Foot Infection and a Cold

V&J got a much needed weekend away to their beloved Sea Ranch, but V returned home with a cold and some kind of infection in her foot. She made a trip to the emergency room where she was treated with IV antibiotics. She returned the next day for a second treatment. There were long waits both times so she's pretty tired out.

Miracles Happen

Hello out there in the blogosphere. I have not posted much lately, but that doesn't mean nothing is happening. Vicki's blood counts have been steadily going up, up, and up. Many of her numbers are getting into a normal range. As predicted, the platelet count is the last to reach normal, but it's been going up each week with no setbacks.

Over the weekend Vicki had her first outing for non-medical reasons since August. She's been taking walks and has been given the O.K. to go out for dinner with her out of town guests. It's pretty amazing if you consider the shape she was in just a few weeks ago.

I think they should have rehab programs for cancer patients the way they do for cardiac patients. She's going to need a lot of gentle exercise and good nutrition to rebuilt her muscle mass and strength. Fortunately all of Jack's cardiac rehab lessons came home so they're teaming up on the project.

Still no Transfusions

This week V. went to see her oncologist on this side of the bay instead of going all the way over to UCSF.

She was a little worried that they'd have trouble getting a blood sample. Her veins are pretty messed up from all the chemo and she's had some pretty bad experiences having blood drawn. At UCSF they have a special IV nurse for patients who have this difficulty. V. was relieved when they got her on the first stick at Dr. G's office.

Her numbers are still increasing, ever so slowly, but heading in the right direction all the same. She didn't have to get any transfusions again.

Being able to do all this locally is a great advantage too. It makes for a much, much shorter day which is less tiring which is bound to help with recovery.

No Transfusions Yesterday!!!

Posting an update from V.
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Went to UCSF today and I needed NO transfusions!!!!I got the go ahead to try going to DR Ganey's office once a week for a blood test. We are going to try it on Tuesday of next week. I am a little concerned whether they can get a vein on the first try. Also I am concerned about having to go to John Muir for blood. I am not sure how long it will take. But I am willing to give it a try and see if we can cut down the traveling to and from UCSF.

Posting the following update from Vicki:

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Went to UCSF yesterday and platelets were up again to 15! I did not have to get platelets , I htink this was the first time!But the NP felt my red blood count was too low so I had to go to the LSU (I actually go through admitting) and get 2 valentine's red blood.

The Numbers are Up (Not "Your Number is Up")

Vicki's red and white blood cells counts were much, much better today. They're starting to look almost normal. Her platelets are still very low, but they increased 50% over last week's number so they're heading in the right direction. The platelets are the last thing to come back so this was expected. They topped her off with a unit of platelets today, but she didn't need any other blood products.

Vicki had decided she wanted to get more input before taking the recommendation to receive additional stem cells. With these good numbers it looks like she won't need them and won't have to make that decision. This also means she'll get to save her leftover stem cells in case, God forbid, she needs them in the future.

Anybody out there giving blood? I cranked out a unit of O+ today, a mere drop in the bucket of what it's taken to keep our friend alive and well, but every little bit helps.

Progress Report

I watched the Super Bowl with the McF's on Sunday. Vicki was pretty tired, but we were all on our feet screaming at a late fourth quarter touchdown for those lovely red birds. With her low platelets she's bruising up which makes her sore. She also chills easily.

Monday she made one of her bi-weekly trips to the clinic to top off the fluids. She only needed platelets this time, no whole blood. This meant getting home much earlier and getting in an extra nap. Between worrying about what it might mean if she needs additional stem cells and feeling crummy she hasn't been sleeping well, but after the platelets and nap she says she's feeling a lot stronger.

She asked the nurse practitioner what probability she thinks there is of Vicki's platelets returning to normal without additional stem cells. The NP said 90% and that the additional stem cells would be more a quality of life issue. For now Vicki's thinking those are pretty good odds so it would be best to leave things alone and see how it goes, but she's going to talk to the doc and confirm.

More platelets

Received the following e-mail update from Vicki today:
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Had to get platlets again. That is twice this week. The NP wants to transplant more stem cells. She doesn't think my platlets are coming back fast enough. If they do it I wouldn't have to stay in the hospital and it wouldn't involve anymore chemo. She says Dr Damon is thinking it is too soon to do another transplant. He wants to give me more time for my body to develop more platlets.

