My Treatment History

My local oncologist, Dr. Shapiro, retired. Switching to another oncologist, I realized once again how complicated my treatment history is. The new doctor will flip through my massive chart, but she wasn't there. And I have come to realize over the years just how important a good understanding of the treatment history is critical for a doctor to evaluate new potential treatment options (one key example). A couple summary paragraphs that keep getting re-edited on previous medical notes do not do justice. Knowing my new doctor would have to piece together my past from a big pile of far-from-comprehensive medical notes, I drew up my own birds-eye chart, One Guy's Colon Cancer Treatment Path, which is my cancer treatment history in Microsoft Project format. She actually appreciated it and it made our initial "tell me your history" appointment more profitable.

I am making this available for fellow colon cancer survivors so they might know a little of what to expect or have at least some other reference for which to compare. Every person's path is different, but seeing someone else's might be of some help. For the rest of you - my support team - you might appreciate from it just how far we've come. A good time to reflect and give thanks.

Maintenance Chemo

I realized I have not written an update in a long time. Currently I am taking "maintenance chemo" consisting of oral Xeloda twice a day for 14 days followed by 7 days of rest. In addition I get an Avastin infusion every 21 days. The idea is to take enough chemo to keep the cancer in check, but at a recipe level that is reasonably tolerable. It's kind of like being in a military stalemate and shooting a few rounds across the enemy line every day just to let them know you're ready and make sure they don't get any ideas of advancing. If I go off chemo for much more than a month, Dr. Eng is concerned the cancer can get going with too much momentum. But to take the heavy stuff would be cruel and unusual punishment on my beaten body.

My scans just before the emergency surgery were stable. And my C.E.A. on July 22 was measured to be a very low 2.0, which is a good sign that things are well under control. I am increasing in strength and health due to some other things I'm doing under the advisement of MD Anderson's fatigue clinic. Christine commented that I actually seem to be in better strength and condition now on the maintenance chemo than when I was in remission.

But to be candid, I want to be getting rid of the cancer and not just being "stable". I don't want to be "doing well", I want to be clean of this stuff. Right now, though, they want to keep this going as it is. So I'm trying to build up strength and live as fully as possible until some new opportunity or obstacle comes in this fight.

In early October I'll be scanned and may get a month off.

Opening Ceremonies powered by DLP

Those big displays at the Bejing opening ceremonies were driven by DLP. Nice to know I'm working towards world peace (or is it assisting state propaganda?)

Home

Finally. I was just released a few hours ago after staying in the hospital thirteen days. The last two weeks were grueling. I won't go into any nasty details. It was bad. Bottom line - it seems like Humpty's pieces were successfully put together again and zipped up.

Christine is still doing very poorly with back, neck pain and headaches. So I'm recovering now at Mom & Dad's house up in Fairview.

I am glad now to be able to drink and eat freely. I have not been allowed to eat since getting to the ER. And I lost maybe 10 or 15 lbs. I'm going to write a new diet book: "Just Don't Eat"

Successful Surgery

Just got a call from Greg's dad Jim. The surgery apparently went very well.

It turns out that a hernia was the cause of the blockage - not scar tissue from the original colon surgery as was previously thought.
Dr. Beecherl repaired some (possibly all, your correspondent is not certain) of the hernia, eliminating the cause of the blockage. Also, he found a lot of scar tissue from the original surgery, which could otherwise pose a threat of future blockage, and removed it.
All that messing around in Greg's innards causes a lot of pain in the recovery, and the recovery is further slowed by the fact that Greg finished a round of Avastin just four weeks ago.
Dr. Shapiro was very complimentary of Dr. Beecherl's work.
Greg will be in the hospital for 5-7 days depending on how much the Avastin has impacted his body's ability to heal.

Time of surgery

Surgery is slated for 7am tomorrow morning at Presbyterian Hospital of Dallas. Dr. Beecherl is the surgeon. I'll keep this NG tube that is currently in my nose until at least Thurs or Fri. The length of stay in the hospital will be determined by how much work is involved in untangling the mess and how quickly the intestines start functioning correctly. My own guess based on previous intestinal surgeries I've had is 5-7 days.

Surgery tomorrow

Two weeks ago, I went to MD Anderson for check-up. Things seem to be going well as far as the cancer. There are a few small suspicious areas, but they reamain stable compared with the scans four months earlier. The dr recommended a month of no treatment.

John R accompanied me and we drove back from Houston Tues night. That night I was woke with some abdominal pain. That pain grew during the morning. Long story short, I ended up in the ER with an immense amount of pain and was checked in to Presbyterian-Dallas Hopsital that evening with the dreaded NG tube suctioning my stomach. I have a partial blockage of my small intestine due to scar tissue from a surgery I had several years ago in that area. Things seemed to be progressing nicely once the suction began. Saturday, they removed the tube and by Sunday morning, they thought the intestines were unkinking themselves on their own and I could go home Monday.

But things turned bad Sunday afternoon. (And I'm not talking about Rice getting hammered 17-5 in the College World Series) After hours of misery and vomiting, as things began blocking up again, the doctor decided to reinsert the tube and is now scheduling surgery for tomorrow A.M. at this hospital. I am currently not in pain and feeling about as well as a guy can feel (that is - with a tube up his nose).

I am thirsty. I have not had any food or drink since Wednesday morning. Except a cup of juice and jello on Sunday that ended up in the throw-up pan. It may be true that "man does not live by bread alone" (Mt4). But I do like to eat once in a while. Looks like it'll be another half-week before I get to eat. I'm enjoying thinking about what wonderful meal I'll sink my teeth into. I'll do so with thanksgiving.

My surgeon here and I discussed my going to Houston to have Dr. Rodriguez-Bigas at MDACC perform the surgery as I've grown to trust him and he knows my innards well. But he's out of town this week. So I'm doing it here in Dallas as Presby. The surgery sounds straight-forward. But as Dr. Rod-Big always says, there is no such thing as a simple GI surgery.

One remarkable thing I've noticed - this all seems rather unstressful to me due to the fact that it has nothing to do with cancer.

One request - if there is anyone local for whom it would be convenient to be available to do some pre-surgery errands for me today, please let me know. My parents and family (Peck are in town) have been running back and forth to the hospital all week and we could use someone with some time and energy to assist. The Pecks are returning to St. Louis today and mom&dad live 45 minutes from the hospital.

If you are inclined to pray, please do so for no complications (I am in a weakened state after this week) and that this will not be a recurring issue, as can be the case. Also for Christine, who is continuing to have debilitating head and neck pain. She was able to be with me yesterday, which was great for both of us.

I am not taking calls because I cannot really talk with this tube in my throat. Best way to contact me is email to hewlett at alum dot mit dot edu