Wednesday, December 24, 2008
Wednesday - December 24, 2008
Baking Soda Infusion - Judy did finish the 8 days of baking soda infusion and was sick most of the time, but felt it was worth it if it shrunk the tumors. The infusions did cause most of the back pain to go away, which was really helpful. The tumor markers went from 2,622 on Nov. 11 to 3,000 on Dec 23rd. But it is hard to tell what that really means, since they went from 1,000 to 2,622 (a 160% increase) during the prior two months that she was off chemo. In the prior two months they more than doubled and in the last 6 weeks they only increased by 15%, so maybe the infusions were helpful.
We did get the results of the Nov 25 CT scan on her abdomen and pelvis and chest and comparisons to the Jul 28 CT scan.
Liver - We learned that there was an 8 mm hypodensity within segment 6 of her liver, but that it did not increase in size and there were no new hepatic lesions. There was a mild amount of gas within the intrahepatic biliary tree within the left lobe.
Kidneys - The left kidney was not growing as fast as the right. There was a 10 mm lobulated lesion within the superior pole of the right kidney, which was unchanged. Bilateral extrarenal pelvises were present.
Pancreas - The previous 23 x14 mm hypodensity adjacent to the tail of the pancreas currently measured 15 x 10mm. The 13 mm left adrenal lesion was not changed.
Abdomen - There were numerous small lymph nodes within the retroperitoneum, celiac region and mesentery and there was also a general increase in size and number of lymph noes in these regions. The prior 15 x 8 mm left para aortic lymph node had increased to 18 x11 mm, the prior 23 x 10 mm portocaval lymph node increased to 23 x 13 mm, and the right iliac chain lymph node went from 13 x 7 mm to 17 x 9 mm.
Pelvis - There was a mild amount of free fluid within the pelvis, the uterus was filled with fluid and there was mild asymmetric thickening of the left aspect of the myometrium.
Back - Numerous blastic metastasis were again seen in the lumbar spine and pelvis. A few of these appear to have increased in size. For instance the 28 mm lesion within the L4 vertebral body previously measured 26 mm.
Heart - One mediastinal lymph node in the lower mediastinum anterior to the the descending aorta was 10.5 x 8.5 mm and is currently 12.9 x 10.3 mm.
Axillary Lymph Nodes - Many enlarged right superior and inferior axillary lymph nodes were present and increased in size.
Bones - Diffuse osseous metastatic disease involved the sternum, ribs and thorasic spine, but had not progressed since the earlier CT scan.
Blood Tests - Judy had three blood test results that were of concern to the oncologist. First, her Alkaline Phosphatase went from 298 to 961. The normal range for Alkaline Phosphatase is 39-120. Higher levels may indicate that the bile duct is blocked.
Second, her Aspartate Aminotransferase went from 80 to 131. The normal range for the Aspartate Aminotransferase is 8-35, with high levels indicating possible liver damage.
Third, her Alanine Aminotransferase went from 32 to 56. The normal range for Alanine Aminotransferase is 4-36, with higher levels indicating possible liver damage.
As a result of these significantly increased test results, the oncologist has ordered an ultrasound of her liver and scheduled it for Friday.
The last time we met with the oncologist she informed us that none of Judy's tumors were immediately threatening. So, this time I asked her what she actually expected Judy to die from. She said that it would likely either be a brain tumor or a tumor that would cause the liver to stop functioning. Based on the above test results and the absence of any indications of a brain tumor, it seems likely that a liver tumor will take her.
Saturday, December 13, 2008
Saturday, December 13, 2008
The next day (Friday) we went back for a 3rd infusion of 12 mg's of baking soda and protien. Judy got real sick again and ended up being in bed most of the day on Saturday, with terrible nausea. She called the DO at home and he prescribed ginger root and peppermint tea. It seems unlikely that she will be able to continue these treatments, as the protocol calls for the baking soda amount to be doubled each time and be 100mg's on the final treatment.
We go back to the Wellness Center on Monday and the oncologist on Tuesday. Guess we will have to see what each says.
Wednesday, December 3, 2008
Wednesday - December 3, 2008
Judy finally got the results back from her CT Scan and learned that the tumor she most worries about (the one at the base of her pancreas) actually shrunk a little. If this tumor invades the pancreas it will cause extreme pain and signal the beginning of the end. Unfortunately most of the other tumors had grown some.
Dr Randy Roberts at the Soli Wellness Center in Layton (near Ogden) said that she had progressed well during her first month of the plethora of wellness treatments, but that she still had a long way to go to be at her best. So, we contracted for another month of treatments! We expect to treat there at least another two to four months. Unfortunately none of these costs are covered by our health insurance.
One of the treatments that she received was a detoxifying foot bath. She was so impressed by it that we actually bought the machine so that she could do it at home more than once a week. We are also considering doing baking soda injections at the site of the tumors in her back that are causing the most pain. We think we have identified a local DO who will do them, though of course the Huntsman Cancer Center is discouraging this approach as there are no double blind studies supporting this therapy. However, there is a doctor in Europe that has some successful patient histories with this therapy ... but he is the only one publishing results at this time.
Sunday, November 16, 2008
Sunday - Nov 16, 2008
The intermediate news is that Judy is having more and more back pain, presumably from the cancer in her spine. Even though the cancer in her lymph nodes is not hormone responsive, the oncologist said that when it metastasizes to the bones it often is. So they have put her on monthly hormone injections on the outside chance that they can slow the cancer growth in the backbone a little. Unfortunately she got quite ill after the initial injections. We do not know whether the injections caused the illness, or if it was caused by something else ... like getting overly tired.