I am pretty discouraged and scared. Please pray or send good thoughts my way!

More Transfusions

Vicki went for one of her bi-weekly visits to the clinic today. She needed two units of whole blood and another unit of platelets, but is otherwise doing well, slowly recovering. This weekend she felt well enough to make an outing to the dog park with Jack and the boys.

She's back online doing e-mail, a sure sign she's feeling a bit stronger.

All is Well

I just heard from Jack and all is well. The doctor said that he is not at all concerned about Vicki's blood counts and that a drop is not unusual. He also looked at her blood microscopically and saw no signs of leukemia. He says it'll take at least 60 days from the transplant before her blood counts are anywhere near normal and today is approximately day 30. I have read online that it can be 100 days to as long as a year before they are completely normal.

Today her white cells and platelets were looking pretty good, still up from the last set of transfusions, so she's just getting a unit of platelets this afternoon then coming back home.

Jack sounded much better, very relieved and happy. He said he regretted raising the alarm unnecessarily, but I assured him that we're just happy to have good news.

No News Yet

I talked to Vicki on the phone this morning. She and Jack were on their way to the hospital for their appointment with the transplant doctor. She slept all day yesterday then took a sleeping pill so she could sleep last night. Between all that sleep and Tuesday's transfusions and electrolytes she said she was feeling a lot better.

I have been extremely worried since yesterday's news and I'm sure I'm not alone. Talking to her and hearing her sound so good made me feel a lot better so I wanted to share that with you.

I will post again as soon as I have any news.

A Message from Jack

All - received the following from Jack:

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We left home yesterday for our appointment at UCSF at 10:30 am, and got home this morning at 1:15 am. It was a very trying day, and we are not sure what is in store now. Vic ate a little breakfast (grits and scrambled eggs) this morning and headed back to bed. The dogs pretty much sleep on top of her right now, they try to get so close.... We are very grateful for all of the support we receive from friends and relatives. Please continue to lift Vicki up in your thoughts and prayers.

A Downturn

The McF's went to UCSF for Tuesday platelets. V.'s blood counts were not good. They have dropped below what they were when she left the hospital. This is a very concerning development. She had to receive two units of whole blood, a unit of platelets, and a Neupogen shot to stimulate her bone marrow. This made for a long day and they did not get home until 1 AM.

These appointments for platelet transfusions have been with a nurse practitioner. They already had an appointment to go back on Friday, but the NP has scheduled them to go back on Thursday when the doctor will be there. They will need to discuss these latest results and decide what to do.

Vicki also told me that the veins in her arm are in very bad shape. They can't use her right arm due to her previous breast cancer surgery; removal of lymph nodes compromises her circulation on that side. Her left arm has been used so much that the veins are pretty much shot. When she goes in for blood tests and for transfusions they have to get a special IV nurse to be able to hit a good vein without a whole lot of unnecessary poking.

More of the same

Not much to report, just more slow recovery. V. made a trip to UCSF this week and received a unit of platelets. She will do this twice a week until her counts rise to an adequate level. Between the trip to the city over the Bay Bridge, waiting at the clinic, and getting any treatments it's an all day affair which is very tiring, but it's still better than hospitalization.

I think the thing V. needs from us most right now is continued support in taking it slowly and accepting that her recovery will take a long time. She is very, very fatigued (still not feeling up to doing much e-mail) and disappointed that she's not perking up faster.

Continuing Recovery

Not much to report. Vicki remains at home. Her white blood cell counts have risen to a high enough level that she did not need a Neupogen injection at her doctor's appointment on Friday. (You may remember from previous posts that this is the medication which stimulates the production of white cells.) Her platelets are low, but this will continue to improve over time. She's also made progress on her mouth and throat sores, happy to be able to eat a whole banana this weekend. She's had no signs of infection which is the biggest danger to her continued recovery at this time.

Mentally she's a little down, disappointed that she is not recovering as quickly as she'd like. She had based her expectations on her experience after her previous hospitalization, but has come to understand that this last treatment took a great deal more out of her body, which was already weakened. It will take many months for her to fully recover her energy and stamina, but she realizes that she's heading in the right direction.

