Category: Cancer Update

16 May 2024

I debated as to whether title this “Everything Fred” or “Cancer Update.” I had my echocardiogram yesterday with Mary Ann. It seems she really irritates the receptionists because she doesn’t answer her phone. However, while she was giving me the echocardiogram, she answered the phone twice. I suspect they just don’t like her.

The results came back later in the afternoon to “My Chart” and, to me, they were a little disturbing. One of the side effects of Herceptin is that it can, in some cases, lead to heart failure.

On January 24, 2024 I had an echocardiogram with Mary Ann and the findings read “The left ventricle is normal in size and function with an estimated left ventricular ejection fraction of 55%.” In males, the normal range is 55-65%.

Yesterday’s echocardiogram read “The left ventricle is normal in size and there is mild to moderate systolic dysfunction with an estimated left ventricular ejection fraction of 40-45%.” “Global longitudinal strain = -12.8%.” Normal globular longitudinal strain is -17-(-)24% for males. It measures the strain on sub-endocardial longitudinal muscle fibers which are prone to ischemic damage and heart wall stress.

Those ranges reported are the standard for Holy Cross. The Mayo Clinic cites the American Heart Association standards as follows:

“A left ventricle (LV) ejection fraction of about 50% to 70% is categorized as normal.

A mildly reduced LV ejection fraction is usually between 41% and 49%.

A reduced LV ejection fraction is usually 40% or less.”

By the American Heart Association, I’m borderline reduced and mildly reduced. It seems the Hereceptin treatments are having an effect on my heart. Add that to a coronary calcium score of 165 and I’m already at a medium to high risk for a heart attack.

By my count, I have four more Herceptin infusions with the last one coming August 6th for a total of 17.

Obviously, I’ll be talking to my (1) oncologist (2) cardiologist and (3) endocrinologist. So far, my endocrinologist seems to be the most concerned about my coronary calcium score. He’ll probably hit the ceiling when he finds out the echocardiogram results.

Last night’s movie was Hobson’s Choice starring Charles Laughton as Henry Hobson; Brenda De Banzie as Maggie, the oldest daughter; and John Mills as Will the boot smith who marries Maggie. It was produced and directed by David Lean. It’s an excellent comedic film with an outstanding cast. You forget how good the actors are in this movie until you watch it again. It’s a hard movie to come by. I got it from Amazon but at a steep price. It was worth what I paid for it.

I did manage to walk 0.98 miles today, so let’s call it a full mile. Rain is predicted and we need it. Yesterday’s downpour only whetted the appetite of the lawns in the area.

I’ll keep you posted on what the “experts” say about the echocardiogram.

Stay tuned!

23 April 2024

Apparently, things have been difficult at the cancer center at Holy Cross. I was not wrong that someone failed to schedule my today’s Herceptin treatment. They have a new person on scheduling and they thought it would be more logical to schedule sessions individually, one at a time for each patient. It didn’t work and some of us fell through the cracks. They’ve gone back to bulk scheduling for a patient. It was lucky I caught it and called in about no appointment for today. Once I had everything rescheduled, I had the hematologist/oncologist appointment first and the Herceptin infusion second – usually the reverse.

I had a long conversation with Dr. Velez. First, there’s some good news. My last Herceptin infusion should be June 25 or July 16. The reason there’s some question is Dr. Velez has to go back and hand count every appointment and take into consideration the one that I missed due to Covid. That means I don’t have to go through August of this year.

We discussed whether or not to do another Signatera test to check if I have any breast cancer cells floating around. My last test was in November and the score on the test was zero – no cancer cells. They drew blood for that test today and it’ll be a few weeks before I know the result.

I also asked about another echocardiogram. He intends to have that scheduled before the last Herceptin treatment. Herceptin sometimes leads to heart failure.

We discussed how Gabapentin was not working for my neuropathy. As a consequence, he’s re-prescribed Lyrica. That in conjunction with Cymbalta may have more effect. The Lyrica is 75 mg twice a day and he’s doubled my dose of Cymbalta.

