Thursday, November 30, 2006

Much Better

Whatever Nurse Ruby did to/for Jim yesterday has worked quite a miracle. He is feeling much better. More pep, less discomfort. He even has a bit of a voice today. We went up to Sacramento to see his oncologist Dr. Grennan, a delightful chap. He is pleased with Jim's recovery progress except for the low blood count. Jim is still quite anemic, despite the Procrit injections. We see Grennan again next week to see if there is improvement over the next few days. The good news is, however, that kidney function is recovering nicely.

When we went up to Sac this morning there was a huge traffic snarl-up that resulted from an accident involving a UC Davis commuter bus that takes students and faculty from Davis to the UCD Medical Center. We got diverted onto another freeway and then had to figure out how to get to the hospital from a completely different orientation. This is where Jim began directing traffic and ordering lane changes, speed-ups, etc. At this point I knew he was on the mend. When we were coming back the traffic was still backed up for several miles.

Today has been a day with a ray of hope. Jim is still very tired but at least he is not in as much pain and discomfort. He still has a long way to go, but the immediate issue has been "relieved." Nurse Ruby deserves a big round of applause!

Wednesday, November 29, 2006

An Upturn!

Jim was very weak this morning; he could barely walk without leaning against the wall or hanging on to me. I called the doc and made an appointment for him to be seen in the afternoon. He still had had no action on the plumbing issue, so it was time for drastic measures. After two hours of treatment by a really fabulous nurse named Ruby he staggered out and we came home. He was told that if he couldn't continue with what Ruby had gotten started it would be the Emergency Room and sedation to take care of the problem. As soon as we arrived home he (water) closeted himself away to continue where he had left off at the clinic. I was going out for dinner with friends so left him to work. He assured me he was fine! When I got home at 9 PM he was resting but announced that he had had success and was feeling much better! If I am this relieved, think of how he feels!

I had a wonderful evening with friends. Good food, good talk, good company. A lift for my spirits.

Tuesday, November 28, 2006

Another Really Not-So-Good Day

Jim is weak, exhausted and in very bad shape. All of the attempts at a solution to the "no go" problem have failed. The doc called this afternoon to check on Jim's progress. No progress. So we will go back to the clinic tomorrow and they will do some sort of "intervention." Again, I did not ask. He sees his oncologist on Thursday so does lab work tomorrow. It's always something.

He slept most of the day today. This is the grand fatigue they talk about. He has finally succumbed to it, after a valiant struggle to deny it. I am relieved. This overwhelming fatigue is the body's way of taking time to heal. By 6 PM he was in for the night. Again this evening he said that he is clearing his throat and spitting less frequently. A good sign.

We have switched sleeping arrangements. He likes the guest bathroom better; it is smaller and warmer (and he's spending a great deal of time there!). So he has moved across the house and I have ensconced myself in the big bedroom in the big bed. Yippee! No more twin bed for me.

The gorgeous weather is holding. This morning the roof tops were frosted over. The grass was sparkling with frozen dew. It was brisk and bright for my morning walk. It's almost winter. And because Jim is so cold all the time we have burned almost all of our winter wood. I better call the local supplier and get in another cord! Usually a cord of wood lasts us about three years. This year? Three months.

Monday, November 27, 2006

A not-so-good day

One day at a time. Some days are better than others. A good day. A not-so-good day. These are the platitudes one is told when leaving treatment. Well, today was one of the not-so-good ones. Jim is very weak and listless, can't stay awake for more than about an hour, and is uncomfortable and in pain. I am not sure why but it is very worrisome. We went to see his doc this morning to get further treatment for the binding problem. He sent us over to the X-ray lab to get an abdominal picture, thinking there may be some sort of obstruction. I also noted that Jim looks a bit jaundiced. No obstruction but we don't have the blood results back. (Note: Modern medicine is quite amazing. By the time we left the X-ray, walked down the hall and got back into the doctor's office, the results of the X-ray were up on the computer screen. This was a lapse of about 15 minutes. There, in front of us, was a picture of Jim's guts, full to the brim!) He prescribed the medication that is used by patients undergoing a colonoscopy; polyethylene Glycol. Jim has dosed himself seven or eight times and, so far, no results. If there is no action by Wednesday we have to go back and they will do some sort of "procedure" in the office. I didn't ask.

