We had originally planned to stay in California through Thanksgiving and return home on November 30th. We extended our stay so we could be there for "chemo day" and the recovery days, and because it's hard to leave him when he's not feeling well.
Bobby ha
d his appointment with the audiologist. He has "significant" hearing loss in the high frequency range which may or may not be permanent. That loss is caused by the Cisplatin. His oncology team has recommended a total of three Cisplatin infusions during the seven week radiation treatment. He could choose to skip these additional chemo treatments all together (he's already had one) or they could reduce the dosage depending on how he's feeling. It takes several days to bounce back from having chemo and with the addition of radiation, recovery is slower than before. The decision to have chemo will be discussed with Dr. Eisenberg. In anticipation of receiving more chemo and not feeling great over the next few days, he decided he wanted to head to the beach on Sunday afternoon. His favorite beach.....Point Reyes. It was beautiful.... windy and a bit rainy..... but beautiful. This is part of the description from the Point Reyes website "thunderous ocean breakers crashing against rocky headlands and expansive sand beaches to its open grasslands, brushy hillsides and forested ridges" Very accurate description. The 
waves were huge.There weren't a lot of other people around which made it the perfect place to walk and think and be thankful for this time and enjoy God's beautiful creation with our son.
d his appointment with the audiologist. He has "significant" hearing loss in the high frequency range which may or may not be permanent. That loss is caused by the Cisplatin. His oncology team has recommended a total of three Cisplatin infusions during the seven week radiation treatment. He could choose to skip these additional chemo treatments all together (he's already had one) or they could reduce the dosage depending on how he's feeling. It takes several days to bounce back from having chemo and with the addition of radiation, recovery is slower than before. The decision to have chemo will be discussed with Dr. Eisenberg. In anticipation of receiving more chemo and not feeling great over the next few days, he decided he wanted to head to the beach on Sunday afternoon. His favorite beach.....Point Reyes. It was beautiful.... windy and a bit rainy..... but beautiful. This is part of the description from the Point Reyes website "thunderous ocean breakers crashing against rocky headlands and expansive sand beaches to its open grasslands, brushy hillsides and forested ridges" Very accurate description. The 
waves were huge.There weren't a lot of other people around which made it the perfect place to walk and think and be thankful for this time and enjoy God's beautiful creation with our son. 
His next round of chemo had already been scheduled for Monday, November 29th. After discussing the options with Dr. Eisenberg and going over the hearing test results, the decision was made to have the chemo but to reduce the amount by 30%. Over eight hours later both chemo and radiation were done for that day. 
His radiation has been expanded to include his sternum, spine at L5 and the sacrum. Radiating those areas requires a team to "shrink wrap" him in place with the use of what looks like a shop vac. Apparently it's a twenty-five thousand dollar shop vac.
His radiation oncologist, Dr. Miyawaki (a very gentle, kind man) spent a lot of time with us explaining every detail of the operation. It's a big production to get him ready. The radiation on his head and neck is IMRT, the radiation on the other areas is Stereotactic body radiation therapy (SBRT). The technology used in SBRT allows external beam radiation to be delivered with pinpoint accuracy. One of the benefits of the improved accuracy is that treatments can be completed in a short period of time. Typically, SBRT consists of 3 to 5 treatments carried out over the course of 1 to 2 weeks. The precision associated with SBRT simultaneously helps reduce the dose of radiation to normal tissue around a tumor, thus helping to reduce side effects for patients (http://www.umgcc.org/radiation_oncology_program/sbrt.htm). We're all in favor of reducing the side effects. His neck is very red and itchy after a couple weeks of radiation. Hopefully the other areas will fare better.
The days following chemo were rough. Even though the medical team has recommended the additional Cisplatin, they don't have any hard evidence that it is any more effective than not having it. With that in mind Bobby has decided not to have the third infusion of Cisplatin. He's tired and tired of not feeling well. He's been so strong and positive and doing everything he can to be well and stay as healthy as possible. The end of treatment is near and not a day too soon.
We had to head home for a few days and will return on December 19th. We'll be with him through Christmas and hopefully we'll be there for the last day of radiation which should be on the 27th or 28th. We want to celebrate that with him. He is passionate about life and has been passionate about getting through this treatment to get back to being healthy. He always has a positive attitude and is pleasant to the medical personnel. He says they probably see enough people not feeling well and being grumpy. He wants to bring a little cheer to their day. Isn't that great. I love that about him. We're praying for him to have good days.
"rejoicing in hope, patient in tribulation, continuing steadfastly in prayer;" Romans 12:12
