(a-mend)

MEANING:
verb
1. Alter to remove errors.
2. Make corrections and improvements to.

USAGE:
1. The first printout quickly revealed that our computer program needed to be emended.

I’m not just painting you a rosy picture here – there are so many anti-nausea drugs available today, there is absolutely no reason you should experience a moment of queasiness.  They work.  I took a drug called Emend which amounted to one dose the day of my chemo and one pill a day for the following two days.  I called it a miracle drug.  I had googled it before I began and was encouraged by what I read.  One woman said she regularly stopped for pizza on the way home from her chemo treatments.   It really is that good.

The most significant side effect of chemo is the undeniable fact that you will become extremely tired.  You can’t avoid this, but that’s not entirely a bad thing because your body needs rest.  Sleeping on the sofa in the middle of the day or relaxing with a good book doesn’t sound that terrible to you, does it?  Give yourself time.  The fatigue is temporary.  It will come and go with the treatments, but it is temporary.

I have watched people I care about refuse chemo because they were afraid of everything they’ve seen and heard in the past, everything they anticipate might happen, fear it won’t work, fear of even losing their hair.  Well, hair is overrated people.  Plus, it does grow back.  Plus, guys – you look sexy with no hair…and ladies – you can finally go platinum blonde or red-headed with an awesome wig – and, a bonus – you won’t have to shave your legs or underarms.

So, take a good book, some snacks (yes, I snacked) and/or your I-Pod and a cozy cuddle blanket and hit that chemo chair.  You don’t truly have anywhere else to be, do you?  Having cancer is one of the few times in your life you can really cut yourself some slack and have some complete downtime.  When I was reclined and listening to my music, well, it was kind of heavenly.

I’m still here…

Go forth and be fearless…because you can!

از امروز صبح چهاردهمین دوره ی شیمی درمانی م با داروهایی ک تصاویرش را در این مطلب می بینید شروع شده ک از خوش شانسی م هوا تا حدودی سرد و بارون ی بود – نباید تو هوای سرد قرار بگیرم – ک تا جای ممکن ه تونست م رعایت و سالم ب منزل برسم تا ببینم وضعیت هوا برای فردا چطور خواهد بود گرچه قلبن امیدوارم وضعیت هوا ب همین روال ادامه پیدا کن ه تا عزیزان مون برای مدت ی حتی دو روز شاهد یک هوای خوب و پاکیزه در تهران باشند ضمن اینکه معتقدم ب خاطر یک بی نماز نباید درب هیچ مسجدی را بست.
نگران حال م نباشید چون تا خداوند و بعد از اون شما دوستان را دارم غم ی ندارم و مطمئن باشید در آینده خیلی خیلی نزدیک همراه با سلامت ی کامل در خدمت شما خواهم بود، البته اگر مث سابق حوصله م رو داشت ه باشین
در خاتمه از همه عزیزان بابت پاسخ ندادن ب موقع ب کامنت ها عذرخواهی می کنم اما قول م سرجاش ه، حال م بهتر شد چشـــــــــــم

پ . ن سه عدد کپسول ناقابل – اِمِند ک امروز تجویز شد از قرار هر عدد پنجاه هزارتومن ….. من ب جهنم اما اون بنده خداهایی ک ندارند باید چ خاک ب سرخودشون بریزند ؟ تازه این نمونه ی خیلی کوچیک ی بود ک من ب جهت درمان خود با آن روبرو و از آن باخبرم چون همین دارویی ک البته مقادیری از آن را در تصاویر مشاهده و امروز مورد استفاده قرار گرفت قیمت ش شد یک میلیون و هفتصد و نود هزار تومان ناقابل

********************

Well, I wrote this post a little over 7 hours post surgery. It went well.

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I woke up about 9:30, showered, washed my hair and scrubbed all over really well with Hibiclens.

At 10:30am, I took Emend (a pill to help with nausea…. When I had my wisdom teeth pulled YEARS ago, it made me violently ill, so the doctor and anesthesiologist planned ahead for me to try to help me not get sick).