I also asked about what happens after Herceptin. I remember him talking about another test, the Grail test, that checks for 40 types of cancers. It costs $849 but it is pretty definitive and sensitive. He gave the example of a person undergoing a colonoscopy and being told he was clear and then taking the Grail test and coming back positive for colon cancer. They were able to catch it early and treat.

This brought me to my come-to-god moment with Dr. Velez. I started as tactful as I could – you know me – tactful to a fault – not. I told him I understood he walked a fine line between trying to be upbeat for his patients and their chances and then weighing the outcome. I said he might wish to consider the patient a little more. I explained that I was a single, gay male who had never been in a relationship and 75 years old. The one great joy in life I had was hiking and the neuropathy has robbed me of that. I frankly told him I would not go through this again.

It may sound paradoxical that I’m thinking about the Grail test to determine if I have any of the 40 cancers it detects but if I do have some other form of cancer I’d like to know just for the amount of time I have. I pointed out that when he convinced me to do the regimen I’m on, he gave the example of a woman who refused treatment. He said without treatment, there was a 75% chance of cancer not coming back and with treatment there was a 95% chance of it not coming back. I think he was a little stunned with my frankness and confession I would not go through the process again.

It’s a quality of life issue. I’ve given up hope that the neuropathy will go away or even be mitigated. It’s quite painful to walk any distance and the one thing I enjoy most in life has been taken away from me.

I will point out he’s refused to give up on the neuropathy, hence the Lyrica re-prescription and the doubling of the Cymbalta prescription.

Lastly, he’s had the scheduler to make an appointment with an orthopedist to check my ankle. He’s concerned there may be a ligament tear.

I walked out of the examining room and directly to the infusion center and they seated me immediately in Pat’s section. There was a little lagniappe today in TJ, a massage therapist, making the rounds giving out free neck and shoulder massages. Yes, I took advantage of his offer. He works at the Healthplex on Dixie Highway and he was excellent. I’ll go there and see how he does on a full body massage. The rates are $99 for an hour which is very reasonable for Fort Lauderdale.

My blood tests came back with the same readings as always. There are some low levels of red blood cells and hematocrits and neutrophils but nothing to worry about. Pat has pretty much convinced me to purchase a walker. I’ll probably order one from Amazon and see how it goes.

In summary, some good news, some heart-to-heart with the hematologist/oncologist, a possible new massage therapist, and the probability I’ll be on a walker for a while.

Stay tuned!

14 February 2024

Happy Valentine’s Day!

I put this under the cancer heading because I finally got some answers about the neuropathy today. I’ve been well and truly stuck with needles and shocked with electrodes today. It was pretty evenly divided between the shocking (30 minutes) and sticking with needles (30 minutes).

The shocks were anywhere from very minor (static electricity type) to significant (think hitting your funny bone). The technician did both legs and both arms and hands. For a while there, it looked like I was doing a St. Vitus dance. When she finished, Dr. Chamely came in for the needle probes.

Overall, the needle sticks were not as bad as the shocks. However, sometimes he had trouble placing the needle and any time he had me flex the muscle he was testing, the sensation intensified. He tested both legs and the left arm and leg but let the right arm and hand alone.

If you remember, the neurologist, Dr. Chamely, was basically telling me it was my diabetes that was causing my neuropathy and my endocrinologist, Dr. Jellinger saying it was probably the Taxol. Looks like the Taxol has won out – for now.

I do have both sensory and motor damage both in the upper and lower parts of my body. There is significant spinal stenosis between L4 and L5 (lumbar vertebrae) and L5 and S1 (sacral). The L4-L5 is mostly on the left and the L5-S1 is mostly on the right. The right part of my spinal cord has been damaged longer than the left but the left feels more acute (there’s where my sciatica is occurring) because I’ve accustomed to it on the right.

The real question is whether or not the neuropathy is due to the spinal stenosis or to Taxol. Dr. Chamely pulled up some scientific journals I don’t have access to and one journal reported that 80% of the people with neuropathy due to Taxol got better between 2 months and 2 years. It’s already been well over 2 months since my last Taxol treatment (October 19) so if it is the Taxol that is causing the neuropathy, it should slowly be getting better over the next two years.

