Hospice Care

This is Donna writing. Taking up where I last left off, Calvin had brain radiation on Thursday & Friday, March 22 & 23. He had another bad weekend and was not able to go to church with me Sunday morning.

Monday at noon we went to his appointment at Cancer Care and met with his doctor. After asking how Calvin felt and how he was doing, he gave us the CT scan news. The scans looked bad. The cancer has spread a lot. At some point Calvin told him that he had just had enough pain and suffering. More chemo would just result in more suffering, with no hope for improvement. Calvin also said he didn't want any more radiation either. He just wants it all to stop and for him to be allowed to die, the pain and suffering has gone on too long. Dr. Chay respects Calvin's wishes and understands. There is nothing more he can do for Calvin now anyway. This cancer is incurable and very aggressive, which we were told at the start, back in June 2006. Dr. Chay said he would have Hospice contact us and they would care for Calvin's needs from here on out, but that he would always be available for Calvin at any time if Calvin wanted to see him or talk to him. I asked him what he felt Calvin's life expectancy might be. He said it could be weeks, maybe a month. So we left there in tears, even though Calvin has been feeling that the cancer has gotten worse, we didn't expect the one month prognosis. So we will prepare as best we can and leave the timing up to God.

So, everything has been cancelled: chemo, radiation, and an appointment with his urologist.

Hospice called Tuesday and set up an appointment to come see us. Wednesday morning we were visited by a Hospice social worker and a Hospice admissions nurse. They were wonderful. Calvin signed some paper work and everything is set up for Calvin to receive Home Hospice Care. They gave me their phone number and urged me to call them at any time if there is anything Calvin needs, or if some problem occurs. It is staffed 24 hours a day, 7 days a week. If at some point he needs more care than can be given here at home he will go to their Solace Facility in Asheville.

On Thursday the Home Hospice nurse who will be Calvin's permanent nurse called and came over to meet us and talk to us and get Calvin's meds all organized. The plan being to get Calvin's pain under control. She made some adjustments to his oxycontin and oxycodone. She will be back Monday and see how Calvin did over the weekend. If need be she will continue to make adjustments, and perhaps some changes in pain medications to get the pain managed better. They also delivered a walking cane, and walker, and a shower chair for Calvin. He is very weak and wobbly when he is up walking around.

Today my brother/sister-in-law/& 3 nephews are coming from the Atlanta, GA area for a short visit. Calvin is up to short visits. Tomorrow my son is driving down from Michigan to help me out. There are several unfinished projects in Calvin's workshop in the basement that need to be finished up, and there is some strenuous yard work that needs doing that I can't do. So he will be getting some odds and ends taken care of for me. He will be here 3 days, then drive back up to Michigan. Calvin's mom and brother are driving out from Arizona and plan to be here by Wednesday night. They will have a short visit of a few days here. Starting next weekend Allison will be coming home from college at SVU in Buena Vista, VA, every weekend. My other son and daughter-in-law in Pennsylvania will be bringing her home on Friday and taking her back to college after church Easter morning.

Calvin is still not using a computer, but I will print any emails for him so he can read them. I will try to keep this blog updated on a weekly basis.

Brain Tumors

Yes, it just keeps getting better . . .

This is Donna again. Last Friday, March 16, I took Calvin to the Mission Outpatient Infusion Center again for 2 more units of blood. Allison came soon afterwards and stayed when I had to leave to go to work. Allison drove Calvin home when he was finished. Later that evening, at 6PM, Allison took Calvin to Asheville Radiation where he had an MRI done of his brain. Calvin called me at work at little after 8Pm to tell me that he has 2 brain tumors. But the good news is that they are treatable. They were caught early and are not very large. That explains why he has a hard time comprehending anything he reads, why his attention span is too short to watch and enjoy movies, why he stumbles and has fallen a few times, and why he is so confused and in a daze most of the time.

Monday I took him to Cancer Care for another CBC (his hemoglobin was still low at 9.0 even after receiving 4 units of blood the previous week), and he got his Procrit injection. Then we headed over to Mountain Radiation/Oncology at Mission Hospital (the same place he received the 30 radiation treatments to his prostate last summer). They did all the preliminary work to get him ready to begin radiation of his brain. Small cell cancer does not like radiation and usually responds quickly. He will receive 14 radiation treatments to his brain. Even though his entire brain will receive the radiation, they tell me that there are no bad side effects and will not harm his brain. It will only shrink the cancer. There may be some long term affects which could show up 6 months to a year after the treatments stop, and that would be that short term memory could be compromised. But without the radiation, the small cell cancer would continue to rapidly grow and spread throughout his brain.

