Friday, April 29th we went to Ohio State for what we hoped would be treatment 25 of the immunotherapy drug Keytruda. Unfortunately, Mikes blood level was a 7, and they were unable to treat him. This means he is severely anemic. The reasons for this could be internal bleeding, the tumor is bleeding, or the keytruda is causing it. They asked several times if Mike has had any bloody stools( tar like dark black consistency), or if he had thrown up, or bled at all. The answer to all of those questions was no, so they are thinking it must be keytruda related. Anemia is a known side effect of immunotherapy treatments.
The doctor said Mike had to get a blood transfusion right away, and they scheduled us to come back on Monday for an endoscopy to get a look at Mikes stomach, and to receive another blood transfusion. If you have ever had a blood transfusion, it is basically a 6 hour procedure. I will post more on it later, but it is a long involved procedure. He was able to get one unit of blood on friday, and they scheduled him to get another unit on Monday.
In retrospect, I should have known something wasn’t right with Mike. He was unusually tired the week before his treatment, and his appetite was somewhat repressed. He lost 4 pounds, taking him down to 173 but we had been exercising every night, and I was trying to stay positive. If you have cancer, you are fatigued. That isn’t unusual in itself, but fatigue, and lack of appetite are two strong symptoms of anemia.
We went back to Ohio State on Monday, and Mike had an endoscopy and received another unit of blood. The Dr came in after the endoscopy, and told us that Mike has several ulcers in his stomach again. He couldn’t find any blood, which was good, but although he could see the exit of Mikes stomach, he couldn’t get the scope through all the ulcers to the exit. There was a a lot of undigested food in Mikes stomach despite having not eaten for 12 hours, and that is not a good sign.
He advised Mike to go back on a liquid diet, until they can get a handle on what is going on. If you are our facebook friend, you know that Mike has absolutely not been on a liquid diet! lol
He took several biopsies, and is supposed to call us soon with his results.
In the meanwhile, Mike will go get his blood work done here at U of M this week, if the numbers aren’t better he will need another transfusion. His blood level has to be at an 8.1 to receive treatment, and our goal is to try again to get treatment this Friday. They need to figure out why the blood level is so low, if in fact it is from the immunotherapy, or if there is something we aren’t aware of.
His appetite is better this week, he has been using the carofate to coat his stomach, and not eating hard to digest foods like leafy veggies, and pork. We are choosing to look at that as a positive.
I would like to say that you get used to these ups and downs that cancer throws at you, but you don’t. Each time something bad happens it is as upsetting as the first time. The only thing you can control is your own response to the bad news. We decided a long time ago that we would live with cancer, not let it rule our lives, or take our joy, and that we will continue making memories. We went to Florida for a few days to celebrate Mikes birthday, had a great time, and will keep on moving on…