Sunday, November 20, 2011

Home Again

Hi! We just wanted to let everybody know that Mom was discharged from the hospital at about 10:30 this morning, We are assuming that chemo treatments will begin as scheduled tomorrow.

Thanks again for your support!

Megan and John

Friday, November 18, 2011

11/19/11

After having a good Wednesday that got better as the day went on, Kathy went from bad to worse on Thursday. The chills arrived while reading the morning paper, then the fever.  We finally made it to the scheduled blood draw at 2:00 but the nurses couldn't eliminate the fever either.  I think it was in the 103-104+ range.


So, back to the hospital.  They used cold cloths or ice packs when it spiked around 2 a.m. and when I got there at 8 a.m. she was fever free.  Let's hope it stays away so we can start Round 2 of the chemo on Monday (scheduled for Nov. 21,22,23,25,28,29,30.


Kathy did have some toast and bacon for breakfast and then needed to sleep. I'll try to update this tonight or tomorrow.


John

Saturday, November 12, 2011

A Detour

Bad News and Good News:  The bad news is that at I am not a viable candidate for a Blood and Marrow Transplant; the good news is that I am  not a viable candidate for a Blood and Marrow Transplant.  Say what?

Late afternoon on Thursday we (John, Pat Dorn and I) met with Dr Hogan, one of Mayo Clinic's hematologists/oncologists and an expert in BMT transplants. We had seen him in August and after that meeting, I was pretty sure I didn't want to pursue a transplant. But after encouragement from others--family, friends and medical personnel--I decided to kick the door wide open, the door I'd left open in August, in order to at least explore my eligibility.  Nothing to lose, right?

Well, It was the right decision and I didn't lose a darn thing in the process.  In fact, I think if I would have lost had I NOT pursued the exploration.  I can say with satisfaction that I did everything I could and left no stone unturned.

Here's the gist of our meeting:
Blood and Marrow Transplants are dicey for everyone, but dicier for people who have a number of risk factors.  The disease itself, of course, is the biggest risk factor, but pile on a few others and the chance of a successful outcome is greatly diminished.  The risk factors I'm dealing with include my age, the nature of my particular type of Myelodysplastic Syndrome (atypical, with a relatively rare chromosome abnormality), and a history of breast cancer (even though my breast cancer was teeny tiny, removed with a lumpectomy).

What Dr. Hogan was most worried about was that even though I have good health in many ways--low blood pressure, low cholesterol, no history of heart problems--my disease is not under control enough to consider a transplant. I've had only one round of chemo, not enough to determine the efficacy of the drug.  He said I really need to complete 4 or 5 cycles, followed by a bone marrow biopsy, to know if my blood has gotten healthy enough for a transplant.

Add an extremely short list of possible donors to the mix and it becomes formidable.  My siblings are really the only donors to consider because, in my case, anything less than a perfect match would be another risk factor. 

I asked Dr. Hogan what he would say if I insisted that we go through with a transplant.  His answer was sobering.  He said, "I would have grave concerns if we were to attempt it." 

So, here's where we are...
I will continue to have transfusions as needed while I'm having chemo treatments.  In February or March, assuming everything goes as planned, I'll have the biopsy and we'll see.  Dr. Hogan said it's always possible to revisit a transplant if my disease stabilizes.   If, after another evaluation, I'm still not a good candidate, there are other options, clinical trials among them.

So how is this Good News?

Because I actually felt a sense of relief by the time our meeting was over.  Quality of life is more important to me than length of life and post transplant life, with all of those risk factors working against a positive outcome, would most likely be a hell more hellish than Hell. 

My sister-in-law said that  if they told you that a there was a 90% chance of a successful cure after you put in the biggest fight of your life, (which, by the way would never happen for anyone) you may be more willing to go the distance no matter how hard it is.  My chance is under 40%, probably closer to 10%, and that's the deal breaker.

I want to live the rest of my life as normally as possible.  I want to spend time with my husband, our children and grandchildren.  I want to visit with my siblings, my in-laws, whether by phone or in person.  I want to stay connected to my friends.  I don't know how the future's gonna look, because my crystal ball is on the fritz, but I hope to live each day to its fullest even if that means only reading the morning paper.

