Sunday, July 17th, 2011 -- Part I: Health Update

Hello Blogees and Blogettes!

So much has happened in the last 17 days, I truly get confused as to what people know and what people don't know. For those of you on Facebook, you may have been following the ongoing Health Journey... but a lot of you are not on Facebook, so you've only been getting the blog updates, which the last one was 17 days ago! Then there are the few emails, but those are mostly just family emails... and they are very disjointed because when I try to keep too many places up to date, I end up only confusing myself and everyone else because all three places have updates only as time permits. So I really and truly want to get back to one spot for Health updates and I'll be more conscientious of making sure the title of the blog entry specifies when it is a health update. That way, for those who are only interested in the medical stuff, they'll know which blog entry contains it... and those who also enjoy my babble/rants/chats, they can read both :D

Soooooo... this first Sunday entry is a health update! I have lots of pics and chit chat for the second one (Part II) but may not get that one done until tomorrow ... we shall see how the evening goes :)

Last you all heard from me was back on July 1st.... Canada Day! The Sunday before, I ended up at St. Paul's Emergency because of the difficulty breathing. They managed to get things back to some form of normal, so I left the hospital in way better shape than I had entered the hospital. I also had seen my oncologist the day before and our new plan was to take a break from the chemo. She wanted to hear from me in a week and hopefully the wheezing/whistling/breathing problems should all be cleared up now that I wasn't on chemo. This was because we now realized that the wheezing/asthma like symptoms were a sensitivity to one or both chemos (most likely the one that I started back in February since I had been complaining about bronchial symptoms, etc. since we started that chemo.

Ok, so now starts the continuing saga of the health update. A week after my appt. with Sharlene, the breathing/wheezing/asthma symptoms still hadn't gotten better. At least, if they were getting better, I couldn't say that I noticed a real difference. I still got tired easily, I still had problems with the breathing going up/down my 8 steps from the floor my apartment is on to the carport level, etc. So, Sharlene said she was going to see about arranging an emergency Chest CAT scan (different from the 3 month Abdominal/Chest CAT scan that we do to monitor how/if the chemo is working and that I have an appt. for on July 27th). Now, when she asked to have the July 27th one bumped up, it wasn't possible... so I'm not sure what magical words she used, or if she used her "pull" but she managed to get one right away for me. The reason she wanted me to have this now is, she wanted to rule out the possibility of Blood Clots

So, this past Wednesday I went in for a "spiral" Chest CAT scan and blood work. Well, lo and behold, they found a Baby Blood Clot. I say "Baby" because it is very small and there's only one. OMG! One small blood clot can cause this much difficulty with breathing??? For the life of me, unless others react differently to blood clots in the lungs, I can't see how anyone could possibly not report them until they are too big to deal with... I'm having a hard enough time just being able to breathe and get some air in my lungs! I can't imagine how much worse it can get!

Sharlene explained that we have caught this one in it's very small stage and the treatment is to go on Blood thinners. The idea is that the blood thinners will break up the clot and then the body will just absorb the pieces. She says this clot is so small, the body may just absorb it without it needing to be broken up. Meanwhile by being on the blood thinners, that will prevent anymore from developing (and prevent Baby Blood Clot from growing). Standard protocol will be to be on the Blood Thinners for 6 months... so yes, I had to go the next day to the Thrombosis Clinic at VGH (Vancouver General Hospital) to see a Hematologist and to have a nurse teach me how to give myself a shot since I'll have to do this twice/day.

Sharlene also explained that in a healthy, non-cancer patient, if they were to get blood clots in their lungs, it would be a big deal and they would need to go under rigorous testing to find out WHY they have blood clots. But for cancer patients who have been on various chemo treatments, it doesn't come as a surprise to find blood clots. That is quite a common reaction to everything the body/system is going through and going through it with a compromised immune system.

