Oh, my… it is October already. Happy falling leaves, cooler nights, fading flowers, longer sleeves, simmering stews, and pumpkins in the oven time of year!

Went to see Dr. Picozzi today. Darrel had blood drawn for platelet test and then we waited a while to see Dr. P.

He quizzed Darrel on how he felt and what might have changed since last time. Darrel is always like, “I’m fine, Nothing is different.”

I told the doctor that I had Darrel stop taking the metoclopramide because he was sweating profusely (when he is usually cold) and also I noticed him twitching more than usual when sleeping.

One of the severe but rare side effects of the drug is tardive dyskinesea (try saying that fast even once!) Tardive dyskinesea is abnormal muscle movements, mostly in the face. Can be irreversible if not caught quickly. Dr. P said to cut the dose in half.

Darrel’s platelets had only gone up to 78 and they need to be above 100. We asked the doctor what the options were for standard of care with or without the study. The doctor told us we had 3 options:

1. Wait until next week to see if his platelets come up to where they need to be for the study. That would still depend on them getting the radiologist to ‘change the wording’ on the CT scan results regarding the fluid in his abdomen and pelvis. His platelets have gone up 13 since last Thursday ,so it is conceivable that they will be at the required 100 by next week.
2. Go into the other study that combines Gemcitabine and an antibody that is some how radiated. There is a 2/3 chance for Darrel to get the treatment and a placebo.
And, finally, if he doesn’t go into either study,
3. There is another chemo treatment that includes an oral that is supposed to make a difference in how the chemo hits the cancer cells. It has shown some success. Makes me wonder if we shouldn’t have been trying that for the last 2 months.

The doctor specifically asked Darrel what he wanted to do and Darrel wanted to see if his platelets come up next week so he can get into the study.

So, we have an appointment on Tuesday morning when we will make a final decision.

Darrel has definitely felt better today and has barely even taken a snooze. So, I am thinking the full dose of the metoclopramide was making him sleepy/comatose along with the higher pain meds. We shall see how he is tomorrow.

Courtney has continued to be the wood gathering, cutting, splitting king. He found someone who has a splitter. He went down to Federal Way tonight to get it and the truck hitch wasn’t compatible with the splitter trailer. So, maybe tomorrow.