The bad news is that during the last two months (that Judy has been off chemo and feeling better and better) her cancer marker has more than doubled. The presumption that we are making is, that while her general health is getting better and better, her cancer tumors are also getting bigger and bigger.
At this point we are assuming that she probably has less than a year left. However, our focus is going to be on helping her feel as well as she can for as long as she can vs extending her life at the expense of feeling poorly all of the way to the end.
Sunday, November 9, 2008
Sunday - Nov. 9,2008
Jerry had a not-so-good week. His rectal bleeding came back a couple of times, but went away on its own and he is doing better now. The considerable loss of blood has made him even more tired than his heart condition. He probably exacerbated the problem with a 60 day colon cleanser he bought over the internet and did not quit using until after the bleeding restarted following the cautery. He got his flu shot like a good guy and now has a cold, with heavy sinus drainage, a fever blister and even more shortness of breath. However, he made good progress getting the garage cleaned out, the shelving set up and even repainted the garage floor with some paint Steph and Derek had left over. He should be able to get Judy's car in within the next week or so. (The floor paint has to dry a week before you can put a car on it.) So, Saturday will mark the accomplishment of a big Fall goal for Jerry.
Monday, November 3, 2008
Monday, Nov. 3, 2008
Jerry spent the last 24 hours in the University Hospital trying to determine what was causing his heavily blooded stools. They did find an Arterio-Venous Malformation during his colonoscopy. (You can Google AVM for more information.) This malformation is when there are no capillaries between an artery and a vein. The blood just recirculates, without feeding the cells. Usually it is not a problem, but ocassionaly the vein ruptures. This is what caused the bleeding in his stools. They cauterized the rupture and told him that he was good for several more years.
Sunday, October 5, 2008
Sunday - October 5, 2008
The garage painting is coming along and the watermelons, tomatoes and cantaloupes are still growing. Today, since we had to be home all day, we are trying out Jason's new smoker and are cooking up three small elk roasts. Derek and Steph may be coming over for the afternoon session of conference and elk dinner afterwards. Jason may also come by.
Pictures from the "Shave Fest"
Read the September 15, 2008 post for details. Here are the pictures! |
Before - Kip's Dad, Kip's Brother, Kip, Sharol, Shelly (front), Judy, Steph, Derek, Jason |
Enjoy It While It Lasts - Sharol, Judy, Shelly (front), Steph |
New Fashion? - Shelly really wanted to stop here! (Actually, rumor has it Shelly went first and after she was bald everyone said "Just Kidding" and started packing up to go home.) |
Newer Fashion? - Sorry Stephanie... not even your smile can pull this off! |
How expensive is shampoo? - Julia (Sharol's daughter) and Sharol discussing the potential money Julia could save in hair product. |
Everybody's Doing It! - Sharol, Stephanie and Shelly showing just how much fun this can be. |
Awwwww - Ain't she cute? - Judy sporting her new "care-free" hair style. |
Living the Religion - Mom's Bishop came over to teach a lesson on eternal families. After the lesson, he announced that he would be... how shall we say... an "active" participant in the festivities. Now that's what I call living your religion: Mosiah 18:7-9 |
The Finished Results - Shelly (honestly, she wanted to do this, we didn't make her), Sharol, Stephanie, Judy, Jason, Jerry, Julia, the cat (his head was also shaved - Mom wasn't about to let the cat strut around the house with a full head of hair). |
I "heart" M O M - You can't see it, but the cat had a "!" on his head. We are still trying to figure what this would have read if all 7 of her children had been in town. |
Wednesday, September 24, 2008
Wednesday - September 24, 2008
We are looking at some possible alternative medicine regimens ... but are not sure if any of them make sense. Some have to be done in place of chemo, so now would be a ideal time to try them. One possibility would be two weeks in Tijuana with a Cesium chloride IV 12-14 hours a day and a new raw fruits and vegetables diet. We estimate this would cost about $15,000 and that none of it would be covered by insurance.
Another alternative would be to go to a chiropractor in Layton, who Sheri's mother-in-law swears by, another would be to go to a DO in Provo and a third would be to purchase the cesium chloride over the internet and administer it by spraying it on the skin. We reading a lot on the internet, talking to others patients and trying to make smart decisions as we move along.
We have harvested the last of the peaches, the tomatoes are producing a 5 gallon bucket every few days, the broccili is going strong and even a couple of cauliflower heads have begun to form now that the weather has turned cooler, we have two large watermelons and about one dozen canteloupes. We are mowing the lawn shorter and shorter preparing for winter and have put a 10' x 20' canvas garage up in the driveway to hold stuff from the garage while we paint it, reorganize the shelving and get ready to put a car in the garage for the first time in our married lives. Always before it has been full of "stuff". Even when we had a 3 car garage and a 30' x 30' workshop in California, we never had a car in the garage. So, we are making progress more progress in some ways than in years!
Monday, September 15, 2008
Monday, Sept. 15, 2008
However, it was too much for Judy and she was pretty sick on Monday and ended up spending 3 days in the hopital before all was said and done. They never did get to the source of the infection, though they tried. I thought they would put her on a high powered IV antibiotic and was quite surprised when they went the other way. They took her off all antibiotics to let the infection bust out, so they could find the source. It never did bust out and Judy got tired of all the tests and blood draws and finally just said, " I have had enough. I am going home!" After coming home her temperature came and went and she seems to be very gradually getting better. We have concluded that she must have gotten a touch of the flu bug.
