09-18-2009 Home From Houston

Hello to all. Dicky here for both of us. Thanks to Abby and her quick fingers for posting a quick shout-out yesterday as we were leaving M. D. Anderson in the heat of Houston rush-hour traffic. She and her mother worked out the basics on the cell phones and Abby filled in the gaps.

We made it safely back to Ruston in the 9:30 p.m. range and crashed hard.

This blog post contains the promised details from Abby’s overview yesterday. As I peruse the disparate list of those who wish to be reminded of a blog posting, I feel I should issue TWO reports for the two distinct types of folks on the list. After you read the first one and feel no need to read further you’ll know which group you are in. If you read further for more details, then, well, there you have it. We appreciate both types!

REPORT #1--the short version [think Reader’s Digest]:
· We saw Dr. Yao [on Thursday], who affirmed that Kim’s situation is “Stable, zero growth, good to continue in the clinical trial.” [You Report #1 readers will appreciate that he was in the examination room for maybe 4 minutes! He and we both talked very fast.]
· Kim received the first clinical trial injection of either the Lanreotide [the drug they are testing] or a placebo. This came after a 4 hour wait—we were scheduled to get the shot at noon and got it at 3:20 or so. Paperwork snafu.
· We drove back to Ruston.
· Fast.

Thanks for riding along with us!
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REPORT #2--for you detail lovers [think War & Peace]:
· We got into an examination room to meet with Dr. Yao in world record time: we were in the room by 10:10 for a 10:00 a.m. appointment. Neither our girls nor we could believe it. I was texting them along the way.
· We met there with Michiko Iwasaki, Dr. Yao’s research assistant, for almost an hour. In that hour we covered more of the details of the clinical trial, as Michiko explained the reporting method that Kim is to use for all that goes on with her physically from day to day. Kim also filled out a questionnaire from the European Organization for Research and Treatment of Cancer [EORTC], who evidently originated and/or oversees this trial. Michiko and Dr. Yao’s Physician’s Assistant did a basic physical exam of Kim as well as the ever-present taking of the vitals.
· Dr. Yao showed at 11:14 for about 4 minutes and answered our rapid-fire questions, assuring us that Kim was “stable, zero growth, and ready to proceed with the trial.” In there somewhere he explained [in answer to one of the questions] that the reason for the Ultrasound this week was to get a baseline mainly for the gall bladder—the drug in the trial has a tendency to increase the risk of gall stones, so they will check Kim regularly.
· At 11:30 we moved downstairs to an Ambulatory Treatment Center [ATC] Bed Unit for Kim to get her first clinical trial shot. It is the place the out-patient chemo patients come for their treatments. We waited a cool 2 hours and 40 minutes there because of flawed paperwork—no Yao signature, then a truncated date that read “09-17-20” instead of “09-17-09”. Don’t you just love computers?
· Along the way the lady arrived to take Kim’s blood, so we moved to a room where that could be done, while still waiting for that much-needed doctor’s signature and the corrected date. Michiko was a tireless worker and continued to help move things along. With no cell coverage in the ATC unit [a rarity for MDA which is WiFi campus-wide] we had to step out and find a signal to call Michiko, as well as to update the girls. Frustration did have a tendency to set in [he said in a very vague passively-worded sentence].
· We finally got in the day-clinic room at 2:20 to await the shot. As I was drifting off to sleep in the recliner there, a fellow showed up from the “Place of Wellness” in the MDA complex—a massage therapist on staff—who was circulating through the rooms of chemo patients and offering free foot massages [thus Abby’s reference yesterday to the foot-massage]. He worked on Kim’s feet while I drifted off to some soap opera on the TV.
· The injection arrived at 3:30 and because of the nature of the trial [and I guess the Europeans who started it] the nurse’s protocol seemed like she was establishing the correct codes for a nuclear launch. The shot came gently and without incident and we were dismissed. We flew out the door, back to our car, and waded through Houston traffic back to Ruston.

There you have the Tolstoy version. Thank you, you detail peeps, for caring about the small stuff. Your care for us is NOT small stuff to us.

Post-Clinic Report

Hi All,

Abby blogging, once again, from Boston--about as far from the action as I can get, but just a quick phone call away.

Mom and dad have asked me to throw a few sentences up on the blog just to give all the worriers/pray-ers/interested parties a quick update. They plan to post their FAR more detailed account of the last 24 hours sometime tomorrow, so check back.

They want to say sorry for the delay in communication, but they got stuck waiting around MDA all day because of some paperwork snafus (a missing signature, an incorrect date...). They met with Yao briefly this morning and, according to my text message from dad at 10:18, Yao said, "zero growth ... stable. We are ready to go." With this green light, mom got prepped to start receiving The Shot.

And by "got prepped" I mean "waited a few hours to give blood and then get the shot." There was a foot massage involved, but you can ask her about that later.

She wanted me to say she had a prizewinning shot-giver with whom she felt very comfortable and she's "already feeling the shot go to work." Now they know the drill they will be reenacting every 28 days or so for the next 2 years. Mom has just had, as she put it, the first course of a 24-course meal. Mmmm.

So all that to say, welcome (all of us) to the clinical trial. More from K&D tomorrow.

Abby

09-16-09—LET THE “TRIAL” BEGIN

WE ARE IN HOUSTON again for that time we’ve been waiting to kick off…

WE ARE FIRING UP THE BLOG for a couple of days at the request of our daughters, family and friends. Dicky is doing the typing with editorial oversight from Kim. It still seems a good way to get the most information to the most people in the shortest amount of time. It also allows us the opportunity to give the info to a typing daughter who can post when we can’t get to the keys.

THAT ALL SAID, we are not expecting anything out of the ordinary on this trip to M. D. Anderson, but since there are more tests and there is a meeting with Dr. Yao, we figured there would be more to tell. Thanks in advance for your prayers and your desire to keep up with this with us.

THIS TRIP is a combination of: [a] the last few tests prior to the starting of the clinical trial described thoroughly in earlier blog posts, [b] a meeting with Dr. Yao to get the results of the CT scan and Octreotide Scan from the August trip, and hopefully, [c] the first of the 24 Lanreotide shots for the clinical trial.

THE MDA SCHEDULE this week is as follows:
> Wednesday, September 16, 2009
· Ultrasound at 7:30 a.m. [NPO 8 hours prior to that—the reason for our arrival Tuesday night.]
· Resting EKG about an hour after that.
· “Fluid” collection is a 24-hour thing that started this morning at 7:00 a.m.

> Thursday, September 17, 2009
· Dr. Yao appointment at 10:00 a.m. , which normally is a 1- to 2-hour waiting thing.
· Lantreotide/Placebo shot at 12:00 noon. Remember we have a 50/50 chance that the shot Kim is getting is not the actual drug for the clinical trial.

We plan on returning to Ruston after the shot Thursday. This post is coming right after the Wednesday events were completed. All but the ongoing “collection process” is done for the day. Kim will be able to eat normally today, uh, except for the things off of the list for eating today—like tomatoes, avocado [goodbye Mexican food!], eggplant, plums, bananas, walnuts, pineapple and CHOCOLATE.

Thanks for your interest and your prayers. As always feel free to pass the blogspot on to anyone who might be interested, and feel free to post your thoughts here or to heaven or shoot an email to jrlove@gmail.com or kimclove@gmail.com. We are checking in at all those places!

We'll post something after our meetings tomorrow.