Tuesday, January 31, 2012

How low can you go?

Here I am, on day seven of my first chemo cycle. I had my bloodwork done this morning. My bloodcounts are lower than normal - as expected - but not dangerously low. All in all that is great news. In other words, I'm right on track with where we thought I'd be at this time.

The weekend was not all that pleasant, with quite a bit of nausea, especially on Friday and Saturday, followed by feeling very tired on Sunday and into Monday morning. But by now, I am feeling pretty good. I'm trying to get back into normal life, by moving around more (walking on the treadmill, etc.) and doing a few things around the house.

In other news, I've been cleaning up my drafts folder on this blog, posting lots of old pictures. I've backdated them, so in case you are interested in some fall and Halloween pictures from around here, scroll back to late November / early December.

Thursday, January 26, 2012

Chemo day two update

I'm thru the first 24 hrs of chemo.

First they had to access my port. The nurse was great and did an awesome job. My port is sitting a little deeper than apparently is usual, so she went with a little longer needle, a one and a quarter inch needle. Unfortunately that wasn't quite long enough, so she had to do it again with a 1 and a half inch long needle. Not the most comfortable thing in the world, but in the big scheme of things not that big of a deal. And once the connection was made, it really was quite comfortable.

The first part wasn't that bad. They started out with the steroids and the anti-nausia drugs. The steroids quickly made me feel like I had just downed 10 cups of coffee. Karsten came to visit me during his lunch break, and he said I was talking pretty fast as well.

Then on to the good stuff. The first three rounds of chemo will each consist of three different drugs. Two of them come in big syringes that the nurse hooks up to the lines close to the port. Since it's not that good for the veins, they do it in a special way. They pull back a little, so some of my blood can mix in with the medication, then they push the mix in, and follow with a flush of saline. Rinse, lather, repeat... The last one is in a regular bag and is administered over an hour.

Then I got to go home, and to be honest I felt pretty great. I did the laundry, loaded the dishwasher, cleaned the micro wave, cleaned the silverware drawers, and cleaned the fridge, all in the hour before Natalie came home!

The steroids seemed to wear off slowly over the evening. Natalie and I spent most of the evening watching a movie on the couch, just cuddled up. Of course, I had checked with the doctors before hand, and it's perfectly save for her to be around me after chemo, I cannot transfer the medication to her by touch. I'm so grateful for that.

Later in the evening, the steroids wore off completely, and it was a bit like hitting a brick wall. I was very tired, and had quite a bit of nausea. In general, I think it felt like a good size hangover, though it's been a while since I had one of those! Luckily, it was time for my next round of anti-nausea medication, which helped a little bit.

This morning, I went back to bed after Natalie and Karsten left, and got a couple of extra hours of sleep. This morning I'm feeling pretty good, except that I'm not interested in eating at all (which is a first for me!). I'm also a bit tired, but really not that bad at all. So far, so good!

This afternoon I'm going back to the clinic to get a shot that will boost my immune system. After that, my next appointment is in a week to check my blood counts. Other than that, I'm just hanging out at home for a while. I've been warned that the weekend might be a little rough, I guess we'll see. I've got some pretty good meds to help me out, so I'm not too worried. 

Wednesday, January 25, 2012


Karen is having her first round of chemo today and I went over my lunch break to spend the time with her.

She is just getting started and is just getting the medications she need prior to the chemo drugs now.

They will be starting the first of the trio of drugs in just a few minutes.
It will be interesting to see how she responds to the therapy.
Based on the nurse it sounds like she will not really feel any side effects until this weekend or so. Then the biggest risk is actually about a week to a week and a half after the treatment as her blood count and immune system will be at its lowest.

Saturday, January 21, 2012

A week in review

Wow, where did the week go? I guess it's a full time job being sick...

As the previous post said, I was back at the plastic surgeon on Monday. There was some liquid collecting under the skin on my right side after they took my last drains out on Friday. So, they did a one-time draining, which basically means they take a big needle and suck out the extra fluid.

Then I went home and tried to not do too much, and put something cold on it, and waited. The fluid did come back, but over the next couple of days it seemed to get absorbed again. So by now, that issue seems to be resolved.

Then on Wednesday, I had a couple of appointments. One was the "chemo-teach". It was an hour spent with a nurse, going thru the different chemo drugs, how they are administered, what side effects they have, what to do about the side effect, etc. In general, what to expect when you are on chemo. Really interesting, I feel much better prepared now. And, we scheduled my first chemo appointment for Wednesday next week. I'll have a total of six treatments with three weeks between each. The first three cycles include three different chemo drugs, the last three are only one (different) drug.

