Hello dear ones,
As I write this, on a foggy and chilly Portland Saturday morning, I'm savoring my cup of morning coffee and blowing my overlong hair out of my eyes. What makes me mention these things, you might wonder? Well, if you know me, you also know my mind doesn't always follow the most linear route, but there is a point to my ramblings :) In this case, I'm glad that my coffee tastes good to me this morning and I may actually have to get a hair cut after all.
Another week of treatments and, for the most part, I still feel really good with no significant side effects. This week I did find my food tastes changing and things that appealed before, no longer sound good. Coffee has been one of those "on again/off again" things. One morning it smells great and tastes good, but the next day it has no appeal. No surprise as this is one of the side effects of treatment and an area that can be a concern, because that's when people will stop eating and lose too much weight. For all the things that don't sound good, there are still lots that do and my weight hasn't fluctuated enough to raise any alarms.
As for the haircut, I canceled my scheduled appointment two weeks ago because I figured it would have started to fall out by now and why pay good money only to have it end up on the bathroom floor, right? Well, my curly mop is still firmly attached to my head and is long enough I feel somewhat akin to a dandelion so am considering a haircut after all. Dr. Karamlou and all the nurses have said that many don't lose their hair in the first round of Cisplatin, but do in the second round. I start chemo again on February 13th (Cisplatin and Etoposide). So now you understand the comment about the overlong hair :)
Had my weekly blood work on Thursday and Dr. Karamlou was very ok with the results - my blood counts are low. I was surprised that this is actually good news because I'd previously understood that to mean it could defer treatment or put me in isolation, but he explained the count isn't too low (though that can happen). Instead, it is an indication that the chemo is working in/on my body. He said that my numbers are just where they should be for this stage of treatment. I learn something new every day. He also told me to enjoy feeling good as I'm going to start feeling lousy in about two weeks and it won't be much better after that, and the last two weeks of this protocol are going to be really rough (his words). Doesn't sound like much fun, but I was reminded again of one of my favorite verses, Phil. 4:13 - " I can do anything through Him who gives me strength". I'm ready to climb this chemo-rads mountain if it's what's needed to heal me.
I had the opportunity to go to another mountain, Mt. Hood, yesterday and (with Dr. Karamlou's ok) spent the day there with a dear friend. It was probably one of the most beautiful winter days I've ever had on the mountain - crystal clear blue skies, very light wind and warm enough I didn't need many layers. It was so clear we could see Mt. Jefferson, 3 Fingered Jack and Mt. Bachelor etched in the horizon. Truly a gorgeous day. It was difficult to breathe after any exertion so I had to move quite slowly and that was a painful (emotionally, not literally) reminder of the cancer in my lung, but I didn't let it get in the way of enjoying a wonderful day on the mountain. It put a healthy pink in my cheeks and a huge smile on my face and I loved the day for the gift it was.
Another gift this week was time with my students.....I was able to go to the 6th grade band concert on Tuesday night and it was wonderful to see them perform. They sounded great! I went to Fowler on Thursday to meet with my teaching team and help plan a social studies unit for February with my sub, Linda, and saw all the kids then. Truly, they are the absolutely best medicine for me and I loved being there. Dr. Karamlou gave me the ok to work a few half days if I feel up to it and I'm considering that for a few mornings next week. As he told me, do it now while I feel good. I've put this to the Lord for direction so we'll see.
Friends and family continue to shower me with love, comfort, prayers, support and encouragement and I am blessed beyond comprehension. I am more deeply touched and encouraged than I can adequately express. For me, a person who is rarely at a loss for words, that says a lot. "Thank you" just doesn't seem to cover it.
Love and hugs to all of you,
Susan
Saturday, January 31, 2009
Sunday, January 25, 2009
First eight day cycle complete. All blessings so far!
Hi everyone,
Sue has an update through today that is very upbeat (no surprises). I would like to let you know that we plan to start a "Sunday with Susan" where friends and family can send me an e-mail about how Sue inspires you, or how her experience has changed the way you view certain things or just a simple personal note to Sue you would like her to see on the blog. Please e-mail me anytime knowing that it will be published on the first Sunday following your e-mail. This will allow Sue to read, see and feel the support scripted from her friends and family.
My e-mail address: mmccormick@peets.com
Sue's update:
It is with a deeply grateful heart that I can say, after a full week of chemo and radiation, that I still feel good. No significant weight loss, all blood count and enzyme reports are in the normal range, my hair is still firmly attached to my head and no nausea or other complications. Praises all!
The first eight day cycle of chemo is done now and I don't begin (chemo) again for another 20 days. Time for the Cisplatin and Etoposide to do their work, melting away the tumors! Radiation is daily, M-Fr., for the entire 56 day cycle so I'll start again tomorrow. It's funny how quickly things can become a routine. Just two weeks ago, all of this chemo-radiation stuff was planned but hadn't begun yet and was a little overwhelming, just from an unknown entity standpoint. Now, the places I go and people there are familiar and part of my daily fabric. Friends have come to sit with me while I'm getting the chemo infusions and I've really enjoyed the time with them. There has also been time to sit and reflect upon the day and the blessings God continues to give me and I love that time alone with Him too.
