The Final Chapter

Mary passed away Monday night at 9:15, surrounded by her family.  She died peacefully in my arms.

During the last two weeks the pains in her abdomen were getting more intense and she was feeling weaker every day.  On Sunday, May 22^nd her friend Barbara drove her to her daughter’s baby shower.  I don’t know how she made it through the day as she was already feeling very ill.  On Monday she stayed in bed almost the entire day.  Early Tuesday morning she was feeling nauseous and light headed and at 5:00 I took her to the emergency room at Jeff.  She was admitted right away.  Tests for signs of infection were negative.  It was the cancer that was taking its toll.  After talking to her oncologist she decided to stop all further treatments.  On Friday we moved her to the hospice of the University of Pennsylvania.  A nice, new facility with 20 rooms and friendly staff.  There she was kept comfortable.  She was ready.

Mary gave me the best 8 years of my life.  I miss her terribly.

Thierry

I’m Still Here

I know some of you are concerned about me because I’ve been quiet the past couple of weeks. Well, it hasn’t been quiet from where we sit. I think in my last blog I mentioned that I had new pains in my chest – which is not really my chest but sort of the chest- abdomen area. I did call the doctor on Monday the 2nd and got an appointment immediately. This was Dr. D at Penn. They took a chest x-ray, did blood work and had me get a PT scan. We got home about 5:00 p.m. that day, having left at 10:00 in the morning.

Dr. D called me on Tuesday evening to tell me that the pain came from the liver and that the tumors were still growing. She told me I would be going off the study immediately and that she would contact Dr. A at Jefferson to talk about future treatment. It was a big decision deciding to go back to Jeff and to stick with Dr. A and not go back to Dr. M, my original oncologist. This was one of the major decisions we had to make that day, which caused me much angst. We had to think about the convenience of Jeff over Penn to receive treatments; Jeff is closer if I need to go to the emergency room, or what they offer in hospice care – to name a few. I liked the fact that Dr. A and Dr. D didn’t seem to have any problems talking to each other – there didn’t seem to be any egos or territorial issues involved.

Later in the week, while the folks at Jeff were trying to work out all the details with my new treatment plan, I received a call from Jeff saying that my platelets and white counts were low. The platelets were too low for me to get treatment. This would mean a delay in beginning the new chemo.

On Wednesday the 4th I sneezed and got a searing pain down the right side of my abdomen. The pain was debilitating and hurt especially when I took a deep breath, belched or sneezed. We had our friends take me to the emergency room at the hospital – fortunately there was only a 1.5 hour wait. They immediately plugged me into a morphine IV and came up with a list of tests: chest x-rays, ultra-sound of my gall-bladder, blood tests and cultures. They sent me home at 7:00 a.m. the next morning, unable to tell me anything. They did give me scripts for morphine. It’s amazing how quickly you become constipated on morphine. Now I have to take more stool softeners and laxatives to keep things moving.

I was told on the 13th that my platelets and white counts had gone up and that I could start the treatments this week. On Saturday evening, the 14th, I came down with the chills. When I took my temperature it read 99.9 which is high for me. We cancelled the plans we had to go out for food and drinks with friends, and I went to bed instead. When I awoke Sunday morning my temp was 100.8 – at this reading the docs would have wanted me to go to the hospital. I took two Advil and took my temperature every couple of hours. It went down and settled to about 97-something. This morning my temperature was normal.

As soon as the office opened today I called the oncologist and spoke with her assistant. I explained everything that was going on with me. She had me come in for a series of blood work, cultures and an x-ray. There will be no chemo this week either – we just have to wait for the tests results.

I think I’ve been handling things pretty well. This may be due to the anti-depressants I am now taking and the constant state of “high” I think I am in from the morphine. My support system has been here for me. During these last two weeks I was treated to a massage, been to lunch and movies with friends and family, went shopping and bought an outfit to wear to Lauren’s baby shower, which is this weekend.

Thierry was busy as well – when he was not sitting in a waiting room somewhere, he managed to plant twenty-four tomato plants,30 hot pepper plants and roughly 36 sweet pepper plants in my dad’s garden. Thierry also planted a tomato plant in a pot on our balcony and filled out the containers. The grass we had planted last year came back. (Unfortunately, Jeannine’s bulbs that she planted in the fall did not.) We picked something with a purple flower and they look great with the grass.

Hopefully I’ll find out what is going on this week and we can get a handle on it. It’s very odd to roll along with a temp of 97.6 and in a few hours have it read 100.8. Have a great even week!

