Sunday, January 27, 2013

1/27/13 Nadir

Steve

Nadir.  That’s the word that was bandied about a few times during our pre-chemo meeting.  It means low point, especially as it pertains to white blood cells and other lab values.  For example:  “The nadir for your white cells will be 10-14 days after the chemo treatment”.  That’s the period of time when the body is the weakest and is thus most susceptible to infections.  But nadir, in a broader sense, can apply to other things as well.

For years, I have told people that my office is located at the nadir of Holman Road.  If you’re familiar with this road, which connects the lovely areas of Greenwood with Crown Hill, you know that it dips down to roughly the QFC area before heading back up.  For some reason, not sure why, I have gotten quite a few puzzled looks when I describe by office’s geography in such terms.  Lately, I have switched my approach and tell them that my front door looks directly at the garbage cans of Luisa’s Mexican Restaurant.  The lights go on.  They all know where Luisa’s is, nadir or no nadir (great hand-rolled tortillas await you at check-in, by the way).

Another nadir can be moods or just plain feeling crummy.  They warned us about that too.  Nurse Janelle said that Gabrielle would feel the worst on days two and three after chemo and slowly improve for a couple of days before it all hits again.  Well, that’s what we’re in right now.  Nothing tastes good.  I offered Gabrielle anything under the sun for breakfast, to which she said “no” to everything, but finally (more as a gesture to make me feel better, no doubt) agreed on letting me make her some bland pancakes with applesauce.  She ate just over one.  Didn’t sleep well last night.  Stomach was churning and gurgling.  Is still getting significant drainage from part of her abdominal incision.  She is worried that all the medicine is leaking out, but I assured her that there is plenty that is sticking around to do the job, otherwise she wouldn’t feel so lousy.

She is wondering if she has the strength to do this for 18 weeks.  I counter with the fact that she is the strongest person I know and that she will do fine.  However there will be tough challenges along the way, like last night and today, but that she’ll get through them.  One day at a time.  Or as she likes to say, “Eyes on Jesus.”  That’s a good place to focus, don’t you think?

The kids have made one of those paper chains that are popular around Christmas time to go on the tree right up along with strings of popcorn and ornaments made out of cellophane-wrapped sugar cookies.  It’s got 126 links, one for each day.  They have written encouraging notes or Bible verses on each one.  Each day down, and another link comes off.  Right now, it is draped along the banister.  Eyes on the prize.  We’ll get through this.

I also remind Gabrielle that the term “nadir” implies that the opposite also exists:  zenith, or high point.  You can’t very well have a nadir without that now, can you?  To go back to my Holman Road analogy, zenith is an apt term, as at the Zenith of Holman Road, you will find such fine establishments as Dick’s Burgers (a Seattle institution that gives Inn ‘n Out Burgers a run for its money), Holy Grounds Coffee and Daniel’s favorite: Value Village.  That’s the Crown Hill Zenith.  The Greenwood Zenith has Bick’s where Rachel Ray once did an episode.  They have one mighty tasty (albeit pricey) hamburger.

So the nadir of Gabrielle’s emotions and how she is feeling will soon give way to a zenith.  Along the way, we look at little bright spots:  the birds at the feeder outside the window, cheerful flowers, plants and cards, a bright, airy house which sure beats nine days of Room 440 at Northwest (no offense, you guys at Hotel Northwest were awesome…you just weren’t home).

And that’s Sunday.  Thanks for your prayers and support.  Now, if I can just talk Gabrielle into a trip to Dick’s or Bick’s, we’ll be making some real progress.

Friday, January 25, 2013

1/25/13 Finished first chemo treatment!

Dear Friends & Family,

Hallelujah!  We made it through my first chemo appointment!  Only 17 to go!!!

It was a long day--six hours.  The blood work took longer than normal before we could start, so next week I will go in on Thursday for the blood work and then we will be all set to start the chemo at 10:30 on Friday. 

