The surgery went very well and Kev is recovering just fine. He is alert and talkative and is moving around pretty well. They have him taking potassium, magnesium, antacids, antibiotics, steroids and his usual anti-convulsants and Vicodin is doing a good job of controlling the pain. (No chemo drugs for the short term). He did get a couple doses of insulin because his blood-sugar levels were a bit high. This is a side effect of the meds (and is probably exacerbated by his present diet which consists entirely of fruit juice, puddings, jello and ice cream!). He should be off the IVs tomorrow (Wed) and be coming home on Th.
This time around Kev had the idea of getting his hair cut short before going in for the surgery and it looks like it was a good plan. Instead of shaving the entire right side of his head they only shaved a strip along the cut. Once all the bandages come off, we'll get a good picture.
Thanks for all the good thoughts and prayers!
Wednesday, June 27, 2007
Saturday, June 23, 2007
Cycle 4, Week 3
Kev went in on Friday for his 3rd IV of Abraxane for this cycle. His blood counts were low so he had to go back on Sat for a shot of Neulasta. This helps "boost" his blood cell growth. Because of the sudden growth, this drug often causes bone pain, similar to growing pains that teenagers get. However it doesn't really bother Kev very much.
He also met with his Anesthesiologist (standard visit prior to surgery) on Friday. This is all becoming very "normal" to us now. The nurses in the pre-op recognize us on-site. The anesthesiologist knows the special "anti-nausea cocktail" Kev gets without us even having to mention it. I know which chairs in the waiting room are the most comfortable and what time the nurses come in with their "updates". I have even become accustomed to the 5am check-ins on surgery day. Everything is very predictable and in a sense that provides its own comfort. However we're fully aware that the only certainty is that nothing is certain. So when we were informed that we should check in on Monday at 10am instead of 5, it was a surprise that we gladly took. I hope that's the only surprise we get from this surgery.
He also met with his Anesthesiologist (standard visit prior to surgery) on Friday. This is all becoming very "normal" to us now. The nurses in the pre-op recognize us on-site. The anesthesiologist knows the special "anti-nausea cocktail" Kev gets without us even having to mention it. I know which chairs in the waiting room are the most comfortable and what time the nurses come in with their "updates". I have even become accustomed to the 5am check-ins on surgery day. Everything is very predictable and in a sense that provides its own comfort. However we're fully aware that the only certainty is that nothing is certain. So when we were informed that we should check in on Monday at 10am instead of 5, it was a surprise that we gladly took. I hope that's the only surprise we get from this surgery.
Thursday, June 14, 2007
Another Surgery
We met with the neurosurgeon on Tuesday and discussed the MRI. Since his last scan 2 months ago, there is a new small 6mm metastatic nodule in the right orbital surface of the frontal lobe. Additionally he pointed out that there is an increase in growth in the postsurgical cavity. The smallish markings that have been present since the surgery (and have been stable for the last year) were presumed to be "scarring", but this new and sudden growth is indicative of a recurrence.
He explained the new growth is in a fairly insignificant region of the brain. The left part of the orbital surface of the frontal lobe controls primarily "higher cognitive functions" and the right side is the "back-up" for the left side. It is highly unlikely for tumors in this region to cause any seizures or physical/mental impairments other than the effects it causes by getting larger and putting pressure on the brain in general. However the area where the recurrence is (right side frontal lobe) will most likely cause seizures (as we saw last year) and could affect control of left side of his body. So it was determined that Kev should have surgery to remove the recurrence (scheduled for June 25) and a month later will have stereotactic radiosurgery (which is a very precise delivery of radiation) on the new growth. If the stereotactic radiosurgery is not effective (determined by stabilization at 6 months post treatment) then a real surgery will be scheduled. It is felt that we have more time with the new growth to try a less intrusive procedure first, before resorting to "brain surgery".
Additionally, the neurosurgeon offered to remove a larger tumor (approx 3cm) in Kev's neck at the same time as the recurrence. It's not necessarily causing him any problems now but could present eating/breathing issues if it started to grow quickly.
Tomorrow (Friday) Kev get his 2nd weeks treatment of Abraxane as part of his 4th cycle.
He explained the new growth is in a fairly insignificant region of the brain. The left part of the orbital surface of the frontal lobe controls primarily "higher cognitive functions" and the right side is the "back-up" for the left side. It is highly unlikely for tumors in this region to cause any seizures or physical/mental impairments other than the effects it causes by getting larger and putting pressure on the brain in general. However the area where the recurrence is (right side frontal lobe) will most likely cause seizures (as we saw last year) and could affect control of left side of his body. So it was determined that Kev should have surgery to remove the recurrence (scheduled for June 25) and a month later will have stereotactic radiosurgery (which is a very precise delivery of radiation) on the new growth. If the stereotactic radiosurgery is not effective (determined by stabilization at 6 months post treatment) then a real surgery will be scheduled. It is felt that we have more time with the new growth to try a less intrusive procedure first, before resorting to "brain surgery".
