Saturday, August 29, 2009

What's Up With the Doc 72? - More Than I'd Like

It's been a rocky week. Monday I got hit with that overwhelming discomfort thing from which I am always unable to get any relief. I told Robert that I wanted him to find me a recliner but then let my mother and sister in on it and between the three of them I had a brand new La-Z-Boy in my family room by Tuesday afternoon. It seems to be the place that I am most likely to find a position of comfort and is a wonderful gift in my new state of being. Tuesday and Wednesday were better than Monday, but Thursday I woke up vomiting. I made it to an 8 o'clock meeting but apparently looked so poorly that my boss walked me down to the emergency department, where I spent most of the rest of the day.

They didn't find anything big and scary to explain the vomiting - no brain mets on a dry CT, no abdominal obstruction - but my liver function tests are about twice normal and my platelets are low (that latter is from the chemotherapy a week and a half ago). I got fluids and IV antinausea medicine and eventually got myself home and into the recliner. No vomiting yesterday, but the nausea persists. They started me on steroids and I'm hoping to see some relief from that over the next couple of days. The other not too good thing, along with the elevated liver function tests, is that I've lost 8 pounds in the last 2 weeks. So it feels like the balance is beginning to tip in cancer's favor.

I'll see how things go this week before I make any decisions about work. I'd like to keep working through the middle of October, but I don't know if that's going to be workable. I can do a fair amount from home and I know they are amenable to that, so we'll see.

My spirits are flagging a bit as I start to run into walls that I don't seem to be able to get over. I started an antidepressant Wednesday night but that's on hold with the vomiting on Thursday. The steroids should perk me up at least a bit.

Everybody except Lindsay is back in school and she starts Monday, so the new season rolls along. Hannah is at her first volleyball practice/try out for the school team and I look forward to the games upcoming.

Think good antinausea thoughts for me and I'll try to keep the updates coming.

Lots of love,


Friday, August 21, 2009

What's Up With the Doc 71? - A Rough Few Days

I feel like a bear stumbling around after winter hibernation even though it's only been three days. As I've been reporting, I always seem to have some level of nausea. It was a little worse when I went in for my first Gemzar on Tuesday but I was otherwise fine and knew they'd be giving me something for nausea IV before the chemo so we went ahead. Half way through the chemo I threw up what appeared to be everything that had gone into my stomach that day. They held the chemo, gave me some fluids and more antinausea meds then finished the chemo. That was far from the end of the story, however. I threw up twice more - once as soon as I got home and one with my 10 pm medications and then had diarrhea for most of the evening/night. My temperature never got above 100. Wednesday I basically didn't make it out of bed except to go to the bathroom. Things finally started to improve yesterday afternoon after I took some Compazine (old school antinausea medicine) and actually managed some dinner last night.

Even though this started during chemo, I don't think it had anything to do with chemo. I actually think I had a viral gastroenteritis so plan to go about my business and give the Gemzar another go in two weeks. My oncologist and I are talking about pain and nausea control (the opiates may certainly be contributing to the constant low grade nausea so we may try messing with those a bit, although my pain is very well controlled right now and I'm a bit nervous about changing any of that up.

Other than that, everything is status quo. My vital signs and blood counts were fine on Tuesday. I managed to get in to work for a few hours yesterday and aim for the same today. We have a quiet weekend planned before the insanity of a new school year hits next week, and I do mean hit. Emma starts classes for her masters program Monday, Lindsay registers for her class(es) Thursday, the same day that Hannah and Philip start their senior and junior years of high school, respectively. We'll be sitting in volleyball bleachers in no time! Even though summer waited a long time to get here, I'm already tired of the hot sticky weather. I'm not looking for first frost or anything, but dew points in the 60s would be an improvement.

So, anyway, I seem to be recovering from this latest little kick in the pants. No more chemo until September!

Saturday, August 15, 2009

What's Up With the Doc 70? - Helping Hands

I know it hasn't been a week, but something pretty remarkable happened last night and I wanted to share it with you. I was lying in bed just after 10 pm and in quite a lot of pain. I was waiting for my Ibuprofen and rescue oxycodone to work. While I was lying there, I decided to see if I could put all the good thoughts and prayers and hopes you send to good use. So I visualized them all as hands - mothers' and fathers' hands, siblings' and friends' hands, children's and elder's hands - and allowed them to lift me and let me feel weightless. I imagined them gently stroking the lines of my face, gently rubbing my back, neck and shoulders and deeply massaging my feet and hands. Before long I was pain-free and able to go to sleep and slept, with only one bathroom interruption, until my alarm woke me at 6 am (for more medicine). I could easily have awakened my husband or gone to one of my children's rooms, but that would have required physical effort on my part and then, "not quite so hard." or, "a little harder, please," or, "a little to the left," or ,"just a little longer, please." Instead, I got exactly what I wanted for just as long as I wanted it. So thank you all for the thought and prayers and hopes that turned into helping hands for me last night. They were a great comfort.


