Emotions run strong today

Today was a day where it became certain that Kay is not going to be able to go to Portland for Jean's graduation party and ceremony. After seeing seven different physicians today, and lots of consultation the consensus is that in order for her to have adequate bile drainage, and to have her best chance to clear up this biliary infection (cholangitis) she needs not just several days of IV antibiotics, but a larger stent in the common bile duct. To do this the interventional radiologist and the gastroenterologist are going to work together tomorrow using the existing small stent to place a larger stent to adequately drain the bile, and allow the infection to clear and stay clear.

This will be done late tomorrow afternoon. Kay is disappointed, as we all are that she is going otot miss the graduation events, but we are going to do it virtually. I have some arrangments to make but the plan is that I'll stick in Puyallup tomorrow to keep Kay company and be here when they place this stent. It is really comforting for her to have me around for things like that. Brett and I will head for Portland after she is done with that, and get in later tomorrow evening. Jean is going to meet Bill and Horace Pullen at the airport and hang with them tomorrow. Fay and Keith Colmar are already in Portland, and had some fun with Jean today.

Saturday I intend to have local friends spend much of the day with Kay, and we plan to use Kay's Macbook and Jean's Macbook to video conference during her party, so everyone will get a chance to have some face-to-virtual-face time with Kay.

Kay may be able to come home Sunday, and if so I'll drive home Sunday evening about the time Horace (Dad) and Bill (brother) fly back to ME.

This is a lot to digest for all of us in one day. We had really hoped Kay could at least come to Jean's party Saturday, and that she would not need another biliary procedure. She is pretty discouraged tonight, but I know she and we will buck up and do what it takes for her to get well.

Your prayers are appreciated, and we feel the love. Pray for a successful stent, for joy and fun at Jean's graduation events, and for Kay to have endurance and strength through all these physical and emotional twists and turns.

Goodnight.

Ed

Sepsis

The latest setback is that both of Kay's blood cultures from yesterday morning show that she has a bloodborne infection with a potentially serious gram negative rod shaped bacteria, with the usual "final ID and sensitivity" to follow. This means Kay will need several days of IV treatment. She is also going to get a blood transfusion today. Lots of specialists to see her. A more complete message to follow at bedtime tonight. I am racing to the office.

Ed

Positive spirits reign

By the time I went in to visit Kay about 5 PM, I was not in my best spirits. Up early, Kay in misery, the ER visit, lots of tests, hospitalization, missed the morning clinic, interviews and meetings all afternoon, a quick dinner, then in to visit.

I got to Good Sam and Kay's smile lit up the room. She is elated that she has an appetite today. She refuses to be down, and just remains totally positive. She says her survival depends on remaining positive, and she is 100% certain she is going to beat this "thing."

How can I not smile back and just hug her. Well it is tough to hug much, the port infusing, and the bile drainage tube a bit tender still, but a gentle hug worked. We had a really nice visit. Her walking the halls now is almost a "airborne shuffle" pace. She ate three full meals between noon and 7 PM. She told me about them in detail, an egg salad sandwich (both halves) for "lunch" then a grilled cheese sandwich, again "both halves" as a snack, and then an open faced turkey sandwich, mashed potatoes with gravy and string beans for dinner. These are really the first full meals she has eaten since her diagnosis. She says she ate so much she "stopped counting the calories."

We can all sleep well tonight knowing Kay is eating. Now to figure out how to get rid of whatever is causing her to be sick. We suspect an infection of the biliary tract, she is on IV antibiotics, and may need to take these for a while. I may be able to take her to Portland this weekend, and just give her the IV meds in the hotel room. All TBD.

Sleep tight.

Ed

Another eventful day

We had hoped for a quiet and relaxing day today. It was not to be. At 5 AM Kay started to have pain in the left lower anterior chest, worse with breathing. By 6 AM she was short of breath and had severe pain with deep breaths. It got so bad we called Dr. McCroskey who recommended she go to the ER to assure she did not have a pulmonary embolus, a blood clot to the lungs more common in certain cancer patients, ovarian cancer especially.

The good news is that all the tests at the ER were negative for a pulmonary embolus. Last night we had clamped off the external bile drainage tube, and it is possible that Kay developed an infection in the biliary tract. Tests today did show that her internal bile stent is draining perfectly, and that her bile ducts are decompressed just fine.

