Tag Archives: Alimta

by | February 6, 2012 · 10:49 pm

“Going Mobile”

Discharge day! We’re thrilled! The post title is an appropriate song by The Who. Today’s events went like this:

10:45 am: It sounds like the doctors are happier with her heparin blood level. The heparin IV could come out today. Because her Chromogenic Factor X test takes several hours, we will not know if she can go home. If she does stay, she will move to a different room on 8th floor. Fairview is stripping and cleaning the floors and performing maintenance checks on the rooms. “Hurry up and wait” is the theme for today.

2:00 pm: The expectation of a hospital stay is for the patient to focus on recovery. Fairview Southdale has been exceptional in that regard. Certain administrative obligations pop up detracting from recovery, like dealing with the short-term disability people. “Benefits coordination” is an oxymoron in that company. Lucy got passed to three people so far and each of them asked the same questions. They were just as clueless after her surgery nearly two years ago.

3:00 pm: Lucy’s Chromogenic Factor X result was at the midpoint of her therapeutic range. Her Coumadin dose is set and she has her instructions. The IV lines are removed and she is dressed. Everything is loaded and she has her walker. All that remains is waiting for the pharmacy to fill her prescriptions.

5:30 pm: The pharmacy finally asked for her prescription insurance card. She has a new drug plan this year and the old information was still on file, and there always is a delay when painkillers are involved. Lucy is moving with more confidence after the IV tree went away. Her friend Diane called while I was loading the vehicle. Lucy also called her siblings during the wait. The sunset was nice.

6:10 pm: Lucy headed home wondering what sort of mess waits after me having full run of the house for the past eleven days. She didn’t cringe after touring the house, so I think I did all right. I think the chicken strip dinner I picked up for her at Dairy Queen also helped.

Our house is a rambler with a basement. The basement has a rec room, a laundry room, an office, a ¾ bathroom, and a storage area. The bedrooms are on the main level. One of the guest rooms is now an office for her. She doesn’t need to go downstairs until her leg is better. Most of the main level has laminate flooring. She is navigating the walker quite well in the house.

I picked up some of the wet wipe style washcloths hospitals use for cleaning up a patient in bed. I also picked up a couple of the shower caps that have the shampoo in them. Lucy does not have to worry about slipping in the shower.

Lucy’s next blood test is Thursday. Next week she will get a PET scan since it has been about a year since her last one, see Dr. Thurmes about her leg, and see Dr. Boente about her next Alimta treatment. There is a possibility she may need a break from chemo until her leg fully recovers. Even though her medical leave got extended until February 13th, she may need another week added. Her next assessment may not happen until after that date.

We’re happy being home and are grateful and humbled by the outpouring of love and support you have given us through this ordeal. Thank you!
I picked up some of the wet wipe style washcloths hospitals use for cleaning up a patient in bed. I also picked up a couple of the shower caps that have the shampoo in them. Lucy does not have to worry about slipping in the shower.

Lucy’s next blood test is Thursday. Next week she will get a PET scan since it has been about a year since her last one, see Dr. Thurmes about her leg, and see Dr. Boente about her next Alimta treatment. There is a possibility she may need a break from chemo until her leg fully recovers. Even though her leave was extended until February 13th, she may need another week added. Her next assessment may not happen until after that date.

We’re happy to be home and are grateful and humbled by the outpouring of love and support you have given us through this ordeal. Thank you!

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by | February 1, 2012 · 2:45 pm

And on the seventh day…

Lucy’s Coumadin dosage needs adjusting upward, so she will be here at least one more day. Unfortunately, her hemoglobin dropped from 7.8 to 6.1 so she needed a two-unit transfusion. Lucy’s birthday is Sunday the 5th and I would love to see her home by then! It is a day-by-day holding pattern.

Molly, Dr. Nashawaty, and Jackie from Minnesota Oncology were by to see her progress. Acute anemia can show up in patients receiving chemo. Lucy was originally scheduled for her next Alimta treatment on Thursday, February 2nd. The treatment moved to February 16th. Her body will get a little more chance to recover. Her white count is stable and in the normal range, and her platelet count is normal and stable.

So maybe today didn’t start great, but there is still good news. Molly noted that Lucy’s calf skin is less taut. It no longer looks like it is going to split open. She still has quite a bit of swelling in her right ankle and a slight amount in her left ankle. The left ankle swelling will reduce as she becomes more active. Her right leg still cannot be massaged and they can’t put a “puffer” on it because there are still a couple small clots. They do not want the clots to dislodge and start traveling. A “stay-cation” is good enough for the clots.

