1/24/13 Day Zero

Steve

Today is "Day Zero", the term given to the day before chemo begins.  For those with good math skills, and adequate caffeine on board, that means tomorrow is "Day One", and then off we go from there on our 18 week journey.  This evening Gabrielle takes some additional medicine to get ready for the big onslaught of high power drugs tomorrow.  One of them, dexamethasone, is guaranteed to keep her awake, so we'll most likely but watching all sorts of late night infomercials, Leno, and baby even start the Vicar of Dibley DVD's that Kay kindly loaned us.  Don't know anything about the vic, but should be good for a few laughs.

Yesterday, in addition to some visitors with amazing food (breakfast, lunch and dinner no less...a trifecta!), we received another gift which is equally a delight: beach glass from Chuck.  He is a good friend who spends some of his time up on Shaw Island where he turned us on to the fine art of beachcombing for shards of glass.  It actually gets quite addictive, strolling along with nothing to do but wander and search for old broken bottles that have been worked over by the gentle sanding action of the waves and rocks to form pieces of art.  Here is a picture of some of our treasures:

A couple of these pieces are ones Chuck brought over.  Take a look at the big one and the piece just in front of it.  Obviously, the big one is the bottom of an old wine bottle, but now it is a work of art, especially with those barnacles.  Just in front of that one, is a rare purple piece.  Chuck says they are especially valuable because the purple is due to lead which they don't use any more and that it must be at least 50 years old.  I'm sure glad we don't all turn purple when we hit 50.

Just last weekend, Renee and I went beachcombing where we found our first blue piece of glass (far left).  Renee also found the top of what most certainly is a Rainier beer bottle which fits her just like a ring.

I like the whole picture of an old busted piece of a bottle with sharp edges, good for nothing but the recycle bin, being gently worked on over time to create an object of beauty with gentle smooth edges and a fine, sanded surface that is fun to look at and hold in your hands.  Isn't that what happens to all of us with the sands of time?  Just as long as we don't turn purple, and I would prefer not to grow too many barnacles.  Here's to Day One tomorrow.  Maybe I'll slip a couple of pieces of beach glass into Gabrielle's pocket for good luck (most likely not the wine bottle). 

1/22/13 Post chemo prep meeting

Steve

We have just come back from a marathon session with Dr. M. and her staff as they outlined the course ahead.  Dr. M. spent a good hour with us and went over quite a few things in great detail. She reviewed the final pathology report of tissues samples which she took during surgery and it was pretty much what we expected: stage 3 of the most common type of ovarian cancer.  Next stop:  a visit with Whitney, a very kindly and gentle medical assistant who removed Gabrielle’s staples.  She didn’t fill in the area with that nifty gold epoxy that they use in kintsugi pots, but I didn’t mind one bit.  When all that was said and done, we spent another 45 minutes with Janelle, the infusion nurse, who went over the full course of therapy and specifics of what’s coming and what to expect.

I was taking notes as Janelle talked so as to be as accurate as possible.  I realize that I have a little more medical expertise, so am paraphrasing the more technical aspects of what she said to make it more understandable to non-medical readers.  Here is the “cut to the chase, just the facts, Ma’am” version a la Joe Friday from Dragnet:

The treatments will begin with accessing the transdermal, sub-phreno osseo revergitating, galvanic squamous gelatinite through a simple process of reverse osmo chrysallic thrumbo strapullian instillation.  This, in turn, will result in the egress of the outflow tract of the sub xerophytic, flangian Avogadrian quasi colloidispherical semi luminiscal chemo therapeutic fluxism.  At this point, the thermoregulatory encrypted prions of the aforementioned fluxism will need to be circumferentially redirected through the islets of Langerhans via the sub-equatorial crenellations.  This, being a critical step in the whole process, will require close monitoring through a previously arranged portal for the Franz Kafta kebabian incubus.  At this juncture, the cruciferollius discombobbitizes the soylent green via a gymnoelastic dingle shaft fluxor resulting in an antipyogenic sterile cuckholdian flamdoodle.  The multi disparturian fallo-oophorian applebeesian strudel und schnitzel vit noodles sequentially supinates toward the oscillatory thrimjig of the molokini sporulations.  This infuscation will then kiegelitate…a simple process in which the kalipygian steato heptadiode motates and mishkinizes its humptillian throckmorton.  Repeat weekly till 18 sessions are done.