Next week I have a blood draw on Monday and another on Thursday.  If a transfusion is necessary, it would probably be on Friday.  Thanksgiving week I will start my second round of treatment in Chemo Bay. 

We'll be hosting our family again the Saturday after Thanksgiving, if all goes according to plan. We'll make the turkey and all the rest will be provided by the kids.  If there's some reason they can't come here (I'm sick, the kids are sick), the back-up plan is to go to Megan and Troy's.  We will have much to be thankful for this year.

Wednesday, November 9, 2011

It's My Party and I'll Cry if I Want To

Oh, yeah...I've thrown myself a big old Pity Party the last few days.  I know all about being positive in times of health crises; however, emotions hijack my intellect and negative thoughts poison my outlook.  I'm not beating myself up for how I feel -- I think it would be worse if I didn't acknowledge my feelings -- but the hard part is getting back on an even keel, not dwelling on the stinkiest aspects of this stinky experience.

So what does a Pity Party look like?  I submit that most people know because they've thrown one of their own.  (Aside: What's the origin of THROWING parties?  I mean, I've thrown showers, birthday parties, anniversary celebrations and I can't recall even one time when I've actually THROWN something. Just wondering.)  In my case, the party "un-favors" included fear, frustration, sadness, anger, exhaustion -- just overall bitchiness.  OK, so John asks how different is that from my everyday demeanor.  But, seriously and, more importantly, honestly, I am trying to teach myself to embrace these emotions because I think it helps me better appreciate the tiniest of silver linings that appear now and then.  I want to be fully human and that means I need to accept the whole kit and kaboodle of this disease and all of its implications.

Full disclosure -- nobody would want to come to one of my Pity Parties; they're not fun.  There's a lot of crying, arguing, and blaming (self and others).  I think my biggest issue is loss of independence.  I've never wanted to be a diva or princess and consider myself to be fairly self-sufficient.  Now I rely on others for so much and it doesn't sit too well with me.  I know the drill -- other people want to help just as I want to help others -- but it's just so damn hard to accept!

Pity Party's over, folks! Thanks for listening.  Oh, one last thing...cancer sucks!  OK, now it's over.

John and I are heading to Rochester this evening ahead of my appointment tomorrow with Dr. Hogan, one of Mayo Clinic's hematologists.  By the weekend we should know if I am a viable candidate for a Blood and Marrow Transplant (BMT).

John's brother and his wife,  Dave and Pat Dorn, graciously invited us to stay at their home in Rochester when we have appointments.  We are so grateful for their kindness and hospitality.  Plus, Pat will come to our appointments to be another pair of ears.  See, that's one of those silver linings!

Love, kisses and hugs to everyone!

Sunday, October 30, 2011

Tough Decisions are Really...Tough

Again, I want to express my gratitude for all of the support John and I have gotten from so many.  I started to respond to the people who had posted comments on this blog and quickly realized the task was more than I can handle.  Until I come up with a manageable system, I must resort to this general THANK YOU to all of the people who have posted comments, called, sent cards, prayed, written emails, raked leaves, and provided meals.  Even more have asked how they can help.  It means so much to us we get weepy thinking of the generosity of such wonderful people.  So, to all, we say...

Thank you
&
We love you!

Decisions, decisions...

I have an entourage!  Peeps.  Homies.  Roadies.  It's true.  I'll explain.

Since August it feels like I have spent more time at a medical facility than at home.  Often I'm not even asked to present my insurance card.  Instead, they say, "Any changes since yesterday?"  Protocol requires that I give my name and birthday for just about everything, a rule I support, and now I'm kind of expecting a ton of birthday cards when my big day rolls around.

During all that time spent at Camp Dracula and Club Med, and now at Chemo Bay (Mankato Clinic Infusion Center), we have not had one bad experience with any of the personnel, from medical staff to food service.  Not one!   It's almost uncomfortable, if it weren't so comforting, to be cared for in such a thorough and thoughtful way.  I am blown away by their kindness.  One might say it's their job to be that way.  Well, yes and no.  For example, an aide might come in to change the bedding, do it and leave.  That's her job.  She doesn't have to linger, smile, wonder what else she can do for you, then with a twinkle in her eye ask what flavor slushy she can bring you.  Simple example, but representative.  

