Weird day. Tough day.

Not sure where to start. Its Monday evening of Week 4. We had every hope that the week would start strong and finish the same. Um, that didn't quite happen. Nothing went as hoped...let alone as predicted. We'll start with where we finished...we "closed" the oncology center again. Went in at 2:00pm for a meeting with the oncologist....left the center at 6:15pm. How did we get to this ending?

As a reminder, Roger had a kinda rough weekend. Well, it turns out there is a reason he felt so crummy. A combination of things came together this weekend and today. Roger's blood counts have tanked. White blood cells have plummeted. There is a fancy term for this, neutropenia. Basically it means that Roger is very, very susceptible to infection right now because his immune system has taken a beating by the cancer drugs. So take out-of-whack blood cells and mix that with dehydration (despite drinking loads of fluids)...and you have a formula that will topple the strongest of people. And topple it did. Before meeting with the oncologist, Roger always has blood drawn to get a weekly read on how Roger's system is adjusting to the treatment. Today's blood draw nearly left Roger on the floor passed out. Fortunately he felt himself "going" and let the nurse know. They managed to pull him out of it before he lost consciousness.

Dr. B said it was the combination of Roger's poor blood counts combined with the dehydration that caused the problems. So this lead us to Roger having more fluids and a couple anti-nausea drugs. The last bag of solution finished at 6:15. Roger was back home and on the sofa by 6:30.

Happily Roger feels a little better...doesn't feel faint anymore. Dr B said we'll see how he does this week. He and the wonderful nursing staff warned us repeatedly that Roger could easily pick up an infection so, avoid crowds, avoid dirt, mold, spores, etc. Wash your hands. Wash your hands. Wash your hands. We have masks for Roger to wear if he is going to be around a lot of people. He's been told to wear rubber gloves when he thinks he's exposing himself to anything infectious. It all got very serious (more serious than it has been - if that's possible). We need to watch a little skin bump on Roger's back for possible infection. We need to watch for a fever above 100.5 degrees. We need to pay even more attention.

If Roger's blood cells don't improve by the first of next week, his chemo may be pushed out a little. Dr. B said he thought they should improve but we won't know for sure until Monday. There is nothing we can do to improve the numbers. All we can do to help is to try to avoid any potential infection. So, take no offense if we avoid any social gatherings, we're just trying to be careful.

So that's the end of the day, the middle of the day was simply confusing. Roger received a call from the genetic counselor. As mentioned previously we met with this gal last week. Roger did a test to confirm that Roger has the "cancer gene". We have been operating under the thought that he has it....his sister has it (and had two bouts of cancer) and her son has it. So, it seems reasonable that Roger has the same gene mutation especially because his cancer is in the gastrointestinal track just as his sister's cancer was. Here is the confusing part. The genetic counselor today said that Roger does NOT have the genetic mutation that his sister does. Or so the test results have indicated. HUGE confusion. The doctors want to test Roger's sister and then compare the tests. So, we're not really sure where we stand. Back to that deadly question...what if? What if he doesn't have the genetic mutation? Would that mean that he may not need the surgery because there isn't a genetic predisposition for the cancer to return to the esophagus? What if? Or, what if some test wasn't conclusive enough? Or, what if there is another gene mutation slightly different that hasn't been fully identified. This whole genetic-study-thing is relatively new for cancer.

The nursing staff in the infusion area proved themselves yet again to be the amazing caring people we've been watching for weeks. They ALL gathered around one of the patients receiving chemo and sang happy birthday. I know it sounds like a small thing but I gotta tell you that simple gestures like this touch the heart and warm the battered-spirit. All the patients in the room turned to listen, some sang along, and most clapped when the song was over. The spirit and joy from these nurses left the room a little more light hearted.

Weird day. Tough day. Physically draining, mentally taxing. Will keep you posted as each new day unfolds.