All kidding aside, Gabrielle will be getting two different medications: one through the portacath in her upper chest every week for 18 weeks, and a separate one every three weeks instilled directly into her peritoneum (abdominal cavity).  As such, every third week will be the toughest as she will be getting two medications.  Her first treatment is set to begin in three days.  The medicines have the potential to decrease her white blood cells, platelets and red blood cells.  Therefore, prior to each session, she needs a blood draw to make sure everything is OK. 

Common side effects include fatigue (a huge problem), nausea, a metallic taste in the mouth, peripheral neuropathy and (sadly) hair loss, all of which we expected.  Gabrielle will be getting a concoction of medicines prior to the treatments including steroids (dexamethasone), anti-nausea meds and some antacids as well.  She was encouraged to conserve her energy and focus on using what little energy she has wisely, picking the things that are most important to do first, whatever that may be.  Rest is important, but also activity.  She even got the go ahead to go to the gym—in modest amounts, once she is up to it (not right now). 

During our time with Dr. M., Gabrielle made a point of telling her that she didn’t want to know statistics about ovarian cancer at this stage, as the important thing is that she is one person fighting this, not simply a number.  She did ask if Dr. M. could give her a success story to hang her hopes on during the chemotherapy period.  Dr. M.’s face brightened into a big smile and quickly responded that she had tons of success stories and volunteered to contact one of her patients who has been through this same stage and beaten it and have her call Gabrielle with words of encouragement.  That sounds like a good plan to me.

Dr. M. had to race out as she is heading to a national conference where she will be speaking to her peers on, guess what?  Ovarian cancer!  Gabrielle and I feel very blessed that we have gotten someone so knowledgeable in her field that her peers look to her for the latest updates.  By comparison, the best I've gotten is publishing a tip in a medical journal on how to remove ear wax.

So now we’re back home, relaxing in front of the gas fire, and letting all this information sink in.  Gabrielle has just finished reading several very encouraging cards and is now asking for Kleenex as she never fails to be touched by the warmth and compassion that is expressed in them.  You are all very dear to us. 

Here’s looking ahead to Friday: day 1 of chemo!  You go, girl!

1/21/13 Monday greetings

Hello friends and family--Gabrielle here.

Happy Monday to you all!

I didn't sleep very well last night with so many thoughts swirling in my head, but it's great to know there are three couches and numerous beds within steps of me whenever I need to rest today.

Daniel is home with me and Renee will be home soon (since Monday's are her day off).  We are having a mellow morning.  We walked to the end of the block and back enjoying the ping of little ice chips melting off the trees on our street and feeling as though we were in London with all the fog.  We have been paperwork maniacs this morning.  All bills are paid.  Tax statements are in the file awaiting our CPA's magic touch in February.  Medical leave paperwork is printed out and ready for my doctor to sign  tomorrow.  Daniel is busy writing thank you notes for so many kindnesses.  It feels good to accomplish a few things!

Reflecting with thanks about simple pleasures.  Yesterday I was in heaven having a long, heart-felt talk with my friend Sue while sipping tea by the fireplace.  Today I was so thankful just for a long hot shower and shampoo, all on my own. Even did the duct taping of the port-o-cath all by myself.  Have also been enjoying the little birds going crazy over the freshly filled bird feeder and suet outside my living room window.  And last night I was thankful for the escape of television.  Particularly, Hawaii 5-O.  Steve McGarrett and Danno are the two heroes, of course, and I like that I have my own Steve and "Danno" at home!   And my sweet Renee who is another one of my heroes each day.  Last night 5-O rescued Chin from near death in a prison riot.  Cancer is nothing compared to watching Chin and 5-O battle hundreds of rioting prisoners who trying to kill Chin!  And then there was Downton Abbey.  I only watched episode two last night--so don't spill the beans yet on episode three!  Hope to catch that one tonight.  It is so calming to escape to that lovely English estate with all the characters you grow to love (or despise, as in Thomas).