A Bit Up and a Bit Down

I want to thank everyone who commented on last week's blog. I realize I must have sounded like I was throwing in the towel, but I was really a bit angry at some of the things I had been hearing - and I guess about the cancer itself. All of your kind thoughts and words meant a lot to me. Many folks sent me emails because they are unable to post on the blog.

It's been a bit of a seesaw week. I have had my dark days, but have also had a couple of really good ones.

Lauren had a big crowd at her house on Easter Sunday. Lots of food and family from out of state. My dad's brother, along with his wife and son, were visting from New Hampshire, as were my sister's two sons. It was great to see everyone.

I had to have blood work done three days in a row. All for the study, but I found out that not all the blood work would be paid for by the study. So, after several phone calls and suffering a minor meltdown, I learned that because my family doctor is at Jeff, I have to go to Jeff for routine blood work and tests (like MRIs, etc.). I guess I should see all this as a minor inconvenience. Thursday was the big day. I had to be at Penn at 7:00 am for a blood draw before I took the meds. Blood was taken two more times, 4 and 8 hours after the first, so we had to hang around all day. Fortunately, Lauren was able to get away for lunch so she picked Thierry and me up and we scooted across town to an old favorite restaurant. She was in great form and her humor and spirits really picked both of us up.

Friday I met with a psychiatrist (for the second time) to talk about things. She prescribed an anti-depressent which I will begin taking today. Hopefully this will smooth out my moods. When I asked the trial nurse if this would be okay she told me that everyone is on an antidepressent and no, it wouldn't impact the study.

Friday afternoon I actually felt very upbeat and happy. I went to the movies with friends and then out to lunch. After a very big glass of wine and spending time laughing, I actually had a lot of energy. Thierry and I went out for coffee, then later friends came by and we ordered a pizza. Then Saturday came. I awoke with terrible pains in my chest/abdomen which hurt only when I move. It feels like things are growing or swelling - just what, I am not sure.

Lauren treated me to a fundraising luncheon Saturday afternoon, which we did attend. Unfortunately I was not great company. I came home and took some Advil and lay down for a while. I felt a little better and Thierry and I went out to dinner and then to a friend's joke party. What a great idea for a party, isn't it? It was really fun to sit back for a couple of hours and just listen to jokes - and laugh! I am amazed at how comfortable some people are in getting up and letting jokes roll off their tongues - and the fact that they remember them. Two couples did skits that were really funny. If you've never been to one, time to host one!

This morning I am in pain again. I took some Advil and it seemed to help for a while, but the pains are creeping back. I'll try to see the doc tomorrow.

Much to do this week, so I am hoping for a good one.

Doom and Gloom

I’m doomed. I don’t say the rosary every day – don’t even go to church. I don’t believe in God, at least not the God most people attach to. I am on the fence about miracles. I am not a vegan and do not pop tons of supplements every day (they don’t go well with chemo). I am taking chemo – allowing all those evil toxins into my body. I don’t visualize enough and sometimes have trouble seeing the cancer completely disappearing and I don’t spend a lot of time self-reflecting.

It has been coming at me from all sides this past week. First there was a conversation over dinner about miracles and prayer, and how if you don’t believe, you won’t be the recipient of a miracle. The second topic which left me feeling a bit doomed was an email about a woman who appears cured of rectal cancer after a pretty grim diagnosis. She attributes the cure to self-reflection. Now, to be fair, the woman with the rectal cancer truly believes that “for her,” and I want to emphasize that she stressed that this process worked for “her,” self-reflection and visualization helped cure her cancer, which she believes sprung from her internal struggles. She also had special radiation treatments – in other words, she did it all, but she truly believes it was her self-reflection and recognition of internal struggles which had the greatest influence on her health.

So, what have I done to help myself? I actually have prayed – to whomever and to all the saints known to cure cancer. I put my trust in my doctors. I have tried to enjoy each day. I eat whatever goes down and is not a turn-off due to the chemo and makes me feel good. I have tried not to worry about the cancer itself by keeping busy and not focusing on the disease. I sporadically do some visualization and meditation (the phone rings off the hook every time I lie down to do this) and go to bed with good thoughts and envision being with my granddaughter.

I know that this information is passed along with good intentions. I am being presented with alternatives and options to help me get through this time. Intellectually I get that, and, deep down, believe in the power of creating your own reality. But, and it is a big but, when you feel tumors growing inside of you and awaken each day to a new pain in a different part of your body, these ideas also make one feel like a bit of a failure. Because a couple of dozen people in the same number of years had a serious cancer that went into remission (or was “cured”) and who happened to practice some form of alternative treatment, we are all presented with the notion that this can be us.

