One Down - Seven to Go

Well, my first day of chemo is done with. Not too bad actually....will really depend on how the next couple of days go. Had a good nap when I got home. They gave me Taxol and Carboplatin today along with anti-nausea meds and a few other side drugs. My next chemo treatment is scheduled for August 19th, so I should have a couple of weeks feeling good before they hit me with more drugs again.

Abby is still being wonderful and careful around me, she is so sweet (she can be a little devil at times though and drive Kyle crazy!!)

All in all, not a bad day.

"And This Too Shall Pass......"

Its about to Start

Okay, the chemo starts tomorrow. I'm feeling pretty good and getting around good as well. I'm a little apprehensive but I'm sure that's to be expected. It will be an all-day treatment, so hopefully I can catch a nap or two while the chemo is doing its thing.

"And This Too Shall Pass......."

Cindy's Pre-Chemo Haircut!

Chemo is now scheduled

Hi Everyone,

Its wonderful to be home! I've been home now for a week and feeling much better. Abby has behaved wonderfully and not jumped on me to irritate my incision at all. Abby is really glad to have all of us home and her regular routine in place again. She did enjoy her week long visit with "Grandma" (my mother came to stay for a week) as she was spoiled more than normal.

We had our first post-op visit with the oncologist this morning. Things are progressing nicely and looking good. I am scheduled to begin my chemo treatment next Wednesday, July 29th @ 8:30 AM. Each treatment after that will follow every 21 days.

As far as my ankle injury, I hope to begin rehab on it in the next couple of weeks. Things are finally moving forward on all fronts.

Thank you all for your thoughts and prayers over the last several weeks. Knowing that there are so many people that care has really been a Godsend.

God Bless.

Cindy

First day home

We're all very glad to be back home. Cindy's mom is here helping out for the rest of the week. Starting yesterday morning, Cindy has felt much better and is able to get up and around with minimal effort or pain. I know she prefers the food here to what they served in the hospital, too.

This afternoon she got a port-a-cath inserted that will be used to give the chemotherapy. Her first follow up appoinment with the Gyn-oncologist is next Wednesday. That's when we'll discuss the chemo regimen and get her stomach staples out.

After 12 long days . . .

We're headed home!!

One more day down . . .

Things keep moving along well. Cindy has been up walking a few times today and is tolerating a regular diet. Her oral pain meds have been cut back a bit and, other than a few muscle spasms, seem to be controlling the pain pretty well. Unfortunately, some pain will just come with the territory as her abdominal incision heals.

Her renal function has continued to improve and her other labs look good too. Barring any unforseen difficulties, the medical team is planning on sending her home on Monday.

Fingers crossed . . .

Things are going very well right now. Cindy was moved from the ICU bed to the surgical oncology wing yesterday (and walked from one room to the other!) The IV pain meds have been discontinued and she's getting oral meds now. There's talk of getting her a regular diet today, which would really help her energy level - broth and red jello just aren't cutting it!

She should get to go home in the next couple of days. She already has an appointment for Tuesday afternoon to get a port-a-cath inserted at the clinic office. She will probably be treated with cispatin or carboplatin and taxol every three weeks for 6 cycles.

A little more about what we found out from the pathology report: the tumor was confined to the right ovary and the fallopian tube on that side. All visible tumor was removed and none of the abdominal washings or samples that were sent (lymph nodes, omentum, etc) showed signs of cancer. That means her cancer is stage IIa. The majority of ovarian cancers are diagnosed at a later stage, so Cindy was very lucky that this was caught early. It makes the likelihood of successful treatment much higher.

Lymph nodes are NEGATIVE!!!!!

This morning we got the best news of the last 2 weeks - the inflammed lymph nodes that were removed during surgery are negative for cancer! That means that Cindy's cancer is only stage II. The Gyn-Oncologist was very happy and said that it will be easier to treat. Since all of this started when Cindy tripped over Abby's baby gate, she's the hero in all of this that let us catch it early. Cindy's mom is going to give her a big hug when she arrives tomorrow!

Other signs are looking good, too: her creatinine is down some, meaning her renal function is improving and her white count is back to normal. We're crossing our fingers that we'll get to move out of the ICU room today.

Thank you all so much for your prayers. Other than having the surgeon say "Oops, we were wrong and there wasn't any cancer in your ovary", this is about the best possible news we could have gotten.

After further review . . .

. . . the ruling on the field is overturned.

Well, I spoke too soon earlier. After I left for lunch, the intensivist came back and decided that he'd prefer to keep her in the ICU room to more closely monitor her renal function. Her white count is also up again, but the ID specialist thinks its just a post op reaction. Either way, she's still hooked up to the monitors and we're hanging out in ICU. No results from the renal ultrasound yet.

