First Taxol Infusion

Venita had her first Taxol infusion yesterday. Three "pre-med" IV infusions and then the Taxol. Two of the pre-med infusions--Benedryl and something else for nausea--had an odd cold burning feel going in--like the cold burn of BenGay or IcyHot.

The Benedryl put Venita into hyper-mode. She normally avoids Benedryl because of that reaction. The first hour of the Taxol infusion, all she could do was squirm around in her recliner, wanting to crawl on the ceiling. She was finally able to get to sleep and the final two hours of the Taxol were in slumberland.

Venita has had no Taxol side effects yet and is feeling remarkably well today. She got about an hour's worth of garden weeding done and plans to do a little garage clean-up. Not noticing shortness of breath. No fever; last night experienced hot flashes (which is "normal"). There were thunderstorms last night so Max and Ennis hid downstairs rather than waking Venita up every two hours for food, so she slept fairly well.

Saw Dr. Boob last Thursday and got another 60 ccs infusion in the expander implant. (340ccs so far.) Dr. Boob says one more infusion in 2 weeks. The implant now is just about the size of Venita's real left breast. He also said he's not going to replace the expander implant in the right side with the silicone implant during the left breast mastectomy this fall. He says he will wait and "change out" both the left and right side expander implants at the same time--after radiation. (Keep your fingers crossed that radiation won't been needed on the left side because if it is, it has to be done after the expansion, and that would put the implant change out into the spring instead of the winter.)

Only one doctor's appointment next week--Venita's GP. Venita is looking forward to that. She thinks it is time to cut back on the Paxil because she's been getting really low blood pressure readings.

Venita also wants to find out whether there has been cardiac damage from the chemo and because Dr. Chemo won't order the tests, she's hoping the GP will either talk to Dr. Chemo or order the tests herself. With Venita's pre-chemo EKG, stress test (echocardiogram), and Mugga scan, there should be plenty of baseline to evaluate potential cardiac damage from the chemo.

Back to Chemo

We saw Dr. Chemo this morning and he cleared Venita to start Taxol, the recreational chemo. She starts Thursday, and will get infusions every two weeks. She will have training on Wednesday to find out what drugs she has to take with it and the possible side effects, but so far we've heard it's relatively easy and only causes muscle aches.

Venita's temp has only broken 100 degrees four times in the past week. She still has serious shortness of breath, but it is getting slightly better. And it seems her taste buds might be coming back some; she ate soup the last couple of days, a big step up from juice and jello. When asked, Dr. Chemo suggested Venita smoke marijuana. Although medical marijuana is not legal in Delaware, he said that "people manage" to get hold of it.

P.T. Cruiser called today to get details on Venita's failure to show up for therapy. (PT's been on a 2-week vacation and Venita thought moving from the chair to the bed was therapy.) PT released Venita from therapy and told her to show up with a new scrip once she started feeling up to it.

Dr. Boob put more saline in the expander implant last week. It's now up to 280 ccs (capacity is 450). So the end is drawing near on that process.

Thanks to all who have offered words and thoughts of encouragement during what has been a very difficult time.

BTW, Bailey's cremains came home last Thursday.

"A Touch of Pneumonia"

...According to Monday's chest X-ray, says Dr. Chemo's office. That might explain the fever and shortness of breath. Venita is now back on oral antibiotics.

Home from the Hospital

This week, Venita spent from Monday night until Thursday noon in the hospital on IV antibiotics. Dr. Chemo and a doctor who is an infectious disease specialist kept trying to figure out what is causing the fever.

Venita had blood, urine, and stool cultures, chest X-Ray, CAT scan of the chest, abdomen, and pelvis. Nothing that would be a possible cause showed up. On Thursday morning, Venita asked to come home because there was nothing happening at the hospital that was improving the situation. Dr. Chemo seemed somewhat pissed, but OK'd the release.

This was Venita's first ever hospital admittance. She was in the oncology ward. Food was so bad she asked food services to stop bringing her a tray. Her roommate got a DX of lung cancer the morning Venita was leaving. Why couldn't they have done that somewhere private?

So the fever continues, but it is not peaking as high as it was. Now it is only peaking in the 102 degree range. and it is taking longer to peak; sometimes 6-8 hours instead of the previous 3-4 hours. Last night, for a brief period, Venita felt like the fever had broken. She could think clearly, and move without pain and fatigue.