My three chemo nurses are wonderful.  Great bedside manner and very comforting throughout the process.  They explained everything really well and checked on me continually.  They even let me order lunch (which is a freebie with your chemo if you are there for four hours or more...there is such thing as a free lunch) and brought me lots of bottles of water.  Daniel was with me the whole time and Steve about half the time.  He also had to get some paperwork done at work.  We played Estimate (my favorite card game) and I was easily beaten this time as they give you Benadryl with your chemo.  Rather woozy!  We played Scrabble, which I won before the Benadryl kicked in.  We watched Top Chef "Last Chance Kitchen" online on Daniel's computer.  And Daniel said a beautiful prayer of thanks when we were done.  Tonight we will read our daily devotional together in "Jesus Calling" and in the One-Year Bible and pray again.  Prayer is becoming like breathing.  Frequent, steady, life-giving. 

When we got home, I went on a round the block walk with Steve, going "slightly" farther than our last walk.  I had to stop several times to shake back and forth (think Chubby Checkers "do the twist") to slosh the chemo in my belly around real well.  Unfortunately, when we got home, a bunch of fluid (hopefully more the saline than the medicine) had "leaked" out of part of my abdominal scar that is not fully healed in only two weeks' time.  Now I'm going to lay down and flop back and forth in a lying position to continue spreading the chemo and hopefully, not having too much more drip out while lying down!  Really enjoyed the walk though on such a pretty, cheerful day.

At chemo I met a new friend who has given me her name/number to call her anytime.  She was diagnosed 11 years ago with stage 4 ovarian cancer.  She has had lots of remission since then but is currently experiencing a recurrence and beginning chemo again. I was very encouraged, however, to meet a stage 4 patient who is ALIVE after 11 years!  This was a sweet note of encouragement from the Lord!

And speaking of encouragement...oh my goodness!  When I got home from the hospital, you won't BELIEVE what was on my porch (it's like every day is Christmas)!  Our cousin Robby and his wife, Becky, sent me an authentic autographed picture of Kelsey Grammar (Frasier) for me--his biggest fan!  Most of you know Frasier is my favorite comedy of all time and I have seen all episodes about ten times.  I will treasure this photo.  Thanks, R & B, for such a thoughtful gift!

But wait, there's more!  There was a gorgeous flower arrangement from two of my dear friends from my Children's days, Bruce and Jeannie.  Happy memory with Bruce--went to his house one night and told him the downtown Nordstrom store didn't have my favorite work shoes and never offered to order them, so I assumed they were out of production.  The next morning I got a call from Bruce saying "Gabrielle, I have your shoes--they are shipping in today!" I couldn't believe it that such a busy man would take time to do this kindness for me!  Favorite Jeannie memories--two lovely spa vacations together and eating my first grapefruit right off the tree at B & J's Palm Springs home.  I still wear the light blue "moon" nightshirt that Jeannie gave me on our spa trip, which was over my b-day weekend!  Thanks so much, B & J, for the flowers and lovely card about your thoughts and prayers for me.  Speaking of my birthday, which is coming up on 2/18, I wonder if I will have any appetite to go out to dinner or if we will just stay home.  We are about to cancel our Canlis reservation for Valentine's Day (sob) as I just can't eat enough to make it worth paying for that special night with a five-course pre fixe menu.  Oh well--NEXT Valentine's day we can go and I will even have my own hair all grown back!

But wait, there's MORE!  Two other dear Children's friends, Bill and Luanna, sent me the largest basket of Harry and David fruits you ever did see!  Apples, pears, kiwis, limes, avocados, and mangos!  Fruit tastes really good to me these days and I quickly had Daniel slice me some apple to go with my "fatten me up" snack of two saltines topped with peanut butter and chocolate chips.  Delicious apple!  Thank you, Bill and Luanna, for this perfect gift and your prayers and love.

And even MORE, there were two more cards in the mail from two friends at work, Kristi and Maribeth, that made me smile with such sweet sentiments.  And an awesome encouraging e-mail from my friend, Ted.  Thanks to all of you who heretofore have not been mentioned in the blog for your gifts, cards, etc.  I have been trying to get out thank you notes with Daniel's help but we can't keep up.  So I will try to thank people in the blog going forward and shoot a text or e-mail when I can.  OK?  Every kindness means the world to me.  I feel I am not alone in this battle.  You are all with me.  I have never felt so blessed in my life. 

