clear and chemo fun-ness

Katie had her MRI of her elbow yesterday and on initial examination, the orthopedic oncologist thought it was lesion-free, just had some possible joint damage. he is also ok, sort of, about us going to Sloan.

Quite frankly, I don't care one way or another how he feels...I wasn't nearly as impressed with him as I was with Dr. Wright, the medical oncologist. Dr. Damron seems...smirky, or something like that. But as long as he is competant. He hsa worked with Dr. Athanasian and likes him, so ok. We asked him about what exactly he would do with the ulna, how much he'd take out and all that...and I'm not sure he gave us the best answer...He said he was planning on removing the effected part of the bone plus a 2-3 cm margin, which doesn't seem like enough at all. He is also not planning on replacing any of the bone he removes and he said that she shouldn't notice much difference in flexibility/dexterity/strength, though there would be a little bit of loss in these areas. But a) this is her right arm and she is right handed and b) she does bookbinding, which requires very fine motor skills, mostly with her right hand.

So we'll talk with Dr. Athanasian about this and see what he says. Dr. Damron is an orthopedic surgeon, meaning he mostly works with legs. Dr. Athansian specializes in hand/wrist/arm surgery so I rather defer to him on this one. Plus the surgery would be covered 100% at Sloan, where we'd have to pay the deductable here. but whatever, we'll find out on Friday what our options are.

Katie also talked with Dr. Wright over the phone yesterday and he outlined the "road map" for her chemo: she'll be admitted next wednesday AM and they'll put in a double-lumen port-o-cath, then, assuming the port insertion goes fine, they'll start the adriamycin/cisplatin that night. She'll get the full dose but over a longer period of time, overnight I believe, along with lots of fluids, and then they'll monitor her reactions. She'll be out either Thursday night or Friday afternoon, depending on how she reacts. Then she'll have 3 weeks off, then on the fourth week be admitted for a day and get the methotrexate and fluids and rescue drug. She'll get the methotrexate once a week for 3 weeks, then, on the fourth week, get the adriamycin/cisplatin again, hopefully without hospitalization, then have another 3 weeks off. 3 months of this. then the surgery and then, well, whatever they decide to do for the next four or so months following that. I am so glad about the 3 weeks in between, as is Katie, since it will potentially make work easier for her. and really, it only works out to 12 neoadjuvant chemo treatments, even though they are high dose, nasty ones. but lots of down time in between and all that.

I have no idea how bad this will be, but we can only prepare for the worse but assume the best. This week's project is a living will, which names me as having medical control if she can't make decisions. This is mostly so that our rights as domestic partners are protected legally, but also, in a worst case scenario, so her wishes are laid out clearly, for everyone's sake. we've talked about doing out living wills for a while now, but only half heartedly, because, hell, why would we need them? but, yeah, here we are, with the big C breathing down our necks, so we have to be prepared for the worst. But, yeah, if she makes out a livng will, she won't need it, right? thats how these things work. its how these things have to work.