6 December - Deb and Kate outside of St Paul's Cathedral
Deb and I visited Kate at her flat in Collier's Wood and then travelled up to London for a day out. Had a great walk along the South Bank and crossed Millennium Bridge to St Paul's.
8 December - Start of third cycle of chemotherapy.
Had an appointment with Dr Sanghera at QE Hospital. (Saw the same doctor for 2 months in a row - things must be improving in the NHS). We discussed:-
1 Deb's general health. Dr Sanghera was pleased that Deb is generally in good health - no muscle weakness, problems with speech, fits, seizures or anything else that would indicate that the tumour was progressing.
2 Blood test. Results of test were excellent. Red blood cell count, white blood cell count and platelet count were all in the normal range. Dr Sanghera thought the previous low platelet count may have been due to the effect of the prolonged chemotherapy during the combined chemo/radiotherapy phase and the new counts were a sign that the bone marrow was now recovering. It was agreed that the we could carry on with the chemotherapy.
3 Chemotherapy. Deb was weighed again and the dose of chemotherapy recalculated. The dose was increased slightly from 360 mg to 380 mg per day.
4 MRI Scan. On 29 November Deb had her first MRI scan following the end of the radiotherapy. We were shown the scan and alongside the scan taken in June 08 when Deb was first diagnosed. Comparing the two scans you could see that the low grade part of the tumour was slightly reduced in size. The high grade part of the tumour which was a bright circle about the size of a 10 pence piece in the early scan was slightly bigger but was now diffuse. We should read nothing into this latest scan. It could be 'pseudo-progression' and what we are looking at is a transient image caused by the chemo/radiotherapy. (I asked Dr Sanghera if it is transient how long would it last - he does not know! I will look that up - if you know it is transient you must have some idea when it will end.) This November scan will be the baseline and tumour growth in future scans will be measured by comparison against this benchmark. The clinical team will have a conference tomorrow (9 December) to discuss Deb's case. They may decide to do another spectroscopic scan (don't know what this means - Dr Sanghera said it just gave more detail - will look this up as well. Doctor said it would not benefit Deb but it would be useful for him?). I will speak to Fred Berki, Macmillan Nurse tomorrow to find out what was said at the conference. A further scan is set for 2 months time when the results will be compared with the November baseline scan.
5 Steroids During the course of the last month Deb reduced her steroid dose by 0.5 mg each week. When she got down to 1.0 mg per day she started to get increased frequency of headaches, some of which were sharp shooting pains behind her left eye. After consulting the Macmillan nurse it was agreed that the steroid dose would be increased back to 1.5 mg per day. Deb has been good on this raised dose with no further sharp headaches. It was agreed that she would remain on 1.5 mg per day for the time being. If she remains well she may try to reduce again at a later date.