Venita is on Tylenol therapy, but no oral antibiotics.

Venita sees Dr. Chemo on Monday morning. Chemo is on temporary hold for now.

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Goodbye Sweet Bailey

Adopted on Venita’s 42nd birthday, August 10, 1994.

Euthanized June 9, 2006.

Bailey came to us as Brad. He was a perfect Tuxedo; beautiful. He had been “in custody” at a no-kill shelter since May 29, 1992. When he was trapped at a truck stop in Danbury, CT, he was believed to be about one year old. He was at least 15 years old when he was put down; we think he was older, maybe 18.

Brad resided in the “shy guy” room in the shelter and not handled or socialized to people. His first adoption a month earlier failed.

Brad was feral. He was terrified of people. Often, Venita wondered whether he was autistic.

Venita didn’t like the name Brad. She wanted to name him Crocker or Crosby. But he wouldn’t respond to a name unless it started with B. So Bailey he became. Jim nicknamed him Buddy. Venita nicknamed him Bail and BailButt.

It probably took about two years before we could even look at Bailey without terrorizing him. He would camp himself under the kitchen table and watch us. If he ever saw us looking at him, he would take off for another location. Should he have ever gotten out of the house, he would have been irretrievable.

Although declawed in the front, Bailey was a holy terror to corral for the annual vet visit. Once, as Venita was going up the stairs to corner him in an upstairs hallway, he jumped onto her back and pushed off with his back claws. He was strong! The only way to get Bailey in the carrier in the early days was to outlast him during the chase around the house.

As Bailey got older, and arthritic, we were able to approach him more easily, but he still let us know when we were not welcome by growl, or full-mouthed hiss, or getting up and leaving. Where Venita now lives, Bailey had 2 ½ rooms. For the winter, he had beds next to the furnace registers in the dining and living rooms. For the summer, he had the Florida room, where he could lay in sunbeams and next to the screen door for most of the day. His dining room bed was his “safe place;” and it was often there that Venita could approach him for petting, headbumping, and brushing. Looking back, Venita did not approach him nearly often enough. Out of the way like that, he was easy to forget. Sometimes, a couple days would go by without Venita seeing Bailey. He would sneak into the kitchen for food when Venita was on another floor of the house or sleeping.

There were times over the years that Bailey would join Venita in bed, but only after she had laid down and usually only while the light was still on. He was ever vigilant against the terror of people, even though he desperately wanted to love and be loved.

If Bailey hadn’t gotten along with the three other cats (Maxwell, Ennis, and Lily), he would have been returned to the shelter. But Bailey loved our cats. Small problem was that he wasn’t socialized to cats either. He would walk straight up to Max and Ennis and give them a full frontal headbump at anytime, even when they were eating. This lack of feline socialization persisted to the end. Bailey also didn’t realize that at 15 pounds, he didn’t have to be subservient to the bitchy little 9 pound Lily. She would haul his ass around the house, showing him that she was not the lowest kitty on the pole. But that was Bailey; a most gentle soul.

We got Bailey so that we would have an even number of cats. Venita thought that with four cats, everyone would have the chance for a friend. It didn’t work out that way, but the dynamics of four was very different from the dynamics of three, and we would not have missed a day with Bailey.

Bailey always had been overweight, but he got grossly obese the last couple years. The swinging cow belly look. With his weight, coupled with his arthritis, it was painful for him to get around. But Bailey NEVER failed to make it to the litter box, even though it meant having to painfully negotiate steps and sometimes brave a gauntlet of Jim and Venita watching TV in the family room. Starting in November 2005, Venita withdrew Bailey’s dry food and he slowly lost weight and became much more active again. He started jumping into the bedroom window about 2 months ago, an activity he enjoyed but had given up some time back.

Bailey’s desired weight loss continued past ideal and he started to look boney. About a month ago, Venita noticed a housewide bout of black-green diarrhea and mouth foaming, but she was on her way out the door to therapy. When she returned, she found Bailey on the chair in her room foaming at the mouth and oozing diarrhea. Directly to the vet that day and the next, but nothing but “no result tests” and shoulder shrugs. In the course of 6 months, Bailey had lost about a third of his body weight.