In addition, I have sensory and motor problems in the upper arms. He did find it was not due to carpal tunnel so I can get rid of the wrist braces. That should make sleeping a little easier at night. However, it is probably due to my habit of resting on my elbows too much. So, he says not to do that.

Here’s the caveat. If the neuropathy is not due to Taxol (I have always thought it is) then it’s due to spinal stenosis. Other than surgery, my main option is epidurals to relieve the pain. I’ll find out more about that with my appointment with the pain specialist, Dr. Wu, on Monday.

Strangely, I count this as good news! If Taxol is the problem, there’s a good chance it will progressively resolve itself. To help with the pain, Dr. Chamely upped my Gabapentin doses to 900 mg a day versus the 600 mg. He reminded me the drug is safe up to 5000 mg/day so I’m a long way off from the maximum dose. I’m to see him in six months.

Tonight is movie night with Chris. I told Tucker he’s in charge of the popcorn!

Yesterday, I tried a Tamale Casserole recipe. I liked the results. I think I could probably do without the ground beef and make this a vegetarian dish and still like it. This is a keeper!

Stay tuned!

Tamale Casserole

INGREDIENTS

1 pound ground beef or bison 
1 can ranchero beans 
1 jar medium salsa 
1 box gluten-free corn bread and muffin mix 
1 egg 
1 ⅓ cup low-fat buttermilk 
6 tablespoons melted unsalted butter 
1 can diced mild green chiles (optional) 

DIRECTIONS

• Step 1
  Preheat the oven to 400°F.
• Step 2
  In a large skillet, brown meat, breaking up any large pieces.
• Step 3
  Drain well and return to stove.
• Step 4
  Add beans and salsa, stir to combine and simmer over medium heat 5 to 7 minutes.
• Step 5
  Let cool slightly then spoon into a 9×12-inch casserole dish.
• Step 6
  Prepare cornbread batter according to package directions, using egg, buttermilk, butter and green chiles, if desired.
• Step 7
  If desired, mix drained green chiles into batter.
• Step 8
  Carefully spoon over top of beef mixture. Smooth out to cover.
• Step 9
  Bake until cornbread is lightly brown and filling is bubbling, about 25 minutes.

31 December 2023

New Year’s Eve! The fireworks have already started. It should be quite a show in the neighborhood tonight. I maintain it’s the adults shooting off the fireworks and not for the kids entertainment. A lot of dogs and adults will need tranquilizers tonight.

I’m tired of feeling numb and tired. I think I’m beginning to figure this stuff out. Herceptin has side effects of fatigue and edema (swelling). Diabetes has as a side effect edema which can cut off circulation to the extremities and that can cause nerve damage. I suspect both Hercepin and diabetes have had a synergistic effect on me for the painful neuropathy. My feet and lower legs are certainly swollen – and numb – and painful.

On the other hand, I would have assumed the fatigue would abate the farther away I get from a Herceptin infusion. It has not. I drag around the house all day. My gait is somewhat zombie-like.

There are suggestions for the edema. I’m wearing compression socks and I plan to put my feet up today – literally. Several websites suggest elevating the feet above your heart. When you think about it, that’s hard to do. I can lie on the couch with my feet on the arms and my head/heart level with the cushions. Another option is my bed. I can raise the foot of the bed (it’s a bed that allows you to raise the head or the foot).

My glucose levels are high and my endocrinologist is concerned. As a consequence, I’ve started Jardiance again. I’ve got reservations about that but I need to get the glucose levels down. Dr. Jellinger wants me to test my glucose three times as day (as opposed to the usual one). So far, yesterday was 150, 200, and 185 (morning, after lunch, before bedtime).

I’m continuing to wean myself off Lyrica. I don’t think it did anything for me in the sense of reducing the pain from neuropathy. Too bad. It was a cheap drug through Publix.

My mental attitude is just OK. It’s depressing to go through this day by day with seemingly no improvement. I just hope the new year brings a better response physically and mentally.

By the way, I got an estimate of cost for the echocardiogram. It was over $4900. Fortunately, it was also estimated my insurance would pay for the entire procedure so my cost was projected to be $0.00. I keep waiting for some slip up or some unauthorized procedure to wipe me out financially. Keep your fingers crossed for me.