By 11:30, I was showered and ready to go. I was also hungry and thirsty. I hadn’t eaten since 12a and no water since 4a.

The ride there was quiet…. My fiancé held my hand and told me that everything will be just fine. Just his presence made me feel better.

We got to the surgery center, signed in, I signed final paperwork, and was temporarily separated from my fiancé.

The nurse brought to my recovery room and he was asked to wait for a few minutes while they started my process. I put on a gown and silly surgery grippy socks and got comfortable.

The nurse asked me a few final questions, answered my questions and took my vitals. Another nurse who would assist in surgery came in to say hi and see how I was doing. She was sweet, very warm and friendly like the first nurse.

The anesthesiologist came in and helped to calm me. He gave me a pain-free IV and said when I get in the surgery room, he will let me know when the “sleep time” will start.

I had to give a urine sample to the nurse and when I returned, my fiancé and the doctor were waiting for me.

We talked to the doctor. He answered final questions, put me at ease, and marked my chest for surgery. He said I’ll be in surgery for 45 minutes to an hour and we will be starting soon.

He left to prepare and within minutes it was time to go. My fiancé kissed me and I was wheeled off on my recovery bed.

In the surgery room I started to get really nervous. But the staff was AMAZING!!

The nurse had me slide from my recovery bed to the surgery bed and got me comfortable. She laid a warm blanket on me and massaging leg wraps on my calves. I had to stretch my arms out and they were covered up with warm towels.

The anesthesiologist told me that it’s time to start and to relax. He said I’ll close my eyes and when I open them, I’ll be in recovery. He did warn me that there would be a chance that I might wake up a little when I am sat up to be bandaged (but I did not).

He said to tell him when I feel something… And about that time I sure felt something. I was able to say “I think I am starting to feel…” and that’s all I remember.

About an hour or so later, I started to come around in the recovery room. I was greeted by an incredible recovery nurse. He was the best of them all.

I don’t recall too much right away other than having to move from the recovery bed. And I know I felt a little nauseous

The anesthesiologist came in and he and the nurse gave me more meds. The anesthesiologist told me he also gave me a lot of anti-nausea in my IV too.

I was in and out of it for what felt like a long time. My fiancé was the best though! He helped me take sips of water and ginger ale and have me cracker bites.

When I had to focus and do something, I could. But I fell asleep in between those times.

I didn’t feel true pain (and now it’s 9:46 and I still haven’t). My arms sore (the nurse told me its from the way they have to manipulate them during the surgery( and armpits are a little “pinchy” (again my incisions are there and all the gauze and bandages are kinda rubbing me funny).

Otherwise the feeling is a terrible pressure on your chest, the weight and tightness is manageable but is very present. I won’t call it pain really…. It’s more of an uncomfortable, constant pressure and tightness.

Plus it’s taken up till now to be able to take a deep breathe without a great deal of pressure and increased tightness. The nurse gave me a breathing toy (“Air-Eze”) where I have to make the ball float in the tube when I breathe in to help me use deep lung breathing.

(Later I realize how much it helps.)

My doctor came in to check on me, have me take a hydrocodone (Vicodin) for pain (even though I wasn’t in that bad of pain). He said everything went very well and that they look great. He seems genuinely excited to show me them tomorrow.

He said I still have to pee before they will let me leave and to try to go soon.

The nurse came in and helped me walk to the rest room… And it was a no go.

So I drank a cup of water, a can of ginger ale, and three little cans of cranberry juice (on top of two IV bags I already had running through me….. Guess who was probably dehydrated when she went into surgery…).

The nurse also showed me a few tricks like pouring warm water over the genitals, bare feet on the cold floor, running water, and finally walking laps.

Then he dropped the catheter bomb if I couldn’t pee on my own….

I tried one last time and I really strained. I finally peed!!

But the activity and straining made me nauseous!