The day of the diarrhea/mouth foaming, Bailey stopped eating and didn’t eat again. Never pooped again either. Despite Venita’s best efforts at things like trying another vet and getting probiotics, appetite stimulants, SubQ fluids, and food soup into him, she was completely unsuccessful at turning his condition around. Yesterday, he “slid” down the stairs to the litter boxes, because he could command his back legs no longer. He was skin and bones. Venita scooped him up, put him in the “sick room,” and called the vet for an appointment today to put him down.

This morning Venita put Max into the sick room with Bailey. Bailey loved Max the most, because Max came to put up with the headbumps and would let Bailey eat and drink from a plate/bowl with him. Max didn’t want to go near Bailey (we suspect Max could “smell” the nearing death), but Bailey loved just having Max in the room. He started purring.

At the vet’s office, Bailey pulled himself around the room exploring and trying to give us his loud angry meow, which he could not manage except as a nearly noiseless chirp. The alternative vet and the vet tech were very kind with the procedure. Venita stayed in the room watching and crying; Jim couldn’t stay.

The vet sat with Bailey on the floor and gave him a rubdown to the sound of new wave music. He loved that vet and her touch. She gave him the first shot to put him into a “coma.” He really fought the effect, but finally rolled over onto his right side. She rubbed him more, and then inserted the IV line into his rear leg. As she started to inject the barbiturate, he took a final deep breath. The vet checked for a heartbeat, pronounced him gone, and invited Venita to stay as long as she wished. Venita stayed, petting Bailey’s silky black fur, feeling how pliable his body now was, headbumping him, until his foot pads started getting cold. She did not give him a belly kiss. Bailey had never allowed that in life, and Venita had promised him long ago she wouldn’t violate his dignity when he died.

Even though Venita would like to know what took Bailey, she is not having the vet open him up. The vet suspects diffuse cancer.

Venita will pick up Bailey’s cremains a week from Tuesday.



Saturday update: Overnight Venita had shaking chills and a temp of 103.6. She’s under orders to call the oncologist with that type of condition. She may just end up in the hospital this weekend.

Into the Fire

And we thought the frying pan was bad. Venita white blood cell (WBC) count on Tuesday morning was 300 (normal is 3800 to 10,800). Dr. Chemo called her in on Wednesday, and she showed up in 3 layers of clothes plus jacket, ski cap, neck scarf, and shivering like a naked polar bear. Temp was only 102. Dr. wanted to put her in the hospital for two days for IV antibiotic. Venita declined; the cat Bailey is on ABs and fluids and may need to be put down when he returns to the vet on Friday.

So Dr. Chemo sent Venita to an outpatient procedure unit for the IV ABs. At release, her temp was 104. She continues in bed and on Tylenol. This morning's temp was close to 99 and the bed sheets weren't soaked. Maybe there is an end to this tunnel.

We'll call Dr. Chemo this morning for followup. Good chance he'll want a stat CBC to assess whether more IV ABs are needed.

Been AWOL

Where have they been? Where are the updates?

First of all, we want to recognize Robin’s distress and her post on the FDMB asking for prayers for herself. Called back on her mammo, Robin has an area in her right breast for which she will receive a sterotactic needle biopsy on June 21. Robin you know that you are totally in our thoughts and that we will be walking with you every step of the way through your challenge.

The week of May 22, being the second week of Venita’s 3rd chemo cycle, usually would have been her good week as side effects diminished and she regained her appetite. She had looked forward to a Memorial Day picnic where she could enjoy eating a grilled cheeseburger and corn on the cob.

But certain side effects became worse, in particular major fatigue, alternating chills and sweats, an incidence of vomiting (no associated nausea), and hardly any food that didn’t smell like cat food or taste like sawdust. All in all, it was nearly impossible for Venita to function. She cancelled two of her 3 physical therapy appointments, and PT Brusier sent Venita home from the one she was able to drag her butt to.

Friday, Venita saw Dr. Chemo, and the reasons for many of these problems became clear. Near the end of the appointment, Venita asked what the white blood cell (WBC) count from her Tuesday blood draw had been, and it was only 1200. (Normal range is 3800–10,800 and the previous Tuesday, her count had been 4800.) Dr. Chemo surmised the fatigue and chills/sweats are the result of an infection and put Venita on antibiotics. She also spent several full days in bed. Bought a digital thermometer and found her temp was fluctuating between 96 and 105 degrees.

