Monday, July 30, 2007

A theory of chemo relativity

To say that yesterday and today were good days would be too simplistic of a statement without giving some thought as to what makes a good day when you are undergoing chemo treatments. You see it really is relative to your experience.

Once you consider what goes into making a good day vs. a bad day, you get a whole different outlook. And not just on the one day, but on your life as well. Seems a fairly heavy statement I know, but I am noticing a difference on how easy certain things will roll off Nancy's back or my own for that matter. But that is getting a little ahead of what I was trying to say...

It's about choosing to look at the glass half full and not half empty. (I know! I promise it's the last time I'll use that phrase.) It's about appreciating the fact that you can walk half way around the block even though you could walk miles a few months ago...

So, I hope you get the picture. Each day a little better, a little stronger. This is the "good week." Next week, well we wont' go there - it's next week and today was a good day...

xoxo

Saturday, July 28, 2007

Up, Down, All Around

That pretty much describes day 4 since Nancy's last treatment. The day started out well but presented some challenges you could say. I mean, we are talking cancer and chemo therapy here, not the flu or a tooth ache...

One of her favorite phrases seems to be, "What is wrong with me?" As if she didn't know. Or better yet, she does know but either forgets or thinks the way she feels sometimes is just going to go away if she could just find that one magic fix. I just keep reminding her that she is a cancer patient and that it will get better. Maybe not when she wants it to get better, but it will get better.

This is an interesting period for some not so obvious reasons. Like I wrote yesterday, the wind's stopped and all seems calm at first. But underneath that "calm" is some very real unrest - physical and emotional.

The biggest physical aspect seems to remain food. Either finding things that actually taste good or being able to eat enough once you hit on something. And it's about remembering to eat before she gets too hungry. It's like pain management - you stay ahead of it before it gets to be too big of a gorilla.

Then there's some more subtle things that she has to battle right now, including restlessness and an inability to concentrate. We were talking today about the fact that maybe she tried to do too much yesterday and today, and that her stomach pain and nausea tonight were a direct result of that. So we thought that tomorrow she should just take it easy.

"But what do I do all day?"
"Why don't you try just reading the paper..."
"I can't read, my eyesight is all off right now."
"Okay, then we watch TV and movies all day. Listen to some music."

We joke that she is sometimes a better patient than at other times. But through it all, I am so proud of how she's handled it. I will admit that she scares me when she begins to doubt her ability to finish the treatment. I probably shouldn't be writing this - but what the hell - you're all part of her recovery now. I go back to what I said a minute ago, "It will get better. No one can say exactly how or when, but it will get better. You will not always feel this shitty."

You feel so helpless, so powerless to fix it all. The only tools I am left with are reassurance, some soup, a glass of lemonade and a back rub. You try to deal with each day as it unfolds.

So, enough of that. On to another angel since it's been a while. ( I need to take more pictures next week.)

Meet Nurse Alicia. Alicia is the quiet, but oh so efficient type. The kind you really want in your corner when the you-know-what hits the fan. Not only does she really know her stuff, she has a real calm assurance about her that puts you at ease when in her care.

So, lets' see what Sunday has in store ;-)

xoxo

Friday, July 27, 2007

"Ain't it grand the wind stopped blowin'?"

For those of you not familiar with the phrase, imagine a family coming out of a storm shelter to view the wreckage of a tornado and dad says, "Don't see anything the matter here, Ma. Ain't it grand the wind stopped blowin'?."

This is sort of how I have been feeling the last two days about Nanc's condition. The treatments are over for another 10 days, no more trips to the hospital, no hydrations, no needles, no major nausea - basically the wind has stopped blowing.

However, there are still certain effects of the chemo that would be easy to overlook. Let's see, there's the neuropathy, the hair loss, the totally wacked out taste buds, the fatigue, the inconsistent bodily functions and more if I could take the time to catalog them all. It would be easy to let up on our attention to these and to what we need to do in order to lessen them for now and for future treatments just because she's feeling a little better.

Diet, exercise, hydration with electrolytes, and lots of rest over the next ten days and the next round will be that much easier. Especially if combine these things with everything we've learned over the last 5 weeks.

