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Clavicle healing, last carboplatin infusion coming


LexieCat

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Went to the ortho surgeon this week for a followup on my broken clavicle. He said it's healing--slowly but it's getting there. He wants me to stop wearing the sling at home, for the most part (so my shoulder/arm don't get too stiff) and wear it only if I'm going out or needing the support. With my next infusion on Friday my oncologist is going to add the zoledronic acid (in lieu of the Boniva I've been taking for my osteoporosis), which we hope will help the healing and strengthen the bones.

The upcoming infusion is supposed to be the last with the carboplatin, after which we switch to Alimta & Keytruda for maintenance. 

The odd thing, though, is that I just got a notice to schedule a scan for mid-January. It seems weird to be switching to maintenance BEFORE I've had another scan to see how I'm doing. Maybe there's a break in between the infusions? I'll ask my NP about that on Friday (I'm seeing her for this visit rather than the oncologist). 

 

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Lexie,

I confess, I'm not well versed on the standard of care involving combination chemotherapy (Carboplatin, Altima & concurrent Keytruda) and the circumstances leading to changing treatment. Like you, I think a scan and results assessment would be the mechanism for moving to a maintenance posture.

Oncology NPs are a new thing to me. I know they and PAs are common in today's general practice medicine community. I've not encountered them in my oncology treatment experience. But I do recall how helpful and informative my chemo nurse was to me during treatment, particularly in mitigating side effects. I think zoledronic acid is also called Zometa, and this formulation has been commonly used to shore-up bones for those with bone mets. My reading suggests it is very effective and I hope it works for you.

Stay the course.

Tom

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I just dug out my first notebook (now I’m on my second!) to find the notes about the triplet.  There was no break in treatment, once the Carbo was completed we were to roll directly into the Alimta/Keytruda infusions every three weeks.  I was a little surprised about the scan schedule which was to be scheduled for every six to eight weeks.  The scans seemed to be scheduled  per a time frame as opposed to the infusions.  
 

 

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Yup, Zometa is the brand name. My oncologist was inclined to wait till my current supply of Boniva (once a month pill) runs out in Feb, but I reached out to my PCP (who prescribed the Boniva and was aware of my fracture) and she agreed I should start with the zoledronic acid sooner rather than later. My oncologist was cool with that. I normally take my Boniva on the first of the month, so they said they'd start the zoledronic acid with this infusion. 

My NP is the person with whom most of my communication happens. She is terrific and the way things have worked is my appointments alternate between seeing her and seeing the oncologist on the same day I have my infusion. I've been seeing the oncologist any time I've had scans done. 

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Lexie, glad you are on the mend! Hope your eye is healing too. 

Could it be that January is the earliest your insurance co. would approve? I can't think of anything else. 

I have monthly phone or virtual visits with my oncology NP for blood work results and to check on any symptoms, and then virtual visits with my oncologist after quarterly PET scans. This works for me. 

Be well! 

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Just now, Rower Michelle said:

I just dug out my first notebook (now I’m on my second!) to find the notes about the triplet.  There was no break in treatment, once the Carbo was completed we were to roll directly into the Alimta/Keytruda infusions every three weeks.  I was a little surprised about the scan schedule which was to be scheduled for every six to eight weeks.  The scans seemed to be scheduled  per a time frame as opposed to the infusions.  
 

 

I got my first scan right before my first infusion (every three weeks), and my second one right before my third infusion (which would be roughly six weeks later). So it seems like the next scan should be roughly six weeks after the last one, and before the next infusion. But I'll ask. If I recall correctly, I got the notification to schedule but the oncologist ordered the scans the visit before, so this might just be some kind of automatic notification.

The other reason I'd like to have the scan sooner is that my daughter plans to head back to Colorado on December 12 or 13. I'd feel better having the results of the scan before she leaves.

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7 hours ago, Judy M2 said:

Lexie, glad you are on the mend! Hope your eye is healing too. 

Could it be that January is the earliest your insurance co. would approve? I can't think of anything else. 

Yeah, my eye is much better, as long as I remember to use the gel before bed. It's a bit annoying because I like to read or watch TV before falling asleep and the gel blurs my eyes so it's difficult to see.

I don't think they submit the request for approval until the scan is scheduled, so I tend to doubt that's the issue. I have a feeling it's just that they put a scan into the system and that was what it spit out. I'll straighten it out tomorrow.

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I read something somewhere about scans generally being every 6 weeks for the first 18 weeks, then every 9 for the next 34.  Mine are a bit out of that timing since I was hospitalized with the stroke and they did scans during that time, plus at the last infusion (#3) because it was already scheduled.  I'm scheduled to have another on Tuesday as well as yet another brain MRI.  My next infusion (#4) is Wednesday. You skipped ahead of me, Terri, while I dealt with the colitis and 18 days of prednisone 😊, so I'm two weeks behind schedule now.  

Susan

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7 minutes ago, Sabacat said:

Scans generally being every 6 weeks for the first 18 weeks, then every 9 for the next 34.  

 

Suzan: You are correct except for the "next 34" because that depends on the success and failure according to my oncologist. I also asked about when he will discontinue Alimta and the answer was that depends on how long you tolerate it and also the red blood cells count.

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15 minutes ago, Sabacat said:

I read something somewhere about scans generally being every 6 weeks for the first 18 weeks, then every 9 for the next 34.  Mine are a bit out of that timing since I was hospitalized with the stroke and they did scans during that time, plus at the last infusion (#3) because it was already scheduled.  I'm scheduled to have another on Tuesday as well as yet another brain MRI.  My next infusion (#4) is Wednesday. You skipped ahead of me, Terri, while I dealt with the colitis and 18 days of prednisone 😊, so I'm two weeks behind schedule now.  

