No Break Yet

Blog readers beware. I am writing this entry and I am not as eloquent or coherent (thanks to the morphine) as Bill. He has done an excellent job describing the situation without using too much medical speak or supplying too much information.

The week of February 16th was a week of recovery for me. I was exhausted after the week before when I had surgery to put a port in, chemotherapy, surgery to replace my stents and 4 radiation treatments. My blood counts were too low to get chemotherapy last week. I did get 5 radiation treatments last week, but otherwise spent a lot of time in bed. This last weekend I had more energy, but I overdid it going up and down the stairs. On Saturday I had to sleep with oxygen.

Late last week, I received the written notes from the stent procedure on Friday, February 13th. The doctor described the strictures (tumors) in my bile ducts as significantly improved. So the PacMen and PacWomen and all of the people that have been praying for me have made a big impact. Wocka, Wocka, Wocka.

This week will see the end of my radiation treatments on my spine on Tuesday. I also thought it would be the last chemotherapy treatment before a 2 week break, however Bill and I met with my medical oncologist this afternoon. The doctor will be adjusting the dosage and I will be having chemotherapy treatment tomorrow, Tuesday February 24th and Tuesday March 3rd. I will then have a break the next week. The schedule that we are going to try is 2 weeks of chemotherapy treatments and a 1 week break. The doctor was happy to see my blood work was looking good. The CA 19-9 tumor marker dropped from 5,000 to 1,000 over the last 6 weeks. This was exciting news. Thank you for all of the prayers. They are definitely working.

So how did I do?

Michelle

Signs of Improvement

Prayer works. Yesterday Michelle had her 5th ERCP since the beginning of this journey, and the plan was to replace the plastic stents installed on January 5 with larger metal stents to reduce the chance of blockage. However, when they removed the old stents and took a look at the condition of her bile ducts, they were surprised to find the blockages much improved. So much improved, in fact, that they decided to place new plastic stents and hold off on the permanent metal ones for now. They want to see her again in 8 weeks to refresh these stents and re-evaluate her condition. This is really good news because it seems to indicate that the chemo is working. And, we believe, it also means all the prayers are working.

At the same time, Michelle's day-to-day physical condition has been not so hot. Due to the chemo, her blood counts (both red and white cells) are low and getting lower. Her hemoglobin, which is a measurement of the oxygen carrying capacity of her blood, has started dropping again after being relatively stable since early December. On Thursday she completed her 7th of 14 radiation treatments, and the impact on her energy levels is significant. She is close to exhaustion all the time, and we have to be diligent with pain and nausea medications to keep those side effects under control. We're really glad we have the pulse oximeter on hand to check her oxygen saturation level, because it has a tendency to drop when she gets too fatigued. She slept with the O2 turned on three times this week.

The port installed on Monday is working as advertised. She was very dehydrated on Thursday morning (blood pressure 80/60) so we took her in for hydration and they left the port "tapped" (needle in place) for Friday's procedures. They were able to use the port for all her IV needs yesterday. No more pokes!

Flash Update: All's Well

The port installation went smoothly today and Michelle was home in her own bed resting comfortably by 11:00 AM. Thank you all for your prayers.

Surgery Scheduled Monday 2/9 8:00 AM

Michelle will have an IV port installed in her chest tomorrow morning at 8:00. This is a quick procedure but it requires a surgeon and general anesthesia. We met with the surgeon Friday and he showed us his port. He was treated for colon cancer 5 years ago and his port is still in place. It lies just under the skin, and the tube from the port empties into the jugular vein.

Michelle continues to do well in the wake of last week's treatments. Her nausea and pain are both under control with medication, but she is very fatigued. Most nights she has been sleeping well, but occasionally (like last night) she has trouble falling asleep and ends up awake most of the night.

We have engaged the enemy on all fronts

Since last week's post, Michelle has experienced more than a few ups and downs. When I wrote the post last Wednesday, she seemed to be doing much better but almost immediately after the post went up her condition went down. The last half of last week found Michelle becoming more and more nauseous, and more fatigued. Her pain seemed to be spiking more, and she was using the breakthrough pain medication more and more often.

On Friday we went to the radiation oncologist for Michelle's simulation appointment. They placed several tatoos on Michelle's abdomen and sides for use in targeting the radiation machines. Michelle was bummed, because she's lost the moral high ground and can no longer tell the kids not follow her example and avoid tattoos. (They also HURT!)

The nausea cleared somewhat by Sunday night, and the pain seemed to lessen a bit as well.

Monday night's prayer meeting was small, as several of the regulars stayed away to avoid sharing their sniffles with Michlle. It was still a very moving, intimate time with the 8 of us in attendance. Pastor Karen led us in guided imagery, taking us to one of Michelle's favorite healing spots - a clearing deep in the pine forests of northern Michigan. Eric brought his famous home-made pretzels and we all shared them. Next week we are planning to share communion with Michelle.

Even though there were fewer in attendance this Monday (we've had up to 18 at past gatherings), we keep hearing of more and more people who are praying with us at 7:00 every week. It's very humbling to us when we hear of all the churches, groups, friends of friends, close friends and family who are praying for Michelle every week. Michelle can feel those prayers working and our appreciation goes far beyond words. Thank You Thank You THANK YOU!

We heard from the Gastroenterology specialists at University of Colorado Hospital (UCH) in Denver on Tuesday. They scheduled an appointment for Michelle on Friday, February 13 at 9:30 AM to refresh her stents. As you may recall, the current stents (placed January 5) are plastic and expected to last 6-8 weeks. They will be replaced with "permanent" metal stents which should last at least 9 months up to several years. The metal stents have a larger bore and are much less prone to blockage.

The best news is that there is no evidence that the current stents are blocked. In fact, Michelle's bilirubin this week is only 0.1 points above the normal range: 1.3 vs 1.2! Hallelujah and Amen! (It's still important to go ahead with the replacement, because the plastic stents will eventually start to break down.)

Also on Tuesday, we heard back from the radiation center. They wanted to start Michelle's radiation treatments right away. She is scheduled for 14 daily treatments every weekday at 9:30. The first treatment was scheduled for Wednesday.

Tuesday's chemo treatment went smoothly (they even placed the IV on the second try this time!) and she didn't feel too terribly bad Tuesday night and slept well.

Wednesday's radiation treatment was quick and painless. She receives a dose both front and back, targeting the tumor in her T11 vertebra. They gave us some moisturizing cream to rub gently on her skin twice per day: the skin will become very tender, similar to a first-degree burn.

Michelle felt surprisingly well on Wednesday, and even reduced her pain medication to 2 doses per day instead of 3, with no breakthrough pain at all. Having learned how the nausea medications work for her, we carefully dosed her and managed to avoid most of it.

Thursday was pretty much a repeat. Radiation at 9:30, followed by a restful day, but without the severe out-of-control nausea experienced last time. As I write this, Michelle's getting ready for bed after a reasonably (and surprisingly) good day. She even ate a good dinner!

Tomorrow we meet with the surgeon to plan for installation of a port. This device will reside just under the skin of her upper chest, and provide easy access for blood draws and IV medication, without getting poked 2 or 3 times several times per week. We don't have a schedule for the installation, but we're hoping it will happen before the next chemo on Tuesday.

And that's all the news I'm fit to print this week. As Tigger says, TTFN!