Kay is staying in the hospital at Good Samaritan at least tonight, to be on antibiotics while blood culture tests are done to see if she has serious infection. Our hope is that these tests all come back negative, she goes home tomorrow, and this was all much-to-do about little. Anyway, I just got off the phone and Kay is ecstatic, she just finished a whole sandwich and fixings, her first complete meal in recent memory, and she feels good.

My poor patients again today had to be rescheduled on short notice, but everyone at the office has been extremely supportive, and I suspect I'll have some patients left when I become more dependable. Anyway, I feel blessed that I could be with Kay this morning to help with decision making and for love and support.

Tomorrow evening I help Brett move home from Seattle. He is going to live at home for the rest of his quarter at school, and commute to classes, either by rail, or by car. Then Friday, all-goes-well we are off to Portland for Jean's graduation party Saturday and graduation Sunday.

So far really no problems we can directly relate to the chemotherapy. Maybe this pain was somehow related, but we just do not know what caused that with any degree of certainty.

I'll post again after I see Kay this evening. I had a series of meetings at the office this afternoon, and Kay is much more confident and comfortable in hospitals now, not necessarily a life-skill we all want to develop, but a good one for Kay to be accruing now. She is as always, a quick study.

Until later.

Ed

Day is done.

Wow, does our yard look great. When we got home from the Cancer Center today after Kay's first chemotherapy session, to find Terry Asplund on her knees weeding the flower bed in the front yard. She was followed by her husband Dave and Barb Aune. Before they left, Paul Freese brought a fabulous dinner. Wow, wow, wow. We are feeling far too blessed by all this pampering. I have to say it is incredibly nice and helpful though.

Kay has jut cruised so far. Not even a hint of nausea, no allergic reactions at all during the infusion, and no problems with the external bile drainage tube clamped off for 3 hours now. It is about 8 PM now, we are winding down for an early to bed night.

Tomorrow if all goes smoothly, Kay will get the external bile drainage tube removed, and will basically rest up.

Sleep tight.

Ed

Chemo session #1 almost done

Today we move on. After waiting several days for Kay's liver enzymes to come down to a level where she could qualify to participate in a clinical trial, we decided we just had to get on with treatment. This is the first time I have really seen the chemotherapy process first hand, and they are smooth. Having a modern and beautiful cancer center here in Puyallup is really sweet.

We got her at 11 AM, and Kay was quickly brought to the infusion center, where they have Lazy-boy type recliners for the patients. "Chairs" as they call them. They put an infusion needle into the port-a-cath Kay had placed earlier, not a painful thing at all, and then give her lots of drugs. IV decadron (a corticosteroid) and IV benadryl to prevent allergic reactions, a long lasting IV antiemetic, and IV ativan (for nausea but also makes her very drowsy. She then essentially slept through 4 hours of IV infusions, no side effects at all except the drowsiness.

Now we go home. The big thing tonight is we clamp the external bile drainage and see if Kay tolerates that. If so she may be able to get the external drain removed tomorrow. That would make her unattached for the first time in a while, and able to shower. I plan to get mine first before she uses all the hot water.

I'll make this quick. We are going home.

Ed

Waiting

Good news today is that Kay's alk phosphatase was down to 350. Bad news is that Kay's alk phosphatase was down to 350. It needs to be at 300 to qualify for the clinical trial she hopes to participate in, and although she is closer, still does not qualify. After Kay spoke with Dr. McCroskey it sounds like the plan is to draw this again early tomorrow AM, and start chemo tomorrow, or possibly Wed. If low enough on trial, if not to start with the best chemotherapy regimen and consider adding the Avastin off-label (non- FDA approved, not in a clinical trial) if we and Dr. McCroskey agree it is appropriate.

Anyway, Jean is home, I am about to leave work, and we had another session of hypnosis this AM. Kay is getting very good at induction, and I think this is going to help a lot.

Yesterday I planted all of the "shoe flowers" in pots on the back deck. I told Kay I gave it the "old 3rd grade try", with my gardening skills definitely not the "old college try. "

More as I know more.

Ed