The Nose Report

As a result of the CT scan and appointment with the ENT doctor last week, we were happy to learn my sinus infection has cleared up. However, there is a large cyst on the left side. It was first discovered in 2004 and has gotten larger, to the point it is putting pressure on the areas around it and that explains part of the reason for all the feeling of pressure in my face, especially in my left cheek bone. Also, the “turbinates” are enlarged to the point they have practically filled my nasal passages making it difficult to breathe, especially at night. They also have impaired my ability to smell and, consequently, my sense of taste is impaired as well. Since I have already tried all the medications that would help this problem and it has only gotten worse, surgery is now required; but the ENT doctor assured me it is a fairly simple surgery, as far as sinus surgeries go.

So now, everyone is wondering what “turbinates” are. They are on the lateral walls on each side of the nose and are made up of tiny layers of bone (kind of like a sponge) and are covered with a very vascular (lots of blood vessels) layer of soft tissue. Their function is to warm and humidify the air entering the nose and provide a bacteria-fighting enzyme. They are also covered by millions of cilia (little hairs), which filter the inhaled air.

The ENT doctor assured me I could finish my last round of chemo and then schedule the surgery after ample time has passed for me to recover. It will be essential that my blood counts and platelets have returned to a fairly normal level before surgery.

I was able to begin my last round of treatment last Tuesday. Hooray! I have two more treatments this week and then I hope for some ongoing recovery of my strength and stamina.
I’ve experienced more nausea and difficulty with my stomach being “unsettled” from the chemo drugs and acidic from the steroids, even though I’ve had medication to help with both. I’m just weaker overall and everything is more of an effort. My hands had healed up a little, but now they are so sore and raw that I can barely touch my clothes to dress myself.

When my treatment is completed, it will take some planning to schedule surgery, recovery time, bone marrow biopsy and follow-up appointment for the report and not have all of this drag on for a couple of months.

So, prayer warriors, these are the present needs.

South, not quite to the border

On Tuesday morning, I was able to schedule an appointment with an ENT doctor. His office would not schedule a CT scan until after he had seen me at the appointment. In order to do a culture I needed to be off antibiotics for at least one week. Consequently, the appointment was scheduled for Monday, January 12. I passed all this info along to my oncology nurse here in Redding.

Steve was leaving Tuesday morning to drive to southern California to attend the funeral of a relative and since I wasn’t in treatment and had no appointments for the week and my blood counts had come up enough to be around people, I quickly packed and went with him. I was even able to help drive for a short time. It felt really good to get away even though the purpose was to say good bye to a wonderful man who had lived a long, productive life, and who had such a positive influence in so many lives. The day after the funeral, we were able to visit my dad whom I hadn’t seen in 2 years. He’ll be 92 this month and certainly isn’t as strong as when I last saw him.

I received a phone call on Thursday morning from my oncology nurse in Redding to tell me my hematologist had gone ahead and scheduled the CT scan and it would be done at 7:30 Monday morning. I am to take the film with me to the appointment with the ENT doctor. Also, he had talked to my doctor at Stanford and he agreed that my sinus problem needed to be dealt with before I had more treatment. Not knowing what next week will bring after the appointment on Monday, we decided we’d better head home on Friday and get some things done, such as put the Christmas decorations away and clean house.

The pain in my legs from the neuropathy was more intense most of the week and I would have sharp, shooting pains in my feet from time to time. It would keep me awake at night, and during the day, I would try to just keep smiling, but I would get quiet, as my brain would fog over from the pain. It wasn’t as bad on Friday while we were driving home, but the bottoms of my feet felt really hot. I do have a prescription now for medication if the neuropathy gets any worse. My legs were still pretty weak and wobbly most of the week and I had to walk slowly and carefully and made sure if Steve’s arm wasn’t available, there was something to hold onto. By Friday afternoon, though, I felt I was beginning to gain some strength in my legs. The weather is clear and the temperatures will be in the 60’s for several days, so I’m hoping I can start walking a little and further gain some strength. My hands are still quite tender and an itchy rash has developed.