One day during my last Club Med stay, a tiny sprite of a woman popped into my room, announcing that she was the hospital social worker.   After a brief moment of bewilderment on my part (weren't my kids too old to be taken from me?), the young woman, Josie, charmed her way into my heart.  Before long, I agreed to a meeting with her colleague, Lacey, who would be happy to tell me all about the Palliative Care Team (PCT) of which she was a member.  Well, OK!

It went down mostly like this:  We met Lacey, a soft-spoken, kind-hearted young woman, and before long we were hooked.  Well, of course I was interested in palliative care--who wouldn't be?  Advocacy, help with decision making, a shoulder, an ear--who could turn down an offer like that?  Lacey arranged a meeting with the rest of the team: Ellen, oncology nurse; Dr. Cory Ingram, Phyllis, nurse practitioner.  At that meeting, in addition to getting acquainted, we discussed a situation that had presented itself a couple of days earlier:  Should I explore a bone marrow transplant, an option I had unenthusiastically left open when I was first diagnosed? 

What happened was that Dr. Tin, the infectious disease specialist who had been consulting on my case (because of the fevers), dropped in on me--John was still there--at about 10:00 p.m.  We had not yet met Dr. Tin, but had been told by many that he was a good person to have in your corner.  So, this guy marches in, introduces himself and wastes no time barking, "Why aren't you going for a transplant?  You are healthy in all other respects and you are wasting time the longer you wait."  Who is this man?  My head was still wrapped around the possible effects of a powerful antibiotic, Vanco, which had been started that evening (Dr. Tin's orders).  Vanco's the drug that would make me itch and turn my skin red.  Oh, and it could damage my kidney.  I'm thinking, go away and don't come back until you've got a good idea.

By the time Dr. Tin left, both John and I felt blessed to have had the conversation.  He had helped us see that EXPLORING the option of a transplant was a no-brainer.  No harm in being evaluated--might get rejected anyway.
Then the PCT weighed in.  The next step would be to gather all of the principals, including my children, to ponder the pros and cons.  They were all there: the PCT; Dr. Kumar, my oncologist; Dr. Lal, the hospitalist who was my doc while I remained at Club Med; John, Christopher, Megan and Rebekah (by phone, which didn't work out so we talked later).  After a thoughtful discussion, I made my decision:  I would pursue the transplant option.  

We will head to Rochester on Nov.10 for the screening.  We were told we would know pretty quickly if I even qualify.  If I don't, well then, it's back to the status quo: Vidaza (chemo) and transfusions.  If I do, then I'm in it for the long haul.  It's a scary proposition, one I sometimes can't bear to think about, but one I am confident I can face, especially with the support of my family and friends.

My entourage?  If you've read this far into my long-winded entry, you have figured out that my peeps, homies and roadies are all of the players mentioned above.  How lucky I am to be so well cared for!

Saturday, October 29, 2011

It's a Beautiful Day--Every day

 Saturday, October 29, 12:30 p.m.

Life is full of surprises, as "they" say.  I thought I'd be posting on this crazy blog like, well, like crazy.  Instead I've just been going crazy trying to keep infections and fevers at bay.  It has not gone according to the script I had carefully crafted in my head.  But today's a new day and a beautiful one at that.  So here I go...

I am home alone.  I know!  I'm thinking here's my chance.  Trouble is, I can't think of anything to do that wouldn't involve getting out of my pj's to do it.  I am so disappointed in myself.

Today is Ruby's 3rd birthday party.  John, Megan, and Megan's two kids, Kyle (7) and Eliza (almost 2) drove to Apple Valley to celebrate.  I decided to stay home because we felt it would be too risky to be among a group of people, especially young ones, so soon after a round of chemo when I am most vulnerable.  Rebekah set us up with Skype the last time she visited so the plan is to connect towards the end of the party so Grandma Kathy can wish Ruby Lu the happiest of birthdays.  Because I love her so, I will even clean up and wear fresh pajamas!

Ruby's birthday isn't actually until November 3 (her GOLDEN  birthday), but this turned out to be a good weekend to celebrate particularly since Halloween is the theme of the party.  It should be lots of fun -- I love seeing the kiddos in their costumes.  Rebekah has no doubt unleashed her creative impulses with the party decorations.  She always does such a good job.