I don’t want to die. I never thought I would die young, although I worried at a young age about breast cancer. Did I create my cancer? Did my early fear of cancer (my aunt died of BC when I was in my 30s and another aunt was diagnosed shortly after) cause this disease to grow in my body? Is this whole thing ultimately my fault, and is the fact that I have had several different treatments with limited results due to the fact that I really have a death wish and haven’t focused on the right things.

This totally is not where I want my head to be right now.

The Trial Begins

I’ve hesitated to write my blog for a couple of reasons. The first being I think I am depressed. Don’t know if this is due to the new drugs or just to the general state of my condition. The second reason is that my blood pressure will rise when I start to relive Wednesday, the day I officially began the study.

Actually, the study was sandwiched between two very nice events. Early in the day I went with two friends to the Art Museum to see an exhibit of fashions created by Roberto Capucci (http://www.philamuseum.org/exhibitions/411.html). Over eighty of his works were exhibited encompassing his entire career. His designs incorporated a wide spectrum of colors, incredible fabrics, and are more art forms than fashion. We then had lunch at the museum restaurant before heading off to Penn.

Thierry met me there, along with a research assistant who was anxiously awaiting my arrival. For some reason everyone was in a tizzy, worried that my blood work and EKG wouldn’t be completed in time for my scan. I had to throw a wrench into things by insisting that I be stuck only once – taking the blood from the access IV for the scan. I was quickly strapped into the EKG wires and someone was brought in to access my scarce veins. She was determined, and after what seemed like several minutes of digging, got the thing in.

A nurse handed me pills and paperwork and spouted off some instructions while all this was going on. By the time I got out of the little treatment room I started to become anxious – not feint – just teary.

We were then escorted to the basement where the scanning equipment is, only to find that we were scheduled to be in another building. Fortunately the buildings are connected by a series of walkways so we didn’t have to go out into the rain. The doc who was in charge of the scan was very nice. He did the injection and took his time answering my questions and explaining the procedure. We had to wait an hour after the injection before I could be scanned; the scan itself took about 30 minutes.

I was mentally exhausted when we left and went home and crashed for an hour. We later had dinner with friends which revived me a bit. Early Thursday morning I got a call from the research assistant (M) informing me that they did not perform the correct blood work and I would have to go back that day. I made it clear they would have to access my port if they wanted blood.

I checked in with the front desk and told them I was there for blood work. They said M would be up shortly to see me. She and I talked and she apologized for the mix-up with the scan – stating that I was in fact scheduled to have it done in that building. She again went over a few of the instructions and future blood work requirements, then left me in the waiting room. After sitting there for an hour, I went up to the receptionist at the desk to find out when I would be getting the tests done. She said I would have to talk to the triage nurse and pointed with her finger around the corner.

I went up to the triage nurse who for a few minutes just looked at me. Finally, after taking a phone call, she asked if I needed something. I began to explain the mix up with the tests and wondered when they might be calling me, stating that I had already been there over an hour. I didn’t tell here that everyone else around me had been called back for their various treatments. She looked up my chart and said that I was there to see M and that I saw M and that was all I was scheduled for. I explained again I was to have blood work done – she proceeded to repeat her statement. I told her she was going to have to call M and get it straightened out. She told me that they were very busy, she had 8 people ahead of me and that I could be there for over an hour. I told her that all I needed was to have blood drawn – which takes minutes – and that she should speak with M and let me know how long I would have to wait – since I wasn’t supposed to be there anyway. She suggested I go to the regular lab – I told her no, they were to access my port – which only a nurse can do. Needless to say, neither one of us were very happy. I was called about 15 minutes later.

What amazes me is; here I am, at a world renowned medical facility, in a medical trial, and the place appears so disorganized. I have such an unsettled feeling about all of this. I miss the girls in the oncology unit at Jeff, and I feel pretty much out there – alone.

The pills seem to be going down alright. Other than feeling a little tired and having minor flue-like symptoms later in the afternoon, I am okay. I do feel a bit depressed, and continue to have some intestinal discomfort (resulting from the tumors). I plan on doing something about the depression, and will try to remain focused. I feel bad for Thierry, though. When I get like this I don’t feel like talking – to anyone. I could just curl up in bed with some mind pabulum on the TV.

The week ended on a good note. Friday Thierry and I went out for dinner and had a delicious paella. We then went to the Kimmel Center to see the Orchestra National de France. Two of my favorite pieces were played, Debussy’s “La Mer” and Stravinsky’s “Rite of Spring”. This performance was part of the Philadelphia International Festival of the Arts – the theme of which is France. The Kimmel Center erected a replica of the Eiffel Tower covered in lights. As we were leaving the concert, we were entertained by a light and music show. It was much fun. I felt good and we had a really nice time.

