Tuesday, October 30, 2012

i would give you some violets ...

Dear friends -

On behalf of my mother, my brother, and myself, I -- we -- cannot thank you enough for your constant expressions of good will and support over the past year.  Your kind wishes sustained both our parents through Dad's diagnosis and treatment and struggle.  We really believe that without your thoughtfulness, he would not have survived as long as he did.

Dad had, as you know, come home from the hospital and begun hospice care last week, on Tuesday, 16 October.  By the second weekend at home in hospice he had become significantly weaker.  Friday night he was very restless; Saturday we began arrangements to move him to Hospice House on Sunday, when it became clear that even with help from family and friends, Mom wasn't going to be able to care for him at home by herself.  He did not protest this; his only question about moving to Hospice House was whether they had wi-fi there.  We know that was a signal that he accepted the necessity of that decision.  But Saturday night he was even more restless and very agitated, and we called a hospice nurse to help us make him more comfortable; and in the midst of proceedings to transfer him to Hospice House in the middle of the night rather than Sunday morning, Daddy passed away at 2:30am Sunday, 29 28 October.  We were with him, holding his hands and patting his head and telling him we loved him, and we are confident his departure was as peaceful and painless as it could possibly have been in the circumstances.

His memorial service will be two Saturdays from now, 10 November, 2012, at 6pm at the First Unitarian Church of Cleveland.  Please contact one of us if you need directions or further information.

Although this will be the last blog entry specifically relating to Dad's health and progress, we hope you will continue to tune in, as it is possible that after a period of adjustment to life without him, Mom may be back to post about her journey toward healing.  In the meantime, thank you so much again for your sustaining messages of love and encouragement.  They helped Dad during his treatment and they have helped us in the days since he's been gone.  Thank you, thank you, thank you.

best regards
melissa


... but they withered all when my father died.

Saturday, October 20, 2012

another transition, another phase


So here we are, four days after deciding to transition to hospice care.  Melissa and Matt have been at the house these four days, and Dennis and Sharon for most of the time.  In addition we've had visits from everybody in our bridge group surrogate family, as well as from neighbors (Ken from next door on his regular Thursday morning visit, and Kristin from across the street to check in, having seen the hospice ambulance arrive at the house on Wednesday) and other friends. 

 

Wednesday was a full day, getting checked out of the observation unit, delivered back home, and set up with the hospital bed and other supplies and the hospice nurse who will be on our "team."  Thursday brought Dennis and Sharon's first day of visiting, as well as the recently-regular visits from Ken and Olivia. We also had a visit from our hospice social worker, who set up a nursing-assistant personal-care visit for Friday.  Friday, after the hospice visit Olivia came back to teach Melissa (and Sharon ;->) how she makes her healing chicken-matzo ball soup—a great experience in so many facets that I can't begin to explore them here.  Besides that, John and Liz came, and had a bowl of chicken soup and a nice visit with Steve.

 

Friday night, I decided to take over the night-time monitor from Matt, to test whether I would be able to handle on my own night-time calls from Steve (since his hospital bed is on a different level of the house from any of the bedrooms).  We had begun to realize that Matt needs to get back to his wife and baby pretty soon (to return when he can, probably in a couple of weeks), and Melissa also will be heading back home at least briefly to pick up loose ends before coming back to spend more time here.  From that experiment I learned that I'm not really up to doing this alone.  I emailed to Nora and Margie (my sisters) who blessedly and quickly agreed to come and stay with me while Melissa and Matt are away taking care of their other responsibilities. 

 

Today we had visits from Kristin (offering support from her own household and from the neighborhood at large) and from Clair and Grace.  Steve rested a lot but also very much enjoyed the two visits.  Dennis and Sharon spent the morning and early afternoon with us before heading home—a very difficult good-bye.  Tomorrow, Melissa will drive Matt to the airport for his flight back home.  In the afternoon we expect a visit from Melissa's school friend Shoma and the arrival of Margie to begin my sisters' support regime.  Monday, Melissa will leave us for a couple of days while Nora and Margie settle in to help me.

 

I think it must be apparent to the most casual reader that we have a phenomenal support network and so much to be grateful for.   Our hospice social worker suggested that Steve may actually have several additional weeks of reasonably high-quality time left, and we are aiming to make the most of them.  Thanks again to all of you for your ongoing interest and support.

 

Tuesday, October 16, 2012

starting hospice care at home


When Steve's pulse was high and blood pressure low yet again this morning, in addition to some other worrying  symptoms, I was not surprised that my call for advice yielded yet another instruction to head for the Emergency Room.  This time the preliminary tests suggested congestive heart failure, with a possibility of pulmonary embolism—the latter of which for various reasons it seemed impractical to explore further.