I returned to the room my fiancé helped me to dress and the nurse gave me Zofran for the nausea. And it took a little bit, but it eventually helped.

The nurse wheeled me out to my car and assisted me in. He was so sweet and comforting. And he commended my fiancé for his excellent care of me. He said that he is hired!

Since we don’t live close to the doctor’s office, we opted to stay at a hotel close by. And I am SO thankful for that!!

The short few mile drive was slightly painful. I really couldn’t support myself all that well since I have the armpit incision and the gauze is padded up pretty thick under there.

We finally got to the Hilton and I was wheeled up to the hotel room. I didn’t feel nauseous anymore and was just sore.

And I got my first glimpse of my chest. WOW! They already look good and I’m so excited to see them tomorrow. My fiancé seems excited too. And he also seems more calm.

My fiancé got my all set up on a bed and comfortable. and we ordered something to eat. I enjoyed a nice fresh caprese salad and I did not feel ill at all. I took my antibiotic and painkiller and had some Gatorade.

I am now resting comfortably, and am going to watch some TV and relax. I’ll be taking more painkillers and a muscle relaxer soon. The pain pump seems to be helping too. Not that I have anything to compare it too, but if you’re on the fence about it, I would say it’s worth it. I wouldn’t want to know what it feels like without it.

I will say this though, I am experiencing a little bleeding from the tubes from the pain pump. It’s not terrible and doesn’t hurt. But it does look a little freaky.  http://www.iflo.com/prod_onq_classic.php

My post-op appointment is at 10am on 06/27/2012. I’m excited for that and yes… I’ll be updating that appointment and finishing older posts too.

Four days after I had my consultation, I was back in the officer for my pre-op appointment.

The staff had me fill out some more paperwork and copied two forms of  ID and took the rest of my payment.

Soon, the patient coordination took me back into the consultation room.  She sat down with my fiance and I and gave me what she called the “Patient’s Bible”.  She said that we will cover everything that is in there, but it’s a take home guide for me to refer to later.

This nice, professional, and easy to read soft cover bound booklet was very helpful and informative. And… This booklet was seriously necessary!!

The topics it covered were:

- Preparing for surgery

- Medications to avoid

- Going to the surgery center and directions

- General surgical risks

- Specific surgical risks

- Anesthesia and other information

- Other risks

- Consent for surgery

- Post operative care – outpatient surgery

- Specific post operative instructions

- Longer tern post operative instructions

- As you heal

- Specifics as you heal

- Financial and cancellation polices

The patient coordinator then had me remove my top and put on the ugly looking bra.  She brought in several different sizes of implants.  She, again, had me put too different sizes in the bra without telling me what CC they were and asked me which one I liked best.

I picked my favorite and it was the same one I had picked at the consultation.  It made me feel more confident that I was sure I knew what size I wanted to be post surgery. She noted it down on my chart and had me remove the bra and put on a robe.

We walked into the room where I had the 3d image taken at the consultation.  The doctor met me in there and took a few pre-op photos of my chest. He then took some measurements of my breasts and told me that it would take 339cc implants to make my breasts int the masterpiece he wants them to be.  I was again very firm and said that I want a C cup, not a baby D.  He was very patient and told me not to worry, they will not end up being too big.

Since I had done my research on him and his work, I believed him and had 100% confidence in him.

We again verified that I was going to have silicone implants placed under my pectoral muscles through the transaxillary (armpit) incision with the use of an endoscope, that I would have a pain pump.

The doctor went over all of the medications he was going to prescribe me and how to use them.  I told him that anesthesia makes me throw up and narcotic pain killers also make me nauseous.  He said he would prescribe me things to help with that as well and he’d let the anesthesiologist know about my sensitivity to anesthesia.