My best "medicine" this week was attending the all school musical on Thursday evening. Dr. Karamlou gave me permission to go as my blood count was just fine and I was so excited to see the kiddos in their play "Seussical". Many of the kiddos I've taught over the last three years were in the production and it was just so darn fun to see them perform. The hugs and greetings afterwards truly were medicine for my soul - I'm glad to be home to have time to heal, but sure am looking forward to being back to work as soon as reasonably possible.
Snowed again last night and it's melted now, but sure is cold out there tonight. I know my friends and family in the midwest and east coast are rolling their eyes at "cold" here in Portland, but....brrrrrr! I'm ready for a heatwave - maybe we'll actually get up to 50 degrees this week. :-) Spring is coming soon though, no matter the weather. Pitchers and catchers report for early camp in spring training in just a short time and before I know it, there will be preseason games to listen to. Yes!! Randy Johnson signing with the Giants for a year....could be an interesting development. Feel free to weigh in with your opinion on that one. Like I said, it's my year for the Giants to take home a World Series ring (sorry, Barbara, the Royals will have to wait until next year :-)
Take a moment for yourself and savor the blessings of your days. Whether it's family, friends, sunshine, snow, baseball, chocolate, a hike outdoors or a good book indoors, there are so many things that add such sweetness to our days. I'm grateful to enjoy each and every one, and am thankful too for the blessing each of you are to me.
Susan
Sue has an update through today that is very upbeat (no surprises). I would like to let you know that we plan to start a "Sunday with Susan" where friends and family can send me an e-mail about how Sue inspires you, or how her experience has changed the way you view certain things or just a simple personal note to Sue you would like her to see on the blog. Please e-mail me anytime knowing that it will be published on the first Sunday following your e-mail. This will allow Sue to read, see and feel the support scripted from her friends and family.
My e-mail address: mmccormick@peets.com
Sue's update:
It is with a deeply grateful heart that I can say, after a full week of chemo and radiation, that I still feel good. No significant weight loss, all blood count and enzyme reports are in the normal range, my hair is still firmly attached to my head and no nausea or other complications. Praises all!
The first eight day cycle of chemo is done now and I don't begin (chemo) again for another 20 days. Time for the Cisplatin and Etoposide to do their work, melting away the tumors! Radiation is daily, M-Fr., for the entire 56 day cycle so I'll start again tomorrow. It's funny how quickly things can become a routine. Just two weeks ago, all of this chemo-radiation stuff was planned but hadn't begun yet and was a little overwhelming, just from an unknown entity standpoint. Now, the places I go and people there are familiar and part of my daily fabric. Friends have come to sit with me while I'm getting the chemo infusions and I've really enjoyed the time with them. There has also been time to sit and reflect upon the day and the blessings God continues to give me and I love that time alone with Him too.
My best "medicine" this week was attending the all school musical on Thursday evening. Dr. Karamlou gave me permission to go as my blood count was just fine and I was so excited to see the kiddos in their play "Seussical". Many of the kiddos I've taught over the last three years were in the production and it was just so darn fun to see them perform. The hugs and greetings afterwards truly were medicine for my soul - I'm glad to be home to have time to heal, but sure am looking forward to being back to work as soon as reasonably possible.
Snowed again last night and it's melted now, but sure is cold out there tonight. I know my friends and family in the midwest and east coast are rolling their eyes at "cold" here in Portland, but....brrrrrr! I'm ready for a heatwave - maybe we'll actually get up to 50 degrees this week. :-) Spring is coming soon though, no matter the weather. Pitchers and catchers report for early camp in spring training in just a short time and before I know it, there will be preseason games to listen to. Yes!! Randy Johnson signing with the Giants for a year....could be an interesting development. Feel free to weigh in with your opinion on that one. Like I said, it's my year for the Giants to take home a World Series ring (sorry, Barbara, the Royals will have to wait until next year :-)
Take a moment for yourself and savor the blessings of your days. Whether it's family, friends, sunshine, snow, baseball, chocolate, a hike outdoors or a good book indoors, there are so many things that add such sweetness to our days. I'm grateful to enjoy each and every one, and am thankful too for the blessing each of you are to me.
Susan
Tuesday, January 20, 2009
Wearing the steel toed boots!
Hello dear ones,
Today was day 4 of chemo and day 1 of radiation and I'm still wearing the steel toed boots to kick a little cancer....well, you know my line on that :-) So far so good, with no side effects and I still have good energy. Today, Rena (one of my chemo nurses) told me I was the perkiest chemo patient she's ever had....I like that!
It's hard to believe that just a week ago I was in the classroom with the kids. I feel like I've entered a whole new world - one that is populated, thankfully, by wonderful caring nurses and good doctors and some darn incredible technology. I feel like I could be an extra on "E.R." with all the lingo I've learned recently. Dang, too bad George Clooney isn't still on the show, I'd sign up in a minute! Last Wednesday I had surgery to put in the chemo-port....I can't explain it too well, but it is a small mechanism that lies under the skin right below my left collar bone. If I press on the area, I can feel it there and now that the surgical site has healed, it's not painful anymore. Accessing it with the needle the first time last Friday was another "special moment" (can you say half gallon of Rocky Road ice cream as a reward? :) but it's ok now. This is where the IV line for the chemo is literally plugged into my chest - it goes to a line that feeds from the port to the vein by my heart that carries the chemo through the body to the tumors/lymph nodes. Truly amazing technology....it reminds me of the little transporter thingies the people on Star Trek had on their tunics -sort of a "Beam Me Up, Scotty" look to it. Since it connects at the chest, I'm hands free to read, correct student work, sleep, eat, watch dvds, chat with family or friends that come to hang out with me while I'm getting the chemo, get up and move around the center.....the IV bags are on poles with a wheel base so I am free to move about the country, as they say in one of those airline ads.