On Saturday she gave me enough instructions to bottle 13 pints of pickled beets and 8 1/2 quarts of tomatoes from our garden. Today I am going to try my hand at banana nut bread!
Sunday, September 7, 2008
Sept 7, 2008 - Sunday Afternoon
She has convinced that doctors to give her chemo straight through, without stopped every fourth week to give her body a rest. She persuaded them that the week without chemo was worse than the weeks with it. So, we'll see how that goes.
Saturday we canned more tomatoes, made a Apple Crunch with Zucchini, griced and froze the rest of the Zucchini and made special chicken dinner rolls and banana nut bread. I started out alone early Saturday, but before long Bunny (Judy's sister like cousin) just popped in to help with the canning and Carol Jean Shultz (the sister of the missionary that baptized Judy, who is currently serving a family history mission in Salt Lake) showed up to make the chicken dinner rolls and the banna nut bread. Everything turned out just the way it should and Bunny left a plate of enchiladas for our dinner. Later in the day, the RS Pres (Teresa Smith) brought a loaf of pumpkin bread and a bowl of pumpkin soup and the neightbor at the end of the cul-de-sac (Judy Richards) brought in a dinner of roast beef , potatoes and carrots.
What kind a loving people we have had the privilege to associate with in our lives! You are wonderful and we love and appreciate you greatly.
Most of Judy's hair in now gone, including her eye brows so she is going to go ahead an shave her head today. Several week ago I told the kids that I would shave mine too as a show of love and support. Since then Shelly has arranged for a dinner at the house at four today, followed by a lesson from the Bishop on "Families are Forever" and a head shaving fest. Our three daughters her in Utah have decided to have their heads shaved as well ... and donate their hair for the creation of wigs for other cancer patients. Rumor has it that others may join in, such as our granddaughter and some of her new school friends from Cedar City (though I am not in favor of this since it is their senior year in high school and shaving their heads would impact so many of their important pictures) and some of Kip's family members. We'll let you know the final outcome later.
Thursday, August 28, 2008
Thursday, August 28, 2008
Our Ukranian house guest (Elena Yanova) has moved to Bountiful, where she will be closer to the LDS Business College. She is living with a couple that serve the Temple Square Missionaries by checking their apartments and providing soap etc. to the apartments where they live. They used Sister Yanova's apartment as an example of good housekeeping when she was on Temple Square and actually made a video of it for training other sisters.
Otherwise things are pretty normal around here. Judy has started her fourth month of chemo on Paxol, though it may be her last as she is loosing the feeling in her hands and feet. She is noticing trouble with handwriting and even typing. Not being able to type in today's computer age would be almost as bad as loosing your vision!!!
She has felt well enough at times to work bottling the surplus tomatoes from our garden. They are really produding well these days, about a dozen a day. We also harvested our corn, got about 20 quarts for the freezer. Our second crop of beets will soon be ready and we actually have a few watermelons and canteloupe beginnin to get big. Hope they beat the frost.
Saturday, August 16, 2008
8/16/08 - Saturday Afternoon
Jerry spent last week in Cedar City helping Sharol and Martell get their books ready for their delayed tax filings. He literally worked 14 hours a day for 7 days straight in order to meet their Aug 15 deadline, only to find out after he got home that the deadline was actually Oct 15. None the less, all are happy that everything is done well ahead of the real deadline.
Jerry and Judy will be spending this next week with Judy's sister in Grand Junction, Colorado ... as this is her week off chemo. Jerry will be taking his new Polaris 700 4 wheeler out to do a little riding with Bob. Judy will try to visit with her cousins and aunt while out there. This could be her last visit to her home state of Colorado, so she is really going to try to live it up and enjoy the scenery!
They may also spend a night with Jerry's Aunt Barbara Walston in Moab, Utah on the way back. He may even be able to arrange a deer hunt next Fall with his cousin Brian during the visit.
Judy's children took good care of her while Jerry was in Cedar City. Jason sat with her in the ER until 1:30 AM, Stephanie stayed with her the next day and night and Shelly and her family came over the following night. Unfortunately Shelly's kids got sick and spoiled the night of fun at Grandma's. It doesn't look like Judy caught whatever it was that they had, so all is well on the Wasatch Front!
Thursday, July 31, 2008
7/31/08 Thursday Afternoon
Judy had her heart ultrasound and stomach CT scan on Monday. The cardiologist thought the tightness around her heart was more likely related to blood flow restriction than to cancer. The cardiologist said that the tumors throughout her abdomen were shrinking, but that she had a spot at the base of her pancreas and spots on the bones in her back that were not previously visible. She noted that the spot on her pancreas was probably there all along, but had been blocked from view by the overall swelling of the pancreas ... which had now subsided. She guessed that the spots in the bones were more likely from the dying cancer cells than new cancer cells. They gave her a medication to help strengthen her bones and then gave her the same chemo treatment as before ... which now seems to be causing numbness in her hands and feet. Since it does not yet affect her ability to dress herself and do other routine things around the house, they are going to keep her on the Taxol a while longer. However the numbness can be permanent, so they won't be able to keep going with the Taxol if the numbness begins to affect her daily actitivies.