I was prescribed:

- Hibiclens (an over the counter antiseptic/antimicrobial surgical soap used to wash the skin/body the morning of the surgery)

- Emend (Aprepitant) 40mg capsule (to take 3 hours prior to surgery to help me not be nauseous when I wake up from anesthesia)

- Zofran (Ondansetron) 4mg tabs (to take after surgery to stop nausea if it were to get bad)

- Keflex (Cephalexin) 500mg capsules (antibiotic to take following surgery)

- Vicodin (Hydrocodone/Acetaminophen) 5-325mg tabs (Vicodin with acetaminophen for pain and swelling after surgery)

- Robaxin (Methocarbam) 500mg tabs (muscle relaxer for after surgery)

- Halcion (Triazolam) 0.25mg tabs (sleep aid for the night after surgery and as needed)

- Peri-Colace (a stool softener AND laxative to help with the constipation)

A hidden cost of getting a BA is the cost of prescription medication.  If you do not have good prescription coverage, this could be expensive.  And ALL of the medications your plastic surgeon prescribes ARE NECESSARY.  

We went back to the consultation room for follow up questions and information.

Post-Op Blues:

The doctor reminded me that the day after surgery when he removes the bandages I need to understand it is not the final product.  He said the worst thing I can do it be expecting the final product and not less than 24 hour post-op swollen breasts.  He also warned of the “post-op blues” where the patient becomes sad, depressed, upset, etc with having undergone surgery, the current result and how they feel.  He said some women feel this in varying degrees and some don’t at all.

With all of that being said, all follow up questions answered, and feeling confident, I left the office with my surgery scheduled for June 26 at 3:30pm with an arrival time to the surgery center at 1:30pm.

I was excited and nervous!

Tuesday, 4/17/2012

7:00 – Awake, but feeling anticipatory nausea for the day to come.

7:20 – Drag myself from bed.  I am so tired and sore from trying to get my gardening and yard work done for the week.  I won’t feel like going back out there until about Sunday.  Actually, I won’t feel like doing much until Sunday.

7:30 – I get ready to go, taking breaks to dry heave.  I make sure to wash my hair because I may not take a shower tomorrow, depending on how I feel.

Put lidocaine and prilocaine cream over my port-a-cath (portable catheter embedded in my chest, below my right collarbone).  The cream will numb up the spot where a nurse will put in a three-quarter inch coring needle.  This needle will connect me to an IV pole and all my drugs that will hang on it.

8:30 – Take my boys to school. I am driving, so I can focus on something.  This helps with the nausea I am already feeling.  If I were the passenger, I would be a mess.  So, I drive and chat with my husband to help take my mind off the day to come.  Usually I drive up to chemo with my grandmother.  She comes up from Oregon for most of my treatments, but this time she had to stay home to go see doctors of her own.

8:40 – Stop at Starbucks for a decaf soy latte and a Chonga bagel.  This is one of two chemo day breakfasts that I can stomach.  The other is apple pies and an unsweetened iced tea with lemon from McDonalds.  I call this my “breakfast of champions”.  I will definitely get the McD’s sometime this week.
(I am aware that some might now be thinking, “Wow. That’s good for her!”  Don’t judge.  Some food is better than no food, I think.)

Take Emend in the Starbucks parking lot because I am still experiencing nausea.  Food will help, but Emend is a miracle anti-nausea medicine I discovered a few years ago.  It is expensive, but so worth it.  I take it before chemo, then again on Day 2 and Day 3.  It mostly just keeps me from painfully vomiting for the next few days.  It is truly a miracle med.
Then we set off for the drive to Seattle, a little more than 30 miles away.

9:45 – Check in at the doctor’s office, where the receptionist and I chat about The Voice, especially Adam Levine’s unsightly new haircut.
I then head to the lab to have my port-a-cath accessed and get blood drawn.

During my lab time I chat with the nurse about New York because I will taking a trip to “the city” in a couple weeks.  She is from Long Island and I briefly lived in Westchester County (Rye, home of Playland, to be exact).  She also asks if I am still writing, so I tell her about shelving my book to start blogging.  She asks for the address, so she can follow it.