Please pray that whatever the ENT doctor finds can be easily remedied so I can finish my treatments.

Treatment suspended for now

I am happy to report that many of the side effect issues are beginning to lessen. My hands are in much better shape after using a prescription cortisone cream. The rash on my body is almost completely gone. The pain and cramping in my legs is infrequent and minimal. The doctor did prescribe a medication for me today for the neuropathy pain, but it may not be needed at the present time.

It was decided at my doctor appointment today that my treatment is suspended until my sinus problem is dealt with. The next step is an appointment with an ENT, CT scan of my sinuses and a culture done to determine whether I’m dealing with a bacterial or a fungal infection. As I’ve stated before, not only chemotherapy but also high-dose steroid treatment puts me at risk for fungal infections. (I do have several spots on my body that are developing a fungal rash again.) My local hematologist is concerned that I might be dealing with a fungal infection in my sinuses since it has not responded to all the antibiotics and actually seems to be getting worse.

The results of the Free Light Chain test done last week were available today. It shows that my free light chains are still actually below the normal range, which hopefully indicates that the cancer is under control for now. I am hopeful that my immunoglobulin panel will show further recovery when it is repeated sometime in the next few weeks.

My local doctor will be talking to my Stanford doctor tomorrow morning to discuss what is next: will the 6th cycle of treatment be completed when my sinuses have cleared up; will 5 cycles be adequate for now; should a stem-cell transplant be considered and stem cells harvested now while the cancer load is reduced? I’ll post again when I hear from my local doctor.

Thanks for your many prayers this week. When you pray for the immediate issues, it gives us such encouragement to see His hand at work in response to those prayers.

Another year begins

Another year rolls around and with it we hope will be improved health for me. Side effects have really accumulated, leaving my week off treatment a struggle. Weakness and neuropathy are increasing and spreading, and one wonders how you can be numb and in pain at the same time. The pain from neuropathy does not respond to ibuprofen or any other type of analgesic. It only responds to medications that are specifically designed for nerve pain; medications that I don’t have as yet. The weakness in my legs is what I notice the most as it is difficult to stand up from a chair or to climb stairs, which we have an abundance of in our home. As long as I don’t stand for too long, I can walk on a level surface successfully, so am able to make the long walk from the parking lot of the hospital to the infusion center and am able to continue to help with a little grocery shopping. My vision has become somewhat blurry and I have a rash that developed last week and am grateful it doesn’t itch. My hands are red, raw and have sores. Cortisone cream and other hand creams for dry skin have helped some, but Steve has to be my hands for anything that requires any kind of pressure; such as unscrewing a cap or opening a bottle or taking the lid off of something. My sinuses continue to be a problem and my voice is now hoarse. The question is whether this is chemo related or a separate problem that has developed due to my impaired immune system. Also, is the inability to smell or taste from chemo drugs or the chronic sinus infection? I’ve been on several different antibiotics and it has helped some, but hasn’t completely cleared up the problem.

Usually, during my week off, I really perk up. However, that has not been the case this time and my local oncology nurse has been in touch with my oncology nurse at Stanford. As a result, on Monday afternoon when I see my local hematologist, we will talk by phone with my Stanford doctor and “come up with a plan”. So, things are a bit up in the air regarding what is going to happen next. I don’t know if I will begin the final cycle of treatment on Tuesday, or whether there will be a delay or…..???

My blood counts were low this week. In fact, my neutrophils (the infection fighting white blood cells) were the lowest they have ever been. This has required 2 neupogen shots to force my bone marrow to make more. My doctor said my neutrophils were so low, that I was susceptible to an infection from my own bacteria. How’s that for scary?

When we hear people say “We’re praying for you” we are reminded of the Spiritual network we share as Christians and the comfort and strength we receive as a result of all those prayers.