Moving Forward

It’s been a busy medical week for Nelson and Ann Sophie with multiple appointments at the Mayo Clinic. Today is day #10 of Nelson’s targeted immunotherapy treatment, and like everything else, there’s an upside and a downside.

The upside is that it’s (hopefully) targeting the cancer cells in Nelson’s body, teaching his own immune system to fight back. The downside is that in these last days, after having had only mild nausea on the immunotherapy, now he’s vomiting again with greater intensity. Though Nelson had been off of all nausea medicine, not needing it, now the strongest of three med choices still isn’t helping.

In addition, his legs have become more swollen than ever (he called them tree trunks), so one appointment this week was to alleviate that. He received an IV combination of albumin (protein) and a diuretic to drain some of the fluid, which is leeching out of his veins and settling in the tissues—thanks to the cancer. The IV infusion lasted about an hour.

Since the IV, Nelson has lost eight pounds of fluid, which helped his swollen legs some. He’ll receive a second IV diuretic along with more albumin on Monday. If fluid continues to drain from his legs, bringing them closer to normal size, Mayo’s will custom-make compression stockings for him, which should help in the future.

Nelson’s left arm is also swollen, but for a different reason. A sizable blood clot is inhibiting the circulation in his arm by clogging three veins near the shoulder. (See picture.) But we learned something phenomenal about the human body today.

The doctor said that in two-thirds of people who have blood clots, the clots never resolve, even with blood thinners. In those cases, then, the body gradually begins to reroute the blood to nearby veins, expanding their use enough to move blood around the clotted area. (See the doctor’s pencil lines on picture.)

Nelson and Ann Sophie actually got to see these new veins in imaging tests today. To prevent additional clots, Nelson has learned that he’ll be on blood thinners for the rest of his life.

His medical team began the immunotherapy with a half-dose ten days ago, waiting to see if his system could tolerate it. The plan was to move to a full-dose regimen this week, but because of all the vomiting, that strategy is on hold for now. He takes one pill every morning exactly two hours after eating, and another every evening in the same way, putting the pills 12 hours apart. Ann Sophie has become a clock-watching cook and follows medical instructions perfectly.

Nelson says Ann Sophie could be an official member of the palliative care team with her expertise in administering meds and caring for Nelson’s every need, making him as comfortable as possible. She is still expertly draining his left lung daily, as well as managing their extensive home pharmacy of pill bottles. And she’s his strongest cheerleader throughout every day, without fail. We are all deeply gratef for her.

“May the God of hope fill you with all joy and peace in believing, so that by the power of the Holy Spirit you may abound in hope.” (Romans 15:13)

Cancer–Plus and Minus

Fighting cancer can be a full time job, and it’s not just the many doctor appointments and tests. It’s also the drain of committing to battle the disease. A cancer patient can fight and fight some more, yet still lose ground. Determining to continue, then, can wear a person down till there’s no fight left.

Nelson has had his highs and lows during his war against lung cancer and was pulled into another low just yesterday. Without an end-date to the cancer, it can seem like it’ll go on forever.

He and Ann Sophie were tempted to cancel a doctor appointment with a new oncologist yesterday afternoon, hoping to take a little time away from thinking about cancer, but the staff persuaded them to attend.

As it turned out, it was God’s rescue from the low. Ann Sophie said, “The doctor was very positive and filled us with hope.” He told them that Nelson had lots of reasons to be stressed but that he was handling it well, better than most in his position. This was uplifting to hear.

Ann Sophie said the doctor looked a lot like Santa Claus and made her wish they could stay and have him read stories to them all afternoon. Looking back on the day, it was clear that just when they’d needed a strong boost, God brought Dr. Santa Claus into their day.

It turned out that Nelson’s albumin level was extremely low, causing him to feel worse than usual. The doctor recommended he take in as much protein as he can eat or drink, and then as time passes, his levels will slowly rise, making him feel much better.

Dr. Santa also schooled them in how to take the first immunotherapy drugs, which Nelson did last night. The two pills, which had arrived via FedEx (one needing refrigeration) were to be taken exactly 12 hours apart, two hours after eating. So Ann Sophie went to work on making a chart to help keep things well regulated. What a blessing she is!

Dr. Santa said Nelson should be feeling a little better even at the end of the first week—more encouraging news. And it’s no small gift that the nausea of chemotherapy is now in the rear view mirror. Nelson takes no anti-nausea meds now, after having needed them daily. This, indeed, is progress!

“Better is the end of a thing than its beginning.” (Ecclesiastes 7:9)

Ready, Set, Go…

All systems are GO for the immunotherapy, and the first two potent pills will arrive at Nelson and Ann Sophie’s apartment via FedEx on Tuesday. Nelson will have to wait for the official go-ahead from his medical team, based on how his daily health monitoring is going, but in every way possible, he’s ready.

Ann Sophie is still draining his left lung daily, yesterday getting 700 milliliters, which is a lot. But the good news is that his right lung, which used to be of significant concern, has dried up completely. Cancer cells there are not producing any fluid—a dramatic change from the preceding five months. The team has talked tentatively about removing the drain catheter from that lung, which sure sounds like progress to us!

Nelson’s limbs are still swollen with fluids, but some of that is due to the clot. Doctors have said it will take three months or more for the large clot to begin to dissolve, if the blood thinners are working. We’ll have to be patient.

Today Nelson’s brother Hans, who is in the States from England with his family of eight, is on his way from Michigan to Minnesota. He’s looking forward to spending a little time with Nelson, with whom he is very close. There’s nothing like a bout of cancer to make us all value our relationships more than ever before. And amidst all the hard stuff that’s  happening every day, that’s a really good thing.

“Iron sharpens iron, and one man sharpens another.” (Proverbs 27:17)