Monday, February 22, 2016
Cycle #17 of Folfiri. The doctor reviewed Mike's x-rays taken during his recent hospital stay and stated it show sign of bowel obstruction. There was just some fecal matter in the colon. Due to scheduled labrectomy in 2 weeks by Mike's dentist to deal with his eroding gums, there was a hold placed on the Bevacuzumab. The doctor ordered his treatment with a 20-30% dose reduction. He scheduled Mike to return in 3 weeks instead of the usual 2 weeks due to the planned dental procedure for cycle #18.
Weight: 182 lbs/83 kg
DENTAL PROCEDURE: This labrectomy was performed on March 7, 2016
Monday, March 14, 2016
Cycle #18 (rescheduled) Due to Mike having laser surgery to repair his gumline one week ago, his appointment was rescheduled to Monday, March 21, 2016. The doctor stated this area was granulating. There were no signs of infection. Mike denied any uncontrolled pain, fevers, chills, diarrhea, or oral ulcers. The surgical area is healing. Denied any oral pain. Mild leukopenia and thrombocytopenia secondary to treatment. He is to return in 2 weeks for palliative chemotherapy. Continue daily activities.
Weight: 187 lbs/85 kg
Monday, March 28, 2016
Cycle #18 Bevacizumab held today to allow the gumline to heal for a good 4-6 weeks. The doctor stated that Mike may be progressing despite the present regimen, and he may need a complete overall of his chemotherapy. His plan was to simply readmit the Bevacizumab for a few cycles and then repeat the CEA.
Mike was sick this week with a head cold along with the nausea from his treatment.
Weight: 188 lbs/85.5 kg
Monday, April 11,2016
Cycle #19. Return for palliative treatment with Bevacizumab added. The doctor will treat Mike with approximately 4 cycles, and then reassess his CEA and scan.
Weight: 190 lbs/86.4 kg
Monday, April 25, 2016
Cycle #20. They proceeded with cycle #20. Remain active and continue with oral care. Report any uncontrolled diarrhea, oral ulceration, or pain. After completing cycle #21, he should be reassessed to see what his response to this therapy is due to his increasing CEA level. Return in 2 weeks.
Weight: 186 lbs/84.7 kg
Monday, May 9, 2016
Cycle #21. Mike continues to be fully active ad able to carry on all predisease activities without restriction. Advised to remain active and continue his routine medication. Return in 2 weeks, repeating a CEA, CT scan of the chest, abdomen, and pelvis to reassess the diease.
Weight: 187 lbs/85.1 kg
Monday, May 16, 2016 CT scan & CEA
CT Chest/Abdomen/Pelvis - Worsening pulmonary metastases noted since last exam. These have increased slightly in size and number when compared with prior exam, Slight increase in size of hepatic metastases in the dome of the liver when compared to prior exam. No retroperitoneal or pelvis lymphadenopathy seen.
CEA - 568.9. This is up from 142.0 done on March 14, 2016.
Monday, May 23, 2016
Mike returns for results of his CEA and CT scan. Due to the progression shown in his recent testing, the doctor suggested FOLFIRI/zaltrap. This will need to be authorized through his insurance. Appointment scheduled to start this regimen next week.
Tuesday, May 31, 2016
Cycle #1 FOLFIRI/zaltrap. Risks and benefits discussed. Return in 2 weeks for cycle #2.
Weight: 186 lbs/84.4 kg
Monday, June 13, 2016
Cycle #2. Mike's upper quadrant discomfort has resolved which the doctor felt may be a good sign. He has no evidence of active infection at this time. Zaltrap can cause significant neutropenia. The doctor felt if he proceeded with cycle #2, Mike would become significantly neutropenic and at risk for infection. He decided to delay the chemotherapy 1 week and allow Mike's white cells to have a better recovery. His WBC was 2.50 (normal 4.5-9.1). His Platelets were 104 (normal 150-330).
Neutropenia, pronounced noo-troh-PEE-nee-uh, is a decrease in the number of white blood cells. These cells are the body’s main defense against infection. Neutropenia is common after receiving chemotherapy and increases your risk for infections.
Weight: 185 lbs/84 kg
Monday, June 20, 2016
Cycle #2. WBC were 2.60 which is up from last week. His platelets were 98 which is lower, Mike was advised of the risks and benefits of further therapy including infection and prolonged neutropenia. They decided to proceed with cycle #2. He is to return in 2 weeks for potential cycle 3. Mike's abdominal discomfort has resolved, so the doctor thought he that he may be having a response to the treatment.
Weight 187 lbs/85.2 kg
Tuesday, July 5, 2016
We had a relaxing and quiet Fourth of July. Mike returned for Cycle #3. Neutropenia seconday to therapy, white count adequate. Mike complaining of sore spots in his mouth again. The doctor put Mike on Penicillin for his oral pain and dental infection, He was advised to contact his dentist. Cycle #3 was completed. CT scan of chest/abdomen/pelvis to assess response to therapy scheduled as well as a CEA. Mike is to return in 2 weeks for further palliative treatment. Cycle #4 will be initiated provided his scans demonstrate improvement, We await the results of these tests.