Thursday, August 13, 2009

Wht's Up With the Doc 69? - Chugging Along

No big news this week except that Tuesday was 17 months post-diagnosis. Seventeen months ago I didn't expect to be here now, but here I am! Even though I will be going in for Gemzar on Tuesday, the majority of my cancer treatment is symptom control at this point - fine tuning what meds and when will keep me as pain-free, nausea-free and alert as possible. I spoke to the oncologist about Ibuprofen and its antiplatelet activity and wondering whether we should switch to another NSAID but he didn't think so. He feels all the NSAIDs cause poor quality platelets, which aggravates the poor quantity problem with the Gemzar so he says we'll just watch it. If the Ibuprofen causes problems we'll back off on it and add Tylenol and increase narcotics for a while. Speaking of which, pain has been well-controlled on 20 mg of oxycontin twice a day with 5 mg oxycodone as needed (usually once or twice a day) until I fell in the kids' bathtub on Monday. We're using that one because ours was leaking so it had to dry for a few days before being recaulked. The kids' shower has no nonskid material on the floor and I took a good header. My right elbow is bruised but pain-free. My neck hurt immediately but then went back to it's usual state, but my left hip and low back have been unhappy - not quite as bad today, so I think it's muscular. I did tell the oncologist and we agreed to just watch things for now. I'm on Zofran during the day for nausea and Ativan at night and I seem to be holding my own. Oh, and there's a new mat in the bathtub.

My nonclinical work has proven to be interesting and time-consuming. The entire policy manual for the institution has to be reviewed and revised every year and keeping up with Connecticut statutes is always fun. H1N1 flu continues to entertain everyone and running the quality improvement program for our medical staff is perennially like herding cats. It's keeping me busy and distracted but is not too taxing, physically, so just right for my life as it is now.

Hannah and Philip spent the early week with Uncle Bruce and Aunt Dottie on Long Island. Philip and I are going back this weekend and Hannah may go back with a friend next week. All clinging to summer, we are, as we start having to deal with things like senior portraits (Hannah), 10th grade physicals (Philip) and the general getting ready for another school year. It's mid-August, in case no one noticed!

Friday Lindsay and Jacob came up and we all went to see Julie and Julia and then went out to dinner at the restaurant where Hannah works. The movie and the food were great and we had a wonderful time.

That's pretty much it for now. Good thoughts for our shower to stop leaking and that the Gemzar is gentle on me. More next week.


Wednesday, August 5, 2009

What's Up With the Doc 68? - One More Shot

I saw the oncologist yesterday and wound up having a good cry in the office. That happened when he mentioned the possibility of trying the Navelbine again and then got a call that he had to leave the room to take. It actually gave me the time to collect my thoughts and be able to explain to him that, while I don't get deathly ill and wind up in the hospital with side effects of Navelbine and other chemo regimens, I do feel just awful. For 5 of 7 days in a Navelbine week I simply can't get comfortable - not in any position, not even for 5 minutes. Off chemo if I manage my pain meds and my meals just right I can sit and talk or sit in the car or sit at my desk for unlimited periods of time. I can interact with family and friends. I can work on a quilt. I can enjoy a movie. I can laugh. So when he came back in the room I explained that to him. I explained that I would deal with the Navelbine if there were a REASONABLE chance of a SIGNIFICANT response and SIGNIFICANT increase in survival. That's not what Navelbine offers, though, so I'm done with it. The only drug approved for my cancer that we haven't tried is Gemzar (gemcitabine). Most prominent side effect is low platelets. The usual schedule is weekly for 3 and then off 1 but the oncologist says that counts are usually too low to give the chemo on the 3rd week so that, in this case he recommends every other week treatment. Infusion is about an hour. Some people get a flu-like syndrome a few hours after leaving the doctor and, if this includes fever, no more Gemzar. I told him I'm willing to try anything once - so we're scheduled for this August 18th. If it doesn't find some way to make me miserable it would be every two weeks until whenever. Meanwhile, I continue on Zometa to try to help with the bone pain and prevent fractures.

My insurance is confused about Hospice and right now is saying they won't cover it while I'm on treatment. I really don't need any of their specific services right now, so I'm OK with whatever happens with that. My doctor will refer me for traditional hospice when we agree that we will not pursue any further treatment, when I'm less active than I am and when pain control becomes more than he wants to handle. Speaking of that, we've increased the Oxycontin to 20 mg twice a day so that maybe I won't have breakthrough pain. I'm still on the Ibuprofen three times a day and, as I said above, when I take my meds on schedule I'm feeling pretty well.

I'm adjusting to my new work schedule without patients. Luckily, H1N1 novel flu looks like it will keep me busy for months to come. Friday, my last clinical day, was long and difficult. I forgot my 2 pm Ibuprofen and by the time I got home I was truly miserable. It took until mid afternoon on Saturday for me to even start feeling human again. But I did and the rest of the weekend was fun with good food, bad movies and family to enjoy.

That's where things stand this week. Next excitement will be after Gemzar on the 18th, but I'll report in before then.