Bigfoot Discovered!

Not the bigfoot we found.

Karen began hobbling around the house Monday evening, complaining that she must have pulled a muscle in her leg. Because there is nothing I enjoy more than telling other people what to do, I asked her to remove her pants and get on the bed. Unlike all those girls in college that ran screaming from the room, she complied. I examined her legs and quickly came to the conclusion that her left leg was swollen from the knee on down to her now much bigger foot. Once Karen confirmed that she didn't recall being bitten by a rattlesnake, we called the doctor. An ultrasound was scheduled for this morning (Wednesday) after Karen cajoled the doctor into letting her go to work for important meetings on Tuesday.

Unfortunately, the ultrasound revealed that Karen had a pretty significant blood clot in her leg. This is almost certainly a side effect of the crizotinib and it sucks. If the clot were to break free it could bob along her bloodstream into her lungs and cause a pulmonary embolism which really isn't even half as much fun as it sounds.

The kind of ultrasound we're used to getting.

So now Karen is taking blood-thinning medication to dissolve the clot and prevent new ones. She's going to be taking Warfarin starting right now and will continue to do so for at least three months to be sure the clot is properly deadified. In addition, she'll need to have a series of 3-5 shots of Arixtra over the next several days as well in order to quickly get her blood thinner. And while she couldn't have any grapefruit with the crizotinib, she REALLY can't have it now with  Warfarin in the mix. Luckily, we don't generally eat grapefruit. Like kindergarten gerbils, we prefer to eat our young.

STATUS UPDATE

• Karen has a blood clot in her left leg that has left it swollen and somewhat painful.
• The blood clot is most likely a side effect of the chemotherapy drug she is taking, Crizotinib.
• For at least the next three months Karen will be taking Warfarin, a blood thinner.
• For the next 3 to 5 days, Karen will get a daily injection of Arixtra to more immediately "fix" her blood.

Smaller is Better

We heard from Dr. Sherman this afternoon regarding Karen's PET scan from last week. Karen didn't want to wait to find our her result until her next appointment at the end of the week and had asked the office if someone could call if they got a chance.

So the news is all basically good. The mass in her lung is showing a marked decrease in size. Her lymph nodes are getting better and the spots in her liver have seen a reduction in size as well. There is also evidence of an overall reduction in activity. This confirms what we already believed: she is responding well to the medication. Although she could have had an even stronger response, this is still really good news.

I gave Karen this news while she was at work for the second week. Things in cancerville are looking up.

Working Class Hero

It's been almost three months since we got Karen's diagnosis and we've come a long way since then. Back in November/December Karen was struggling to take full breaths and was terribly weak. Today, she went back to work, riding in on BART and even hoofing it up a set of stairs when she found the escalator wasn't working. She worked a full day, came home to a lovely dinner of homemade spaghetti and meatballs, hung out with the family, and went to bed at her new bedtime of 9PM. Unless the roof caves in or I once again attack her in my sleep (and that's only happened twice), she'll be going back tomorrow.

Our working girl returns to the office with a great new 'do.

It's pretty remarkable that she's managed to reclaim her spot in the day to day world. Back around the New Year she had virtually no energy and we both thought her working days were behind her. Since then she has made remarkable progress, especially over the last week. Knowing that she was gearing up to return to Wells Fargo, she stopped taking naps and stepped up her activity, pushing herself to do a little more each day so that she would be prepared for today. Her oncology and pulmonary appointments this past Thursday went well and she was cleared by both doctors for work. Assuming that the results of her PET scan later this week go well she will be scaling back her oncology appointments to monthly check-ins. The crizotinib is really doing its job but I think Karen really deserves the credit here. This was something she really wanted and she made it happen.

Not that she was the only one that wanted her back to work. Arriving at her office this morning she was greeted by a handmade red carpet leading to her office, an office filled with balloons. She's fortunate to work with a great group of people that really care about her.

Here's hoping the PET scan on Thursday is fantastic.

Ship of Fools

And so the easing into a more ordinary day-to-day existence continues. Karen's energy, after about a week where she seemed to be going backward, is maintaining its steady momentum toward something more robust. As a result, Karen has committed to return to work this coming Monday, February 18. She'll be spending some days working from home but on that day she'll be braving the actual commute in to the office. Initially she had targeted the 15th for her return but not only does she have an oncology appointment that day, but I'll be out of town for work. After some deliberation, she decided she'd prefer to return to work with me in town just in case it doesn't go absolutely swimmingly.

You say "cruising" and this is what I think of. 

And we have committed to that freaking Alaska cruise. I am trapped. Deposits have been made and cabins have been secured. And while we have never splurged on travel insurance before, we ponied up the extra cash this time because, c'mon, wouldn't you? The trip should be an absolute nightmare like all cruises are and Karen cannot wait.

Next week we will be hitting one of our first big milestones. Karen has a PET scan slated for the 21st that will give us a literal look at the state of her disease. We've got evidence the crizotinib is doing its job since she's breathing better and her energy is rebounding but the scan will really let us know how all the tumors are doing.

Although the state of the tumors is unknown, the state of the Coffeys in general is clearer. We're all doing pretty well and are welcoming the return to something approximating normalcy. Dash has been terrorizing innocent people on BART with this creepy artificial hand, Miranda is working out in the most hilariously inept way imaginable, and I'm especially looking forward to March since we have issued a moratorium on visitors for that entire month. Finally, I don't have to feel guilty about puttering around in my sleep clothes well past noon.

Carpe YOLO

Karen's oncology appointment yesterday went pretty well. Her energy has been getting better daily, the nausea is more or less under control, and her coughing and shortness of breath are gone. She's not taking and pills or cough syrup at all, either. All of this led Dr. Sherman to opine that this is sound "clinical evidence" that the crizotinib is working although we'll have to wait until she has her scans done at the end of the month to get actual proof that it's working.

Since it's working, it's reasonable to assume that she should enjoy the 8 - 9 months of effectiveness the drug averages for its users. Following that, said Dr. Sherman, there's a chance she could respond to "maintenance chemotherapy" that will buy her much more time than the few weeks or two months we thought chemo would get her. Granted, there's only something like a 40% chance this'll work but still...we took it as good news.

So we left the doctor's office feeling pretty optimistic. Karen is feeling well enough right now to accelerate her plans to return to work. Instead of waiting out the month, she's shooting for a February 15 return. She really wants to get things back to normal and we're all onboard for that.

Still, we have adopted a more aggressive stance on doing things these days. We're not putting stuff off the way we did when our inevitable mortality seemed a more far-off prospect. For instance, I decided--after long ago giving up trying when my efforts were insanely fruitless--to try to get a reservation at the French Laundry in a bucket list kind of way. I called the restaurant and was totally prepared to use the cancer card in order to maybe secure a better spot on the waiting list. What happened instead was they had a sudden opening and we got an actual reservation. On March 28, no less. Which is Karen's birthday. So that's kind of awesome.

And Karen got me a pair of tickets for the second weekend of Coachella this year. To be honest, I balked at first. The money involved kind of freaked me out and I didn't really feel that right now is the time for me to be running off to do the things that might be on my Things To Do Before I Die List. But it was on Karen's--she really wanted to do something for me and it would be pretty ungracious of me to turn this down. So I'm going. Not sure with who yet, but I'm going.

And all of this means we are probably almost 100% certain to go on that damnable Alaska cruise. Oh well.