August 7th

We had two appt. yesterday.  The first was with Dr. Trang the ear specialist.  Because of the nerve damage (or Bells Palsey) he was able to confirm the diagnosis of skull based osteomyelitis (SBO).  Essentially this is a really bad infection in the boney areas around Dad’s ear.  He made an appt. to see another infectious disease specialist, a one Dr. Hydari (sp?), who he thought could do a better job of picking out the antibiotics.  Because of this infection we have to forego anymore chemo treatments for at least 4 weeks.  The antibiotic treatment will likely be about 8 weeks.

Dad was very depressed with this news and it was tough to see his reaction.  He didn’t even want to go to the afternoon appt. with Dr. Nguyen.  Bill, Tom and I kept that appt and had a good chat with Dr. Nguyen.  He led us to believe that the chemo is a corrective treatment not a palliative one.  In other words, we are not pursuing the chemo just to make Dad more comfortable.  There is a good chance for long-term recovery from this type of lymphoma.

Tom and Bill take Dad to see Dr. Nichols today.  They will look into draining fluid from not only Dad’s thoracic cavity but abdominal cavity as well.  We want to know if the fluid in Dad’s abdomen is having an effect on his appetite and digestion.

Dr. Trang gave us a prescription for a stronger pain killer and Dr. Nguyen gave us a liquid to stimulate Dad’s appetite.

Here are some of my thoughts (hope you don’t mind):

If you had your choices of diseases, the lymphoma might be near the top.  As cancers go, it doesn’t sound too bad.  On the other hand, bacterial infection that cause skull based osteomyelitis?  Well, that would be at the very bottom of my list.  It’s hard to get and hard to get rid of.  I’m sure like many of you, when told Dad had cancer and an ear infection, our first thought would have been that the cancer was more troubling.  This ear infection is nasty and now it has halted the chemo.  The chemo inhibits his immune system for three weeks.  After that, according Dr. Nguyen, it bounces back.  The bacterial infection has just retreated farther and deeper into his body making it much more difficult to attack.  We can’t stop the treatment for the ear.  It will cause unbearable amounts of pain as we have already seen in just a short time.  To me that path is clear.  Dr. Nguyen will tell us when he’s cleared for chemo again and asked that we give the antibiotic treatment two weeks before we do another assessment.

Best-cased scenario:  Dad responds to the new antibiotic treatments well enough for us to get three or four rounds of chemo, the lymphoma retreats, and then we are just fighting the war on one front – the ear.