Dr. Chui (Good News)

We got to OHSU before 10 this morning. They did his blood work first. He weighed 153 lbs. and his BP was 135/85 (about normal for him). Dr. Chui (no Resident doctor today) said the ultrasound of his kidneys showed they were okay. However, his CRE and BUN were still elevated - but less than on Monday. His Red Cells were actually up a little but not quite in the "normal" range yet. They were good enough that he didn't need another transfusion. Dr. Chui asked Curt how he felt (pretty good, although he still takes Excedrin for his headaches) and decided to let him have a reduced dose of Cisplatin (it is hardest on the kidneys). Dr. Chui thinks Curt's problems with the CRE and BUN are because he does not get enough fluids. He also wants him to eat more. We mentioned Curt's doctor at the Corvallis Clinic thought Curt should take some medicine to stimulate his appetite. Dr. Chui thought it was worth a try and gave Curt a prescription. The nurse who took his blood sample did not have trouble with his Port, but 90 minutes later the fusion nurse had trouble and had to use some TPA to open it. While waiting, he got a massage of his feet, hands and shoulders from a volunteer masseuse. It was another nice day. There was fog in the morning until we got past Salem and then a ceiling of clouds the rest of the day with some sun peeking through. We had a great view of Mt. Hood from Curt's station at OHSUand didn't get out of there until almost 4. On February 12 Curt will have another MRI. We will head to the coast with the Bakers after that for the long weekend. On February 18 Curt will see Dr. Chui for the results of the MRI and possibly another treatment. Dr. Chui said to just schedule one more possible treatment after that.
I will post this now and Curt can edit it after the OSU-USC basketball game (on TV) is over. OSU won!

Dr. Chui (kidney problem)

It wasn't bad driving to and from Portland today. The sun was out and there were a few sprinkles this morning, and no moisture coming home. We got to OHSU after 10. Curt has lost about 5 lbs. (weighs 149.9 lbs.) in 3 weeks and his BP was 124/80. He saw another Resident Doctor first and Curt told her all his problems. One of the biggest concerns is the headaches he is getting. He needs to take Excedrin about every 4 or 5 hours and sometimes takes some Oxycodone. They asked how painful these were compared to before he started the chemo (they seem to be less, but Curt tries to take something when he feels the pain coming on). The other big concern is his weight loss. His sore tongue and cheek, with a lack of chewing, are major factors. He only eats liquids or very soft foods. I have used my new hand blender a few times for him. The numbness in his hands and feet are about the same. We have been having nice weather lately (not much rain and in the 50's), and he has taken several walks. His ear is bothering him again. It feels plugged and sometimes has pain. We have been putting in some drops again, and he thinks it helps. He is going to run out of that pretty soon. Dr. Chui thought Curt looked pretty good in general and his eye is not so bad now. Dr. Chui told Curt to double the antidepressant he is taking. I guess it is good to gradually work into the dose he might need. Because of the pain and Curt's weight loss, Dr. Chui wanted to do one more treatment today and then have a MRI in a couple weeks.
When Curt went in for the treatment, they had trouble again with his Port. They finally took a blood sample from his arm. One good thing is that the red cell count was okay (it was a little low). However, it showed his kidneys were not functioning right to get rid of the BUN (Blood Urea Nitrogen) and CRE (Creatinine). This can be caused by certain medications (including chemotherapy) and dehydration. Curt does need to drink more. So Dr. Chui did not want to proceed with the chemo today and wanted Curt to get an ultrasound of his kidneys after getting 2 big bags of fluids. It took a couple nurses almost 2 hours to finally draw some blood through his Port (they finally put in something to dissolve any obstructions and had to wait for that to work). Then it took at least an hour for each bag of fluid. Our friends, the Huffords, stopped by to visit for a little while. The ultrasound was afterwards in the same building. It was almost 5 o'clock before we got out of there. Dr. Chui wants to see Curt again this Thursday for another blood test, go over the ultrasound, and possibly have the chemotherapy. If this chemotherapy is not working, there is only about one other kind to try, and it has very bad side effects on your skin. So we wait to see what happens next.

