liver problems all around??

If you have met Otis, you know that he is a very sensitive pup.  He loves his people and he hates being left alone.  They say that dogs can sense the emotions of their people and I definitely believe this is true. 

Otis was with me through my first round of treatment in 2005.  He took care of me as much as anyone did -- laying on the floor by the couch as a healed from surgery or recuperated from chemo.  When I was sick in 2010, Otis became really anxious.  He knew something was wrong and it really wore on him.  He has always been a picky eater, so when he stopped eating last week, I figured it was related to the stress that Mike and I were carrying around as we waited for the results from this round of scans.  When he started vomiting over the weekend, we knew it was more serious.

After 8 1/2 hours at the oncologist Monday, Mike spent 7 1/2 hours at the vet Tuesday.  Dr Slavin saw him first.  She ran bloodwork and noticed a difference in his liver function.  After an xray, she sent him to a specialty/emergency vet hospital in Robbinsville.  They did an ultrasound which confirmed that his liver is extremely small.  This is a sign of chronic liver disease -- the extent of which can only be confirmed through a biopsy.  They admitted him overnight to try to control the vomiting and get him eating again.  Thankfully, Steve and Ami were still in town -- Steve was able to go with Mike and Ami  (and the kids) kept me company (this chemo hit me much harder than the Abraxane did -- more on that tomorrow).

We were able to go up to visit with him today and he seems to be doing much better.  He is finally eating and keeping food down.  He seems a bit tired, but he was happy to see us.  They want to keep him overnight again to make sure he is healthy enough to go home. 

I get that he feeds off of my emotion... it's kind of cute, actually!  But does he really have to copy me and develop a chronic liver condition?!? 

first date: Ixempra and Avastin

Starting back on chemo was a disappointment, to say the least.  However, the anxiety and mix of emotion was compounded by the fact that I was saying "goodbye" to my old friend Abraxane and "meeting my new friends" Ixempra & Avastin for the very first time.

Abraxane and I had "met up" 27 times over the course of 33 weeks (6/30/2010 - 2/16/2011).  We were old friends.  Like it is with so many of my oldest and dearest friends, I knew what to expect when we would "get together"...

• with Nancy... it's nonstop laughs and, more likely than not, the "rat on a stick" joke...
• with Char... it's company for the day-to-day, cooking, shopping, playing with Regan and, more likely than not, an episode of gray's or the bachelor/ette...
• with Jess... a run-down on those we've each been in touch with, a quick update about work, a check in on the family, hugs, laughter and maybe a few tears...
• with Katie... an all-nighter... as we discuss everything under the sun... and remark on our talented toes... 
• with Maura & Abby... an all-nighter... as we pretend we're ten years younger and try to make up for lost time...
• with Abraxane... 3-4 hours at the hospital... followed by a tired day and then, basically, back to "normal".  While the chemo did wear on me over time, my appetite was great and I was able to manage a relatively full plate of work, family, friends and ultimate frisbee!

So, prior to my first date, I did what every rational person would do to prepare for meeting my blind date... I stalked them on google.

While Avastin looks fairly harmless, Ixempra is a bit of a "bad boy".  Ixempra's personal website shows an older woman with a headscarf on the landing page.  Perfect.  I was just beginning to really embrace my short, spiky, new 'do.  The link to "side-effects" categorizes the possibilities into "common side effects" and "serious side effects".  Neither list is pleasant.  If it works... heck, I'll try anything.

Mike and I arrived at the hospital for my 8am appointment and after I registered, I headed to the back where the nurses accessed my port, drew some blood, checked my vitals and set me up to see Dr C.  He ran us through the options again, answered a few questions, did a quick exam and said "It's time to get started.  Go get 'em".

I settled into a chair in the quiet room and got hooked up for my pre-meds.  Benadryl, dexamethasone (Steroid), and a few anti-nausea meds are pumped into my IV and within 10 minutes I was fighting off the Benadryl stupor, unsuccessfully... slurring my words... unable to maintain my train of thought.  The nurse said "don't fight it honey" and that was all the permission I needed, quickly drifting off into a drug-induced slumber.  I slept through an hour of premeds, 20 minute flush, 3 hours of Ixempra, 20 minute flush and 90 minutes of Avastin.  Mike was a trooper, sitting quietly beside me all day (working a bit and organizing his pictures from Kenya... I swear... they are coming soon!) 

