Celebrities drive them. Environmentalists promote them. I have a hybrid, and I think I'm going to keep her. She's not exactly a gasoline/electric hybrid. She's a long-term survivor/still-in-treatment hybrid. At least that is what I learned when I took Erin to clinic yesterday. It began with the question, "So, Heidi, Erin will hit the five year mark since diagnosis this summer. That is half the milestone you need to be moved into Zoanne Dryer's survivor clinic at TCH [aside: being off treatment for two years is the other]. Is someone on the solid tumor team keeping track of the issues that the survivor clinic would monitor? You know, things like late effects from treatment?"
Heidi looked at me like I was clairvoyant and said, "That's exactly what I've been wondering."
It turns out no one has. So, when scan time rolls around again in July, we will add some additional tests into the scantravanganza: echocardiogram (heart function), GFR (kidney function), and extra blood work (thyroid function and growth hormone function). In the meantime, Erin appears to be doing so well [cue drum roll] that we have the thumbs up to schedule clinic for her locally both in late May and late June. That means Houston is a recreation-only destination for the foreseeable future. Blood counts were especially robust yesterday, and included a hemoglobin count of 12.1 (normal) as well as normal white count and platelets. Heidi downgraded her assessment of Erin's counts from AAA to AA because she was running fairly high on the eosinophils (which are an indicator of allergic response. . .go figure. We live in the Brazos Valley, Motto: "If the Pollen Doesn't Get You, the Mold Will.").
We have also opened talks (which may turn into serious negotiations in July) over whether to switch Erin off of oral etoposide. Heidi recommends moving off of that onto an oral version of cyclophosphomide, which she thinks is incrementally better on almost every dimension. The big concerns for continuing etoposide is that Erin's tumor may become resistant to it and/or she may develop secondary cancers from taking it so long. The big concern for stopping etoposide is that something else might not work as well keeping Erin's tumor pinned to the mat. I'll have to research it for a while, so if you have any thoughts, experience, or comments about it, drop me an email.
In the meantime, we had Erin tested again to see if she has ever had Epstein-Barr virus. If she has, then she would become a candidate for Heidi's latest vaccine program. I'll let you know if EBV was one of the many things that plagued Erin last winter.
Before I close, I would like to tell you that Willie was not the worst dog in the world this week. A friend of mine has an old German short hair (as well as a couple of other dogs, whom she wouldn't mind sharing with a needy, but clueless, family). On Tuesday, my friend was out doing works of great and selfless value (delivering meals on wheels to the homebound). She received her first round of punishment for this good deed when the sky opened up and let out a massive thunderstorm, which seemed to intensify every time she jumped out of her car to trot a meal up to a house. The second, more long-lasting punishment came when she arrived home to discover that her old dog, crazed by the storm, had removed and eaten the sealing gasket from her refrigerator door. That's right the refrigerator still cools, but now she has to use duct tape to keep the cool air in. . . at least for the next week while she waits for new parts. For a moment, Willie shines in comparison. I can only wonder how he will top that.