 

Oncologist and social worker came to our ER bed to confer with us, and the conclusion was that Steve is far too weak to qualify for any further chemotherapy.  We had sort of seen this coming, and before long had agreed that hospice care at home would be our best next step.  When Steve asked the oncologist if he could hazard a guess at what sort of time frame we should expect, the doctor said that though of course we never know for sure, he thought it would be good if the children came now. 

 

So, Melissa arrived around 7:20 and visited with me and Steve in the overnight-observation unit where he is staying until the hospice facilities can get set up here at the house tomorrow.  She will pick Matt up at the airport shortly, and Steve will come home tomorrow morning.  His brother Dennis will come tomorrow evening.  Then we'll see what happens next, and how soon.  And we'll let you know.

 

Thanks again for all of your support through this experience.    


Sunday, October 14, 2012

complications--but still enjoying our visit

So, Friday morning we had cleared our schedule to get ready for airport pickup at mid-afternoon.  But unfortunately, Steve woke up feeling it was difficult to breathe in a satisfying way while lying in bed, even though the head of our bed is well elevated and he had three pillows to boot.  I called the infusion center for advice, and the nurse said shortness of breath is "really an ER issue," so off we went.  Huge thanks to Clair who took over the airport pickup on short notice

The ER folks did their tests and diagnosed pneumonia (in addition to the cancer metastasized to the lungs, and fluid surrounding them).  They infused antibiotics (as well as other fluids for dehydration) and sent us home with a seven-day follow-up antibiotic prescription and a home oxygen-pump setup.  We arrived just a few minutes before Clair's airport delivery of the kids, and later had an extensive delivery, installation and training visit from the oxygen suppliers.

We had a nice Saturday, and were set up for a Sunday-lunch visit from Margie and Ted.  Then our routine blood-pressure-and-pulse check showed pulse of 138—out of acceptable range, I seemed to remember.  So, we called the advice line (infusion center not open on Sundays) and after having me re-check to be sure the pulse reading was accurate (counting to the nurse's clock it came out even higher) the nurse consulted the on-duty doctor who said we really needed to come to ER again, because pulse that high created risk of cardiac arrest.  So, off we went again (Matt came with us this time)—so Margie and Ted had a lunch visit with Celeste and Dylan, which I understand was very nice and of course the rest of us were very sorry to miss it.

This time, the ER physician diagnosed Atrial Fibrillation and managed to correct  this episode of it with an infusion of a drug specific to that condition.  He said that given all the factors operating here, the best thing was for us to return home and let Steve be as comfortable as possible—which we can all agree would not happen in the overnight observation unit or in hospital.

So—when we got home Margie and Ted had left for a concert obligation, but there was still some lunch left for us.  ;-}  Now we're having a quiet evening at home (Steve resting in his chair).  Tomorrow M+C+D head back to Cambridge (airport limo courtesy of Clair again).  I have arranged with my supervisors and colleagues at school for an unbelievable amount of support and coverage.  And we will go forward (I seem to have said this before…) doing the best we can.

Thanks to all of you for your support.  We'll be getting in touch to arrange visits as we find ourselves able—but please don't take this as a request to stop offering to come.  We appreciate the offers, and hope to be able to take up all of them soon.


--Carol

Thursday, October 11, 2012

some more good times, lots of rest in between

We did make the family-visit trip last weekend, and it was a wonderful experience. We got to see some relatives we haven't seen since this time last year (as well as some that we've seen a few times in between), and the flow of emotion and support was great. On the other hand, Steve arrived home quite exhausted.


On Monday evening, the bridge group relocated this month's gathering to our house to save us driving out, and we had a very good time. Again, though, so much of a good thing turned out to be quite tiring.


On Wednesday, we went to the infusion center and did qualify (via satisfactory blood tests) for this week's chemo dose. We don't know at this stage whether Steve's fatigue is due to the disease or the chemo or the combination of the two—but we're doing the best that we can. Steve is resting a lot between visits, and we both are looking eagerly forward to our long-weekend visit from Matt and Celeste and Dylan.


Thanks to all of you who have sent messages of support, via postal mail or email or other even more ethereal paths. To those who have said, "when can we visit?" we hope to reply soon after the above-mentioned long-weekend visit concludes. To all of you, thanks for keeping us on your radar.


Best wishes,



Carol

Friday, October 5, 2012

scaling back activity plans


This week brings little news beyond our slowing down and scaling down our October schedule.  The oncologist had Steve go in for a gastroscopy/colonoscopy on Monday, just to see what they could see.  The gastroenterologist reported finding nothing surprising—lower tract looked on the whole fairly normal, but in the upper tract the primary tumor (at the junction of esophagus and stomach) is present –large, circumferential and "friable," which  seems to mean "easily crumbled."  I didn't ask, but I'm guessing that means it's not just a scar tissue shrunken by the radiation treatments last winter, and that if it "crumbles" that's a way it spreads?  At any rate, that was the report.

