Dr. Bajorin’s team just left. They reported that Debbi’s response to all the antibiotics was positive and therefore concluded that the encapsulated nodules that showed some changes between the CT scans of 3/13 and 3/18 were most likely due to infection. This does not mean the Debbi’s lungs are cancer free… unfortunately. But, it does mean that she will be transitioning to oral atibiotics, being released from the hospital in a day or two, and continuing with her chemo treatments for the spiculated cells that are still in her lungs.
On two occasions I was able to view the CT scans with a Fellow from Debbi’s primary team. The spiculated cells look like 100 individual grains of rice that are well disbursed in a set of lungs whose volume could probably hold at least 100,000 grains of rice. In addition, on both scans, there was an area that looked like a dime sized black circle encapsulated by a ring of white tissue. This area appeared to be a nodule that could be cancer, infection, fungus, etc. This nodule was not present on CT scans before the 13th but Debbi’s lungs did have an area which lead the doctors to believe she had pneumonia. Given the ratio of the 100 spiculated cells to the possible volume of 100,000, it is no wonder that the doctors always commented that they thought that Debbi’s lungs sounded surprisingly clear.
Dr. Michael Glickman of the Infectious Disease department speculated on Wednesday the 18th that the pneumonia or some infection had manifested itself in this encapsulated nodule and was slowly responding to the antibiotics. He said that this had no bearing on the cancer already in her lungs (which we are identifying as the spiculated (spikey) cells or “grains” of rice, rather these spiculated cells were still present but the bigger nodule, he believed, was due to infection.
We are praying that Dr. Glickman is exactly correct and that the spiculated cells do not morph into structures that look like the nodule I saw on the scan. Hopefully this will mean that the Taxol chemotherapy can still be effective and that we will enjoy and cherish having Debbi with us for much longer.
This visit to the hospital did have one distressing side effect that we are still dealing with. Debbi is quite filled with liquid. Her lower half looks like someone hooked up a garden hose and pumped her full of fluid. Debbi’s medical record indicates that she is allergic to Sulfa drugs. Lasix is the most common diuretic and it is not known to harm kidneys but it does have the Sulfa molecule. The doctor were reluctant to prescribe it. Debbi was insistent so yesterday a single small dose of Lasix was administered with a side of Benedryl in case of an allergic reaction. Debbi seems to be tolerating the Lasix and we are waiting for a dose today. It is readily apparent that she needs this. Even though she describes the pain of being “water-logged’ I can not imagine it. It looks so painful. We went for a 3 lap walk around the floor yesterday and it just looked difficult. I brought well-cushioned summer flip-flops for her today and I am hoping that she will be able to complete more laps and that the exercise, Lasix, and who knows what will remove the excess water weight soon.
So there is definitely a lot to be thankful for today.