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More Good News from Houston

Kathy and I are hanging out at Houston Hobby airport waiting for our flight home. We’ve been here since Monday for a routine visit three months after my final round of PRRT. I had several follow-up tests and exams at Excel Diagnostics including a MUGA scan, renogram, bone scan, MRI, CT, and octreoscans. I also had the gamut of lab work last week. All of the results are good. The imaging shows continued tumor death in my liver and other areas. Some areas of tumors in my lymph nodes and diaphragm are stable. There is no evidence of disease in my bones. My kidney function is normal, and there is no sign of toxicity in my kidneys from the PRRT.

A couple of the most dramatic findings are that the overall tumor bulk in my liver is down to about 25%. A few years ago as much as 40% of my liver was involved with cancerous lesions. The doctor showed us the MRI of my liver and the difference from then to now is amazing. Also great is the fact that my neuroendocrine tumor markers are all the lowest they’ve ever been. These include cga, neurokinin a, serotonin and 5HIAA. That last indicator is the one that surprised us the most because it’s what helped to diagnose me with carcinoid back in 2005. At that time my 5-HIAA level was 87. The highest that indicator has been in the last six months was 55. My test last week showed it at only 15.

The hope now is that this therapy will continue to work over the next several months to further reduce tumors, and that I can enjoy up to five years (or maybe more?) of tumor free progression. I will continue to have follow-up scans and tests on a regular basis. We still have to work out the details but I should be able to have the majority of that work done at Cedars-Sinai in LA rather that having to return to Houston.

We’re so thankful AGAIN to our wonderful friends Mary and Russ who opened their home to us this week. We feel like part of the family and really enjoy our visits with them. While we won’t miss the humidity here, we will miss the people and the great care. I feel so fortunate to have had the opportunity to receive this therapy.

2 Scans Down and a Bunch to Go

We’re huddled in Houston where it was a brisk 47 degrees today, a full 60 degrees cooler than our trip in August. This time I asked for the blankets while I was in the scanner for 20 and 30 minutes at a time.

Today’s scans were a renogram, to make sure my kidneys are functioning well to flush the radiation; and a bone scan to check for mets. Over the next few days I still have an MRI, CT, and several Octreoscans which measure the uptake of the radioactive material by my tumors. It took four sticks to get my IV started today. UGH! I hate IV’s. I have a bunch of lab work tomorrow morning and I’m really hoping they can find a vein on the first try. We’ll get the results of everything when we meet with the doctor next Tuesday afternoon (the appointment got switched from Monday).

Kathy and I love the staff at Excel Diagnostics. As miserable as all of this is for me, the people there really make it okay. We get big hugs like we’re old friends and we laugh and joke our way through the day. Thank goodness for friendship and humor. Speaking of which, we had a wonderful time today meeting Candy, a kindred spirit who has been going through all of this right along with me. A pancreatic NET from SoCal, she had surgery similar to mine at Cedars nearly three years ago and started PRRT here about a year ago. Done with her therapy, Candy’s back in Houston for some follow-up scans. She has been a constant source of inspiration for me, and someone that Kathy and I have both leaned on. We get to spend more time with her tomorrow and we’ll all grab some dinner together.

Mary & Russ are great hosts and we feel right at home here. It’s great to have a place to just relax and unwind in the evening. I think if we had to stay in a hotel for two straight weeks during this I might go crazy.

TGIF

Aaahh, the scans are all done. Woohoo! No more IVs until next Wednesday. Double Woohoo!! Today was the fourth and final octreoscan, about an hour lying still in the machine from Monday’s picture. That was followed by an IV injection of the glucose tracer for the PET scan. We sat around for 45 minutes while that was absorbed by my tumors, then had the actual scan in the machine above. It’s the same machine I had my CT scan in yesterday. The PET scan was also about 45 minutes. Then that was it.

We’re going to take it easy this weekend, catching a Giants-Astros game tomorrow at Minute Maid Park. No plans for Sunday. Monday afternoon at 2:00 we meet with Dr. Delpassand to hear the results from all of the scans this week. I’ll post more after that meeting. Have a great weekend.