Otherwise, my big plans for today include putting black-eyed peas on to soak tonight so I can cook them tomorrow and “eat a bait” of them for good luck. (Using the word “bait” with the word “eat” was a thing my Grandmother Ruby always said.).

Everyone asks me, as a Southerner, if I eat collards with the peas. The gist is collards represent money coming in the new year and the peas are for good luck. My family never did collards routine. We would eat them if available but sometimes the frost took them out. Maybe that’s why we never had any money.

Another tradition elsewhere in the South is Hoppin’ John where you mix the peas with rice and onion and bacon. Again, not a Searcy or Agnew tradition. I’ll stick with my black-eyed peas, although I do add diced onion.

I’m optimistic about 2024. I know it’s easy to be downcast with the election of a president and endless commercials. I certainly have reason to be depressed with the continuing cancer treatments. However, I tend to be a person whose glass is half full – but with a nod to being prepared for the worst. It’s the Boy Scout in me with that motto “Be Prepared.” That was reinforced when I was in the Coast Guard whose motto is “Always Ready” (Semper paratus).

Happy New Year, everyone!

Stay tuned!

20 December 2023

I have good news! Dr. Burgers gave me the all clear for the next 6 months. She did an ultra sound of both breasts and said everything was fine. Hopefully, the check-up in June will be the same.

I apologized profusely for missing the Monday appointment to everyone in the office but they seemed to think it was no big deal. Indeed, Dr. Burgers mentioned there were several no-shows today. Everyone is Christmas shopping, I suppose.

When I was leaving, Kathy, the Nurse Navigator, greeted me with a huge hug which I badly needed. It was good to see her. She’s been a great help during this entire process. I told her Dr. Fingado (my arthritis-of-the-hand doctor) sang her praises and she was pleased.

I had an earlier appointment with the chiropractor. My left hip bothered me all day yesterday – perhaps caused by 3 hours in the infusion chair. I got up several times to go to the bathroom, but it’s hard to get comfortable in those chairs for 3 hours even though they are designed for comfort. I guess I need to walk around more but it’s hard when your feet feel like they are fat.

Dr. White, the chiropractor, spent some time with me, particularly on the Cox table. It helped somewhat. What I’m looking forward to is taking Lyrica tonight to see if it begins to help with the neuropathy which is especially bad today. The only problem I can see is that it may increase dizziness and depression. I’m dizzy enough as it is and I’m sure as hell depressed, so it should be eventful on this drug. I’ll try anything to appease the neuropathy gods. The good new is Publix Pharmacy charged me the outrageous price of $0.55 for Lyrica. Dr. Velez said that Walgreens and CVS charges $400. I don’t know if that is for a 3 month supply or a one month supply but I liked the price at Publix.

I’ve decided to cancel the rest of the acupuncture appointments. If my neuropathy is getting worse, then it’s not helping. It’s also $80 a visit out of my pocket.

It’s been overcast and windy all day and sputtering rain. I wore shorts to all the appointments today because it’s easier to get in and out of the clothing. Be assured I also wore a jacket everywhere. I only wear long pants (jeans) to the infusion center because I get very cold there. I hate wearing long pants because that means putting on socks. It’s really hard to put on socks when you feet are numb and burning with pain. It takes me a while to make sure my little toe is not on the outside of the sock. It’s the same with shoes – even the slip-on ones.

I tried Nancy and Michel’s TENS unit yesterday. It works just fine and, to be honest, I can’t tell if it is doing any good but I’ll use it again tonight. The company of the previous unit will not refund me the full price on the gloves and socks I bought but offered to give me 50% rebate if I keep the gloves and socks. Then they offered me a special deal for a new TENS unit. To say I’m leery is an understatement. I’ll keep the unit, the socks and glove. It may work if I keep the unit plugged in and not rely on the dead battery. The one Nancy and Michel replaced it with is a much more substantial unit. The other one didn’t impress me.