Jerry had his heart MRI and his new U of U cardiologist told him that he did not put too much stock in the lower (42%) ejection fraction even though the MRI confirmed it (43%) and that Jerry would not be able to feel a 50% blocked coronary artery if everything else was OK. However, the cardiologist did say that Jerry had water in his lungs and on his heart and that the water in his lungs was causing his shortness of breath, not his heart. He made five medication changes for Jerry: 1) took him off Maxide (a mild diuretic); 2) put him on Lasix (a much more powerful diuretic); 3) reduced his Coreg back from 50 mg twice a day to 25 mg twice a day (said the heavy dose might be contributing to his exhaustion); 4)Doubled his Lipitor from 40 mg to 80 mg (since his cholesterol was 289 and had been down to 200); 5)put him on Spironolactone for his blood pressure and to lessen the affects of the expected Vitamin K loss that will be caused by the Lasix.
He told Jerry that he should begin having less shortness of breath and more energy soon and that he would see him again in 6 weeks.
Sunday, July 20, 2008
7/20/08 Sunday Evening
I go in Monday afternoon for an MRI on my heart, a new diagnostic tool for heart problems. The cardiologist said he thought that my low (42%) ejection fraction might have been a mis-read. He said the procedure used to get it was not very reliable. He also took a cholesterol test blood test and probably will be putting me back on a statin.
It is going to be a big week this week, with doctors' appointments and Shelly's wedding and reception on Saturday. Even though Judy made it through 3 hours of church today, it is not likely that she will have enough energy to make it next Sunday.
Sunday, July 13, 2008
7/12/08 Sunday Evening
Wednesday, July 9, 2008
7/9/08 Wednesday Night
We are not all that sure that the reaction was caused by the chemo, since she has had a red face twice before. Once before she even started the chemo and last week the day after the chemo. However, we will have to watch her closely during the next chemo session to see if the red face comes back part way through.
We were advised that on July 28th they will do a new ultra sound to see if they can detect any change in the size of the tumors. Until then, it is all about how Judy feels.
I believe that Judy is gradually getting better and consequently that the tumors are probably shrinking. She seems to be getting stronger every day. She feels she has enough strength to walk from the parking into the infusion room for her chemo. Before she always asked for a wheel chair!
She has also been on a few outings in the last couple of weeks, one that lasted all day and tired her considerably. She did not feel well the next day, but bounced back the following day. She also went shopping for wedding dresses tonight with her daughter that is planning on getting married on July 26th. They found a dress that they could both agree on! (Shelly's kids and I weeded the garden, ate watermelon, otter pops, ice cream sandwiches and went 4 wheeling near the house. We had a great time!)
Saturday, July 5, 2008
7/5/08 Afternoon
Wednesday, July 2, 2008
7/2/08 Wednesday Morning
Saturday, June 28, 2008
6/28/08 Saturday Night
Sunday, June 22, 2008
6/21/08 Sunday Evening
Saturday, June 21, 2008
6/21/08 Saturday Morning
This coming week is her week without chemo. This allows her regular fast growing cells to rebuild. Apparently they rebuild faster than the cancer cells. It will be interesting to see how she feels without the chemo.
Wednesday, June 18, 2008
6/17/08 Wednesday Afternoon
Monday, June 16, 2008
6/16/08 Monday Morning
Sunday, June 15, 2008
6/15/08 Sunday Morning
Thursday, June 12, 2008
6/12/08 Thursday Morning
They were unable to identify the source and so just started her on a 90 minute IV dose of Levaquin and sent her home with a prescription for pills to continue the treatment. She was released from the hospital at about 8:00AM and is now home catching up on her beauty rest.
Wednesday, June 11, 2008
6/11/08 Wednesday Evening
Tuesday, June 10, 2008
6-10-08 Judy's Comments
I am hoping for a new beginning tomorrow. Some energy to get out of bed and actually do something productive. Jerry has been SO GOOD in caring for me. He just sold his canoes, trailer and go carts. We are entering a new phase of life and love the memories of all the fun times and friends.
Thanks for all of your love and care.
6/10/08 Tuesday Evening
Saw doctor about 9:30 AM, but blood test results were still not back. She finished with Judy and sent her to the infusion center for the chemo. Clotting test was low, so Judy will have to increase coumadin this next week. Other tests were OK.
It was 11:30 before the premeds were ready and noon before the chemo was started. The chemo went well, with Judy actually sleeping during the last 30 minutes or so. We finally left the infustion center around 1:30 PM. (We had hoped to be finished by 11:00 AM, so it took quite a bit longer that we expected.) She will do one more week of chemo, then take a week off.
Judy felt relatively good late yesterday afternoon and evening and even felt OK this morning and afternoon. She thinks that she is actually beginning to feel a little better and is planning on doing a little organizing around the house in the morning. Aunt June has offered to come over and help tomorrow evening. So Judy will probably get things lined up in the morning for Aunt June to do in the evening.
Things are progressing nicely and we are grateful for all of your help and especially your prayers! We are enjoying the tender mercies of our Father in Heaven, even during these tender times. We love and appreciate you, one and all!
Monday, June 9, 2008
6/9/08 Monday Evening
She has been in bed sleeping most of the day, too sick to even watch much TV. (Though she does like Dr Phil & Oprah.) She is doing a little better tonight and is in her office working her emails and talking to family members on the phone.
We have to leave for her 2nd Chemo in the morning at 7:00AM. Should be home by early afternoon.