10:30 – My appointment is scheduled for 11:00, but I beat some people out who are still at the lab.  The earlier the better, since this is going to be a long day regardless.

After my oncologist looks me over and asks questions about my appetite and bowel movements, I tell him I want to skip my next chemo for my trip to NYC.  I do not normally skip chemo, and I do not recommend it, but I have been doing this for so long.  A break now and then really helps me reenergize and keep a positive attitude.  My reasoning here is that I have a CT scan two days before the trip, and I will get the results the day before our break of dawn flight.  I explain that I will need a trip to celebrate or just a few days away to put normal life on hold.  My scans have been looking fine, but I have not had one in a while, and anything is possible.
My oncolgist is from New York, so we talk about places to eat.  He wants me to get four White Castle burgers and go to Tom’s Diner.  When I tell him we are taking the boys, and my youngest has requested a visit to the Bronx Zoo, he pulls a subway map up on the computer and we plan the quickest route.
While he prints out a prescription for Marinol (THC from a lab, pharmacy-approved), my fabulous nurse writes me a scrip for 4 White Castle burgers and a “slice”.  She has a great sense of humor and keeps all her patients smiling and laughing.

11:00 – I show up in the treatment center to check in for a Noon appointment.  I ask for a bed or stretcher because chemo has become my official nap time.  I am informed that the chaplain knows I am there.  She is in meetings, but will be back to visit.

The waiting room is really crowded, but there is nobody at the puzzle table.  I sit down to work on a puppy and kittens puzzle.  Cats give me the creeps, so I immediately take all the pieces with their eyes and place them upside down in the box.  Someone else can handle that part.

11:45 – A chemo nurse comes out and calls my name, then takes me to a room with a bed.  I make myself at home, then identify myself so she can put on my I.D. wristband.  The band has to match the labels on all the drugs they will give me.

12:00 – I briefly talk to my dad, who is at work.  We have talked or texted during all my treatments.  He has never been to an appointment, unlike my mother, so this is his way of being there.

12:10 – I get hooked up to the IV pole with some saline, so my freedom to move is now limited.  The nurse goes through all my drugs:  Benadryl because I have had past reactions to my treatment; Ativan – controls nausea, but makes me so sleepy;  Atropine to help control diarrhea; Decadron – a steroid that is used to treat certain types of cancer; Avastin – used to treat metastatic colorectal cancer by inhibiting blood vessel growth; Finally, the CPT-11(a.k.a. Irinotecan or “I run to the can”).  This is the big gun of the chemo cocktail, and the reason for the atropine.
Before my nurse leaves me to my five-hour infusion, she takes my blood pressure.  It is 116/60, and she asks me if I take blood pressure meds.  Avastin is known for giving patients high blood pressure, so I tell her I take Lisinopril.  She tells me Dr. Oz says if we all took that, there would be no more heart attacks.  Hmm, I guess I can cross a heart attack off my list of worries.  We then discuss gardening and Seattle weather.

12:20 – I am off and running with an extra pillow, 2 blankets, and some chamomile tea.

12:35 – The librarian filling in for my leave of absence from school this year calls.  She is calling to FaceTime from our district’s high school Battle of the Books competition, so I can watch my students compete.  Everyone seems to be off to a good start, but I will be asleep before the end, most likely.

?? – I have now lost track of time.  The chaplain arrives, so I excuse myself from FaceTime, thanking them for including me.
Our chaplain is a snow bird and has spent the last few months in Arizona.  I am so happy to see her, but I am already getting drowsy.  We catch up and talk about the book and the blog.  She was the one to really give me a push when I was first kicking around the writing idea.  Eventually the Benadryl and Ativan begin to win the struggle between sleeping or talking, but she stays until my words are no longer making sense.

?? – Moments later, I am in la-la land for several hours.

To be continued…

Comfort

Most patients, even newbies, have some idea of what to expect with surgery recoveries and treatments. There were some big surprises for me, though, and at the risk of sharing too much, I thought I’d pass along some trade secrets. It might get a bit graphic – apologies to the uninitiated.