Friday was day one and it was a long one, primarily because there is so much prep work to be done before chemo begins the first time and I also met with Dr. Karamlou for a final rundown of how all this will work. Each chemo session begins with a vitals check - weight, blood pressure, temp., etc. There is a certain irony in checking weight to be sure I am not losing any. After years of going in the opposite direction (on the scale), it's a bit weird to be concerned about losing weight, but there are significant medical reasons to be concerned if that happens. No worries, folks - the scale is holding steady! Once a week there is a blood draw to check cell count.....this is what determines how my immune system is doing. If the white cell count drops too low and stays down, chemo might be deferred for a short while until the levels build back up and it would be during this time I can't be around people much...cooties, I guess. Fluctuations in blood count are quite common, I'm told, and rarely last, but if it becomes a problem, I have to isolate for awhile.
I got both barrels of the chemo agents on Friday, Cisplatin and Etoposide, which is what made it such a long day. Each bag takes an hour or so to empty and there is a bag of hydrating fluids given before and after each one of the chemo agents. Anti-nausea drugs are in with the hydrating fluids and seem to be doing the trick as I've had no upset stomach at all. Days 2-5 are just Etoposide and then no chemo for days 6-7. Cisplatin only on Day 8 (Friday). Then we wait 20 days and start the chemo protocol all over again.
Radiation began today and I will have that every day, M-F, for the whole 56 day process. Again, another odd process for someone who has had no prior experience in any of this. I lie on a bed in an isolated room and am positioned so that the radiation beams can line up with the three tattoo dots put on my chest last week. One at the base of the throat and two more midline down the chest area. The machine lines up with the scans the radiation techs view from behind protected glass and when the cross hairs are in place, they zap. The whole procedure doesn't take too long and is not at all painful though continued exposure to the radiation is likely to give me a very sore throat for awhile. The tumor sits adjacent to the esophagus and trachea at the base of my throat so to thoroughly fry the thing, it also means radiation at or on the esophagus. Not ideal, but not too many other options if we want to get to the critical area of mass. Might be drinking lots of smoothies or pureeing my hamburgers for awhile in the near future :-)
This is now my world for the next weeks....the total time, assuming no significant delays for low white cell count, is 56 days and I should finish up around my birthday. About a week to 10 days after the last treatments, scans will be done to measure progress. Obviously, the birthday present I want this year is significantly reduced (or thoroughly evaporated) tumors and lymph nodes! The pancreas cancer is still a big issue and must be addressed as soon as reasonably possible after this treatment. Though Cisplatin is not a pancreatic cancer specific chemo agent, it will go to the nodule and have some effect on that too. Ideally, it would best to treat both cancers at the same time, but the effect on my body of the two chemo agents that would treat lung and pancreas or radiation on both sites would be so hard on my body, it is possible treatment would have to stop midway and then nothing could be done for either. Not a risk worth taking.
This has been an amazing, bizarre, sometimes surreal and emotionally challenging journey and not without it's tears and apprehensions. Truly, there are probably 10,000 others things I'd rather be doing than all this cancer stuff, but I trust God and His plan for me and I know we are on this journey for a reason. The daily blessings are many and I savor every one of them. If you've been following Portland weather, it has been a season of extremes this winter and we've had record snowfall in December, the absolute deluge of rainfall and now record breaking high winds (for days in succession). The days are crystal clear blue skies and sunny (love it!), but very, very cold. I'm delighted that Corbett and I have taken good, long walks every day in the sunshine and enjoyed every minute of it. I celebrated the first day of chemo by going to the movies with mom and friends on Friday night and am so grateful to feel good and have energy to do just the simple normal daily things. Today I enjoyed a hamburger and fries with my dear friend, Annie, and it was great! Enjoying them before I have to put it in a blender :-) My community of family, friends, church, neighbors and people I've never even met, but are praying for me through requests of others - I've received e-mails and cards from people that are offering to be prayer warriors in places I've yet to visit....it's such a gift I've been given and I don't take a bit of it for granted. God continues to bless me beyond all understanding!
I told my kiddos when I left Fowler last week that I plan to be back to school with them after spring break at the end of March and I have every intention of getting through this rough road ahead and making good on that promise, blue Marge Simpson beehive wig and all! Call me, write me, come visit me, hang out with me while I'm having chemo - it's all good.
Love and hugs to all of you, I know you are wearing those steel toed boots and kicking a little cancer butt.....right along with me!
Susan
Today was day 4 of chemo and day 1 of radiation and I'm still wearing the steel toed boots to kick a little cancer....well, you know my line on that :-) So far so good, with no side effects and I still have good energy. Today, Rena (one of my chemo nurses) told me I was the perkiest chemo patient she's ever had....I like that!
