2016/08/03 – Mixed Signs

The new immunotherapy is showing some promise. It is known that it sometimes causes a flare-up in tumor activity as it begins to work. My tumor has flared up. There is necrosis in one or more regions of the tumor, which is cancer cells dying. I hope this is the storm before the calm.

I have included here, for the incurably curious and strong of heart, a very graphic slideshow of the progress of the tumor.  Do NOT open it if you are at all squeamish.

SHOW THE PHOTOS...▼

Kaiser continues to support me admirably, with home health visits, supplies and equipment, weekly infusions to improve my hydration, and of course the help and advice of a slew of doctors, nurses, and others. The latest piece of equipment they have persuaded me to accept (at no direct cost to me) is an oxygen concentrator.  I have not had much trouble breathing, but there have been a few wheezing incidents (I believe mostly caused by drying in my bronchi) so now I have a “rescue inhaler” of albuterol (like used for asthma) and this miniature oxygen plant:

Oxygen Concentrator, Pump, etc.
Oxygen Concentrator, Pump, etc.

Air is about 70% Nitrogen and 20% oxygen, with the last 10% including CO2, water vapor, and various other gases. For decades, the most effective method of separating oxygen from air was cryogenically (super-low temperature/high pressure) and large industrial plants still use that method.  They liquefy the air, then gradually decrease the pressure/increase the temperature, to evaporate and collect each different gas separately. It’s called fractional distillation.  That is an expensive and dangerous method, because of the extreme pressures needed, but it works well at an industrial level. The concentrator does not liquefy and fractionate the gases. It uses a process called pressure swing adsorption (PSA) which involves pressurizing air to only about 20PSI (1.5 atmospheres)  in the presence of the mineral Zeolite. Under that small increase in pressure, Nitrogen sticks to the surface of Zeolite. That is called adsorption.  While the nitrogen is stuck to the surface of the Zeolite, the concentrator pumps out the oxygen and other gases,  then releases the nitrogen back to the atmosphere for another cycle.  With the nitrogen removed, what is left is  a mixture that is about 90% oxygen.  That’s good enough for medical use, so it is pumped out a tube to a nasal cannula, but Kaiser does not stop there.  They also supplied me with a pump that will take the oxygen-rich mix and pressurize it into a cylinder I can take with me outside the apartment, and an “emergency cylinder” that is quite large and high-pressure, in case the electricity goes out or the concentrator fails.  My tiny apartment is starting to look like a medical supply house, and the concentrator and pump heat my bedroom up 10° F higher than the rest of the apartment. Once the pumping fills both small cylinders, I will turn the machine off until I need it, which I hope will be NEVER. It’s taking days, but one cylinder is full, and the other one should be soon.

As for the immunotherapy, it’s a 3-week cycle, and I just had my second infusion on Tuesday the 26th.  We’ll assess the progress or lack thereof at time for my third infusion (August 16th) and if there is no improvement by the fourth infusion (September 6th) we will likely consider the immunotherapy to have failed, but there are already some good signs. I am very hopeful about this drug, and my having stabilized in most of my functioning.  There have been no new negative developments, other than the steady growth of the tumor outward, which in itself may mean that it has slowed or stopped its advance on my carotid artery and vagus nerve.

No new problems is good.  I’m encouraged.

3 thoughts on “2016/08/03 – Mixed Signs”

  1. Hi Wayne, and tardy well wishes from Eugene. Thanks so much for keeping me up to date on your horrific journey; I’m especially thankful for your steadfast optimism and fighting spirit. Puts the small things in life in perspective. Know that you’re in our thoughts and prayers always, and that we share your hope that, fifteen years from now, you’ll remember this as the worst year of your life. Love you, brother. Keep swinging.

  2. Hey Wayne,

    Thanks for the update. I’m glad to hear the encouraging news and continue to pray for you during this time. Hope you have a joyful day today.

    Martina

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