Your bowels may never have been a problem until you were diagnosed with cancer, especially those of the lower abdomen and pelvis. But starting with CT prep (barium shakes) and moving right through surgery prep, anesthesia recovery, and on to chemo, there will be days when you can think of nothing else. (As a life-long poop-o-phobe, this was a horrible adjustment for me.) Start by asking the radiology department to give you Gastrografin instead of barium shakes before your scans. A flavorless vial of liquid that you mix with the juice or Crystal Light flavor of your choice, Gastro is orders-of-magnitude more palatable than that thick white crap. Not only does it go down so much easier, but it doesn’t seem to run like a Roto-Rooter through my lower intestines for the following three days. If your hospital/clinic doesn’t carry it, start complaining, loudly, until they do. I don’t care if it costs more – make the people who write the checks take a few swigs of the banana-flavored “Smoothie”, and they’ll be on your side in a jiffy.

On the other hand, anesthesia of any sort, various chemo agents, most narcotic pain relievers, and nearly all anti-emetics push your GI tract off the opposite cliff. (My gal Kelly Corrigan refers to it as “tear-jerking constipation” and is not wrong.) With the chemo protocols, it’s really smart (and pretty easy, once you figure out your patterns) to prepare your body ahead of time: lots of fiber, fruits and veggies, and plenty of hydration the day before your treatment. Once you’re on the chemo, make sure you keep your nausea under control (take the Zofran before you need it), but maintain your system with Senokot (or the drug-store generic) – I used to take one to two pills, three times a day, for the first week after treatment. If senna isn’t enough on its own, and you’re DRINKING tons of water and GETTING SOME EXERCISE (yes, even just a stagger down the block), you may want to add Miralax. I personally couldn’t stand this stuff, but have heard others swear by using it routinely. On occasion, I needed to escalate to Milk of Magnesia, and there were two post-anesthesia occasions when I had to ride the Fleet train. My advice: get on top of your symptoms early, and keep adding more aggressive interventions until the problem is solved. Skip the middle-of-the-night run to the 24-hour Walgreens at all costs.

Jeez, I’m just having a little freak-out that I’m actually discussing all of this. (See earlier comments about poop-o-phobia.)

When all of this colon fun gets to be too much, ask your doctor for Anusol. Take warm baths with Epsom salts. Stock up on Tucks and Prep H. ‘Nuff said.

Nausea

The stomach gets really hammered during cancer stuff. Fasting for blood tests. Heartburn from chemo. Nausea from nearly everything. There are lots of options to get you out from under it, so don’t stop trying until you find a solution that works for you. My first oncology nurse, a 30-year veteran, God love her, told me when I was feeling nauseous, to eat something, and that might cure it. If eating didn’t make it better, then medicate it! I was lucky enough to have Emend covered by my insurance, and it was fabulous during my first round of chemo. Last summer, I got IV Aloxi as a pre-med before my carbo/taxol, and it worked just as well, without me having to remember to take it. Zofran makes me a little nervous, because although it’s very effective, and widely prescribed, it bungs me up like a cork. Ativan is lovely, if you can swing it, but there better be another responsible adult in the house if I take it. (Great for naps and bedtime.) These anti-emetics are so effective that even after four years of treatments, etc., I have only actually thrown up once, and that was when I was trying to avoid taking Zofran. Silly rabbit.

Heartburn during my IP chemo often felt initially like nausea, but once I started taking Prilosec every morning the nausea disappeared. If you’re feeling nauseous, you might want to start with heartburn meds and escalate if those don’t work (especially as they won’t terrorize your colon like Zofran).

Sleep

One of the best (?) things about cancer is that I’ve been able to catch up on my sleep. Daily naps that I used to feel guilty about when the boys were toddlers are now necessities, and the family accommodates my soporific indulgences with good-natured ribbing, if not stocking feet. Thus I recommend a good pair of earplugs, which make napping anywhere, any time effortless. Next time you’re on an airplane, buy their blanket/earplug/neck pillow set, and you’ll have a Nap Kit ready in case of an emergency. All for less than $10.