Almost Done with Scans

Today was pretty easy. Just about an hour in the same scanner for the third phase of the octreoscan. The imaging plates slowly rotated around my body giving them a pretty cool 3-D picture of tracer uptake in my tumors and elsewhere.

That was followed by a CT of my abdomen, something I’ve had done dozens of times. First they had me drink a quart of contrast that they says tastes like a chocolate milkshake (lie) then they gave me an IV in the back of my hand for more contrast. That’s usually no big deal but the vein blew out so it was a little painful.

We were done in time for lunch and a leisurely drive back to Spring. I’m feeling much better being back on my regular injections. Tonight I have a special high protein, no carb diet in preparation for the PET scan tomorrow. The PET tracer is a glucose analog so they want your cells to be very hungry for that tracer when it comes along.

More tomorrow after my final scans. Thanks for stopping by.

The Dreaded MRI

Well enough about the weather already because apparently my ranting isn’t going to drop the mercury one bit.

Here’s a picture of the wonderful home we’re staying at in Spring TX with some old friends, Mary and Russ and their two sons. It’s really great to have a comfortable environment and some excellent home cooking during this adventure.

Today involved two scans in the same apparatus with a similar nuclear injection. They were octreoscans, where the isotopes bind to my tumors so they can get a good idea of how effectively the real therapy next week will also bind to my tumors. Tomorrow and Friday will each entail an additional octreoscan to track that effectiveness over time.

I also had an MRI today. I don’t care what anybody tells you or where you have it done, but when you’re 6’2” with broad shoulders squeezing into a little tube with your arms bent over your head while a loud machine screams at you for a prolonged period of time is never fun. It’s all part of the process however and I know that the images are invaluable in displaying very clear pictures of my tumors.

The good news is that I’m back on my octreotide injections this evening and am already feeling a little better. I’ll be on them until Sunday night when I’ll have to go off again to prepare for next Wednesday’s therapy.

The other PRRT patient that we met was on a second scanner in the same room with me today. She and I spoke briefly this afternoon, and of course we’re both very hopeful for great results from this therapy. She has also been off her injections for a couple days so we were commiserating. This is all a little easier with a shared experience.

Tomorrow will be another octreoscan and a PET scan (which I’ve never had before). I’ll post more after that. Take care y’all.

More Scans – Day 2

I think it was actually a little hotter today in Houston than yesterday. Incredible. I suppose you could fry an egg on the sidewalk, except I heard a report that it’s so hot all of the chickens are laying hard boiled eggs.

Today consisted of more scans on the same machine that was in yesterday’s photo. First was a renogram to check for kidney function, then a bone scan. Different blends of the same radioactive isotope were injected for the imaging. The kidney scan is done to make sure that my kidneys are functioning okay since that’s where next week’s radiation therapy will settle aside from my tumors. They need to be confident that my kidneys will be able to handle the influx of radiation and then effectively clear it from my system.

The bone scan was done to look for the possibility of bone metastases. That scan went from head to toe. Afterward it was evaluated, and then they did a follow-up scan on my abdomen to get a better picture of some areas that they wanted to look at a little more closely. Ideally the first scan would have been enough, meaning they didn’t see anything. We’ll find out the results of this scan, and all of the scans from this week when we meet with the doctor on Monday afternoon.

I also had to stop taking my injections yesterday morning since that drug can interfere with some of the imaging. It’s the first time I’ve been off of Sandostatin for years, which helps control my symptoms, and today I’m not feeling so great. Lots of flushing and discomfort, especially after eating. I get to start my injections again tomorrow evening and can stay on them until Monday, when I’ll be off of them again. Hopefully this therapy will be very successful and will help knock down my carcinoid syndrome symptoms.

Through it all, the people at Excel have been great. I’m also very fortunate to have Kathy by my side every step of the way.

Tomorrow afternoon will bring a couple rounds of octreoscans and an MRI. I’ll post more then. Take care.