We wrapped up at about 4:30 pm and headed home.  The first date was long but relatively uneventful.  We spent a low-key evening, visiting with the Vogels. As a lay in bed that evening, I couldn't help but feel a little bit apprehensive about what was to come.  Like the mix of emotions that keep you awake the night after a first date, I was nervous, anxious, and above all... hopeful.

vogel summer bash 2011

In what has now become a bit of a tradition, Vogel Summer Bash 2011 made my 35th birthday one to remember!  Joined by 50-60 of our closest friends and family, Mike and I had a great weekend.  The weather was perfect -- sunny, but not too hot in the shade -- and, somehow, all of the details came together to allow us to really enjoy visiting with all of our guests.

Friday night saw the arrival of my mom and Steve & Ami & Zach & Keleigh and, much later, my brother John.  Many hands made for quick work on Saturday morning.  My nephew Zach and I were the first ones up so we headed out to pick up bagels for everyone for breakfast.  The guys & Ami put up the tent and set up the tables and chairs, while Mom & Keleigh made up centerpieces.  After lunch, the next crew of arrivals showed up -- Tate/Suzie/Tegan and Pete/Jude from CT.  We got in a nice visit with them before the craziness of the day really peaked.

The party wouldn't have been complete without adding the lovely ladies of Crack'd, my ZS posse, my 2nd family the Scott/Pine clan, or the dearly missed Hoffman-Dono's and Fink's (throw in the Biddle/Coynes, DOM and my "Special Friend" Shetaga and you have a party indeed)! 

With the 13 overnight house-guests, the party continued well into the night... giant S'mores and another round of veggie burgers/pasta salad provided the necessary nourishment!  Sorry Jon & Tina!

Abundant leftovers provided for a 2nd day of feasting -- the Trowbridge family and their new ninja set added to the excitement!

All things considered, it was the perfect way to celebrate the gifts of friendship, family and another year of life, love and laughter!  Thanks to Mike for making it happen and to all of our guests for making it perfect.

 

 

ding ding ding...round 3...

I got a call from Dr C yesterday morning (at 7:15am - early!) and he confirmed what I, somehow, already knew.  While the bone scan and lung CT looked stable, there is clear progression in the liver.  As Dr C put it -- the good and bad news is that this tumor is quite content to just throw a party in your liver. 

Because this progression came within 6 months of my last dose of Abraxane, it's an indication that the tumor was beginning to adapt to the Abraxane and grow in spite of it (it couldn't have grown this much in just 4 months).  We'll be changing up the weaponry and the tentative plan (pending insurance approval) is to attack it with two new chemo drugs:

• Ixempra
• Avastin

The stomach pains that started just before our trip to Africa have gotten a bit worse and I knew that was a sign that things were just not right.  I'm so thankful that I know my body as well as I do.   I'm thankful that Mike and I took the trip to Kenya when we did.  It gave us two weeks to focus on us and not think about cancer or work or any of the normal-everyday-unimportant-issues that we stress about.  We focused on the beauty around us and between us and for that, I am truly thankful.

CA 27-29... 279

The day after we returned from Kenya I had an appointment with Dr C.  It's my second follow-up since the switch from chemo to Femara and the first blood work-up.  Unfortunately, the CA27-29 tumor markers are back up again, meaning that the Femara may not be working.  

Last year, when my mets were diagnosed, the CA27-29 was over 200.  Normal range is ~40, though the test is not considered super reliable and they don't use it routinely to monitor after early-stage diagnosis and treatment.  My doctor does use it with his metastatic patients as it can often be a leading indicator of whether the current treatment plan is working.  While I was on the Abraxane, the CA27-29 marker dropped significantly in September & the December reading was down to 50 (almost normal).  In February, it was at 60 and based on the reduction of tumor mass in my CT scans, we decided to take a break from chemo and try a hormonal therapy - Femara.  After four months of Femara, it's back up over 200. 

We'll be following up with a CT scan and a bone scan.  Depending on what we see, we'll decide on the next step.  If there is limited tumor growth, there are other hormonal medicines we can try.  Otherwise, we'll blast it again with chemo.  My body seems to tolerate the chemo fairly well, but Dr C is hoping to give me a few more months break before we go back to that. 

I should have the scans done in the next week or two -- will keep you posted on what we see.