Dr. Lee (for mouth)

Curt saw Dr. Lee this afternoon to see if he could do anything for his sore mouth. Dr. Lee was concerned about Curt's weight loss (he weighed almost 152 lbs. and his BP was 130/90) and his general all around weakness. He said Curt should be drinking 3 Ensures (or Boost or whatever) a day and eat liquids or soft food. He did prescribe a numbing gel to put on his tongue. If his appetite does not improve in a month (he wants to see him again then), he will give him something to stimulate his appetite.
He also said Curt should try to "exercise" (i.e., some walking) every day. Curt stumbled a little when he stood up, and Dr. Lee could feel the atrophy in his leg and hand muscles. He thinks Curt should maybe use a walker. Curt doesn't want to do that. I will walk with him. If he hasn't improved in a month, Dr. Lee will prescribe physical therapy. He said it is important to keep up his strength with the chemotherapy. Dr. Lee said OHSU has been sending him updates about Curt and mentioned the CT scan that did not show any cancer. However, I think the cancer might be in a different place in his head.
Dr. Lee also had Curt get the H1N1 vaccine. I shouldn't have gone along, because I got one too!
(I did need to go though, because Curt doesn't drive anymore.) After seeing the doctor, we went to Borders and BiMart. When Curt got home, he drank an Ensure and is now resting.

Blood Transfusion #2 & Update

On Tuesday, January 5th, Curt had his second blood transfusion for red cells. The nurse tried on and off for about 1 1/2 hours to access his Port and finally gave up and put an IV in his arm. He had 2 units of blood that took almost 2 hours each. When he began, his BP was around 106/67. They check it periodically and it was around 114/75. Toward the end, it was 85/54. The nurse had him walk around and it went back up to 116/74 (the final reading). After the transfusion, he got his "booster" shot for white cells. We went to OHSU after 9 AM and left around 2:30 PM. I went to bridge that night.
On Wednesday some Portland and Corvallis friends came over about 10 AM and helped put our Christmas boxes, suitcases, etc., up in our storage area in the garage. They also did some yard work and brought lunch. Curt got up about 11 AM, but got sleepy again about 3 PM. They left then. Curt is still able to do most things (except heavy lifting) a little at a time.
Yesterday afternoon Curt went with me shopping (got Turbo Tax and Quicken, among other things) while the cleaning lady was here (my Christmas present). Curt is still pretty tired and weak (a shower really wears him out) and sleeps a lot. He feels light headed at times. However, his nose does not run like it did. He is taking some Excedrin (not Oxycodone) for a little pain. Eating is still a problem with his sore tongue and trouble chewing and nausea. So there is a slight improvement, but we need to wait to our next visit to Dr. Chui on January 25 to see how things are going.
We are looking forward to the Bogner family coming during Spring Break. We hope to spend 3 nights with them and Bakers at Seaside on the coast. We also plan to spend President's Weekend in February at Seaside with Bakers. Angie's birthday is February 13.

Treatment #9

Another long day at OHSU. We drove up this morning for his 9:30 appointment with Dr. Chui. Curt weighed about 155 lbs. (lost about 5 pounds). As usual, he saw a Resident Doctor (they are always different) first. Dr. Chui wore a mask, because he had been sick. I was actually encouraged with what Dr. Chui had to say. He looked at the CT scan from Illinois and thought it looked good. It showed what had been done during his past surgeries around his sinuses, but didn't show any new tumors or growth. He said the discharge was to be expected from his sinuses, and he needed to watch for infection there. The odor was probably from old gunk that has been accumulating there. The lack of feeling and weakness in his feet, and somewhat in his hands, is a side effect of the Taxotere chemo. Dr. Chui decided to skip the Taxotere and just do the Cisplatin this time. He thinks the Taxotere might have been doing the best job on the cancer, but we will wait 3 weeks to see how the Cisplatin is doing. At that time they will decide on what to do for the next treatment (if any). Dr. Chui really thinks the chemo is helping. Another major problem is the pain around his left ear and jaw. Dr. Chui said that is to be expected with a "tumor eating away at the base of your skull." Curt has switched to Oxycodone for that and hopes he doesn't get too constipated. Another major problem is his tiredness and lack of energy. The nurse had a hard time opening up his Port to draw blood. We had to wait about an hour for something to dissolve and open it up. The first blood he drew was not conclusive, so he did another draw. This was a better draw. It showed his kidneys were borderline and his red cell count was way down again. So we are returning at 9 AM tomorrow for another blood transfusion. This time we came prepared to spend the night at Angie's. He can get his followup shot here after that. I thought we would be out of there sooner, but it took a long time to get the Cisplatin started, and he also had 2 big bags of saline fluid. It was after 4 before we left. I am worried that he is not eating enough. It is hard for him to chew, and because he has no feeling, he often bites his tongue. He did eat breakfast at home, but has only had an Ensure, a little soft drink, and a piece of candy so far today. We got to Bakers' after 4:30, and he immediately went to lie down (after trying to sleep in the lounge chair the whole day at OHSU). Sure hope the transfusion does better this time! Curt is also going to start to take an antidepressant. He has expressed some emotional these past few weeks. Dr. Chui said that is to be expected too.