The other shoe drops

Kinuko Y. Craft's divine Cinderella

My nice and relatively easy 20 month run on Xeloda is officially over. 

It was a good run but the drug has finally failed me--or my cancer has bested it, whichever--in a fairly dramatic way.

I had had a CT scheduled for later this month, but for 3 or 4 weeks before that I had developed a worsening cough and found myself more and more out of breath.  I was hoping it was a cold, a viral or bacterial infection, just something (anything) normal that normal people get and normal people get over.

It was not.

Last Monday I called the triage nurse in oncology.  I had been ok waiting 3 more weeks for my CT scan but things were getting worse and over the weekend it developed into a case where something like going upstairs made me feel like I was drowning.  Even little Pollyanna wannabe me know that was not good.  So, with my smart husband's increasingly strident suggestions, I called oncology the minute the office opened for the day (the triage line is 24-7 but that seemed a little like overkill since it wasn't an emergency and they would probably need to consult with my onc when she came in anyway) and told the triage nurse what was going on.

The triage nurse talked to my oncologist.  My oncologist moved my CT to first thing the following morning.

I had the CT, got a call from my oncologist, and went in the following day to see her and talk lungs and CTs.

During the previsit vitals the tech moved the pulse ox monitor from finger to finger.  She asked me if my fingers were always like that (fingernails of ghostly white), she mentioned my oxygen was low and my pulse was high.  I assured her that I was there to talk lungs so it might not be so surprising.  After bloodwork my onc had the tech walk me around with the pulse ox on to see how low it went (within reason, of course).

 My oncologist showed me my CT scans.  She showed me the plural effusions (liquid surrounding my lungs) and how on the right side it covered the length of my lung (mercifully less on the left) and how there was much haziness throughout both my lungs that hadn't been there in April.

That explained a few things.

She said the CT couldn't say if it was infection or spreading cancer.  It could also be heart failure.  She admitted me to the hospital to let pulmonary do their thing and get some heart scanning done.  They also gave me supplemental oxygen which is a wonderful thing.

Long story short, they diagnosed me with bilateral plural effusion, acute pulmonary failure with hypoxia, and something else I don't remember that meant there were things in my lungs.  They drained 750 ml fluid from my right lung and sent some for testing (the pulmonary fellow said that would make me feel better and it does a bit but, honestly, not enough to feel normal like I had hoped). They did a million other tests, put in a mainline to access my vein, drew a bunch of blood, took an EKG, an echo-cardiogram, and a follow-up lung X-ray.

And this is what they came up with:  it's not an infection of any kind, my heart is the same as it ever was, but the plural effusions show cancer and both lungs have "diffuse interstitial infiltrates seen throughout both lungs more pronounced at the lung bases" aka cancer.

So, that's dramatic.

But my oncologist is no stranger to drama because she's an oncologist.  And so she has a plan.  On Monday, first thing AM, I'm going in to to the usual pre-visit testing, talk about the plan, and start right in on a combination IV chemo treatment.  They aren't even waiting to place a port; we are, apparently, going hardcore offensive against this cancer to try and clear out those darn lungs. 

I believe the plan is a drug called Gemzar combined with Taxol.  But I'll know more on Monday at my appointment before they give it to me. 

So this weekend I am taking it easy, monitoring my oxygen saturation, wondering how much longer I'll have hair.  And Monday, I'm back to my chair in the infusion suite and back to the wars.