The second class on Wednesday was called "Look good, feel better", and was put on by the American Cancer Society. Great class! I learned a lot about skincare for chemo patients, and about how to maintain a wig, and how (and where) to paint your eyebrows if you loose them. Lots of information that I would not even have thought about before.

Then Friday I went back to the plastic surgeon. As mentioned, the collected liquid is starting to be absorbed and is no longer much of a concern. There were a couple of other little concerns, though. On the right side, there is an area that is healing slower than the rest. We've known from the beginning that that would probably be the most problematic area. It has something with how the blood supply to the skin is in that area, which they measured during my surgery. Not a huge concern, but enough that the plastic surgeon didn't want to give me a fill on that side so that we don't stretch the skin in that area right now. On the left side, the plastic surgeon was also a bit concerned. He thought I might have a small leak. I had to bite my tongue when he said that, all I could think of was this episode of Will and Grace:

(Scroll to time index 09:50 to see what I mean...)

So, the plastic surgeon gave me a fill on the left side only, so that he thought the two sides were about the same size. I can't really feel if it is leaking. It's just saline, so the liquid will be absorbed by my body if there is a leak. I think it is a very slow leak if it is there. Anyway, I'll be going back to the plastic surgeon on Wednesday morning (before the chemo) so he can evaluate. I guess we'll just wait and see.

In other news, I started fighting off a cold on Friday afternoon. I guess it's better to do that now than in a few weeks... So, for now I'm off to the couch with a warm cup of coffee!

Have a great weekend!

Monday, January 16, 2012

Back to the plastic surgeon

Karen is going in to the plastic surgeon again today. She is having some liquid from the drainage accumulating under the skin. It just does not feel right so she is going in to get it checked out and probably drained.
Hopefully they can just do a one time drainage so he doesn't have to get drains put in again.
It sounds weird but she is wanting to get going on the chemo but she cannot get started if she has drains.
Her approach is that the sooner she gets started the sooner she will be done.
Updates to follow once she comes back from the doctor.

Friday, January 13, 2012

No tubes and stitches - means we can hug

This is what Karen has been looking forward to for weeks:

You have me in stitches - no more

We just got back for today's round of doctor visits.
It seems like it is a full time job being sick !

First we went to the plastic surgeon.
Everything is still looking good. He did take out the stitches from the surgery which is a good step in the right direction. Even better though he took out the drains.
One was still draining quite a bit but he is more concerned about the risk of infection by having them in for such an extended time, so he decided to take them out. Hopefully the liquid will not accumulate under the skin.
We will be going there again next Friday so he can check up on it to make sure everything is working out on this.

Karen also got her next "top off" so she now has approx. 540 cc in each side - this is a definite B size. The target is to get close to 800 cc before they will do the permanent implants - or something in the range a C size. The 800 cc is the upper limit for what they will do on a reconstruction, but it is a very appropriate size for Karen's frame.

Karen has to take it a bit easy over the next two days to make sure the drain sites close up properly and to minimize the amount of liquid collecting in the wound site.
But she is just ecstatic about having the drains out.
The first new task she can do without drains - give Natalie a big hug.
Karen is all smiles looking forward to Natalie coming home from Daycare.
- and being able to get a real shower doesn't sound too bad to her either.

PET scan results - good news all around - straight from Star Trek

Karen had a PET scan this Tuesday.
She was pretty nervous about it as it is a test that will determine if there are any areas of cancers anywhere else in here body.
Let me first share that she did not have any areas of concern which is great news.
Secondly - this test is about as close to the Star Trek Science as I can imagine.

The test is done by injecting a radioactive compound that is tied to a sugar-like molecule into the bloodstream. It is a very low dose of radioactivity and it has a half life of only 4 hours or so.
Nonetheless they needed a full history of the amount of X-rays Karen has had over the last many years to ensure that her total radiation dose does not exceed a safe amount.

Unfortunately I was not able to accompany Karen on this test but her description was very detailed. The radioactive compound comes in a syringe that is safely stored inside a large, lined metal can. I know that this is more for the safety of the workers that work with this every day, but it is still pretty cool.
After they injected it, Karen was placed in a small room with dimmed light. She now had to sit absolutely still for about an hour. No reading, no moving, no music - just her and her thoughts. Wish I could have listened in on those !
This is done to ensure that the radioactive compound is preferentially absorbed in the cells that are the most active - this is typically the cancer cells. If she would move around or watch TV the normal activity of the cells would skew the results.
When the hour was up she was literally strapped to a board to avoid any movement and then put in a machine similar to a CT scanner. This took about 1/2 hour and they did a scan from the knees to her head. I am glad she is not really claustrophobic.

