"Wocka Wocka Wocka Wocka"

Visualize an army of Pacman, Ms. Pacman, and all their tiny little Pacfriends gobbling up the cancer. That's Michelle's vision of how chemo works. (The sound effects in the blog title are mine.)

Michelle came through her first round of chemotherapy with flying colors, although it was quite a ride. After an uplifting prayer meeting on Monday night, we arrived at the treatment center at 2:15 Tuesday afternoon. The treatment itself went well, with no complications, and we left about 3 hours later. Michelle said she felt bloated and "weird".

They prescribed Compazine and Ativan for nausea, on top of the Zofran we have already been using, and advised Michelle to take both when she got home. Although she experienced little or no nausea, the Ativan apparently caused muscle spasms that lasted all night long and kept her from sleeping. She was finally able to fall asleep around 6:00 AM, just as I was leaving for work. She slept pretty well until around 2:00 PM and then came downstairs to make a fruit smoothy.

When she went back upstairs to our bedroom, she felt completely wiped out and was breathing heavily. I had come home from work early because both kids had to work in the afternoon, and I grew concerned about her breathing. We checked her oxygen saturaion with a fingertip pulse oximeter I bought over the internet. The reading was 74%, and it dropped to 64% as I watched. (For perspective, they sent Michelle home from the hospital in December with oxygen because her reading kept falling to the low 80's - normal readings fluxuation between about 91 and 99.) We immediately put her on oxygen and her levels quickly returned to normal. What a scare!

The rest of Wednesday was pretty uneventful. Michelle was very, very tired but so far not really nauseous and her pain was under control. She slept well Wednesday night.

Thursday was a different story. While she did sleep OK, she was still quite fatigued. In the mid-morning she felt well enough to take a shower, but her O2 saturation fell to 80 and we put her back on oxygen for a while. The nausea struck with a vengeance in the early afternoon. I guess you could say that the medications did their job because she never actually vomited, but her misery was palpable. I took the day off work as planned and did all I could to comfort her, but in the end there was precious little I could do.

Fortunately, at around 5:30 PM the nausea passed and she suddenly felt better. It was like a veil of fog suddenly lifting, very much like the way a fever will suddenly lift. Michelle was able to eat some dinner and just lay back and relax. We spent the evening watching some TV and she slept like a baby all night.

Friday (yesterday) we met Dr. Gwen H. Lisella, MD. She is a radiation oncologist and will be performing palliative radiation treatments to address the cancer that has apparently spread into the bone of Michelle's T11 vertebra. We saw the image from last week's MRI. The good news is that the cancer is well away from the spinal cord. There is a black area on roughly half of the front side of the bone that the radiologists identified as cancer. Dr. Lisella said this area is fairly east to treat without huge impacts on the abdominal organs, but there will still be some nausea and increased gastric reflux as a result of the treatment. She is going to consult with both Dr. Marschke to coordinate radiation therapy with chemotherapy and with Dr. James Derrisaw, the pain management specialist who administered the celiac nerve bundle block back in December*. We should hear back from her by next week Thursday to set a treatment schedule.

The radiation treatments will take place over a 2 week period, Monday through Friday. We may want to try to schedule them to take place during the 2 week chemo hiatus in early March. Dr. Lisella said that such a delay should not make much difference in the outcome of the treatment. Given this week's experience with chemo, I support the idea of not adding daily radiation to the mix at this time.

* - The celiac bundle block was a treatment to provide longer-term pain management for Michelle's intense abdominal pain. The treatment was administered during her hospital stay the week of December 15 and consisted of a 4-point injection of a powerful alcohol solution which dissolved the nerve sheaths, effectiving deadening the pain transmission of the major abdominal nerves. The injection sites were near the T10 and T11 vertebra (in the middle of the back near the bottom of the rib cage and the top of the stomach). There is no indication or expectation that this injection had anything to do with the dark spot on the MRI. Dr. Lisella want to consult with Dr. Derrisaw to make sure all bases are covered, and to further rule out any relationship with his treatment and what we now see with T11.

We continued to add to the healing wall this week. We added pictures of everyone who attended this week's prayer meeting, plus hand written signs "God has a Plan for Me" and "One Day at a Time". These additions, plus a prayer from our dear friend Brenda and pictures friends and family members who have fought bravely and unselfishly cared for others, were a great source of strength and inspiration for Michelle during her lowest moments this week. She feels overwhelmed by all the love and support she is receiveing and tears up when she speaks with amazement at all the people who love and care for her. God bless you all, and please keep up your prayers.