News from Auburn Fri Oct 3, 2008


In this issue:
Health update
To C or not to C ...
And the rest of the news
Impatient patients
Family news

Health Update
Short story:  (the long story is under "the rest of the news" at the end of this section):
The virus/cough that took me to the emergency room last Friday continued to hold vigil throughout the weekend.  My local oncologist, Dr. E Graves, asked me to come see her Monday, where she put our minds to rest on a number of items about which Viva and I were concerned.  On Tuesday she contacted me to ask how I was doing.  (It's good to have long-lasting friends!)  After a few emails between her, me, and UAB, the team treating me decided that I had pneumonitis, not to be confused with pneumonia, and I was prescribed a steroid for its treatment.  My breath volume, pulse, etc. began to improve within 36 hours.

Thursday I went to UAB for PFT (pulmonary function test, aka "do your lungs still work?") and MUGA (cardiac) tests.  The tests were mostly uneventful.  I describe them in more detail below.  Results from these tests will not be available until I meet with Dr. Salzman of the bone marrow team, appointment date and time TBD.

The dry cough and associated symptoms (spots in front of my eyes, etc.) are remarkably similar to what I experienced in late January and early February.

To C or not to C ...
One of the dangerous things about being a shut-in is reading the internet too much.  A recent article on the NY Times news feed cited a study at Memorial Sloan-Kettering that indicated that taking vitamin C tablets may reduce the effectiveness of chemotherapy by 30-70%.   (Here's a more detailed article from the American Associate for Cancer Research; the NYT article greatly simplified the result)I took vitamin C early this year to aid in the absorption of iron for anemia during chemotherapy.  "Great," I thought, "I ruined my own chemotherapy."  Viva, hearing this news, did her own reading on the web, and found plenty of other studies showing that Vitamin C was helpful in fighting cancer.

So, there you are.  It's a dangerous thing to get medical advice from a newspaper.  By the way, the doctor behind the study cited by the NYT "notes that cancer patients should eat a healthy diet, which includes foods rich in vitamin C. It is use of large doses of over-the-counter vitamin C that is worrisome, he says."

Moderation.

And the rest of the news
This last week was fairly difficult for us.  Since I contracted the virus mentioned above, my measured breath volume dropped by nearly 1/2 (and that from what was already about half of someone with two healthy lungs) and I had some pretty tough coughing fits.  I'll spare you the details; if you want them, you can read the Summary of September on my blog: 
http://homepage.mac.com/hodelas/tar/C745067260/E20080930224523/index.html

When we met with Dr. Graves she suggested several ways to help clear the small amount of material in my lungs.  One suggestion was "percussive stimulation," that is, to beat me on my chest around the paralyzed lung to loosen things up.  I turned to Viva and said, "You now have medical license to beat your husband.  The bruises won't show so no one will know."  

The PFT and MUGA tests on Thursday were ordered to help the BMT team to make a decision on whether I'm a viable candidate for the transplant procedure.  The PFT tests breathing capability while the MUGA scan checks cardiac capability. Needless to say, I wanted to pass the tests, so I started "cramming" once the steroid enabled me to breath deeply without immediately going into a 20 minute coughing fit.

The PFT went reasonably well. There are three tests:
(1) holding my breath for at least 10 seconds with a full breath ahead of time. (Try doing THAT with a congested chest!)
(2) tracking how quickly CO2 is flushed from my system (they mix O2 and N2 in varying amounts)
(3) having me exhale both forcefully and over a long period of time. Of course I informed the tech that those instructions are contradictory, so she told me to give a hard puff at first and then see how long I could keep blowing.

The tech was satisfied with my results, so I expect I'm in reasonable shape, but just in case I asked her to write that I'm getting over a virus.  I told her my breath volume measured at home was around 1500-1750 ml.  She told me that she measured 3.5 liters. Not bad for a guy down a lung!

The MUGA (heart) scan required me not to cough for 10 minutes, so (after a brief coughing fit) I went to sleep using the meditation/relaxation techniques I learned under the radiation mask in August.  

Impatient patients
When the MUGA scans were done I was asked to wait down the hall while they verified that the scans were successful.  While I and another patient waited there we heard a deep southern drawl boom down the hallway, "IS THERE ANYONE HERE WHO KNOWS THE TIME OF DAY?"  
A nurse answered "3:00 Mr. So-and-so."  
"WHEN ARE WE GETTING OUT OF HERE?"  
I very deliberately did NOT shout, "no later than 5pm."
"By 3:40.  Once we get you on the table it will be 10 minutes."
Again, I very deliberately did not shout, "Would you like for me to order a pizza?"

When I say I very deliberately did not shout those things, you can well understand that I really, really wanted to.  :-)

Family news
My sister Kathy and her 7 year old son Gabriel visited us this week Fri-Tues.  Last weekend, while we watched the Tennessee-Auburn game on TV,  Gabriel asked, "is that Kayla's basketball team?"  Kathy hid her face in her hands. 
I asked Gabriel, "do you know the difference between a basketball and a football?"
"Yeah.  Basketball has a netty thing."
Kathy's expression did not improve.

However, after I called Kathy with the results of my PFT/MUGA scan, she sent me this email with the subject line "Further Tests  are needed."

From: Kathy [name/email deleted]
Date: October 2, 2008 6:14:55 PM CDT
Mr. Hodel,

   In order to make a final decision on whether or not to proceed with your bone marrow transplant, we need to administer a few more tests. Please make an additional appointment at the clinic to determine whether you are in a proper state of health to successfully accomplish the following:
1. Raise one eyebrow while making the hand gesture associated with the Vulcan Salute ("Live long and prosper")
2. Burp "Supercalifragilisticexpialidocious" (use of carbonated beverages acceptable)
3. Rub your belly while patting your head.
4. Flex your pectoral muscles in time to the tune of the Dueling Banjos
5. Tie a cherry stem into a knot using only your tongue and teeth.

We will give you a final decision after we have reviewed these assessments.

Fondly,
Your Bone Marrow Transplant Team 

Yes, the whole family thinks like this.  :-)

I'll write again in a week.

Posted: Fri - October 3, 2008 at 11:10 AM           | |

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