 

We did go in for the chemotherapy on Wednesday, and after some saline and iron infusions (preliminary tests showed dehydration and anemia) the doctor asked Steve whether he wanted to go ahead with the chemo—which he did, so we did. 

 

Steve is still feeling weak and tired—probably somewhat more so than recently.  We are still going ahead with our family visit trip this weekend (at least I still think we are—it's 8 a.m. and we hope to leave around noon), but have canceled our other October travel plans.  The latter is disappointing, but realistically he concluded that those activities would take more strength than he can count on having at this point.  Matt and family will come here to see us next weekend; otherwise, we will pretty much be quietly at home. 

 

In hope of getting this weekend's trip underway, I will stop short here.  We will plan to keep you posted.  Thanks as always for your interest and support.  It continues to be much appreciated.

 

--Carol

Wednesday, September 26, 2012

good trip to Oregon, not-good CAT scan


To start out with the good stuff, just let me say that we had a very good time visiting with Eddie and his friends in Salem.  The trip was a bit of a stretch, but we are very glad to have done it.  Beautiful weather, and good visiting.

 

This morning, though, our oncologist had to let us know that the CAT scan results from last week show Steve's cancer has progressed on pretty much all fronts—lungs, lymph nodes, abdomen—and fluid in his lungs has increased.  We are disappointed, of course (to put it mildly), but have to admit it's not entirely a surprise because the energy bounce we had anticipated during the three weeks off chemo never came, but rather the reverse—less energy, more discomfort.

 

The doctor says we are getting near the end of the list of likely chemo regimens for this type of cancer (for which there are apparently fewer choices than for some other kinds).  There is one more to try, and we are trying it.  Present plan is for two cycles of three weekly doses with a week off in between, then another scan.  Meanwhile, the doctor will consult with his colleagues elsewhere to see if they have any ideas he hasn't thought of, or if there are any trials of new drugs for which we might be eligible. 

 

We hope to go ahead with most of the activities we have planned for the month of October, which involve quite a bit of traveling (mostly family visits).  We'll just have to take things as they come—which is always true, of course, but seems a more obtrusive realization now than it has before.

 

Thanks as always to all of you—our friends, "cheering section," "prayer warriors," and other well-wishers.  We continue to appreciate every encouraging vibration.

 

--Carol

Thursday, September 20, 2012

Days of Awe

These are the Days of Awe.

 

Many of you know that on the Hebrew calendar the first day of the new year took place on Monday, the 17th (beginning at sundown of the evening before), and that the ten day period following, what we refer to as the Days of Awe, culminates on Wednesday, the 26th, with the Day of Atonement.  While I am not particularly religious or observant, I am nonetheless affected by what strike me as the ethical and moral issues that religious milestones measure, and in this case, at this time in particular, I am thinking about what fills me with awe.

 

In this ten day period we are supposed to be highly introspective, and use the opportunity for a serious review of how we spent the year that just ended and a contemplation of how we plan to spend the year that lies before us.  The standard greeting at this time is "May you be written down for a good year," reflecting the mystical belief that there is a book of fate into which all of our names, and all of our futures, are inscribed.  If we believe that literally, and if we believe that we are creatures endowed with free will, it is hard to imagine just what effect our behavior or the behavior of others will have on our futures.  But I don't think it does any harm to enter into a periodic review of the choices we make and the actions we take, and this is as good a time as any to conduct that review.  We are supposed to forgive debts owed to us, smooth over disputes we have with other people, and, essentially, enter the new year fresh.

 

For me the past year has been one where I believe I didn't have a great deal of choice, and if I did, I would not have chosen the year I have had.  Except for one important thing.  Because of my illness and my ongoing needs, I have come to learn how extensively goodness characterizes the people I have known--people I have known well or slightly, and people I hadn't known at all before.  From all corners I have received encouragement, assistance, generosity, affection, genuine concern, patience, and services.  My best friends have been like sentinels, ready to spring into action at the slightest indication that I needed something.  Friends of less intimacy have been no less generous; in fact, in some cases I have been left astonished at how faithfully I could count on some people I hadn't before known all that well or thought of as especially close.  But I was proven wrong over and over.  My family has been indescribable, and they have risen to the challenges with energy and devotion that are inspiring.  The medical people I work with, who could, if they wanted, see me as one more medical record number, are unfailingly positive and patient, and go out of their way to see to my comfort and well being.  The support group I attend is full of people like me, dealing with realities we never thought we'd have to face, but sensitive and responsive to the individual needs and conditions of the others in the group.  This one important thing, this newly found and consistently reinforced reminder of the essential goodness of so many people, is what fills me with awe at this particular time on the calendar as well as all the other weeks and months of the year.

