It turns out that Bill has developed two bed sores, one of which has an infection.

The hospice nurse couldn't get hold of our doctor (he is on leave for a week and will be back soon). She contacted another doctor (I don't know him), and he said that because Bill is on hospice he wouldn't recommend giving the antiobiotics for the infection.

This, of course, would mean that the infection could become systemic, and Bill would be in a compromised position regarding the spread.

I feel very uncomfortable with the decision as Bill has been eating well, and able to leave the bed (by way of the Hoya Lift), and is communicating with us.

My thought is to ask our doctor (when he returns) as a second opinion (actually, should have been the first) whether he agrees with this stance.

Thank you for any comments on this. It would be so appreciated.

It is not that we are trying to keep Bill alive at any cost, but that we don't think that antibiotics come under the heading of aggressive treatment.

Any thoughts?

Barbara

_________________
Bill died peacefully on March 25, 2010. He was very much loved, and will be sorely missed.

Link to "Bill's Story," and more detailed list of treatment regimens:

http://www.lungevity.org/l_community/viewtopic.php?t=37269

Photo: Barbara and Great Granddaughter KayMarie taken January 2010 at Rehab where Bill was gaining strength.

Hello Barbara,
So sorry to hear that Bill is having problems again. I am no where near an expert but if it were my husband, I would push to get an antibiotic for the infection along with a regimen for treating and dressing the bed sore. A bedsore left untreated with or without an infection will get worse and sepsis is a real worry but as well, they can become extremely painful.
I am not sure whether or not this would be considered aggressive treatment but in my book would not only make sense but also be competent medical care. It has been some time since I have nursed but even back when we worked on geriatrics you treated a bed sore and or an infection with whatever was necessary.
Just my thoughts,
Sandy

_________________
[size=67]Husband 61 years old, rarely ever sick, had occasional cough treated as asthma
Jan 30/07 Chest x-ray tangerine sized mass in LUL, smoked since age 11, quit that day
Feb14/07 CT Scan shows 5cm X 5.6cm mass in upper left lung
Diagnosis - Primary lung cancer with ipsilateral and mediastinal lymphodenopathy.
Bronchoscopy- Squamous NSCLC Stage 3A, non-resectable due to proximity to pulmonary artery and mediastinal involvement.
Bone Scan and MRI of Brain Clear and has good performance level
7 weeks of daily radiation (2 beams) & two cycles of Cisplatin/Etoposide
Last week of Radiation, Booster doses, 3 beams instead of 2
Evolving Skin rashes throughout treatment - steroidal topical creams and benadryl.
Post treatment fatigue and shortness of breath
Post Treatment CT Scan-tumor reduced 40% in dimensions, 60% in volume& no significant mediastinal adenopathy seen. Small non-target nodule left lower lobe.
Chest x-ray post radiation scarring, atelectasis, mild degenerative changes thoracic spine
Cleared for Start Trial, One time dose of Cyclophosphamide or placebo by IV
August 07-First of 8 weekly injections of Stimuvax Vaccine (or placebo), four needles, one in each arm and one in each side of the belly
High Uric Acid, constant aching pain in knees, worse in left knee, possible gout
Oct 07 Maintenance Arm Stimuvax Trial, Vaccine every six weeks unless progression
Dec 07 CT Scan shows small left-sided pleural fluid and mixed interstitial and airspace disease in left upper lope and superior portion of left lower lobe and in right upper lobe. Previous identified mass shows markedly decreased, now 1.8 X 2.3cm. Small non-calcified nodule, nonspecific in appearance, within left lower lobe, 4mm in size warrants short term follow up.
Feb 08 Chest Infection cough, SOB, Levaquin antibiotic & Hycodan Syrup
Mar 08 Started physiotherapy twice weekly as part of an integrated gradual return to work program
April 08 CT Scan Radiation changes sharply defined, component of pneumonitis has improved. Resultant volume loss and traction bronchiectasis. Mass LUL has decreased in size, 1.6 X 1.5cm. 4mm nodule LLL and a small left pleural effusion are stable. There is a small pericardial effusion, which has increased in size from prior exam. No auxiliary, hilar, or mediastinal adenopathy! Nothing abnormal in abdominal part of CT scan other than a fatty liver and gallstones and no evidence of abdominal metastases, Continue with Start Trial
May Chest Infection symptoms, 7 day of Biaxin antibiotic and Salbutamol Inhaler
June 22/08 officially back to work full time.
Aug 08 Chest x-ray Arthritis both knees, right shoulder rotator cuff, upper third of spine
Sept 08 CT Scan Stable, minor continued shrinkage of original tumor, 4mm nodule and small pericardial effusion stable Continue with Start Trial.
Sept 08 Chest x-ray unable to measure any remaining original tumor.
Dec 08 Chest x-ray volume loss left upper lobe related to radiation therapy, lungs otherwise clear. Cardiac silhouette mildly enlarged. No Evidence of recurrent Tumor
May 12/09 CT Scan - No enlarged mediastinal or hilar lymph nodes, Progressive volume loss left upper lung, traction bronchiectasis, post radiation fibrosis, 3mm left lower lobe nodule stable since July 2007, small stable pericardial effusion.
No Evidence of Recurrent Disease.
Oct 6/09 Ear Specialist for advanced hearing loss – hearing aid prescribed.
Oct 20/09 Dermatologist to monitor skin & mole changes radiated areas-
Ultra sound finds a 3.5cm lipoma (non-cancerous lump) on left upper chest
Continue Start (Stimuvax) Trial maintainance
Jan 5/10 Virus with secondary bronchitis, off work 3 weeks
Feb 1/10 X-rays, blood work, stable disease
Mar 23/10 Start Trial temporarily suspended (I hope!)[/size]
June 17/10 Start Trial will resume subject to local ethics

