Friday, December 1, 2017

Homeward Bound

Kay has been in the hospital at Good Sam in Puyallup since Tuesday for fluid and nutritional support while we have waited for her bowel to begin to function again.  The initial CT scan was felt to show a bowel blockage, but when a tube was placed through her nose to drain her stomach very little drainage happened.  This led to reevaluating whether there is a mechanical blockage, or maybe just a dysfunction of the small bowel related to medications including chemotherapy and the cancer in the abdominal cavity.  For the last 24 hours Kay has been able to drink clear fluids without much trouble, and today especially has been drinking well.  For lunch she had her diet advanced to “full liquids” (who would think of mashed potato and gravy as a liquid) and she is enjoying eating again.  No pain or problems so far, and the hope is that if she does well this afternoon we might go home tonight or maybe in the morning.

The future from there is less clear, but the first step is to go home and tolerate eating, regain some strength, and then figure out what to do from there. Thanks to everyone for your prayers and help.  Now to get in the Christmas spirit.

Tuesday, November 28, 2017

Update on Kay's Situation

Thanksgiving 2017 will be one to remember, or maybe better to forget if we can. Our place is in major renovation mode, and we were blessed to stay at the Asplund’s home while they visited family in Portland.  On the day before Thanksgiving, after a really enjoyable day visiting with Stephanie Allgood and doing art projects, on getting home Kay started to feel really poorly.  By early Thursday morning she started with diarrhea and then a strange vomiting without nausea.   This was severe enough that our move to the Asplund’s was put off until early afternoon.  Her gastrointestinal troubles continued all day, and Brett and I had a very quiet Thanksgiving meal while Kay struggled on the couch. 
By mid-evening Kay was getting very weak, and we went to the ER for IV hydration and evaluation. Her labs looked OK, she managed not to vomit there, and we got home by about 1 AM.  We slept in Friday, but all weekend Kay couldn’t eat anything without severe pain, and by Monday morning we contacted Dr. McCroskey and he saw Kay yesterday.  He ordered an abdominal CT scan that explained the problem, showing a distal partial small bowel obstruction.  (near the end of the small bowel before it dumps into the large bowel was a place where the bowel narrows considerably causing the bowel above there to dilate and fill up with air and fluid.)  This explains the pain with eating, the vomiting, and the severe bloating Kay has.  It is not clear what is causing the partial obstruction, but it is a fairly common problem in people who have had abdominal surgeries.  It may be related to adhesions, or possibly kinking where cancer causes a loop of bowel to bend too sharply.  It is not considered a surgical emergency at this time.  The plan is for Kay rest in the hospital, not eat or drink, get IV hydration and use a naso-gastric tube to drain her stomach and decompress the small bowel above the point of obstruction.   This may or may not work, but often it does once the proximal swelling of the bowel loops goes down.
This is likely to take a few days though and though we have been trying to find reasons to get out of the condo-under-construction, this was not high on our list of ways to get away.
The other not-good issue found on the CT scan is that the fairly small metastasis of the cancer to Kay’s liver and the area behind her peritoneal cavity have grown quite a bit in the last 2 months, despite being on the weekly Taxol chemotherapy.  This is an issue we will need to address after the bowel obstruction resolves and Kay is well enough to resume her chemotherapy.

Kay is at Good Samaritan Hospital in Puyallup, and maybe in a day or so a brief visit once or twice a day will be nice, but at least today we need to just get settled in and appreciate everyone’s prayers and best wishes.