It's all about little steps. We're not talking about a 14 oz. porterhouse, mashed potatoes and cheesecake followed by a 5 mile hike. It's enough that the oatmeal tasted good, (she ate a whole bowl along with a couple of slices of a fresh peach,) walked half way around the block, and did it all without feeling like she was going to puke. And she was able to actually put in a few hours of work.

It's the little things that give hope - that make her feel like "Hey, maybe I can get through this thing!"

xoxo

Wednesday, July 25, 2007

One Third of the Way Through

"Is the glass half empty or half full" would be another way to phrase the thought. Two cycles down and four to go.

"One third done," I keep saying.
"Four more to go," she says.
"One third done," the nurse says.
"Ugh, four more to go," she laments.
"One third done," Dr. Lang says.
"One third done," she finally says.

What a team.....

Nanc had quite an appetite last night, however short lived it turned out to be. Some of the wierd tastes were back this morning. The Kashi waffles were a miss as was orange chicken at Panda Express. Usually one of her favorite things and it was just bleh. (You need to say Bleh out loud as you read to get the full effect.)

We are back today for hydration and the Neulasta like I wrote yesterday. One more hydration tomorrow and we are looking to have maybe a week of fairly decent days next week. Keep your fingers crossed....

As we sit each day at the infusion center, we've gotten good at spotting the newcomers a mile away. I am sure it's exactly how we looked 5 weeks ago. For starters, everyone has hair and it's difficult to tell exactly who the patient is among the posse members when they arrive.

Then there's the deer in the headlight look. That look of pure fear of the unknown. Like jumping off a ledge with no visible safety net. But you come to learn that the nurses, the aids, the schedulers, the pharmacists, the crew that changes the sheets between patients, the IT techs who keep my wireless connection up and running, the clerks who keep all the records in order, and last but not least, your doctors - these are your safety net as you wind your way through that fear until it becomes a routine.

It's become a routine for us and the new ones are easy to spot now. You almost want to run up to them all, give them a big hug and tell them that it's going to be okay.

Nanc has already put her name on a list of patients to be called by women who want to talk to someone going through treatment. Who knows what's in the wind when this is all said and done...

xoxo

Tuesday, July 24, 2007

"I wonder what a normal life would be like..."

Is what Nancy said this morning as we were driving down Ventura Blvd. on our way to the cancer center. It was one of those moments when we both had the same exact thought as we were watching all the people going about their business at 7:30 in the morning. (That's one of the side effects of being together for 30 years.) The cancer world makes you forget what your old life used to be like pretty quickly. We were both in agreement on that little observation.

However, it seems that we are in some disagreement on how she did last week in terms of the chemo. I am of the opinion that she handled this round much better than the first time. Nanc has a different opinion because it was still very difficult on her physically and emotionally. For a third perspective, Dr. Lang confirmed that this round was like night and day compared to the last round. She was severely dehydrated three weeks ago, hadn't eaten or drank anything in days, and was so weak she could barely walk. We even had to delay her treatment for 2 days.

I won't deny that it was hard for her because it really was. Sunday and Monday were the worst of them all. Nothing tasted good, it was hard just to drink. Not that she couldn't keep things down, she couldn't get anything down. The mere thought of certain things made her gag. And forget about tasting or smelling things - even water smelled funny.

It's really hard to see someone you love so much have to go through something like this. Some days, it takes all your energy just to get even so you can stay positive and keep up the fight. Tears seem to be stuck at the back of your throat and can start flowing for no reason. And the only thing that tastes good to you is vanilla ice cream. Am I having sympathy side effects? More likely it's the stress of being a care giver, a position I was will to take on but had no idea how hard it can be. I am not feeling sorry for myself, don't get me wrong. I am just going back to our main theme this morning for a second.

However, no matter what Nancy says, she still did a lot better this time than last time. Besides, you can't trust her opinion right now - she has chemo brain - and I have the keyboard...

We are at Cedars today, getting some hydration, waiting for the blood work to come back so we can start the IP Taxal. She's feeling better right this minute, sitting up in bed, chatting on the phone and nibbling on a pbj sandwich. But even that was "mealy" she said so she's sticking with an orange. Then it's on to chocolate pudding to see how that goes. Sometimes we try 8 or 9 things until we hit on something that works.