It's hard to believe that just a week ago I was in the classroom with the kids. I feel like I've entered a whole new world - one that is populated, thankfully, by wonderful caring nurses and good doctors and some darn incredible technology. I feel like I could be an extra on "E.R." with all the lingo I've learned recently. Dang, too bad George Clooney isn't still on the show, I'd sign up in a minute! Last Wednesday I had surgery to put in the chemo-port....I can't explain it too well, but it is a small mechanism that lies under the skin right below my left collar bone. If I press on the area, I can feel it there and now that the surgical site has healed, it's not painful anymore. Accessing it with the needle the first time last Friday was another "special moment" (can you say half gallon of Rocky Road ice cream as a reward? :) but it's ok now. This is where the IV line for the chemo is literally plugged into my chest - it goes to a line that feeds from the port to the vein by my heart that carries the chemo through the body to the tumors/lymph nodes. Truly amazing technology....it reminds me of the little transporter thingies the people on Star Trek had on their tunics -sort of a "Beam Me Up, Scotty" look to it. Since it connects at the chest, I'm hands free to read, correct student work, sleep, eat, watch dvds, chat with family or friends that come to hang out with me while I'm getting the chemo, get up and move around the center.....the IV bags are on poles with a wheel base so I am free to move about the country, as they say in one of those airline ads.
Friday was day one and it was a long one, primarily because there is so much prep work to be done before chemo begins the first time and I also met with Dr. Karamlou for a final rundown of how all this will work. Each chemo session begins with a vitals check - weight, blood pressure, temp., etc. There is a certain irony in checking weight to be sure I am not losing any. After years of going in the opposite direction (on the scale), it's a bit weird to be concerned about losing weight, but there are significant medical reasons to be concerned if that happens. No worries, folks - the scale is holding steady! Once a week there is a blood draw to check cell count.....this is what determines how my immune system is doing. If the white cell count drops too low and stays down, chemo might be deferred for a short while until the levels build back up and it would be during this time I can't be around people much...cooties, I guess. Fluctuations in blood count are quite common, I'm told, and rarely last, but if it becomes a problem, I have to isolate for awhile.
I got both barrels of the chemo agents on Friday, Cisplatin and Etoposide, which is what made it such a long day. Each bag takes an hour or so to empty and there is a bag of hydrating fluids given before and after each one of the chemo agents. Anti-nausea drugs are in with the hydrating fluids and seem to be doing the trick as I've had no upset stomach at all. Days 2-5 are just Etoposide and then no chemo for days 6-7. Cisplatin only on Day 8 (Friday). Then we wait 20 days and start the chemo protocol all over again.
Radiation began today and I will have that every day, M-F, for the whole 56 day process. Again, another odd process for someone who has had no prior experience in any of this. I lie on a bed in an isolated room and am positioned so that the radiation beams can line up with the three tattoo dots put on my chest last week. One at the base of the throat and two more midline down the chest area. The machine lines up with the scans the radiation techs view from behind protected glass and when the cross hairs are in place, they zap. The whole procedure doesn't take too long and is not at all painful though continued exposure to the radiation is likely to give me a very sore throat for awhile. The tumor sits adjacent to the esophagus and trachea at the base of my throat so to thoroughly fry the thing, it also means radiation at or on the esophagus. Not ideal, but not too many other options if we want to get to the critical area of mass. Might be drinking lots of smoothies or pureeing my hamburgers for awhile in the near future :-)
This is now my world for the next weeks....the total time, assuming no significant delays for low white cell count, is 56 days and I should finish up around my birthday. About a week to 10 days after the last treatments, scans will be done to measure progress. Obviously, the birthday present I want this year is significantly reduced (or thoroughly evaporated) tumors and lymph nodes! The pancreas cancer is still a big issue and must be addressed as soon as reasonably possible after this treatment. Though Cisplatin is not a pancreatic cancer specific chemo agent, it will go to the nodule and have some effect on that too. Ideally, it would best to treat both cancers at the same time, but the effect on my body of the two chemo agents that would treat lung and pancreas or radiation on both sites would be so hard on my body, it is possible treatment would have to stop midway and then nothing could be done for either. Not a risk worth taking.
This has been an amazing, bizarre, sometimes surreal and emotionally challenging journey and not without it's tears and apprehensions. Truly, there are probably 10,000 others things I'd rather be doing than all this cancer stuff, but I trust God and His plan for me and I know we are on this journey for a reason. The daily blessings are many and I savor every one of them. If you've been following Portland weather, it has been a season of extremes this winter and we've had record snowfall in December, the absolute deluge of rainfall and now record breaking high winds (for days in succession). The days are crystal clear blue skies and sunny (love it!), but very, very cold. I'm delighted that Corbett and I have taken good, long walks every day in the sunshine and enjoyed every minute of it. I celebrated the first day of chemo by going to the movies with mom and friends on Friday night and am so grateful to feel good and have energy to do just the simple normal daily things. Today I enjoyed a hamburger and fries with my dear friend, Annie, and it was great! Enjoying them before I have to put it in a blender :-) My community of family, friends, church, neighbors and people I've never even met, but are praying for me through requests of others - I've received e-mails and cards from people that are offering to be prayer warriors in places I've yet to visit....it's such a gift I've been given and I don't take a bit of it for granted. God continues to bless me beyond all understanding!
I told my kiddos when I left Fowler last week that I plan to be back to school with them after spring break at the end of March and I have every intention of getting through this rough road ahead and making good on that promise, blue Marge Simpson beehive wig and all! Call me, write me, come visit me, hang out with me while I'm having chemo - it's all good.
