7/24/18 Back home

We are back home now.  The doctors still aren't sure why she was so confused yesterday.  She definitely perked up with some hydration, but it looks like there is something else going on, such as declining liver function.  When we got her home, she slept on the couch till we prodded her to get up and eat about five bites of dinner (quesadillas and guacamole) and then went to bed, where she has been for the past 11 hours.  

At this point, things don't look very good, and it has all been so sudden.  We are still processing the rapid turn of events.  One minute, we're on our way to Houston for a clinical trial, and the next we're in the ER at UW talking palliative care.  Let's hope for a better day today.

No visitors please.  

7/23/18 ER update

After spending most of the morning and afternoon in the ER, she is about to be discharged.  They gave us the option of being admitted for further workup, or heading home.  Gabrielle strongly wants to head home and has been chomping at the bit to get out of here.  She has had some labs (slight worsening of liver tests), head CT (no brain bleed), and a liver ultrasound.

Nurse just came in to unhook the IV, so I gotta run!  We're heading home in about 10 minutes.  So glad we didn't go to Houston today.  The labs here indicate that the liver tests alone were not at the level they would like to have for the study. 

I challenged her to Scrabble, but the kids said that I would have an unfair advantage.  What's wrong with that, I ask??

7/23/18 Houston is a "no go"...

Steve here with another quick update.  We had planned to go to Houston today.  However, when Gabrielle woke up, she was in no condition to fly: confused, very shaky.  I spoke with the trial coordinator and relayed my concerns.  After seeing how she looked, we (mostly me) made the difficult decision to cancel Houston and make a beeline for the UW ER instead.  She was immediately taken back to a room, and was quickly surrounded by nurses and the ER doctor (a former classmate of Daniel's).  Right now, she is dozing while we wait for labs and a plan to be formulated.

At the very least, it looks like she is going to be admitted to the hospital.  I don't know much more at this point.  Will keep you posted.  

Looking at how she is right now, she would have been in no condition to fly anyhow.

Please, no visitors at this point.  It is all pretty overwhelming to have all this happen so dramatically. Don't take it personally if we don't respond to texts right now--there's a lot going on and we're running on fumes. But know that we appreciate your prayers and well wishes.

7/19/18 Houston is a "go"!

Hello, friends.  Quick note on Gabrielle.  She had her labs done today and they are good enough for her to proceed with the trial down in Houston.  This is the trial which involves check point inhibitors.  In particular, they wanted to make sure that her liver tests weren't too far off, and they weren't.  There are some abnormalities on the tests, but not enough to put the brakes on the study.  I spoke with the coordinator today and she said that things can proceed, which is something we are delighted about!

We fly out on Monday the 23rd (Gabrielle and Sheriff Steve this time), and will return on Saturday, July 28th.  She will have a couple of days of testing, meet with the doctor on July 26th in the morning and then get the infusion of the drug in the afternoon, then one day to rest before flying home.

Till then, we are biding our time around the Dudley household.  Gabrielle's appetite has still been quite poor...and it has nothing to do with my cooking!  She didn't even finish her ice cream tonight.  She rests a lot, but when she does, she is peaceful.  Yesterday, we played Scrabble, and I finally won a game!  But only by a few points.  I almost felt guilty for winning when she was so sleepy and woozy from her pain meds, but not guilty enough to let her win, that's for sure.

I don't have much else to report, but wanted to let you know about the labs.  I will try and update you next week from Houston, or if any of the following take place before then: I cook something new on my car's dash (supposed to be hot this weekend), I win a second game of Scrabble in a row, Gabrielle starts eating my cooking, I manage to stay awake during the Aussie soap opera, or if my "Cuzz'n Rob" larns to spelll enny bettor than he duz now.  

Thanks for the prayers, and all your support in so many ways!

Steve

7/17/18 Back to Houston next week...we hope

     Yesterday we got a call from the research coordinator who said that after consultation with the main doctor for both studies, that Gabrielle should continue with her plans to be in the second study.  Main concern is that the first study involves a long period of time in which she doesn't get any treatment at all, and he didn't want her to have to go too long before having some sort of intervention.  Possibly down the road, she may be a candidate for the first study again, but for now, it's the check point inhibitor trial.  