Additionally, the neurosurgeon offered to remove a larger tumor (approx 3cm) in Kev's neck at the same time as the recurrence. It's not necessarily causing him any problems now but could present eating/breathing issues if it started to grow quickly.
Tomorrow (Friday) Kev get his 2nd weeks treatment of Abraxane as part of his 4th cycle.
Tuesday, June 12, 2007
Cycle 4 starts
A brief update:
Kev met with his oncologist on Friday and they decided to start a 4th cycle of Abraxane & Nexavar that day. The CT scans indicated, in general, a slight shrinkage in most tumors. (a more detailed report will follow). The new brain lesion was also discussed and it was agreed that Kev should meet with the neurosurgeon to discuss options. We have an appt with the neurosurgeon Tues.
Kev met with his oncologist on Friday and they decided to start a 4th cycle of Abraxane & Nexavar that day. The CT scans indicated, in general, a slight shrinkage in most tumors. (a more detailed report will follow). The new brain lesion was also discussed and it was agreed that Kev should meet with the neurosurgeon to discuss options. We have an appt with the neurosurgeon Tues.
Thursday, June 07, 2007
LIVESTRONG CHALLENGE
On a more positive note, Kelden, Nick and I have decided to form a team and ride in the LIVESTRONG Challenge this October in honor of Kev.
The money raised funds the Lance Armstrong Foundation. LAF helps people with cancer focus on living. Their slogan - "We believe that unity is strength, knowledge is power and attitude is everything" pretty much sums it up. LAF has been a tremendous help to us providing both practical and inspirational information.
Most recently Cancer supporters here in TX united together to get a Cancer Bill successfully through the TX house and Senate which assures a public vote in Nov and offers Texans an opportunity to approve $3 billion in general obligation bonds that would provide $300 million a year for cancer research in Texas. This is especcially important for us since there currently is no cure or even a standard treatment for Malignant Melanoma. And there is a direct coorelation in cancer research between money and cures. All Kev's treatments now have the same goal - to keep the disease stabilized long enough for a cure to be found. Please join our team, or if you can not attend the Ride, please support the cause by donating to one of our team members. Links to join and to each members webpage can be found on the team page: http://austin07.livestrong.org/team_matterhorn
Join the fight - Take the Challenge!
The money raised funds the Lance Armstrong Foundation. LAF helps people with cancer focus on living. Their slogan - "We believe that unity is strength, knowledge is power and attitude is everything" pretty much sums it up. LAF has been a tremendous help to us providing both practical and inspirational information.
Most recently Cancer supporters here in TX united together to get a Cancer Bill successfully through the TX house and Senate which assures a public vote in Nov and offers Texans an opportunity to approve $3 billion in general obligation bonds that would provide $300 million a year for cancer research in Texas. This is especcially important for us since there currently is no cure or even a standard treatment for Malignant Melanoma. And there is a direct coorelation in cancer research between money and cures. All Kev's treatments now have the same goal - to keep the disease stabilized long enough for a cure to be found. Please join our team, or if you can not attend the Ride, please support the cause by donating to one of our team members. Links to join and to each members webpage can be found on the team page: http://austin07.livestrong.org/team_matterhorn
Join the fight - Take the Challenge!
Wednesday, June 06, 2007
MRI Results
Normally appts with the Neurologist these days are uneventful. He manages Kevs seizure activity and anti-convulsant meds. And since he has had no seizures since his brain surgery last August and his anti-convulsant meds hasn't changed since Dec (still taking 1000 mg Keppra twice daily) there is rarely anything to discuss when we meet. But today we had the new MRI results to look at since they weren't ready when we met with the Neurosurgeon on Tues. Unfortunately the results were not what we wanted to see. Kev has a new brain metastisis on his frontal lobe. It presently is only about 4mm and the Neurologist is not worried about new seizure activity since this part of the brain is not usually associated with seizures, but it does present other problems. For one, it pretty much disqulifies Kev from participating in any clinical trials for at least 6 months. In addtion, it's indicative the cancer is becoming more aggressive. Last time a brain metastisis appeared all other treatment stopped and the focus shifted to the brain. We meet with the oncologist on Friday and he is the one that will determine our next steps.
Tuesday, June 05, 2007
Tests
Today was a day of tests for Kev - MRI for the brain; CT Scan for chest, abdomen & pelvis; X-ray of chest; and blood draw. He also had an appt with the nuerosurgen to get his stitches removed in addition to a general check-up. Normally we get the MRI the day before meeting with nuerosurgeon so we can go over the results with him, but this time a scheduling glitch put both on the same day. However he does have an appt with his nuerologist on Wed so we get MRI results then. Friday is his appt with his oncologist and discuss which treatment options we should get started with.
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