Last night as I was getting ready to go to bed, the house alarm started beeping. The error code was 6F which meant the radiotelephone used to connect to ADT was not working. This morning, I called ADT and they said a technician would call me at 8:30 am to troubleshoot. That time came and went. I needed to get ready for the chiropractor so I forgot about it until I looked at my phone and saw three calls from ADT with messages about missing my appointment. My phone didn’t ring once. I’ll restart the process tomorrow.

Tomorrow, I have no doctor’s appointments. I’ll use that time to talk to the high schoolers at Hollywood Chrysler Jeep and see if I can get an appointment to get the jeep’s recall fixed, the headlight changed, and the check engine like assessed.

I have several invites upcoming. I had to cancel the Christmas light tour with Chris last night. I just didn’t have the energy. I have lunch on Sunday with two friends and then with Michel and Nancy on Christmas Day. The day after, I have lunch with two more friends. I’m not sure I’ll be able to make any of them. Hopefully the Lyrica will help with the neuropathy and I’ll start to feel better. The good news is my glucose has dropped these last few days so perhaps I’m coming off the prednisone, finally. That means my adrenals should be picking up their function and I should start to feel better.

I just hate having to say to people wanting to do something with me “it depends.” That gets old for them and for me.

Stay tuned!

19 December 2023

Six hours of sleep last night but it was in starts and stops. I made it in to the cancer center early by 15 minutes. My appointment was for 9:30 am but they took me back at 9:15. Jason is my nurse today. Pat is on holiday. It’s the first time I’ve had a male nurse at the cancer center. He likes to talk football.

Dr. Velez showed up just about the time Jason started my saline and Magnesium. I started in on my questions. He scheduled this morning the echocardiogram for January. Once it is confirmed, I’ll have it listed on the My Chart account. He says the port is MRI compatible and will be no problem. He did not prescribe the gabapentin (Dr. Burgers did for the surgery pain) and he didn’t really consider it effective in treating neuropathy. He didn’t know the neuropathy was causing me so much pain. I’m not sure why he didn’t know this since I’ve been complaining about it forever. He was the one to recommend acupuncture.

In any case, he’s prescribed Lyrica. He sent the prescription to my local Publix because CVS and Walgreens charge over $400 a month while Publix is around $17. I’m starting out with 50 mg twice a day to see how I tolerate it. I can up it to 100 mg twice a day if neuropathy doesn’t improve. He’s also put in for an appointment with a neurologist. That was in relation to the stubbornness of the neuropathy and the muscle weakness.

He considers the lack of energy associated with my not sleeping well. The Lyrica should help with that. He hopes the neuropathy will ease and my energy level will pick up and the fatigue will ease.

The Signatera test came back negative so my cancer has not reappeared.

He’s agreed to provide me a handicap placard. It’ll be good for 6 months and can be extended.

After the saline and Magnesium finish, Jason will start the Herceptin.

I’m actually doing fairly well this morning. My gait is a little better and I have a tad more energy.

I forgot to mention that when Holley brought me my lunch of ribs she brought me a beautiful bouquet of flowers that included peonies. She knows they are one of my favorite flowers.

After the infusion, I’ll head to my Walgreens to pick up the Temazepam. I can still take it with the Lyrica for sleep but not at the same time. The Publix prescription for Lyrica will probably be ready sometime today or tomorrow.

I have no idea what’s happening to me but I forgot my appointment with Dr. Burgers yesterday. I called to reschedule. Whatever is happening must be catching since I was rescheduled for Thursday at 4:30 Pm. A few minutes later her nurse called me back and said she forgot Dr. Burgers wasn’t in on Thursday. I’m now scheduled for Wednesday at the same time.

I also tried to schedule an appointment with Hollywood Chrysler Jeep for the engine check light and to get the headlight replaced. I also asked about the drivers side headrest and the recall. It was like high school kids were manning the phone. I was finally told there was a headrest in stock but they didn’t know who it belonged to. However a new one was due today but they didn’t know who that belonged to. As to the recall, I was told it was a computer upgrade. That’s not what the website says, it’s a parts issue. In any case, I’ll call later this week to see what’s what.