Love and hugs to all of you, I know you are wearing those steel toed boots and kicking a little cancer butt.....right along with me!
Susan
Saturday, January 17, 2009
First two days of chemo went well.
Sue had her first dose of chemo the past two days and everything went as planned. I spoke with her today and she was as upbeat as ever and you wouldn't know she had almost 6 hrs of chemo in the past 48 hrs. There will be a detailed note tomorrow or Monday (directly from Sue), but continue to keep her in your prayers as she starts radiation along with chemo Monday.
Thank you again for all your support.
In Him Always,
Matt
Thank you again for all your support.
In Him Always,
Matt
Saturday, January 10, 2009
The Battle Begins!
Hello dear ones,
Wow, this week flew by! It ended on a really great note - we took the kiddos on a field trip today to see the film "City of Ember". It's based on a book we read as a class novel and it was a fun day. Popcorn, pizza, 317 6th graders on buses....you can imagine :-) I'm really going to miss them.
Met with Dr. Karamlou yesterday and the dates are set to begin chemo and radiation. I start the chemotherapy on Friday, January 16th and radiation on Monday, the 19th. They're hitting me with both barrels as the top priority is to shrink and fry the tumor and lymph nodes in the lung and chest. I'll be on a combination of Cisplatin and Etoposide with a side order of radiation. After the chemo cocktail/radiation does it's job, then surgery to remove the (significantly reduced in size) tumor in the lung and pancreas can be considered. The chemo is a 56 day protocol and given via IV - I don't have chemo every day, there is a specific calendar for the different treatments. Radiation, however; is every day.
Next week (on Monday) I meet the radiation doctor (Dr. Kee) and the preliminary scans, etc. are done to identify the exact spots where they'll radiate. I don't know exactly how the process works, but sure will after Monday. Dr. Morris will do the surgery to put in the chemo port (under the skin near my collarbone) on Weds. morning - this way they won't have to try to find a vein every time I have chemo. Between the chemo port and radiation tattoo spots, low necked shirts and dresses are out for awhile, but at least it's winter and cold so not a worry :-)
My concern in focusing on the lung and lymph nodes, though I clearly understand why it is so critical to attack them first, was nothing being done for the pancreas. Dr. Karamlou said the Cisplatin will attack the cancer in the pancreas as well and that made me feel a little better.
My last day of teaching is Thursday, January 15th. There's no way to know how I'll react to the chemo and radiation and Dr. Karamlou didn't sugar coat anything when discussing the possible side effects. None of them sound at all fun. Although I intend to feel just fine with few side effects, it's best to give myself time to rest and heal and be well. I'm really going to miss the kids and my goal is to be back after spring break at the end of March. Not much to be done about the hair though - I think it's pretty much a given that's going to go. Somewhere in the 2-3 week range after treatment begins is what I'm told. The Marge Simpson blue beehive is definitely one of the wigs of choice - the rest of the headgear will likely be my SF Giants ballcaps and scarves.
How will we know if the chemo-rads are working? At the end of whole treatment, CT scans are done to measure the tumor(s). Blood tests are done weekly to be sure the white blood cell count doesn't get too low. It's all about numbers and measurements now. I knew I should have paid more attention in math class :) One piece of good news - I gained 2 lbs. this week. How is that good, you ask? One sign of advanced cancer is a rapid and unintentional weight loss, especially with pancreatic cancer. Not only am I still feeling good, I can gain weight and that is a good thing. Always a blessing somewhere, right?
The bumpy road begins......I can't say I'm looking forward to this part of the journey, but I am looking forward to coming through it as a cancer survivor. I still feel, and have always felt, I am in the center of God's palm and He is with me every step of the way. I am thankful for the peace He gives me and the many, many blessings I receive every day. The Lord is my light and salvation, whom shall I fear? (Psalms 27:1) He is the God of hope and each day is a good one.
Have a great weekend, I plan to!
Love and hugs,
Susan/Sis
Wow, this week flew by! It ended on a really great note - we took the kiddos on a field trip today to see the film "City of Ember". It's based on a book we read as a class novel and it was a fun day. Popcorn, pizza, 317 6th graders on buses....you can imagine :-) I'm really going to miss them.
Met with Dr. Karamlou yesterday and the dates are set to begin chemo and radiation. I start the chemotherapy on Friday, January 16th and radiation on Monday, the 19th. They're hitting me with both barrels as the top priority is to shrink and fry the tumor and lymph nodes in the lung and chest. I'll be on a combination of Cisplatin and Etoposide with a side order of radiation. After the chemo cocktail/radiation does it's job, then surgery to remove the (significantly reduced in size) tumor in the lung and pancreas can be considered. The chemo is a 56 day protocol and given via IV - I don't have chemo every day, there is a specific calendar for the different treatments. Radiation, however; is every day.
Next week (on Monday) I meet the radiation doctor (Dr. Kee) and the preliminary scans, etc. are done to identify the exact spots where they'll radiate. I don't know exactly how the process works, but sure will after Monday. Dr. Morris will do the surgery to put in the chemo port (under the skin near my collarbone) on Weds. morning - this way they won't have to try to find a vein every time I have chemo. Between the chemo port and radiation tattoo spots, low necked shirts and dresses are out for awhile, but at least it's winter and cold so not a worry :-)
My concern in focusing on the lung and lymph nodes, though I clearly understand why it is so critical to attack them first, was nothing being done for the pancreas. Dr. Karamlou said the Cisplatin will attack the cancer in the pancreas as well and that made me feel a little better.