Her blood work shows a slight drop in white blood count, she's a little anemic and has a lowered potassium count, again. So, along with the chemo today she will get a shot of Aranesp for the red blood count and more potassium through the IV. Tomorrow, along with more hydration, she will get something to raise her white blood count called Neulasta.

And if you want to read and listen to another perspective on what the world of cancer can be like, there's a great blog on NPR written by Leroy Sievers, a real writer, suffering from brain cancer. He also produces weekly podcasts that are broadcast on NPR. Yesterday's entry "Cancer Doesn't Care Whether You Want to Go" is worth listening to or reading. There's a link to the audio on the site.

If you don't want to read through his blog, here are two of my favorite quotes that I related to when I was browsing around yesterday:



"After that day, your life is never the same. "That day" is the day the doctor tells you, "You have cancer." Every one of us knows someone who's had to face that news. It's scary, it's sad. But it's still life, and it's a life worth living. "My Cancer" is a daily account of my life and my fight with cancer."



"When I was first diagnosed with cancer, when the doctor looks at you and tells you that your old life is over, that you're about to enter a strange and terrifying new world, your brain is screaming, "I'm not going, I'm not going." You only have a few seconds to process the doctor's words, and then, whether you want to or not, you're going into Cancer World.


"And at each fork in the cancer road, you scream those words to yourself, over and over again. Starting chemo? I'm not going. Brain surgery? I'm not going. Radiation, Radio Frequency Ablation, Cryoablation. Verterbroplasty? I'm not going, I'm not going, I'm not going.

"Except that you know you are. Even though that next step is going to be scary, probably painful, you know that you're going to go. You don't really have a choice."

"Sometimes I try to fool myself into believing that I have some control over what happens to me too. But I know better. Even when you have a pretty good idea of how the battle's going to turn out, sometimes you have no choice. You get out of the helicopter and hope for the best."



It's now 2:00 and she is almost done with the chemo for today. She had quite a bit of difficulty today with joint and limb pain. It was explained by the nurses as a result of the low potassium and a side effect of the taxol. Not easy to take at all but heat helps. And then comes her version of "I'm not going" which is "I'm not doing this again."

We should be home by 3:30 or so unless she has me driving all around LA in search of something that tastes like it's supposed to taste. We will at least be stopping to pick up some soft French rolls to make a sandwich she remembers from high school. I'll do just about anything if it gets her to eat.

Oh, and we discovered Pedialite freeze pops too. Great electrolyte replacement alternative to Gatorade or pills for that matter.

So, that's a little glimpse into our normal life, or cancer world right now....

xoxo

Sunday, July 22, 2007

Note to self...

Cancer patients undergoing chemo who find it difficult to eat and/or drink, need nourishment at short intervals. Small meals about 2 hours apart consisting of anything they can tolerate.

We forgot this little tidbit of information today. It made the day more up and down than it had to be as Nanc got too hungry this afternoon and was weak and a little dis-oriented as a result. We won't let that one happen again.

All in all, she is doing better than last time thanks to all the hydration the last 3 days. That and a refrigerator full of food. Thanks to everyone who dropped it off this week! We can't thank you enough...

And a special thanks to Scott, Nancy's brother, who came down and helped out this week. He weeded, planted, took out the garbage and all it cost me was a few cappuccinos and one fancy hose nozzle from OSH ;-)

So, to Scott, the food folks, the folks who just drop by and take care of stuff for us, we can't express our gratitude enough...

xoxo

Saturday, July 21, 2007

My one and only pitch...

I promise. However, I think once you read the following two letters, you will agree with me on a couple of things. One is that Dr. Jennifer Lang (Jennie) is a very special woman. The other is that cancer research has come a long way but still has a very long way to go. One visit to the clinic or the infusion center is proof enough. Trust me on that one.

So, the first letter speaks for itself and then you will get to hear from another of Nancy's angels, Dr. Lang.



June 29, 2007

Dear Friends,

It has been three and a half years of many surgeries, 12 cycles of intravenous chemo, 6 cycles of intraperitoneal chemo, endless scans, blood tests, hospital stays, trips to doctors, the list goes on. I am one of the lucky ones. Each day I am getting stronger, my hair is growing in, my scans are clear.