Dr. Chemo surmised the vomiting without nausea so late in the cycle was not chemo-related, but rather reflux. His office had advised Venita to take a particular over-the-counter product for this two-weeks before, but once Venita learned the cost, she had called back in for something prescription, but that had fallen through the cracks. Dr. Chemo wrote and Venita filled a scrip for Prevacid. No more vomiting since.

Through the Memorial Day weekend, Venita remained pretty low key. She was able, thankfully, to have her 4th chemo session on Tuesday, May 30. Getting the infusion was touch and go for a bit because Venita’s fever had been up to 102 degrees the previous day, but a WBC count of 12,000 saved the day.

That is the last of the brutal Adriamyacin/Cytoxin chemo, and Venita now moves on to the recreational chemo—Taxol. Everyone promises fewer side effects—likely achiness only. Four session; one every two weeks. Last chemo should be on July 25. Seems only a short 8 weeks away!!

Venita also is taking a break from physical therapy until after brutal chemo is completely out of her system.

Bailey the sick feral cat is not doing well and also needs your thoughts. He is starting his 3rd week of not eating. His blood tests are now showing distress/disease in his liver. He is getting (yesterday and today) IV fluids and antibiotics at the alternative/conventional vet. Hopefully, he will be able to undergo a dental procedure this afternoon; the guess is that an inability to chew set him on this failing course. He is either going to rally here soon, or we will lose him. If the latter happens, we will be very hurt, but he will have had a great run!!

The Week of May 15, 2006

The big appointment weeks are starting to become second nature.

Jim's Dermatologist

Monday Jim saw his dermatologist and had a pre-cancerous skin lesion frozen off. Follow-up in 3 weeks.

V's GP

Monday V saw her GP who gave her a new dosage (3 mg) of the second sleeping pill--Lunesta. Seems to be working. Now if Venita could find the off button on Max's stomach alarm, be wouldn't be waking Venita every 2-3 hours for a snack. Venita really created a monster with this 24/7 free feeding wet food solution to his diabetes. Speaking of feline diabetes, the blood glucose level for Ennis, Max's littermate, continues to be in a nondiabetic range since his dental procedure.

V's PT

Monday also was a PT day, as was Thursday. Because of the increased wound fluids drained last week at the mast site, we've cut range of motion exercises back to fewer reps and for the weight training exercises, either cut back to 1 lb. weights, or cutting the exercise out altogether. Seems to be a correlation between the ramping up of the exercise level and the increased fluids. Thursday also was a "slow" PT day because of fatigue from Tuesday's chemo. (V went to Dick's Sporting Good's and got herself those multicolored foam-covered barbells in various needed weights.)

Chemo

Monday's final appointment was a pre-chemo chekup with Dr. Chemo's nurse practitioner, Betsy. A few tweaks on side-effect medications. The biggest side effect is bone pain, which results from V's Neulasta shot on Wednesday, which helps to raise her white blood cell count. Instead of waiting until the onset of the bone pain on Friday pm/Monday am, V starts 2 Ibuprofen every 3 hours on Wednesday, the day of the shot. Then 2 Dilaudid every 3 hours is layered on top on that starting Friday pm. Here it is Saturday am and no bone pain yet. Betsy also approved the use of ginger capsules (as suggested by Martha and Alley Cat) as a supplement to help with queasy stomache.

Chemo #3 was Tuesday. Venita drove herself and slept through most of the procedure. Came away with a couple large bruises. One is in her hand where the nurses were trying to find a new infusion spot but "blew past" the vein. Another bruise in the actual infusion spot, which worries V because one of these chemical can cause tissue necrosis if it is released outside the vein. Big immediate side effect this time with fatigue. V came home and napped another 4 hours, and then got 14 hours overnight.

Wednesday, V went to crash at the home of local friends Ellen and Dick. She just showed up unannounced about 3 pm looking for a sanctuary from things to do and things to plan, and looking for someone to take care of her. V said just to leave her sleep except to wake her in time for PT the next morning. Ellen left V sleeping in this huge Daddy-Bear sized chair in the living room until 5:20 (dinner soon). Dinner was fried white-fish (V doesn't eat fish, but it looked and smelled great), asparagus, and twice-baked potatoes. V filled way up on the vegies. Watched two hours of TV--one of CNN evening news commentary and one of Baltimore Orioles baseball. V then headed home. She had had enough sanctuary time to rejuvenate her, and there were cats to care for and meds to take.