There has been an ongoing saga with the TENS unit since it won’t charge. The company demanded a receipt for proof of purchase. Michel and Nancy told me it was a silent auction prize. They felt badly and ordered me a new unit and made sure it was delivered last night. I can’t wait to try it out. I’m sorry their unit didn’t work and certainly didn’t expect them to replace it but that’s how they are – too good to me.

That’s it for today. Stay tuned!

17 December 2023

I certainly would not have wanted to be on a boat last night at the Fort Lauderdale Boat Parade – if they had had it. I wouldn’t even want to watch it. It was rain and wind most of the night with more predicted for today. Melinda posted on Facebook that Fort Lauderdale was pressure washed and blown dry. That’s an apt description.

Starting Monday, I hope to get some answers. I have zero energy today. Monday is a blood draw to check my cortisol level. Tuesday is a Herceptin infusion and I will be able to talk with Dr. Velez, the hematologist/oncologist. I just can’t go on this way. I’m too tired to do much of anything. I also need Dr. Velez to schedule my next echocardiogram. I’m just not getting better the way I was promised. I’m not sure if it is the effects of the Taxol lingering or if it is my cortisol levels. Wednesday is chiropractor and Friday is hydration infusion. It’s getting ridiculous the number of doctor appointments/infusions/adjustments I seem to go through in a week to no avail.

Dr. Velez wants to start me on Tamoxifen but I need to be physically better before he does that. I have the medication already at the house but I’m not to take it until he OK’s it and he said he wants me to be in better shape before I take it.

It feels like I’m in a nightmare and can’t wake up. It portends a bleak future.

My walking has gotten worse along with the neuropathy. My gait may be due to back issues but it certainly is not helped by the neuropathy. In essence, my fingers, toes, soles of my feet and tops of my feet burn with occasional stabs of pain. Even typing the blog is painful.

OK, that’s enough whining. I’m headed to bed and try to get some more sleep. I don’t blame you if you don’t stay tuned.

29 November 2023

It’s been a busy day. I wrote yesterday I got one hour of sleep. I improved on that last night getting 1.5 hours. I thought I was doing pretty good after the infusion on Tuesday but when I crawled into bed at 6 pm, I started aching. First, it was low back pain. It then spread to my hips. Then to the thighs and then to the calves. It was excruciating pain. I tried everything in the book and got no relief. I thought I was going to have to call someone to drive me for today’s appointments but as I started slowly moving around, I got better. Apparently standing helps. Lying supine does not.

My first appointment was with Amy Sear, acupuncturist recommended by Dr. Velez to help alleviate/mitigate the peripheral neuropathy. She had to temporarily move her office from Johnson Street near Hollywood Memorial to Washington Street near Memorial South. Actually, her temporary office is in the same building as my cardiologist so I had no trouble finding her.

First, she’s a talker. She would ask you a question and before you could complete the answer, she was off on another tangent. Every malady I mentioned, acupuncture would help. I also needed more than one session – of course.

The process was relatively painless. The most I felt the needles were in my left ear (she didn’t do the right ear). She worked needles into the feet, the sides of my hands where you find the pinkies, the top of my head, and my forehead. I was well and properly stuck. She would leave the room periodically and come back and twist or tap the needles deeper. On the fourth visit she removed the needles.

My next appointment is at the old office on Johnson Street, assuming the plumbing problems are solved. I think we scheduled 4 more. Medicare only covers acupuncture for back pain. I was quoted a price of $150 for the first visit and $50 for each visit thereafter. For that price, I wanted her to take a photo of me with pins stuck all over but I didn’t ask.

I’m not really sure acupuncture will work but I’ll give it a try. She did make one comment I took to heart. When I told her the Cyclobenzaprine (muscle relaxant) did nothing for my back, she suggested it wasn’t muscular but neural. She recommended her chiropractor. When I went back to the jeep, I called and got an appointment for 4:30 this afternoon. I can’t go through another night like last night.

I made it back home after a quick stop at the Walgreen’s pharmacy and Winn-Dixie – collard greens tonight to go with our winter temperatures of 56°F.

