Avastin Update
Bryan, Adam and Teresa are taping the Carolla podcast, so I've got an hour to kill. I can either sit and watch smoke rise from the 105,000 acre Station fire just across the highway, or I can update everyone on Bryan's Avastin treatment. It's a no brainer, really.
Bryan had his Avastin infusion last Friday, exactly one week after the doctor recommended it to us. Where there might have been insurance slow-downs, there were none. Where they may have been scheduling conflicts, there was an open 8:00am time slot. While it was great that Bryan was scheduled within one week, it also seemed sudden and required a lot of emotional prep work on our part.
Obviously, there was a lot of anticipation and build-up for the day, for reasons which I've mentioned in recent posts. Bryan was trying to get into as positive a mindframe as possible, so we did some additional research on the uses of Avastin, along with the expected results. While this helped, a true turning point for us came from a comment that a reader posted that referenced a CNN article about Avastin. In short, it quoted a Deputy Director at Duke University's Brain Tumor Center who is routinely using Avastin as a treatment immediately after diagnosis rather than as a last resort. Given that this is a relatively new drug and administering it early on is a pretty revolutionary technique, we kind of see Bryan as participating in his own personal clinical trial. So for some reason, that really gave us some hope and helped us get in a "ket's kick some cancer ass" mindframe.
Bright and early Friday morning, Bryan and I headed to Cedars' Cancer Center. We had no idea that a recent - and HUGE - construction project had just been completed, so we were directed into the brand-spanking new infusion center. I'm going to be honest here and say that in the event the purpose of the room was NOT to infuse cancer-killing drugs, I could spend days in that place. It's THAT nice. Easily the Four Seasons of cancer centers. Each patient gets their own private designer "cubicle," so to speak, complete with a huge reclining chair, sliding frosted glass doors, portable plasma screen TV, and lunch menu. It's so modern, quiet, clean and truly a place that aims to make patients as relaxed and comfortable as possible during treatment. Forget the fact that they check your blood pressure every fifteen minutes and stick you with needles; just necessary evils.
We were greeted by Cindy, a canc0er center nurse, who explained in detail every part of Bryan's infusion. His treatment started with a 50-minute Benadryl infusion for anti-nausea and to stabalize his blood pressure, followed by a 15-minute, 10mg infusion of Decadron (steroids), and finally followed by a 1 1/2 hour infusion of the Avastin itself.
I had Bryan put his headphones and try to meditate while the nurse went through the possible side effects with me. I figured there was no need for him to stress over the descriptions of side effects that have a measly 1% chance of happening. The more relaxed Bryan could be, the better. Turns out the Benadryl relaxed him so much that his heart rate went really low, so they came and made him sit up to boost it. Apparently he was relaxing "too much" during his infusion. Who knew that was even possible?
The nurses monitored Bryan's IV, pulse, blood pressure and temperature several times, so otherwise he was left to meditate and listen to the feel good playlist on his iPod. After so much anticipation, it was overall a really simple and painless experience. Much ado about nothing, you might say.
That said, four hours, three infusions and one pretty nasty (Bryan's description) hospital-provided egg salad sandwich later, Bryan was ready to go home. I wasn't expecting him to be done so early, so I had planned lunch with a friend during his infusion. While the infusion "cubicles" are fantastic, there's not exactly room for anyone to sit with the "patient" without feeling totally in the way of the nurses and doctors. So I made sure Bryan was settled and went to lunch with my good friend Lissy. She knows exactly what I'm going through as her brother had pancreatic cancer several years ago. So we got our lunch to go and took Bryan back home, where he napped for about 4 hours. The day was moving along, the infusion was complete and all we could do was wait.
We laid low over the weekend and I didn't post any updates, mostly because I didn't know what to say. It has truly been a work in little, tiny progressions.
Now, however, it's been four days since the infusion and we can already tell a difference. Bryan's energy is up, meaning he wakes up at 9am is actually UP. He doesn't move to the couch to take a nap from 10am to noon. He actually stays awake. All day. And his balance is improving. He's able to consistently take good steps that resemble steady walking without tipping over. We were incredibly ambitious yesterday and went to the bank and to Whole Foods. Bryan walked into the bank (with my support) and handled every detail, like taking out his wallet, giving the teller checks and providing his signature. He did great. Then at Whole Foods we were forced to park further away (where the hell are you, handicapped placard?? Sacramento DMV has taken over a month to get it to us). I offered to drop Bryan off at the front, but he wanted to find a shopping cart and use it to balance walking into the store. So that's what we did. And he walked the shopping cart ALL the way around Whole Foods, without panicking over someone walking next to him, getting overwhelmed at noises, sounds, etc. It was amazing and more walking than he's done in over a month. I helped him every step of the way, but his steps were even, balanced and straight. A huge, huge improvement.
Physical improvements aside, mentally Bryan seems much more "with it" and his humor is definitely coming back. He was definitely full of piss and vinegar the other night when I was asking him what he wanted for dinner. Without getting into details, suffice to say he gave me a lot of shit about something as simple as dinner, and while most women would get annoyed, I was beyond thrilled. It was the most personality I've seen from him in a few months. It was hilarious and it put the biggest smile on my face because it meant we could start dishing out the sarcastic banter again, one of our favorite things to do.
So, all in all, we're optimistic about the Avastin. We're taking measures to make sure he doesn't get blood clots or other side effects. So that means nightly leg massages, stretches and elevating his legs, etc. Must be nice. :)
He'll get Avastin treatments every two weeks and they'll get shorter and shorter. We've heard several stories from people who were put on Avastin to get through radition effects, and they are very positive. So we've switched our tack on the "last resort" rumor of the Avastin, because this is the beginning, not the end.
Assuming Bryan continues to improve, we're looking at having him do some intense in-patient rehabilitation, during which he'll get several hours of treatment every single day for up to 10 days. Basically, it will fast track his recovery and physical functionality, which would. Be amazing. We're waiting to get approval from insurance, after which Bryan may be admitted as soon as next Monday.
So there it is! A great update and we're hoping to continue with many more positive changes, no matter how small. Like Bryan putting on one of his socks and shoes by himself, which he did this morning.
It's all about baby steps. Literally.
