Blood Work

[mstlyn]

OK, if other things weren't a red flag, this one definitely is. An oncologist (or any doctor, for that matter) should not be so absent-minded. At the very least, he should be somewhat familiar with Anthony's case, especially after all this time.


LDH is a less precise marker because it is produced by many normal cells in the body. It is more of an indicator of tumor burden rather than an indicator for the presence of a germ cell tumor. Also, some germ cell tumors show no markers whatsoever, not even LDH (mine didn't).

Despite all of these short-comings, you are doing a kick-ass job here. Anthony is really lucky to have such an attentive, diligent, and all-around cool mom such as yourself .

Thats what I sit thinking to myself everytime we go in to talk to this oncologist. Absent minded is the perfect description, thanks FED!

I didn't want to call him a crappy doctor cause I don't have that impression of him, but he is definitely absent minded. On each visit I see that he doesn't seem familiar with Anthonys cancer at all.

I'm very thankful that you all have been here to teach me what we need to know, otherwise, I dread thinking what the outcome may have been because I would have been clueless, and depended on these doctors to know what they are doing.

These last few months have been very stressful, but this forum has made things better for us. The information I found from all of you is largely responsible for saving my son.

Thank you seems so shallow; but THANK YOU

[Fed]

He said "oh yes I did, I forgot about the lung nodules" and he said, let me change that. He changed the chart to stage IIIA and all this time he had in my sons chart that he was IIB.

OK, if other things weren't a red flag, this one definitely is. An oncologist (or any doctor, for that matter) should not be so absent-minded. At the very least, he should be somewhat familiar with Anthony's case, especially after all this time.

He also told me that LDH is not a tumor marker. I don't know for sure if it is or not, but I assumed it was because that was one of the numbers I have seen a lot of men post.

LDH is a less precise marker because it is produced by many normal cells in the body. It is more of an indicator of tumor burden rather than an indicator for the presence of a germ cell tumor. Also, some germ cell tumors show no markers whatsoever, not even LDH (mine didn't).

Despite all of these short-comings, you are doing a kick-ass job here. Anthony is really lucky to have such an attentive, diligent, and all-around cool mom such as yourself .

[mstlyn]

Yes, I saw your other post after I asked about the chemo. I am glad he agreed to the in-house last day. . I don't know why, but I was going to forward the conversation with Dr Nichols page that was Tcrc, so that you could print that out to him, where he also says that it ok to combine the last cycle to 4 days.( page 2 where that is written, is mis-linked for some reason) But now that he is going to do it in house, kind of a moot point, except your right, What about the next person down the road? I might wait until the end of the week to give him any information, as who knows how he would react. Chances are, he is not treating any other tc people right now . Lets get him done with chemo !!

In one respect , it is good he has been concerned about the toxicity effect , and had that in mind through out, but to me it is puzzling for him to say that he is already cured, and probably dosen't even need the 4th cycle ( if I remember that correctly) and yet, was worried about it in combing the last cycle to 4 days. He may be right that 3 did it, but the protocol says 4 for a reason. It removes the word " probably " from the equation and the studies say " 3xBEP is basically the same % ( slight difference) as 4xEP not 3x EP. We go for the sure, rather than the probably.

For me, the last cycle was the easiest . I always say what I have heard, felt, and seen in others, that when you are done with the last chemo, that you should pay attention for emotional "side effects". As fast as this starts, it kind of ends just as fast, and being so involved in all the appointments, tests , treatments etc etc, it basically comes to what ammounts to a the equivilent of driving 100 miles and hour for months, to slowing dow to 10 mph. That's when it kind of hits you. The few weeks after. While it is exciting to be finished, all the sudden you have more time to think about all that has happened. Alot of people go thru the OMG I had cancer, I lost this, etc etc, so just be aware of possible depression, or a "grieving process" Not everyone has it, but it is common. Same for you, this has pretty much consumed you for months, and for the most part, it will stop. It will slow way down. Take care of yourself too.

Almost there, and you have done a fantastic job of getting this done, watching out for your son, and making sure this was done the right away.

I am always amazed by the wives, and mothers I have met over the years. It is just incrediable how they kick it in gear, and be the driving force. My hats off to you all.