We went to the oncologist the day after to get the results of this test as well as the results from the genetic testing.
The PET scan as mentioned was clean for cancer but the amazing thing is that it identified any areas that have higher than usual cellular activity. So the notes described:

An impacted molar
Slight sinus infection
The incision from the surgery

Now I think that is straight out of a Sci-Fi. Get one scan done and it will tell you (almost) everything that may be wrong.

I am sure this test is not quite recommended as a pure preventive measure though. Even though it is a small dose of radioactivity Karen was told to stay at least 3' away from small children for 24 hours and warned not to fly or use public transportation in the same period. Apparently some of the very sensitive instruments at some airports can detect the radiation from the compound as it breaks down which could be mistaken for someone trying to bring radioactive materials.
So I had a good Daddy Evening with Natalie since Karen couldn't be near her.

Anyway due to Karen still having 2 drains from her surgery and because there were no defined areas of cancer on the scan it was decided to postpone the start of the chemo until the drains were out. So for now she is tentatively scheduled to start on 1/23 with chemo but it may even be pushed to 1/30.

Now tomorrow is a visit with plastic surgeon to remove the stitches and get the expanders "topped off". He will likely not take the drains out yet as they are still drawing quite a bit of liquid out. I know Karen is really looking forward to getting them out though.

Thursday, January 12, 2012

Another update

Hi Folks, Karen here. I'm baaack...

Actually, I'm sitting at home "focusing on healing", which means being as lazy as I can. Which isn't nearly as much fun as it sounds... Anyway, I thought I'd give you a quick update, so here goes:

I had a couple of tests over the last week or so. A test checking my heart, since some of the chemo drugs can affect the heart. Good news, the test showed that my heart is perfectly normal. I also had a PET scan, which is basically a full body scan to check if the cancer had spread anywhere else. Good news, the test didn't find any other cancer (though it did find that I apparently have a little bit of a sinus infection... wow, I'm kinda impressed with that amount of detail.)

We met with the oncologist yesterday. They want me to heal at least four weeks before I start chemo, so that means the earliest we can start is the 23rd. But I also have to have the drains out before we can start. And even though the plastic surgeon said they might be ready to come out when I meet with him tomorrow, I'm not so sure that's going to happen (they are still draining quite a bit). So, realistically, I might not start chemo until the 30th.

So, I'm actually just walking around trying to heal. I'm not on any painkillers and feel perfectly fine, apart from the drains being in the way, having to be careful not to reach too far, lift too much, etc. I'm reading a lot of books, watching a lot of TV and movies, and surfing the net. I'll probably even start updating this blog again with post that are not all cancer related!

Friday, January 6, 2012

Houston we have b@@bs - well at least a good beginning

It has been a whirlwind of doctor visits, checkups and discussions here in the new year.
We have been at the plastic surgeon twice and Karen went to the cardiologist to get an EKG to get a baseline of her heart before she starts chemo.

Karen is up and moving around and is able to drive herself now. This gives her a lot more freedom now that I am back to working and she can get around to some of the doctor visits by herself.

Today we had our 2nd visit at the plastic surgeon and I joined as this was the first time they injected additional saline into the expanders for the breast reconstruction.
It actually went very quickly and we were surprised how simple and relatively crude a process it was.
They simply numb the skin above the the breast with a small shot and then they pulled out this cartoon size 60 mL syringe and needle. The expanders has a metal piece as part of the valve. They move a small magnet over the breast to find the valve and marks it with a pen. They then insert the needle in through the skin into the valve of the expanders and inject the saline. They put in about 120 mL in each breast which is in addition to the original 300 mL in there from the surgery.
The whole process only took about 5 min or so only and Karen went from a small A cup to something like a small B.
She is doing pretty good even though the injections does give some uncomfortable pressure on the skin and chest muscles. And I think we are both pleased to see that the process is working and the reconstruction is starting to take shape.

Karen will be in at the plastic surgeon again next week to get her next fill. That may be the last fill for now until the chemo is over - we don't really know how they do this as they normally try to be very careful about anything that may cause infection while she is on the chemo treatment.