January 23, 2011
This is Dennis' brother Larry again.
It has been awhile and some of Dennis' friends have let me know it is time for an update - so I will do my best even though there is not a lot of new information to share.
I never realized how hard the cancer treatment was for the patient, or for his family and his friends. Dennis can do little but endure. Family and friends can do even less. I know this has been particularly tough for his wife, his kids and mom.
Dennis spends most of this time in his recliner chair now. Besides going to treatments, sleeping is his primary activity. His trips to the bathroom for his regular mouth rinses are made with short tiny steps.
His voice is almost completely gone now so I can't really report much about how HE feels about all of this as we can't chat. His doctor said that this is temporary and his voice will return. Last week they found a small infection in his throat and that is being treated with antibiotics. Because of some bad coughing recently, they x-rayed him to make sure he isn't coming down with pneumonia. Results are expected next week but assumed to be good as no calls were received. His medical team seems to be on top of things, always alert and reacting promptly to any potential issue.
Dennis still goes in for daily hydration. More specifically, he is hooked up to a clear plastic bag suspended on a hook above his head, just like those used for a blood transfusion. The bag holds a liter of water to which they blend in the elixir of the day. Currently this is a bit of pepcid to help his stomach and esophagus, some magnesium and potassium to make up for losses caused by the radiation, and a dose of zofran anti-nausea medication. The water falls from the bag with a slow drip, drip, a drop at a time into a tube and travels directly into his blood stream. When watching this almost hypnotic dripping, it seems it will never end but two hours later it is over. Dennis sleeps through most of this process.
Some key dates for you data cruncher types like me.
- His final chemo treatment will be on February 3.
- Next week, radiation treatment #28, will be his last broad area treatment. The remaining radiation treatments focus solely on the site of the original tumor.
- His final radiation treatment, #39, is scheduled for February 10.
Dennis is taking a real beating now. This period has been tough on his wife and his mom but that is how the treatment works. He suffers a lot but the cancer suffers more. It dies.
January 11, 2011
As I mentioned, Thursday is a big chemo day and that's going to further slow him down for a few days, but afterwards I hope that he will be back writing to you.
When I spoke to him, I asked about his hair. He said it's mostly gone but a nice layer of peach fuzz remains. His eyebrows and eyelashes are holding well but he has lost his nose hair. And he hasn't had to shave for about three weeks....
Not needing to shave has turned out to be a good thing as his skin has become really sensitive. Dennis explained that the radiation treatments have left the skin of his cheeks and throat looking like they had a "bad day at the beach." In actual fact, he is quite solar sensitive now, so he must dash from shelter to shelter when he has to go out. Dennis occasionally gets knots in his muscles which he believes are due to dehydration so, as I mentioned in the previous post, he works hard to keep properly hydrated.
Talking hurts and leaves his throat feeling raw, particularly around the site of the original cancer, in the base of the tongue area. His saliva glands have been deeply impacted by the treatments, so that explains the mouth washes and rinses he does continuously throughout the day.
I think the saliva provides a really good example of how important something we normally ignore can be. Skipping right past its main function of helping to breakdown food to prepare it for swallowing and digestion, saliva does a lot of other things. The mouth is a warm, dark, moist place that it is a perfect environment for bad things like germs and oral yeasts to grow. Saliva breaks these down and rinses them away. It neutralizes acids that attack the teeth, gums, and esophagus. It keeps the mouth and throat areas moist so they don't dry, crack and get infected. This moistness is also very important to our ability to talk. The radiation, particularly where Dennis receives it, interferes with all these functions. Numerous times a day he has to manually try to make up for this with washes and rinses. Just listening to Dennis talk about his efforts in response, I have become much more appreciative of some of these little miracles that occur within that I hadn't even noticed before. Now, when I become aware of saliva in my mouth, I feel fortunate.
One of the biggest things that bothers him is periods of short term memory loss. He will check his work email and think he should act on something immediately, start to type and then doze off. Later he will awaken and know there was something he wanted to do but not remember what it was. Now that really bugs him. Dennis is definitely a person with an orientation to action.
In summary, Dennis is actually quite busy. Each day has a whole list of mandatory activities to do, and there are always additional demands arising-- another test, a consultation and so forth. With the fatigue associated with these treatments, he is working hard each day just to stay with the program.
The good news is that the doctors are pleased with his progress. And this week he will be half way through his radiation treatments. I believe all the sleep and even the short term memory loss are part of the whole healing process, so we just need to be patient at this time.
On one hand, I suspect there will be a time in the future when people look back at these chemo and radiation treatments with the same horror as we look back at the crude amputations of medieval times. On the other hand, I am deeply grateful that they are available to my brother now because, though brutal, they do actually work. I fully expect that we will see Dennis back to his family and friends, back to work, and back to his ham radio this year.
January 10, 2011
- 4:00 am - Awakens and has a can of food, which goes in through the gastrostomy tube in his abdomen. He has lost a lot of weight but it has stabilized, as long as he takes nutrition on a very regular schedule. Afterwards, he tries to get back to sleep again.
- 6:00 am - Gets up and does his morning ablutions. A particularly important part of this is a lengthly session of mouth washes and rinsings. With his saliva glands almost out of commission, this is particularly important, both for comfort and hygiene.
- 6:45 am - Heads off for Hoag Memorial Hospital in Newport Beach for his daily radiation session. Lieska drives each day.
- 7:30 am - Appointment begins with putting the mask on and getting locked in place. Next comes aiming the equipment, followed by a taking a CAT scan which requires 2 or 3 minutes. Evaluating the CAT scan to ensure everything is properly set up takes another 4 or 5 minutes, and finally comes the radiation, which itself last about 6 minutes.
- When finally released from the machine and the mask, they head home again where he has another can of food through the G-tube.
- 9:00 am - They are off again. Next is a trip to the doctor's office for hydration. Dennis gets hooked-up for a liter of water via the Port-A-Cath point in his chest. They have begin to add some supplemental magnesium and potossium as both get depleted by the radiation treatment. During this period Dennis brings along his eyecover and earplugs and usually is able to sleep about an hour and a half out of this two hour procedure.
- When they return, Dennis is pretty well exhausted for the day. Lieska changes and heads off for for work at about 1:30 pm.
- And then for the most part Dennis sleeps, awakes for brief periods to add a can of food, do some mouth washes and rinses, and is back to sleep.
Tomorrow I will add some additional subjective comments that Dennis shared with me.