Barbara,
You asked for "thoughts" , so in my way of thinking, I agree with you . I have no experience dealing with hospice, but I know many here have and hopefully they will chime in with their personal experience. I just know that the risk of systemic infection is very real. To think that a patient would be denied, a much needed, antibiotic because he is on hospice would certainly be a very upsetting thought and not what I thought the purpose of hospice was meant to be. Certainly, the hospice people have had similar situations before and would know if that is common practice. I'd push for the antibiotic. God Bless you and Bill...

Hugs,
Sue

PS: Can you tell the thought of this upset me?

_________________
[size=84]husband, Mike, 59 years old
**2-01 dx'd Stage 1 nsclc-9cm tumor to right lung-no lymph node involvement...
**4-30-01 pneumonectomy right lung removed. No followup chemo or radiation , but scans and xrays were done
**1-28-04 dx w/recurrent stage IV nsclc tumor on stump of where right lung had been removed , lymph node involvement, tumor adrenal gland -lft side, **02-04-04- taxol & carboplatin 3 treatments-didn't work
**02-12-04- radiation 10 to lung for bleeding
**04-2--04-taxotere had 4 treatments. shrinkage had occured in all after 3.. continuing taxotere. making him very tired ... upper body swelling ..
** 08-01-04-in hospital
latest..
**08-02-04 had stent put in .. superior vena cava.. the vein was being blocked by pressure tumor.
**08-05-04-started 10 radiation treatments,
**08-30-04- started Navelbine on 3 weeks and off 1 Scan after 5 treatments show chemo Navelbine not working -slight decrease to lung mass, but slight increase to adrenal ....
**11-01-04-starting Gemzar ... had 3 treatments... too many side effects... Ct of chest and upper abdomen done on Dec. 2nd -results some shrinkage
**12-06-04-started Alimta Dec. 6th- first treatment went well Had 2nd treatment Dec. 27th ... developed a rash and is tired, but otherwise ok Scan Feb 7th, 2005 STABLE doing good continuing Alimta April 18th scans showed stable disease (after 6 Alimta treatments), but he now has pneumonitis... no more treatments until much better.. on prednisone and oxygen..
**05-31-05 Ct scan of chest showed pneumonitis resolved and stable cancer
**06-06-05-our 35th wedding anniversary... onc confirms everything resolving and stable -reccommends break continued til August
**6-15-05 to 6-18-05 in hospital due to mental confusion ..
had MRI-member empty head club

