Tuesday, May 5, 2009

5AM reveille

We're off to the National Cancer Institute in DC tomorrow to meet with Dr. Harold Fine for a consult-- possibly to see whether he'll take Mom as a patient and get her involved with Avastin therapy, above and beyond regular therapy. The appointment's at 9AM; the paperwork says we have to be there 2 hours early, i.e., at 7AM, which means we need to be on the road by 6AM, which in turn means waking up around 5AM. Joy.

On Thursday Dad and Mom are, in principle, leaving for Houston. They'll arrive in Houston in the mid- to late afternoon, will stay the night at my aunt's palatial estate in Conroe (the very same big sister who was here for a couple weeks), then will make the 60-90-minute drive into downtown Houston to meet with docs for a morning appointment at the M.D. Anderson Cancer Center. I imagine that my parents will return to Alexandria very soon after-- either Friday or sometime over the weekend, depending on what sort of family discussion occurs in my absence.

Mom's May 11 appointment with Dr. Tonnesen (the Fairfax Hospital radiologist) has been moved back to May 20. I'm a bit nervous about the timing; Mom's supposed to start regular therapy soon, and we're talking about an aggressive tumor that will recur.

Questions for us to ask the experts, both tomorrow morning and in Houston on Friday:

1. What percent of the tumor was removed during the debulking, and how does this affect Mom's prognosis? What about the relevancy of the fairly high off-the-cuff Karnofsky score that Dr. Meister had given Mom?

2. Let's get into the nitty-gritty: how adverse, really, will the effects of in-tandem radiotherapy and chemotherapy be?

3. How much difference would it make, really, for Mom to remain in Houston for treatment, or for her to remain in northern Virginia? I'll be curious to hear the opinions of both NCI and M.D. Anderson on this point.

4. How should we interpret the MRI and CT images we saw on the compact disc? (This may actually be a different form of question 1, as I'm aiming to find out just how much of the mass remains in Mom's head.)

5. What do we need to know about clinical trials-- enrolling in them (specifically, Avastin therapy), etc.?

I'm sure there are other questions... perhaps I'll think of more in the morning.


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