Sunday, June 8, 2008
6/8/08 Sunday Evening
Stephanie, Derek and Julia came over to check on Mom and stayed to visit a hour or two. They had a sandwich (less the tomatoes) and a serving of dessert. Played with the kitten and talked for a while, then went home. It was good to see them. Judy was able to sit in her easy chair during the whole visit and felt fairly good.
Saturday, June 7, 2008
6/7/08 Saturday Morning
Friday, June 6, 2008
6/6/08 Friday Morning
We went shopping yesterday and she bought a wig for the day when she will no longer have any hair. Her hair has been so thin for years that the full head of hair on the wig makes her look 15 years younger.
We also bought a new mask for her sleep apnea machine and after just one night she already likes it better. Instead of being a full face mask or a mask that just covers her nose, it has nasal pillows that actually go into her nostrils about 1/4 inch. The new mask is much easier to keep in place and doesn't cause your face to be so hot. Now we just have to find a good chin strap that will keep her mouth closed when she is asleep. We have tried everything on the market, so I've been thinking about creating one myself.
Today is our 40th wedding anniversary and we are looking forward to just taking it easy! Judy's parents made 50 years and mine 45 years, but doesn't look like we will make either one. But, that's OK ... because we have lived a good, full and happy life. What more could we have asked for?
Wednesday, June 4, 2008
Last night all of the kids and grandkids were over for a little farewell, as were Kip's parents (Shelly's fiance's parents) and brother and the Hathaways. We had dinner and visited all evening. Judy took it easy and let the girls do the work, so she fared fairly well. She also slept well again last night .
Sheri and family left this morning at 6:00AM. Judy got up to say goodbye. Microsoft, where Danny works, is beginning to ask some of its employees to work from home. So we are hoping that Sheri and family will soon be moving (from Seattle) to Utah as well.
John and family will be leaving this morning as well ... and our house will be empty again. They sure helped a lot. I was planning on watching a couple of Sheri's kids this last week, but as it turned out I spent most of my time with Judy going to, staying at or coming home from the hospital and the burden fell to John and Amy. Sharol and Stephanie also helped a lot with Sheri's kids, as she took a well deserved and long overdue vacation with her husband. How nice large families are when one needs a little extra help!
Tuesday, June 3, 2008
Judy did make it home yesterday about 2 PM. She is pretty weak, but did get a shower and went on an errand run with me. She got too tired midway, so I had to bring her home and go back later to finish the errands. She slept well last night, and should be up in the next hour or two.
Turns out her regular chemo treatments will be Tuesdays at 8:00 AM.
Elena (our Russian speaking house guest) returned from a month in Arizona and is helping around the house. She plans on attending the LDS Business College this Fall, but can begin working part time with them on July 1st. She plans on commuting from Lehi for the time being.
Sunday, June 1, 2008
Judy took her chemo with flying colors. No nausea, no pain, no reactions! She has not lost her appetite and is eating well, so they have been able to stop all IV fluids.
They even tested her porta cath and it passed with flying colors as well.
At this point they are planning on keeping her overnight, to see if the oral antibiotic (Cipro) is going to hold the infection in check. If so, she will probably be released before noon tomorrow.
She is scheduled to return a week from tomorrow for her second chemo treatment.
Just met with the oncologist (and associates). Had a long conversation. Judy is doing well for the moment, though not coming home today. Still not sure where the infection was, but it is being handled by the antibiotics. They will take her off the injected antibiotics and put her on oral ones today, but want to keep her another day to be sure she responds well to the oral antibiotics.
We learned this morning that if Judy had been able to be treated with hormone therapy, that she might have expected to live another 7-10 years. However since her cancer is no longer hormone receptive, she has to be treated with chemotherapy. Once on chemotherapy the average "advanced breast cancer" patient lives approximately 2 years.
We were advised that since Judy's liver has only one or two spots of cancer, as opposed to being covered with it, that she may live longer than the two year average.
Judy is presently waiting for breakfast, has had her dose of steroids to keep her from reacting too much to the chemo. Her chemo has been deferred until 10:00AM. She probably won't be too nauseated by the chemo, but will probably loose her hair again.
Saturday, May 31, 2008
Just spoke with Judy, she is doing much better. She talked with the oncologist who advised her that:
1. She was expecting to give her chemo at around 9:00 AM Sunday;
2. That most of her problems were coming from the cancer sites;
3. That they planned on doing chemo weekly for 3 weeks, then off a week and continuously repeating the pattern for awhile;
4. That she should begin to feel a difference in about 4 weeks; and
5. That she should feel like a new person in about 3 months.
When I left Judy last night she was eating some light foods, seemed to be feeling better and getting ready for her evening medications. Aunt June and Uncle Tom came to visit and had dropped food off at the house and so offered to bring anything from home that we needed. The hospital asked us to bring in her CPAP machine and medications, so that they could duplicate the dosages. They saved me a couple of hours of driving.
Judy is at the Huntsman Cancer Center, fourth floor, room 4507. Sorry I did not get the phone number. We are hoping that the antibiotics kick in good today and that she will be ready for chemo either today or tomorrow and be able to come home shortly afterwards.
Friday, May 30, 2008
Judy thought that once she got the porta cath in, she would no longer need to have needles put in her arm. She could not have been more wrong. In order to pin down the infection source they needed blood drawn from two sites. The surgeon did not want the porta cath used for two more days, so they tried to draw blood from the midline. They had trouble with it, but finally got it to cooperate. Then they stuck her in the hand for the second site. They got about half the blood they needed and it clotted. Then they stuck her in the arm for the rest of the blood. So much for no more needles!
