[stanford_status] Monday, Dec 4th - Current Status
John R Larsen
john at larsen-family.us
Mon Dec 4 20:18:57 EST 2006
Stanford has had a somewhat difficult 36 hours. Sunday morning he
started needing oxycodone for breakthrough pain again. He didn't
sleep very well last night and was up about every three hours. On
Sunday he very much wanted to attend Church services, which we
always do. It made him quite tired and he came home to rest after a
couple of hours. However, it was uplifting to be with our church
"family" and feel their love and support.
Stanford had an appointment with Dr. James O'Shea today at 4:00 PM.
Joyce and I were with him. He noticed that Stanford's hair is
starting to grow back. Also the acne looking rash from the Erbitux
is starting to go away.
This morning blood was drawn for lab work. His hemoglobin number
was down to 8.8 compared with a week ago when it was 9.4. Another
blood draw will be done this Thursday. Dr. O'Shea didn't think that
Stanford was in need of another transfusion yet. We've been taking
his pulse and blood pressure. His pulse is in the 97 to 116 range
depending on activity. His blood pressure is always in a good
normal range. His temperature is normal or slightly above 99.0.
A dosage change starts this evening. Stanford will now receive 60
mg of oxycontin twice a day. This is up from 40 mg twice a day. It
is expected that this higher level will allow him to sleep better at
night and control the break through pain. Dr. O'Shea said he has
had patients on as high as 400 mg per day. If these levels are
reached then there are other alternatives such as a patch delivery
We asked about the itching that Stanford experiences from the oxy
drugs. Stanford said is wasn't too bad, but Dr. O'Shea said if this
becomes more of a problem that Stanford could switch over to
morphine based drugs. He said that since his brain is now used to
narcotics that the switch probably wouldn't have the same effect as
when Stanford was on morphine in June after the surgery. That made
him very tired and loopy. Stanford doesn't like taking any drugs,
but he would rather do that than experience pain.
Sources of pain. Dr. O'Shea explained that the liver is in a
capsule. When the tumors grow or bleed it can cause pressure on
this capsule which causes pain. Another source of pain is when
blood gets in the abdominal cavity and irritates the lining of the
Dr. O'Shea was very open with us. He explained that Stanford has
already gone through three different "cocktails" of very powerful
chemo drugs and they haven't had any effect on the cancer. The
probability of gemcitabine having any effect is in the 0 to 5%
range. Stanford said he wasn't feeling up to having chemo today or
maybe even this week. Dr. O'Shea said if Stanford starts feeling
better in a couple of days with the new level of oxycontin and wants
to try chemo later this week that it can be arranged. It is all up
to Stanford and what he wants to do. The side effects of
gemcitabine are supposed to be less than those of the other drugs he
has already been on. There is always the worry that in his weakened
condition that it could make him deteriorate more quickly.
We asked about clinical trials. The difficulty in Stanford's
situation is that his cancer is of "unknown origin". The four
pathology labs that tested the small bowel tumor in June and July
were unable to determine what type of cancer he has. Clinical
trials are performed in very controlled conditions in order to
measure the effectiveness of the drug. Stanford isn't a candidate.
Another area of trials is alpha trials. These are trials of drugs
that have only been tested in the petri dish and in animals. These
types of trials have a very low success rate, in the 0 to 5% range.
The side effects can be very traumatic. These trials are always
done in research hospitals. Dr. O'Shea wouldn't recommend any kind
of alpha trial for Stanford because of all the negatives.
Dr. O'Shea asked Stanford if he was getting as many visitors as he
wanted and if he was able to see his family and friends. Stanford
said he has been able to see lots of them, but that it has dropped
off lately. Joyce's parents are here and will return to Utah this
Wednesday morning. Stanford's Aunt Lori (John's sister) is arriving
this Tuesday evening and will be here until returning home Saturday
We asked about diet and nutrition. At this point it is more
important that Stanford get calories of any kind rather than be
picky. For example, if he wants a chocolate milk shake instead of a
vegetable fruit smoothy then go for the chocolate milkshake.
Whatever he wants to eat and enjoy is the way to go. Dr. O'Shea
said scientists are still trying to determine the link between
cancer and nutrition.
Dr. O'Shea asked Stanford how he was doing with his faith and
spirituality. With conviction Stanford said his faith was strong
and fine. Stanford has a very strong belief in God and Jesus
Christ. He knows that the Lord is mindful of his condition and he
trusts in the Lord. Stanford met with his Bishop this Sunday
discussing spiritual matters and had a good session with him.
Several people have asked us why a transplant can't be done. We
asked Dr. O'Shea about that. He explained that transplants are done
in a situation when a dosage of chemotherapy required to kill the
cancer also kills an organ. This is done in cases where the chemo
has been shown to be effective, but not completely at the doses
being used. For example, in the case of bone marrow, good bone
marrow is set aside in storage and then the body is blasted with
chemo that kills all the bone marrow. Then the good bone marrow is
put back in the body. In Stanford's case the chemo he has received
hasn't been effective so a transplant isn't an option. In
Stanford's condition he wouldn't survive the seriousness and trauma
of a liver transplant and even if he did, the tumors would simply
grow back because the chemo can't kill it.
So, family and friends of Stanford, we still pray and hope. We need
Stanford to get stronger so that he can even attempt the chemo.
Let's be specific in our pleadings with the Lord and if it is His
will, give Stanford life.
Thanks for all your support,
John R Larsen <john at larsen-family.us>
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