Next up was my wellness check with my primary. He hold me the Gabapentin I’m on (100 mg) is the minimal dose to alleviate pain. You can dose as high as 900 mg. He suggested I do 100 mg twice a day instead of once. I’ll also probably have to increase the dosage over time to help with the peripheral neuropathy. Sadly, he said I’ll probably have nerve damage for the rest of my life. It’s been exacerbated by being a diabetic. I can’t stand to think it will never get any better.

The other thing he suggested is to stop taking the blood pressure medicine Losartin. My dizziness is probably due to my pressure being too low. He said stop it if I like and we can always go back on it if my pressure stays too high for too long.

My GP is worried about my glucose levels. I assured him that Dr. Jellinger was more than looking after me.

I met with Dr. Masterson, the chiropractor recommended by Amy Sear. It seems my Medicare and United Health covered today’s session. I figure he wants me to come twice a week until…. He put something similar to a Transcutaneous Electrical Nerve Stimulation (TENS) unit on my lower back and let that run for a while to loosen up the muscles in that area. He then did a simple manipulation that immediately allowed me freer movement in my legs.

The big concern is that I’ve developed weakness in my lower extremities to the point that when I first get out of bed, my legs almost collapse on me. He’s concerned there may be long term nerve damage if this isn’t corrected. He’s requested my GP to authorize an MRI. He can do it but it will cost me out of pocket but if the GP requests one, Medicare/United Healthcare will pay for it.

To be honest, I’ll do anything to get a good nights rest.

I have tomorrow off! I may go to Bliss Nails and get my fingernails and toenails clipped. I’ve tried for the last two days and I just don’t have the strength in my hands to do it. Bliss Nails is where Jim and Holley go on a regular basis. Chemo has made my nails brittle and they flake off and form notches in the nails which catches on any and every thing. Looks like I’m ceding small parts of my life to someone else’s control.

Stay tuned to see what falls apart on me next!

28 November 2023

Whether it was the prednisone or the sore back, I got all of one hour of sleep last night. For the back, I alternated between an ice pack and a heating pad. Nothing worked. I took 1/2 tab of cyclobenzaprine (muscle relaxant) and it did no good. The first time I took a whole tab of that it knocked me out for an entire day. Then in the early morning, diarrhea hit – three times. That’s the first in quite a while. Wade slept through it all. He later told me it was the best night of sleep he’s had since he’s been here.

Barbara picked him up at 6 am this morning and we all said goodbyes. He stops in Denver and is hoping he’s not stranded. He later texted me it was 40°F and snow on the ground.

I took an Uber to the cancer center and made it with plenty of time to spare. Sean, the driver, was talkative and he could relate to me since his mother was a survivor of stage 4 lung cancer.

Pat was my nurse again (hurrah!) and I asked if she could give me a fix of saline in addition to the Herceptin and Magnesium. She did! I started to feel better immediately.

Strangely, my blood work was pretty good. My white blood cell count was even normal (and has been since I stopped Taxol). Of course, my Magnesium was low and I needed that drip added. Otherwise, there was nothing in the blood work that would lead you to believe I felt like crap.

Earlier, I texted Dr. Jellinger my vitals: BP 148/91 (the monitor asked if I was sure), Pulse 98, Temp 97.9, Glucose 211, and Oxygen 98. He later texted me to have nurse or physician to check pre- and post infusion. Pre-infusion the BP was 126/76 and post-infusion it was 135/71. I suspect he was concerned with the morning reading I did at the house.

I sent for an Uber around 12:30 pm and it was just arriving to drop a fare off at Holy Cross. Pedro was his name and he didn’t speak much English. You are given a PIN code on your phone and he has to type that in to confirm the ride. I had to give him the numbers in Spanish. He drove very fast and moved into the lane and then signaled his move. He didn’t follow the map and when I told him which exit, he merrily sailed past my exit and headed to the Fort Lauderdale International Airport where we got tied up with semis lined up to get into Port Everglades. I still gave him a 4 star rating and tipped him.

I’m slowly putting the house back together after Thanksgiving and Wade’s visit. It didn’t seem like he was here for a week. Time really flew!

Since I’ve been hydrated, I hope to be able to drive to my two appointments tomorrow: Amy Sear for acupuncture and Dr. Dunhill for wellness check.

