When we were eventually joined by the healthcare specialist, she gave us a replica of the NIH scan report. It noticed an "unchanged 0.8 cm left sub clavicular nodule partially imaged on the primary slice." The lungs were clean, and the total thing else inside the stomach was "unremarkable." Dr. Aragon-Ching stated that this report was the most effectual news that she might just additionally predict. She stated that there was no approach to recognize if the melanoma stopped progressing consequently of the ddMVAC chemotherapy, or if would have done that no matter even so. However, she was willing to accept as actual with that the chemo had some have an impact on, in view that this scan again measured the node at .8 cm, which was a little bit smaller than the pre-chemo scans. This suggested that the chemo might just additionally have led to the metastatic melanoma now not to most efficient cease creating, no matter to a little bit recede. She also stated that it was now not absolutely that extra chemo would have led to the melanoma to inside the reduction of any extra, so stopping the chemo after three rounds was a favorable name: I was prepared to enjoy the cruise and the holidays chemo-free, and failed to give some thing else up by now not doing the last three rounds.
Dr. Aragon-Ching advisable that, for now, I now not resume ddMVAC or have the alternative treatment. Instead, she advisable that I have fastened scans (each 2-3 months) and display computer screen my mets, and wait and spot if it begins to unfold. It's extraordinarily prone to do so — spreading is what this classification of melanoma likes to do — no matter unless it does, she saw no are looking out to subject me to any additional options. She reiterated how all of my options purely are now not intended to be healing (in view that medical doctors do now not recognize systems to cure metastatic bladder melanoma), no matter are intended to be palliative by supporting to in all probability slow the progress similtaneously easing my discomfort. Ironically, through my full melanoma journey, all of my discomfort has been led to by the facet with out drawback of my melanoma options: the primary around of chemo; the restore from surgery and my persevering with efforts to address my neobladder; and the nadir of the ddMVAC chemo.
Another money in of now not having had all six rounds of ddMVAC chemo, my healthcare specialist stated, was that, if and when the melanoma resumes spreading, we will go returned to ddMVAC again, and spot if it might in all probability paintings a 2nd time. She accompanied that, although the ddMVAC chemo wiped me out with overwhelming fatigue, I under no circumstances reached the bounds of toxicity. That resolution likely does now not be obtainable if I had done all six rounds, since I'd likely have reached biggest cumulative toxicity. I was satisfied to defer the basis of additional chemo into the undefined fate.
I asked with reference to the lingering with out drawback of the chemotherapy. I referred to how my feet get colder faster, and take longer to heat up. I've especially seen this at evening. While I was inside the course of chemo, I sometimes would alternate holding the heating pad on my stomach, and my feet. I have now not mandatory a heating pad on my stomach since I ended ddMVAC, no matter my feet feel like blocks of ice at evening — far only unheard of than beforehand the ddMVAC chemo. Dr. Aragon-Ching stated that bloodless feet is a form of neuropathy, a known facet have an impact on of ddMVAC chemo. She stated that, of the five% or so of sufferers who have neuropathy, sometimes it is exceptionally painful, such as persistent pins and needles, or stabbing pains. She stated that some sufferers with neuropathy see the signs diminish through the years, no matter as a rule it is an permanent shift. I bet I'll reside with it — especially if Jennifer continues to permit me heat up my icy feet on her. 🙂
More importantly, I am in touch with reference to the ongoing shortness of breath that I directly experience whenever I exert myself. For instance, the day past I carried two boxes of Christmas decorations down to the basement, and was sucking air after the 2nd location. That's method out of individual for me. After a chew of snow fell over the holidays, I was gasping after sort of a little while of pushing snow with a shovel. Dr. Aragon-Ching at the commence guessed that it was a lack of conditioning, no matter I knew it was something extra — it absolutely is like my lungs couldn't alternate enough oxygen. She accompanied that, in infrequent circumstances, the adriamycin (the "A" in MVAC) might in all probability have an impact on the heart. Even less elementary is the possibility of PE, or pulmonary embolism, which is a blockage of the major artery of the lung by a blood clot. She ordered most efficient a few tests — an echocardiogram to be told about my heart, and a air flow/perfusion scan (v/q scan) to be told about the flow of air and blood in my lungs. I'm scheduled to have either of these scans on January 23. If some thing else suspicious is noticed, she'll go upfront with an full-comparison CT scan. In the meantime, she stimulated me to slowly ease returned into some fastened physical recreation.
She also renewed my prescriptions for Ambien CR and Lunesta, which I purely alternate taking each evening to resource me sleep through my unpredictable nocturnal incontinence.
After we were done, she had me go over to the infusion lab so my port might just additionally be flushed. It had been two months since it was accessed, and she or he failed to need it to get blocked, like it did in 2012. That took a further hour or so of waiting for a 30 2nd system. All in all, we were at the GW offices for almost 4 hours. Jennifer and I had been looking forward to to exit to lunch after were were done; it became an early dinner.
On the ability home, we talked approximately what this capability. It's in all probability terrifi news that the melanoma has now not unfold, no matter we proceed to perceive that it is still a question of time. This scan alleviates transient term considerations, no matter as John Meynard Keynes accompanied, inside the lengthy term we are all lifeless. I do now not recognize how lengthy my run will be, no matter give thanks that for now the sun is shining.