It has now been a month since our last trip to the ER, but there have been some trends moving in the wrong direction the last couple weeks. In particular, Penny continues to struggle to get enough calories and has lost another 5 pounds or so. She has also had increased fatigue and just not felt very good much of the time.
Yesterday she had an appointment with the palliative care team. We've worked with them before -- especially following her big surgery in 2016. Their role is to help manage various symptoms, primarily by prescribing drugs of various sorts. Interestingly, many of the drugs they prescribe were originally designed for other purposes but have side effects or other unintended consequences that can be useful in certain situations.
The most troubling symptom the last couple weeks has been a feeling that her stomach is full and doesn't have room for any food. This isn't exactly the same as the feeling of an impending blockage, but it isn't pleasant, and makes eating impossible. And the feeling is not just a feeling -- several times it has been followed by nausea and vomiting. It turns out that the kind of cancer Penny has can sometimes damage a nerve that is involved in signalling the stomach to empty, so likely the feeling is a reflection of what is actually happening. And there's a drug for that: Reglan, in very small doses, lest it cause things to move too quickly and cause other problems (like dehydration). The plan is to begin with Reglan tomorrow.
Another result of this "backing up" is acid reflux. Of course, there are drugs for that. But we need to find out if they are compatible with the current treatment plan.
If/when we discontinue the current trial, the palliative care team would like to prescribe a course of steroids which should help with appetite and fatigue without increasing metabolism in ways that would require more calories to offset.
In the meantime, tomorrow is another treatment day. The usual pattern is to begin by getting some labs drawn and then to meet with Dr Lakhani to discuss symptoms before making a decision about treatment. The dermatology consultation is Friday morning, and the next CT scan is next week. And we're supposed to call the ophthalmologist in the next day or two to check in related to vision issues (which appear to be getting a bit worse as well).
That should be enough to keep us out of trouble for the next little while.
Comments
Dawn Mulder: May you feel held up and strengthened through His grace as you navigate all of this. Praying over you both💛
George Monsma, Jr.: Oh my, sorry for the difficulties Penny is having. Thanks for the update. I'll continue to pray for relief for the side effects and for success for the treatment in restraining her cancer. And strength for you too, Randy, as you care for her.
Bonnie Mulder: Praying for Penny and for you, Randy, as you pursue each thread of this. I pray you will feel fully supported by your team in the myriad of medical appointments and that there will be goodness in each day.
Chriss Pruim: Randy and Penny - I am praying that God will give you strength for today. Thank you for the updates.
Glen Boer: We're keeping you both in our prayers
Laura DeHaan: Praying for peace and comfort (and a return of hunger!) for Penny. As always, I am so appreciative of your detailed updates, Randy.
Talon Rindels : Ohhh I hope the Reglan works without many side effects! ❤️
Herm De Vries: Thanks for this update. Praying for strength for Penny, you, and your family to get through this new set of challenges.
Marie VanderLinde : Praying the Reglan is helpful, and the treatments are to good effect. Thank you for the update, Randy.
John Witvliet: Praying for just the right approaches to each symptom and for strength for each day...
Teri Warners: Praying that the drugs do their job and that you both have a restful night.