Sunday, January 20, 2013

1/20/13 Post-Surgery Thoughts


Steve


It is Sunday morning and the house is quiet.  I like that.  It means that Gabrielle is still asleep, giving her body a break from the pain and allowing her to regain her strength.  As for Gabrielle updates, that's it since the last note.  You can stop reading right here and we'll fill you in later when there is more to report than the sound of sawing logs (figure of speech..she would never do that!).


It has been a little over a week since Gabrielle's surgery.  In thinking about the procedure that Gabrielle had, I was reminded of the fact that it was very similar to the type of operation I used to perform in a different life as a veterinarian up in Lynden.  As I recall, Tuesdays and Thursdays were surgery days where my newly minted surgical skills were let loose in the operating room, often to perform a spay or a neuter.  Dee, my assistant, would help me anesthetize the animal and hook it up to the gas anesthesia machine, and then go off to clean teeth or pick out a bunch of ticks for a while (from an animal, not herself) and leave me alone to work my magic as anesthesiologist, surgeon, scrub nurse and surgical assistant all rolled in to one.  Every thiry minutes or so, she would pop her head in to see how I was doing (along with giving me an update on how many ticks she had removed).  Admittedly, being new, I was a little slow, so she would often make some snide comment about how Dr. Erickson was so much faster than me, as if speed is what you are after in a complex abdominal surgery. 


In veterinary circles, we casually threw terms around like spay or fix to apply to this sort of surgical procedure.  And I am not for one minute suggesting that Gabrielle got spayed or fixed, so don't go telling her I said that.  I am just saying there are similarities, that's all.  During a "spay", I took out the uterus, ovaries and fallopian tubes.  That's what Gabrielle had removed, plus a little extra on account of that pesky cancer.


One of the vets I worked with told me that we should stop using the term "spay" and start using a longer, more medically descriptive (and confusing) word so people understood the complexity of the operation.  He said that if we kept using "spay" and "fix", it sounded so simple that people would balk at paying more for it, if we wanted to raise our rates.  He proposed something like "total open hystero-salpingo-oopherectomy with general anesthesia", so we could get as much street cred as "the real docs".  For me, I preferred the term "spay"...but only as it applied to non humans, not my wife.


In trying to budget for Gabrielle's surgery out of my next paycheck, I did a little quick ciphering.  I seem to recall that we charged $75 for a spay.  I told my buddy from vet school, Dr. Sam (ace Yakima vet), that I was trying to remember what a spay went for and he said that I needed to account for inflation and that in Yakima, they are now around $175 and over here "on the coast" as the people in Eastern Washington call anything west of Snoqualmie Pass, a spay could easily run $250.  Wow!  And to think I was only getting $75!


So, at least I've got a ballpark figure.  I also know that Dr. M. did a little more than the routine, so I'll add a few bucks for that.  I am also aware that she needed the assistance of an anesthesiologist (from Harvard, no less!).  Do you think $400 will be enough?  We'll see.


[Addendum:  I just read this to Gabrielle and she doesn't mind the spay analogy, so I got the OK from her to hit "post".  Also, it is now Sunday afternoon and she is resting quietly after experiencing some sharp pain while on her walk.  So, no more walking for now.  We're all off to the basement to watch last week's episode of Downton Abbey so we can be ready when this week's episode airs at 9:00 tonight.  Let's hear it for Lord Grantham and company!]

Saturday, January 19, 2013

1/19/13 Saturday evening update

Steve

We've had a mellow and quiet day around the house, Gabrielle's first full day home.  She has been able to cut her pain pills back quite dramatically, which is a huge plus.  She is still in pain, but powering through.  I will leave the exact details of the inner workings of her intestines to someone else.  The other big event was a walk all the way to the end of our street with Daniel--down to the start at Fremont on one end, and then back the other way to the cul de sac.  It is so encouraging to see her strength slowly returning.  Oh, and she is eating real food now.  Not a lot, but much better than what she was doing.  Big smiles all around.


As for me, I keep thinking about songs I've been hearing on the radio.  Two, in particular come to mind.  The first one is that silly song about "Another one bites the dust".  It's sort of depressing at first run through.  But then when you think about it, doesn't it all depend on who or what is biting the dust?  Years ago, my buddy Kenny at what used to be Seattle Harbor Tours told me he wanted them to play that song as the recessional song at his wedding.  Yep, his lovely bride, Connie would have loved that.  But, to Kenny, he was another bachelor biting the dust.  Fortunately, common sense won out and he opted for another song (though I can't remember what it was).


