A Rough Patch

Steve and his family have been going through a bit of a rough patch. We already talked about the flu and how that affected Steve's driving temporarily. Then there was the low platelet problem which has prevented Steve from taking Temodar.  Unfortunately, his platelets have continued too low to resume his Temodar. We are a bit unhappy about this because we have heard from Dr. Hu that Temodar is the first line defense against glioblastoma and the most effective drug they have to fight recurrent tumors.

Blood lab results from 9/12/14 showing, once again platelets below 100,000, and therefore, too low for Temodar:

WBC 5.1 RBC 4.85 Hemoglobin 15.8 Hematocrit 46.1 Platelets 94,000

Creatinine 1.1

Then Steve got to have blood drawn again on 9/26 just prior to his Avastin treatment and just after his scheduled MRI: WBC 7.8 RBC 4.84 Hemoglobin 15.9 Hematocrit 46.1 Platelet 68,000

Creatinine 1.1

Like.Creatinine 1.1 .Creatinine 1.1

This was his first MRI since starting his new Avastin treatments. Steve was feeling quite anxious about this appointment, fearing an increase in the tumor size because of his flu symptoms. 

Terry let us know the results with this information: "Hi Everyone! Steve's MRI showed NO NEW GROWTH!!!!!! Yeah!!!!!!!!! Thanks for the good thoughts, prayers, and love!!!!!!! Long day for my love...MRI;blood work; Chemist infusion ; all while dealing with the end of a chest cold and a sore right knee muscle....Been a long month... Many Thanks Love Terry".

She later gave us more details: "the Avastin did it job the MRI showed no new growth!  Dr. Hu was very happy with the results, Next treatment October 10th, and next MRI in Early November. Steve’s platelets  have been taking a beating as a residual effect from the Temodar, so we are discussing different treatment options to allow he platelets to recover.

One option is to do the Avastin alone, the next option is for Steve to wear the NovoTTF device, and the third is to do both, this is the option Dr. Hu is recommending. I have attached links to both websites for your information.The  NovoTTF  is a device Steve would have to wear at least 18 hours a day for it to be effective. Plus he figures he needs to get clearance from work.  It would be a real lifestyle change. so we have a great deal of thinking and due diligence to do over the next week or so."

http://www.novottftherapy.com

http://www.avastin.com

Steve had blood work on Thursday, 10/2 "Only a CBC...and his platelets were 106,000 Yeah!"

Terry had mentioned a sore right knee muscle above. When it didn't get better, Steve went to his regular doctor's office and was diagnosed with a strain. Because the pain was now closer to the ankle, he was given a boot to keep the ankle from moving when he walked.

Now we are up to Friday, 10/10/14 when Steve had his Avastin infusion treatment. He went wearing his boot like he was supposed to do. Dr. Hu questioned Steve about the boot, seemed to develop some concern and, at the end of the IV treatment, sent Steve to have a venous doppler ultrasound to the calf and leg, which showed…… A HUGE BLOOD CLOT covering the whole leg from hip to ankle. Steve was sent right to the emergency department and then stayed overnight in a nice, private room. He got IV heparin blood thinner to stop the clot from forming and to help decrease the risk of part of the clot breaking off and killing him. Saturday morning, Terry showed the nurse she knew how to give shots and now Steve gets twice a day Lovanox blood thinner shots at home for at least the next month and  probably once a day thereafter for the foreseeable future. They got to go home Saturday afternoon.

So, two rumor recurrences this year, the flu with visual problems, a cold, low platelets with interruption of chemotherapy, sore leg now diagnosed with a serious blood clot which luckily wasn't any worse and now a new decision to start the NovaTTF which we will talk about in a new post to come.  

It's been a bit of a trial for them. Steve doesn't like being sick so has not been pleased with these complications. On the other hand, he's been so lucky that he has been able to continue working, except when his cold was too bad, and he's been lucky that the blood clot didn't cause any serious problems.

Let's hope the rough patch is over.

All Better

Hi Lisa......Sorry crazy week.....Steve had his ophthalmologist on Tuesday, All his test, including a Visual Fields test came out normal. Emailed Dr. Hu with results, and he cleared him to drive. Conclusion the flu Steve had last week intensified the symptoms of his active tumor. He over the flu, and not list to the right any longer. YEAH! Love you bunches.

New Onset of a Possible Visual Field Deficit

Steve and Terry weren't too alarmed on Sunday evening when Steve developed a mild headache. After all, Steve's body received a lot of chemotherapy last week when he finished his normal round of 300mg Temodar on Wednesday and then began his first round of Avastin on Friday. It was bound to be hard for him and some residual discomfort would be normal, right?

As the next few days progressed, however, so did Steve's headaches and Monday night, Steve began feeling chilled. He had spent his work day in a cool, air conditioned room designed to keep some supercomputers cool so it was understandable. Tuesday, his headache felt worse and he was even more chilled so maybe he would feel better after spending some time under the blankets, which he did after dinner, going to bed early.

Now, unbeknown to us, Steve had been out to lunch with his work buddy, Steve Cox (the same friend who had encouraged Steve to see his doctor about his original word finding problem which led to the discovery of his cancer) and Steve Cox noticed that our Steve was driving too far to the right of the road, actually sometimes hitting the weeds on the shoulder, and our Steve was not aware that he was driving off center. Thursday, Steve Cox let us know about his concern.

On Wednesday, Steve's headache was getting bad and by the end of the day he began to have mild diarrhea. That evening, he misjudged the distance to drive around a stopped vehicle on the road and hit his passenger side mirror, damaging it.  Uh oh, a second event involving vision on the right.

Thursday, he stayed home from work and had a fever. Tylenol helped with the fever.

Terry called Dr. Hu who said Steve's symptoms were likely a viral flu bug. He explained that Steve is more prone to get sick due the chemotherapy lowering his immunity and any infection will exacerbate symptoms from the tumor. He ordered a CBC blood test for Friday and wants Steve to see an ophthalmologist. There is a neuro-opthalmologist at Cedars-Sinai he could see but any one closer can test for visual field and save them the time and trouble of driving in to the city. Terry plans to call Monday morning to make an appointment for Steve.

Steve and Terry agreed that Steve won't drive again until he is tested and cleared by both the ophthalmologist and Dr. Hu. He can carpool with his colleagues to work until then with just a little inconvenience due to differing schedules.

Friday, Steve's blood test results indicated that Steve was fighting an infection with his white blood cell count at 5.8. That is high for a chemotherapy patient and high for Steve. It shows his body is fighting an infection. Today, Steve is starting to feel better. He no longer has chills and his headache is mild.

It's interesting that even with the knowledge that Steve did not see objects on the right side (at least twice) that neither Steve nor Terry have noticed any visual field deficits. It's possibly transitory or perceptual or improved or they aren't observant enough to find it. It will be interesting to know the results of the eye testing.

We hope the testing is done quickly to determine if Steve can safely drive to work again soon.

Steve's next routine lab tests are scheduled for August 21st and his next Avastin treatment for August 29th followed by another doctor's office visit.