Wednesday, March 25, 2015

Primary Oncology Check-up

(MD Anderson Cancer Center has lots of comfy places to chillax between appointments)

We met a new PA yesterday.  He was knowledgable, thorough and extremely soft spoken, which is very comforting.  Unfortunately, the thing that stuck out the most for us was the fact that he reminded us both of a character from the Harry Potter series.  Remember the head goblin at Gringott's Bank?  Well, this could have been his giant twin brother!!

The primary oncology doctor (another one of our ab-fabs) came in and reported that everything looked good on the CT scans within the limitations of his cheap computer monitor; however, once the radiologist had a better look at them with his fancy- dancy monitor he would feel better about his own observations.

So without further ado---there is NO CANCER ACTIVITY at this time.

Yay!, another quick appointment; pleasant and positive.  
For future reference he did let us know that if the cancer should return within the next year or so, Albert is eligible for a clinical trial that is taking place at MD Anderson.  And since a successful cancer treatment does not usually work a second time, it's reassuring to know that he has an Ace in his back pocket.
 More clinical information:

This check-up was for the original tumor that destroyed Bert's thymus, grew into his heart, and eventually lead to surgery and loss of function in his right lung and diaphram.

Remember that the original tumor grew to about 10 lbs and he named it Walter White.  The doctors in Austin were able to cut out most of the bulk of the tumor, but weren't able to get it all.  A big chunk of the thymus tumor grew inside of Albert's heart and is still there.  

Last Spring and Summer, he went through radiation and chemotherapy to kill any cells that escaped during debulking surgery and attempted to kill any cancer that was living on the part they left on his heart.

According to all the tests so far, the radiation and chemo worked!  It killed the visible cancer cells.

But since there is still tumor tissue, they have to keep checking that the cancer cells don't start growing again within that same tissue, which sometimes does happen.  Occasionally there are some cancer cells that actually live through radiation and chemo, but are so small, they just can't be detected, even with their high-resolution microscopes.

No cancer activity at this time means that as far as they can tell from blood work and pictures of the tumor/heart, the tumor tissue is just sitting there; not growing, not shrinking, just sitting.

And that is a very good thing!

Thanks so much for stopping by the blog today!

Endocrine check-up

( pic from: )

Can I start off with an AMEN!?!?!

I love me some Dr. Habra!!  He is an amazing doctor!!

His first comment to Albert was..."You look great".  He stated that compared to the last time we saw him, last summer, Albert was looking tired and haggard, but this time, he looked sooo much better.

Think about it!  How many doctors would remember how you looked 9 months ago?

Albert was very impressed and happy to know that this doctor took that much time to review his previous notes and jot down enough detail in his notes in the first place!  MD Anderson does a great job of acquiring superb doctors/nurses/staff.

All in all, the preliminary lab results showed that everything was looking great and the doctor was pleased with Bert's progress.  More detailed lab results would be available after the visit AND the bone density scan was also scheduled for after, but Dr. Habra was very happy with Albert's overall status.  If anything of significance comes from those data, we would be hearing from him, but then again, we always get the actual written reports from every procedure.

It was a quick, but very pleasant and positive appointment.

We are so lucky to be in such a wonderful cancer center.

Thanks for checking on us!


More clinical information:

The Endocrinologist is checking on Albert's MEN-1 disease activity.  Multiple Endocrine Neoplasia, Type-1 is the syndrome that is causing the tumors throughout his hormone system.  

Remember that this syndrome is a very complicated and very rare disease that is inherited.

It has a knack for affecting most patients in the parathyroids, the pancreas, and/or the pituitary gland.

Albert's disease chose to first present in an even rarer spot, his thymus (cancerous: Neuroendocrine Carcinoma).  Additionally, he had more traditional symptoms including: an enlarged parathyroid (non-cancerous: Adenoma) and still has a very small growth on his pituitary gland (non-cancerous: Prolactinoma).

The most effective, least invasive way to keep checking on these tumorous areas is to monitor Bert's hormone levels.  On three month intervals, we are specifically keeping track of his ParaThyroid Hormone (PTH) and Prolactin hormone activity.

Of course, all of his hormone levels are tested, but these hormones are very important indicators for the tumors that are already active in his thymus, parathyroid, and pituitary.  These are what I refer to when I say: disease activity.

And then it gets more complicated!!

