Yesterday Karen had a CAT scan along with the usual blood lab work. The big news is the CAT scan looks good. It showed no new growth, except something on the left side of her thyroid. The doctor says nodules in the thyroid are almost always benign, however, it's still something that we need to look into. He wants to do an ultrasound on her neck in six weeks to take another look at it. I'm not sure if it's for a more detailed look, to watch for blood flow using doppler, or if it's just to watch for growth since it is another 3 months till the next CAT scan. He didn't go into much detail, but said not to worry about it, so I didn't push for too many details. It does seem to be bothering Karen, but she's pretty resilient and I'm sure she'll stop worrying about it once she's given it some more thought.
Overall, her blood work looks better than last time, but despite that, the doctor wasn't too happy with the results. He was quite happy with her hemoglobin count. It's still lower than where it should be, but it has risen quite sharply. Her platelet count has dropped a little, but he's still happy with where we are in regards to that. Where he's not so happy is with her red and white blood cell counts. They have both gone up, but they're not improving as quickly as they should be. Her white blood cell count is still lower than it was in March and April when she was on chemotherapy. Her protein levels are within the normal healthy range, so it's not due to low protein. At this point it's just another thing to keep an eye on.
Her neuropathy has finally stopped spreading. The weird electric-like shockwaves she had been feeling up her arms have gone away. What's new is a strange itching sensation in her fingers and toes that she doesn't seem to be able to scratch. She's also been dropping things. This change was gradual, and we didn't notice the increased frequency of drops until lately. Looking back, it seems it should have been apparent to us earlier, but everyone drops things and we weren't really watching for it. The doctors says this is just a side effect of the neuropathy. Everything else is about the same. Mostly just tingling with a little on and off numbness and mild "pins and needles" pain. I've mentioned temperature sensitivity before, but it's seems to be sticking around. Her hands hurt when touching something hot or cold. It's not as bad as the cold sensitivity she had when on oxaliplatin, but it's still notable.
The gabapentin she's taking for the neuropathy pains in her limbs doesn't seem to be working... until she misses a dose. Then her hands and feet really hurt. Even when she's on the gabapentin she has pain, so either the improvement was so gradual that she didn't notice it, or what seems more likely to me, is the pain from her neuropathy was getting worse around the same time she started the medication. The doctor upped the dosage by another 50%. Like last time, we have to ease into it. Hopefully this will get help with more of her neuropathic pain.
The last few chemo sessions she was really having a hard time walking long distances, so we'd often get a wheelchair when going into Mayo just because the parking lot was so big and it was such a walk to where we were going. She started using a cane off and on around that time and has grown more comfortable with it. I'm don't believe I've ever mentioned her cane use on the blog. Again, it was another gradual change; she would use it now and then, but gradually became a common thing. I should mention that she is still getting better at balancing and walking on numb feet, but she feels safer with the cane. That said, she is feeling comfortable going further distances without her cane. The doctor says you learn to compensate in other ways, vision being a big one, and warned her to be careful standing or walking in the dark.
Some people think that once the chemo is done, everything quickly returns to normal. If you asked us 6 months ago we would have had no reason to think otherwise, but now it seems obvious that the path to recovery is a long one. The doctors say it's not uncommon for the neuropathy to last more than a year after treatment ends. A recent study found the average recovery time to be 9 months, with some symptoms becoming "long term" problems. They haven't found medication that will reverse the neuropathy. Hopefully they can control the symptoms and the body works it out on it's own.