Only sometimes you won’t be able to sleep. The steroids that come along with so many treatments can make sleep a tantalizing illusion, even when you’re exhausted. For you, I have no personal recommendation other than Ativan or Tylenol PM, which gave me just enough sleepy oomph to drift off and ignore my lower-back pain last spring. I’m sure there are better options out there, I just haven’t needed them myself – I hear Ambien is fantastic.

That seems to have exhausted my expertise for meds of all sorts. I can’t believe that we spend time talking about these issues, but cancer babes (and dudes) have to stick together and get through this.  I’d love to hear about your favorites. Never know when I might need to use them, right?

How To Help A Cancer Patient, Part I

How To Help A Cancer Patient, Part II

I had the grand lifting a little earlier, Saturday afternoon (which would follow suit since everything happened a day earlier) but I’m physically just not feeling quite as strong. I have a little sinusy-chesty cold, and my body is just tired. I cannot say if it’s the cumulative effects of the chemo, if it’s the chest cold, or if I’m just cranky and over it. The antibiotics for the cold are kicking in, and hopefully I’ll be back to right by the time you’re reading this.

I’ll get back to this epiphany about the fog in a bit.

I’ve seen a world of doctors within the past week. My appointment with Dr. B, plastic surgeon, was last week. I really thought I’d get some questions answered and he’d be able to explain what we are going to do. Unfortunately, this wasn’t his plan for my visit, so he came in, checked out the foobs, said they looked great and started to leave. When I asked him about moving forward with another procedure, he said “Whatever B [Dr. S's first name] and C [Dr. A's first name] decide. I’ll make ‘em look great.” Which, in the overall picture, is fine. I have no doubt he’ll make the foobs look great, and I don’t even mind that he’s got confidence and bravado when discussing his work.

But, I’m a girl of a little more depth, and I want to understand what the process is. Where are we grafting from and how much skin are we removing? Are we removing the entire TRAM or only part? Can we use the new gummy implant that is in FDA trial here in the States? Should we do both sides or only the right since that’s the one that keeps giving me issues? I suppose he really doesn’t have a good answer on any of that at this point, but the under-5 minute visit was a waste of time and effort from my perspective. I will wait until after we’re done with chemo and the next round of biopsies before seeing him again.

Which brings me to yesterday’s visit with Dr. S. I love Dr. S. I hate having to sit all day to see her (typical day at her office: appointment time was at 10:10. First stop, ultrasound, brought back at 11:20. At 12:30 I was brought into an examination room. At 1:00 I saw Dr. S). Next time I need to remember a good book, and a sack lunch.

So, anyway, good news!!!! My armpit tumor is shrinking, which we suspected by the feel test, but now we have measured confirmation. The original tumor was over 3cm, but now it is measuring in at slightly over 1cm. It’s still there, but it’s fading and that is good.

Dr. S. and I also discussed surgery from her point of view. I will have surgery to remove the spot under my arm, that is definite. As for the other spot, Dr. A is kind of leaning towards no surgery, whereas Dr. S would like to remove it. I am willing to be pretty aggressive at this point. I know that there are still no guarantees that the surgery will eliminate the chance for yet a 3rd recurrence, but I feel like I need to leave no options on the table. I am in search and destroy mode, and I don’t care who knows it.

Basically, I will see Dr. S again in February after my final round of chemo. We will do another ultrasound and MRI and get our plan together for surgery. Sometime in there, I will also see Dr. B and let him give me the information he didn’t provide this last visit. And, then we’ll add in another doctor when I begin radiation.