Jesus summed up the greatest commandment by saying we should love God and love our neighbor as ourself.  His love is poured out to me right now through all the love you are showing to me, your friend ("neighbor").  To love and be loved--what could be more important in life?  What an amazing rope team I have.  One foot in front of the either, one day, one hour at a time and we will summit this mountain called ovarian cancer.  The view from the top and coming down the other side will be magnificent!

Love to you all,
Gabrielle




Gabrielle and her main T.V. squeeze

Thursday, January 24, 2013

1/24/13 Day Zero a Quick Review

Hi dear friends/family,

Gabrielle here.  I wanted to check in and say "hello" as I finish up my final day of "life before chemo."  It has been a good day.  Daniel and I awoke to reasonably nice weather so we ate Mike and Colleen's homemade yogurt and granola (yum!) and headed outside for our "not so power" walk around the block.  It was so good to get outside, as most of my waking hours over the last two weeks have been indoors.

Around 11 AM my good friend Erin-Joy came over and brought me--reader discretion advised here--"Naked" juices, filled with lots of healthy fruits and veggies.  She also had mail ordered away to one of my favorite stores on earth--Bruce's Candy Kitchen in Cannon Beach--for one pound of dark chocolate sea foam candies.  You should have seen my face light up when I saw the pink and white striped box.  We have spent many wonderful summers at the Cannon Beach Christian Conference Center with the Bjorge Family and daily trips to Bruce's were mandatory.  By the way--would some of you on my prayer team please pray for Erin's niece Kierstin tomorrow at 1 PM?  She is three years old and was burned in an accident and has to have another trip to Harborview tomorrow to have her wound debrided.  I am not the only one in the world who is facing hardship right now and in need of our prayers!!

At 1 PM Daniel and I took a drive to pick up some meds and went down to Richmond Beach to gaze at the perfectly clear, snow-capped Olympic mountains.  We had our prayer time together gazing at the handiwork of God.  We then felt a small burst of energy and went to Central Market to get some lunch.  I am having trouble with appetite and not much sounds good right now.  Have lost 10 pounds since Jan. 1 (New Year's resolution accomplished for the first time in history).  Daniel said "I'll make you anything in this store that sounds good."  So guess what?  I had a CRAB cake for lunch...followed by a Naked juice chaser and a piece of sea foam.  While eating this delectable meal, we watched one of my favorite movies, "About a Boy."  The theme of the movie is about how people need each other and that you need more than just one other person "on your team."  You need "back up!"  If you haven't seen this movie, watch it!

Around 4 PM my dear friend Loretta came over.  She is a cancer survivor--six years now!  She gave me lots of great chemo tips and encouragement that I WILL make it through the next 18 weeks.  She brought me  a little "angel of prayer."  The little tag with it said "for those who believe in the power of prayer."  I put it on my dresser and she said "every time you look at it, remember how many people are praying for you."  Perfect!

I almost forgot to mention that getting the mail is a highlight of any day.  Today, like most days, there were cards from friends that brought me great joy to read.  I love your cards and notes.  Thank you all SO much!  And then there was a SPECIAL DELIVERY at the door--a card and homemade fuzzy, warm, cozy blanket from my great friend Dean's AWESOME Aunt Evie in San Francisco!  I love it!  I have snuggled with it today and it is going in my chemo day bag for tomorrow!

And the last act of supreme kindness and love in this day was from our dear friends and neighbors, Jerry and Laura, who just brought us clam spaghetti, salad with strawberries and blueberries, bread, chocolate cake, appetizer, beverages, and a ton of gorgeous long-stemmed pink roses.  There can't be better neighbors anywhere in the world (or at least anywhere in Shoreline)!

I am bathed in and overwhelmed by LOVE.  God's love, manifest through all of you, is covering me daily and bringing strength and hope for this tough journey.  Thank you all for coming alongside us and shoring us up for the 18 weeks ahead.  Tomorrow, when I arrive for my five-hour first chemo session, I will close my eyes and say a prayer for all of you, who are praying for and loving me.  Blessings to you all.

Love,
Gabrielle

P.S.  Many thanks to my wonderful friend Maribeth for organizing the meals and the great conversation on the phone today!

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). 

Tuesday, January 22, 2013

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!

Monday, January 21, 2013

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.