Monday, 10:45 PM
High-Level Journal Summary: Notes from meeting with hematologist/local oncologist Dr. Dipti Patel. To my surprise, I got about 80% efficacy from Cycle 6. This was not a wasted effort at all. This results from having a full Day 1 of chemo when both Carboplatin and VP-16 were administered. The toxicity of these 2 drugs being delivered via IV on the same day is where much brain cancer damage was delivered. That is great news.
After detailing other notes, the day ended with an unexpected surprise in the chemo delivery area. It was a surprise, for sure.
Countdowns:
1.) Day 7 of 28 in Cycle 6 of Carboplatin + VP-16 chemotherapy. It was confirmed today that this would indeed be a 28-day chemo cycle.
2008 Seizure Activity:
1.) Last Simple Partial Seizure, or SPS, was 19 days ago.
2.) In 2008, I have had 75 SPS's in 217 days. This is an average of 1 SPS every 2.9 days.
Actual Journal: Dr. Dipti Patel, my hematologist/local oncologist, was back from vacation today, so I was able to visit her at noon. Time with her is precious. I have so much respect for her opinions and her ability to quickly assess and explain.
Notes from today
As we reviewed what happened last week, here are the notes I was able to gather. Some of these notes are right on target and answer questions in such an understandable way. In no order:
1.) Dr. Howard A. Fine at NIH will have to be the person who will determines if I should go into Cycle 7 and Cycle 8. At the same time, Dr. Patel suspects that I will be taken into Cycle 7 and Cycle 8 since my blood counts are still holding up. Therefore, she believes that I will need rest inbetween cycles to fully recover. At this stage of the game, this is all the more important.
2.) My two samples I left at the hospital were both examined, and they were both negative. That is, no bacteria was found in either of them yet. Full testing lasts for 5 days, so the story is not over yet. However, it is looking more and more like bad timing on getting a cold.
3.) My blood counts today were solid for where we are and what we have gone through. As a result, Dr. Patel did not recommend having a $7,000 Neulasta shot this time around. This was my guess as to what she would recommend, just because I feel fairly solid right now (compared to how I would normally feel at this point in a chemo cycle).
4.) My key blood counts are as follows (as compared to one week ago on 7/28/08):
• White Blood Cells: 2.30 K/uL (down from 4.34 K/uL)
• Neutrophil: 1.50 K/uL (down from 2.97 K/uL)
• HCT: 28.0 % (down from 28.8 %)
• Platelets: 217 K/uL (down from 389 K/uL).
5.) The effectiveness of chemo Cycle 6 can be looked at in the following way:
a.) On Day 1, Carboplatin and VP-16 are both administered.
• 80% efficacy is achieved on this first day, simply because of the combination of drugs during the same day.
b.) On Day 2, VP-16 is administered.
• 10% efficacy is achieved on this second day.
c.) On Day 3, VP-16 is administered.
• 10% efficacy is achieved on this third day.
I got the first day achieved, so that means I got 80% of the overall effectiveness of Cycle 6. 100% would have been better, but 80% efficacy is far better than I ever suspected. It makes me feel better about what happened last week, thankful this did not happen in the first day. It also helps to explain why I am still tired from this chemo cycle. It was just a single full day of chemo, but the dual treatment is what was so toxic.
6.) I explained that my sleep patterns are still off right now. I had to take 0.5 mg last night just to fall asleep again after waking at 1 AM. It was only after 1.5 hours of being awake that I gave up and took this drug. I needed to have the rest. Dr. Patel understood the situation and assured me that this is not unusual. Apparently, this IV-based chemo is of the nature that it messes up sleep cycles. As such, countering with Ativan to help get rest must sometimes be done. This helps, because I felt guilty for taking Ativan last night. Getting a night with little sleep just seemed terrible, so that is what prompted me into an action that turned out to be correct.
Good meeting
Just learning that I got more from this Cycle 6 than I expected made today's meeting worthwhile. I thought I did not get anything from an aborted chemo cycle. To the contrary. I got 80% of what we wanted, so there is chemotherapy at work right now, killing brain cancer cells. Knowing this is powerful information. I know that I am not "stuck" in stall position until a possible Cycle 7. The brain war is still being heavily engaged. Amen.
Cap to the meeting
After meeting with Dr. Patel, my Mom asked me to step across the hall for a word. We stepped into the chemo room, and I saw all the nurses I work with during chemo. Then, I discovered that there was a big birthday cake awaiting. What? Didn't that end yesterday? A few minutes later, about half a dozen nurses were gathered around, arm in arm, singing me happy birthday.
My Mom and I then served up all the current chemo patients and caregivers with cake. All but two people accepted, and this sponge cake with lots of fruit disappeared in no time. What a kind thing for my Mom to have done. A pre-birthday gift (world globe and an Eagles Concert), a day-of-birthday present (Carlyle brunch), and post-birthday present (surprise cake). She really loves me. I'm a lucky son, for sure.
Two of many nurses in chemo lab
