Renal Cell Live!

Friday, October 09, 2009

Cycling On

Wednesday found us at the Cleveland Clinic for yet another evaluation set. As the appointments didn't start until 11:00 a.m., we chose to drive up early in the morning rather than staying the night before in Cleveland.

This time, to see if there were anything behind my reported "fullness" in my neck and slight difficulty in swallowing, I had two C/T scans scheduled, which seemed to make the day stretch even longer than usual. We bounced around from spot to spot (Saint H got in a lot of good step totals on the pedometer they're using at work for a wellness challenge), managed to get in early for every appointment, and topped off the day with a short nap while waiting for Dr. G to arrive with results.

The results were worth waiting for, believe me. First, the C/T scan of the neck revealed no growths or suspicious tissue, only the calcifications in my salivary glands that we already knew about. We're pretty much agreed that the problem is tied to dry mouth. Amongst the easy remedies: have water available at meals for small sips to help lubricate my throat, take small bites, and chew well to make certain that there's nothing left to "bulk up" on the way down. Well, these reflect good manners and general nutritional wisdom, so I'm happily able to comply with orders.

Second, all my labs are consistent. My hemoglobin levels are still low but have only just begun showing a drop below 10 (9.8 this time), so we'll be watching that closely every two weeks. All the other results are high or low as expected for someone with RCC, one kidney, and liver damage. Should I need to return to Aranesp injections, that could easily be accommodated with my treatment schedule. I've discussed potential problems with Aranesp here before so I won't rehash, but Dr. G decided (and Dr. SC concurred) that I would not likely fall under insurance strictures as both Cleveland Clinic and OSU comply with the strict application guidelines.

Third, and most gratifying, the scan results show net tumor growth of zero percent from the May benchmark. The lesion in my right lung is still growing, very slowly, but for the moment it's completely offset by continued reduction of lesions in my liver.

We always finish the appointment with a discussion of next steps, and Wednesday was no exception: I'll continue on the clinical trial, we're rank-ordering further treatment options, and we'll probably never do surgery again. Dr. G's broader assessment of surgery expanded this time from the short "probably not" of my last query. Though it would be nice to be able to excise the one active lesion and be so-called "disease free" for a while, he described the surgical process more fully. Basically, we'd be facing a lobectomy, with removal of at least the upper right lobe; lesion size and location are too much for a simple "wedge" excision. The surgery would involve a full horizontal abdominal opening, possibly a chest cracking, and way too much internal rearranging to suit my taste. In Dr. G's words, "For you, this would be a morbid process." Put it that way and my natural disinclination to surgery is increased immeasurably! It took eight months to fully recover from my liver resection, and I swore I'd never go through that again. Thank goodness my doctor agrees with me!

We left in the height of rush hour and got home at 9:00 p.m., with a stop for dinner along the way. We've decided the one-day trips with full appointment load are way too taxing to undertake again. Whoopee, more hotel points, I guess.

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