8-3-2005-Ct scans chest , abdomen and pelvic....Waiting and praying...
**8-8-2005-Ct results were that the chest area looked improved, but the adrenal area had increased and involved some lymph nodes.
Started Tarceva 150mg 8-16-2005-8-20-2005 stopped 2 weeks due to severe rash on 9-8-2005 started back on Tarceva at 100 mg now.. stopped again on 9-19-2005
9-30-2005 scans slight progression to nodes behind adrenal..
10-10-2005-Camptosar- CPT-11 started
10-31-2005- CPT-11
refused more CPT-11 made him extremely fatigued and nauseated
Dec. 6th -CTscans chest, abdomen & pelvic. shows stable but tumor compressing the esophagus..
Dec. 19th- had stent to trachea put in
Dec. 21st- he had stent to esophagus and feeding tube put in
Dec. 22nd.. he will ill put in hospital... vomiting and also coughing and congestion in for 4 days... home for Christmas Dec. 25th... still recouperating with antibiotics etc.
Continuing cough and numerous doctor visits.
*Jan 30th-Feb 4th- hospitalized again with cough ..
Still has cough , but controlled most of the time Hasn't been able to resume chemo

**My "prince charming", best friend, husband and soul mate,, Mike passed away March 2, 2006 after being a 5 year survivor and fighting a very courageous battle**
______________________
Mom- 78 yrs old..
nsclc diag May 2nd, 2007-surgery 2sm tumors removed in wedge section... lymph nodes clear
Tarceva as adjuvant started on June 23rd..quit July2nd.. side effects numerous... am waiting now til next appt. July 13th
July 20th... Mom NED.PET clear and normal .. will go back on half 75mg Tarceva... see how that works..
Stop Tarceva 8-25 too many side effects
Oct. 22nd- Mom surgeon visit, chest xray and results .. all clear, no sign of cancer...
Feb. 18th Mom's PET Scan
March 7th Mom's PET Scan results.. NED
Sept. 22, 08 Mom PET Scan
Sept. 29, 08 Mom PET results new nodule 3/4 "...here we go again.... :-(
*Updated*- Mom surgery- Oct. 30th.. surgeon removed top part of upper right lobe. Nothing showed malignant. She had pneumonia after surgery and a 3 week hospital stay, but she is slowly regaining her strength and is currently NED..

March 3, 2009 CT scan.... results showed some little things along suture line that the doctor believed was healing.. will wait til next scan and compare.

June 2, 2009- CT Scan.. results there is an area along suture line that has increased in size and thickening.. doctor thinks could be cancer... a needle biopsy will be done..

A quick update.. the results of the needle biopsy did confirm that it was cancer...

Cyberknife was done the first week in November..

Pet scan .. Dec. 8th...
Dec. 11th -results .. cyberknife worked and the rest of the scan is clean... YAY!!! Happy Birthday (Dec. 19th.. 81st) and Merry Xmas Mom!
Dec. 2010 NED!!!
June 2, 2011.. Pet Scan results .. NED!!!
Nov 3, 2011.. CT scan results.. NED!!!
Sept. 18, 2012 .. our loving mom has passed on ..Heaven received a most precious angel.


graphic by
http://www.maryslittlelamb.com[/size]

I agree. Being on hospice means the emphasis is on comfort care, and I think using antibiotics to prevent an infection from a bed sore would be part of comfort care, just like changing dressings and keeping the area clean. That would be true whether or not any infection might progress into sepsis.

Love and Aloha,

Ned

_________________
Ned is just my nickname, though it would be nice to merge it with the other meaning eventually...

Aloha means "Hello, goodbye, love, compassion, welcome, good wishes." It means belonging to others with a common humanity. It's defined better as a feeling in the heart than by words.

Dx NSCLC adenocarcinoma IIIb Sep 2006, now stage IV. Taxol+Carboplatin+Avastin 4 mo., Avastin 8 mo., Tarceva 16 mo., Alimta 12 mo. (sometimes combined with Cisplatin or Carboplatin), Navelbine since Feb 2010, 10 sessions of WBR in March 2011. See My Cancer Journey: viewtopic.php?p=351369#p351369 — UPDATED 03/05/2011.

Above left: Our golden retriever Rosie, who joined the family on 3/5/08 at the playful age of 2.

