After driving eight hours round trip for a three hour doctor visit, I just spent an hour writing an email to Drs. Hausner and Hanna. To say that I'm tired would be an understatement. But I'm also very excited. We had a very great conversation with Dr. Hausner this afternoon and things continue to look up for Team Stryker. First, I have to take a moment to mention how Hausner's accent is positively adorable. I want him to be my GPS voice in the car or maybe read my grocery list to me. When he left the exam room, Rich said, "I could listen to him say 'cream' all day."
Ok, back to the matter at hand. Dr. Hanna removed some staples and did a very professional and pleasant version of saying "take it away, Dr. Hausner!" Hanna's job is to cut people open and remove things and when that no longer became the task at hand, he deferred to his esteemed colleague.
Dr. Hausner then came in and told us all kinds of good things. He doesn't think that Rich will need chemotherapy. Instead he wants him to get the monoclonal antibody therapy (mAb) to slow/stop the growth of the mucin. The good news is that the mAb therapy doesn't have all the icky side effects of chemo. The primary side effects are a skin rash that can look like pimples (treatable with steroid creams in a Czechoslovakian accent) and mild diarrhea. Hausner also mentioned that patients tend to get longer eyelashes. My already very hairy husband found the one cancer treatment that makes more hair. And if you haven't seen his lashes lately, they're already pretty long and luxurious, so he's going to become a walking mascara commercial.
The other good news is that we're not really in a hurry to start this. We're still waiting on the K-Ras test results which will probably take another two weeks or so. And then we can just work up to scheduling the mAb therapy when he's ready. The mAb therapy will go on for a few months at least so we can see if it's helping. The odd thing about that is we really only have one CEA tumor marker to see if it goes down and the rest is just seeing how Rich feels. Hausner actually talked about measuring Rich's girth on a regular basis to make sure it doesn't grow, which would show the slime was spreading. But it didn't show on the CT scan, so it's all we've got.
Hausner had several great phrases today. I wish I could just record him with my iPhone and then Songify him, because that would be ideal. But to paraphrase, he said that Rich has "especially organized mucin with collagen fibers" versus the green slime others might have. He also said that Rich's tumors were "completely bland" but "good looking" so we shouldn't worry about them getting out of control. His tumors at least have a great personality.
We learned more about the appendix today too. I know several folks have asked why they didn't take out Rich's appendix while they were in there since it supposedly started all this mess. Since we're crowd sourcing Rich's cancer, I made a point of asking about that. Hausner said that when the appendix duct got blocked, the appendix continued to produce mucin. It didn't spring a timid little leak out the side. It swelled up to the size of a Vienna sausage and then ruptured. So the only thing remaining of his appendix is the sad tattered remains of tissue there. What happened, though, during that rupture is it spread those mucin producing cells all over Rich's abdomen. They're still doing their job to produce colon lubricating mucin, but instead of within the closed system of Rich's digestive track, it's all over his organs. We've had a slime containment breach. And as Hausner and I said, going after the appendix now is futile because the proverbial horse is already out of the barn. We now have to deal with all those little slimy horses that have gone out to pasture all over Rich's
perineum peritoneum (oops).
Rich is feeling moderately better this evening and I know I am. We don't need to start chemo (or only a very small chance of it if the K-Ras result comes back as mutated which we don't think it will). And Rich's slime is "especially organized", "bland", "good looking" and "well-behaved". We really should get his slime a Match.com profile. We even have photos from Dr. Hanna to use.
Hausner said that Rich can just continue to heal and go back to work and go back to all his hobbies "that are so dangerous!" Our medical oncologist had only one concern, that Rich's chosen hobbies look very dangerous. If that's the worst thing our oncologist is worried about, we're doing pretty great.
Most notable today is that when we were getting out of the car in our driveway tonight, Rich stopped me and said, "thanks for everything today." And then he smiled at me. It was the first smile I've seen since we entered the hospital for surgery two weeks ago. I hadn't realized how badly I've missed it.