Chemo and PA School

Well I have been told it is time for a little update on Ricky's Blog. As you have already heard, the game plan is to take chemotherapy for one year. Ricky took his first dose of medicine on August 19th and then every night for a total of 5 nights  This date was chosen because it was just inside the 6 week mark since his surgery yet it allows him to take only two treatments while he finishes his last section of classwork. His third round will start just after the end of his quarter exams. He has to take the medicine every 28 days. He takes it for 5 days and then has 23 days off. It is an oral mediciation that he takes but it is still chemotherapy with all of the side effects.

His first dose was Aug 19 (Thursday) which allowed him to take most of the doses over the weekend. He still had to take the last dose on Monday and each night he took it the side effects were worse. By Tuesday morning he was very sick yet he continued his program at Touro University. The week of Aug 23 -Aug 27 was a very rough week at Touro including 4 tests. Ricky was able to take all 4 tests and pass 3 of them. The 4th one he did well enough to pass the course. He said he was a little embarrassed because he sat in the back of the room to take the tests with a trash can next to his desk. Each time he would puke it was a little disruptive to the rest of his classmates......but hey what is a guy suppose to do? If you are on chemo and nauseated and need to upchuck what's a little test or two. Especially if you are in your last section of classwork and passing it means you move on. Fortunately one of the teachers had a little compassion and allowed Ricky to finish the test in her office where he could make a little noise in private.

He starts his next series of chemo this Thursday the 16th of Sept and again he will take it for 5 nights. He met with Dr Haslem and they have increased the dose another 25% to bring him into the most effective range. He had a MRI on Aug 20 and again everything is looking real good. Dr Reichman is letting him get back to some exercise and his fitness routine for which Rick is grateful. He feels tired all the time from the chemo but he feels good.

Ricky is bound and determined to finish this last five weeks of classwork and move on to his rotations with clinical instructors starting in November. Rick we are so proud of you. We had a FHE a while back in which we were talking about role models and heros in our lives. Each family member had the opportunity to mention someone they felt was a real hero in their live. When it was Mitzie's turn she quietly yet with significant emotion said that Rick was her hero...............I agree completely.

Jeff

Chemotherapy it is

After discussing all possible treatment regiments and protocols with Dr Ray Richards it looks like the best option for this tumor would be chemotherapy. Ray has worked very hard on this and was even able to talk with Dr Jackle at the Mayo Clinic who wrote the current protocol for Oligodendromas in the United States. He indicated that chemo only is "done all the time" in their clinic because it works so well on these types of tumors and because they can spare the patient the long term side effects of radiation therapy. They still can hold radiation therapy in reserve if it is needed.

Ricky now has an appointment Monday the 9th in the morning to meet with Dr Haslem. He has accepted Ricky as a patient and is ready to help him with the chemo side of this process. He and Ray have discussed everything and Dr Haslem is ready to begin the treatments that will help Ricky with this next step. The chemotherapy is given 5 days out of every 28 days and would probably be given for one year. It is still a hard regiment but patients under age 40 usually do well with this type of treatment. It is still chemo with all of the side effects of nausea, vomiting, fatigue, body aches, etc. but Ricky says he is up for the challenge. He is going to try to stay in school and work through it. What a great attitude. We just don't know when exactly he will start it. We'll keep everyone posted.

Jeff

Ricky back in school July 20 2010

Good News!

Today July 26 we finally received the results of the test Ricky has been waiting for. It is complicated but the short version is that the tissue shows a gene deletion at the p1 and q19 sites. When these types of tumors show this deletion it is a good prognostic factor. In other words this is the good type of tumor to have if you have a brain tumor. Doctors know that this type of tumor is much more sensitive to chemo and radiation and many studies show a much better clinical course for people with this marker.

We are very pleased about this. In the big studies many patients lived for "extra years" when they had this type of tumor marker. Ricky has an appointment now with Dr Ray Richards on Friday to see what the next step is. There is still a lot to understand and decisions to be made about how to treat this tumor. Much thought, study, prayer and listening to the doctors will go into this next step. Dr Richards will be able to answer some of our big questions and help with the next step. We are lucky to have him as he has now accepted Ricky as a patient.

It is a big important day. This is huge!!!! For Ricky's sake this test today is very encouraging and very needed. He needed a break in all of this. His prognosis has just taken a big step in the right direction. We are all so grateful. I will post a report after our big meeting with Dr Richards on Friday.

Jeff

Ricky Surgery Video

Oncology Visit July 19

Today Ricky, Erika and I met with Dr Ali Chiquar(sp) from Salt Lake City. He comes down and holds a clinic once a month for all of the patients originally seen at the flagship Intermountain Center in SLC. He outlined what we know about the tumor and what the probable treatment course will be. Since scientists are unsure whether chemo or radiation is better most patients get both along the way. Ricky is now considering a protocol to determine which course of action to take. We are still waiting on one tumor marker (test to tell what is happening) to help determine this.

At this point the doctor did an exam and told Ricky he had a very good outcome from the surgery and that he has 4 good things going for him:

1. He is young and healthy and that means a lot with this diagnosis.
2. His diagnosis is an Oligodendroglioma which is better than the more common Astrocytoma.
3. He had a very good surgical resection. The Radiologist is calling it a complete resection but the doctor explained that with this tumor there is always the possibility of outlying cells.
4. There are no neurological deficits in Ricky's situation which is huge as most people suffer with neurological problems.

At this point we are waiting on these protocol papers to decide what the best treatment choice would be, and we are waiting on this one last tumor marker test which has some prognostic value to give Ricky treatment course guidelines.

The bottom line we will probably start chemo and/or radiation or both in about 6 to 8 weeks from the time of surgery. They want the original surgery to heal.

Ricky is doing great and is in great spirits. For Family Home Evening tonight we took out half of his staples. Erika will take out the other half in two days. They are going to Vegas in the morning and he will be in class Tuesday. We all wish you great luck Rick.

Jeff

Well Wishers From Family & Friends

Ricky's mom Lori and Uncle Jim and Brother Kasey


Dad Rick and sister Syd


Erika and Brother Kasey


Ricky with Ryder


Ricky helps shave his PA friends heads


Some of Ricky's Las Vegas' PA Class. They came to visit Friday July 16th. To help support Ricky they shaved their heads.