Sooooo, of course I had questions. I have been complaining since the beginning of Feb when we started the new (to me) chemo, Irinotecan. Even from the first treatment of it I was complaining of bronchitis symptoms that started almost right away and never really did go away. I was pretty sure it was bronchitis since I know the symptoms very well, but thought it was ironic that I haven't had bronchitis for some time but as soon as I started this chemo, I was hit with it immediately. But no, both Sharlene and my GP, Sean Fay, both assured me that chemo does not cause or trigger bronchitis. The fact I'm susceptible to it, chances are I was exposed to it and came down with it quickly because my immune system is compromised and not 100% in fighting order. Ok, that made sense. Well, as time went on, the bronchial symptoms seemed to take on the new symptoms of the "wheezing" when I would exhale. Now I had NEVER had that when I had bronchitis, but apparently this is not uncommon with those who suffer from chronic bronchitis. Ok, I can buy that, but I just know I have had chronic bronchitis for YEARS and I have never ever had the wheezing. In medical terms, the condition is called bronchialspasms and people with chronic bronchitis, asthma or COPD are susceptible to this condition. Ok... but it never did go away. If anything, it became worse and the wheezing started happening when I inhaled, not only exhaled. Well, apparently if you get the wheezing on the inhale, then you should seek medical attention immediately. I didn't know this but it was shortly after this happened that I ended up at St. Paul's Emergency because it was hard to inhale or exhale... and breathing normally just wasn't close to happening.

It was at this point that I think Sharlene had decided it was time for a break from the chemo and I had decided to tell her that I NEEDED a break from the chemo. Her reasons were probably different than mine... she realized that my immune system was not keeping up with the stuff I was being exposed to. I told her I needed a break because with this difficulty in breathing, I just didn't feel I had the strength to go through another chemo session. Of course, it was at this time that she said she wanted to hear from me within a week to see if the breathing had improved... if the breathing (aka asthmatic response to the chemo) was not having to deal with the chemo, then it should show a marked improvement. As I mentioned above, the breathing didn't improve in the one week so Sharlene wanted to rule out blood clots in the lungs. When I had the emergency Chest CAT scan this past Wed, Sharlene had 3 radiologists go over it to make sure absolutely nothing was missed.

The first question I asked was, "If blood clots are common with cancer patients, why wasn't that one of the first things that we checked for when I was complaining of bronchitis? then the bronchialspasms? then the asthma response?" Well, with each of the complaints, they all checked out as being what they were (Bronchitis, Bronchialspasms, Asthma Response to the build up of Chemo and then the breathing getting worse indicated possible blood clot(s). It is not unusual for a cancer patient to have multiple conditions showing up... but what is unusual was that I had all four at once. Considering I have a compromised immune system, my system was actually doing very well having to fight 4 conditions at the same time. I doubt anyone with a strong immune system would be able to do any better than I did... so that somewhat pleases me.

The plan now of course is to get rid of the small blood clot, hopefully it will just end up being absorbed and the blood thinners will prevent any other blood clots from forming anywhere in my body. At first, it almost seemed like the blood thinners were clearing up the breathing. I have to admit, it is a lot better in that I'm not going into that panicky feeling I was getting when I just couldn't get enough air in a breath. That is all gone and I can breathe quite normally now. The wheezing is still there but the annoyance now is the cough. It's like a bronchial cough once the tight chest has broken up. With bronchitis, that cough sounds horrible but is actually a good thing. I'm not sure what I'm dealing with now... before there was a dry cough where I wasn't coughing anything up, so I wasn't sure why I was coughing. Now it's a loose cough, so I have no idea if this means it's on the way out.. or ??

Tomorrow I have to go to the Blood Lab at St. Paul's. The Hematologist has ordered some blood tests, I think to determine if there's enough blood thinner in my system or if the dose has to be adjusted. NEXT week (July 27) I will be getting the regular CAT scan so we can determine what's happening with the tumours in the lungs. Did the 5 months of chemo actually stabilize them? Let's hope so because now that I'm on the blood thinner med, I can't be on chemo. Meanwhile, if the tumours start growing, then we have to weigh the risks vs the benefits... stick with the blood thinner so no new clots form and hopefully we get rid of this single clot and hope the tumours don't grow quickly... or, go on the new (to me) chemo (Vectibix) and stop the blood thinner, hoping that no blood clots form.

Oh well, we'll deal with each thing as it comes up... no point worrying about the "What ifs..." when we don't know what will happen next until it happens. As my GP has told me since we started this journey... one step at a time, one hurdle at a time. We aren't going to worry about all the possible hurdles that can come up, only the ones that do come up and with those, we'll fight them one at a time.

So there you have it!! It's now 11:15pm and I managed to get PART I: Health Update done. The chit chatty, fun entry, I'll see about getting it done tomorrow or Tues. Give folk time to read this one first before I do the 2nd one :D

Have a great week, everyone!!

Hugggggggssss,

Cheryl