Tanning Booth Trauma

We already know tanning booths are bad for you, but here's one more reason why: Mom went to have her MRI yesterday and absolutely couldn't go through with it. Severe feelings of claustrophobia set in almost immediately, which to those of us who have never experienced it, may not make sense, but I've seen many patients go through it and it is frightening for them. She said it reminded her of her one and only tanning bed experience, which lasted only seconds as well.

And because nothing can ever be simple, she scored herself a urinary tract infection too. Just a standard day in the life of recovery.

Dr. Nelson removed her staples, and despite the pain that accompanied that pleasant experience, she reported that Mom is recovering beautifully.

MRI re-try on Friday morning. We'll practice some deep breathing, and hopefully still be in a bit of a turkey coma. Otherwise, she's home and comfortable in the splendiferous care of my little sister Gwennie.

Dr. Ramhan Noodles

I couldn't help myself.

I'm sure I've spelt his name several ways up till now, but I've finally got it right. He is covering for Dr. Donadio while she is on maternity leave. Dr. Ramhan (ra-MON) has always had a special place in our hearts because he was the oncologist on-call last Christmas Eve when we ended up in the ER, and he's also married to our dentist!

We met with him yesterday early morning and he explained to us that Mom's case was actually presented at oncology rounds, meaning oncologists from every walk of life, including those who have cared for her, discuss her case, look at her files, and come up with what they think is the best plan. Because Mom has already done chemotherapy, and this transitional cell carcinoma wasn't knocked out the first time, it's less likely that chemotherapy would be effective a second time. The plan has taken on a new life, and this time we're trying radiation. Unlike chemo which is systemic, radiation is very focal. It only impacts where it hits. Which brings me to some very good news- once the tumor was removed, a thorough wash was done of Mom's entire pelvic cavity, and that fluid was collected and sent to pathology for testing. The pelvic cavity wash came back negative for evidence of cancer cells, so for all intensive purposes, Mom is cancer free right now. 

I know what you're thinking, "you said that last year before chemo too!" Well, when there's no physiologic (tumor) evidence or scientific (microscopic cancer cells) floating around, that's how they explain it to you. If there are any little cells hanging out, they're in her pelvic cavity, which is why radiation right to that area has the most potential to kill the little buggers.

Emotionally, this was very hard for both Mom and I to latch on to. It seems every day there is a new twist. You have ovarian cancer. Just kidding, it's a recurrence. You need chemo. Just kidding, you need radiation. As Mom put it, she has a certain comfort level with chemo; she knows her nurse, she knows where the bathrooms are,  and she knows she knocked the symptoms out of the park. Radiation is new territory, with new symptoms and side effects. We'll meet with her radiation MD, Dr. von Rooy, the second week of December to talk it all through. The earliest she'll start is in 4 weeks, because her scars need to be more than well healed so as not to put her at risk for infection. More to come on radiation...

Dr. Ramhan was very helpful on many fronts. He also suggested Mom have a baseline MRI on Monday. This is because she has nodules on her liver that were felt and seen during surgery. After looking at the impressive collection of CAT scans she's collected over the years, these nodules has been there all along with very minimal changes, but he just wants to get an MRI now of her pelvic area so they'll always have something to compare it too.

He also gave me some great resources to research and get linked in with clinical trials happening all over the country. I gave a call to the organization and was hooked up with Krista, who will have her pulse on all trials Mom is applicable to participating if she wants to. Any time Mom's situation or treatment changes (ie when she starts radiation), Krista gets a call, she modifies Mom's profile, and sees what else is out there. It's a phenomenal system, and so user friendly. We've gotten a list of 7 that meet her criteria so far, but we'll go through those in a few days.

We've also got an appointment with Dr. Choueri at Dana Farber, who we saw last year as well, and Dr. Bajorin at Sloan-Kettering, who Dr. Ramhan worked with closely for years. So we're covering our bases, consulting with the experts, researching clinical trials, drinking lots of tea, catching up on Mad Men, and rearranging Mom's bedroom today. We're very busy and productive people.

Home, Home on the Range

She's home! We finally got discharged at 7:45pm. Dr. Nelson was so apologetic that she hadn't heard about le gas sooner (and therefor worked on the discharge paperwork sooner), but she was in surgery all day. Seriously? It doesn't get more amazing than her. We had a good consult with her and she gave Mom very explicit instructions about what is safe activity and what is no-no activity. For example, walking is highly encouraged, driving is off limits for three weeks. No push/pull movements (like loading or unloading the dryer), but stairs a few times a day are okay. As she starts feeling better and better, I'm sure we'll have to do a good job of reminding her to take it easy.