Below: Hannah, our golden companion 1994-2007.

When my husband was home on hospice they would not allow any type of antibiotics at all. He also had severe bed sores. So, what I did was buy the antibiotic cream with pain relief in it from the drug store. Hospice told me I wasn't allowed to use it but I did anyway. It helped him a great deal with the pain from the sores. They told me to put him on his side and tuck a pillow under so the sores could breath and heal. He refused and always ended up flat on his back yet again. Hospice has rules that perhaps we don't agree with as far as medications, but I only cared about my husbands comfort. I also had some antibiotic pills left from the past months that I gave him.

Bless both you and your husband during this time. I know exactly how you're feeling and what you're dealing with. Contact me anytime if I wasn't clear enough in this message ok?

((((hugs and prayers))))

_________________
Jan 09 husband diagnosed with stage 3 adenocarcinoma.
Oct 09 passed peacefully at home after enduring a very difficult battle. I miss him dearly.

Barbara - I cannot imagine an antibiotic for a bed sore would be considered aggressive treatment by anyone's standards. I have no experience with hospice, but as Ned said, they are supposed to be about comfort - how comfortable can anyone be with open bed sores. I hope you are able to get ahold of Bill's doctor and get something for him that will take care of these.

You are both in my prayers everyday.

Diane

_________________
3/98 Dx squamous cell NSCLC 2a at 50 yrs
4/98 Left lung removed, no chemo/rad
8/08 Persistent cough and shortness of breath, first appt. with pulmonary doc 11/4/08
11/08 X-ray and CT show tumor in right lung. PET scan confirms tumor, shows no apparent spread
12/08 CT/needle biopsy shows squamous cell NSCLC IIIB, doctors don't seem to agree if its a new cancer or recurrence - but onc believes it is a new one
12/08 Start concurrent radiation/chemo, Cisplatin/Etoposide
1/09 Chemo switched to Carbo/Taxol due to intolerance of Cisplatin
2/09 Radiation completed
3/09 Chemo completed
5/09 CT shows spot where tumor was likely/hopefully scar tissue
6/09 Begin Lucanix trial
9/09 CT scan - stable
12/07/09 CT scan - stable
3/1/10 CT scan - stable
6/1/10 CT scan - stable - begin 2nd year of trial
8/23/10 CT scan - stable
10/25/10 CT scan - stable
1/20/11 CT scan - stable
4/25/11 CT scan - stable - completed drug portion of trial, now follow-up with 3-mo scans
8/1/11 CT scan - stable
10/24/11 CT scan - stable. At my request, switching to 6 mo scans.
4/24/12 CT scan - stable.
10/30/12 CT scan - stable.
2/26/13 CT scan - stable

Avatar is with 10-mo-old grandson Ethan at Xmas

Barb, I don't know the answer based on hospice rules. I even searched the internet and couldn't find anything definitive.

That said, I am appalled that hospice would not provide an
antibiotic. I thought hospice was all about caring and comfort. To let someone suffer needlessly is just cruel.

I hope you have gotten this solved and that Bill's bed sores are on the mend.

_________________
Ginny
Please use gdecoursey@aol.com for email.

Earl born 1/28/42 - dx 9/21/02 - died 8/18/04. He was the sunshine of my life.

barb--I agree that you should be able to make the argument that this is comfort care. From what I have been able to tell these types of rules are set by the care service and not any sort of hospice regulations.

Susan

_________________
76 year-old mom diagnosed with stage IV lung cancer January 5, 2007.

15 radiation treatments to the spine and four rounds of chemo, Jan-May, 2007.

Stable disease May, 2007-May, 2008.

Bone scan May, 2008 shows new mets in the spine, pelvis and ribs.

July, 2008--finished radiation and has a Quadramet treatment.

October, 2008--Scans show mild progression. Began chemo (carbo/taxol/avistin). Will have four rounds of threatment (every 21 days) and scan in January.

01/05/2009--TWO YEAR SURVIVOR!

4/2009--STABLE! No treatment. Next scan in July

7/2009--Scan shows pleural effusion. Fluid drained and malignant. Cancer has spread to other lung and a 13 mm lesion is seen on the liver. Mom to begin Alimta on 8/3

11/2009--Alimta was hard on mom and scans showed progression.