Tuesday was Calvin's first radiation treatment. He gets a 30-second blast of radiation to one half of his brain, then it is repeated on the other half. We are in and out quickly.

Today, Wednesday, March 21, was Calvin's CT Scan at Cancer Care He had to drink 2 bottles of contrast, one right after the other over a 2-hour period, finishing up by his 11:45am appointment time. After the CT Scan it was another CBC and urinalysis. We later received a phone call that his CBC results were stable. The remaining test results would take longer and we will be called with them.

Thursday & Friday will be radiation again at 4:30pm both days. Then on Monday we will meet with Dr. Chay at Cancer Care to get the CT Scan report and talk about resuming chemo.

March 15th Update

This is Donna updating. No, Calvin is not in the hospital, but he has not felt up to using a computer. Since it has been almost 1 month, I decided to do an update for him.

It has not been a good month, in general. Calvin had chemo on Monday, Feb. 26th. This was his first Monday chemo, having changed the day from Friday to Monday, hoping that his weekends would be better. They have not been. He had chemo again on Monday, March 5th. He went in again on Monday March 12th for his regularly scheduled Monday chemo, which would have been the 3rd treatment of round 4 of the 6 rounds he has been getting since January 2007. After having his temperature checked (it was over 102) and his blood count done (his red blood count was very low again) it was decided that he would be unable to get his chemo. They also got a urine sample for a urinalysis. (Sometime in the night Sunday night his urine once again became very red with blood and clots.) So they worked on getting his temperature down, and got him set up with an intravenous antibiotic. Allison & I were both there with him. (I had driven up to SVU on Friday, picked up Allison for Spring break, and driven us back home by late Friday night. I will take her back up to college on Sunday, and drive back home Sunday night.) I went to work and Allison drove Calvin home when he was done. We had taken two separate vehicles, knowing I would have to leave to get to work.

On Tuesday morning, March 13th I took Calvin to Mission Hospital's Outpatient Infusion Center for a blood infusion. They wanted him to be given 2 units of blood. That took about 4 hours. Allison stayed with him when I had to leave to go to work. She then drove him home when he was all done.

On Wednesday, March 14th Calvin had an appointment with his Urologist, Dr. Sech. Dr. Sech got the results of Calvin's urinalysis from Cancer Care, and Calvin indeed has a urinary track infection. He has been taking Cipro, an antibiotic, since Monday. Dr. Sech proposed that after the infection is gone, that Calvin might consider having a laser procedure done through a cystoscope, to see what is going on in his urinary track, and use the laser to try to break up some of Calvin's prostate tumor. He had proposed this to us back in January during Calvin's hospital stay, but Calvin was not ready then. So we are considering it now. For normal "garden variety" prostate cancer it is very successful in decreasing the frequency and urgency of urination, which Calvin has been having to deal with. It might work as well on Calvin's extremely rare tumor. It is called "The GreenLight PVP Laser Procedure." It would be done as an outpatient under general anesthesia. If there are no problems, he would be discharged that same day, with a catheter, which would only be in place for 24 hours. At worst they would keep him overnight and send him home the next day.

Just got a call from Cancer Care. This morning when we were there for a check up they drew some blood for a CBC. Calvin's hemoglobin is still too low. They are going to schedule another blood infusion for 2 more units.

About the only good thing that has happened in the last month, is that Calvin did get baptized. He had been meeting with the missionaries here in our home, and he did a lot of reading, and questioning, and listening, and praying, and wanted to be baptized. That occurred on Saturday evening, March 10th, with Confirmation on Sunday morning, March 11th. So he has his Christian faith now, and the much brighter prospect of life after death.

Calvin's days are spent mostly in bed. He has no energy. Can't read much, can't watch the TV or a movie for very long, has to force himself to eat. So there has not been much "quality of life". That is why were are considering this laser procedure. He feels he needs to do "something" to try to improve his quality of life. Also, once we get the results from his CT Scan which he will be getting on Wednesday, March 21st, we will know the status of the cancer, and where we need to go next. Please keep him in your thoughts and prayers.