But, how about cancer cells biting the dust?  I am all for that.  I think it would be a great song to play at the beginning of every chemo session.  If  there are any bits of tumor hiding in the recesses of Gabrielle's body, each and every one will be biting the dust left and right before the 18 weeks of chemo are done.


Then there's another song:  American Woman.  Oh, that's a depressing sounding one too, especially the line about: "I've got better things to do than sit around growing old with you".  What a lie.  I can't think of anything I would rather do than sit around growing old with Gabrielle.  It is my idea of paradise here on earth, with her by my side.  If I ever hear that song again, I will change the words to: "Ovarian cancer, stay away from me.  Ovarian cancer, set me free.  She's got better things to do than sitting around growing old with you." 


There's another song that I've been thinking about, though I haven't heard it lately: Simon and Garfunkel's "I am a rock".  I can't remember all the words, but they go something like this:  "I am a rock, I am an island.  And an island never cries; and a rock feels no pain."  Paul Simon makes the case for life being simpler if you go through life as a loner, not allowing yourself to be touched loving someone else.  I suspect he is actually saying the exact opposite, in an ironic sort of way, similar to Mark Antony's speech about coming to bury Caesar, not to praise him.  Though I may be rusty on the details of Shakespeare's version of the events as they happened in the Roman forum (or wherever he was).


I can see Simon's point, though.  One of the more appealing shows on T.V. I have seen in many years is that one on PBS about the old codger who builds the log cabin beside some lake in Alaska.  Just him alone in the wilderness, with a few assorted animals along the way.  It is so bucolic, tranquil.  You just want to move there and build a house alongside him.  But is being a hermit really the way to go?  Do I really want to be that island?  No way.


This is a long preamble to say that I am realizing more and more each day the rich tapestry of family and friends who have touched me deeply.  From the beginning of the horror of all this unpleasant news, we have transitioned from being shell-shocked, to a more positive experience.  We have been wrapped up in the arms of a terrific support network that is truly humbling to experience.  From the professionals at Northwest Hospital, to neighbors and concerned loved ones showering us with treats, dinners, bagels, flowers, potted plants, wonderful e-mails, silly videos from a certain cousin, affirming messages to phones, texts, comments on this blog--it is such an outpouring of love and positive energy that sustains me (and all of us) during the dark times.


So this is a big and very warm-hearted thank you to each and every one of you.  Your prayers and kindness have melted this rock many times over.  Who wants to live alone beside a lake in the wilderness when I have friends like you?  Now, let's all sing about the cancer cells biting the dust... 

Friday, January 18, 2013

1/18/13 Home Sweet Home!

Home Sweet Home!

Hi, Gabrielle here.  I could hardly sleep last night, tossing and turning with excitement (and yes, a bit of delirium from all the drugs that follow a major abodominal/cancer surgery).  What was I excited about?  The fact that they were going to let me OUT of the hospital by 10 AM today, Friday, Jan. 18.  So much to do--packing, finding the "going home outfit" (loose, comfy, clean?), having the I/V in my right hand removed and the port-o-cath in my left collarbone "de-activated" until I will need it again for chemo next Friday.  There were favorite nurses and CNA's who needed hugs and goodbyes, discharge orders to digest (don't lift anything over your head, only lift things weighing less than a jug of milk, walk, rest, take pills).  There were flowers and cards and tea and candles and many other treats to pack up and take home from the blessed readers of this blog.  And lastly, there were trips to two pharmacies to pick up all my new meds (one of which are daily shots to prevent blood clots that Daniel J. Dudley, future M.D. was taught to give to me by my favorite nurse, Kim.


I arrived home tired but elated.  Never has home looked so good.  I have walked three times through each room of the house today just smiling and taking it in.  Love, peace, favorite memories, and comforts await me in every room. Clean sheets on my OWN comfortable (not rubber air mattress) bed.  My lotion, my tissues, my blistex or Burt's bees at every turn.  My neighbors--we have the best neighbors!  Not to mention more flowers than you have EVER seen in one house in your entire life!  So beautiful!  So cheerful!  '


Oh, and did I mention there was a UPS package for me on the porch?  The note read "If you are opening this, it means you are in your cozy home and you have "earned" your very own "Mrs. Potato Head."  It was from my former SPU assistant, dear friend, and cheerleader--Ami Archibald!  I'm having fun taking off Mrs. Potato head's hair, replacing her bald head with her baseball cap, and imagining what I will look like about two months from now!  ;-)


Thanks to each of you, dear family and old and new friends, for your words and deeds of kindness and love toward me and my family.  Thanks for your continued prayers for my complete healing and endurance through the long battle ahead (well, only 19 more weeks--not all that long).  Thanks for the FOOD that is filling two fridges and now that I can eat again, oh, am I ever enjoying  your healthy, thoughtful, "healing" meals!


