I wish I could be more upbeat

This is a tough time for darling Sally. There are a lot of problems and it doesn't all make sense yet. First, the fluid in her abdomen was drained (1700 cc) and fluid in her left chest (pleural cavity) was drained 300 cc. Sally felt better for about 16 hours but the fluid reaccumulated and she is back to not being able to eat much and feeling miserable. We do not have the cytology on the fluids yet. Second, her liver function is deteriorating with abnormal enzymes, a bilirubin of 2.7 mg/dl, and a prothrombin time (INR) of 1.5. A Doppler ultrasound of her portal and hepatic venous systems does not suggest any thrombosis in those vessels. I know this won't make too much sense to many of you, but for the medical people following this, I thought I would put it in. Third, her serum sodium has been falling and is now very low at 117 mEq/L with a normal about 135. The reason for this is obscure. Renal function is normal. It may be related to the liver or an effect of the cancer (a paraneoplastic syndrome), but his would be rare for breast cancer, I think.

At least the bone marrow seems to be functioning OK now, whereas that was the problem earlier. All blood counts are normal except for mild anemia with hemoglobin of 10.6 g/dl. And all of this in the face of an absolutely normal CT scan recently except for the bone metastases. Clearly, this cancer is not imaged by CT except for the metastases in the bone. Why, when everything seemed to be going well, is the liver having problems? Sally is not taking many medications but even these few are being stopped in case they are contributing to the problem. It's not clear what the next steps will be. We will discuss with Dr. Conlon on Monday.

I'm worried!

Things have not been going well this past week. Sally has continued to feel tired and she has developed more swelling of her abdomen. We saw the doctor today who thinks she has fluid in the abdomen (ascites) and that is contributing to her lack of ability to eat much at one time and her shortness of breath. Sally is scheduled to have a tap of the fluid with cytology to see if there are cancer cells in the fluid. She is also scheduled to have another endoscopy of her stomach to follow up on the previous EGD to see the status of the cancer in the wall of her stomach. We should know more in a week.

Kinda slow recovering

Sally is still not feeling as well as she would like. We think this is probably just the effects of the 6 cycles of the chemo taking its time getting out of her system. There is not anything specific, just lack of energy. We had a great Easter at Lorrie's, and we were so psyched that she wouldn't be having any more chemo for now that we expected her to be feeling better than she is now. I hadn't updated the blog because I wanted to report more good news, but I think that it is time to let you all know what is going on. I'm hoping my next entry will be more upbeat.

Reallly Good News!!

We just got back from seeing Dr. Conlon. First, the CT scan did not show any tumor in the liver (he was worried that it might) or in other abdominal organs. The chest is clear. The pelvis is clear. The CT did confirm multiple metastases to bone--as before. The blood counts are all normal and the hemoglobin is 10.6. There are some mild abnormalities of liver function that have been present previously, but not terribly elevated.

So, his conclusion is that she has had a significant response to the Taxotere over 6 cycles of chemotherapy, and that it is now time to stop it and watch. She will remain on the Aromasin (the hormonal therapy). He wants to see Sally in one month.

We had not quite expected this and we are both excited by the news. We are, of course, hoping that there will be a durable remission and the the tumor in the bone will be held in check with the Aromasin. Sally is ecstatic as you can imagine.

We will be going to Lorrie's for Easter dinner and celebration.