Cancer Treatment Update

I got distracted from blogging in June of 2009… just prior to my next round of appointments to check on the state of my health. I had a series of appointments and tests in August/September. The two year anniversary of the surgery to remove the tumor was November 26, 2009. And I had an appointment with Dr. Williams, oncological surgeon extraordinaire on January 28, 2010. Okay, so where are we?

In mid June I did the obligatory blood test to ensure that the thyroid meds were actually being effective. The previous tests had been in late April after the checkup where Dr. Williams had suggested that the thyroid was indeed under performing. There were no significant issues, we assume, as the appointment to discuss the results was scheduled for the first week of August with my GP, Dr. Randy Naiker. Dr. Naiker is very good… if there was anything out of the ordinary, he would have scheduled me in earlier.

I went to the appointment with a list of items that I thought may be of interest… this is one of the things that I’ve started to do; make lists of how I’m perceiving my body’s behaviours. So, the things that I brought to the table were:

  • continuing vertigo
  • pain in my right thigh
  • continued deterioration of my handwriting
  • weakness/shakiness in my right hand and arm
  • deterioration in my vision
  • changes in my ‘swallow’

At the appointment we did discuss that an improved exercise regimen would help to stabilize my handwriting and the challenges with my hand/arm. Deterioration of my vision, well, dammit, that was probably age related. The ‘swallow’ will need to be monitored, and I need to actually concentrate on it…

But the good doctor decided that we wouldn’t just accept the ‘damage caused by chemotherapy’ rationale as the reason for the vertigo. Now this is where I get a bit annoyed at myself for not recording some of the discussions we had. Did you know that there is a difference between ‘dizzyness’ and ‘vertigo’? Well, apparently there is… and when I do some research and jog my memory about the conversation we had, I’ll let you know all about it. In the meantime, he decided that we would be very proactive. He ordered a neck/carotid Ultrasound, and a Holter Monitor test. He wanted to rule out the possibility that the scar tissue from the surgery might be inhibiting blood flow.

Annoyingly, when the lab called me to give me the dates, the ultrasound was scheduled for Dec. 23rd, and the Holter for Nov. 30th. Remember that this was the first week of August: I was so frustrated that I badgered the lab receptionist who was trying to schedule the tests until I got the ultrasound moved up to later in August! And to be entirely fair, the young sounding woman on the other end of the phone actually called a competing lab group to get me that appointment. Unfortunately, there was nothing she could do with the Holter test.

The pain in the right thigh mystified the doctor. Again, to be proactive, he gave me a chit for an x-ray.

Here’s where I admit to being a ‘bad patient’. First of all, I tried to do the x-ray twice… but the wait was too long both times… and then I forgot about!!! When I remembered around the date of the Holter test, I couldn’t find the requisition.

And, when I got the call reminding me that I had the Holter Monitor test scheduled, I actually made them change it to a later date because it was inconvenient… I had neglected to enter it into my calendar and booked a series of training sessions over top of it. I finally got the Holter in just prior to Christmas.

There was no phone call after the ultrasound. There has been no phone call after the Holter. I think that it is pretty safe to assume that we don’t have a blood flow issue here…

Going into my recent appointment with Dr. Williams, I generated the updated list:

  • a dry cough that doesn’t seem to have a trigger; happens irregularly. Can sometimes be full on, body wracking and can also be quite light
  • reflux seems to be pretty much under control
  • sometimes I develop severe esophageal spasms when eating, if I don’t keep the fluids flowing
  • right thigh pain; I admitted to having forgotten to get the x-ray and losing the requisition
  • generally saliva production is good; sufficient for day-to-day, but not good enough to eat without lots of liquids
  • mucous buildup in my sinuses
  • tongue is much better, although some of the autonomic responses are slowed, and the strength is still not there
  • my weight is up to 177 lbs.
  • hearing is back to about 90% of pre-chemo levels

Well, that was the list. I actually started off by suggesting that the synthroid was probably working, but that I had noticed that my body odour had changed and it corresponded with the introduction of the synthroid. He made a note, but did not suggest anything. I then moved on to say that the reflux seemed to be under control, but that I would like to continue to use the Previcid for a little while longer. He agreed. I then brought up the coughing, but only after Gail poked me several times… this elicited a surprising response!

It turns out that one of the ‘treatments’ for reflux is really just a mitigation strategy. Previcid, for instance, really only changes the acids that cause the serious discomfort and damage to a ‘base’ (damn… gotta start remembering my chemistry!) . Okay. And that means what? Well, it means that you can still be having the back flow happen, but you don’t feel it! In my little book of incidents that I keep, I have recorded several breakthrough reflux incidents… the inference is that there are more, but I haven’t felt them. Dr. Williams suggested that we need to consult with a pulmonary specialist to see if there’s anything weird going on… that might be caused by aspiration of reflux derived fluids. So the damned coughing may be caused by reflux. Heavy sigh. I just shake my head.

I’m headed into another round of tests: blood test (keratin), followed by chest CT, and then on to whatever the pulmonary specialist has in mind.

At least there is no sign of recurrence of the cancer! This is a major bonus!

Oh, and the doctor graciously wrote me up a requisition to replace the lost thigh x-ray chit.

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