Weight: 186 lbs.84.3 kg
Cycle #17 of Folfiri. The doctor reviewed Mike's x-rays taken during his recent hospital stay and stated it show sign of bowel obstruction. There was just some fecal matter in the colon. Due to scheduled labrectomy in 2 weeks by Mike's dentist to deal with his eroding gums, there was a hold placed on the Bevacuzumab. The doctor ordered his treatment with a 20-30% dose reduction. He scheduled Mike to return in 3 weeks instead of the usual 2 weeks due to the planned dental procedure for cycle #18.
Weight: 182 lbs/83 kg
DENTAL PROCEDURE: This labrectomy was performed on March 7, 2016
Monday, March 14, 2016
Cycle #18 (rescheduled) Due to Mike having laser surgery to repair his gumline one week ago, his appointment was rescheduled to Monday, March 21, 2016. The doctor stated this area was granulating. There were no signs of infection. Mike denied any uncontrolled pain, fevers, chills, diarrhea, or oral ulcers. The surgical area is healing. Denied any oral pain. Mild leukopenia and thrombocytopenia secondary to treatment. He is to return in 2 weeks for palliative chemotherapy. Continue daily activities.
Weight: 187 lbs/85 kg
Mike and I hiking Ryder Park trails outside of Montoursville, PA
Monday, March 28, 2016
Cycle #18 Bevacizumab held today to allow the gumline to heal for a good 4-6 weeks. The doctor stated that Mike may be progressing despite the present regimen, and he may need a complete overall of his chemotherapy. His plan was to simply readmit the Bevacizumab for a few cycles and then repeat the CEA.
Mike was sick this week with a head cold along with the nausea from his treatment.
Weight: 188 lbs/85.5 kg
Monday, April 11,2016
Cycle #19. Return for palliative treatment with Bevacizumab added. The doctor will treat Mike with approximately 4 cycles, and then reassess his CEA and scan.
Weight: 190 lbs/86.4 kg
Monday, April 25, 2016
Cycle #20. They proceeded with cycle #20. Remain active and continue with oral care. Report any uncontrolled diarrhea, oral ulceration, or pain. After completing cycle #21, he should be reassessed to see what his response to this therapy is due to his increasing CEA level. Return in 2 weeks.
Weight: 186 lbs/84.7 kg
Monday, May 9, 2016
Cycle #21. Mike continues to be fully active ad able to carry on all predisease activities without restriction. Advised to remain active and continue his routine medication. Return in 2 weeks, repeating a CEA, CT scan of the chest, abdomen, and pelvis to reassess the diease.
Weight: 187 lbs/85.1 kg
Monday, May 16, 2016 CT scan & CEA
CT Chest/Abdomen/Pelvis - Worsening pulmonary metastases noted since last exam. These have increased slightly in size and number when compared with prior exam, Slight increase in size of hepatic metastases in the dome of the liver when compared to prior exam. No retroperitoneal or pelvis lymphadenopathy seen.
CEA - 568.9. This is up from 142.0 done on March 14, 2016.
Monday, May 23, 2016
Mike returns for results of his CEA and CT scan. Due to the progression shown in his recent testing, the doctor suggested FOLFIRI/zaltrap. This will need to be authorized through his insurance. Appointment scheduled to start this regimen next week.
Tuesday, May 31, 2016
Cycle #1 FOLFIRI/zaltrap. Risks and benefits discussed. Return in 2 weeks for cycle #2.
Weight: 186 lbs/84.4 kg
Monday, June 13, 2016
Cycle #2. Mike's upper quadrant discomfort has resolved which the doctor felt may be a good sign. He has no evidence of active infection at this time. Zaltrap can cause significant neutropenia. The doctor felt if he proceeded with cycle #2, Mike would become significantly neutropenic and at risk for infection. He decided to delay the chemotherapy 1 week and allow Mike's white cells to have a better recovery. His WBC was 2.50 (normal 4.5-9.1). His Platelets were 104 (normal 150-330).
Neutropenia, pronounced noo-troh-PEE-nee-uh, is a decrease in the number of white blood cells. These cells are the body’s main defense against infection. Neutropenia is common after receiving chemotherapy and increases your risk for infections.
Weight: 185 lbs/84 kg
Monday, June 20, 2016
Cycle #2. WBC were 2.60 which is up from last week. His platelets were 98 which is lower, Mike was advised of the risks and benefits of further therapy including infection and prolonged neutropenia. They decided to proceed with cycle #2. He is to return in 2 weeks for potential cycle 3. Mike's abdominal discomfort has resolved, so the doctor thought he that he may be having a response to the treatment.
Weight 187 lbs/85.2 kg
Tuesday, July 5, 2016
We had a relaxing and quiet Fourth of July. Mike returned for Cycle #3. Neutropenia seconday to therapy, white count adequate. Mike complaining of sore spots in his mouth again. The doctor put Mike on Penicillin for his oral pain and dental infection, He was advised to contact his dentist. Cycle #3 was completed. CT scan of chest/abdomen/pelvis to assess response to therapy scheduled as well as a CEA. Mike is to return in 2 weeks for further palliative treatment. Cycle #4 will be initiated provided his scans demonstrate improvement, We await the results of these tests.
Weight: 186 lbs.84.3 kg