12/2009--began Tarceva, noticed almost immediate improvement.

2/25/2010--Celebrated Mom's 80th birthday!

5/15/2010--Mom watched her oldest granddaughter graduate from college and then paritied well into the night! She's still feeling great.

6/15/2010--Mom watched her youngest granddaughter graduate from high school. Still feeling great!

8/2010-10/2010--Mom begins feeling tired and stays in bed more and more. Scans reveal that the cancer is moving rapidly throughout her body.

10/13/2010--Mom wins her battle once and for all, and passes to a place where the cancer can no longer touch her.

For a more detailed timeline see:

http://www.lungevity.org/l_community/viewtopic.php?p=360385#360385

Thank you all for the input on the antibiotics. Today, I was able to get hold of our GP, and after explaining to him about the need for something for the sores, he ordered an antibiotic to put into them.

I don't know how this will work as opposed to an overall ingestable antibiotic, but it should be able to do something.

We will be using it tomorrow as it was not available late today at the pharmacy. Hopefully, we will get it by morning.

Barbara

_________________
Bill died peacefully on March 25, 2010. He was very much loved, and will be sorely missed.

Link to "Bill's Story," and more detailed list of treatment regimens:

http://www.lungevity.org/l_community/viewtopic.php?t=37269

Photo: Barbara and Great Granddaughter KayMarie taken January 2010 at Rehab where Bill was gaining strength.

Barb,
I am so glad you got the antibiotic and I hope it makes a big difference in Bill's comfort. I was disgusted to learn that this wasn't "allowed" for someone in hospice. I understand the reasoning to some small degree but like so many other's said- this is comfort care, pallative care- not life saving care.

When both my parents were in the hospital I pushed and pushed for them NOT to be overly medicated (which is often times done to lead to respiratory failure) and I refused to sign off on fluids/feeding/lasix

None of those things on their own merit will save a life...it may sustain it for a bit longer, but they aren't life saving measures.

I wanted my parents to go when their bodies were ready for them to go- not because of a decision by any doctors to withhold basic care.

You are a great advocate for Bill. I am saying and sending up lots of prayers for you both during this difficult journey.

(((hugs)))

love,
K

_________________
- Katie Brown, Co-Founder and Director of LCSC-

15 yr cancer survivor.

"Any of us who have experienced the cancer journey- and survived it-
have an obligation to make the path clearer and aid those that come after us."
- Lance Armstrong

In memory of Jessee Dewey, SCLC
December 29, 1938 - September 6, 2003
Lisa Dewey- Jan. 22, 2007
my parents are together in heaven


facebook www.facebook.com/lungevity

Katie,

Thank you for the support. I am of like mind when you describe what you wanted for your parents. The same goes for me.

It will be, if I can help it, when Bill is ready and not a minute sooner.

As for the medications, Bill has been on a Fentanyl 25 mcg patch, and very little else.

Since this hospice began, he has had a 1/2 Percocet on two occasions. That's about it. He remains lucid and it is so much more pleasant when he can talk to us and relate to what is going on around him.

He is in no pain, and we do hope that continues.

Your input in relating your experience has given me the bolstering I needed.

Tonight, we are experiencing such very strong easterly winds that our American flag ( on pole on front lawn) is in shreds.

Gratefully, no blackouts as yet and hoping that there won't be any.

Barbara

_________________
Bill died peacefully on March 25, 2010. He was very much loved, and will be sorely missed.

Link to "Bill's Story," and more detailed list of treatment regimens:

http://www.lungevity.org/l_community/viewtopic.php?t=37269

Photo: Barbara and Great Granddaughter KayMarie taken January 2010 at Rehab where Bill was gaining strength.

The latest is that we will be putting Bill on a (Foley) catheter for the urine. It will help greatly in keeping the wound from being inundated with urine - a giant help.

The antibiotic that his nurse requested was refused by our doctor (GP). Why? Who the hell knows? But, he is not the end all - be all. A higher power is.

Despite that, we will do our darnedest to get him whole again where he was prior to the bed sores. Presently, he has the classic one - sacral (sacrum) area.