The thymus tumor grew into Bert's heart.  So even though the tumor is still there, the radiation and chemo knocked out the cancer last summer, hopefully forever  (his primary oncologist checks on this one today).

One parathyroid has already been removed, but he still has 3 more.  When these are producing too much PTH, they also trigger his bones to release more calcium than they should.  The calcium leaks out of the bones and into his blood and eventually out his urine.  The problem with that is that our bones need their calcium!!

Yay!  Albert's blood calcium was at the high end of normal.  BUT it was still normal!  On its own, without medication.  YAY!!

The bone density scan yesterday will let us know if his spine (osteopenia) and hips (osteperosis) are improving/staying the same/deteriorating.  We will get those results in the next few days.

The PTH results should also be in today, but weren't available for the actual doctor visit.

In addition to checking his prolactin, they also check Bert's testosterone levels.  When the prolactin shoots up, the testosterone tends to drop.  By checking both hormones, we can keep better track of any problems as early as possible.

Dr. Habra will only scan his pituitary yearly to avoid any potentially harmful effects from too many MRIs. His next scan is already scheduled for September.

You actually made it to the end??!!??  I am very are a SUPER follower!!

Tuesday, March 24, 2015

Valet Parking

(pic this morning, after much needed rest)

After the visit with the endocrinologist yesterday, we had ONE thing on the brain... C-O-F-F-E-E-E-E-E!

We signed in at the hospitality center to get our complimentary cup of joe and cookie (breakfast) then headed over to the observation solarium to find a comfy chair and phone charging station for a little relaxation before the ride on the trolley.  The bone density scan was next and we needed a re-charge to get through it.

As we sat there enjoying our piping hot coffee and peanut butter cookie, we watched the valet parking team in action below us.  The window washing team was harnessed in and washing the windows above us.   As all around us, fellow patrons slept in recliners, read the paper, talked on the phone, assemled puzzles, visited with each other and/or played on their electronic devices.

The valet dance below reminded me of our VERY FIRST visit here.  Each driver intently following the wildly gesturing arms of the attendant, wanting to follow their instructions, but can't help but be confused by the movements that are similar to an airplane tarmac.  I think somehow the attendants here could benefit from a couple of  flashlights with long cones attached to the top to improve visibility.

As each person debarks from their vehicle, I sense their tension.  Valet parking is complimentary for the very first visit at MD Anderson.  Our first arrival felt as though we had happened upon a luxury hotel.  They helped us with our bags and made us feel welcome and comfortable; each casually providing directions or assistance as though they lived to help you.  It helped melt away that tension and we felt like we were in good hands, finally.

The patient is generally in the passenger seat, requires more assistance, and has the look of fear in each of their faces.  Fear of the unknown mostly.  Wondering what the visit will bring, whether it be answers or just more questions.  Sometimes, patients receive an expiration date, some a miracle, or still others, like Albert, get smiles and reassurance that no matter how long or short he lives, he will be in good care until that time...'taken care of'.

Although our coffee break was short, it was exactly what we needed!

The bone density scan was quick and relatively painless.

What we needed after that was S-L-E-E-P!  and that is precisely what we did for the rest of the day!

Next, I'll let you know what the endocrinologist said to Bert, it was priceless!

Thanks for checking in!

March 2015 visit to MD Anderson

Aaand, we're back!!

It's time for Albert's 3 month check-up and we started this morning bright and early!

Driving in to our friend's house last night felt like old times.  It took me longer to pack up and leave the house and it seemed harder to get the puppies ready for their extended stay without us.  Maybe I've gotten out of the practice?

However, once we arrived, it was like we were home, away from home!  Our friend welcomed us last night with: "My casa es su casa!" and she REALLY means it.  Even the cozy bed was calling our took less than 5 minutes for either of us to pass into our coma-like slumber once our heads hit the pillows.  It truly is amazing that we have such a wonderful place to call home whenever we are here for Albert's visits.

We will be eternally grateful.

The past few months have felt long.  It's hard to explain, but we have been in some kind of 'funk' while Albert has been working long and very weird hours; yet it feels like he has been home more than ever.   We have both been exhausted even though we rest more than usual.  We have not really done very much, but feel completely overwhelmed at the same time.  

As the visit begins this early morning and our bundle of nerves comes to its climax, we sit here waiting anxiously for Albert's name to be called and for this whole process to bring us what it brings, so that we can gratefully chew upon new nuggets of information.

Thanks for checking on us!