Today we met with an oncologist to discuss chemotherapy. He said, with the kind of cancer Karen had, and with it as developed as it was (stage 4), the risk of recurrence or progression is "extremely high." Even with chemo, the odds are still pretty good it will happen again. But, it's less likely. He says there aren't any clinical trials that might apply to her treatment, but the most common treatment has been pretty much standardized on for many years now. That's chemotherapy with fluorouracil in conjunction with the vitamin leucovorin, which makes the chemo more effective. And since it's advanced cancer, they use oxaliplatin as well. Collectively known as FLOFOX. She would come in, get 4 hours of chemotherapy, and then leave with a pump which would continue to deliver chemo for another 46 hours. This would happen every 2 weeks for 6 months. They can be less aggressive, but at her age, they don't feel it's worth the gamble of not being as aggressive as possible. She's young so it shouldn't be all that rough on her. He also said, with this kind of treatment, it wasn't even likely she would lose her hair. It sounds like she's up for it, and we've scheduled another appointment in about 3 weeks to make sure she's healthy enough and to go over things one more time before starting treatment.
The home health nurse only just showed up again yesterday. There seemed to have been some sort of snafu and the home health company "lost" Karen. It wasn't until Karen mentioned it to someone following up from the Mayo Clinic that they made contact again. The ostomy supply company also "lost" Karen, and we had to resubmit an order for supplies. The nurse that came out yesterday said they're the ones who should have submitted the order. We did get a starter kit, but have yet to receive the rest of the supplies. Not sure what we'll do it stuff doesn't arrive soon.
When Karen was (almost not) released last Friday, the doctor said there were going to be good days and bad days. And for her not to compare today to yesterday, but to think back to how she was a week ago. That said, it turns out there's been more bad days than good days. Karen's found that naproxen works better at relieving her abdominal pain than ibuprofen, so that's good. She is using slightly less Percocet, but a lot of the pain is from the gas in her intestines now. Those pains are much sharper than the abdominal pain she's use to, and the Percocet just doesn't do much for that kind of pain.
She seems down about how slow things are healing, and now it seems once she's just about recovered from the surgery, she's going to have chemo to deal with. Her heart rate still sits in the high 80s. I'm not sure when that will return to normal. I've seen her at 63 before. I've also noticed when the nurse takes her blood pressure at home it's in the 90s, and at the Mayo Clinic, it's in the 110s. That says something about all of this.
