Another Holding Pattern

My team leader talked with my oncologist late on Tuesday about my shortness of breath and had me go in for a blood test called D-dimer. Without getting all technical, this blood test shows whether or not there are blood clots in the veins (that’s way over simplified, but good enough for this blog!) Karen thought since my shortness of breath wasn’t related to exertion in any way, it could be blood clots in the lungs.

The test came back higher than normal, though not by a lot, so off I went for another CT scan. Fortunately, the scan showed no clots. There was also no fluid buildup in the lungs or around the heart, no evidence of other inflammation in the lungs, and nothing that showed any reason for the breathing problems. My lungs and heart sound good. I’m glad it isn’t blood clots but wish there was some obvious reason for my symptoms – or maybe not. 🙂

So what we came up with is possible bronchitis from the horrible winds we’ve been having this Spring that are blowing dust, pollen, and other particulates all around and my breathing some of that into my lungs. Since bronchitis doesn’t show up on CT or X-ray, this is just a theory. So back to antibiotics to prevent any more serious lung infection from taking hold and a wait-and-see holding pattern again.

Status Report

The latest blood work shows that my white and red counts are normal and holding steady, which means my immune system is in good shape, and I have the green light for – sushi! Something I have missed so much since I started chemo back in November.

However, my CEA and liver enzymes continue to creep upwards, I’m having shortness of breath without exertion, and a dry hacking cough. The shortness of breath could be the Alimta, it could be allergies, it could by COPD, it could be any number of things. Same thing for the cough. But if they were caused by allergies, there should be a decrease on the days I’m taking the Dexamethasone, and there isn’t. The increase in liver enzymes and CEA could be related and could just be an effect of the chemo. So my next appointment will include another CT scan ahead of schedule. And if the symptoms get worse, I’m to let the team know and they might do the CT scan even sooner.

I’m feeling okay, so I’m thinking there probably isn’t anything going on with the cancer just now, but the symptoms are troubling anyway. I didn’t sleep well at all last night because of the Dexamethasone, and that med upped my pulse and BP today. But my O2 saturation levels are maintaining at around 97%, which is great.

So I’m basically in another holding pattern, but staying positive. And now it’s nap time!

On Death

I was asked the other day if being diagnosed with cancer had changed how I felt about death. And the answer is no. I do wonder what life will be like for my family and friends, but those thoughts have been with me for longer than I knew I had cancer. I can’t answer for everyone, but death is something I think about rarely. I’m comfortable with believing that death isn’t an ending but a beginning, and I know I have lots of living to do yet.  So I’m not ready to leave this world any time soon. Of course, I probably won’t have any control over when I die.

When I was first diagnosed, I was told that lung cancer isn’t curable just manageable. At that point I was certain this cancer would kill me, and I thought Stage 4 lung cancer was always fatal; the question is just when and how long I could keep it under control. I have since learned that it is possible to have no evidence of disease (NED) after treatment. And I know of some who have been NED for years. But there are also those whose treatment doesn’t work and who die early on with the disease. Part of the problem with lung cancer is it often isn’t diagnosed until the late stages when it has already metastasized. And the traditional treatments don’t always work, or they work for a little while then the cancer becomes resistant. There are some exciting new treatments out there that harness the  power of the body’s own immune system and others that target a particular DNA mutation switch – all fascinating. And options for clinical trials that may not have been available when I was diagnosed, which was just in October of last year.

I remember reading “On Death and Dying” by Elisabeth Kubler-Ross as an assigned book for one of my nursing school classes. Of course back then I had no sense of my own mortality. I saw patients die and I saw patients get well and leave the hospital. I cried with the bereaved families and rejoiced with new parents and the families of those who went home. And the five stages of grief stayed with me from all those years ago. Now I find myself going through those same stages – because those stages don’t just occur after someone dies; they can also be a response to a diagnosis such as cancer.

The five stages are denial, anger, bargaining, depression and acceptance. They do not happen in a linear fashion, so people don’t necessarily go from denial to anger then bargaining etc. The stages can occur in any order, and people can even sometimes skip a stage altogether. Some never reach acceptance. I seem to vacillate between anger and depression with a little acceptance thrown in there every once in a while. But mostly I’m fighting and convinced I can beat this, at least for a while, and determined to live my life the way I want to live it – not the life this cancer wants me to live. I never did just ‘go with the flow’; I was always the one fighting the status quo – and I still am.

Tiring Day

Yesterday was sort of an adventure. We drove to Scottsdale, about a 2 hour drive, to meet with the oncologist running a clinical trial of a lung cancer treatment. From here to there is all Interstate and there are a few areas where blowing dust is a concern when there are high winds, and yesterday was quite windy. If you don’t know about blowing dust in these parts, Google Haboob Arizona and look at the pictures or videos – that will show you what it looks like. So we left early to give us enough time that we wouldn’t be late for the appointment, which was at 1pm. We have cruise control in our vehicle, which Steve had never used before, so he was like a little kid with a new toy! Cruise can be useful on the Interstate by keeping the speed constant and conserving fuel.

The drive was uneventful, with one stop for lunch – we packed snacks and sandwiches. But it was scary to see how many people were driving while talking on their cell phones – including big rig drivers. A couple of the big rigs kept drifting into our lane, so we were quite happy to get past them. And of course there were all those people driving way faster than the speed limit. The worst part was driving on the loop roads around Phoenix; so much traffic going well over the speed limit and changing lanes with no warning and weaving in and out of the other cars on the road – white knuckle driving at its best!

The staff at the oncology office were pleasant. The oncologist we met with was probably younger than my kids – not necessarily a bad thing but weird all the same. He explained the trial, asked me a bunch of questions, gave me the once over, and said he didn’t think I qualified for this trial. From my medical records, he said he saw that my tumors had shrunk, even if it was just a small amount, and he thought the regimen I’m on now is keeping things in check. This particular trial is for people who have been on the platinum-based chemo therapy, but whose cancer has progressed. And he thought that waiting and doing the CT scans every 2-3 months was the thing to do. If nothing else, he confirmed that my disease is under control at the moment, and that we are doing the right treatment for now. He also said that the CEA levels didn’t necessarily reflect what was going on with the cancer. I’m sorry I didn’t qualify for the trial in one respect, but having a second opinion was helpful.

The drive home was also uneventful – we didn’t get inundated with dust storms and we didn’t get blown off the road. By the time we pulled into our driveway, I was exhausted! The dogs were so happy to see us – we were gone for 6 hours but they acted like we’d been gone for days! They ran circles around us and each other; ran in and out the doggie door yipping and whining and barking. It was quite the greeting! Then they spent about 10 minutes chasing each other around the back yard. They are such goofballs! So they had their dinner, and we had ours, and it was an early night for both of us.