Monday was a full-on day. It started with a 9am appointment at the Nuclear Medicine dept at Wellington Hospital. The first test was the kidney function test. This involves having a radioactive isotope injected into a line in my right arm and then having a series of scans performed.
The isotope is processed by my kidneys in the normal way and a series of blood samples are taken every hour for five hours. The samples are then analysed to make sure that the isotope levels in my blood are dropping. If my kidneys are functioning correctly the levels will decay at a predictable rate.
Next up was the Gated Heart Study. This also involved a radioactive isotope that was injected into my arm, this time my left one. I also had an injection containing Tin before hand. The isotope binds to the tin and then that in turns binds to the red cells in my blood. (Well at least that's my understanding of the process).
I'm then put on a scanning bed, a lot like a CT scanner, and pictures of my heart are taken over a period of around thirty five minutes. From these pictures it is then possible to calculate the hearts efficiency. The amount of blood drawn in against how much is pumped out. Any damage to my heart valves would become apparent, possibly ruling out further chemotherapy. I'm told my heart is still in good shape.
The next test was Lung Function. This involves sitting inside a small sealed glass cabinet and breathing into a tube. Well.. kind of.. There are various tests that you are asked to perform. Breathing all the way in until you think your lungs will burst and then pushing it out until you almost feel like your chest will implode is one of them. Another involves panting into the tube and then pushing against a restriction that suddenly occurs. A computer graphs everything as it happens and then compares it against my previous figures from when we did the 'baseline' tests back in 2005.
No further lung damage has occurred in the last year. I lost about 15% efficiency after my first hit of chemo but none since.
My lung capacity is down slightly on last time but that's to be expected from the radiation damage to my bronchial tubes. I think if I'd done the test a month ago when I could hardly breath the results would have been a lot worse. So I kind of passed the lung test too. They aren't what they used to be, but with exercise I can increase the capacity, however the efficiency may never return to what it was.
This morning I had another meeting with Dr D'Souza. I was late due to traffic and he had to be called back from a meeting. He's been seeing me outside of his usual weekly clinics. It's good to know he's very keen to keep the ball rolling on this. In contrast to previous experience I've had within the public hospital system.
There's still no clear plan yet but he has confirmed that I will be having high dose chemo with stem cell support. The timing is unknown and is based around how quickly I can get my stem cells back from Germany. I've had a devil of a time getting any sort of response out of them. Finally yesterday morning they emailed me and said that they would complete the required paperwork and forward it to me and Wgtn hospital in the next day or so.
The last time I saw Dr D'Souza I suggested that having a couple of cycles of salvage chemo would be something I'd very much agree to.
I thought that it would help reduce the involvement of the cancer until the high dose could be started and also give us an opportunity to do another stem cell harvest off the back of the last chemo cycle. This is based on the phenomena whereby there is a rebound effect on the stem cells after chemo and a greater harvest of cells can be gathered than would be the case without chemo. Also reducing the cancer load means we have less work for the high dose to do and can reduce the burden on my system at a time when I would have a severely compromised immune system.
Today Dr D'Souza suggested that another round of salvage chemo was an option and that he could harvest off the back of the last cycle. I wonder if he realises this is exactly what I talked about at our last meeting. Fingers crossed we go down that path.
The other option is straight into high dose chemo and the stem cell transplant at the first opportunity. Personally I don't think this is the best option. He has indicated that there may be an opening for treatment this side of Christmas. I'll be subtly pushing for the salvage option when we next meet.
I'm racing this weekend at Shelly Bay. I expect that it will be the last event I enter for some time as there is only one event early next year, which I'll probably miss due to treatment and after that there's one event in April then nothing until August.
I've made some tweaks to my car, Launch control and minor suspension improvement in an attempt to do better than the 1:13's of the previous two years I've entered the annual Shelly Bay sprint.
I'd like to do an 1:11 second run, smashing the record of 1:12.85 set by Joe McAndrew in 1996... we shall see :)