Well, things did not go well this morning. Judy was so sick that we were 1/2 hour late starting out. When we got to the clinic she had a fever, so they said no chemo today.
We did learn that Judy's cancer is in stage 4, meaning that there is no cure. (By definition, stage 4 breast cancer is when the cancer spreads beyond the breast and associated lymph nodes.) The good news is that she has been in stage 4 since her hip cancer 11 years ago and she could yet live for years and years to come. No cure means that if something else doesn't kill her first, that the breast cancer will eventually kill her.
When they did the labs this morning they discovered that she has an elevated white cell count and abnormal liver enzyme test results. One possibility is that she has a touch of the flu, another is that she has developed an infection from the bile duct stint site, the portacath, the pancrease or the kidneys. They decided to admit her to the hospital for additional tests and to put her on antibiotics for a couple of days. They hope to be able to give her chemo before she is released.
A little later on our oncologist's partner came in and said he thought that the bile duct stint might have moved or closed off, so he has ordered more tests and feels that they might have to redo the stint. To early to tell, though. So it is another round of wait and see how the tests go and how she responds to the antibiotics.
Thursday, May 29, 2008
Yesterday was a difficult day for Judy. She was quite nauseated and stay flat on her back most of the day. Today was only slightly better.
We talked with her oncologist just a few minutes ago and were advised that Judy's biopsy looked most like breast cancer cells. That was the good news. The bad news was that the cancer was not hormone responsive, so she will have to have chemotherapy. They are doing one additional test (nu tu du or something similar) to see if she will be sensitive to a particular chemotherapy drug.
We are presently waiting for a call back from the oncologist, who is trying to fit Judy into her schedule tomorrow for plan development and the start of chemotherapy. Judy is most anxious to start the chemotherapy, as she literally feels worse and worse each day without any kind of treatment.
The oncologist's nurse just called back and Judy is scheduled to go in, in the morning at 8:30 am. She will do labs, meet with the doctor and then get her chemotherapy. It appears that they will be giving her a drug called Taxol once a week thru her portacath. (This time it will go in the midline, then they will pull the midline. From then on it will go in the portacath.) The portacath has to be flushed once per month, if not used. Since they will be using it weekly they will be doing all of the flushing. She will probably loose her hair, which is no big thing for her ... since she lost her hair when she was on chemo 23 years ago. Last time her hair grew back darker and more curly!
Tuesday, May 27, 2008
Today was eventful, Judy woke up quite nauseated ... which was probably from the stressful anticipation of the surgeries and I woke up so tired that I could hardly walk three steps without breathing so heavily I would have to stop and rest. I think I just had a touch of the flu, as I am feeling better this evening. We left for the hospital a little after 9 AM, after Judy got a blessing from me and John. We got to the hospital right on the money at 10:15 AM. They registered us and we thought we would visit a friend in the cardiac center while we were waiting to be called in. We mentioned this to the intake personnel and they said they thought we would be called in right away. There were probably 30 people waiting in the outpatient surgery room, but they called us first ... we weren't sitting for more than a minute or two. Judy was put in a "clean room" to prepare. They, of course, had her put on one of their gowns (reminded me of the dance in the movie Parent Trap, where one twin cut a pie shaped piece out of the back of the other twin's skirt, without her know it ... which meant that she went back into the dance missing a critical piece.)
Since it is a teaching hospital there was a string of nurses, anesthesiologists, doctors and surgeons that poured through her room asking questions, feeling her neck, hooking up lines, flushing her midline and trying to decide how best to approach the two procedures. When the actual surgeon came in, he felt her neck and mentioned that it was not a single lymph node but rather an aggregation of them. I asked if he was going to remove it entirely. He said not, because it would leave too big a hole in her neck, that he was only going to take a good biopsy.
They did not put her under general anesthetic since she has heart breathing problems already, just gave her enough anesthesia to keep her from knowing what was going on. The teaching surgeon put the porta cath in, but let one of the resident's take the biopsy. They were right on schedule, getting her in a littler before 12:15 PM and getting her into recovery by 1:10 PM. The surgeon came out and said that both procedures went well and that she tolerated them well. She was in recovery about 20 minutes, when they put her back in another "clean room". She was there another 30 minutes or so while they prepared her release instructions and gave her a double dose of pain killers (Lortab). Aunt Bunny and Uncle Barry came to see how she was doing, and brought her a cute little pot of yellow flowers. They were shown into the recovery room and stayed with us until we left the hospital.
Judy got home about 3:30 PM or so and went directly to bed and mostly slept until about 7:00 PM. She got up and ate dinner (potato soup that Amy made) and visited a little while before going back to bed.
Now we wait again, two or three days for the pathology reports to come back on the new biopsy. Hopefully the report will tell us what type of cancer it is and we can then begin treatments.
While there, I made an appointment with one of the cardiologists in their Cardiology Center, hoping that I can get a little better treatment for my heart (which has lost a full third of its pumping capacity during the last six months since I had the last two stints put in ... down from 75% to 42%). Only time will tell!
We saw Adam Nelson while there, a couple of times. Once in the cardiology unit where he works and the second time when he brought one of his patients out to the valet parking where we were waiting to pick up our car. He said that I would really like my new cardiologist! I sure hope he is right!
