Cycle 3, Day 1

Mom chillaxing in the hammock. Jamaica Plain, MA, June 2009

Feeling really positive after our meeting with Dr. C this afternoon. He sat down with Mom and I and walked us through all the CT imaging done last Friday. Here are the take-home points:

• The handful of lymph nodes that were clearly inflamed with cancer have shrunk, some by roughly 15% in size.
• The mass in her neck and groin is very hard to measure because of the way it infiltrates in to surrounding tissue. So although we are unable to quantify the status of these masses, Mom can feel that the groin tumor especially has decreased because her mobility is much improved. Additionally, the tenderness she was experiencing in her underarms and breasts is also far less than 6 weeks ago, which is reassuring that inflammation decreasing.
• There is something around her gallbladder, which we won't know if it is cancer or not without a biopsy, but since it's not impacting anything negatively, leave well enough alone. To know if it was cancer wouldn't change our course of action.
• She has a small pericardial effusion on her heart. The pericardium is the outermost layer of the heart, and sometimes fluid gets trapped inside that layer. If enough fluid accumulates, it can impair proper pumping of the heart, tire the heart, and cause problems. We would know if she was negatively impacted if she experienced any shortness of breath, which she hasn't. The plan is just to keep an eye on it. No further tests are necessary at this point.
• Before her next chemo in three weeks, she is going to have an implanted port-a-cath placed. A "port" as it's often referred to, is a catheter placed in the chest that goes directly in to a major artery. She has been having IV's placed and blood drawn so frequently in the past few years that good veins are getting harder and harder to come by. To access a port, a small needle is inserted in to the head which sit right below the surface of the skin. Blood can be drawn, fluids and chemo given, etc. It is very convenient for those who require long term chemo and lab draws. It is not a major surgical procedure and she should be in and out within the day. Date TBA.

A productive day all around. There are not always answers for all of our questions, but as of now, the clinical trial is considered productive and she is to continue as planned.

Mom Have Unusual Results? Shocking...

She never did like being predictable, in life or cancer!

Dr. C gave Mom a call where she's up in Maine visiting family and said that the good news is the measurable tumors have shrunk. The not good news is that the cancer seems to be moving in unusual patterns. So all I can gather from 2nd hand information is that it is shrinking and moving all at the same time.

Huh?

Tomorrow Mom will fly to Boston bright and early so we're going to get some breakfast and brainstorm a million questions to inundate Dr. C & Co. with at her appointment in the afternoon. Then it's chemo, which marks the official start of cycle 3.

She feels well though, not too tired, no pain, and is well fed after a long weekend up north. Stay tuned for another post tomorrow evening.

Oh, and I just want to give a little shout out:

20 years ago today, Gwennie stole my "only child" thunder. Punk.

mother's day 2009, Still River Farm

Patience is a Virtue

Unfortunately...

Because we're all going to have to be extra patient to get Mom's CT scan results back. She had her 6-week scan yesterday, and we won't have the official read until Monday. As always as soon as we hear, I'll post asap.

Over all she's been doing really well. The fatigue is the worst side effect of all. For someone who is a mover and a shaker, it hasn't been easy for Mom to balance work with rest, but not for lack of trying. There have been a few bouts of nausea here and there, but otherwise her white blood cell has improved so she's no longer considered neutropenic (i.e. she can partake in raw fruits and veggies again).

Thank you for all the inquiries. As of this morning, she's in Maine visiting family, relaxing, and resting before chemo on Tuesday. Stay posted...

Cycle 2, Day 1

Tuesday marked the start of the second cycle of treatment, each cycle being 3 weeks. Mom had chemo, an EKG, some blood work, and overall her team is very impressed with how well she is doing. Her blood work shows that she is neutropenic, which means her white blood cell count is lower than desirable. White blood cells are responsible for fighting infection, and it is very common that they get attacked during chemotherapy. Because this makes Mom more prone to infection, she has to be diligent about hand-washing, staying away from fresh cut flowers, not eating uncooked fruits or vegtables, and checking her temperature regularly. If you're sick and planning on visiting, don't even THINK about.

The other thing we've learned is that her "good" cholesterol (HDL) is low, and her "bad" cholesterol (LDL) is too high. I don't believe this impacts her cancer on a day to day basis necessarily, but my point in sharing is that anyone who knows my mother knows she makes a lot of effort to live a healthy life, so if you haven't had your cholesterol checked recently, make sure you do at your next visit. Many of the CVS Minute Clinics (started by a Simmons nurse, thank you very much) provide cholesterol checks too. I recently ran in to someone who hadn't seen a doctor in 9 years! I almost fell out of my chair- there is so much screening that occurs in a routine visit, and it is so essential to make sure we're all getting our regular check ups. So if you're one of those people, take care of it!

We also learned that the skin biopsies taken last Tuesday show evidence of cancer. This isn't terribly surprising considering they all seemed to pop up when her cancer recurred, and we already know the cancer is moving through they lymph system. So what? Some cancer cells were dropped off on her skin along the way. It doesn't change the course of action, it doesn't change her clinical trial, we just keep on truckin' forward toward the CT scan in a few weeks.

The morning of Mom's chemo I knew she'd gotten up much earlier than me, so I crept by Gwennie sleeping in the living room and assumed I'd find her in the kitchen reading, but then there she was doing her qi gong. I wish I could have somehow captured the moment of her standing in front of the window, rainy grey mist outside, wearing a beautiful head scarf drenched in yellow and orange, going through the slow motions. It made me stop and realize that Mom is really doing everything in her power to take control over her body. It really is a lesson to us: now is the time to take care of ourselves and do the things necessary to pave the way towards a long and healthy life. There is plenty we cannot control, but we can control the choices we make every day towards being healthy individuals and supporting one another in doing so.

That's my last plug for annual physicals!

Eat Your Heart Out Sinead

There's a new baldie in town.

It's been roughly two weeks since Mom's first round of chemotherapy, and this time her lovely locks have taken a serious hit. It started coming out quickly, and she opted to be proactive about the process. In her own words:

Monica has offered to shave my head before the Taxotere does it for me. She is approaching this event with (somewhat alarming) relish. To quote, “what daughter hasn’t wanted to buzz her mother’s head?” Meanwhile, Gwennie just follows me around with the dustbuster. Cancer is a journey, without a roadmap. You have to accept the adventure, take the bumps, and enjoy the smooth parts in between. Love is your fuel; laughter is your refreshment, friends are your rest stops, family, your refuge, and acceptance, your destination. So thank you for continuing to be there for me, and enjoying the ride when we can!

It didn't occur without a few tears here and there, but who can blame her. She approached this with the same grace and courage she does all challenges.

Thank you Richard!