Lots going on today . . .

. . . most of it good! Cindy had a good day yesterday. The nurses got her up in a chair a couple of times and her pain was pretty well controlled. Overnight she slept really well (which means I did too - the couch in her room isn't the worst place I've ever slept, but it sure isn't the Four Seasons !)

Today she's going to be transferred out of the ICU area of the oncology floor to the regular surgical oncology unit. The tube that was draining her stomach has been removed, and so have most of the monitoring devices, so she'll feel a lot less tethered to the bed. She was able to start a clear liquid diet today. Her stomach incision looks good and her temp is normal. She was getting a little loopy from the pain meds, so the dose has been decreased so she can feel a little more with it and hopefully continue to keep moving around. I've heard that the nurses on the unit she's moving to can be like drill sergeants, but the sooner she gets up and walks around the better.

Really the only thing that's not going great right now is her kidney function. After getting a little better the last couple of days its gotten a little worse again. She's still peeing - which is good - but some of the lab tests are still abnormal. She's going to have a renal ultrasound this afternoon to see if that can give us any answers.

Overall, though, things are going really well. We're still waiting for the pathology reports from the samples taken during surgery. Those will be used to more accurately stage her cancer and guide the chemo treatments that will start in the next couple of weeks.

Good news - they decided to go ahead and take the breathing tube out last night. Hopefully that's one less day of recovery she'll need. She's about as comfortable as can be expected and has a PCA pump for pain control.

Cindy's surgery was completed about 7:30 tonight. They did identify a tumor on her left ovary. Dr Smiley told us that it seemed fairly well contained, with no apparent seeding of the other ovary or organs. The lymph nodes were inflammed, but we'll have to wait a few days for the pathology report to know if they were cancerous. Based on that her cancer is either stage II or III. She had a total hysterectomy, but there was no need to operate on her large intestine.

After recovery, she'll be going to the ICU part of the oncology floor. Because it'll be relatively late by the time she gets settled, they're going to leave the ventilator in place until at least tomorrow. With the large incision, the pre-existing PE, etc she may be on it for another full day.

We've crossed one hurdle but there are more to come. Cindy will be in the hospital for 5-7 more days. Chemotherapy will begin in about 10 days, but we obviously haven't discussed how often or for how long.

Nothing new today . . .

We're just hanging out waiting for surgery tomorrow afternoon. Cindy's temp has been normal/near normal all day so she's felt OK. She tried to get some sleep today, but the parade of people coming through - respiratory, case workers, hospital volunteers, hospital chaplain, etc - was busier than ever. I think she only got about 30 min of sleep at a time. Oh well, like one of the med students said, she'll get a good nap during surgery tomorrow. Her serum creatinine is still elevated (meaning her kidney function is decreased), but its the same as yesterday. Hopefully, it'll normalize after surgery.

Today was a pretty good day. Cindy's temp was more or less normal most of the day and she was able to get some rest. Her renal function is still the same, and a nephrologist saw her this afternoon. The decrease in kidney function could still be because of the dye used or from one of the antibiotics. We'll just have to watch it closely for the next few days. Otherwise, its just status quo until surgery.

Cindy's fever was lower most of the day yesterday and is normal so far today. She feels much better when her temp is normal. The abdominal distention and pressure is still there and that's what's giving her the most trouble right now.

They decided to move her surgery up a day, so it'll be on Tuesday afternoon. We're still very nervous about what they'll find, but hopefully that will finally answer our questions. So far none of the tests - blood cultures, sinus CT, chest x-ray, etc - have identified the source of her fever, but at least we're crossing things off the list. Right now the two best possibilities seem to be an intra-abdominal infection or an inflammatory reaction as I mentioned yesterday. Unfortunately, that also means that Cindy will be in the hospital until after surgery, but that's probably the best place right now.

Cindy's hematocrit was a little low this morning, so she's getting a couple of units of blood in preparation for surgery. Lab tests also show some reduction in her renal function, which is a bit concerning. Physically it still seems normal, so hopefully its a transient reaction to the dye used in some of her scans.

On another note, many of you have asked if we need help with Abby, our lab puppy. We had already planned to board her when we thought the filter placement was going to be done as an outpatient and we just extended her stay. She loves the group playtimes and is worn out at night . . . a tired puppy is a happy puppy! I picked her up today and she'll stay at home until Tuesday when she'll go back again for another couple of days.

A long day and night . . .

Cindy's first full day in the hospital was busy. In the morning, all of her doctors made rounds. The infectious disease consultant is not convinced that her fevers are the result of an infection. Its possible that it could be an inflammatory reaction from either the DVT/PE, the ovarian mass, or both. He did order an echo to rule out endocarditis (it was normal), and a CT of her sinuses to evaluate the possibility of a severe sinusitis. That's being done this morning (Friday).

