Joe had an appointment yesterday at Dana Farber for blood work and discuss possible next steps. There was some trouble getting the blood done and inserting an IV. They tried to use his right arm and no luck, so they had to do it on his left arm. When we went upstairs for his vitals, his blood pressure was 92/65 the first time and then 98/52 the second time. They also had to take blood again (thank goodness they still had the IV port in his hand) because the previous blood draw was all clotted. Then we met with Dr. Jackman who discussed the options again. He started off by saying that Joe looks good and we should look at the quality of life and how he is feeling. Then we should discuss therapies. Do nothing? And Joe is the way he is (which isn’t bad) or do we do a therapy and who knows what will happen. Joe again said he wants to try the chemo. So Doctor talked about doing what we discussed before, do chemo once a week for 2 weeks, and then a week off. He also talked about the chemo that’s been advertised on TV (Optivo), but he said that chemo is really for patients who are stronger and more mobile than Joe. Basically folks who are stronger, able to move around on their own, working, etc. Joe wants to do the 1st chemo. So then the Doctor indicated that Joe's sodium was low and his blood pressure is low. He felt that Joe is probably dehydrated. He discussed how much water he should be getting (1 liter per day), Joan will increase it. Also, because Joe's veins are weak, the Doctor wants a port to be installed (didn’t say where) for the chemo. Doesn’t want Joe to become a pin cushion. In addition, one of the side effects of this chemo is tissue damage at the IV site when infused. So better to have the port. Doctor said no chemo until port is installed. Joe also was having a major leaking problem with his feeding tube. He was soaked and there’s a lot of redness (similar to diaper rash). So we went over to the infusion area, they set him up with a saline drip to help with the potential dehydration and hopefully increase his sodium and BP and this was going to be 2 hours. After about an hour and a half, they realized he had to get over to the thoracic “out patient” area at B&W to get the feeding tube fixed. Got over there (after a lot of mix ups) and they fixed it. It was pretty painful for Joe. The doctor there said he would probably have to come back tomorrow. We found out at that time that not only did they want Joe to come back to get hydrated but apparently his white blood count is very high, which indicates infection, and they are concerned about the low blood pressure. They took his BP there and it was still only 98/56. They felt with the hydration he had in the past few hours, it should have gone up. When we got back home, Joe was pretty weak. There was a message that he would have an appointment the next day (today) at 1:00 for labs, then meet with Pam (Nurse Practitioner) at 2:00pm and then hydration again at 3:00pm.
Today we went back in. He had a blood draw and then we met with Pam. His white blood cells are higher than yesterday and his BP is lower (95/52). She wanted to know if Joe had any fevers, dizziness, constipation, diarrhea, etc. Anything to indicate an infection. Nothing. Wanted to get a urine sample but Joe had nothing to give! So for now, he was hydrated again. All blood pressure medication (not that he was getting much) is terminated as well as all cholesterol medication. Just need to keep an eye on any possible infection, although Pam indicated it could just be the cancer.
A port will be installed for the chemo. We have requested it be done at Faulkner for convenience sake, anytime between tomorrow and Monday. If not, it will be on Monday at Brigham & Women's. His chemo is set up for Tuesday beginning at 9:45 for blood, 10:30 Dr. Jackman and 11:30 chemo.
Elwood Strong!
Today we went back in. He had a blood draw and then we met with Pam. His white blood cells are higher than yesterday and his BP is lower (95/52). She wanted to know if Joe had any fevers, dizziness, constipation, diarrhea, etc. Anything to indicate an infection. Nothing. Wanted to get a urine sample but Joe had nothing to give! So for now, he was hydrated again. All blood pressure medication (not that he was getting much) is terminated as well as all cholesterol medication. Just need to keep an eye on any possible infection, although Pam indicated it could just be the cancer.
A port will be installed for the chemo. We have requested it be done at Faulkner for convenience sake, anytime between tomorrow and Monday. If not, it will be on Monday at Brigham & Women's. His chemo is set up for Tuesday beginning at 9:45 for blood, 10:30 Dr. Jackman and 11:30 chemo.
Elwood Strong!
