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As I have often done, I publish very current information for those who may be interested.

I published MANY pages to meet the publishing date of my Wednesday Letter -- newsletter dated June 9, 2004.

But, this is a very active area just now so I'll regularly come back to this page and add whatever seems of interest.

June 9th.

The Oncologist is convinced that Bonnie has not had a heart attack, and that the symptoms she described to the Primary Care Physician do not indicate a heart attack.

But, when something like this is hinted, the brakes go on -- so the radiation doctor didn't want any more radiation until Bonnie has seen the Cardiologist -- that will be scheduled soon.  He will eventually do an ultrasound -- the Oncologist is convinced he will find nothing to worry about.

In the mean time Bonnie gets no radiation and no chemo -- so she has a few days to recover.

We are looking at some new therapies.  As these seem of interest or value, I'll publish about them.

June 11

Today was the day for the tests by the Cardiologist.  But, some more optimistic news came the day after the doctor told Bonnie she had had a heart attack.

The Oncologist said, he didn't think Bonnie had such an attack.

Why?

• If the Primary Care Physician had really thought she had had a heart attack, just about by law he would have called an ambulance and had her admitted, through Emergency, into the hospital.  He didn't.

• There is apparently a "chemical marker" in the blood from a heart attack, and if the Doctor had really thought she had had a heart attack he would have surely taken a blood sample for testing.  he did not.

• The Oncologist also re-asked her questions about symptoms, and Bonnie described how she did not have chest pain, but did have stomach pain -- he said that there should have been chest pain if she had a heart attack.

• Bonnie described the same symptoms to the Oncologist as she had to the Primary Care Physician, and the Oncologist said, "Those are not the symptoms of a heart attack!"
   

Nonetheless, with this "warning from any doctor" it would be impossible for either the radiation doctor or the Oncologist to move ahead with any treatment -- Bonnie got a "reprieve!"

(It is possible, I believe, for a being to "cause" a flutter on the ECG machine so that there SEEMS to be a possibility of a heart attack for the sole purpose of delaying the radiation and chemo treatments!  It can happen!)

So I have now become reasonably knowledgeable about the "Thalium Stress Test" and the "Heart Tomography Scan."   Bonnie had both of those on June 11th.   One nurse tried to get me to leave the small exam room and I made it clear that I was not going to leave.

Those tests were interesting -- they ended about 4:30 PM -- there would be no way the results would get to the radiation or oncology doctor before Monday == the technician "can not" give you his opinion of results -- only the doctor can, and he only to another physician -- not to the patient.

But, the technician, perhaps impressed with my firm demand that the "patient consent form" which I signed for Bonnie be witnessed by the physician on duty -- that I had added the words, "Under no emergency circumstances of any kind would we allow an angiogram or bypass surgery."

Without my added caution, and getting the doctor to acknowledge this comment, the patient consent form would have allowed the testing doctor to take any emergency steps he felt necessary -- if something went wrong. This is exactly the language people sign without ever realizing that some number of times the "something wrong" happens and the attending physician decides that an angiogram is vital -- urgent and they order it without your consent -- you have already signed.

So the technician was friendly, seeing how firm I was on this, and he showed the test results to me and explained that he saw nothing indicating a heart attack.

So, the big decision Bonnie has to make, more treatment or not, has been pushed off to Monday.

I'll write more as it happens.

This weekend, June 11th - 12th are critical == not in Bonnie's physical health, but in her decision on whether or not to accept more chemo and radiation.

What do you think?

Here are the factors involved:

• The Oncologist is mostly the "manager" of this case -- he says that it is vital NOT to interrupt the pattern of chemo and radiation

• Yet, there have now been several interruptions.  As of June 11th Bonnie has been off any chemo for more than two weeks, and off any radiation for about one week.

• The plan had always been to have the expected treatments, then a CAT Scan about 10 days after the last treatment and THEN a decision by the Surgeon as to whether or not he felt that a "clean resection" was possible (a "cure" by removing any remaining cancer, and not leaving any live cancer cells behind).

• The chances of that surgery are now reduced because of the interruptions.

• If Bonnie says "no more" to both radiation and chemo -- probably she can get the CAT Scan, although they may refuse??

• She may or may not then get a surgery looking for a "clean resection" or for a "palliative treatment" (to make her "feel better" but giving up on any "cure").

So, Bonnie has to make decisions -- or not!

In the meantime she really just wants to be able to swallow some water -- and since the gagging is getting less, and the prediction is that she will feel better after being off treatments, we are looking forward to her possibly being able to swallow some water on Sunday.

How would swallowing affect her decision.

A care-giver has to be very sensitive for the needs for these types of decisions -- and allow the patient to decide in any direction.

Karl

June 13, 2004

Bonnie continues to improve.  I had predicted that she would swallow today -- it happened.  Very small amount, but she did.

Also, as I have been expecting, today was another time when she coughed up "something like dead cancer cells." They were about 1/4 inch, a triangle, with two small red spots in two corners, and a more faint red spot in the third.

There is no reason NOT to believe that some or all of the cancer is dead, and has not yet been fully "absorbed" or disintegrated -- and that some of it, close to or even part of the esophagus, gets through the wall of the esophagus, to the interior, and comes up when she coughs.

This could well become much more dramatic soon.

Tomorrow is Monday -- she gives a blood sample.  Probably neither the radiation doctor nor the oncologist will be willing to "put her back on treatment" until they see the results of that blood test, and certainly until they get the report from the Cardiologist.

In the meantime, Bonnie feels better and better -- but, of course, this is just what the doctors predict.  They never hide the fact that they know that the radiation and chemo cause terrible pain and discomfort -- so they will acknowledge the fine improvement.

After all, Bonnie has now been off chemo for about three weeks, and off radiation for about 2 weeks.

They will want her to go back on it.

Bonnie has to decide.

What will she decide?

Karl

June 15, 2004

See letter to doctors, delivered by hand this date

Bonnie continues to display "symptoms" which the doctors do not understand -- so they constantly look for some "bad news explanation."  My own explanation has been described in these pages, and was described in the above-link letter to the radiation and oncology doctors.

Both doctors mentioned their concern that a "pulmonary embolism" could be the cause of Bonnie's "shortness of breath" and other symptoms.  The X-Ray called for when the radiation doctor first heard of these symptoms did look at the lungs, but was not the type of X-Ray that would detect a pulmonary embolism.  In any event, that X-Ray showed no problems.

Doctors only know to look for problems.  After they found no problem with the lungs or heart, but then suspect a different sort of problem with the lungs -- probably scheduling Bonnie for some sort of test on Wednesday, June 16th.

A pulmonary embolism is simply a blood clot, somewhere in the body, where the clot "breaks loose" and travels through the blood stream, getting stuck in the lungs.

Click here to read much more about this health problem.

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