My last day of teaching is Thursday, January 15th. There's no way to know how I'll react to the chemo and radiation and Dr. Karamlou didn't sugar coat anything when discussing the possible side effects. None of them sound at all fun. Although I intend to feel just fine with few side effects, it's best to give myself time to rest and heal and be well. I'm really going to miss the kids and my goal is to be back after spring break at the end of March. Not much to be done about the hair though - I think it's pretty much a given that's going to go. Somewhere in the 2-3 week range after treatment begins is what I'm told. The Marge Simpson blue beehive is definitely one of the wigs of choice - the rest of the headgear will likely be my SF Giants ballcaps and scarves.
How will we know if the chemo-rads are working? At the end of whole treatment, CT scans are done to measure the tumor(s). Blood tests are done weekly to be sure the white blood cell count doesn't get too low. It's all about numbers and measurements now. I knew I should have paid more attention in math class :) One piece of good news - I gained 2 lbs. this week. How is that good, you ask? One sign of advanced cancer is a rapid and unintentional weight loss, especially with pancreatic cancer. Not only am I still feeling good, I can gain weight and that is a good thing. Always a blessing somewhere, right?
The bumpy road begins......I can't say I'm looking forward to this part of the journey, but I am looking forward to coming through it as a cancer survivor. I still feel, and have always felt, I am in the center of God's palm and He is with me every step of the way. I am thankful for the peace He gives me and the many, many blessings I receive every day. The Lord is my light and salvation, whom shall I fear? (Psalms 27:1) He is the God of hope and each day is a good one.
Have a great weekend, I plan to!
Love and hugs,
Susan/Sis
Tuesday, January 6, 2009
Update from the oncologist: Surgery is off the table for now.
Hola mi familia & friends,
Today was the first day back to school after the three week snow/Christmas break - it was great to see the kids again and hear the stories of their snow adventures, but all of us are out of the classroom routines and needed a little "school WD-40" to smooth out the kinks. That alarm sure did go off awfully early this morning!
I met with Dr. Kate Morris this afternoon - she is an oncology surgeon and the appt. was to determine whether or not the pancreatic nodule could be removed before chemo-rads begin (my new word for the day, this is how the doctors refer to chemotherapy and radiation). Another really delightful doctor and I know I will work well with her as we continue on this cancer journey. Anyone who has a large stuffed hippo in one of her office chairs and a great story to go with it.....we'll get along fine!
The upshot, after lengthy conversation and reviewing the MRI that shows where the pancreatic nodule is in relation to other organs, blood vessels, etc. is we are not going ahead with the surgery at this time. As was explained to me before, if the nodule can be resected with minimal complications and a quick healing time, it would the optimum thing to do. Dr. Morris explained why they (she and Drs. Tsen and Karamlou) are not convinced this is the best option. The nodule sits at the tail of the pancreas (that is good) but is right next to a major blood vessel connected to the spleen. Ideally, the nodule can be removed with no impact to the blood vessel (about the thickness of a thumb - it's a big one), but this is an unknown until she is actually in there. If it turns out the blood vessel is impacted by the nodule, she would have to remove the spleen and it would not be a quick recovery at all. Also, if there are any leaks in the pancreas (digestive juices going places they shouldn't in the intestine) after the surgery, that could also be a major problem. Evidently, the tissue in the pancreas is the consistency of wet Kleenex and not easy to work with. I asked about Cyberknife and she is very familiar with it, but says in this case, it would make surgery at a future date very risky. One of the times it would hurt more than heal.
To use her words, taking the nodule out right now is a gamble. If all goes well and I heal quickly, the gamble paid off. If it doesn't and I don't heal quickly, the gamble would mean no chemo-rads. for a long while and that, truthfully, could take away any chance to heal me. Very hard words to hear, but not a surprise. I knew this going into the appt. today and it is the reality of where we are on this cancer path.
She met this morning with Drs. Karamlou and Tsen and they are evaluating many options to come up with the best overall plan. As I've heard from just about every doctor in Portland and SF, my case is not typical at all and there isn't a large data pool to draw from in terms of prior treatments. Not that my situation hasn't happened before, just not a lot of data to compare. There is a "circling of the wagons" with all the experts right now - the Legacy group here in Portland, the UCSF group and Dr. Brett Sheppard at OHSU. Turns out Dr. Morris knows him (Dr. Sheppard) well and plans to contact him tomorrow for his input. Also, the pathology stains have been sent to UCSF for a second review by their pathologists, just to be absolutely certain that everyone agrees on the final diagnosis of the two cancers. The lung stain was sent last week and the pancreatic stain was sent FedEx today.
The remainder of the appt. was spent talking about chemo-rads., what types will likely be used and how they will be administered. I have choices about the different types of ports/pic lines that can be put in either my arm or under the skin by my collar bone - pros and cons to both, but it's up to me. The purpose is to have an insertion point for the IV (for the chemo) so they don't have to put a new needle in me every day (works for me!). The chemo agents are the same as the ones Dr. Dubay talked about in SF (remember the light reading material I was given about the different drugs?) and Dr. Karamlou will confirm all this when I see him on Thursday. He is also researching any clinical trials that would be beneficial for treatment. Also, I will meet the radiation doctors too - a few new folks to add to my "A" team. Unless there is a significant change of opinion, I expect to start chemo either this Friday or early next week.
