7/27/18 Chemo day...a long one!

Today goes down on record as the looooooooongest chemo day ever!  Her appointment was at 11:30 and just went on and on, just finishing at 8:00 PM!  Can you believe it?

When we were sitting in the waiting area, she asked me if I brought the Scrabble along.  I told her I forgot.  Then she asked if I could download it onto my phone...apparently she was chomping at the bit to get back at me, having lost to me by 5 points last week.  

As for the chemo marathon, here's how it went: started out with a bag of IV fluids, which took two hours.  Afterwards, due to a low blood count, she got a unit of blood, then the chemo (Taxol) and some magnesium, followed by another unit of blood.  Each unit of blood needed to drip in for two and a half hours and the Taxol, about an hour.  Of course, there was "down time" in between that stuff dripping in: getting the IV placed in her arm, premedicating her for the chemo, checking vitals and then checking them again.

Through it all, she was a trooper and kept wondering when she could leave.  We kept telling her "in a little bit".  During this marathon session, she napped, dozed, snoozed and watched a little Frasier and the Great British Baking Show.  As for us, well, we took turns stepping out for a little fresh air, but for the most part stuck with her through it all.  She stayed cheerful throughout this marathon day and even took time to ask our nurse about her summer plans.  She's like that: always taking an interest in others.

As soon as she got home (8:40), she just rolled into bed, one very tired, chemo patient.  She is off in slumberland now with Renée watching from the chair next to the bed.  

Sadly, she has been pretty foggy throughout the latter half of the day.  We are hoping for a better day tomorrow.  We are all a little shell-shocked over the rapid change in her health, especially the weakness and confusion.  We had thought that it would be more gradual.  Less than a week ago (last Saturday, to be exact), she and I had a nice walk at Edmonds Marina Park (pix below), and the weekend before that, she and I splashed around in Lake Washington on an inner tube.  See how cheerful she looks!  I don't know why I look so serious on the inner tube, I was having a great day (I think I was busy saying, "don't take the picture till I'm done peeing").

                                                     
                                                     Beauty and the Beast (or Aquaman)

                                                   Edmonds Marina Park six days ago

                                  My one true love

7/25/18 Update after visit with oncologist (how's that for a creative title?)

Hi, folks.  Steve checking in.

Her visit with Dr. Goff went well this afternoon.  We discussed all the options, which mainly boiled down to two:  chemo or no chemo.  Houston is off the table as she is too ill for the trip and the rigors of the trial.  There are pros and cons to each option.  Chemo is very hard on her.  But it has the potential to help.  The "no chemo" approach would focus on keeping her comfortable and minimizing suffering.  After much discussion, she (we) opted to try a little more chemo with the full understanding that at this point, it is mainly to shrink the tumor size, not get her into remission.  A lot of the pain is coming from a swollen liver, and the hope is that if the tumors are even a little bit smaller, then the pain won't be as bad.

She is slated for another round of Taxol on Friday (two days hence, assuming I get my days correct...though one is never sure these days (have been up since 3:30)).  

Today, after her oncology visit, she got a liter of IV fluids as she really has not been drinking much.  She perked up quite a bit.  The current thinking is that the fogginess was a combination of dehydration and liver involvement which can cause confusion.

When we got home, we were treated to a wonderful cooler of goodies including dinner, yogurt and blueberries from Karissa and Jon.  Apparently some squirrel (or other varmint) thought so too as the top of the cooler was gnawed all to bits (see pix below).

She is much clearer today than yesterday, and I would be willing to bet that she has a better handle on what day it is than I do.  She even picked up her phone for the first time in three days to check her messages.  Go ahead and text or e-mail her if you like.  I am not sure if she will answer, but I'm fairly sure she'll read the message.

She chided me for trying to help her eat dinner, telling me in no uncertain terms that she could do it herself.  She also shouted directions to Daniel in the kitchen on how to tweak his homemade clam dip:  "how many cans of clams are in here?  You need more!  And a touch of onion powder.  And a little more cream cheese!"  It's good to have the old Gabrielle almost back.  

She is still quite weak and unsteady on her feet.  She doesn't like us "hovering over her", but is also very good natured about it and knows it's for her own good.  

Thanks for your prayers.  

And now the pix.  Here's what greeted us on our porch when we got home:

Hungry squirrel...either that or a woodpecker with a lot of fortitude.

And here's the payoff!  Granola, Greek salad, wonderful beef kabobs, pita bread.  Even whisky cherries (they must have a special tree!).  I wonder what exactly the squirrel was after.  I am hoping it wasn't the amazing kabobs as that would mean we've got carnivorous squirrels (or woodpeckers...oh my!) in the neighborhood.  And if that's the case, we've got bigger things to worry about than cancer.  Cue Hitchcock's The Birds!

7/25/18 Tuesday...I mean Wednesday!

Gabrielle remains about the same, though perhaps a tad more lucid.  She was asking for her glasses so she could read something, but quickly said "no" when I asked if said reading material could be a Scrabble game.  Likewise, when asking for the paper, she sneered when we offered up the sports section.  Ultimately, she sat back, very relaxed and smiled and listened attentively as I read the Bible to her: mostly selections from the Psalms which she had underlined (aside: there's some good stuff in there!).  

She actually had a decent breakfast: scrambled eggs, toast and raspberries!  Yummers!

She had a fever last night and drenched the sheets, making us wonder if some of this is due to an infection.  We had toyed with a return trip to the ER to get a second look.  However, we are going to stick with original plan and see her oncologist today at 1:00.  We are not sure what will happen at the appointment.  It's possible she'll be admitted for some IV fluids and antibiotics, if she does indeed have an infection.  Though that is mere conjecture on my part.

However, the big picture is such that she is no longer a candidate for the trials in Houston, and is most likely not going to be getting any more chemo.  Both because it hasn't been helping, and the toxicity from the chemo has been hitting her system pretty hard.  At one point recently she told one of the kids, "I'm done".  We all agreed that she has put up a great fight.  Now it's time to rest.  We can see the big picture.  But it's still not pleasant going into her bell lap which she wrote so eloquently about a few months ago.

Pastor Bryan (the same one who married Renée and Riley) will be coming by for a visit soon.  After that, it's off to the doctor.  

As always, thanks for all your support.  It has been a rough week.

Steve

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