 

I am approaching the first anniversary of my diagnosis.  I have come through it, so far, with a lot of success, but I know I have a long way to go.  I have several goals, some of which I have to admit to myself I will not see fulfilled.  But I am working again a little, writing some, playing my piano a bit now and then, reading voraciously (I couldn't read at all until around March, I think), dancing, playing bridge, and traveling.  Today I am going to fly across the country to visit my oldest childhood friend in Oregon.  I recently saw an old friend who expressed some genuine surprise that I was up and around, driving myself where I needed to go, looking less dire than I did when he last saw me in the winter.  All of that is good.  Tuesday was Dylan's second birthday, and when we called (not because he knew it was a special day, but because we did) and sang "happy birthday" over the phone, he very clearly said, with prompting from his parents, "Hi, g'amma.  Hi, g'ampa."  Someday I will hear him say "I love you, Grandpa," and some day I will read the paper on which he writes those words.  Goals worth striving for, and made all the more realistic by the outstanding care I am receiving from all the people I mentioned above.

 

So in these Days of Awe I reflect on the year that has passed and what I think lies ahead for me, and I conclude that with all your help and good wishes, I have no reason to doubt that where I want to go is where I will go.  If you, my friends and family and medical team, don't fill me with awe, I just don't know what will.

Wednesday, September 5, 2012

a bit of a hiccup

We went in this morning for our fourth-of-four chemo infusions for this cycle, but the preliminary blood draw showed that the white blood cell count was too far below normal for the treatment to go forward. Normal range is 4.5-11.0 of whatever units it is they count, and Steve's reading was 1.8. The nurse said this is not surprising, because white blood cells are generally hit hard by chemo treatment, and a rest from the chemo will probably result in their making a good comeback. Since we had two "off" weeks coming up anyway, this day off will result in a three-week recovery period, so the reading should likely be fine next time. Meanwhile, we still have the September 17 CAT scan on our schedule—the results of which should give us an idea of what progress the chemo has been making against its actual target.

I expect it will be a few weeks before there is further news. We won't get the CAT scan report until after our short trip to Oregon in two weeks. Possibly Steve will have something to add to the annals between now and then, but I will most likely check in again sometime in the range of 9/26.

Thanks, as always, to everybody for your support. Take care of yourselves.

--Carol

Saturday, September 1, 2012

Still moving on



Our weekly blog-entry pattern seems to have stretched itself out a bit.  I had thought Steve might be doing the next entry, and he intends to do so again one of these days, but meanwhile here's a short update for anyone who is still checking and might be wondering how things are going. J

 

The second and third installments of this four-installment chemo round have been successful (that is, the critical blood counts have been in good enough ranges so they could go forward), though Steve's energy level has remained generally somewhat lower in these past two weeks than it had been recently.  He has been trying to get by with more food by mouth and less time on the feeding machine.  He likes the freedom from the machine, but his weight has continued to drop—so some reversal of that pattern may be necessary.  Yesterday he ate pretty well and used the machine overnight, and this morning we were both pleased to note he was back up a couple of pounds.  Next Wednesday is chemo #4, and then after a week off we get another CAT scan to assess the progress of the chemo vs. the cancer.

 

We are relaxing at home over Labor Day weekend. (Steve is napping now.)  I have been busy with the start of school, which seems to be going well but keeping me busier than I expected, for some reason.  We've enjoyed a bridge group evening and have another coming up soon, and will soon be rescheduling the playreading group that got canceled when we went to Flint.  In September we plan to visit Eddie in Oregon, and then for October we seem to have (tentatively, at least) scheduled out-of-town activities for every weekend of the month. In addition, Steve has scheduled himself for at least a couple more teacher-training programs, and is in touch with his textbook co-author and their publisher about some further work in bringing their texts to online format.  All of this scheduling clearly shows an optimistic attitude going forward. Our total schedule for the next couple of months looks to me challenging even for normal circumstances, so I guess we had better start storing up our energy now!

 

We've also had regular as well as irregular visits with many friends, and it continues to be true that social contacts are highly therapeutic so we hope you will all know that we are always happy to see you—please don't take the above paragraph's crowded-schedule content as a suggestion to stay away!

 

We hope all is well with all of you, and we thank you again for your support.  Enjoy the last bits of summer.

 

--Carol



Saturday, August 18, 2012

keepin' on keepin' on...


