We met with Dr. O’Dwyer today to review Mom’s CT scan; he’s changing everything. We retreated to the beach to bask in the sun and salt air, and the generosity of a friend.
Early this morning my sisters and I took Mom down to the Abramson Cancer Center to meet with Dr. O’Dwyer and review Mom’s recent CT scan. We recovered from our initial scanxiety shock and went with open minds and open hearts to hear his expert opinion.
Still, we were nervous.
Dr. O’Dwyer is confident and assured and he really had nothing but good things to say. He spent a lot of time talking to Mom directly about her symptoms, and what she is doing about them. He was very adamant that Mom needs to get more protein into her diet and eat more, and is a little concerned about Mom’s weight loss. My sisters and I (and my of our regular visitors) have been beating this drum since March, but, you know, maybe hearing it from *one* more person will get those protein smoothies going again.
After examining Mom, Dr. O’Dwyer turned to the main event: reviewing the scan. To paraphrase, he said:
“It looks like maybe the tumor grew a little bit. Not much, in fact, it is very close to the same size. But we are not doing all of this just for no growth. We want shrinkage. We want to shrink the tumor and get you to a place where we can meet with a surgeon. That was goal in the beginning, and that remains our goal. Right now, we need to re-evaluate, and to re-evaluate, we need to make some changes. So we are going to change from Folfirinox to the other regime we discussed in the beginning: Gemcitabine/Abraxane.”
This regimen has shown a lot of success, especially when used after a patient uses Folfirinox. The Folfirinox is the first choice, but if it is not producing the best results, the standard practice is to shift to Gemcitabine.
This is a totally different regime.
With Folfirinox, we went down to Penn every 2-3 weeks for a 5-hour session, followed by 46-hours of at-home chemo delivered via a pump Mom had to wear with a should strap.
With Gemcitabine, we will go down to Penn every week for a 3-hour session, 3 weeks in a row and then 1 week off. No at-home chemo.
The symptoms we should expect with Gemcitabine are the same Mom experienced with Folfirinox, but perhaps less extreme.
Dr. O’Dwyer wants Mom to do three weeks in a row, take a week off, then three weeks in a row again, and then they will see how the numbers look.
Gemcitabine has to be on a stricter schedule, ideally the same day each week, and no skipping weeks.
So, much of our planning for the next few months just went out the window. OK, we always knew something like this could happen.
Dr. O’Dwyer wanted to start TODAY, while we were there. We had plans to take Mom down to the beach for a few days, and we thought today’s meeting would be about 30-minutes and then we were going to head for the coast.
None of THAT was going to happen like that.
We immediately started scrambling, me hovering over the checkout desk with the scheduler trying to get all of the dates lined up, my sisters feeding me their schedules so I could get the best dates.
It turned out that there was just no room for infusion today, but we could get a chair tomorrow.
So… we packed up and headed for the beach, and we plan to drive Mom back tomorrow for her first chemo on the new regime.
I didn’t get a picture of the inside of the minivan on the ride down, but I was one of seven, including my Mom and Dad, and floor-to-ceiling bags and food and drinks. The Sienna felt heavier than when we go on our cross-country road trips!
We made it.
A good friend is letting us stay at their home in Brigantine, NJ, and it is heaven. Beach-front. Stunning views. Tons of bedrooms. We set Mom and Dad up in the primary bedroom, and we are all jealous.
My wife and three of my kids are here. My younger sister Alia is here with most of her family, and my Dad’s sister Janine and her daughter Molly are down tonight. My older sister, I hope, might swing down for a day or so. Some other people might pop in. It was a last-minute opportunity, so whoever can make it, can make it.
The generosity of our friend to offer us their beach home is incredible. It was so very much just what we all needed. Mom’s diagnosis was in March when it was still cold and rainy and dark.
It has been a long spring!
And even though Dr. O’Dwyer insists we see the gem in the rough, and even though our spirits are high for the new regime, we are all exhausted, and we could have used some miraculous news.
Who knows — there are many cases of people who had little to no impact from the Folfirinox and then had incredible, tremendous results from the Gemcitabine.
Why not Mom?
There are little gems everywhere. There are my Aunts who have been showing up and sitting with Mom for hours and hours. There are friends who surprise us with their generosity. There are stories that inspire and fill us with hope. My Godmother, my Mom’s best friend, seems to know just when to deliver the thing — a well-written text, some amazing snacks, a hug and a long visit, a random Amazon delivery — that we need. There is a full moon and clear night. There is the sea, and the sun, and a beautiful day in a beautiful space.
Tomorrow (Thursday) Alia and I will drive Mom back to Philly for a few hours to begin her new chemo regime.
Tonight, we will watch the moon rise over the ocean and we’ll toast to our good fortune and our good friends and our good family.
Tomorrow is a new day.
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