The goal now is to shrink/eliminate the tumors with chemo and radiation. Surgery is not completely out of the picture, but it will be at a much later date, if at all. I'm still feeling good and that's such a blessing. Dr. Morris checked my lungs and abdomen and, just like Dr. Dubay, didn't hear or feel anything wrong. Both have commented about how unusual it is to have absolutely no symptoms, given the size of the tumor - quite an anomaly, I'm told. I just smile and tell them God has His hedge of protection on me and I'm grateful for His mercies.
Lots ot digest, I know, but we are moving fast now. As I was told before, once all the information was in and evaluated, things would move quickly and they are. I know I'm ready to kick some cancer butt! :) Have to get all this cancer stuff healed so I am ready for my summer trip to Ashland for the Shakespeare Festival, Charlotte N.C. in November for my gal pal trip and baseball (pitchers and catchers report to spring training in just a few short weeks - yes!). This is the year my Giants go to the World Series, I just know it!
As I start this next step, the chemo and radiation, I am reminded of one of my favorite passages, Philippians 4:13 which reads "I can do everything through Him who gives me strength". These are words that give me great comfort and I hope they do for you too.
Love you all much, will talk to you soon, hugs all around,
Susan/Sis
Today was the first day back to school after the three week snow/Christmas break - it was great to see the kids again and hear the stories of their snow adventures, but all of us are out of the classroom routines and needed a little "school WD-40" to smooth out the kinks. That alarm sure did go off awfully early this morning!
I met with Dr. Kate Morris this afternoon - she is an oncology surgeon and the appt. was to determine whether or not the pancreatic nodule could be removed before chemo-rads begin (my new word for the day, this is how the doctors refer to chemotherapy and radiation). Another really delightful doctor and I know I will work well with her as we continue on this cancer journey. Anyone who has a large stuffed hippo in one of her office chairs and a great story to go with it.....we'll get along fine!
The upshot, after lengthy conversation and reviewing the MRI that shows where the pancreatic nodule is in relation to other organs, blood vessels, etc. is we are not going ahead with the surgery at this time. As was explained to me before, if the nodule can be resected with minimal complications and a quick healing time, it would the optimum thing to do. Dr. Morris explained why they (she and Drs. Tsen and Karamlou) are not convinced this is the best option. The nodule sits at the tail of the pancreas (that is good) but is right next to a major blood vessel connected to the spleen. Ideally, the nodule can be removed with no impact to the blood vessel (about the thickness of a thumb - it's a big one), but this is an unknown until she is actually in there. If it turns out the blood vessel is impacted by the nodule, she would have to remove the spleen and it would not be a quick recovery at all. Also, if there are any leaks in the pancreas (digestive juices going places they shouldn't in the intestine) after the surgery, that could also be a major problem. Evidently, the tissue in the pancreas is the consistency of wet Kleenex and not easy to work with. I asked about Cyberknife and she is very familiar with it, but says in this case, it would make surgery at a future date very risky. One of the times it would hurt more than heal.
To use her words, taking the nodule out right now is a gamble. If all goes well and I heal quickly, the gamble paid off. If it doesn't and I don't heal quickly, the gamble would mean no chemo-rads. for a long while and that, truthfully, could take away any chance to heal me. Very hard words to hear, but not a surprise. I knew this going into the appt. today and it is the reality of where we are on this cancer path.
She met this morning with Drs. Karamlou and Tsen and they are evaluating many options to come up with the best overall plan. As I've heard from just about every doctor in Portland and SF, my case is not typical at all and there isn't a large data pool to draw from in terms of prior treatments. Not that my situation hasn't happened before, just not a lot of data to compare. There is a "circling of the wagons" with all the experts right now - the Legacy group here in Portland, the UCSF group and Dr. Brett Sheppard at OHSU. Turns out Dr. Morris knows him (Dr. Sheppard) well and plans to contact him tomorrow for his input. Also, the pathology stains have been sent to UCSF for a second review by their pathologists, just to be absolutely certain that everyone agrees on the final diagnosis of the two cancers. The lung stain was sent last week and the pancreatic stain was sent FedEx today.
The remainder of the appt. was spent talking about chemo-rads., what types will likely be used and how they will be administered. I have choices about the different types of ports/pic lines that can be put in either my arm or under the skin by my collar bone - pros and cons to both, but it's up to me. The purpose is to have an insertion point for the IV (for the chemo) so they don't have to put a new needle in me every day (works for me!). The chemo agents are the same as the ones Dr. Dubay talked about in SF (remember the light reading material I was given about the different drugs?) and Dr. Karamlou will confirm all this when I see him on Thursday. He is also researching any clinical trials that would be beneficial for treatment. Also, I will meet the radiation doctors too - a few new folks to add to my "A" team. Unless there is a significant change of opinion, I expect to start chemo either this Friday or early next week.
The goal now is to shrink/eliminate the tumors with chemo and radiation. Surgery is not completely out of the picture, but it will be at a much later date, if at all. I'm still feeling good and that's such a blessing. Dr. Morris checked my lungs and abdomen and, just like Dr. Dubay, didn't hear or feel anything wrong. Both have commented about how unusual it is to have absolutely no symptoms, given the size of the tumor - quite an anomaly, I'm told. I just smile and tell them God has His hedge of protection on me and I'm grateful for His mercies.