Cora (4) and Ruby are both Little Mermaids this year -- different versions.  Kyle is going to be Indiana Jones and Eliza will be a colorful owl.  Megan scoured thrift stores searching for "authentic" Indy apparel which included a leather satchel, not an easy item to procure.  Can't wait to see the world adventurer when he and Eliza come to 1040 for their tricks and treats.

Eliza's owl costume was made by Megan, probably just this past week if she's at all like her mother.  If she finished it only last night, then I know for sure it's my good example she's following.  I don't think we EVER had our costumes ready until the evening before, or more likely, the day of the event for which they were needed (like a school parade).

When Megan was a kindergartner, we (probably me--I don't think I gave my kids much choice) decided she would be a crayon.  I found a piece of cardboard, shaped it as best I could into a cylinder (although the back edges overlapped and we used shoelaces to tie the cylinder together--easy to get into and out of), cut holes for her arms, painted it white (thinking about safety--more visible on a dark night--or maybe it was the only paint I had and it was too late to go to the store), glued a paper "point," with an opening for her adorable little face, on to the cylinder, and with black paint topped it all off with the official Crayola trademark logo and lettering.  Perfect!  And the paint was even dry for her to wear it to school the next day.

Halloween night Rebekah offered, or was enlisted, to take her little sis around the neighborhood to score some loot.  Usually John had that honor. Honor, hah!  It was a strategic move on his part--he always offered to carry their treat bags between houses--so he could steal from his kids while they blithely skipped to the next door.  On this night, though, John wanted to hand out the candy (I think he had found a scary mask to try out on our trick 'n' treaters) and I probably was cleaning up the guts and blood we'd had for supper (spaghetti) and was way happy to give our ten-year-old, dressed as a gypsy I think (that good old standby), the job of escorting Megan.

I'm a little fuzzy on the sequence of events, but I think one of our neighbors came to our door and said Megan was having some kind of a problem.  I recall that John quickly passed his door duties to me and hightailed it over to the neighbor's to assess the situation.  What he found was a white crayon on the ground trying desperately to get up while her older sister was nearly doubled over with laughter.  Poor Megan had fallen and she couldn't get up!

I'm not sure how long she had to endure such abject humiliation, but I'm pretty sure it was longer than it should have been.  When I reviewed the scenario from my vantage point at our front door, it looked liked Megan's father--her own father!-- and the neighbor had joined Rebekah in the frivolity.  I didn't worry too much, though, because I figured John would never want to face my wrath when the whole crayon debacle ended.  Sure enough, he rescued her and  they completed the rounds as a trio.

What had happened was that a huge design flaw had gone undetected.  Actually, Megan had faced an issue with the costume earlier in the day when the kindergarten class had to climb the risers at a program in the school auditorium.  She was unable to bend her knees because the cardboard covered them!  Of course, I didn't hear about this until well after the whole falling down incident or I might have made an adjustment.  So, there she lay, unable to bend her knees while her sister, too weak with laughter to be of help, watched her flail around like some upended albino turtle.  Don't bother telling me the obvious--I know the laces in the back could have been untied and Ms. White could have been freed a lot sooner.  Alas, no one but me knew the intricate workings of this child  trap.  Besides, the story is better as is.  And Megan's therapy is working.

Happy Halloween!

Edited on 11/10/11: I found a picture of me in my crayon costume. I don't think Mom will mind if I add it.  
I guess I had a few details wrong with regard to the construction of the costume.  Oh well, the outcome was the same.  My poor baby!
~Kathy 11/12/2011

Wednesday, October 26, 2011

Wednesday Evening 8:00

Today, the 3rd day of chemo, went much better than the 2nd dose.
 
Yesterday, after breaking a fever in the morning,  Kathy's temp went over 102 while getting infused in the p.m. so we stayed an extra 60-90 minutes and took advantage of some extra saline hydration. 
 
Seems like the chills, fever, sweats, nausea, and headaches show up when they feel like it.
 
Today, a headache and low-grade, short-lived fever were the most noticeable bumps.  We even went for a drive through the Kasota prairie just to enjoy the late afternoon October weather.
 
Hope all of you smelled a flower or two as well.
 
John