Now we will pull out some delicious leftovers from all of you who have so lovingly provided meals and have lunch.  Then some rest. Then another walk.  Simple days, simple pleasures.  Thanking God for the gift of life this day, and for all of you who are praying for us.  This is the day the Lord has made, let us rejoice and be glad in it!  (Psa. 118:24)

Blessings!

1/21/13 Monday morning metaphors

Steve

She’s been home three days now and settling into a bit of a routine.  Therefore, not much new to report each day.  At this point, her progress is marked by little steps:  walking a little farther, eating a little more food, staying asleep a few more minutes.  She has lost so much weight since all this began and I would love to see her reverse that trend. 

The big events of this week are an appointment with Dr. M. and her staff to get the final pathology report and hear about the specifics of the chemotherapy.  That will be tomorrow.  Then on Friday, the chemo begins.  None of us know what to expect, though many have told us of their own experiences.  It is all a big black box at this stage.  I (or someone) will certainly keep you posted as to how these events unfold and how our little journey of discovery unfolds.

And now a brief word about metaphors.  There are all kinds of metaphors people can use for an experience like this, or life in general.  Some examples are …

-cowboy stuff.  A couple of times over the years, we have heard a cowboy preacher talk at the conference center at Cannon Beach.  His speech was peppered with analogies like, “hey, pardner, you’re welcome at my campfire any time” or “God is the trail boss and we’re all His l’il dogies”.  Stuff like that.  He even built a façade of a western town around his fire pit in the south forty at home to lend a little atmosphere to his campfires.

-battles.  The first example of this that comes to mind is St. Paul discussing getting ready to face the enemy wearing the full armor of God in Ephesians 6.  Good stuff. 

-sports.  Fourth and long.  First and goal.  Hitting a home run.  Bottom of the ninth.  Bases are loaded (no, that’s not the inebriated string section at the symphony).  Hitting it into the rough.

These all tend to resonate with certain individuals, and perhaps not with others.  Well, here’s my metaphor that I keep coming back to:  sea voyages.  I have always loved the sea and have been fascinated by the early explorers who set out from a safe harbor to parts unknown on wonderful voyages of adventure and discovery, knowing full well the privations and perils that await them.  In my office, just over my desk, a map of the three separate voyages of Capt. Cook stands sentinel over me.  When things get rough and I am worn out, I look up at the various colored lines depicting his trips and think of what he went through and how things weren’t all that rosy for him (especially when he got to the Big Island of Hawaii).  I’ve immersed myself in books by or about Capt. Joshua Slocum (the first man to sail alone around the world), Ernest Shackleton, Magellan, Richard Henry Dana (Two Years Before the Mast), Moby Dick (read it three times, but it always ends the same…absolutely love it…and yes, I know this is fiction), Sir Frances Drake and many more.

One of the most interesting books about sea voyages that I have come across is Rounding the Horn, which simply details the difficulty of getting around Cape Horn at the tip of South America.  It has some of the roughest waters in the world.  It is also the only part of the globe where there is no land mass anywhere around those latitudes, so the waves can build up with nothing to stop them as they gain momentum and height.  If my oceanography serves me correctly, those waves have a very long fetch.  Not “fetch”, like Neptune telling the waves to fetch this boat to the bottom, but fetch in the sense that the waves travel unimpeded, having a chance to build up a head of steam (a train metaphor thrown in to keep you on your toes).

There is so much about a sea voyage that I can identify with.  You need a sturdy ship, a good crew, a skilled captain and navigator, and a vision of where you are going.  You need to be ready for hardships along the way and be prepared for everything from the doldrums, to intense storms.  Sadly, not all ships make it, but most do, and Gabrielle will too.  And right now, Gabrielle is rounding the Horn.  We are a well equipped ship with great crew (all you folks), a merciful Captain whom we serve and guides us, a sturdy ship, and a lot of faith. 

Thanks for shipping out on this journey with us.

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!]

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... 

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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