Yet, there is still no cure.

Along this difficult journey I have been extremely fortunate to meet and be treated by so many compassionate, caring, dedicated, intelligent and just plain amazing medical professionals.

Last summer Jennifer Lang, MD, UCLA/Cedars Sinai Gynecologic Oncology Fellow, came into my hospital room at a very difficult moment in my treatment. She put me at ease and touched my heart; actually we touched each others hearts. A short time later Dr. Lang told me that she had decided to run a marathon and raise money for women’s cancer research. In between her 16 hour days (mostly 7 days a week) she has trained for and will run the San Francisco Marathon on July 29. She will cover the 26.2 miles to raise money for the Women’s Cancer Research Institute (WCRI) at Cedars Sinai Hospital.

Dr. Lang is doing this for me. For all women.

Please join me in supporting Jennifer’s Run. Read what she has to say.

Open your wallets, your hearts. It all adds up. Every dollar matters

No one should ever have to hear this terrible diagnosis.

Love,
Linda




And here is Jennifer's Marathon Mission Statement:



Linda Gordon lay in her hospital bed, wearing black round-rimmed glasses and a red kimono, and told me a story that changed my life.

I had arrived in California just weeks before to begin a fellowship training program in Gynecologic Oncology. Linda was the first patient I had personally been responsible for accompanying through a full course of intraperitoneal (IP) chemotherapy. It’s a tough regimen, and Linda was coping with harsh side-effects. Through it all, her grace and poise, beauty and intellect were an inspiration to me. All of the so-called problems in my own life seemed to melt into meaninglessness when I thought about Linda, and women like her everywhere facing this fight against cancer.

The tools we had to offer her- surgery, cytotoxic drugs, imperfect imaging studies and even more imperfect blood tests for monitoring tumor markers- seemed far from adequate. So much progress has been made in Women’s Cancer, but there is still so far to go.

Linda told me about her wonderful friend Gail, who at age 43 was diagnosed with metastatic breast cancer. Linda decided to run a marathon to raise money for breast cancer research. She did, and handed over a check for $17,000 to a local hospital, where ground-breaking breast cancer research continues to take place. I knew in that moment that I had to run a marathon for Linda. If she could get through 6 cycles of IP chemo (in addition to the 12 cycles of IV chemo she already had), I could damn-well get through 26.2 miles of road.

Dr Beth Karlan, past-president of the Society for Gynecologic Oncologists, and Director of the Women’s Cancer Research Institute (WCRI) at Cedars-Sinai Hospital in Los Angeles, has been a role model to me for the merging of compassionate cancer care with cutting-edge basic science research.

The mission statement of the multidisciplinary WCRI is: “To reduce the threat of cancer to women through research, education, early detection and prevention.“

Personally, I’m very demanding of myself and my field:
  • I want screening tests that identify women at risk for cancer, or in the earliest stage so that we can prevent disease from taking hold.
  • I want medications and treatment plans that eliminate disease without harsh side-effects.
  • I want women, the pillars of society, to know that we pledge to do everything in our power to preserve their health and wellness and help them to live long and productive lives.

I chose the San Francisco Marathon deliberately. The road to a cure for women’s cancers will have many hills along the way. This will be the most challenging thing I have ever done. But I know that I will be carried along by the spirit and courage of all the beautiful women who have, are presently, and will face a cancer diagnosis at some point in their lives.

My dear friend and trainer said to me: “If you want to run a marathon, you need a REALLY BIG reason.” Advancing cancer science is the only way that we are going to win this battle. So here’s my “big reason”: I’m running for Linda.

Please support all the women in your life by contributing to this cause.

Jennifer Lang, MD



If you find yourself in a position to be able to donate to this cause and further research on women's cancer, click here for a contribution form and contact information. It is in PDF format so you will need Adobe Acrobat to view and print the form. Click here if you need the free viewer.

And how is Nancy today you ask? Better but still suffering through the major side effects of the two treatments on Tuesday and Wednesday. Her potassium is back up to 3.9 today, the highest it's been since she started chemo I think. She ate a little and is asking for Jack in the Box. We'll hit the drive-thru on the way home ;-)

xoxo