Monday, May 26, 2008
Today was an average day. Judy slept quite a bit, but ate well and is looking forward to tomorrow's biopsy. Surgery is scheduled for 12:15 PM, however it will probably be the end of the week before we get the pathology report back and can start treatments. She took her last painful belly shot this morning and won't resume again until tomorrow night. She will have be on them for three more days until the coumadin comes to full strength.
Sunday, May 25, 2008
Today was a very wearing day as we had all of the kids and grandkids come back over for individual family pictures in their Sunday best at 11:00 AM, fed them lunch and had them join us for church at 1-4:00 PM. Judy was too exhausted to join us for church. After church they all came over to the house again and Uncle John took them all for scooter rides. They then came in, ate dinner and had pie for dessert. We talked and talked and Aunt Bunny and Uncle Barry came over and they visited with us and remembered lots of fun things with us. We are both very tired, but have quite enjoyed the day.
John (our middle son) and Amy (his wife) and their three children will be spending the week with us. They are going to help us care for two of our oldest daughter's children, Jonathan (8) & Gabrielle (6) while mother and dad are enjoying some time with his parents.
We thank everyone for the large meal that was brought in on Friday night. We ate on it then, all day Saturday and part of Sunday. The grandkids so enjoyed the fresh fruit and just ate on it and ate on it to their little hearts' content.
Saturday, May 24, 2008
Judy had another average day yesterday. She is still getting the painful Lovenox shots in her belly both morning and evening, to keep her blood thin until after the surgery next Tuesday at 12:15. We also flush her midline with a saline solution and herprin every day. Actually we have to flush twice a day to keep the line clear.
She does ok as long as she takes her pain and nausea medicatons and doesn't overdo it.
All of our children and grandchildren are coming in today to check up on grandma, so it is going to be a very busy day!
Thursday, May 22, 2008
Wednesday, May 21, 2008
Not a very good day for Judy. She was sick and in pain a good part of the day. She spoke with her oncologist and she ordered Judy on pain killers, anti-nausea meds and medication for her upset stomach. Judy felt better for several hours after taking all of the meds. Her oncologist said she would see Judy tomorrow and even start therapy if she continued to feel poorly.
Tuesday, May 20, 2008
We spoke with the scheduler for the surgeon this morning and learned that he will be out of town on Wed & Thur. So, she probably won't be able to have the biopsy until Friday or after.
Monday, May 19, 2008
The Bad News: We are still on the runway! The pathology report on the biopsies was available, but showed very little new information. They were needle biopsies and simply did not have enough tissue to make a usable diagnosis. The diagnosis made was that the biopsies contained "adenocarcinomas" (cancers that grow in glands and organs). This means that we still do not know if it is pancreatic, liver or simply lymph node cancer and therefore still cannot start treatments.
They are going to leave the midline IV in until the next surgery. (This means daily flushes with saline and heperin.)
She is also going to have to continue the painful stomach shots of Lovenox twice a day for at least another 5 days. (They cost nearly $70 each and she is in the Medicare gap of prescription drug coverage, so there will be no insurance relief.)
The Good News: Her blood test showed that her kidney function is continuing to improve.
They have ordered a complete removal of the lymph node on her neck, so that they can be sure they have enough tissue for a more definitive diagnosis. It won't even be scheduled until tomorrow morning, and not completed until Wednesday at the earliest. Then we will have to wait until Friday or Saturday to get the results. This means that treatments will not start for at least one more week.
While she is under anesthesia for this surgery they are going to place a porta catheter in her chest wall, so that they won't have to keep sticking needles into her only good arm for blood draws, medications or other procedures. They will all go into the porta cathether for the rest of her life!
They are still considering putting her on hormone therapy for treatment. These would be oral medications.
So, again, it is just wait for the next procedure!
Judy ate a nice, full meal last evening and rested well last night.
She is still in pain, she thinks from the tumors pressing on her organs, and is quite tired. She hopes to be able to get a few things done around the house today. She doesn't need to cook or clean up, but does want to read some mail and organize her desk a little. We'll see, as she needs to save strength to make a trip to Salt Lake later today.
We are scheduled to go into the Huntsman Cancer Center in Salt Lake today to have a blood draw and then have the midline removed. She is hoping that we will get the results of the pathology reports prior to the midline being removed, so that it can be used for at least the first chemotherapy treatment.
Sunday, May 18, 2008
Judy has pretty much slept all day. She thought she might go to church for awhile, but when time came to go at 1:00PM she was just too tired to go. She is gradually recovering from her stay in the hospital and all its attendant procedures. We look forward to actually beginning to treat the cancer and make some progress there as well.
Judy is doing better today. The got a good night's sleep (in her waterbed) and the pain has subsided some. She will probably rest most of the day and hopefully by Monday will feel well enough to see the Oncologist (cancer doctor) and start her Hormonetherapy or Chemotherapy, whichever they decide to do after the pathology comes back.
At this point we believe that the cancer involves only her lymph system and is a metastasis from her breast cancer 23 years ago. They say that such a metastasis after this many years is unusual, but not unheard of. We hope it is from the breast cancer, as this is the easiest to treat on the one they have the greatest success with.
As always there is ambiguity. Her GI Surgeon said that the cancer in her abdomen was ominous looking and her Oncologist said that she thought everything would be treatable. Maybe this is the difference between a man being brutally honest and a woman trying to play down the trauma.
While no stents were required in Judy's ureters (the tubes between her kidneys and bladder), her kidneys are having some difficulty absorbing the contrast dies from the various test procedures.