I still stagger around like a drunken sailor (which I was at one point in time) due to the neuropathy. It also feels like I am wearing wooden clogs when I walk. At least I have the energy to put a load of clothes in the washer. I suspect I’ll go to bed early tonight. Apparently, I dozed off in the infusion chair today which is pretty hard to do with all the activity around you.

Stay tuned!

20 November 2023

It’s been an interesting day. I at least got 7 hours of sleep last night and a short, short nap this afternoon.

Most of my morning was a drudge. I feel terrible when I get out of bed and simply slog through breakfast and any tasks I set myself. I changed the linen on the guest bed, dusted around the room and tidied up as much as possible in anticipation of Wade’s visit for Thanksgiving. It left me exhausted.

Farah called around 10 am and said Dr. Jellinger would Tele-Med me around noon or 12:30 and provided me the link via email. I knew that was a pipe dream. Dr. Jellinger takes time and talks with his patients. I’ve learned to be the first patient of the afternoon because every patient thereafter is late getting in to see him. I don’t begrudge him that – I appreciate his taking time with them. Besides, I’m retired, what else do I have to do?

Farah called me back around 1 pm and apologized. We reset the Tele-Med for 2:30 and he was ready (after a glitch or two) at 2:40 pm.

In essence, we re-hashed my symptoms. I mentioned that the side effects I’m experiencing are common to both adrenal insufficiency and Taxol treatments. He then asked when my last Taxol treatment was (October 17) and then proceeded to look up the half-life of the drug. Based on his calculations, I should be over the major effects of Taxol (not, it seems, the peripheral neuropathy). I can tell the side effects are abating – my beard is coarser, for example.

We then shifted to adrenal insufficiency and he questioned how much I was urinating with the Jardiance. To make it short, he’s stopped the Jardiance. He thinks it is dehydrated me and causing my fatigue and tiredness and lack of energy. I’m to start up my blood pressure medicine again (Losartin) but at half the dose (50 mg vs. 100 mg). I’m to continue to take the prednisone at 5 mg daily.

If after two or three days off Jardiance and I don’t bounce back energy wise, I’m to add 2.5 mg of prednisone at bedtime. The real problem is the longer you are on prednisone, the longer it takes to come off it. He’s concerned my adrenals will not bounce back if I stay on the prednisone too long.

Any way, I’m to text him Saturday morning (he’s in New York) and let him know how I’m doing and provide him my vitals. Next Monday I’m going in for a blood draw.

He asked me to take my blood pressure resting and supine and then take it standing after 1 minute and 3 minutes. After being supine for 5 minutes my BP was 152/92. I took twice more: 147/91 and 152/93. After standing 1 minute it was 136/90. After three minutes 138/88.

He later texted me he expected a greater drop in pressure. I’m to go full dose on Losartan if my BP is consistently greater than 140/90 on the half dose. If this doesn’t work, there is something else that is going on with me that will have to be determined. Keep your fingers crossed.

One of the peculiar things is that I usually start to feel better towards the evening after a terrible morning and afternoon. I take the Jardiance in the morning, so we both wondered if the effects of Jardiance was wearing off and the effects of the prednisone kicked in.

Ironically, I was out of Jardiance and needed the prescription refilled. It was ready today and I drove to Walgreens and picked it up (to the tune of $118). When I asked about the glucose test strips, the pharmacist came to talk to me. Apparently, the government will not refill those until 2 days before the prescription is due.

The pharmacist asked if I had a supplemental policy to Medicare and I said yes, United Healthcare. He asked what plan. I said “F.” He said “Good, they cover everything.” I mentioned I get tons of mail asking me to change plans and he told me never, ever change from”F” if I don’t have to. It’s a good thing I’m grandfathered in because AARP and the government stopped that plan.

I did manage to work on a bed side lamp. The light kept flickering. I pulled the bed out to reach the plug and took the lamp to the kitchen table and started to work on it and check the wiring. It looked good and when I put the guts back together, the light still flickered. I decided to change the bulb. Voilà! It was the bulb. I should have checked that first!

Stay tuned!