     Plan for now is to return to Houston on Monday, July 23, have several more days of testing and then get an infusion of the check point inhibitor later that same week (most likely Thursday, but maybe Friday).  Home on Saturday.  However, before we take a trip down there, they want us to get some preliminary labs here later this week to make sure that her liver an blood counts are within the right parameters for the trial to proceed.  That happens this Thursday at the UW.  In particular, they look at things like platelets, neutrophil counts and liver function tests...all of which have been impacted by her cancer and/or treatments in the past.  

      So, we're hoping to get the green light after the testing.  We don't want to wait till we get all the way down there and then get told to head home due to abnormal labs.

      In the meantime, she has finished her two rounds of antibiotics, but is still on the blood thinner.  Appetite continues to be marginal at best.  I made her a great Caesar salad yesterday for lunch, and she promptly looked at it and said, "Don't get mad, but I don't think I can eat this now."  That would have been fine, but then she added, "or ever".   Happily, Daniel wasn't so discerning and snapped it down like candy when he got home.  And who could get mad at Gabrielle anyhow?  As long as she gets her chores done on time.

     She really wanted applesauce, but we didn't have any, so I smooshed up three apples, tossed in a little Martinelli's and cooked them down to a soft sauce, which she did like.  So yesterday's tally, food wise was: half a bagel, two scrambled eggs with cheese, and the applesauce.  Oh, and for dessert, she had the top half of one of Renée's birthday cupcakes...the side with the frosting on it, of course...eaten just the way she likes to eat maple bars.  By the way, Happy Birthday to Renée!  She is...?? years old today (being a gentleman, I won't say her age...but I can tell you that I became a dad in 1988).  

     Speaking of my cooking, I had a real bang up day yesterday.  In addition to making the aforementioned "inedible" Caesar salad, I made some kettle corn (did this after Daniel came home and saw that the package we bought at the Edmonds Sunday market had somehow dwindled to nil), which was a big success.  Also the applesauce.  However, my best culinary adventure was cooking some egg whites on the dash of my car.   It was a tad toasty yesterday, and I wanted to see if my car was as good as an oven.  Here are the before and after pictures, you decide:

Look mighty tasty, don't they?  And it only took an hour and a half to cook two of them.  Next up, chocolate chip cookies?  Oysters?  Salmon?  You may not want to ride with me in my car for a while.  Right now, it sort of smells like sulfur.

Hoping to update you once we get to Houston.

Chef Steve signing out.

7/14/18 Waiting game

Once again, Steve here as guest blogger.  Gabrielle keeps telling me she'll do a blog post, but then things get away from her.  Anyhow, thanks so much to all of you who have expressed concern, support, and so much more in this past week, as things have been tough.  We have been immensely cheered by flowers from my mom and Fran's chocolates from Renée and Riley (no, I didn't eat any, you two!), as well as lots of cards and calls, texts of support.  Karissa and John dropped by with some great BBQ for dinner one night.  So kind of them!  I suppose I am missing something...oh yeah: the bottles of Camden's ketchup from Portland courtesy of neighbors Laura and Jerry (not quite as good as his infused vodka, but then again, it's goes better on top of burgers).  Oh, and Mark and Tanya dropped by before their late night hockey game on Sunday, along with a special treat for me from the beverage section of Trader Joe's.  And thanks for the visits from Julianne and Marti as well.  Gabrielle was delighted to meet Amy and Matt's new baby, Edison or Emerson (forget which...my bad!).  Cute little nipper!  Holding a newborn is good for the soul!

So here's the update.  After a rough couple of nights in the hospital, she turned around pretty quickly, with sodium levels improving (though not quite normal) and fever resolving.  They found a tiny blood clot where the infected port had been so that means she is now on a blood thinner for six weeks.  Is also on two different antibiotics.  She was asking to leave about 30 minutes after surgery on Sunday, but we prevailed upon her to listen to the doctors so she stayed the night and then got discharged on Monday.  

On Tuesday, Dr. Goff made room for her in her busy schedule to see her, which was very nice of her and encouraged Gabrielle a great deal.  Got a better handle on pain control (a huge plus), plus got some valued input as to the next step.  As it looks now, she is a candidate for another trial at M.D. Anderson involving a class of drugs known as check point inhibitors.  We had hoped to get down there this week, but so far that isn't happening.  Maybe the following week.  Meanwhile, I called the research coordinator for the first trial and asked if she could check to see if she could be considered for that one again, since the infection is better and she is doing better.  She seemed interested and said she'd run it by the chief doctor of the study.  But so far no word.  Hopefully by Monday we'll have some news.