She is getting quite sore and is still on pain medications for the pancreatitis.
She was released to come home from the hospital around 3:30 PM.
They left the midline (deep IV) in just in case they need to do additional procedures. Judy is hoping that it will last long enough to get at least one chemotherapy treatment early next week. (A regular IV is usually good for about 72 hours. However, hers were collapsing in less than 12 hours. So they decided to put in a highly sterile midline, which can last up to two weeks.) The midline has to be flushed with a saline solution and heprine every day. The Cancer center gave me three days of heprine, but only one day of saline. So I tried to buy two more days a local pharmacy. They did not carry the saline solution, so I ended up going to the American Fork Hospital and begging the extra two days.
They did not put her back on her blood thinners (for her heart), just in case they needed to do additional procedures or take additional biopsies after they got the pathology reports back. (It takes a week to get off the blood thinners.) That meant that she had to go back on those painful belly shots of Lovenox to keep her blood from clotting. (She had already had one clot after the heart stents. This was about a month ago and was in her calf. So, in addition to the Plavix, they had to put her on Coumadin. Both are generally thought to be blood thinners, but are actually anti-coagulants.)
She is very sore and very tired and will probably sleep the rest of the afternoon and evening.
5/16/08
They did not put the stents in Judy’s ureters. They got some clues that the kidneys were shrinking and so they did a cat scan and found they were doing better and decided that the stents were no longer necessary.
The yellow coloring in Judy’s eyes and skin is receding and she has tolerated the testing quite well. The nausea and itching are much better and she is more comfortable. She was actually allowed to eat for the first time since Tuesday and really enjoyed the few bites she was able to eat.
We still do not have the pathology studies of the biopsies, so we still don’t know what type of cancer she has. Maybe they will be ready tomorrow, if not early next week.
Judy has developed pancreatitis (an inflammation of the pancreas), probably from the GI surgeons poking around in the vicinity. She is on pain medications for this.
If the pancreatitis gets better she will be released tomorrow afternoon to go home.
We expect to go back on an outpatient basis next week and begin whatever treatments are determined to be appropriate.
5/16/08
They did not put the stents in Judy’s ureters. They got some clues that the kidneys were shrinking and so they did a cat scan and found they were doing better and decided that the stents were no longer necessary.
The yellow coloring in Judy’s eyes and skin is receding and she has tolerated the testing quite well. The nausea and itching are much better and she is more comfortable. She was actually allowed to eat for the first time since Tuesday and really enjoyed the few bites she was able to eat.
We still do not have the pathology studies of the biopsies, so we still don’t know what type of cancer she has. Maybe they will be ready tomorrow, if not early next week.
Judy has developed pancreatitis (an inflammation of the pancreas), probably from the GI surgeons poking around in the vicinity. She is on pain medications for this.
If the pancreatitis gets better she will be released tomorrow afternoon to go home.
We expect to go back on an outpatient basis next week and begin whatever treatments are determined to be appropriate.
Thursday, May 15, 2008
5/15/08
A few minutes after we got into the room another Dr. came in and said she had fluid in her kidneys and they would need to bring her back to the OR tomorrow for 2 more stints. He also said no food until after the surgery was over. For those counting, she hasn't been allowed to eat since Tuesday at midnight. I could tell she was feeling a little better because she gave every nurse who came in a lecture about starving her to death!LOL
So they tried to biopsy the lymph node in her neck this morning, but the samples they got were no good. The pathologist stayed for the surgery so he could try again while she was out. He also poked a needle through the wall of her bile duct and got a sample of the lymph nodes around her pancreas. He said that was definitely cancerous, he also assumes her neck is cancerous but can't be definitive until he gets the labs back.
Her pancreas itself seemed to look just fine, as well as the interior of the bile duct, but he took a brushing anyway so we can know for sure. At this point they are going to assume its breast cancer that has just metastasized in other locations. It's the most probable and our best shot at treating her.
I asked the Dr to stage her Cancer for me but he was unwilling to do so until he knew for sure what kind of Cancer it was. I also asked him what he thought it was if not breast Cancer and he refused to answer. What can you do? He said since tomorrow is Friday we would probably not learn where the Cancer originated until Monday. If I'm able to get some information about it tomorrow I will post an update. We expect mother home tomorrow evening at the earliest, and quite possibly not until Saturday.
Update 5/14/08
We told him that we had tried to get in to see Dr. Saundra Buys (a highly recommended oncologist at the Huntsman Cancer Institute) but had been told that she was not accepting new patients and even then she was booked out a month. We decided that that was too long to wait and begged the scheduler to find someone who could see her sooner and biopsy her lymph node and that we had then been referred to him. He said that he knew Dr Buys well and that he would give her call. He came back after calling her and said that she would see Judy immediately if we would go over to her office right then.
We spent and hour or so with Dr Buys and she said that she would manage Judy’s care and that the first two items of priority were to get the bile duct opened up and to properly diagnose the problem. We then told her we had an appointment on June 2nd to have Dr. Adler redo the procedure to open the bile duct and that we had complained that the appointment was too far away without any progress in getting it moved up. She said that she would call Dr Adler, that he owed her a favor or two. She came back after the call and reported that if Judy would be admitted to the Huntsman Cancer Institute Hospital that he would do the surgery the next afternoon.
Talk about answers to prayers!
She is in Room 13 on the 4th Floor of the Huntsman Cancer Institute Hospital. Her phone no. is 587-4513.