First thing she did was take a long shower, and then I made her my grandmother's Dijon chicken with parsley and lemon couscous. She's back to the bland and easy on the belly diet until things are really cruising.

Tomorrow morning at 8:40 we're right back in the cancer center for an appointment with Dr. Rhaman, who will tell us what the plan is for chemo, but that won't start until the week of December 8th.

And then Gwennie gets home around dinner time, which will be Mom's best medicine of all!

Stick a Pin in It

I'm sure that's what Mom would like to do to her belly right now, because although she's had two little tiny teases of toots, her belly is still very distended and uncomfortable. She's up and moving as much as she can tolerate, and otherwise her hematocrit is back up, her blood pressure is back to her norm, and she is ready to go home!

It's been so great to see her so chipper. Amazing it's only been 3 days!

Chicken Soup for the Bowels

No, not the name of my new novel. Mom's friend brought chicken soup from Crown (a major hit last year) and it's really gotten the tummy grumbling! She went for a long walk this evening, climbed a flight of stairs, and is doing everything in her power to get things moving.

She took to the 2 units of blood well, and she's just had labs drawn to check if her hematocrit is on the rise.

I'm hoping she gets a good night of rest, without sheet issues, and hopefully tomorrow will be the day. In the meantime, we're just hanging here sharing a grape soda (totally organic and sugar free) planning the Thanksgiving menu. GRAVY!

Stinkin' Sheets

Sorry for the late post last night- long day and I was pooped. Mom had an okay night. She didn’t wake up feeling terribly well-rested, and believe it or not, it was her sheets' fault! They were all bunched and messy and she just couldn’t seem to get settled, but she doesn’t remember anyone coming in the room, taking vital signs, etc. so we figure she just conked out and slept right through it.

Unfortunately, her hematocrit dropped to 21 this morning down from 24 yesterday, so she’s scored herself 2 units of blood today. Her blood pressure is still low for her, but within stable limits. No gas, but improved bowel sounds. She was able to have some cream of wheat and crackers for breakfast, and I snuck her some fresh watermelon too.

Her spirits are top notch, she’s starting to read some emails and check out the blog. She walked the hallways herself today, and we’re hoping this blood will speed up the process. I’m feeling pretty confident that if this transfusion does its job and she’s able to get her gut moving, maybe tomorrow we can go home.

I know I mention this a lot, but my Mom's health is being directly impacted by the generosity and effort from a complete stranger. Donating blood is one of the easiest ways to help save lives, and it makes you feel so good. You know that feeling you had walking out of the polls on November 4th? Multiply that by 10!

D/C the PCA and Move to PO

What?

Mom's nurse was a new graduate, so I can completely empathize, but she was a little heavy on the acronyms! To translate, Mom's Patient Controlled Analgesia (a pump through which she can self-administer pain medication) was discontinued, and she's now taking pain pills when needed by mouth. This symbolizes a huge step in the right direction, because her pain is well managed, not to mention that she's had not one bit of nausea, has walked the halls twice, and is hoping to try solids tomorrow- providing things move along tonight, if you know what I'm sayin'...

We met with Dr. Nelson bright and early, who was happy with Mom's progress, and graciously and patiently explained and re-explained many details of the surgery since Mom's memory of yesterday is limited. The only main concern throughout the course of the day was her extremely low blood pressure, which was causing waves of intense dizziness. It was explained that this could be due to the combination of extreme blood loss during surgery and the anesthesia. As I mentioned before, her hematocrit (measure of whole blood circulating) was also down to 30 yesterday post-op from a healthier 37 pre-op (42 or greater is ideal in adult women). By this morning it had dropped to 25, then 24 this afternoon, and we were sure a blood transfusion was on the horizon. To combat her low blood pressure, she was being pumped up with tons of IV fluids, but by the afternoon, she started peeing a ton and her blood pressure rose a bit and she really perked up.

Dr. Nelson said her hematocrit and blood pressure certainly warrant close watch, but often times from so much fluid, the hematocrit can get a bit diluted, but as the body regulates by releasing that excess fluid as urine, things can re-regulate themselves. Hopefully, no blood transfusion.

Overall, Mom had such a great day. She had visits from friends, received a ton of emails through St. Frannie's patient care website (Kudos to Tante Charlotte for sending two in one day!), and had one great nurse after another.

This recovery experience has already been drastically different than last year, it's certainly providing me with great hope and relief, and I can only imagine how happy my Mom must be.

Since her pain and nausea are well controlled, she just needs to pass le gas, tolerate a full diet, and have a symphony of bowel sounds. Then- home we go!