Lastly, I want to thank Steve, who though sick and needing to wear masks, visited me and did errands for me as often as he could this week while juggling home and bills and two jobs.  He is the real deal, thirty years and counting.  I want to thank Renee, as I did earlier, for girls nights in the hospital, great talks and spiritual comfort during the worst week of my life. I tell people she is my daughter, my friend, my pastor, and my therapist all rolled into one....and she IS.  And what can I say about Daniel who spent more hours with me in the hospital than anyone else, anticipating my every need and caring for me with a servant heart, just as Jesus washed the feet of the disciples.  What a great doctor he will make (and wherever that young woman is that I have been praying for since he was a baby...you know, the one who will be his wife one day...she will be blessed beyond belief by my sweet son.)  ;-)


Ultimately, I offer thanks to Jesus who heard me cry out in pain and despair "help me Jesus" about a million times this past nine days.  And He did.  What a privilege it is to know and serve Immanuel--the God who loves us and is WITH us.  Amen!


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1/18/13 Home!

My mom's going home in an hour!!!!!  We're so happy!

There are only three things I'll miss about the hospital:


1. The molasses ginger cookies from Macrina Bakery.


2. The view of Mt. Rainier, the Olympics, and the city skyline.


3. The awesome RN's and CNA's--especially Premilla, who learned early in the week how much I rely on coffee, and subsequently found me whenever I was at the hospital (even when she wasn't assigned to our floor!) and brought me coffee and snacks.


As soon as we pack up and get my mom's IV out, we'll head home!  My mom is feeling much better now.  Her pain and nausea are under control, and she's walking without a walker.


Her next trip to the hospital will be on Tuesday to learn about chemotherapy and to get her staples removed.


Good job tackling the first obstacle, Mom!  We're so proud of you!


-Renee

Thursday, January 17, 2013

1/17/13 Night-Vision

2:00 pm

Hi, it's Renee.  Well it's Thursday and my mom is unfortunately still in the hospital.  We're hopeful that she might go home tomorrow, though we've been saying "tomorrow!" for about five days now.  She asked me to bring her more shirts yesterday, and I deliberately brought only two, hoping she'll be home within two days.  She must be getting so tired of the hospital.  I'm getting sick of it and I've been there much less than she has.  To that effect, I had a slightly disorienting experience over the weekend.  I walked from my car into the hospital via the long main hall on Sunday morning and went up to the fourth floor.  When I left the fourth floor on Monday night, thirty-three hours later, I headed towards the same hall only to find a freshly built wall in my way.  You know you've been in a hospital too long when the building's architecture literally changes during your stay.


Anyway, my mom's incision site is healing well, but she's still dealing with bouts of pain, nausea, and tremors from all the meds.  It's awful seeing my mom suffer.  I know my dad, Daniel, and I all wish we could take her place for a while and give her a break.  Unfortunately it doesn't work like that, so we're doing anything else we can to cheer her up and distract her.  Daniel came up with the idea of rationing out all the nice cards my mom's been getting, opening and reading one to her each time she has a small victory or a particularly discouraging challenge throughout the day.  She is so encouraged knowing you're all rooting for her.


Another favorite distraction of hers (and ours) is watching reruns of Frasier, inarguably the best sitcom of all time.  My mom wants me to try to persuade Kelsey Grammar (Dr. Frasier Crane) or David Hyde Pierce (Dr. Niles Crane) to come visit her.  She says to tell them she has cancer and that they ought to swing by if they're ever in Seattle.  I told her she's not that sick, but nice try.  With the word "cure" being tossed around, I'm not confident we have much pull with celebrities, though I'll at least try to get her an autograph if I ever get ahead of myself.


The good news of the day is that my mom's portacath is now up and running.  This means no more pokes for blood draws!  I think they can give her injections and IV's through it too, but you'd have to ask the science educated members of the family to be sure.  The plan is to start chemotherapy next Friday the 25th.  As I understand it, my mom will get chemo treatments in her abdominal port every week and also treatments in her portacath every third week.  Or maybe it's the other way around.  Either way, we're looking at eighteen weeks of chemo.  God willing, this will all be over in June!