Dr. Boob

Venita saw Dr. Boob for another drainage on Thursday. He agreed there was fluid in there, but he couldn't get it out and the needle poked something inside that hurt (the first time that's happened) so he gave up that effort. Dr Boob had spoken with a colleague about the continuing fluid in V's seroma and that colleague suggested that Dr. Boob begin filling the temporary/expander implant--that might "squeeze" the seroma and "encouage" V's tissue to absorb her own fluids. Sounds logical, and that's what took place. He put 60 ccs of saline into the expander. The saline in the implants makes it feel more comfortable. It reduces the "hot spots" in the expander that were being caused by it sharp, 90 degree corners. But that's this time. Seems to V (from other Personal experience she has read) each fillling might bright "relief" or "discomfort."

Capacity for the temporary expander imlant is 450 cc, which at a weekly fill rate of 60 ccs would mean between 6 and 7 more fill-up sessions. That would finalize the filling about the same time Dr. Cutter wants to start planning the left breast mastectomy. So perhaps the swap-out of the temporary implant for the permanent implant could take place in the same surgery. Time wise it will work, but we need to talk with Dr. Boob about whether he also sees that as a possibility. He might have some concerns about cross contamination between the two surgical sites, or maybe concerns that V would have overly diminished strength/capability because of a bilateral procedure.

Sick Bailey

V's cat Bailey continues to be sick. Continuing inappetance, minimal bowel movements, dehydration (he's on sub-Q fluids). This has been going on now about 10 days. New current symptom--that wet-sounding breathing that he has had his entire life, but which he has not exhibited since he had been losing weight with the switch to an all-wet diet.

Yesterday V put the vet together with a compounding pharmacist. The meds are now in a Fancy Feast Savory Salmon-based oral preparation that V syringes in and most of it stays in. V also made an appointent with another Vet; the earliest she can get in is Tuesday later morning. We hope he makes it that long (euthenasia looks like a strong possibilty here), and are prepared if we need to take him to the ER vet.

Some Thoughts From a Sucky Couple of Days

V saw Dr. Boob on an emergency basis yesterday. Pain and swelling in the wound. He drained 120cc, the buildup in just 3 days.

TV programs (talk shows, news) are focusing on breast cancer--a big tie-in with Mother's Day. Venita's head keep screaming "I have cancer!" She has been trying just to stay in the moment and avoid those thoughts.

Bailey the feral cat is very sick. He's been losing weight and has had a run-in with inappetance, constipation, and diarrhea the last couple of days. When first observed, he also had frothing at the mouth. Two vet visits, most blood values normal, vets are stumped but still charge outrageously for their "professional services," guest room converted to a cat hospital, SubQ fluids for dehydration, Cypro to build appetite. Frankly, he doesn't look like he's going to make it. But he's had a good, long life for a feral cat.

Chemo #3 coming up on Tuesday; 3 appointments on Monday.

Quote from a teleconference sponsored by Y-Me: We see ultrasound as a secondary screen for women with dense breast tissue. When we compare cancers that are not seen on the mammogram in women with dense breasts as opposed to women with fatty breast, the false negative rate of a mammogram may be as high as 30 percent... . . ...Yep, we know that mammo is a lousy diagnostic tool for certain breast types and certain cancers. But the ultrasound and the MRI didn't turn out to be all that hot either.

Pain Management and Other Matters

Neighbor nurse Mary has been working with Venita on a pain management schedule for the bone pain. There has been some tweaking; at present the schedule is (a) 2 Ibuprofen and 1 Dilaudid followed (b) 3 hours later by 2 Tylenol and 1 Dilaudid followed (c) 3 hours later by 2 Ibuprofen and 1 Dilaudid, and so forth. Venita ends up in bed alot on this schedule. She will keep this schedule up through tonight, except she will not take Dilaudid if she has to drive within 4 hours.

V has been in bed so much that she is now having trouble being there. The clock seems to take four hours to go from 12:21 am to 12:28 am, all the time V is dozing.

Christine, a professional hairdresser and daughter of a friend, buzzed V's head on Sunday morning. V says her head now always feels wet, like she just got out of the shower.