Tuesday, October 31, 2017

Initial Good Response to Taxol

It's been a while, so as I wait at the Subaru dealer for my service to be done, and Kay is at Rainier Oncology getting the second infusion of her second 4-week cycle of Taxol for her ovarian cancer I am taking time to report on her status so far.
As previously reported Kay got a nice response to the combination of Taxol plus Avastin, but developed a tiny bowel perforation likely from the Avastin so she had to stop that drug.  After a break from treatment to allow the infection to resolve Kay has restarted treatment on weekly Taxol infusions a a single agent.  She gets 3 weeks of Taxol infusions the a one week break to recover, which constitutes a 4-week cycle.
Today she is on week two of cycle 2 of the weekly Taxol infusions. She has been tolerating the Taxol quite well, each week having some fatigue and malaise on the Thursday - Saturday after the Tuesday infusion, but this is only moderate, and she is overall doing better. 
She lost a lot of weight when sick with the bowel perforation, but has started to gain some weight back, and is enjoying eating high calorie foods to accomplish the weight gain.
Initial indicators are that the Taxol is helping.  Her ascites (intra-peritoneal fluid accumulation) seems to have resolved and her CA-125 which had gone up a little when she was off treatment to treat the infection, has gone down by >50% after the first cycle of Taxol.
Pray for continued benefit from the Taxol, minimal side effects, weight gain (for Kay not me ;.) and patience, endurance and tolerance for all involved. 


Wednesday, September 13, 2017

Update: Infection Seems to be Clearing

After a 6 day stay at Good Sam to have a drainage tube placed in her intra-abdominal abscess and to get IV antibiotics and total parenteral nutrition (IV nutritional support) Kay came home Monday.  She continues to seem like she is getting a little better each day, and today actually felt fairly comfortable.  She is still getting daily IV antibiotics, and the drainage tube in uncomfortable and annoying, but her fever is gone, her abdominal pain much less, and her energy a slight bit better.
We are hopeful that the drainage tube will come out after we meet with her oncologist Friday, and maybe then or shortly after she can switch to oral antibiotics.  I'm sure she is looking forward to a good shower unencumbered by areas she needs to keep dry, and to getting the somewhat painful drainage tube removed.  
We are settling into our new place in Old Town, Tacoma and looking forward to being able to enjoy the walkability of the neighborhood, meet the local shop owners, explore the waterfront park, and generally become more active. 
Kay also continues to look forward to our Art Beats Cancer event at the Bird Cage in Kirkland from 1-4 PM on Sunday, Sept 24th.  Hope to see some of you there.

Keep up the prayers for continued healing from the infection, and especially for the chemotherapy she will need to restart soon to be effective.
Thanks for all of your support and prayers.

Ed & Kay

Thursday, September 7, 2017

Update on a Tough Week or Two

Finally tonight I feel like I have enough time and energy to post an update on Kay's situation. She started her second cycle of chemotherapy with Avastin and Taxol about 16 days ago, after doing pretty well with the first cycle, and actually having a really good last 10 days of that cycle.  On the third day after the first infusion of cycle 2 Kay started to have worsening abdominal pain which progressed daily until a on day 5, a week ago Sunday night, she developed fever, her chills worsened and her abdominal pain became so severe we went to the ER.
She was admitted for IV antibiotics for presumed peritonitis, though the cause was uncertain. We suspected a small perforation of her bowel which is a know possible complication of the Avastin therapy. Kay responded very well to the IV antibiotic, and within hours felt a bit better, and within 2 days was dramatically improved.  Her physicians, including the one she is married to, all felt good about her going home on oral antibiotics,  but within a day she began to feel worse, with chills, worsening pain, and after just 3 days she was put back on an IV once daily antibiotic as an outpatient. Beginning the Friday of Labor Day weekend, and each day through Monday, she got the IV antibiotic, but really did not improve, and Tuesday her oncologist readmitted her to Good Sam.  She had a repeat CT scan which this time showed free air outside her bowel, and and what looked like an abscess in her left lower abdomen where her pain has been the worst all along.  Last night Dr. Frood, an interventional radiologist we know from when he put a biliary stent in for Kay 8 years ago, again performed a successful percutaneous drainage procedure with CT guidance to place a drain into the abscess.  About 60 ml of pus was removed, and the drain has worked well since.
Today Kay has had a day the is better in some ways, namely no fever, no chills, and to me she looks better, but worse in that the pain from the drainage procedure has been pretty bad.   Kay hates opioids, but today they have been necessary.
On another note today Cheryl and Patty, two of Kay's great friends, worked in our new condo to unpack, organize, and generally make the place fit for Kay to return to after she leaves the hospital. We are both very grateful for their help, all the support, love and prayers of innumerable friends. Brett and Jean have helped spell me at the hospital, and tonight I felt comfortable enough to head home before dark and relax for a bit before bed.
Pray that this drainage procedure allows her infection to fully heal, that her bowel seals over and no further leakage and infection occur, and that she can resume chemo soon with good suppression of her cancer.

