Wednesday, September 17, 2008

New normal, chapter 472

Little known fact: Brad Pitt is from my hometown.

The way I figure it, that means I should have had first dibs on him above Jennifer Aniston, Gwenyth Paltrow and Angelia Jolie. Sadly, Jen, Gwen and Angie ... all significantly skinnier, cuter and richer than me. I am sure those gorgeous, pouty lips of Angelina's helped her steal Brad away from me. 'Cause if not for her, I soooo would (NOT) have had a chance with him. Alas, it would take an extraordinary amount of botox to make my lips do the Angelina pout thing.

Mandy, on the other hand? Mandy has got skills. We are talking mad skillz, people, in the Angelina lip department. Give that girl a little bit of Carboplatin and voila! No botox needed, thankyouverymuch. The undesirable effect of the Angelina look on her is of course the hives, the face swelling to twice its normal size and the whole not-breathing thing.

And frankly? She is already pretty darn cute and don't need no stinkin' Angelina lips.

So, no more Carboplatin induced Angelina lips for her. She will hopefully forever be among the ranks of the thin-lipped, just like her Momma.

Her first treatment with the new chemo drug, Vinblastine, was today. It took a mere 3 hours start to finish. This is far preferable to the former 9-hour chem-o-thon. She tolerated it well; no hives, no anaphylaxis, none of the whole not-breathing thing, which is even better.

I am, however, surprised at how tired she has been today after treatment. Usually it takes a while longer for the post chemo effects to kick in, but today, she came home and slept from 1-4pm and was back in bed for the night at 6:45 and is sound asleep a mere 15 minutes later. She did not eat anything for dinner at all tonight, not even the brownies that were for dessert. (Though the rest of us thought they were delicious! Thanks, Janet!)She said her stomach would "not be happy" if she put anything in it. So, we shall see how the nausea is or (hopefully) is not with the new med.

I am significantly less than thrilled about having to go to second-line treatment. Generally speaking, second-line is second-line for a reason. Unfortunately, chemo drugs are not like other drugs. For example, your Doctor tells you you need meds to combat high blood pressure and he scrawls out a 'script for Drug A. So, you head to your local pharmacy and get yourself a thirty day supply of Drug A. Well, 15 days in, it has given you a headache, made you constipated, made you start growing feathers, whatever. You can call up your Doc and say, "Yo! Doc, I am sprouting feathers here. Got something that will control my high blood pressure that is a lot less bird-like?" Doc says, "Yup, sure do, and sorry about the feather thing." He can promptly phone you in something to your local pharmacy that works every bit as well as Drug A, without the constipation, headaches, feathers or whatever. No compromise in effectiveness, just a lot less need to stock up on seeds and line your bathroom floor with torn up newspapers.

Chemo drugs, not so much. There are woefully few to chose from for any particular tumor or cancer. Now, that doesn't mean that this particular med and this particular protocol won't work every bit as well as the first one would/should/could have. In fact, in some cases, you can even get better results. It just means that one drug option, in a relatively short list of drug options, is crossed off the list. That part, I am not happy about.

All that said, hopefully, it will work beautifully for her and accomplish everything we need for it to accomplish.

A few concerns with the new protocol:

  • My understanding is it is more myleosuppresive than her old protocol. This means we could be dealing with more frequent issues with her bloodcounts.
  • This medicine can cause cysts in tumors that did not previously have them or exacerbate cysts in tumors that had any cystic component to it at all. Because of this, she will be getting MRI's every two months now instead of every three months.
  • It could fire up the hair loss issue again, but, I am told that it is usually not complete, just thinning. That said, hers is already so thin, I don't know how much thinner we can get, before it isn't there.

    All or none of the above could happen. Or not. Every person responds differently. So, only time will tell how she will tolerate it.

    There are also new ground rules with the new protocol. Her ANC (the blood count that indicates the strength of her immune system) has to be above 1000 or they will hold chemo. Additionally, there are blood chemistry issues (liver, kidney function) that need to be in line or they will hold chemo. Chemo is now every week, with no breaks like on the old plan. And, like I said, MRI's every two months instead of every three.

    Speaking of MRI's, normally, I don't say what days they are on, so people don't worry. But, after some thought, I thought I would let you all know that scans are on this Friday. It should be an all-day affair, due to Mandy's issue with anesthesia. We won't have results until next week, which makes me crazy. Patience is waiting for scan results ... not my strong point. (Shocker, I know.) If you could send up a prayer or twenty for good scans, we would sure appreciate it.

    Her homebound teacher comes for the first time tomorrow. The plan is to have her come every Thursday and perhaps some other days as needed. She seems very sweet and I am sure Mandy will like her.

    That's the news from here, folks. Thanks as always for checking on her and for all of you who called, e-mailed and texted your good wishes today.

    Love to all~
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