is increased radiotracer uptake within the left sacroiliac joint and the right proximal femur. No CT or PET/CT correlation. The areas are suspicious for metastatic involvement.
Good grief, more bone mets!! At least we know where all the pain was coming from. What he thought was a pulled muscle in the groin was really pain from the femur. What, another scan? Dennis went for a AP+LAT of the right femur on April 20th. By now with all the scans I'm surprised he isn't glowing green!! The findings were a 11.4 x 3.5 cm lytic lesion seen in the proximal right femur, concerning for metastatic involvement, and worrisome for impending fracture.
Ok, it's April and turkey season. Dennis is out walking for miles unaware that his femur is close to breaking. At his next appointment he mentioned how much walking he was doing and his oncologist then told him of the dangers along with setting up an appointment with Dr Esther, an orthopedic oncologist. Hmm... would have been nice to know that little tid bit of info earlier, don't you think?
On April 24th we met with Dr Esther and went over the planned surgery. Dennis was to have a steel rod put in along with having endovascular surgery the day before to cut off the blood supply to the tumor in the femur. After looking at the x-ray of the femur we were amazed it didn't break. He really was lucky considering he fell a few times while out hunting, and stepped into a deep hole that actually jarred his leg. Dennis had his bionic leg surgery on April 30th, and was released 3 or 4 days later. He still has some pain were the screws were put into the hip, but he deals with it.
Dennis had his laparoscopic nephrectomy on May 18th. His whole family came down from New York. His mom, brother, sister, and 2 nieces. All went well with his surgery and he was able to leave in a few days. His incisions healed nicely, and he was getting around pretty well in a few weeks. Soon after his family left his cousin Pete came down for his treatments at Duke. Pete had Glioblastoma Multiforme Grade 4, and unfortunately lost his battle Sept. 13, 2009. Cancer Sucks!
Before the nephrectomy Dennis had another scan to see if the sorafenib worked on shrinking the tumor. It did! The tumor shrank a little more than 1 cm, and he wasn't even on it for very long due to the unexpected surgery on his femur.
At the June follow-up with his oncologist it was determined that since we knew the Nexavar/sorafenib worked Dennis would continue taking it, and have scans every 2 months. We also received a copy of the pathology report.
Renal Cell Carcinoma, Clear Cell Type
Fuhrman Grade 2
T1b, Nx, M1
Well, that's enough for tonight. I've got a UNC-Duke game to watch! Go Tar Heels!
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