So, three weeks instead of the predicted two between entries—but on the whole a good stretch.

 

We did have a wonderful week in Cambridge, watching Dylan work at his language and counting skills.  A week-long visit is definitely better than a weekend one for getting to know a little person.  By the time we left we were clearly "Gamma" and "Gampa," among expected members of the household, and had our assigned seats at the kitchen table—all really very happy things, if you don't count the sadness of saying "goodbye till next visit."

 

The other big event has been Steve's first-since-November teaching gig.  He signed up to teach a three-day AP English training in Flint, Michigan this past week, and was very excited to be feeling well enough to do it.  At first he thought he'd drive out on his own, but as the time approached I felt too nervous about his driving alone (especially back home after a day of teaching), so I went along.  He was, as it turned out, glad to have me do much of the long-distance driving, and I got quite a lot of my school-prep work done with my computer in the hotel.  The training went very well, and he was energized and excited to be "back in the saddle" for a change.

 

The day after returning from Flint (Thursday, 8/16) was chemo time again.  His blood counts were pretty good and the infusion went smoothly, though he's feeling somewhat more than usually "beat-up" with the side effects these couple of days.  After two weeks free of chemo, his system is sort of what-the-helling more than it did in the later weeks of the previous cycle—though not as badly as during week one of that previous cycle, so I guess that's a useful comparison.  So far, the pills he has at home are keeping the side effects under control, and we look forward to their subsiding with time.  Meanwhile, we had a quiet evening at home to celebrate our 43rd anniversary.

 

After the end of this four-dose cycle we'll have another CAT scan to assess the progress of the chemo against the cancer.  That will be in mid-September.  School starts for me again week after next, though there are Introductory Week activities during the week coming up.  And Steve hopes to get more workshop gigs in this fall season.  So, onward we go. J

 

Thanks to all of you for following our progress and continuing to send your support over all kinds of media and waves and vibrations.  We feel it, and it helps so much.  Enjoy the last bits of summer!

 

--Carol

 

 

 


Saturday, July 28, 2012

fairly smooth going...


This week's blood tests were still okay, and the chemo went smoothly.  Steve has been feeling basically okay, with the expected side effects of the chemo (fatigue and some digestive challenges) remaining within a manageable range.  We've had visits from friends;  he took a walk with Clair all the way into the village and back; we had a good time at a senior-center dance; and he stayed up to watch the Olympics opening ceremony.  (I, on the other hand, conked out before the end!)

 

Now we have two weeks off from chemo (this regimen is a 4-weeks-on, 2-weeks-off pattern), during which we will spend a week in Cambridge with Matt and Celeste and Dylan.  We expect that to be great fun, but mostly (we hope!) outside of the "health updates" subject range—so it may be a while before we post again.  We hope you all will assume a "no news is good news"  response to this potentially silent period, and will continue to send your supportive thoughts and prayers and vibes in whatever way suits you.  Thanks again for all of that!  And keep enjoying your summer, as we will keep trying to do. J

 

--Carol

Saturday, July 21, 2012

a better week


This week has been consistently smoother than the one before it, for which we are very glad.  Last Saturday evening (last week's blog entry was a morning effort) we went out dancing, to our favorite dance floor and one of our favorite bands, and had a brief but very enjoyable time—a good number and variety of dances, and some encouraging conversation with friends.

 

Sunday we drove to Ravenna for brunch with Margie and Ted (first time we've been there since last October, when we had just received the diagnosis).  That visit also included their friend Ray with whom they share the pursuit of steel drum music;  it was nice to see him again, too.  On Monday we had a fairly quiet day at home.  On Tuesday, I went to school and finished the first pass at organizing my new office (several more passes to go, I'm afraid).  Steve drove to his Reiki appointment in the afternoon, and we both went to our Gathering Place support groups in the evening.

 

Wednesday was chemo day again—but unlike last week, this time all the tests were fine and the treatment went forward (though with a 20% reduction in the active drug).  Everyone there agreed that Steve was looking better than last week, which confirmed our own impression that things are getting back into a better balance. 

 

Wednesday was also the beginning of Nora's visit, which she began at Margie's since we couldn't predict in advance that our chemo day would go so smoothly!  But on Thursday Nora came up to us, and we had a very nice day together, enhanced by visits in the morning from Ken and in the afternoon from Olivia.  On Friday, some of the Ravenna contingent came up for a mid-day celebration of Margie and Ted's 32nd anniversary—and Steve prepared the risotto main dish, which was a great success!  Then in the evening Nora and Steve and I walked down into town for the Little Theater's production of Hairspray, which was very well done and enjoyable.  And all three of us were in good shape for the walk back home, uphill though it is. J

 

So now it's Saturday again.  Nora has left for home, and Steve is having a well-deserved nap.  He continues to feel optimistic about his progress (in spite of the occasional snags, the overall trend seems to continue upward), and we remain convinced that optimism is in itself salutary.  Thanks again to all of you for helping us to continue onward and upward!

