Ana is doing better today in every way except for food consumption, which is pretty much nonexistent. Her mood definitely seems better (note the tiny smile I coaxed out of her in the above picture). She is also in a lot less pain, although occasionally her stomach hurts but I’m not sure if this is related to nausea rather than the tumor. They are measuring Ana’s stomach every day and it is definitely getting smaller. Her daily fevers are also gone, and Dr. Hochberg indicated that this is from the steroids. This is good because it’s one less medication she needs to take (she was taking Tylenol nearly every night when her fever spiked to 101 or 102).
Dr. Hochberg said that even though the tumor appears to be shrinking, the issue is not necessarily the size, but the fact that the tumor is so involved with the blood vessel. The tumor may actually shrink down considerably, but still invade the blood vessel to such an extent that her liver can’t be saved. Any response at all is exciting (and hopeful) news as far as I’m concerned.
So, next steps…
Ana will get chemo once a week for the next three weeks. This will occur on Tuesdays and will involve different drugs each time. Well, not really. The chemo she received this week was a combination of three different drugs – Vincristine, actinomycin d and Cyclophosphamide (or “VAC”). However, for the next two weeks she will only get the Vincristine which is the least toxic of the three drugs (or the most “benign” as Dr. Hochberg put it).
And….this is very exciting…if Ana continues to do well AND starts eating, she will be discharged after next week’s chemo is administered! That means she may be home on Tuesday or Wednesday!!! EEEEEE! Excuse me, while I do tiny mental cartwheels of joy.
But…I’m still holding my breath that this will happen next week because, as I said above, Ana has not been eating. She’s still nauseous, though it is well controlled. Her appetite is precarious at best, and the chemo seems to have knocked it out completely. Her weight was down again this morning and she needs to maintain it (at the very least) or they won’t let her leave.
Now, assuming she gets discharged at some point next week, she can do the following week’s chemo as an out patient, then she’d be re-admitted the week after that (week 4 of treatment) for the full course of VAC. But it would just be a one or two day hospital stay. She’ll get another CT scan at week five to see how much the tumor has shrunk and if it has helped reduce the involvement in her blood vessel.
If. If. If. There are no certainties here. We are literally reaching out to every top liver surgeon that we can locate in the NYC area for second, third and fourth opinions to see if her liver can be saved. Her case will be brought up at Sloan Kettering’s tumor board this coming Tuesday and Jim and I are extremely anxious to hear what they say. Jim also just sent Ana’s test results to a liver surgeon at Mt. Sinai. We will only move forward with resection of the tumor (as opposed to transplant) if we have a surgeon who is confident he can clear the tumor from the vein and save the healthy portion of her liver.
Meanwhile, my search for insurance is on hold until we know what surgical course of action we can take.
In the short term, I am looking forward to having Ana home again and all of us under the same roof. She won’t be able to go back to school (this caused some tears), but she will be able to get visitors and even make trips to the school and public places (during less crowded hours). She’ll also have an arsenal of drugs she’ll need to take – including those damn Lovenox shots (Carrie, would love your help with that!!)