Dorothy says, "There's no place like home."

Vicki is home! She called me early this evening from her own little bed with her fur baby by her side. Very relieved. Very happy.

She'll probably sleep the better part of the next few days because it's so hard to rest well in the hospital, but she hopes to start reading e-mail and checking the blog very soon.

Flying the Coop

Wednesday 1PM Pacific - just talked to V. briefly on the phone and she is going to be discharged today. When I talked to her she was waiting for somebody to come in and pull the line from her neck port thingie (I believe "thingie" is the technical term) and then she gets to go home.

Homecoming - Scheduled for Wednesday

This morning Vicki's ANC is up to 1.07 and she has successfully switched from IV to oral pain meds. Her nurse practitioner and the nursing coordinator have agreed that she'll be ready to go home Wednesday if she continues doing well.

The doctor hasn't been in for rounds today so Vicki is loading up the cannons for the full I-wanna-go-home offensive. God help him if he doesn't surrender easily.

She still feels plenty sick, but her nurse yesterday said that once the blood counts start to rise, the turnaround is pretty dramatic. It's clear that V's spunky index is on the rise so her physical recovery cannot be far behind.

Feeling a Little Better, the Reprise

Our friend is starting to get the tiniest bit cranky pants about wanting to go home. She still has a little way to go, but might be able to go home this week, maybe even the early part of the week.

The doc needs four things before they turn her loose:

1) Pooping - no problem there, quite the opposite.

2) Ambulatory - needs a little work here, Jack is taking her out for a forced march today.

3) Pain Control - need to be able to control her pain with oral medication she can take at home. Her throat is still pretty painful, but the mouth sores which appeared first are starting to heal. She's been able to drink liquids and keep them down and is taking some medication orally so tomorrow they'll start transitioning to oral pain relief and see how it goes.

4) ANC of 1000 (1.0) - Today she was 810 (0.81) and that's a big increase over yesterday so she might have this one licked in another day or two.

I hope this all goes according to schedule because Vicki is about ready to bust out of that joint. We may have to borrow one of the armed guards from the prisoner's room down the hall to keep her from calling a cab and sneaking out during the night shift.

Feeling a Little Better

I spoke to Jack briefly this evening and he said Vicki was feeling a little bit better today. She managed to get down and keep down a Carnation instant breakfast type shake, first food in a couple of days. I'm going to go for a visit on Sunday, will post again Sunday evening.

I passed on your greetings from comments and messages sent to my personal e-mail via a voicemail message to Vicki, but will repeat them tomorrow.

Comments?

Vicki isn't feeling well enough to read e-mail or the blog, but she really appreciates your messages of support. I usually manage to speak to her or Jack by phone every day or two so if you post anything here on the blog I'll make sure they get the message.

Fear

Received an update from Jack this afternoon. He says Vic is even sicker today than yesterday. She cannot hold down even water today, so they are giving her all medications intravenously. She still has a slight fever, so now they are talking about doing a CAT scan. She also still has severe diarrhea, has not yet gotten results from yesterday's blood culture or x-rays. The mouth sores are increasing, going down her throat now and covering one side of her tongue. These are causing most of her pain, aside from the diarrhea.

One part of the treatment plan indicated that at this stage they might not be able to make her entirely comfortable. I wasn't able to speak to her, but Vicki left me a voicemail message and she said she's starting to feel afraid.

Day +10: Happy New Year

I had a brief phone conversation with Jack today. Vicki is feeling pretty poorly. Her blood counts are all pretty much zero so she's exhausted. She's getting lots of transfusions, both platelets and whole blood, to help her body function until it can start to produce blood cells on its own.

The pain from her mouth sores is bad so they've put her on a pain killer pump system; she can just push the button when she needs more relief and doesn't have to try to get down a pill. She had a fever of 101.5 so they've taken some blood for cultures, did some x-rays, and put her on additional antibiotics. Her blood pressure is also quite low so they're giving her medications and electrolytes to help with this.

Of course this is all potentially quite serious, but the doctors say it is not alarming. At this point their main job is to provide nutrition and support to keep her stable and to minimize infections until her body can start to produce blood on its own. They say that her blood counts should start to rise in the next 3-4 days and that she could be home in as little as a week, although in my humble opinion, that seems rather optimistic.