 

--Carol

 

 


Saturday, July 14, 2012

some challenge with the chemo


Steve's initial reaction to last week's new chemotherapy treatment seemed fairly mild, and we had a good time watching Melissa and her curling team do well at the Tropicurl bonspiel in Pittsburgh over the weekend.  By Monday evening Steve was dragging a bit, but we did have a good time at bridge group.  However, by Tuesday a predicted side effect (severe diarrhea) set in with a vengeance, and although we had (and Steve used, to some extent) medicine to counteract it, the results were fairly serious.  Tuesday afternoon we canceled a couple of engagements and returned to the 24/7 feeding machine hookup; but by the time we arrived at the infusion center Wednesday morning for the scheduled chemo infusion Steve was pretty badly dehydrated and his blood test showed not only low platelet count but also seriously low potassium—and possibly other issues that I'm not recalling in detail.

 

Considering all of this, the doctor held off on the chemotherapy for this week and instead checked Steve in for another overnight stay at the Clinical Decision Unit for observation and rehydration and attempts to get the various fluids back in balance.  That along with a different diarrhea medicine seems to have worked well.  We were released around noon Thursday, with a follow-up blood test scheduled but Steve feeling generally better.  Thursday afternoon was sort of a whirlwind, since we had to squeeze in an emergency visit to the surgeon to insert a new feeding tube (the previous one fell out as we were packing to leave the CDU—the balloon that holds it in place disintegrated again ;-<) and I had a dental appointment to keep on the way home.  But we got it all done, and had a quiet evening at home.

 

Friday morning we had a normal breakfast (off the feeding machine again :->), and went to our play reading group in the afternoon.  On the way there we stopped by the lab for the follow-up blood test.  Results of that were pretty good—potassium still a bit low, but the current prescription is to keep up the once-a-day potassium pill and eat some bananas.  J

 

That's our story for this week.  We have another infusion appointment (plus echocardiogram) scheduled for this coming Wednesday, at which point the oncologist will decide how to adjust the dosage—and on we go.  We hope that you all (our friends and loved ones near and far) are well, and that you remain aware how much we appreciate and rely on your ongoing support, both expressed and tacit.  It is such an important part of our therapy!  So, thanks again.

 

--Carol


Wednesday, July 4, 2012

another CAT scan, another chemo shift


I see it's been two and a half weeks now with no blog post.  That has been on the whole a continuation of the "no news is good news" procedure—not a lot to report, though I haven't deliberately refrained from saying so.  Steve has been working on weaning himself from the feeding machine (as he mentioned in his last blog entry).  For the last week or two he has been eating three small meals plus the occasional snack during each day, and using the machine only at night.  His weight has gone down a bit, though not consistently or precipitately.  (BMI scale shows him now just on the border between "normal" and "overweight." ;->) He would love to go off the machine entirely, but that will require significantly increasing his daytime caloric intake.  He keeps aiming for that, so we'll see how it goes.

 

Yesterday we visited our oncologist, who showed us results of last week's CAT scan.  Unlike the previous one (in late April), which showed good reductions in the cancer spots, this one showed increased issues ("atelectatic opacities" and "a new nodular opacity") in both lungs—not big things, but bigger than they were last time, which is of course disappointing.   One of the blood tests, for carcinoembryonic antigen (CEA)—which the doctor described as an "imprecise measure of the amount of cancer cells" in the body—had gone up significantly [usual level in healthy nonsmokers is below 3; Steve's level had gone down to 6 in May, but back up to 30 in June and 39 yesterday].  And the CAT also showed some increased fluid accumulation around his heart, which was one problem involved in our last overnight hospital stay. 

 

Considering all those things, the doctor decided to change the chemo regimen again, this time to Camptosar, in a cycle of four weekly doses followed by a two-week break.  We got the first dose yesterday, and so far no bad side effects have showed up. 

 

The good news is that Steve continues to feel pretty good ("so darn good," as the doctor said, that he even hesitated to change the chemo regimen).  Steve has gone walking with Clair a couple of times, and plans to do more of that.  He regularly drives himself to various visits and appointments now, and as I mentioned above he's eating more and often enjoying it quite a bit.  And except for the specific issues in the long paragraph above, the CAT scan showed stable and normal conditions in other areas.  We plan to drive to Pittsburgh this weekend to see Melissa and her team play in a curling bonspiel; we will return to Columbus July 23-24 for a bar-exam tailgate related to my law school work; and we have booked a flight to Boston for another visit the first week in August. 