Tangentially, can I quickly tell you about a dance performance I attended a couple years ago?  One afternoon my hippest friend dragged me down to a postmodern art gallery in Georgetown.  The gallery was in a converted warehouse littered with baffling works of "art," like a small TV showing only static, some dangling paper cylinders, and a visually cacophonous arrangement of fluorescent lightbulbs.  We were escorted to a dim back room that looked like a racquetball court and seated in bean bag chairs on either side of a large area rug.  Then--and I promise I'm not making this up--we were each handed a pair of night-vision goggles.  The lights went off and soft music started.  I waited for my eyes to adjust but there wasn't a trace of light to be seen.  So I obediently held the night-vision goggles to my eyes and witnessed something incredible: there in the middle of the pitch black room were three people dancing beautifully to the music.  I watched in awe as they followed a carefully choreographed routine--sometimes dancing together, then separating, then somehow finding each other again the darkness.  It was the most bizarre yet memorable performance I've ever seen.


I suddenly remembered that afternoon yesterday as I was processing all that my family is going through.  I remembered how a few times during that dance performance I put my night-vision goggles down to confirm that this was really all happening in pure darkness.  Return the goggles to my eyes, and there was the beauty.  The lens makes all the difference.  This strikes me as an applicable metaphor to the events of the last week.  Cancer is miserable; caring for a sick parent is hard; seeing pain and exhaustion in the eyes of loved ones is devastating.  But through the lens of our faith, my family is seeing beauty even in this dark time.  Where others might see only darkness, we have already found so much light: we're all drawing closer to God, we're building character, Daniel and I are growing up, we're feeling so loved by friends and family, and we're finding myriad opportunities to share our faith.


I have a new appreciation for the title of the old hymn "Be Thou My Vision."  I pray that God will indeed continue to be our vision in this time of crisis--the lens by which we find beauty and order where there is otherwise only darkness.


Thanks for checking in, friends.  You're the best!


Wednesday, January 16, 2013

1/16/13 Tooth Number 4

Steve

I spoke with Sally last night.  She's a dental hygienist and said that since she got the news about Gabrielle, she has been praying for her all day long.  How so?  Even I haven't been that diligent.  Well, she's got this wonderfully creative system.  As she works her way through a patient's mouth with all those fun little sharp instruments of torture, each tooth gets assigned a particular person.  The whole time she is working on that tooth, Sally prays for that person.  What a great idea!  I love it and am honored to know that all day long, when Sally gets to Tooth Number 4, Gabrielle is getting an extra prayer sent heavenward on her behalf.  Is it selfish of me to want Tooth Number 4 to be extra dirty so that she will spend more time on it?  Mea culpa.  Maybe tomorrow I can adopt her strategy and assign a different rubber glove to a different person throughout the day.  Probably wouldn't work.  I'd be tempted to keep Gabrielle's glove on all day long and I don't think my subsequent patients would like that.


On the "what's new with Gabrielle?" front, she's had a rough day.  You'll pardon my levity with the rubber glove comment because I am hoping she will read it and take a little cheer, at the expense of some morbid doctor humor (though I can get more morbid...don't tempt me).  The worst part about today is that her wonderful portacath, so carefully placed by the vascular surgeon who had to be flown in from Milwaukee got plugged and therefore needs to be adjusted tomorrow morning.  It is not as involved a procedure as when it was placed, but still requires another procedure, nothing by mouth after midnight and is discouraging as it represents a small setback.


Nothing on the quest for Mr. Potato Head front.  Still trying.  Spirits lagging.  Evenings tend to be the worst.  I just got a phone call from her and she wasn't doing well, even though she has Daniel, The Champion of the World staying with her tonight.  I drove down and hung out with the two of them for an hour.  She kindly let me rub her back and pretended that she needed lotion on her legs so that I could get close to her and rub them for a little bit as well.  She has been having me keep my distance because of my perceived cold (it's nothing, really...I had it checked out by a doctor:  looked in the mirror and pronounced myself fine).  Still, I am being cautious.  I wear a mask when I see her.  The worst part is that I haven't kissed her in three days.  I miss that.  And hugs.  Don't get me started on hugs. 


Her legs have been shaking uncontrollably for the last four hours.  As I was leaving, the nurse gave her some Ativan which seemed to help.  Nausea remains a huge problem, despite two different anti-nausea medications.  Has no appetite.  Had two saltines and three bites of applesauce around 10:30.  She needs a little more calories than that. 


So, that's this evening.  Here's hoping tomorrow is better and that a lot of people with really dirty number Tooth Number 4 will be seeing Sally all day long.

