And For The Medical Stuff

You really don't need to feel obligated to read this post. I just need to work out my thoughts re: appointments we're having this week and what I think it all might mean.

Reminder: these are our medical concerns:

1. Super kill-y cancer. Currently responding well to treatment. PET scan soon.
2. Optical nerve issue / sight problem called pappiledema
3. Clotting
4. Normal pressure hydrocephalus (backup of cerebrospinal fluid -- csf)

Recently our oncologist took mrguy's case before the Tumor Board. They had lots of questions and asked for lots of lab work. This will come in later.

Lately we've been concerned with Issue 2. We see the neuro-opthalmologist every two weeks. She and the other doctors are working to increase blood flow to and reduce internal pressure in the optic nerves. The situation has improved a bit, and is sort of stable, but still majorly jacked, as we say in the language of learning. All doctors have said "No more Keytruda". A lot of the immunotherapy drugs have neuropathy as a side effect, and the weak spot for mrguy is his optic nerves.

But still -- Issue 1 is really important, right?

Issue 4 is being treated with Diamox and a beta blocker, and they did do a lumbar tap a while back and were sad that it didn't immediately cure the pappiledema but it did reduce the backup of csf at the time. 

And we're trying to keep Issue 3 under control with Eliquis, an anticoagulant.

Issues 2, 3 and 4 are related. Our current theory is that the clotting at the jugular vein started the backup of csf. And then the Keytruda hit his optic nerves when they were already fragile. But if we don't do something to reduce the pressure on his optic nerves, his eyesight could worsen.

Here's where the Tumor Board comes in.

I'm guessing they're wondering why mrguy formed extra blood clots in his brain when he was on Lovenox (his previous anticoagulant). And whether he's predisposed to more clotting. And what's the solution to the backup of csf?

So this is neurology week in the guy home.

Tomorrow we talk with the neurosurgeon. I assume we are discussing whether a shunt or a stent is a possible treatment for the pressure. At our last appointment our neuro-opthalmologist blurted out "I'd do a VP shunt. It's an easy fix unless he has brain cancer because it could get transferred to the rest of his body. But they can also clog." Ohgreat. Well I guess my question is whether the gut cancer could travel up to the brain. That would not be good. In that case, perhaps a stent would be helpful. And we'd need to know what happens if the stent clogs up.

On Wednesday we talk with the head of neurology re: brain stuff. No idea what the meeting is, but I like the way he communicates.

On Thursday mrguy has chemo, and during his infusion he will talk with our regular neurologist. Not sure why?

On Saturday we drive over the bay for his flushing appointment and pump disengagement. 

Oh yeah! The labs. The tumor-ers asked for lots of blood work related to clotting. It all came back negative except for one, which indicates a genetic blip in his makeup regarding clotting. 

To be continued. There was actually a viper venom test that I thought was cool-sounding but he was negative for it.