Dr Kohli visit update

We saw Dr Kohli yesterday morning and he told us that the bone scan showed additional cancer growth in Joe's spine up to T2. We knew that there was additional growth from our visit in September to Dr Amato, so it was not a surprise, but we did find out that at this point there is not involvement with the ribs.
The question that we pondered was whether to let Joe have radiation on his back to help alleviate some of the pain, or a second round of chemotherapy. Because Dr Kohli has not seen any measureable improvement in Joe's condition such as elimination of the ascites, reduction in pain or increased stamina, he does not feel that the chemo is working and opted for the radiation as a palliative care treatment. Joe wants to continue on the chemo path. We talked about the risks associated with additional chemotherapy - fatigue, low blood counts and compromised immune system......but the shred of hope that the chemo may kick in and give Joe some time is the goal that he is looking for. Dr Kohli does not have any experience with this particular cocktail of chemo and we respect his opinion and know his concern for Joe's overall care. My hope is that I can finally convince he and Dr Amato to TALK to one another to ease Dr Kohli's mind as Dr Amato has treated patients - and I have talked with them - on this particular treatment. There's such a fine line to cross here - and sometimes I feel that the doctors have forgotten the patient.
So, today we embark on treatment #2. As I was sitting waiting to see Dr K yesterday, I glanced at the calendar. If we were in Houston Joe would be embarking on treatment #3......
But, at 12:30 we'll enter the clinic, give Joe his pre-meds for the treatment, and then begin. It will take about 4 hours to complete the treatment. On Wednesday he'll go back to the clinic for a shot of Neulesta to help boost his cell counts. I guess these are not available over the counter like his Aranesp is.
Joe is ready for the treatment - he ate a good dinner last night and slept well.

Happy birthday yesterday Roxanne!

love
Vicki, Gina & Tom