Venita skipped her physical therapy on Monday because of the pain and pain meds, but plans to go today. We are naming the therapist P. T. Bruiser! Thanks Charlie, V's former husband, for the name.

V got drained 50ccs on Monday (a week's accumulation) so Dr. Boob doesn't want to see her for 2 1/2 weeks (for check-up and maybe saline infusion) unless V experiences continued fluid buildup.

V did get a little gardening in yesterday--planted 2 flats of impatiens. One flat of everbearing strawberries and 2 periennials in this morning. Hopefully the rest of V's nursery buying spree--one flat of impatiens and a broom bush--will go in yet today.

2 months today--no cigarettes. V wants one to "celebrate."

V is delevoping lists of OTC supplies and of soft foods for chemo. The lists are here. She also added a link from the "permanent" list on the right side of the page.

Week's End Update

Ouch! Bone pain and throat swelling started Saturday. V had a good morning working in the gardens and doing range of motion exercises, but she couldn't move much in the afternoon. She took some Dilaudid for pain and went to bed about 9pm. Maxwell (the diabetic cat) kept waking her every 3 hours for feeding. V will likely end up back in bed soon.

V didn't see Dr. Boob for the 2nd draining this week because he had a hospital emergency. V didn't need it though; looks like the draining is really slowing. She will see Dr. Boob on Monday.

We both saw Dr. Cutter this week. DR was impressed by V's overall condition, although concerned that the mast scar continues not to completely heal. She gave V a scrip for a super-duper antibiotic cream. Next follow-up with Dr. Cutter will be between chemo treatments 6 and 7 to plan the surgery for the left breast mastectomy.

V saw her GYN for her every 4 month PAP this week. V has a low-grade dysplasia caused by the Human Papilloma Virus (HPV). The dysplasia could turn into cervical cancer or go away. This has been going on for about 2 years.

V discussed with her GYN her disappointment about how his PA dismissed V's right breast lump in December. He said he would look into it.

V's hair is not long for this world. Today, May 7, is deemed the official fallout day. Bill P, a local friend, is the winner. Now we have to determine the prize.

V thought Donna B. would do the hair buzzing, but that isn't working out. V is looking for a substitute, and Jim is not an option. V may not be particularly attached to her ears, but she would prefer to keep them!

Chemo 2

Chemo 2 was fine. Jim came along, but V drove back and forth to make sure she could do it.

Real panic before we left for chemo. V is to take an anti-nausea pre-treatment. She went to open the blister pack and the capsule spilt apart and sprayed all over the kicthen. Thank God the onc ward had samples.

The onc nurse infused the Cytoxen really slowly this time because of V's side-effect of facial pain. Nurse said that effect is common with Cytoxen and that slow infusion helps minimize it. Jom wasn't prepared for the extra hour of treatment; got antsy and asked the nurse--does V have to get the whole bag? V asked Jim to go take a walk.

Onc nurse also explained that the facial flushing comes from one of the nausea medicines, and was more than willing to answer questions about why does this happen, why does that happen? Nurse been in this ward for 13 years--vast experience.

V gets her Neulasta shot tonight when neighbor nurse Mary gets home from work. V is going to give herself the shot but she wants Mary to watch to make sure she does it right.

V had PT again today. Range of motion already is improving. Got more exercises to do and starting to use "equipment" like weights, pulley, and treadmill. Also getting some massage to drain the lymph nodes.

Three appointments tomorrow--Dr. Boob, regular GYN, and Dr. Cutter.

Physical Therapy and Other Info

Venita started PT yesterday. So now we have a new player, and we'll need a new name to ID her. All suggestions welcome.

The therapist is a soft spoken woman, but she has something of a "take no prisoners" attitude. She warned Venita that she's menopausal and can have "postal" days. Also warned Venita that Venita also is, with chemo, now menopausal and will do the same.

Walked Venita through 4 arm/underarm stretching exercises that she has to do 3x/day, 5 reps. Discussed how critical posture is to avoiding lyphedema. Demonstrated how Venita needs to start gentle massage on her left breast biopsy scar and on the healed portions of her right breast mast scar to avoid having the scars "adhere" to the underlying tissue. The therapist also wants to see Venita ASAP after Dr. Boob drains her right breast wound so the therapist can demonstrate how Venita can "massage" the area to lessen the amount of fluid that accumulates. (Later in the day Dr. Boob said this was all stuff and nonsense in V's case because the fluid is collecting in a cavity in the "capsule" that is forming around her implant.)