Lucy only needed one Dilaudid shot last night for pain. She is taking oxycodone tablets to manage pain. Her pain pump got removed last night.

A Physical Therapy specialist came by this morning and checked Lucy’s strength and range of motion. She also had Lucy do a series of simple exercises that could be done in bed and left a booklet detailing how to do the exercises. Lucy will do them twice a day.

An Occupational Therapy specialist came by about an hour later. She assisted Lucy out of bed. Lucy managed to walk around the bed. Lucy’s pain doesn’t increase very much when she puts weight on her leg. Her ankle still has a limited range of motion so getting her foot flat on the floor is a challenge. After a couple of minutes she can stand flat-footed. Walking is very slow. She is not unsteady on her feet. Lucy has surprising physical strength for someone so petite. The goal is to keep her from losing strength while her leg gets better. She will try using a walker tomorrow.

Give your loved ones a hug from us, and thank you for your support!

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by | January 23, 2012 · 7:48 am

Start of Chemo Round Four

Our society places a great deal of celebratory value on the passing of the old year. We look back on the old year and hope the new year is better. With as bad as 2011 was, 2012 has to be better, right?

The new year did not start out as nicely as hoped. Because there was a slight increase in Lucy’s CA125 level, Dr. Boente wanted labs done a couple days in advance. A CA125 test takes about two days to complete. The labs indicated her hemoglobin had dropped to 6.8. Lucy needed a transfusion on January 4th. Her next scheduled Taxol/Avastin treatment was scheduled for January 5th. This would have been the first treatment of the fourth cycle.

After Lucy’s CA125 level dropped dramatically during the second treatment cycle, it had been steadily increasing since. She was also having leg pain and stomach problems. Lucy’s cancer had become Taxol-resistant and platinum-resistant. The Taxol/Avastin treatments were cancelled and she was to start Alimta instead. Alimta is given once every three weeks in a very short infusion. Her first Alimta treatment was scheduled for January 12th.

While Dr. Boente was examining Lucy, he checked her legs to determine why they were painful. He did a Homans’ test on both legs. This involved Lucy sitting at the edge of the exam table with both legs dangling over the edge. He then supported her ankle with one hand and started pushing her foot back towards her shin. The left leg was painful while the right leg was not.

Because Homans’ test not a good indicator of a deep vein thrombosis (DVT, a blood clot in a vein deep under the skin), Lucy was scheduled for an ultrasound on her left leg. Fortunately, Suburban Imaging is one floor down from Minnesota Oncology. She had an appointment for that afternoon. The ultrasound determined there was a clot in her left calf. We went back upstairs so Lucy could get a Lovenox shot. Lovenox is an anti-coagulant drug. It is not designed to dissolve an existing clot. She received a prescription for Coumadin, another anti-coagulant. The Coumadin would start after a series of four daily Lovenox shots.

Coumadin is a fickle drug to properly dose. It requires frequent blood testing. The test is known as PT/INR, and is more commonly called an INR test. It’s short for Prothrombin Time/International Normalized Ratio. The desired result should be between 1.0 and 2.0. Lucy’s was at 8.9 after two days on Coumadin. Her Coumadin was reduced from 5 mg to 2.5 mg until she was retested in two days. It was also noted that her hemoglobin dropped below 7.0. Instead of getting her Alimta treatment on January 12th, she had a blood transfusion on January 13th. The Alimta treatment was rescheduled for January 18th, and the next INR test was January 16th.

The January 16th INR test reading was better at 3.9. The Coumadin dose was cut again, now down to 2 mg. Lucy was told to get an ultrasound on her right leg after its examination.

The ultrasound showed there was a clot in her right thigh. Her Coumadin was immediately discontinued and she received a Lovenox shot. The Lovenox shots will continue daily for a week. On January 25th she will see a hematologist. The hematologist meeting will decide her Coumadin therapy and try to find the cause of her chronic anemia.

DVTs are incredibly painful. Lucy’s right leg has ballooned up to twice its normal size but is slowly returning to normal. Walking is still very difficult.

There is some good news despite all the speed bumps she encountered. Lucy did receive her Alimta treatment on the 18th. Unlike her previous rounds of chemo, Alimta is a quick one hour infusion given once every three weeks. Her previous round of treatments took between two and three hours each week except for her “off” week. She is not experiencing any side effects from it. Having to make fewer trips for chemo will be a big plus.

It’s been a frustrating start to the new year. We’re both trying to stay positive. We may not say it enough, but thank you for your concern, prayers, support, and the love you have for Lucy.

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