I got the results of my blood test Thursday and, as I expected, my serum calcium level has increased. At my request, my doctors and I don't discuss numbers because I don't need one more thing to obsess over. So the colleague of my endocrinologist who called today, Dr. M., summed up the results by saying that my calcium level "has gotten worse, but not much worse."
More than five years into this illness, I've become very sensitive to changes in my biochemistry, especially to increases or decreases in my serum calcium. People say the body is a finely tuned machine, and I can tell you from direct experience that this is absolutely true.
When I lose my appetite, when I'm feeling more lethargic than usual, when I have special difficulty in focusing my attention on tasks, it's a foregone conclusion that my calcium has spiked. I've been wrong on this just once.
I also seem to have especially vivid dreams when I'm drowning in my own calcium, particularly dreams that seem to occur just before I wake in the morning. I'm not sure if this is coincidental, perhaps caused by worry, but it's not always a bad thing.
Dr. M. requested that I get a second opinion on the feasibility of surgery from the surgeon with whom I've been dealing since this illness manifested itself in 2002. This was done late last year. His verdict is that the cancer is inoperable. It was also recommended that I get an opinion from the head of surgery at Memorial Sloan-Kettering Cancer Center in Manhattan. This is scheduled for Feb. 23. I pretty much know what he's going to say, because when he and I met for a consultation in January 2006, he had said that surgery would likely not be a viable future option.
Dr. M. also thought this might be a good time for me to begin intravenous treatment with the drug Zometa, which is used to lower dangerously high serum calcium. She added that in the meantime, the head of the endocrinology department at the hospital where I'm treated has contacted colleagues in England and is requesting the materials for the immunotherapy being developed there for the treatment of parathyroid cancer. (In my previous update, I had mistakenly referred to it as gene therapy.)
I'm very candid with my doctors, and they with me. I told Dr. M. that I believe my struggle is entering its end-game. Ever the optimist, she told me that I shouldn't think like that because conventional means to control this cancer's treatment can remain viable for years.
I admire her optimism and am hopeful that she's right.
The decision to begin the Zometa treatment is being left to me. When I feel that my calcium level is beginning to impede my ability to function, then I know it'll be time. As for the immunotherapy, I don't fancy being just the second human guinea pig in this country upon whom it is tried. My doctors completely understand this reluctance.
I'm flattered that they tell me that they respect my opinion and insight.
But when your life is in the balance, you would be surprised just how circumspect and insightful you can become. I think it's as much instinct as it may be intellect.
And now, I must begin to weigh the tough choices.
I just hope it's warmer Saturday than it has been lately. I sure would love to go out and take some photos ...