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Monday, June 20, 2011

Consulting the oncologist - medical report

This time I’ll get clinical, unlike in the posting that was supposed to be this one. This is all about me and a consultation with the Oncologist after three months, so you can safely ignore it if that’s of no great interest to you. I know it is to family and close friends, and that’s why it’s here.

    If I prepare a written summary for Nick, it saves time and we stay right on the point, which we all appreciate.

Here it is.

3 month history

No infections such as flu.
Most significant feature: the return of stronger seizures
Now occurring during sleep periods rather than waking. Almost always in the past they occurred when I was awake.
Seizures earlier this year were mild and usually stopped quickly. These new seizures are now more frequent, affect the right side as a whole and are as strong as those last year, but I recover from them quicker than I did then.
It began with two seizures in the early hours of 3 May. There have been three seizures this month: 5, 7 and 17 June. No doubt this indicates heightened tumour activity.
Decline in
In circulatory efficiency (hard to keep warm in cold weather!)
Increase in
General in brain area and specific to tumour – generally mild but sporadically persistent
Have required only minor medication
Oral medications have not changed over the period, except for 30 mg/week extra Dilantin.
Clexane use has been suspended since 8 June (Opinion on this?)
Periods of sleep increasing  - one each night 6 hrs and one daytime 3+ hrs

Current status
Lucidity: good (but get 2nd opinion from Tracey!)
Some short term memory loss and shortening concentration span
Decision-making slow. Can be indecisive.
Sleep usually good
Body functions normal
Immune system remains strong
Right hand use improved with increased strength but poor for fine control
Diet balanced
Fruit and vegetables, fish, chicken, with minimal processed sugar
Weight a problem but increasing exercise subject to seizure activity.

Here’s a summary of the parts of the discussion that matter.

    We can add a third anti-seizure drug instead of increasing the dosage of current two. We will do this if necessary but not before we are fairly sure that on balance it is the way to go.

    We will resume Clexane at a maintenance dosage and not as a treatment dosage. This means dropping from 120 ml daily to 40 ml. The idea is to try to keep clotting at bay (without overdoing the treatment) so that it does not become more of a factor in the equation than it now is.

    This seems a good compromise to me even though it remains a daily inconvenience. At least my stomach has had two weeks to recover!

    As he said, he is very pleased to see me (noting that I am probably even more pleased to be there!) He was interested to know that I had prepared it alone. I told him that it was so hot off the press that Tracey had barely time to read it, and that I might even have to defend parts of it right there! I guess it gives him an indication of my state of mind.

    So, we all cooperate in optimising the things that provide good quality of life and try to keep the nasties at bay for as long as possible.

    It’s a sensible pathway between extremes, and that remains my philosophy. As long as there are wildcards in the pack, and there certainly are, going to the outer edges is a risk I’m not inclined to take.

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