PT is 3x/week for 2 months. There are 5 basic objectives to the therapy:

1. Scar flexibility
2. Posture (the pain in the incision and nearby sites/fear of being "bumped"/and embarassment can cause women with mastectomies to develop round shoulders
3. Range of motion
4. Strength
5. Cardio-vascular improvement (bodies that are CV healthy heal better and tolerate chemo better)

The therapist is a gardener and sees yard work as a possibility to expand therapy activity. Therapist thought it was right wonderful that Venita mowed her front yard yesterday.

Yes, V did mow the yard thanks to John K, a local man who did the spring service on V's mower free of charge and showed her how she could vice-grip the blade cut-out lever in the on position so that the mower (which has a slightly bent crank shaft after a run in with a stump last spring) would start easier. Thank you John!!

Dr. Boob drained V later in the morning. Jim went along; the first time he had seen this process. V's drainage is slowing down. Only 100cc in the 4 days since the last drainage. Dr. Boob says maybe only two more drainings.

Chemo #2 this morning. V is fearful for some reason, so Jim is going along. V thinks the fear is of the upcoming side effects, not the infusion itself. The mouth lesions with Chemo 1 were pretty serious, and we sure don't want a repeat. V bought antibacterial gel and has a bottle in nearly every room of her house, one for the car, one for Jim's house, and one for the neighborhood bar we frequent. She may develop OCD over this.

This Week's News

The wound drainage is not slowing down. Dr. Boob continues to draw off about 70cc/day for each day since he last drained it. (Two syringe drainings this week, and every week going forward until it stops retaining fluid.)

Dr. Chemo's office called Wednesday and told Venita she had misunderstood the orders and that ahe only gets chemo every 3 weeks. Venita was, hummm, a little upset looking forward to 6 months of chemo instead of 4 months. Turns out there was a typo inputting some info into the computer. Venita is on a 2-week cycle and will get Chemo 2 on Tuesday May 2.

Venita had a face-to-face with Dr. Chemo today. He said her problem with swallowing is that she has cold sores/mouth ulcers in her throat. Dr. Chemo was pretty surprised by that serious a side effect this early in the game. He put her on an anti-viral medication. Dr. Chemo also wasn't surprised/concerned by Venita's two marble-sized axillary lymph nodes. They have been there since the surgical drain was pulled in mid-April and none of the DRs see anything wrong with that condition.

Venita gained 6 pounds since her last weigh-in on April 18. Not sure how that happened, unless it's the mid-night trips to the fridge for ice cream.

Venita got a new sleeping pill (Lunesta) that she hopes to try tonight. She didn't want to use sleep aids the last two nights because she was watching Ennis after his dental procedure on Wednesday (he had 6 teeth/roots extracted).

Need Rice Ideas

Read this morning that a "recommended" diet for chemo-induced diarrhea is BRAT--Bananas, Rice, Apples, and Toast.

Can handle the BAT, but Venita doesn't eat rice. She doesn't like brown rice (too dry), puffed rice, those cardboard rice cakes. Might be able to handle rice pudding if it's not too sweet.

Any ideas for making white rice palatable other than a base for stir-fried veggies?

Maybe other foods that would have the same "powers" in this situation as would rice?

Sadly, we think rice wine is out.

Draining

What's this draining Venita and Jim always are talking about?

Best we understand is that a part of healing a wound like V's mastectomy wound is the adhesion of the back side of the skin layer to the underlying tissue (given the mastectomy removed the intervening breast tissue). This wound is like a giant blister in that fluid builds up between the skin layer and the underlying tissue. As the wound heals, the volume of the fluid diminishes and the "seal" occurs.

During surgery, the surgeon inserts one or more drains to draw off the excess fluid and encourage the healing process. V had a drain in for four weeks; the volume of the fluid draw-off barely reduced during that month(~150 ccs--or 2/3 cups--a day). The theory was to pull the drain and "force" the tissue to start reabsorbing the fluid. That is working in part. Every Monday and Thursday V returns to Dr. Boob to have the excess fluid drained off.

