Elementary my dear Watson

We've been catching up on TV that we missed while we were out of town and tonight we had a mini Elementary marathon. During one episode, Joan (Watson) is talking to Sherlock about how she thought that maybe his father had cancer so she had started going through some pictures to see if she could find signs of cancer. In the story, she used to be a physician, so she's presented as someone with medical knowledge. So it made me wonder. What does that mean? Do I have the cancer "look"? I'm assuming that she meant sudden weight loss, maybe loss of hair, but what else?

I don't know, I feel like I look the same...

Achy breaky tooth

• Bloodwork and treatment at Siteman West County and a dentist appointment

My toothache won't go away (it's been weeks) so we're going to delay treatment in order for me to have it checked out. I met with the dentist today and we've scheduled an appointment for February 4th (3 weeks out from my last treatment of Avastin) for them to fix it. I'm on antibiotics and pretty much round the clock pain killers and the 4th can't come soon enough.

The timing of this break and the very idea of this break has me freaked out. But this toothache is the worst pain I've ever experienced. And if it becomes infected, that is a whole other set of problems. SO we just do it and keep looking forward.

Pins and needles X 100

I feel like the idea of nerve pain can be confusing. I mean, if you can't feel your feet because they are numb, it can't be painful, right? But. It. Is.

http://consumer.healthday.com/cancer-information-5/chemotherapy-news-122/chemo-caused-nerve-damage-may-bother-cancer-survivors-for-years-706971.html

Crappity McCrapperson

One of my least favorite consequences of yesterday's appointment is that when I access my patient portal now, it has "malignant neoplasm metastatic to liver" listed under my conditions. Don't get me wrong, all of the other things that are listed are crappy too, but this seems to add a new level of crap.

Molly and the nervous fellow

• Bloodwork, appointment with Dr. T and treatment at Siteman South County

I stayed up late last night getting ready for today's appointment. I spent time researching how the liver spots could be investigated further and also what kind of treatments might be available. I won't bore you with all of the details about Doppler ultrasounds, PET scans and biopsies. Or the details about radiation, ablation, radioembolization or surgical treatment options. But I'd be happy to share my Word document with you. I just know that I felt ready to sit down and talk it all through with Dr. T.

Dr. T wasn't up first though. When we got back to the patient room, we got to meet with one of his fellows. With Hector still in Colombia with family, Tina tagged along with me today and I think we made the poor guy nervous. It's okay for there to be laughter in an oncology office! My advice: Just follow your patient's lead.

Dr. T came in and it wasn't great news to start, the MRI shows "at least" 4 spots in my liver - new lesions of 6 mm, 5 mm and 4 mm, along with my 7 mm lesion that has been there all along and remains unchanged, that appears as a cyst on the scans. We immediately jumped into treatment options. Treat just the spots - with some sort of ablation (burn them or freeze them). Treat just the liver - with something like radioembolization. Or treat the body - by escalating my chemo to the next level. We talked about scheduling me to meet with an ablation specialist and Dr. T let me take a look at my MRI.

So we are all looking at the MRI, and seeing the spots (all near the exterior sides of the liver - seemingly not connected to important bile duct structures) and we're discussing how this MRI from yesterday was analyzed by comparing it to my MRI from last January, a full year ago. So these lesions might not have just popped up in the last 3 months, they could have been there 6 months ago, or 9 months ago, or who knows. So talking through it, we decide that we are going to continue the maintenance therapy and schedule another MRI in 8 weeks. Then we can answer the question - are these lesions growing on my current course of treatment? And if so, then we decide on what escalation is needed at that point. I'm satisfied with the discussion and the resulting decision.

Tina and I got settled in the treatment room and we talked about soccer and other nonsense... and the time flew by. She even got to meet Molly in her pearls, a sweet therapy dog who comes by on Tuesday mornings.

Donde esta mi cerebro

• MRI at Barnes West County Imaging Center

The first day back from vacation (I got home about midnight last night after a full day of travel) is always rough. Today decided to be extra complicated by adding in an MRI, some stress at work and a dead car battery. I could blame myself for the car battery because I did leave the lights on for an hour while I had my MRI, but I feel like I can't blame myself for anything that happened today. My brain is not back from vacation yet.

Picchu! Bless you.

So, I'm on vacation with Hector and his family. A quick summary, we are moving around a lot in Peru (plane, train, bus, boat), walking, sight-seeing, and eating some good meals. I'm super fatigued after a couple days though and Hector and I have talked about sending me back home early. I would hate to miss out on this once in a lifetime opportunity to visit Peru though, so today I decided to rest. I slept in late while everyone went out. I caught up with everyone for lunch. And then, for me, it was back to the room to relax (and maaaaybe catch a Liverpool game on TV.) My week on Xeloda ended this morning so I should have more energy in a couple days.

I enjoyed some gnoochi in a sage butter sauce at Incanto (I think). Yum. I think this day was just what I needed.