I spent a decent part of my morning staring at images of Dave’s liver. The radiologist and ultrasound tech were having difficulty determining what might be live tumor and what were areas that had previously been treated either surgically or with the Sirspheres. As the doctor put it, “We can see that it is abnormal tissue. We are just not sure what makes it abnormal.” Eventually they brought in a second ultrasound technician and more equipment. This additional equipment allowed them to import Dave’s latest CT scan onto the screen, so that as they moved the transducer around, the CT images would also shift allowing them a comparison to what they were seeing via ultrasound. I don’t mean to brag but I was able to see Darth Vader, a horseshoe crab and The Grimace in there.
There were a lot of people in the small room. There was someone from “research” who arrived with two styrofoam boxes in which to carry the biopsy samples. She spent much of her time pacing in the hallway. There were three doctors from pathology who were ready to look at the samples under the microscope to determine if they were adequate. There were two radiologists to do the actual biopsy, two ultrasound techs and a nurse. Oh, and me. I was in there. Once a promising area was located via ultrasound, they were ready to go. Dave was given preemptive Oxycodone as the procedure promised to be pretty uncomfortable. They also numbed his skin via injection. As the big needles were coming out, I got nervous and excused myself out into the hallway. I couldn’t believe that no one asked me to leave. I kept waiting for my exit cue, but it never came.
I sat in the waiting room and sent a few texts and responded to email. A very short while later, I saw the doctor? from research walk by with her styrofoam boxes. I figured they must be done and was amazed at how quickly they were able to finish up. Minutes later I found out why. Apparently they tried to approach the tumor location from one angle closer to Dave’s belly button but they weren’t able to get to the spot. So they tried again from his side – between two ribs. This caused Dave to yell out in pain. At that point, they determined that they would not be able to do the biopsy. The radiologist explained to Dave that because it was for a clinical trial they were not going to put him through all of that pain to get the tumor sample. If it were a procedure he needed, they would have pressed on.
Our understanding of the clinical trial was that in order to be eligible a biopsy had to be attempted. If it was not successful that would be okay. We weren’t entirely sure if what was done today would count. On the drive home, Dave got an email from Dr. A reassuring him that they would still be able to move forward with the trial. So our little story had a happy ending.
When we left off, Dave was waiting to hear about scheduling a biopsy. Before we left Hopkins on Wednesday, the nurse confirmed with us that the best number on which to reach Dave is his cell phone. When I got home from work yesterday there were several messages from the biopsy clinic on the home voicemail. Of course, when Dave tried to call back, it was too late in the day. This morning I ran a few errands after dropping Parker off at school. When I got home there were two more messages from Hopkins. Clearly someone did not get the memo that the cell phone was the number to call.
Dave got a hold of a scheduler in the biopsy clinic who said they wanted to schedule a liver biopsy. Because Dave had the Sirspheres treatment this summer, he wasn’t sure there was live tumor to biopsy and wanted to make sure that they were also looking at his MRI. The scheduler said she would speak to one of the doctors and call him back. In the meantime, Ellen called. She told Dave that they were unable to biopsy his lungs because the location of the lung tumors would make them dangerous to biopsy. She said that Dr. A was going to consult with the biopsy doctor, and they would have an answer for us by Monday. Ellen also mentioned that in Dave’s labs from Wednesday his CEA was up to 150. Although it wasn’t altogether surprising news, it wasn’t great to hear. It has tripled in the last month. I know I have mentioned before that the CEA isn’t the best test and the numbers can go into the thousands. 150 alone isn’t necessarily anything to panic over. However, what we know about it as it relates to Dave is that any time it has been on the rise, he has had tumor growth in his body.
Not expecting to hear anything more today, Samantha (who came home today!!!) and I headed out to grab a bite to eat. When we returned, there was a message from both the biopsy clinic and Dr. A. (Why aren’t they using the cell phone number?!) Dr. A’s message was something along the lines of “Call me back if you want to or I will talk to you at your appointment on Monday.” Huh? What appointment? So, I called Dave to see if I had missed something. He had no idea what I was talking about and began calling both offices back. Unfortunately he wasn’t able to reach anyone. He emailed Ellen who responded telling him that she could see that an appointment had been scheduled for Monday at 11:30 at the hospital. Dave logged into his patient portal and saw that it was for a liver biopsy. Ellen included an attachment in her response which gave the necessary details for an endoscopy. The endoscopy would be for a lung biopsy. Having had no contact with anyone from the biopsy clinic and playing phone tag with Dr. A means that we will drive up on Monday to Hopkins and pray that they are expecting us and that Dave can indeed have the liver biopsy. Here’s to hoping.