If he has been flusing and stuff, I would think that the higher numbers are just a blip. Obviously they have to be checked out, but he really hasnt had these done since he started, and chemo would be a good reason for them to be higher, especially during chemo. If they were still really high in a month would be one thing, but i think as with mine, when i was done with chemo, they returned to normal.

Rob

Robert, this doctor has confused me a few times. I do like him, and I do think he is a good doctor; but not very knowledgable about TC. He said he follows Einhorns protocols across the board, but I don't think he is well studied in this area when it comes to fine tuning everything.

If you remember I had to ask him why he was not testing my sons AFP, and after that he started testing it.

Another thing, before my son started chemo the doctor told me he has (and these are his words)

StageIII "probably A"

Now ... while he was telling me that it was ok to hold the chemo for an extra week; in addition to saying that its "probably already cured" he said, "ESPECIALLY WITH HIM HAVING STAGE IIB CANCER"

I said to him .. Doctor, you told us he was stage IIIA before.

He said "oh yes I did, I forgot about the lung nodules" and he said, let me change that. He changed the chart to stage IIIA and all this time he had in my sons chart that he was IIB.

He also told me that LDH is not a tumor marker. I don't know for sure if it is or not, but I assumed it was because that was one of the numbers I have seen a lot of men post.

You mentioned that the chances are he isnt treating a TC patient right now, and maybe he isnt; but while we were at the desk getting Anthony scheduled for his last treatment day at the hospital, a man standing there spoke up and said .. is he getting that treatment that you have to have every 21 days, for 5 days in a row? I said yes ..
He smiled and said .. I had to have it too and I beat it.

I didnt get into details with him because there were several people standing around. He did tell me that he finished his treatment last November, and he definitely looked like a healthy guy.
I did hear the lady at the desk giving him instructions for taking some kind of pill each day though. I don't know what that was about.

He praised Dr. Danish too, but I just thought to myself; well maybe you didnt get to meet the people on the TC cancer forum, or he would know the difference between a doctor that is knowledgable about TC and one that is not. I think he probably just missed having holidays interfere with his treatment too since he was done in Nov. I wish I would have thought to ask if he was in treatment during thanksgiving

[dadmo]

One of my great reliefs during chemo was to see those normal markers. It makes the poisioning a bit easier to take.

[mstlyn]

CT scan in 3 weeks ..

[mstlyn]

Robert,

During chemo week he makes a point of drinking at least 10- 8oz. glasses of water, gatorade, juices etc .. He also does this for about 3 or 4 days after chemo week.

Then he goes back to drinking normal, which is whenever he gets thirsty.

Hopefully everything is ok .. and yes he still has his last chemo cycle to go and that will start on monday april 2nd.

Yes its great to hear that his markers are normal!

Tammy

[mstlyn]

High BUN can be caused from a high protein diet.

Too-high BUN level is called azotemia. Heart failure patients often have high BUN due to low blood flow to their kidneys. High BUN can also be caused by heart attack, intestinal bleeding, feeding by stomach tube, dehydration, high stress, or kidney failure

I have eGFR on my latest labs and it seems if its below 60 it indicates a problem.

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This information is kind of scary. If the new blood test is still high, or higher ... I wonder what the doctor will do???? How will he know the cause???

[Michael112]

High BUN can be caused from a high protein diet.

I have eGFR on my latest labs and it seems if its below 60 it indicates a problem.

Too-high BUN level is called azotemia. Heart failure patients often have high BUN due to low blood flow to their kidneys. High BUN can also be caused by heart attack, intestinal bleeding, feeding by stomach tube, dehydration, high stress, or kidney failure

[mstlyn]

We got the results from Anthonys new blood work.

Tumor markers are normal so we're happy about that!

AFP 4.9
HCG <2

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His calcium and BUN is a little high. I don't know how high it would have to be to signal trouble, so if anyone is in the know; please share your information.

The doctor said that its "probably" nothing to be concerned about, but he sent him across the hall to have his calcium checked before we left his office.

BUN is 32 ----------- reference range 7-25 mg/dL
Calcium is 10.3 ------ reference range 8.6-10.2 mg/dL

High numbers could mean kidney damage I think??

GFR Estimated >60
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