Monday, August 28, 2017

One Step Ahead, Hopefully Just One Step Back.

Kay started her second cycle of the Taxol/Avastin chemotherapy regimen last Tuesday, and it started much like first cycle.  Kay felt really good, we suspect from the Decadron high, for about 2 days. Unfortunately from there it has been tougher.   She started to have abdominal pain on the third day, much like with the first cycle, and to hurt all over.  This time though the pain just kept getting worse for the next 3 days, until Saturday it was really hard for Kay to get out of bed. By Sunday it became even worse, and the chills she had been having for the past 2-3 days became worse also. By evening she had a 101.7 fever.  This was enough to prompt an ER visit.
As ER visits go this was accomplished in a timely fashion, we got there about 8:30 PM and by 10:30 PM she had blood test and abdominal CT scan results that did not show any life threatening abdominal catastrophe, but she was admitted to Good Samaritan Hospital oncology unit for monitoring and IV fluids.
This morning she had two doppler ultrasound tests, one for arterial supply evaluation to her bowel, which looked OK, and then another for veinous flow evaluation looking for a blood clot or thrombosis that could block the drainage of the bowel.  These were basically not conclusive and Dr. Aversa our family doctor, and Dr. McCrosky Kay's local oncologist, were concerned about an infection in Kay's abdominal cavity, possibly from a micro-perforation of her bowel that could be a complication of the Avastin.  This led them to put her on IV antibiotics this morning, and so far, just a half day into the treatment Kay is not worse, maybe slightly better.
Pain and sleep deprivation have Kay in a discouraged state, but the family has been able to sit with her today and we are working to keep her and our spirits up.  I am forging ahead with our move to our new condo in the  Old Town district of Tacoma and that should be accomplished by Thursday.
We remain hopeful that this setback will pass and that better days are in Kay's immediate future.
Keep us in your prayers and they will join with ours.

Friday, August 4, 2017

Looking Up We Think

This week Kay had her second weekly infusion of Taxol, after getting the Taxol plus Avastin last week. Each 4 week cycle consists of Taxol + Avastin week 1. Taxol alone week 2, Taxol + Avastin week 3, then a week off to recover.  Our hope is that the Avastin will allow the Taxol to work well enough to cause regression of Kay's cancer and relief of her discomfort and other cancer-related symptoms.
Almost immediately after the first infusion Kay seemed like she could feel things getting marginally better.  Now, only 9 days into therapy she is pretty sure she is a little bit improved.  Her energy is noticeably better, her belly swelling (ascites) is slightly less, and overall she just is in  less pain.  These are subjective markers of improvement, but really the purpose of this treatment at this point is to feel better, improve day-to-day function, and have less pain, so we are pretty happy about her response so far.
On the non-cancer front we have sold our house in Puyallup and are hoping to move to Tacoma by the end of August.  We had tried to purchase a new construction home in Old Town but the legal issues over wetland permitting and mitigation simply made this untenable, and so we dropped that attempt and feel like God was smiling on us.  Literally 30 minutes after deciding no longer to try to buy that house we looked at a condo a few blocks away.  
Both of us really like the place, the location, the floor plan and the view, and we have had an offer n that place accepted and pending our inspection plan to close on the sale before we have to leave our Puyallup home August 28th.
Thanks for all the support, prayers and thoughts of all of our friends and family.  Fay, Kay's Mom has sent daily cards with ideas for hats and scarves for Kay after she loses her hair.  They have been a daily cause to smile and be grateful for Kay's whole family.  Kay's Puyallup friends have been visiting regularly, bringing flowers, goodies, and love when Kay has really needed it.  Pastor Paul has been helpful for all of us, and many other friends and relatives have reached out with help and support.  I talk to my brother Bill regularly and it's nice to have his ear and virtual shoulder.
Jean is home and her partner Alan is visiting from Mexico.  He is a really nice fellow, and we are enjoying his company.  Brett and Taylor have been a constant support and we are grateful for both of our children.
Keep up the prayers, especially for confirmation that the chemo is helping fight the cancer and that Kay keeps on feeling better.  Although she is feeling a little better, we are hoping for "more better" than it is now.