 

So, with thanks to our medical team and to all of our supportive friends and family, we continue forward with energy and optimism.  We hope that you all are well, and will keep in touch in whatever ways work best for you.

 

--Carol 

Sunday, June 17, 2012

citius, altius, fortius

 

 

CITIUS, ALTIUS, FORTIUS

 

 

You might wonder why I chose the Olympic motto of "swifter, higher, stronger" as my title.  I thought that with the London Olympics on the horizon (not to mention thoughts of some very dear English friends), it was an appropriate way to describe how I have been feeling and what I have been doing.  In many ways I feel that I am, on my own level and at my own pace, getting citius-er, altius-er, and especially fortius-er. 

 

Going back just a couple of weeks, here's what's been happening.  Two weeks ago we flew to Boston to visit Matthew and his family.  I was very excited to go--any time with them is an event to look forward to--but I was nervous about flying.  Not that I worry about my safety.  I have flown enough not to worry about that.  But I didn't know how I would deal with security or manage my medical appendage (my feeding machine) on the plane.  I was also concerned about the amount of walking I would have to do if the gates were far from the lobby or baggage return, which is so often the case.  So we called TSA before the flight to ask what we might expect when we got to the security line.  Now, all of us who have flown have experienced the security procedures at airports, and I think that by now even though most of us have accepted the experience as a necessary irritation, we have come to expect a little delay and perhaps some snippiness or lack of empathy on the part of the inspectors.  That's okay.  I wouldn't want to go through what they go through either.  I was imagining and anticipating all kinds of trouble because my feeding machine is difficult to detach and we were carrying liquid food, and I thought all of that might be a problem to bring through the inspection line.  But the woman on the phone said that what I was bringing was approved medical equipment and I should have no problem.  And in fact, she recommended that we approach the captain of the inspecting team on duty and ask for assistance.  So that's what we did.  I did use a wheelchair, not that I normally do, but because we had the medical stuff to carry as well as our normal carry-ons, it seemed like the prudent choice.  And it was.  They took us through the line right away, and treated us with considerable courtesy and understanding.  They patted me down and wanded me and did not require that I remove my shoes.  When the agent said that he now needed to inspect the chair (even though it was theirs), and I said that I could stand while he did that,  he said no, that he could do it while I was sitting.  Carol wrote in her last blog entry that "the TSA people and airline personnel were all very helpful," but I would (and I think I do) express more appreciation for how well they treated us.  That was true in Boston as well.  It's easy to grumble about the security experience at airports (and often justified too), but this was a case where the opposite is true, and I'm happy to be able to report it.

 

While we were at Matthew's house we enjoyed ourselves a lot.  Who couldn't, with such an adorable toddler to play with and watch develop.  Dylan is making daily, maybe hourly, strides in his ability to speak.  He understands everything said to him, and he can identify all kinds of items in the stories we all read to him.  (Can you show me the sheep?  What does the cat say?  Which balloon is red?  And then, which animal is that?  Who says bow-wow?  Which one is the green star?)  But though he hears them and understands them, he doesn't speak them at the same level.  This is normal linguistic development in children, But even in the short time we were there we witnessed remarkable leaps in that direction.  I can't tell you how much more he was speaking, but I can say he was speaking a lot more.  For some time he had been saying "Mommy" quite clearly, but it seemed that he used "Mommy" to mean either mommy or daddy, so Matthew and Celeste were trying to get him to say "Daddy" and to use the two names appropriately.  By the time we were there that goal had been pretty much accomplished.  So we'd see Dylan roaming around the house, and when he saw one of his parents he would announce "Mommy" or "Dada" (he hadn't quite gotten "Daddy," but that's okay).  And he has a lot of words that no one can quite figure out, but he babbles them anyway, not appearing to be terribly bothered that at that moment no one understands him.  Well, a few days into our visit he started saying "Gaga," which Matthew and Celeste said was a new word and they didn't know yet what he was referring to.  At some time he would point to whatever he was talking about, and they'd figure it out.  I said to Carol that since he was saying "Gaga," we should teach him "Lady."  On the day we were leaving and saying goodbye (he was going for a nap and we were headed for the airport), Celeste asked him if he could say goodbye (which he sort of could), and could he wave to us (which he did).  Then she said "Where's Mommy?" and he pointed to her.  And then, "Where's Daddy?", and again he pointed correctly to Matthew.  Then she said, "And where is Gaga?"  Dylan pointed to Carol.  Gaga was Grandma.  We hadn't known.  And then he pointed to me.  I too was Gaga, which makes perfect sense since interior sounds in words are the hardest for children to learn to incorporate into newer and longer words.  So Gaga was either Grandma or Grandpa, and I pointed out that now it was even more important that he learn to say "Lady" as a means of distinguishing which Gaga he was talking about.  I can't wait until we see him again and remind him of who we are, and hear him call us Gaga and Gaga again.

