2014 Nov 6 10 Stories Above West LA

2014 Nov 6, 10 Stories Above West LA

The Infusion Room at Dr. Eshaghian's office in West LA is uncomfortably warm at 10:30 am in spite of the air conditioning.  The building, 20 stories or so, is constructed of steel and black glass and radiates the  sun's heat inside as though the windows were solar panels.  We switch on the extra fan;  the intense heat is dissipated, and we are more comfortable.  Leland is receiving 2 grams of calcium through his port, a process that will take two hours.  His calcium, platelets and red blood cells are all low.  Infusions, injections and oral meds are all being used to normalize his numbers, but they remain stubbornly low even as his PSA continues stubbornly high.

The staff here is great, and all of them work as a team to make our lives as easy as possible under these conditions.  The nurse Lydia, looking more like a China Doll than a nurse, Mary the PA, excellent at her job, are both Asian.  Tony the pharmacist is Filipino,  ramrod straight, short, takes care of all the meds, ordering and seeing that they are mailed to us at home.  Maria, assistant to the doctors, is Hispanic.  She was responsible for our quickly made first  appointment.  She called Dr. Leibowitz at home and told him he needed to call us "today", not in 4 days when he was back in the office and he did.  She shared with us on our first visit that she had developed cancer while pregnant with her last child, and been advised to abort and start chemo right away.  Dr. Leibowitz saw things differently and saved both her and the baby. We shared tears over that story. Dr. Eshaghian is young, olive skinned, jet black hair, practicing orthodox Jew,  intense, very frank and honest in his patient assesments. Dr. Leibowitz is also a practicing orthodox Jew, probably older than we are, white hair, suit, tie and tennis shoes.  All of them are friendly and willing to do whatever it takes to make treatments and travel coincide for their patients who come from all over the world.

We saw Dr. Bahn on Wednesday morning (after breakfast with Lorinda and Frank-what a pleasant interlude) for the prostate ultra-sound.  Dr. Bahn is also Asian, short, immaculate, does the ultra sounds himself-very specialized. It is hard to find that level of expertise, and so his patients too, come from all over the world.  After the procedure, he meets with us in his office, gives us copies of the pictures he took, explains what he saw and the implications.  He also immediately sends his reports to Dr. E. so they are available as soon as we arrive there for the appointment.

Wednesday after seeing Dr. Bahn, we drove from Ventura to Beverly Hills, where Mary had wrangled an unplanned appointment with Dr. Chris Rose, Radiation Oncologist, highly regarded. He squeezed us in, saying that Mary called him and told him he had to see us, since we could not change our flight times.  He was, like all the others, friendly, knowledgeable, and helpful.  His opinion is the leg pain is caused by a large metastasis in the hip socket, and can be alleviated by one or two radiation treatments.  He found a Radiation Oncologist for us in Vancouver, one of his former students, called him as we were sitting there, and made arrangements for Leland to see him immediately. We have an appointment for Wednesday the 12th.

Dr. Eshaghian is disappointed with Leland's response to treatment.  In spite of 16 treatments of chemo, the triple hormone blockade and "anti-angiogenic cocktail" plus other drugs, it is barely holding the cancer in check. There is one more strategy to try, a combination of Zytiga and Xtandi - at the same time.   He has been on both those drugs, one after the other, but not simultaneously. After that, it will be a matter of doing what is possible to keep the monster at bay, until Leland decides he has had enough-that the treatments are impacting his quality of life more than they are worth. I asked Dr. E for a prognosis, and he told us straight up that Leland had an 18 month life expectancy at diagnosis.  He has been blessed with an extra year over that, and another year might be possible. Of course, it is impossible to tell that for sure, but it is an educated guess.

We are dealing with this as best we can, our faith is undimmed. It is difficult at best, heartbreaking at worst, but we firmly believe God sees, understands all we are going through, and has promised to walk with us everywhere, including the "valley of the shadow of death". He has provided all that we really need in terms of medical care, finances, family and friends, and made our lives possible even though we did not choose this path ourselves.  We also remember reading that when someday we can see the end from the beginning, we would not have chosen any other path than the one we have been led upon.  In the meantime, the struggle continues.