With all our love,

Ed & Kay

Wednesday, July 12, 2017

Latest on Kay

I'm back to posting on this family blog because once again we have news that we want to get out to friends about Kay's cancer that she and I just don't have the energy to pass on personally to all of our supporters, friends, and loved ones.  You are all in our thoughts and prayers, and we very much need and want your continued prayers for comfort, peace and good response to therapy.
After 8 years and 2+ months of fighting ovarian cancer, incredibly successfully much of the time, the cancer has seemed to enter an accelerated phase where after a 4 1/2 year remission at least 4 different treatment attempts have failed to stop its progression more than transiently.
Kay, Jean and I met with Dr. Elizabeth Swisher today at U. W. and it was not difficult to read her emotions on her face.  Dr. Swisher is usually a bundle of positive energy.  Kay once asked Dr. Swisher if she was her favorite guinea pig, having responded to her expert treatment so successfully. Dr. Swisher responded from her heart, telling Kay that she was one of her favorite people.  Today we could see a hint of sadness, of lack of good news to share, in her face and demeanor.
We have known since the first recurrence of Kay's ovarian cancer that further treatments had the expectation of knocking the cancer back, keeping it from progressing, and buying time hoping for a big breakthrough.  Even during her 4+ year remission following her third round of aggressive chemotherapy no one was bold enough to use the "cure" word. The bad news is that Kay's cancer growth has morphed into a phase where it seems to be relentlessly growing quickly. Kay is feeling more and more symptoms from the cancer, but overall most days remain good enough that she chooses to to accept further anticancer treatment.  That said, realistically we are starting to accept that treatment needs to be focused on reducing her symptoms and giving her as many days as possible where her pain, fatigue and other suffering do not outweigh the joys and happiness of life. Her physicians don't have treatment options with a very high likelihood of shrinking or even halting its growth.
That said Dr. Swisher had good suggestions.  Kay is going to try another course of chemotherapy, using a lower dose of Taxol weekly, rather than a higher dose every 3 weeks.  This may slow the growth of her tumor, or get it to regress for a while. with less side effects than a higher less frequent dosing regimen.  In addition we are hopeful that it will get rid of the ascites (peritoneal fluid in her abdomen) and pleural effusion (fluid around her lungs) that is causing bloating, abdominal pain, and shortness of breath.  We also have ideas on how to help with her nausea and fatigue, as well as her gastrointestinal difficulties under better control.
What we ask most of all of you is your continued prayers, that you try to be supportive of each other when possible and that you remember that Kay is the same Kay as always, she just has this relentless disease that makes her sick.  She will love phone calls, company and a good laugh, and maybe a good cry occasionally, but just cannot cry with each of you individually.  Kay told me that "our bucket of tears keeps running dry," and it just takes too much energy to be sad with everyone she loves.  Please prayerfully find a  way to treat Kay normally while acknowledging that it is a hard time and that she is not well.
Our love to all of you.

Kay & Ed