Wednesday, April 12, 2006

Numbers

Chemo #3 update—
Now back at the Prince Polonia after chemo #3. Decided to do the 3rd round of chemicals as an in-patient since chemo #2 as an out-patient was a bit too hellish to risk repeating… It was a relief to see the familiar faces of the competent and friendly nurses from the 2nd floor who knew me from my initial hospital stay. Carolyn stayed the night and she was equally relieved to not repeat the out-patient scene.

Promising numbers—
My CA 125 (cancer cell) count which was 903.18 on February 19 and 225.98 on March 14th is now at 20.4— This is indeed good news since 00-35 is the normal range.

My 2 main doctors, Dr. Sandeep Rajan and Dr. Pawan Gupta, came up to my chemo room to deliver the news personally and I can say that they both had smiles on their faces. I, myself, would have done a set of triple somersaults if not for my concern that the IV line would get tangled.

The promising numbers moves up the date for making decisions on the direction of treatment. There will be a new CT scan on the 26th of April (is it really April already?), after which the Tumor Board (made up of 9 doctor minds) will discuss my case and come up with a recommended treatment plan.

I anticipate 3 possible choices of direction—

The textbook direction at this juncture that will most likely be recommended by the Tumor Board will be to do ‘debulking’ surgery. This means cutting me open to find and cut out any visible cancers that may be too small to be reflected in the CA 125 test.

The doctors are aware that I may not be open to this plan of action for several reasons. The main reason is that I haven’t seen convincing evidence that the surgery actually keeps the cancer from returning. I’ve heard from quite a few women who had the surgery only to see the cancer return in less than a year. That coupled with the highly invasive nature of being cut open and plucked apart seems to me like a can of worms best not opened.

The alternate recommendation will likely be to complete the 6 months of chemotherapy and then work hard on rebuilding my immune system so that my own body keeps the cancer from returning. I would consider this on a month-to-month basis as I have so far been doing. (My main concern is still to avoid the neurotoxicity factor that could destroy the nerve endings in my hands and feet.) This ‘systemic’ approach seems to makes more sense (than surgery) to me since we know that cancer cells were also found in my lungs and on my liver.

A third possibility would be to discontinue chemotherapy sooner before my body is further debilitated by the chemo-- and begin the work of rebuilding my immune system as soon as possible.

Lots to think about—but in the meantime I want you all to know that I hold you responsible for the promising numbers. Your incredible and steady support through this extremely difficult time was the only thing that kept me from losing all hope. It was not the doctors and certainly not the medicine—it was all the loving and caring thoughts you sent my way. So here I find myself, bald as hell, skinny and frail—but alive-- and surprisingly hopeful after a what seems a long and bleak period of time. I feel sort of obligated to do my best to make a full recovery in honor of your vigilance. I am indebted to you all.

Love,
Margi

Weather report numbers are not so promising—now 40 C in Delhi (F= c x 1.8 + 32)
Will be glad to get back up to the mountains of Himachal Pradesh.

2 comments:

Catherine said...

Margi.....you are doing great and the numbers are looking good. May my prayers for you bring the same goodness as seeing your work has brought to me. I felt "good in my skin" as an artist as I looked at your travels and incredible images. You have such a special gift.
Bless you, Catherine Ruane

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