On Thursday afternoon, the umbrella filter was placed with no complications, and Cindy was finally able to eat after being NPO all day. Because of the fluid in her abdomen though, she gets full with only a small quanity and then feels miserable. That was the main cause of our long night. A baruim enema is scheduled today to evaluate her large intestine and colon, so she had to drink a prep solution every hour for eight hours overnight. We tried to do it in as little fluid as possible, but the bloating and abdominal pressure made it very uncomfortable. Hopefully she'll be able to get some sleep today and have a more restful night tonight.

Quite a full day today . . .

Well, today ended up a lot more complicated than we thought it was going to be. Cindy had a follow appointment at the Gyn-Onc this morning and then her orthopedic appointment this afternoon.

The low grade fever hit early today, and when we saw Dr Smiley, she wasn't happy with Cindy's continued fever, chills , and increased white count despite her being on oral antibiotics since Friday. She decided to admit her to the hospital, check some blood cultures, and get her started on some IV antibiotics. The good news from her was that Cindy's surgery was able to be scheduled next week - Wednesday, July 8. we're both really glad she won't have to wait until the week of the 13th.

She did allow us to make a detour to the Ortho appointment, though. There we got some more good news - Cindy's ankle probably won't need surgery! Dr Murphy put her in a walking boot and hopefully the ankle will heal with some time and PT.

The IVC filter is still being placed tomorrow, but unfortunately it'll be an inpatient procedure rather than an outpatient one. Hopefully, though, she's on the road to getting rid of the persistent fevers which were really wearing her out.

How we got here . . .

For those that haven't heard the whole story, here it is. It's long, so bear with me.

On Mother's Day, Cindy tripped over the baby gate we use to keep Abby (our 6 mo old lab puppy) in the kitchen. She landed on her left knee, and other than being a little sore there seemed to be no problems. Two days later, she began having pain in her right ankle and calf. The next day, the pain had gotten considerably worse, so she went to a minor med office and was diagnosed with a deep bruise in her calf and possibly a sprained ankle. X-rays of the ankle were negative. Ice and elevation didn't really help, and by Sunday, May 17 the pain was worse than ever and we went to the ER. An ultrasound of her calf revealed a DVT (deep vein thrombosis) in the peroneal & popliteal veins of her calf & knee. Treatment was started with Lovenox and coumadin.

Over the next couple of weeks, she improved and was able to walk off of her crutches and go back to work. By the weekend of June 6, though, the ankle and calf were swollen again. On June 11, Cindy had an MRI of her ankle which showed disrupted (i.e. detached) ligaments in her ankle. She was back on the crutches and scheduled to see an orthopedic surgeon on July 1.

In the meantime, we continued regular visits to our internist to monitor her coumadin. At one of these visits, Cindy asked about a persistent dry cough she'd had for a while. A chest x-ray in the office was negative. The doctor was concerned that there might be a blood clot in her lung (a pulmonary embolism) and scheduled a CT angiogram of her chest on June 22. We went in for the angiogram at 7 am. The radiologist noticed something irregular and wanted to do an abdominal and pelvic CT as well. We went up to the internists office, and he told us that the scan showed that there was a clot in her lungs, but that wasn't all. They had also discovered a 10cm mass on one of her ovaries. While the meaning of this news sunk in, we set up an appointment with a Gyn-Oncologist.

Our first visit with the Gyn-Oncologist - Dr Linda Smiley from the West Clinic -was on Friday, June 26. She reviewed the CT scan with us and confirmed our suspicion that Cindy would need surgery to remove the mass and would also likely undergo a total hysterectomy. Because of the existing blood clot in her leg, an "umbrella filter" needs to be placed in her inferior vena cava before surgery. The purpose of this device is to catch any part of a clot that broke off from her leg before it could reach her lungs. Luckily, this can be done as an outpatient and we'll be at Baptist Hospital tomorrow morning (July 2) for the procedure.

Right now, Cindy feels OK most of the time. She does have a low-grade fever that comes and goes, and when it hits she feels pretty lousy. She's also still hobbling around because we haven't been able to do anything about her ankle yet. Because of all the upcoming procedures, she's been switched from coumadin to Lovenox to treat the blood clot. Lovenox is an anticoagulant that's injected subcutaneously (like insulin) in the abdomen twice a day. It also happens to be the drug that I've been educating health care practitioners about for the last 9 years.

That's where we stand right now. Today, we have a follow up appiontment with Dr Smiley to review some more test results and schedule the surgery. We also get to meet with the orthopedic surgeon. Originally, we assumed that he would do surgery to reattach the ligaments in her ankle, but that seems unlikely now, at least for a while.