Lots ot digest, I know, but we are moving fast now. As I was told before, once all the information was in and evaluated, things would move quickly and they are. I know I'm ready to kick some cancer butt! :) Have to get all this cancer stuff healed so I am ready for my summer trip to Ashland for the Shakespeare Festival, Charlotte N.C. in November for my gal pal trip and baseball (pitchers and catchers report to spring training in just a few short weeks - yes!). This is the year my Giants go to the World Series, I just know it!
As I start this next step, the chemo and radiation, I am reminded of one of my favorite passages, Philippians 4:13 which reads "I can do everything through Him who gives me strength". These are words that give me great comfort and I hope they do for you too.
Love you all much, will talk to you soon, hugs all around,
Susan/Sis
Sunday, January 4, 2009
Looking forward to 2009!
A very Happy New Year to all of you!
Portland has gone from being the new North Pole to a deluge of rainfall...temps. have warmed up to a tropical 50 degrees, but it has rained nonstop for the last couple of days and now some of the smaller rivers are at flood stage. A major highway is closed in one section now because of mudslides. It's going to be quite the winter in the NW, I think :)
Talked to Dr. Karamlou yesterday and he has me scheduled to meet with a Dr. Morris on Monday (not sure what time yet, they are supposed to call me tomorrow). This doctor is a surgeon and the conversation is to determine whether or not the pancreatic nodule can be successfully removed with laparoscopy. If so, that happens first - if not, then we go straight to chemo/radiation. I have an appt. with him (Karamlou) on the 8th and I expect to know when everything will begin (either surgery or chemo) after meeting with him.
Also had more blood work and other tests done yesterday to monitor pancreatic function, should have the results early next week. I'm still feeling good, haven't had any significant symptoms and am grateful for the blessings of each day.
Tomorrow morning I'm taking my file and dvd of all scans, MRIs, PET scan, etc. up to OHSU for Dr. Brett Shepard (one of their leading pancreas doctors) to review. This is a HUGE gift....a friend of a friend is a nurse there and arranged for me to get a consult with him, free of charge. Not sure when I will meet with him as he wants to review all the information first, but it will likely be next week.
Re-scheduled the Stanford appt. (it was set for Jan. 6th) to the 27th. I didn't see the value in getting another oncology opinion and trying to coordinate a one day visit to Palo Alto since we don't have a set plan here yet, a lot will depend on Monday's meeting with Dr. Morris. Dr. Colevas (Stanford) is strictly a lung cancer doctor - this isn't a bad thing, but since I'm dealing with two different cancers, his assistant (Barbara) said he will want to know what the protocol for treatment of the pancreas is before I meet with him.
It's been a great few weeks off, all things considered, and I'm back to work on Monday. No doubt the kiddos (and teachers too!) are going to be very out of the school routine, but it will be good to see them and be back to work at least for awhile, depending on surgery and/or chemo.
Love and hugs to all of you, I'll keep you posted as more information comes my way.
Here's to a healthy, happy and fully healed 2009!
Love you,
Susan/Sis
Portland has gone from being the new North Pole to a deluge of rainfall...temps. have warmed up to a tropical 50 degrees, but it has rained nonstop for the last couple of days and now some of the smaller rivers are at flood stage. A major highway is closed in one section now because of mudslides. It's going to be quite the winter in the NW, I think :)
Talked to Dr. Karamlou yesterday and he has me scheduled to meet with a Dr. Morris on Monday (not sure what time yet, they are supposed to call me tomorrow). This doctor is a surgeon and the conversation is to determine whether or not the pancreatic nodule can be successfully removed with laparoscopy. If so, that happens first - if not, then we go straight to chemo/radiation. I have an appt. with him (Karamlou) on the 8th and I expect to know when everything will begin (either surgery or chemo) after meeting with him.
Also had more blood work and other tests done yesterday to monitor pancreatic function, should have the results early next week. I'm still feeling good, haven't had any significant symptoms and am grateful for the blessings of each day.
Tomorrow morning I'm taking my file and dvd of all scans, MRIs, PET scan, etc. up to OHSU for Dr. Brett Shepard (one of their leading pancreas doctors) to review. This is a HUGE gift....a friend of a friend is a nurse there and arranged for me to get a consult with him, free of charge. Not sure when I will meet with him as he wants to review all the information first, but it will likely be next week.
Re-scheduled the Stanford appt. (it was set for Jan. 6th) to the 27th. I didn't see the value in getting another oncology opinion and trying to coordinate a one day visit to Palo Alto since we don't have a set plan here yet, a lot will depend on Monday's meeting with Dr. Morris. Dr. Colevas (Stanford) is strictly a lung cancer doctor - this isn't a bad thing, but since I'm dealing with two different cancers, his assistant (Barbara) said he will want to know what the protocol for treatment of the pancreas is before I meet with him.
It's been a great few weeks off, all things considered, and I'm back to work on Monday. No doubt the kiddos (and teachers too!) are going to be very out of the school routine, but it will be good to see them and be back to work at least for awhile, depending on surgery and/or chemo.
Love and hugs to all of you, I'll keep you posted as more information comes my way.
Here's to a healthy, happy and fully healed 2009!
Love you,
Susan/Sis
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