Wednesday, March 20, 2019
On Monday, I take one of our "Buff Boys" (beige-colored cats), "Chino," to the vet for his bi-weekly glucose-monitoring day. This is his new routine, as "Chino" was recently diagnosed with diabetes.
In addition, since his diagnosis, I've been injecting him with insulin twice a day, subcutaneously ("sub-q"), going on six weeks now. Though he's eating well, he's lost weight; apparently, it's related.
Without getting too sad, too soon, he looks frail and the stares and meows he gives me seem to be pleas for help which, other than providing food, water and touch, I am clueless as to what else I can do. I'm not anticipating the worst yet, but when I pick him up at the vet later in the day, I'm not expecting the best either.
On Wednesday, I go for my first CT scan in eight weeks. More significantly, it will be my first "CT" since I began immunotherapy. I don't quite know what to expect; although I know what I hope.
The fact is I/we neglected to ask my oncologist what his expectations were: specifically relating to a time frame about the immunotherapy's effectiveness; and as we've moved on, we have a few other questions: Will the infusion have any effect after just eight weeks, generally? Is there a protocol/length of treatment which a patient is supposed to have before success or failure is determined? Are there any indications other than scan results which might contribute to an assessment of the drug's impact on my tumors? Is it possible that the tumors in my lungs might have a different reaction (shrink, stable, grow) than my "Adam's apple" tumor? If so, then what? Are there any side effects from my bi-weekly infusions which could cause my treatment to stop?
Beyond these types of questions, my oncologist prefers not to discuss scenarios. The short summary is: we're looking for some kind of clarity and/or guarantee. Unfortunately, for cancer patients, clarity and guarantees ended on the date of your diagnosis.
On Friday, I have my next scheduled infusion (with pre-infusion lab work on Wednesday). Door to door, depending on how busy the Infusion Center is, and depending how long it takes the pharmacy to mix/prepare my drug, it will be approximately three hours until I'm back home. The experience is not tedious nor is it torture.
Compared to the eight-hour days I had to endure in the early, heavy-duty days of chemotherapy, this time commitment is a breeze. And when one considers the relatively minor side effects, so far, the routine is quite bearable. (I just need the immunotherapy to be effective.)
On the following Monday, we see my oncologist. Typically, we don't see him until later in the week on Friday. In the 10-day interim, my oncologist will email results of the scan – with his assessment – and attach the radiologist's report, so that when we see him, we're aware and prepared.
However, in this week's particular instance, he had availability on Monday, five days post-scan, and not on Friday. As such, we are seeing him so soon after the scan occurs that he might not have any results to email us before our appointment.
This means that we'll be going into the appointment cold, so to speak. Which means we'll be extremely anxious as we sit in the examining room waiting for his knock asking if it's OKAY for him to come in. And then staring at his face as he enters looking for any kind of hopeful sign that the treatment has worked.
And that's what this week-plus-one-day will be: a struggle; about me, for my wife, about our life together and about one of our cats.
Each of the four days/four events itself would be stressful and thought-provoking enough. Having them occur one right after the other, simultaneously almost, is like adding insult to injury. It's bad enough to begin with and it's potentially even worse how it might end with – really bad news.
Through it all, somehow we must remain positive. There's no future in being negative.
To invoke the late Yogi Berra, who said in 1973 while managing the last-place New York Mets: "It ain't over 'till it's over." (And of course they went on to win the National League pennant.)