Introductions

I was finally able to get in to see Dr. Javli at MDA, and it was sort of a mixed blessing. In early December, I broke a rib leaning over in the car to pick something off the floorboard (second such time I’ve had a rib break under similar circumstances) and the pain from that injury coupled with “new” breakthrough cancer pain, and I ended up flat on my back for a little over 6 weeks. In that time, I was finally able to get in to see a pain management specialist, and we’ve only in the last couple of weeks been able to get the pain under control.

Traveling to Houston from Denton (where I live, just north of the DFW area) was a trying experience with the adjustments to the pain management not quote worked out. But I was able to make it through a single day of tests and meetings instead of spreading it out over several days.

First, Dr. Javli told me that I was already in “overtime” for this cancer, meaning that in his opinion based on the spread of the cancer when it was discovered, I probably should have been dead back in November. So I guess in a way I’ve already beaten the odds. But in his mind, since we are already in overtime, let’s make the most of it.

I laid out three goals I had for working with him and the center at MDA:

1. I want to get the pain management under control.
2. I want to restore a good quality of life for the time I have remaining.
3. I want to be able to comfortably make several trips that we have planned overe the next 6 months.

He said that he felt my goals were very reasonable.

Given my poor response to the previous chemo treatments I’ve had, he said that conventional chemo is probably no longer worth pursuing. He sent my tissue samples off for further gene testing and started me on Tarceva while waiting for the results of those tests (I had not been taking any chemo in the 6 weeks between my last CT scan, which showed 12 new nodules in my right lung). He felt that I would tolerate the Tarceva well, and there was a good chance that it would match the treatment outlined once the gene tests came back. And in another blessing, we didn’t have to fight insurance to get them to cover the Tarceva medication.

I’ve been on Tarceva for a week now, and I’m only just now seeing the signs of the beginnings of a rash on my chest. I’ve not had any diarrhea or any of the other symptoms sometimes seen with the drug. As to whether it’s helping, we won’t know until we do another set of scans. He specifically mentioned that the scans done at MDA will be used as a baseline for tracking treatment going forward.

Though my local oncologist isn’t apparently vey pleased with the choice to go on Tarceva, I’ve asked him to get with Dr. Javli and discuss things doctor to doctor and not rely on me as a middle man to translate or convey messages between them.

Dr. Javli did order a bone scan that I need to get done this week to see if the CC has already spread into the bones which he suspects it has. (My broken rib has not shown up on any scan or x-ray anywhere, so I’m sure they think I’m identifying the ne breakthrough pain as cancer and not a broken rib; I maintain it’s broken as I felt and heard the snap when I leaned over and it broke.) There is a tumor growing in that area, however, as I can feel the growth between my skin and the rib. Yuck. I also have another area that is starting to develop a similar pain, and I will go back to my local pain mgmt doctor and see if another round of nerve block injections would be increasingly effective or not.

I’ve felt better over the last few days than I have since I broke the rib on Nov 30. I have hope that I can resume a good quality of life that will allow me to make these last trips, including the Alaskan cruise n June that was supposed to be our 20th anniversary present, but we having to take it early. Last night was a bit of a setback in terms of pain, but I think it was an anomaly and not a sign of things to come.

So there’s my latest update. Crossing my fingers that my QoL continues to see daily improvements and my strength and stamina, or what I can recover of those, will improve as well.