Susan

Well, I BARELY squeaked by--hopefully you'll feel good enough to have a bit of Thanksgiving dinner. I normally don't make turkey/etc. when I'm cooking for just me--I think the last couple of years I ordered crabcakes from my favorite seafood place. But since my daughter's here, I'm making a turkey breast with a very few side dishes. 

We were just laughing about the Thanksgiving we had when the kids were little and living with their Dad but spending Thanksgiving with me. We were ALL in Colorado then, and I worked at a legal research place called Shepard's (which is now Lexis/Nexis). Shepard's had a deal where they distributed turkeys to all the employees. This particular year, they screwed up and bought everyone Kosher turkeys. The thing about Kosher turkeys is that they are "minimally processed"--meaning when I took it out of the package to prepare it, it was covered with pinfeathers. I tried to research how to remove them and was getting suggestions like singeing them off or scraping them off. I tried using a candle to singe and wound up dripping wax all over it. Then I tried to scrape them off but wound up scraping big holes in the skin. By the time I was done, the turkey looked like it was attacked by a plague of moths carrying candles. I had to hide it in the kitchen to slice it so as not to ruin anyone's appetite. It looked pretty damn pathetic.

So I figure whatever else goes wrong with dinner, that will be a tough disaster to match. 

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We'll actually be driving back to GA from Duke on Thanksgiving Day (hoping the traffic on I-95 will be better that way than on the day before), but I'm planning to do a "normal" Thanksgiving dinner for the two of us on Friday.  I never have a lot of side dishes because, well .. there're only 2 of us, but Andy would be disappointed if he didn't have my bourbon walnut pumpkin tart.  That's his reward for 13 hours of driving round-trip, I guess.  And I'll still be on the steroids for Friday and Saturday and won't have to cook after that.  😊

ROFL at your turkey story!!!  I actually remember Shepard's (was a paralegal very early in my previous life) but never heard of a kosher turkey!!  Too bad you didn't have the internet readily available back then.  😁😁😁

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Actually, I'm pretty sure I did try to look up a solution for the Kosher turkey online--that's where I found the suggestions about singeing and scraping. I'd bought a computer around that time (1998) and had my trusty dialup modem and AOL. 

And I remember looking up case law in those big, red books, all during law school and the first 15 or so years I practiced law. My job at Shepard's was to read cases and decide what letter to put on the citation ("o," "r," "d," etc.). The job was called "letter editor" and I was on the Federal Team, reading the world's most boring intellectual property opinions. We were in the process of transitioning to online legal research. That job drove me back to NJ. The people/company were nice, but the pay was lousy and the work mind-numbing. Shepard's (originally Shepard's Citations) had its HQ in Colorado Springs--I remember as a kid asking my mom what they did there, when we drove by their building with the sign out front, and the best we could come up with was that it printed citation books for cops who gave out tickets. Little did I know!

Oh, and you'll have to PM me your tart recipe! I'm not a huge pumpkin pie fan (for plain pumpkin pie) but that sounds awesome!

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Sabacat,

I'll drive 13 hours for bourbon walnut pumpkin tart!

I've also not heard of a kosher turkey Lexie but have dealt with poultry pin feathers! My favorite way is to simply skin the bird. We never eat the skin anyway and brining keeps moisture in the bird. Martha is planning a pumpkin cheesecake with lemon curd topping if I'm good. So, I will be on my very best behavior!

Thanksgiving is my very favorite food group--what a holiday, what a concept! OBTW: who wants to share their favorite stuffing (dressing) recipe?

Stay the course.

Tom

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I've got a good one for cranberry stuffing that I got in a little pamphlet-sized cookbook at the Cranberry Festival in Chatsworth, NJ. Let me know if you want it--I'll have to type it into a doc.

 

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Just tried to send you a link to the original recipe from Fine Cooking magazine but got a message that "Lexiecat cannot receive messages" (????) so posting the link here: https://www.finecooking.com/recipe/bourbon-pumpkin-tart-with-walnut-streusel.  

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Great story, Lexie. In the northeast, Empire is the biggest producer of Kosher poultry. They are always pre-brined and very good. I never experienced feathers, lol. I bet my grandmother would have known what to do about them (if she were alive). 

I have already ordered our Denny's Thanksgiving takeout dinner. We did it last year and it was great. 

And I did some Shepardizing while I was getting my paralegal certficate in the 1970s but luckily never needed it after that. 

Hope everyone enjoys safely! 

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43 minutes ago, Sabacat said:

Just tried to send you a link to the original recipe from Fine Cooking magazine but got a message that "Lexiecat cannot receive messages" (????) so posting the link here: https://www.finecooking.com/recipe/bourbon-pumpkin-tart-with-walnut-streusel.  

Ugh, that happened to me once before--I maxed out on storage space in my PM inbox. Cleared it out--thanks for letting me know, and thanks for the link for the recipe!

 

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Suzan: There recipe is longer than my radiologist report. However the Bourbon makes it more interesting. Somebody must have sabotaged the mail system so you can share it with the rest of us😉

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It IS long, but I find it a LOT easier to make than the traditional pumpkin pie that I used to make.  MUCH easier to make crust for a tart than a pie, for one thing. 

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My stuffing isn't nearly as complicated as the tart. 😁   I just use bagged Pepperidge Farms Cornbread stuffing and add half a diced Vidalia onion, 1 package of thick-sliced microwave bacon (cooked till very crisp and broken into small pieces) and 1/2 cup of chopped pecans.  

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