How does this draining happen? Dr. Boob cuts a small hole in V's skin below the mast scar. He takes a blunt-ended needle (10 gauge or larger we would guess) and pushes it through the hole and some interior tissue until he gets to the fluid pocket. He then screws on a 60cc syringe and slowly draws up the fluid. Unscrew the syringe, dump the fluid, screw the syringe back on, and repeat until--like a straw in a juice box--all Dr. Boob does is draw air and the tissue pulls taut. Dr. Boob routinely gets 300 ccs--1 1/3 cups.

When might this end? Soon we hope. There's alot of pressure with the fluid build-up, and V doesn't like feeling like a juice box 2x/week.

Side Effects

Here come the side effects. Creeping in, slowing but seriously.

Last night the bone pain started. This is from the Neulasta shot, the $3400 shot to make the bone marrow produce white blood cells. Venita's shoulders, back, ribs, and hips are involved. It's just starting but promising over time to get fairly serious.

Troble swallowing. This is the worst right now. Difficult to eat or drink if things won't go down. Not inappetant; Venita is pretty hungry. Can you imagine not wanting a beer because it hurts too much to drink it? Even toast and ice cream are trouble. One thing that's still going down is the La Creme yogurt. Venita has to have a large glass of water with everything she eats to push it down.

The facial pain has dimished, but temperature swings (chills to hot flashes and back) persist, especially at night. But that might be normal life; it was before BC.

Loss of concentration/lack of energy associated with the various drugs, especially the antidepressants.

V is trying to avoid using the sleeping pills because they knock her out for about 12 hours. However, without them she only gets about 2 hours sleep at a time.

OK, enough whining for now. Welcome to the world of chemotherapy.

Fallout Lottery

Let's have a hair fallout lottery! We hear that most women lose their hair by a few days after the 2nd chemo treatment. V's second chemo is currently scheduled for May 2.

Of course, V plans to shave, but she may likely wait until the day the first "clump" comes out.

So post (or email) your guess for fallout day. We're sure a special treat will be in store for the winner!! First person on a particular day gets that day.

Lottery picks:
May 4--Sheree
May 5--Alice
May 6--Mary M
May 7--Bill P
May 8--Cheri
May 9--Julie
May 10--Heather P
May 11--Steve
May 16--Annie
May 18--Laura

Chemo, Jim's Recovery, and Today's Plans

Chemo

Venita had her first chemo on Tuesday morning, a mixture of Adriamycin and Cytoxan.

First a training session. Because of Jim's litttle spill the other day, Jean Ann, Jim's neighbor, drove V and sat with her through the training. Got info on what was going to happen and how to manage side effects.

V sat in a recliner in the chemo room. IV into the wrist area. (No porta cath, remember, because of V's big veins and Dr. Chemo likes to avoid their side effects.) First an anti-nausea pill and an infusion of an anti-nausea drip. Next a fluid drip and the syringing the red Adriamycin into a port on the IV line. Next the Cytoxan drip. (Venita only thinks this is right the right sequence because she slept through alot of this and Jean Ann, bless her heart, went to a book store and bought a knitting magazine and when she came back had an allergic reaction, she thinks, to the ink in the magazine.) Then a syringe of fluid to "clear" the chemo out of the IV line and vein. These particular chemo drugs can cause necrosis if spilled onto the skin or internal tissue, so the oncology team is very careful with them.

The side effects from the 1st chemo have been minimal. Acid stomach and loose stool, which can be handled with over the counter meds. According to Jim, a period of shaking during sleep and alot of coughing and phlegm during the first night. V got her Neulasta shot from nurse neighbor Mary last evening, which is the medicine to build up her white blood cell count. Not sure we mentioned this, but insurance paid $3,400 for EACH of these shots. Wow!! Neulasta has a potential side effect of bone pain. V did wake during the night in a bit of a sweat, but that could be the lymph node infection, the chemo, the Neulasta, plain old peri-menopause, or just a warm room.

V will have chemo again in two weeks, subject to "clearance" from Dr. Chemo.

Very good guidance from Robin about chemo on the FDMB here.

Jim's Recovery

Jim's doing better. He says he's 80%. But he does wear himself out when he tries to do too much, so he may be at V's house for maybe a week longer.

Today's Plans

V and neighbor Mary are planning to treat themselves to a pedicure this morning. V's never had one, but why not a treat? After that V sees Dr. Boob, and will have to have another draining of the mastectomy incision. There's likely another 300 ccs in there. Swollen again, but not as sore as before.