We will be receiving more nursing care for the wounds.

The answer was that he will be receiving four days a week extra care for the wounds. Thank you, God.

Thank you, Lord.

Barbara

_________________
Bill died peacefully on March 25, 2010. He was very much loved, and will be sorely missed.

Link to "Bill's Story," and more detailed list of treatment regimens:

http://www.lungevity.org/l_community/viewtopic.php?t=37269

Photo: Barbara and Great Granddaughter KayMarie taken January 2010 at Rehab where Bill was gaining strength.

Barbara, I missed your earlier posts because I was on Hall Pass. It makes me so angry when I hear these things. I do understand the need for rules and regulations in hospice and many areas of our lives. It is the seeming inability of the people, the individuals we deal with, to respond to those rules with some common sense--like, here's the prescription for the antibiotics but I'd suggest being discreet and paying out-of-pocket for them so it doesn't compromise his eligibility for hospice. I just don't know what's happened to common sense. It is just plain crazy the way we do things today.

Just to be sure they are giving it to you, I will call my daughter tomorrow and ask about the marvelous ointment she was just talking about that she says clears up bed sores very quickly. It may not work until the antibiotics take hold but it sounds like a good maintenance tool.

Bless you and Bill and your family.

Judy

_________________
Cytology report on fluid removed from lung after pleural effusion and pneumonia Sep 07 showed adenocarcinoma cells. Dx IIIb NSCLC Oct '07 at MDACC, Orlando. Fol 6 rounds Taxol/Carboplatin/Avastin and 2 Avastin, CT/PET 4/1/08 pleural thickening gone and no active cancer cells. 11/3/08 STILL NEVD. CT/PET/MRI 5/4/09 Cancer back, still in the pleura and chest wall, small amt of fluid, all in left lung.
5/11/09 Start on Alimta every three weeks.
7/13/10 Had Alimta on road in Corning NY.
8/24/09 Scans show some improvement. Continue on Alimta.
9/14/09 Chemo on road in Mt Holly NJ.
10/6/09 Started regular Alimta infusions in Key West.
11/3/09 CT and PET scans showed significant improvement. Some issues already resolved.
2/3/2010 No evidence of residual or recurrent disease. NED! Stay on Alimta.
5/6/10 Am considering myself still NED until/unless proven otherwise in July. Rabid radiologist thinks he sees something suggestive of similar to some abdominal cancer. No light up on the PET. Am hoping for the best. Stay on Alimta and scan in 9 wks instead of 3 mos.
7/8/10 Chest CT unchanged (NED Feb '10). Infiltration in the region of the omentum is probably slightly more prominent than before. Diverticulosis requiring antibiotics.
Jul, Aug, Sep, continued Alimta in Corning NY, Portsmouth OH and Mt Holly NJ.
10/14/10 Chest CT unchanged from Feb '10. Findings likely representing progressive nodular peritonal carcinomatosis in the midabdomen. Treatment changed to Tarceva started in Nov.
12/15/10 Chest CT unchanged. Abdomen changes compatible with peritoneal carcinomatosis again identified with mild progression noted.
3/16/11 CT chest unchanged. CT abdomen progression ascites (fluid). Progression of soft tissues nodularity on the peritoneal surface anteriorly with diffuse omental involvement.
4/13-15/11 Hospitalized at MDA. Removed 4 1/2 litres (8-9 lbs) of fluid from abdomen 4/14. Started on taxotere before release on 4/15.
5/16/11 Hospitalized for fever, neutropenic. Treated with intravenous antibiotic and antiviral. Given blood transfusion. Note that KW Cancer Center did not give me my Neulasta shot after my chemo on May 6. Onc had me cancel my 5/26 chemo until after my scan on Jun 6. Was discharged on oxygen. Test w/Dr Gerth 5/26 indicated I could go off sitting and sleeping O. Will do walking test 6/2.
6/2 Did not get requisite numbers on walking test. Left for Orlando 6/5 still on oxygen.
6/6/11 MRI normal; CT stable. Taxotere and Neulasta at MDA 6/7 and 6/8.
6/13/11 Appointment with Dr Olham in KW. Off oxygen week of 6/16.
8/8/11 CT scan showed stable with perhaps some lessening of fluid. Stay on Taxotere.
10/10/11 CT chest still clear, CT abdominal lining stable. Stay on taxotere.
12/19/11 CT chest clear, CT abdominal lining stable, MRI clear. Stay on taxotere.

