My Kingdom For Some Sleep

My dear family. In the past year this blog has been intended to keep you informed of Dad's progress regarding his healing after his diagnosis of last spring. Over the course of this year I have attempted to share with you, in as humorously a light as possible, Dad's daily goings on and anything else that might keep you "in the loop" as it were.

This blog that you are presently reading has a slightly different end result in mind. Although, it will continue in the same vein, this blog will also include more detail and medical information than those past. The reasoning is, as it was all along, to insure that all family members have the same information that I have been exposed to and no one feels "out of the loop".* It also then permits you to have a conversation with Dad where you do not feel its necessary to pepper him with questions as 4 other people today have already done.**

*If any information I have presented to you here is different than when we spoke personally - it is because it is the most recent and the most researched.
**In your personal conversations with Dad if he provides you with information that I have not, it is possible I am not aware of that information - if you feel I should be please just send me a message.

With that said...

CAST OF CHARACTERS
Katherine Gordon - Narrator
William Gordon - Beloved father, brother, uncle, friend, man of steel
Dr. Schlam - Gordon's Primary Care Physician/Family Practitioner (PCP)
Dr. Barba - Gordon's Radiologist
Dr. Conti - Gordon's Oncologist
Dr. Clemente - Gordon's Neurologist/Neurosurgeon

All but Dr. Clemente are intimately familiar with Dad's history.
Various other Dr's, nurses and medical staff

Over the past 3 months (Dad will say 6 weeks!) Dad has been experiencing increasing pain in his shoulder area. He had attributed this to a possible weight-lifting incident. So, working on the premise that this was shoulder isolated and it was an athletic injury - it has been addressed as so by the doctors, by me and by "himself". No prescribed remedy was helping. In the last month he has attempted to get his doctors on the same page as he is in "agony" (and when Dad uses that word you know it's BAD). Pain medication was prescribed, ice packs, rest, movement, therapy, stronger pain medication was prescribed,etc.

In the last two weeks an MRI was prescribed by his orthopedic surgeon (knee replacement doctor) to determine the severity of his shoulder injury. The MRI results have not been addressed or assessed due to Dad's most recent experiences. Dad's biggest challenge amidst all of this was that he could not sleep; no position was comfortable and the pain was unbearable. On Thursday, this past week, Dad woke up again with agonizing pain. He called his Primary Care Physician (PCP) - Dr. Schlam. Dr. Schlam told him to go immediately to the emergency room. Dad was able to reach me at school - and I was able to take him to the ER.

The ER tech - who also knew Dad from the past - performed the Xray and discovered some degenerative sightings (areas of the back that show areas of degenerative changes near his spine) and requested a CAT scan. Cut to the chase; the CAT scan revealed that his Melanoma had metastasized and has become attached and part of the spinal column, in the neck area, in the C4/C5 area of the vertebrae. Although, the growth itself is small in size (3mm) - that is considered large when it is a re-ocurrence and in this particular location.

Dad's radiologist - Dr. Barba - prescribed immediate treatment in the form of radiotherapy (radiology). Dad was fitted for a mask to hold his head still on the table, he was scanned (CAT) to determine the precise location of his growth and these results were sent to a fastidious mathematical genius to determine the dose of radiation, the exact location the radiation needs to be focused on and the specific angle of the ray to be most effective in this treatment. It was short of miraculous to see this team work - it is best compared to a most extraordinary ballet.

After these results were released - by this most unassuming and shy 'genius' - Dad got his first radiation treatment. All this is still before even being admitted to the hospital!! After admission - Dad was put in a nice corner room. He was given an intravenous steroid - Decadon - to control the swelling and reduce the pain as well as Dilaudid (for the more severe pain). Dad then spent the next evening attempting to regain some of the rest he had lost as a result of the long term pain he had been tolerating. This rest was not to be (even with the help of a sleep aid). Despite their best intentions - the staff at the hospital must interrupt Dad's sleep - or catnaps - to obtain vitals, give him his next meal (which he chooses from a menu!), offer him the newspaper, administer medications (every 3-6 hours) and just to basically check on him and assess his comfort level - it's kind of a big ol' Catch-22 (he is not comfortable without sleep - and they need to interupt that to assess his comfort level- ugh!)

Dad was scheduled to go home the next day as it was deemed his pain level decreased enough to allow him an oral version of the Decadon that he could self-administer. He did have a 2nd radiation treatment then on Saturday and Radiotherapy was prescribed for the next 3 weeks (4 visits each week). The reason for this length of time (for his back he received 6 weeks) is predominantly dependent on the area being treated. Due to the sensitivity of the area of Dad's cancer - 3 weeks is all this area can safely be exposed to radiation.

Dr. Conti visited Dad as well on Saturday and reviewed the next steps; of course, all work in sync with the radiation therapy and Dr. Conti, Dr. Barba, Dr. Schlam and Dr. Clemente all work together as a team to stay informed of Dad's condition, his progress and the next steps. Dr. Conti did talk to Dad for a few minutes about the possibility of chemotherapy being introduced after his radiation. He discussed oral chemotherapy which due to advances in medicine can have the same success rate as IV chemo - it would just permit Dad to have this all done at home - all while being observed by his medical team. Dr. Conti will see Dad in 2 weeks to determine the possibilities of this next course of action.

Dad decided that he wanted to stay in the hospital one more night - mainly because the staff was so readily available to ease any discomfort he might have and the last thing he wanted was to go home, have a bad night and need to return the next day. So he was permitted to stay. On Saturday evening Dad was also surprised to finally meet the last player in his world of doctors, Dr. Clemente (pronounced Clement). Dr. Clemente is Dad's neurologist. He is brought into Dad's case to evaluate when and if surgery will be necessary. Dad was very comforted by his visit, his manner and his being fully up-to-date with Dad's history. Dr. Clemente is a specialist in the area of Laser and Cryo technologies and he spoke to Dad about these less invasive, safer methods of extracting and/or reducing the size of any cancerous material in a patient. He also mentioned that after consulting with dad's doctoral team (they consult once per week per patient - to all stay on the same page) it might be possible that surgery is recommended even before his prescribed radiation therapy is complete. We will keep you up to date regarding this.

Dr. Schlam will speak with Dad within the week to determine the success of the steroid (Decadon) - and to evaluate the possibility of lessening the dose. Dad also always has available the pain medication of Dilaudid - which he has not taken since his first day in the hospital.

Okay, I think everything is on the proverbial table.

Dad is home resting comfortably - he is in considerably less pain (Thursday on a scale of 1-10 he was a 12; now he is a 2). His spirits are good (Thursday 2; today 9.3). He is comforted by the calls of his family - his schedule will most likely return to what it was earlier (wake after 9a - and sleep by about 9p). He is up to his old antics - reading incessantly, he is out in the backyard, on his new patio, under the umbrella attending to today's papers.

For those of you who want all the details possible regarding Melanoma, metastasized cancer and the medication you can read up on most of the medical information on the Internet. The most useful site might be-

www.cancer.org

I have a list of questions still to ask the doctors this week as I put all the pieces together. When I receive this information - anything that I feel is valuable to everyone will be shared. Thank you all for your love to me - it is felt and provides me with the strength to assist in caring for our beloved patriarch (of course all this is while he works under the illusion that he is caring for me! - which he can't help but do).

Smooches to all,
Kath