6/7/16

The last weeks' silence doesn't mean that no news is good news.  The last couple of months have been rough, the last month rougher, the last week rougher still, and yesterday rough enough to send us to the cancer center here for emergency treatment.

Ever since the last round of radiation, there have been numerous setbacks, though the radiation itself seems to have worked and the pain in my lower spine to have been alleviated.  Whether this is related to the radiation or not, I developed a severe, tight, dry cough.  It was most pronounced at night, when I'd wake up at least once or twice for a ten- to fifteen-minute bout of coughing.  As long as I didn't move, I wouldn't cough, but the moment I changed positions, coughing began.  It was less frequent and less severe during the day, but in both instances it gave me terrible headaches.  Dr. Hashmi gave me a codeine-lace cough suppressant, which eventually seems to have cleared the matter up, though the codeine made me so sleepy that I was even more fatigued (and worthless) than usual.  One good result, however, was that since a puff or two on a cigarette would lead to horrible coughing, which led to major headaches, I quit smoking.  Over a week down, and so far I haven't missed it.  An aversion therapy that actually worked.

The worst side effects were in my digestive system.  First, during the last weeks, I've had many occurrences of nausea.  And that means that many days I have almost no appetite.  The thought of food often makes me want to vomit.  The tendency is especially pronounced at lunch, when almost the only thing I've been able to eat is Greek yogurt, which is at least healthful and coats the stomach.

Even worse has been increasing diarrhea.  Between that and the nausea, I lost 7# in the last week.  By last Thursday, the diarrhea was very frequent.  We thought that maybe, since it was the last week of Votrient before my week break, once I stopped the Votrient on Saturday, the diarrhea would subside.  But it only got worse.  Meanwhile, my blood pressure fell to a low level.  The last time something similar happened was 18 months ago when I was admitted to the hospital for kidney failure and hypotension.  After that, we reduced the Votrient dosage from daily to taking a week off each months.

Not knowing quite what to do, yesterday we called the cancer center here and were urged to come in.
Once there, I had blood work done, the results of which were generally normal.  Then they began an IV with saline solution, since dehydration is a fear.  Dr. Hashmi was at a conference, but we met for the first time with his primary nurse, Ginger, who seemed very knowledgeable and decisive.  After the saline drip, she added a mixture of a steroid and an anti-nausea fluid.  She also prescribed a stronger anti-diarrheal.  Although my blood pressure remains low, the nausea has disappeared (I was actually hungry last night) and the diarrhea seems under control.  We are scheduled for another saline drip this afternoon, though if we don't think I need it, we can cancel.  Ginger also scheduled an advanced meeting with Dr. Hashmi for next Monday, before I resume the Votrient, to see whether we need to reduce the dosage one more time.   I've taken it for five years now, longer than anyone in clinical trials.  It has been remarkably effective, though since after over four years of no further tumor growth, twice within the last few months tumors on my spine have begun to grow, requiring radiation, there is some question about whether its efficacy has been reduced.  And then there are the side effects, especially the diarrhea, which my body may be tolerating less. 

I'm sorry this post is nothing but medical issues--not a single Trump reference in sight.