Again, we were on the 7:55 Seattle ferry for the scheduled Chemo session.  Just so that everyone is speaking the same language, let me differentiate and clarify the terms signs and symptom.  Signs:  any visible observations such as weight loss, change in skin coloration, swelling and puffiness, hair thinning/loss, etc.  Symptoms:  how the body feels such as fatigue, sleepiness, nausea/vomiting, headaches, peripheral paresthesia, mucosal thinning and ulcer formation secondary to the Chemo agent causing difficulty in eating, G-I irregularities, etc.

General Health: I sense that my muscle mass is weakening, and I think I should start some mild arm and leg strengthening training.  The thinning and development of sores in the mouth make eating, (a significant part of joy for me) difficult these last 3 weeks.  For this reason, Dr. Picozzi reduced the dosage of Irinotecan and 5-FU to 75% of my normal dose.  Hopefully this helps to reduce the discomfort.  Additionally, I am having more paresthesia of my ankles and feet.  I can’t tell if I have socks on or off; sometimes I can’t even tell if I have shoes on!  Also, I lose balance momentarily when I stand up from sitting, or whenever I get out of bed.  This most likely is a side effect of Abraxane, but I don’t want any changes in the dosage of this medication until after we get the result of the CT Scan at my next visit.

Physical Exam:  I appear as a picture of health.

Lab Test:  All values acceptable.

CA antigen 19-9, 2 weeks ago when I was pleased when it was 1076.7u/ml, today it came in at 903u/ml.  Very happy with this trend after a high of 3300u/ml on February 8, 2018.

CT scan at the next appointment 3 May will reveal a lot more; can’t wait!!

Deep heartfelt thanks for visiting and your continued care and concern.  Update after the CT Scan next visit.

Returned to Virginia Mason yesterday on the 7: 55 Seattle ferry for a routine Chemo Therapy session. All blood works continued improving slowly toward normality. Asked about new symptoms, I can only say that the GI system was more active with difficulty eating because of the thinning and much increased sensitivity of the mouth and cheek membrane. Even eating a soft croissant hurts because it is ‘rough’ on the cheek mucosal lining. Frequency on the other end was also problematic. Additionally, I felt sleepy a lot. I shut my eyes and I’m asleep. Waiting in line behind Linnea for communion Sunday during the short contemplative time, I truly felt asleep, momentarily, standing upright. I can cope with all this; I am reasonably comfortable. Despite the fatigue, I have enough energy to walk 1 mile with Linnea every other day.

A recap on the factors the doctors consider in determining our present status:
1. General Health
2. Physical Exam and general impression
3. Laboratory tests: CBC, Electrolytes, Liver and Kidney function, etc. Most important to me… the CA antigen 19-9, (TUMOR MARKER)
Remember it was not long ago it shot up to 3300u/ml ?
4 weeks ago, it began to reverse, first good sign.
Today it came in at 1076.7u/ml compared to 1173.9u/ml two weeks ago, I’ll take it even though it is only a 10% change. (may only indicate lab tolerance since normal is <37u/ml.)
4. CT Scan (scheduled next month)

I’ve managed to complete and file our 2017 1040 income tax document. We are planning a leisurely trip to Portland to visit Linnea’s siblings next week. I also have signed up for our Bethany’s Men’s retreat at the end of this month. We are making the most out of living life fully.

Thanks for visiting for I feel privileged of your care and concerns. Hope all’s well with all of you. Update after my next treatment 4/19/2018.