Remarkably Unremarkable

Your PET scans bore me, darling.

"Boring is good." That was the informed opinion of Kathy, our nurse practitioner, during this morning's oncology appointment. This was not an assessment of Karen personally and certainly not one of me--I had just cracked up the nursing staff with a Noel Coward-caliber rectal thermometer gag centered around the punitive application of a digital thermometer with the added bonus feature of a word picture describing Karen standing up and grasping the arms of a nearby chair. When it comes to sly, nuanced wit, I am the undisputed king.

At any rate, the real cause of all the boredom were Karen's PET scan results. She'd had the scans done earlier in the week and they showed continued response to the crizotinib. In fact, they looked just the teeny tiniest bit better than they had last time around in February. We were extra delighted because Karen has been feeling more tired of late and has had some shortness of breath. We, frankly, were expecting bad news. So it was fantastic not to get any. To celebrate we will be getting our Living Trust drawn up tomorrow because we know nothing says PARTY like making a will.

It Beats Eating Live Scorpions

Behold the muscle-bound Stuart Smalley.

Our friend, quality American, and all-around good guy Ken Brown works at Nvidia and thanks to the completely arbitrary nature of the universe he had occasion to chat up UFC commentator and Fear Factor torturer Joe Rogan just the other day when he visited the Nvidia offices for a new show. Ken told Joe that he knows of him primarily from seeing the UFC at my house and that we all thought that Mike Goldberg was kind of a tool. Joe smiled knowingly.Perhaps this was the moment when the mighty Joe Rogan's heart softened just a little. In short order Ken filled in Joe on what we've been dealing with since November and Mr. Joe Rogan grabbed up a piece of paper and wrote the following "Karen, Never give up, never stop being positive, and never stop searching for a way out of this! Best of luck & love to you...Joe Rogan." It's not the most poetic thing in the world but they are tender words indeed coming from the sort of man that gleefully encourages others to drink donkey semen. And donkey urine. And God knows what else.

Karen had had a kind of rough weekend so finding out that Joe Rogan didn't want her to die was kind of nice.

When Karen gets to work on Monday, that sucker is getting taped on the wall.

Heart to Heart

So last Friday Karen had her monthly oncology check-in. While I had managed to recover from the jet lag heaped on my head from my work week in Frankfurt, I had not recovered from the metric ton of insomnia that took its place. I'm all for staying up until the wee hours of the morning but when the wee hours have actual daylight in them even I feel I've gone too far. But Friday morning, ah, it was great, I was sleeping so well. Then Karen woke me up and said it was ten minutes until her appointment and did I want to come and why don't I just keep sleeping since nothing ever happens and I said Okay but call if there's news and I'll join you asap and I went back to sleep. But not really. She left, I woke up, I had some coffee, and there was news and she didn't call me. So I won't be stupidly sleeping through these monthly check-ups anymore.

These aren't the hearts you're looking for.

So the news wasn't huge but it was this: Karen seemed to have developed a heart murmur. And the tumor markers in her blood work had risen which would imply that the cancer was coming back. Or, actually, maybe not since she has seen these markers bump up a couple of times before and it was confirmed by PET scan that all was well. Or well enough, anyway.

The heart murmur apparently demanded immediate attention. Both the cancer and the meds she is taking could potentially have an adverse affect on her heart. Which is wonderful because if you're essentially a pinata stuffed with cancer you don't really feel complete without a damaged heart. An appointment was set for today (Monday the 6th) for an echo-cardiogram to see what was going on with her heart. Happily, Karen already had planned on taking the day off work since her step-sister, the delightful Bridget David, was visiting. The three of us squeezed into the small examination room as a delightful little man in need of a more delightful big shower conducted the test. We will have to wait for a cardiologist to weigh in officially within a week or so but the technician said he didn't see anything to worry about.

As for the cancer markers. The docs at Contra Costa Oncology aren't terribly concerned since Karen has a pattern of having them fluctuate. That being said, I'd feel better with a more definitive assessment and as luck would have it Karen is scheduled for another PET scan on the 21st. We've reached the theoretical mid-point of the crizotinib's efficacy so it's time to take a look and see how she's doing. Ideally, we'll hear back from the doctor within 24 hours of having the test done.

In the meantime, we will bid a sad adieu to Bridget when she leaves Wednesday morning and then bid a fond bonjour to my parents who'll be staying for the weekend in order to observe the fiasco that my birthday has become. And of course, my mother's birthday the same day. And Mother's Day. And probably some other holiday.

I'll post more news when it happens. Which, hopefully, won't be for a long long time.

And Thus April Draws to a Close

Ah, spring is in the air! That can only mean one thing: our self-imposed visitor moratorium is about to end. We've got people lining up to visit over the next few months and that should be fun.

What else is fun: eating at the French Laundry. Karen and I had a great time and enjoyed every single second there. Three hours shot by like nothing. At lunch at Bouchon the following day, we were surprised when a couple of our absolutely phenomenal NYC friends had our waitress drop a fat gift certificate on the table at meal's end. We went to the Bouchon bakery next door where Karen blew the whole thing on an obscene amount of pastries and such that we brought home and shared with the kids. Was it Karen's best birthday ever? I believe so.

What ain't fun: I'm not going to Coachella. A series of work disasters prevented my traveling companion from being able to go and Dash is off the Coachella table since he absolutely cannot miss anymore school. So that whole last post about looking forward to things? Not so much for me right this second. I will be leaving for scenic(?) Frankfurt, Germany for work this weekend where I will thrill to the sights and sounds of an office building and hotel room.

There's not a tremendous amount of health news to report and that's basically a good thing. Karen's leg is still swollen but not so much and not so painfully. She should be having another PET scan sometime in May. In the meantime, we just ordered Crizotinib refill #5 today.

Anyone that wants to visit or just drop by to be social, we would love to have/see you. Drop me a line and I'll add you to the dance card.

Looking Ahead

So until a good friend pointed out that I hadn't updated this blog in about a month I had no idea it had been that long. And I tend to think of that as a good thing since the whole goal with this thing was just to update it when there was "news." Happily, there's not much to report right now. Karen continues to do well although she is pretty sick of her leg being swollen from the blood clot. It looks more and more likely that the clot is going to take the full three months to dissolve that our doctor said it might.

But other than that....nothing much is going on in terms of medical facts and whatnot.

Still, there are things going on around here. We are looking forward a lot. Our lives have been filling up with things to do. Karen and I are going to the French Laundry on Thursday, I've got Coachella next month, my parents will be up in May for my and my mom's shared birthday, and then in June we have that Alaska cruise. Having something good to look forward to is a real boon because it takes our focus off all the other things ahead of us.

Things like: Karen just got her fourth bottle of crizotinib. This means she is entering the approximate midway point of this drug's efficacy. Every biohazard-bagged bottle that comes ticks us closer to the 8 or 9 month mark where we can expect the drug to stop working. Having good things to look forward to muffles the giant countdown clock ticking away in the background. Not that we need BIG LANDMARK EVENTS to make things nice. I don't know that we've enjoyed an evening more than the one a few weeks ago when our good friends the Salvators came by with deep dish pizza for a night of laughter loud enough to frighten the entire neighborhood. We'd love more nights like that so feel free to invite yourself. You don't even need to bring pizza.

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.