1/16/13 Anyone up for skeet shooting?

Steve

Yesterday's big event was the placement of a portacath (or Port-a-cath) so Gabrielle could get chemotherapy without having to get stuck with a needle every week.  It was supposed to be done the day before, but either the operating room couldn't accomodate her or there was no surgeon available to do the procedure.  On Monday late in the day, a harried Dr. Lerner bustled down the hall to introduce himself.  He is a vascular surgeon and had come directly from the airport, having just flown in from Milwaukee.  I like to think that Gabrielle is so special that they are flying specialists in to care for her.  I think he may have had other reasons for his Milwaukee trip, but that's beside the point.  He flew in for Gabrielle and that's good enough for me.


In the course of telling her about the procedure, he said that she had a choice between having it placed on right or left side just below the collar bone.  She didn't care, as long as it worked.  He asked her if she was right or left-handed, to which she replied "right".  It's not her fault she's not left-handed like me.  We can't all be special now, can we?  He helped her decide by asking her if she liked to shoot rifles, or something to that effect.  I'm not entirely clear as I was talking with someone else at the time.  I just heard words like "shoot" and "gun stock rubbing against the portacath".  That sealed if for her and she is now sporting it on the left, well out of the way.


I suppose it would be no fun to head out for a little friendly skeet shooting to hone those hand eye coordination skills and have the rifle butt keep pounding on the portacath.  Gabrielle laughed when asked if she was a hunter or liked to shoot.  No to both questions.  Although she is indeed excited that Cabela's now has a branch up north, she makes a beeline for the snowshoeing section when we go in there, not the camoflauge clothing that comes in oh so many styles.  Want to hide in a birch forest in winter?  In summer?  In a pine forest?  A swamp?  Have they got the clothing for you!  For the life of me, I cannot imagine why anyone would need camo underwear, but they've got it at Cabela's.  Feet get cold during those ice fishing jaunts?  Not any more:  heated camo socks, as if the darned carp hiding beneath two feet of a frozen lake really care what color your socks are. 


Still, I really admire Gabrielle's decision to have the portacath placed on the left side, "just in case".  There is somethign appealing about Gabrielle, in all her post hospital glory, going out to the shooting range and ordering up a box of skeet to shoot at.  Is it a round?  A box?  A flurry?  A bolus?  As is very clear, I am not a skeet shooter either and don't know what units they come in.  But if she does take up the sport, she'll no doubt take along a Sharpie and write "ovarian cancer" on each and every clay pigeon prior to having it launched.  There would be a lot of satisfaction in yelling "pull!"  And blasting the target to smithereens.


"Ah, but what if she misses?"  You might ask.  Hardly!  If you haven't already figured it out by now, Gabrielle is very competetive (in a fun way) and masters anything she has set her mind to.  Those stupid clay pigeons won't stand a chance in the sites of Gabrielle's rifle.  She would practice, practice, practice till she got it.  She would read books, watch DVD's and even start hanging out in the cafeteria of Cabela's seeking the advice of old time skeet shooters, while noshing on one of their tasty elk burgers, till she mastered the sport.  And ovarian cancer, likewise, will bow to Gabrielle's superior will, inner strength and vast array of weaponry she has to throw at it (including, but not limited to her vast network of friends, doctors, nurses, medicines, and the like). 


She does have a bit of history with guns.  Goes way back, when she was in high school, I believe.  Got a job at Fishing and Hunting News selling advertising or subscriptions (yes, aced that job too!).  We have a faded picture somewhere in the basement of her shooting at something with two admiring boys in tow.  Yep, that's Gabrielle.  Even back then, showing off for the guys.  And that's the last time she shot a firearm.  Till now.


But, she got the portacath placed just fine and is doing well.  Daniel stayed with her through the day yesterday.  Renee had night shift (lucky her).  She went on walks and is managing as best she can, as she is trying really hard to earn her very own Mr. Potato Head doll (no news on that front, as I am home now).  I am actually hopeful that she may be able to come home later today, but it's an outside chance.  Needs to have better pain and nausea control as well.


She remains in very good spirits and has been buoyed by the overwhelming show of support through your cards, notes, texts, e-mails, food (yes, she is eating now), prayers and visits (but check first).  Thank you all so much.


A final note to Daniel:  thank you for your very deep and uplifting entry yesterday.  Why should you be intimidated by our writing?  You take a back seat to nobody in the writing department.  Keep it up, DJ!  Looking forward to another post from you today.