Thank you, Judy. If you can find the name of that ointment it would be very helpsul.

Barbara

_________________
Bill died peacefully on March 25, 2010. He was very much loved, and will be sorely missed.

Link to "Bill's Story," and more detailed list of treatment regimens:

http://www.lungevity.org/l_community/viewtopic.php?t=37269

Photo: Barbara and Great Granddaughter KayMarie taken January 2010 at Rehab where Bill was gaining strength.

Barb, I slept late but just called my daughter. The cream is called Allevyn. I've never seen it but never looked either. Don't think it's a script or she would have told me. We didn't talk long because she was at work. When I get offsite, I'll see if I can find it online.

Judy

_________________
Cytology report on fluid removed from lung after pleural effusion and pneumonia Sep 07 showed adenocarcinoma cells. Dx IIIb NSCLC Oct '07 at MDACC, Orlando. Fol 6 rounds Taxol/Carboplatin/Avastin and 2 Avastin, CT/PET 4/1/08 pleural thickening gone and no active cancer cells. 11/3/08 STILL NEVD. CT/PET/MRI 5/4/09 Cancer back, still in the pleura and chest wall, small amt of fluid, all in left lung.
5/11/09 Start on Alimta every three weeks.
7/13/10 Had Alimta on road in Corning NY.
8/24/09 Scans show some improvement. Continue on Alimta.
9/14/09 Chemo on road in Mt Holly NJ.
10/6/09 Started regular Alimta infusions in Key West.
11/3/09 CT and PET scans showed significant improvement. Some issues already resolved.
2/3/2010 No evidence of residual or recurrent disease. NED! Stay on Alimta.
5/6/10 Am considering myself still NED until/unless proven otherwise in July. Rabid radiologist thinks he sees something suggestive of similar to some abdominal cancer. No light up on the PET. Am hoping for the best. Stay on Alimta and scan in 9 wks instead of 3 mos.
7/8/10 Chest CT unchanged (NED Feb '10). Infiltration in the region of the omentum is probably slightly more prominent than before. Diverticulosis requiring antibiotics.
Jul, Aug, Sep, continued Alimta in Corning NY, Portsmouth OH and Mt Holly NJ.
10/14/10 Chest CT unchanged from Feb '10. Findings likely representing progressive nodular peritonal carcinomatosis in the midabdomen. Treatment changed to Tarceva started in Nov.
12/15/10 Chest CT unchanged. Abdomen changes compatible with peritoneal carcinomatosis again identified with mild progression noted.
3/16/11 CT chest unchanged. CT abdomen progression ascites (fluid). Progression of soft tissues nodularity on the peritoneal surface anteriorly with diffuse omental involvement.
4/13-15/11 Hospitalized at MDA. Removed 4 1/2 litres (8-9 lbs) of fluid from abdomen 4/14. Started on taxotere before release on 4/15.
5/16/11 Hospitalized for fever, neutropenic. Treated with intravenous antibiotic and antiviral. Given blood transfusion. Note that KW Cancer Center did not give me my Neulasta shot after my chemo on May 6. Onc had me cancel my 5/26 chemo until after my scan on Jun 6. Was discharged on oxygen. Test w/Dr Gerth 5/26 indicated I could go off sitting and sleeping O. Will do walking test 6/2.
6/2 Did not get requisite numbers on walking test. Left for Orlando 6/5 still on oxygen.
6/6/11 MRI normal; CT stable. Taxotere and Neulasta at MDA 6/7 and 6/8.
6/13/11 Appointment with Dr Olham in KW. Off oxygen week of 6/16.
8/8/11 CT scan showed stable with perhaps some lessening of fluid. Stay on Taxotere.
10/10/11 CT chest still clear, CT abdominal lining stable. Stay on taxotere.
12/19/11 CT chest clear, CT abdominal lining stable, MRI clear. Stay on taxotere.