Sunday we baked pastiche at my mother’s house; quite a production. Pastiche is a pastry that looks like a baked ravioli. We made the dough and ran it through a pasta machine. The dough is filled with a cheese filling and baked. It took us (Jean, Ann, Joan, Lauren and I) a few hours to make about 8 dozen pastiche. One person managed the dough, one person turned the wheel on the pasta machine, another stuffed and cut the pastries, another pinched the dough and another coated the pastiche with egg and manned the ovens. My sister tried to find out the history of this pastry and came up with a blank. It appears this is a Taraborelli original.

Now to get ready for Easter. Lauren and Mike will once again host both families – about 35 in all; something to look forward to.

PS: My friends have been wonderful and have been checking in on me and occupying my time. I don't mean to sound like all I do is sit and brood - there is just only so much one can write about, but I am every so greatful for those folks in my life.

Anxiously Waiting

This week I start the trial. Wednesday I go for blood work and scans and begin the pills on Thursday. I am most anxious.

I am extremely uncomfortable. My side hurts, my back hurts; nothing that I need to be snowed for (morphine) at this point - just uncomfortable. Luckily the weather has been nice and we have been able to get out for a bit.

We went to a concert on Sunday that featured the Pennsylvania Ballet (a first time event - pairing the ballet with the orchestra). This performance was part of the Philadelphia Festival of the Arts celebration currently taking place at venues all over the city. The festival encompasses live performances (ballet, theater), art exhibits and cinema. This is an event that should be recognized (inter)nationally for the level and diversity of programs that are offered.

I managed to take a couple of walks, and even took my weights out of the closet (2 and 5 lbs. only). The weight work did make me feel a bit better; I'll try again today.

That's all for anow. Going to put the invitations together for the "baby shower". Will try to write more over the weekend.

A Mixed Bag

A mixed bag, is what Dr. A from Jefferson Hospital said.  My recent scans showed improvement in some tumors, but not so in the liver.  She took the liberty of calling Dr. D. at Penn and they both thought that the Phase II trial study was the place for me to be.

I could have guessed the outcome of the scans.  The pressure under my right ribcage has increased considerably.  Sometimes it even hurts in that general area.  I also feel pressure in other places, and often have a backache, albeit on the other side. 

I had the scans on Tuesday, but had to cancel my regular appointment with the oncologist on Thursday because I came down with a horrific cold.  After several unsuccessful attempts to reach Dr. A. by phone, on Friday morning I called Dr. D. at Penn to get an appointment.  I had left the house for about an hour when Thierry got the call from Dr. A. with the news about the scans and her call to Dr. D, so all in all the timing worked out okay.  I saw Dr. D. on Monday, yesterday, and I will begin the trial as soon as they can schedule a special scan for me (and assuming the blood work they ran yesterday comes out okay), very possibly next week.

It seems I have lots of the protein that my tumor needs to grow.  The hope is that this experimental drug will stop tumor growth.  It is a CDK inhibitor that affects this particular protein.  It appears that in some cases there has been tumor regression.  And that is my wish; that not only does it stop growing, but that this thing (or things) in my liver actually get smaller so I am more comfortable.

I will be taking two pills a day for three weeks, have a week off, then start the pills again for another three weeks.  This 3-weeks on, one-week off is a cycle.  I get blood work done and see the doctor at the beginning of each new cycle.  This is very similar to prior treatments.  What is different is that I will now get scans every 8 weeks (MRI/CT/PT), and they will add a new type of CT scan, called “FLT”.  The only difference between the two scans I can remember is that the typical CT requires an injection of sugar which goes directly to the tumors. The FLT does not use this type of injection.  I only hope I have enough slivers of veins left for all of these scans.  Another difference in the schedule is an extra day of blood work that requires my going in for a blood test on the 15^th day of my treatment cycle early in the morning before I take the meds; then I take the meds and four hours later return to the hospital for another blood draw.  Thankfully they will use my port for all this blood work – I would have it no other way!

Needless to say I have been a bit in the dumps. Been thinking about “the end” and how I will know when it is coming and what we need to do to prepare for it.  I know everyone says to stay positive and focus on the new treatment – and I am sure I will when I get out of this funk.  But the day will come…….

So, another (newer than) new treatment; another new normal to get used to, and hopefully another few months of a reasonably comfortable life.  I’ll keep taking deep breaths and try to keep the engine fired up, because, as the words on one of the nurse’s pin said: “Cancer Sucks” and there ain’t a whole lot I can do about it.