So, we're in a holding pattern.  Most likely we'll go back to Houston for one or the other study, but it's a bit of a race against the clock at this point.  After all, she hasn't been on any chemo since May 22, and the cancer is acting up worse than a bunch of junior high kids when the teacher leaves the room.  We just need to get something on board soon.  Conventional treatment here in Seattle is another option, though Dr. Goff said that at this stage, chances of knocking the cancer back are not as good as what may be offered with one of the trials in Houston.

So, we'll know more come Monday.  Till then, I will do my best to stay out of the special Fran's chocolates, try and get caught up on the convoluted plot of the Australian soap opera and try and keep my "chinz up" per Cuzz'n Rob's advice.  You do the same. 

So as the Aussies are inclined to say: G'day, mate!  Let's sure hope we have some "g'days" ahead!

7/8/18 A little bump in the road upon returning to Seattle

Hi, friends, family.  Here's a quick update as to what's going on.  

Gabrielle and Daniel got home from Houston yesterday afternoon after a difficult few days in Houston (see Daniel's great entry for more details).  Once she got home, she had very little energy and took a long nap in the basement (after having her mandatory visit to the bunnies, one of whom she dearly missed).  We started watching TV, but as I held her hand, it felt like she was burning up, so I took her temperature and it was 102.3.  She was also a little on the spacey side, just staring off in the distance with a glazed look in her eyes, and not even having any interest in the boring Australian soap opera we were watching.  It was almost as if she had had several shots of neighbor Jerry's special raspberry infused vodka...and she doesn't drink.  So Daniel and I took her off to Northwest Hospital ER where we got checked in right away.  Triage nurse didn't even make her go back to the waiting room; they ushered her right into a room because she looked so sick.  It was either that or she didn't want to make the rest of the folks in the waiting room jealous because of Gabrielle's penguin and snowflake jammies she was wearing.  

Had labs and chest X-ray.  No pneumonia, but she had quite an infection with the access port for chemo therapy being the likely culprit.  She got started on two different high power IV antibiotics (Zosyn and Vancomycin).  Sodium was also quite low which is not as simple a matter to correct as you might think.  You don't just eat a mess of French fries and fix things.  She ended up getting admitted, so that's where we are right now: in the hospital.  

I am writing this from the waiting area of the fourth floor where she is staying while she and Daniel have a second crack at that dippy soap opera I alluded to earlier (A Place to Call Home, in case you are curious.  My advice: go straight to a Dr. Blake mystery, if you like Australian shows, but this isn't a Siskel and Ebert movie column, so I better get back on track).  

Overnight, Renée stayed with her while Daniel and I went home to rest, but we came back this morning and have already met with a whole bunch of doctors: infectious disease, hospitalist, two surgeons, and an oncologist and anesthesiologist are on the slate for later today.  She is going to get the infected port taken probably around mid-afternoon today, though we are not sure exactly when.  

Her sodium is doing a little better.  Happily, she is clearing up from a mental status point of view.  Last night she had trouble even remembering what day it was, though she did get it right after some serious head scratching.  It would have been an ideal time to challenge her to a "friendly" game of Scrabble, but I lost my window of opportunity (as you may guess, "friendly" is in quotation marks because she has a "take no prisoners" approach to any game she plays).  She is much better today, though still very weak.  They won't let her eat till after the surgery, but she isn't very hungry anyhow.  Pain is still an issue but they are working on that as well.

We have had excellent care here at NW Hospital.  Everyone from the custodians to the nurses and doctors have all been nice to us.  We are not sure how long she will need to be here, but it will for sure be at least till tomorrow.  She really wants to get out of here and back home so that she can meet with Dr. Goff, her oncologist at the UW, on Tuesday.  We are not sure of the long-term plan at this point.  Clinical trials in Houston are off the table for now, but she may be able to revisit them once she is healthier.

Wish I had better news to report, but that's the way things go.  Ups and downs.  As Cousin Rob likes to encourage me: Chinz Up.  That's the way he spells things.  I don't know how he managed to get through law school with such louzy speling ennyhow.

Signing off for now.  As soon as the pre-surgery anesthesia gets on board, I think I will have another crack at challenging her to Scrabble!