But for now, we’re just concentrating on chemo. Which brings me back to what I think is making me feel whacked out. I was convinced that it was the Aloxi, which is one of the anti-nausea drugs that I get by IV prior to chemo. CONVINCED. But then, my dear friend, M, who happens to be a pharmacist did some research for me and said it’s unlikely. It very well could be the Emend, which is the other IV antiemetic, but it’s likely not the Aloxi since it doesn’t cross the blood-brain barrier.

So, now I face a decision: do I shake up the anti-nausea treatment to keep the fog away? The combination of drugs have been doing an amazing job keeping the nausea away. I’ve had none of that stereotypical chemo experience of being sick (thank God). But, I really can’t function well and I’m depressed. I’ll discuss all of this with Dr. A at my visit on the 21st and we’ll see if there is another way to manage the nausea that perhaps will leave me feeling better mentally at the end of chemo week.

We are coming off a fun and relaxing weekend spent at home and at the cottage on Bostwick Lake. We feel truly blessed to have the use of the cottage whenever we want, and are so thankful to Athy and Butch for their generosity and love. It has been a refuge to us in many ways. We spent the day there with Mom and Dad, Angela and Derek, John, Lana, and Connie W. We felt so rested and relaxed when we got home last night. What a great way to spend the last day of David’s 21-day cycle of chemotherapy.

That brings me to today. We arrived at Lack’s at 9:30 after having dropped John off at Mom and Dad’s. Following check-in, the usual prep work, (and the securing of one of the small rooms), we were called back for our meeting with Dr. Brinker. Dr. Brinker then proceeded to go over David’s chart, his blood work report and he then asked how the last 3 weeks have been. Following that, he discussed the CT scan that David had last Monday. The scan showed that the smaller tumors in the lower portion of David’s lungs have begun to shrink. He told us that the larger tumor does not appear to have changed, and proceeded to take us back to a computer so we could see the results of the scan ourselves. We see the shrinking of these tumors as a very positive response. These are changes due to the chemo and we THANK GOD for these changes. We ask for your prayers that the chemo KILLS this cancer. We also specifically ask that you pray that the chemo will start to attack the largest tumor.

All in all, Dr. Brinker was encouraged, and he encouraged us! He is impressed by how well David is tolerating the chemo and how well he has felt throughout his treatments. He talked to us about the anti-nausea pills “Emend” that help David NOT have the nausea and vomiting that is so common with the Cisplatin. We are truly so thankful for our insurance which pays the bulk of the apx. $400 (we pay a $50 copay) for the 3 (1 per day of treatment) Emend pills. We are thankful for the Emend which seems to make such a dramatic difference. I am thankful for David’s upbeat attitude. He rarely gets “down”. His attitude is positive and I believe that has a lot to do with his response to the treatments. He takes one day at a time and modifies what he does each day by how he is feeling.

And …… life goes on. Summer is waining, and we are looking towards Autumn.

School will begin soon, and has already begun for Charlie. He is now a teacher/student at Southern Illinois University in Carbondale, working towards his Masters in Fine Arts/Fiction. Following a 2-week workshop/training session, he started school today. He and Liz drove off in a U-haul on August 1st. Driving an uneventful 10 hours, they arrived in Carbondale. When they finished unloading the truck they went exploring in Charlie’s new city. When it was time to come home, Liz took the Amtrak to Kalamazoo where Angela picked her up and brought her back to Grand Rapids.

Angela and Derek (her boyfriend) were here this weekend from Kalamazoo, for Ashley’s wedding and they also spent time with us on Sunday at Bostwick Lake.

It is hard to believe that John will be in 6th grade this year! He starts school on September 2. It is also so hard to believe that Summer vacation is almost over. Time flies when you are having fun …. and even if it is not so much fun.

We are very thankful for all of our family and friends that have been so supportive throughout this ordeal. Again today, Brian showed up to spend time with us, and to show his love and support. He is such a caring and special friend. We have received so many cards, calls and gifts and we thank each and every one of you who have taken the time to show how much you care. It means so much, more that you can ever know. It makes the difficult days easier because we feel that love and support.

Love, Connie

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