[stanford_status] Staying in hospital tonight

[jlarsen at larsen-family.us]

Hello Everyone,

Stanford lost 7 pounds since Tuesday's CT scan so the doctors want to keep
him inpatient overnight.  Joyce and I are with him.  He has completed
three of the four chemo drugs and will start a 24 hour dose of 5FU in a
few minutes.  If he deals well with that then they will send him home
tomorrow evening after starting another 24 hour does of 5FU.  There is a
possibility that he will need to stay another day, but we won't know until
tomorrow.

We asked a lot of questions when we got here.  They also showed us one
picture from the CT scan taken Tuesday.  That image shows many large
tumors in his liver.  One of them was 9.2 centimeters in diameter.  There
are so many tumors that it isn't possible to use surgery to get them out. 
There wouldn't be enough liver left to survive.  They also can't do
radiation because there are so many tumors and radiation would kill the
good liver tissue.  We asked about liver transplants.  Dr. Kim said that
they have sent Stanford's images over to the transplantation unit for
evaluation.  However, he most likely isn't a candidate for liver
transplant.  They explained that transplants are usually done in cases
where the cancer has originated from liver cells.  That is not the
situation in Stanford's case.

They are going to go to a two week treatment schedule.  In two weeks he
will return to DHMC for a repeat of today's treatment.  About a week later
they will do another CT scan to see the results.

I asked if Stanford's care should be treated by the adult oncology group. 
Dr. Kim said that the adult oncology doctors know as much about Stanford
now as the pediatric doctors do.  They have been discussing Stanford's
case regularly with all the doctors.  DHMC is also member of the
"Children's Oncology Group" (COG), which has membership of about 200
different facilities nation wide.  They are all tied together sharing
information.  Clinical trials that are in progress are listed at the COG
website.  Dr. Chaffee will also be attending a national conference of
oncologists the first part of October and will be talking with people
about Stanford's case.  We feel comfortable that Stanford is in the right
place and is getting the best treatment available.

Stanford was dealing with lots of pain Tuesday and Wednesday.  He also
threw up several times.  Dr. Chaffee said we should be approach managing
his pain differently than we were.  Wednesday evening we started giving
him one oxycodone pill every 4 hours even during the night.  That seems to
have helped a lot.  Pain management is another thing that they will be
working on while he is here.  They will try methedone, which only has to
be given every 12 hours.  We'll have to see what they settle on.  Stanford
doesn't like the dopiness and tiredness he feels when taking the pain
killers, but he said that is better than the pain.

Stanford hasn't really eaten or drunk much of anything since Tuesday
evening and the little he had he threw up, hence the weight loss.  He has
been able to eat some today and has been on an IV for fluids.  The new
drugs make him somewhat nauseous when he stands up and moves around, so he
takes it very slowly.

In spite of all this Stanford's sense of humor still comes through.  He is
very tired (as are Joyce and I) and will hopefully be able to sleep better
tonight.  The drugs he is on now don't have the danger to the bladder and
kidneys so they don't have to force fluids into him.  He won't be waking
up every hour having to use the bathroom.

Joyce and Stanford just went past me on the way up to his room.  I'm in
the lobby of the Norris Cancer Center where they have a public access
computer.  It's time for me to gather stuff and head up to be with them.

Thanks for your continued thoughts and prayers.  It does make a difference
knowing people care.

John