Outlier or Miracle?

Yesterday Michelle and I went to see her oncologist, Dr. Marschke. We learned a lot and got some particularly good news about the doctor's expectations for Michelle.

The main topic of the moment was ascites: fluid accumulation around Michelle's intestines. As you probably have read, about every 10-12 days for the last several weeks we've had to take Michelle for a paracentesis to draw off the accumulated fluid. She had procedure #5 this past Monday - they withdrew 2 liters of fluid, about average so far.

Laboratory analysis of the fluid has shown that it's not due to infection, and since it doesn't contain any malignant cells which would indicate cancer as the source, it's a something of a mystery where the fluid is coming from.

We did learn a little more about what to expect: once it starts, it rarely stops. Dr. Marschke told us to expect the need to have fluid relieved to occur more and more often, up to twice per week. We discussed a couple of options to drain the fluid without paracentesis, and have an appointment with a surgeon on Friday to explore the more promising option.

Here's the good part. We asked Dr. Marschke about Michelle's life expectancy. He said that first we have to understand that Michelle's survival so far is amazing. She has lived 5 standard deviations past the mean life expectancy for patients with cholangiocarcinoma (6 months). That means she is an extremely rare case, the extremest of outliers.

In my book, that's a miracle. Here we are 18 months after Michelle first fell ill, and she's still going strong. Dr. Marschke went on to say that in addition to surviving well past any reasonable expectations, the has been no evidence of cancer activity in her body for many months now. The tumor marker, antigen CA19-9, has been bouncing around the 400-600 level for the past 4 months. She's still tolerating the chemotherapy treatments well. She has experienced no fevers, unexplained bleeding, neurological impairment or any other common side effects.

The bottom line: he expects Michelle to live many more months, perhaps even 1 or 2 more years.

Wow.

Call it a statistical anomaly. Call her an outlier. Call it good luck. Humbug!

Prayer. Works. Hallelujah! Amen!

Please understand that heading into this appointment, I was prepared to hear the worst. I was half expecting that the ascites were a sure sign that the cancer was on the march, or that her organs were breaking down, or that something really, really bad was happening. I never expected him to tell us this. I'm still floored.

And ready to make some plans.

You see, when you've been living day to day for as long as we have, you kind of stop making long term plans. When you never know what nasty surprise is coming just around the next corner, you start to get skittish about planning something for next month. Or next week.

Well, I'm here to tell ya I'm doggone sick and tired of living that way and it's way past time to do something about it! So we're going to Vegas, baby! at the end of this month.

And then for the 4th of July we're going to San Francisco, Seattle, or Vancouver.

And it'll be NYC or Washington DC for Labor Day, and maybe a 4 day cruise when the weather starts getting cold again.

And we'll deal with what happens when it happens instead of sitting around waiting for the other shoe to drop.

In other news...

Michelle's voice still hasn't returned, so she has an appointment next week with the Ear, Nose, and Throat doctor to explore options for fixing her paralyzed vocal cord.