 

I don't care how sick you are or how serious your condition is.  An experience like that makes you altius-er without any doubt.

 

Matthew has recently changed jobs and now he works in the office of the general counsel at Harvard, and he can walk to work instead of having to commute as he had done before.  The walk is about a mile from his house, so the combination of convenience and good exercise is a nice feature of the change.  He was out of the office for an appointment on Thursday morning, and planning on being home at lunch, after which he would return to the office for the rest of the day.  Carol said that she'd like to walk down with him to see the place, and they asked if I wanted to come along.  Well, a mile down and another mile back made me pause and take stock.  The last time I tried to walk a distance (this was probably in March or April) I lasted about a quarter or a third of a mile, and then I was done.  So I was apprehensive.  If I went, I would certainly walk slower than Matthew and Carol, and that might influence their attitude about whether I should come along.  But I decided that we had been dancing more, and I had been feeling better, and if I started and felt I couldn't go the whole way, I could sit down on a bench and wait until Carol came back and walk the rest of the way home after my rest.  Or I could call a cab.  Or any number of possible solutions--so I decided to go.  And I'm glad I did.  The office is really just an office, but the mile down and the mile back was an accomplishment beyond what I had expected.  Yes, I was tired, and when we got back I settled into a comfortable chair and rewarded myself with a nice long rest.  I had done it:  two miles (possibly two point two--Matthew thinks the distance is a mile or a mile and a tenth) with a break in the middle.  In actuality I don't think my pace required them to go much slower.  I certainly felt both citius-er and fortius-er.

 

A great time in Cambridge, and plans for another visit in August.  By then Dylan will be quoting Shakespeare and I will be running marathons. 

 

We got home from Boston on Friday evening, and recovered somewhat from the trip on Saturday.  Then on Sunday we drove to Columbus (about two and a half hours) so that I could participate in a training program for some work that I had been doing before I got sick.  For about two years I had served on several visiting teams that observed schools and recommended the level of accreditation they were entitled to.  I enjoyed that work (all volunteer, as so much of adjunct educational work is), and regretted that it was among the activities I had to give up, missing many opportunities during the winter and spring.  My team leader had recommended that I take the training to become a leader myself, and when that training was announced for early June, I decided to go for it.  I didn't know how I would do, but I was willing to take the chance.

 

The training went fine, but we had one personal experience that really suggests progress for me.  I wear this feeding machine and carry it with me wherever I go.  It provides nearly all my nutrition, since even though I have been getting better and better in many ways, I still find eating by mouth to be a challenge in some ways.  One of those ways is that I just can't consume very much at one time.  I simply can't overeat.  If I do I get sick, and it just isn't worth it.  So we run the machine pretty much around the clock.  The feeding rate that I am comfortable with leads to a delivery of about 1800 calories a day, not quite enough for me to maintain my weight, even though I appear to be getting all the vitamins and minerals a person needs.  It's really like a diet of adult-strength baby formula.  What I need to do is increase my ability to eat so that I can rely less on the machine, and some day, soon I hope, I will be able to wean myself from the machine altogether.  At this training we decided to disconnect the machine in the morning, have breakfast (provided), lunch (also provided), and dinner (on our own), and reconnect after dinner, running the machine overnight as we have done.  We didn't know how that would work out, but the result was just fine.  That, along with the long walk to Matthew's office, may be the most significant advances I've made recently. 

 

Carol is at a conference in Denver until Saturday night as I write this, and Melissa has come to look after me in her absence.  We still think it's best that I not be alone for several days, and she has been a real help but mostly a delightful companion these last few days.  I don't want to burden her with the possibility of some problem arising from my monkeying with the machine, so we will resume our experiment when Carol gets home (tomorrow).

 

So what do I have here?  Gold?  Silver?  Bronze?  Maybe I didn't outrun Usain Bolt, but I'll take my achievement over his any day.  He may get to the finish line faster, but I made it there, as Frank Sinatra said so often, my way.  I haven't vaulted over the bar like Dwight Stones, but I think I felt just as high as he must have when he won his medals in Munich and Montreal.  And as for doing the clean and jerk or hanging in an iron cross or taking part in any of the events that display great strength, well, I'd rather feel like I felt after that walk. 

 

 

Here's what they won in Athens.  The winners must have been thrilled.  But when I consider what I have won, I think I did better.

 

Happy summer to all of you.

 

Steve