This afternoon I went to the dentist for a cleaning. When I left home Jim was asleep. When I got back, he was asleep. He was up about half an hour, very weak and almost unable to walk, and is now back in bed. This behavior is something new. He has not been this weak before and I am afraid it has something to do with the gut issue. Morphine is a wonderful invention but is causes havoc everywhere it goes. It will be another watchful night for me.

On the bright side he did say today that he thinks he is clearing out his throat a bit less. If so, that means he will sleep for longer periods of time. Perhaps he will be less fatigued during the day with more sustained sleep.

Had we been able to go, we would have been in Cuidad Jiminez tonight at our favorite hotel, Las Palmas. Cd. Jiminez is the first stop after crossing into Mexico at El Paso. Let's plan for February.

Sunday, November 26, 2006

The rains have come

Every year when we pull away for the trip to Cuyutlán, the rain starts. This year we have not pulled away but the rains have started anyway. It will continue to be wet for a cojuple of days. Then the sunshine will return but it will still be cold. It was a wet and windy day here but warm and toasty by the fireside. On our morning walk we saw the last of the leaf holdouts floating down to the already piled lawns. Tomorrow is pick up day so I can only imagine that folks were out raking and sweeping to get the debris into the street for the scooper.

Jim had an OK day. He alternated between sleeping, watching football and various political talking heads, and clearing his throat. The edema has subsided. He said tonight that he thinks the gunk in his throat is beginning to subside a bit and he is not having to clear it out as often. That would be a real relief. However, when he sleeps he still sounds like a coffeemaker or a water pipe. He is not yet ready to try swallowing anything, not even water. Perhaps in a few days after the pain has subsided a bit more he'll make an attempt.

My cold is much better today. I am hoping that by tomorrow all symptoms will be gone. Jim sees the doc in the morning about his gut issues. Let's hope that gets resolved soon. I think that is adding greatly to his feelings of fatigue and general malaise. If he can get it all "working" again I know he will feel better and will rejoice at the corner he is about to turn!

Saturday, November 25, 2006

Yesterday and today

I spent all of Friday waiting for the hospital to call me back about an appointment for Jim. I phoned at 8:30 Friday morning to ask that he be seen about the extreme constipation he is suffering. This, of course, is the result of the morphine he is using and should be taken very, very seriously. I talked to a nurse who told me that if we don't hear back by noon, please call again. No call by noon, so I called back. Nothing. Meanwhile, I sat right be the phone, literally, all day. No going out, no shower, no moving too far away from the office phone. Jim dozed, shuffled around, dozed some more, wandered about outside, dozed. By 6 o'clock I realized the hospital was not going to call. First the neighbor in back brought a beautiful, fragrant Christmas wreath for the house, a welcome harbinger of the festivities to come. I will put it by the front door where I can see (and smell) it every day. Then another neighbor brought me some delicious lasagne for my dinner so I didn't have to cook. Always a treat. But by the time I was ready to get news out via the internet, Jim was browsing on the net so I didn't disturb him and went to bed.

Today, another bright and sunny autumn day, Jim was feeling pretty good. The morning pep is lasting a bit longer every day, a very good sign. He indicated he was feeling pretty good. At about 8:30 the hospital called back to say Jim could have an appointment with a doc at 1:40 this afternoon. But he had decided he wanted to see his own doctor, which he will do on Monday. At least his plea for help had not been completely overlooked!

I went out for a nice walk, first in two days, with Gina, the lasagne chef and two frisky dogs. Then I went up to the Farmers' Market to buy some apple juice and tomatoes for my week's salads. While there I ran into two friends, both of whom it is always a treat to see and talk with. We have much to catch up on and promised to do so soon. When I left the house Jim was asleep on the couch. When I got back two hours later he was out cleaning the gutters in preparation for forecasted rain. As long as he doesn't get up on the roof and fall asleep . . .

By 6:30 tonight he was exhausted, having perhaps done a bit too much. He is now asleep, and will stay that way for three or four hours. After that, he'll be up for a couple of hours, then back to bed. Every morning he feel a bit more peppy. It doesn't last too long, but a bit longer each day. This is the way the recovery goes.

Thursday, November 23, 2006

It was Delicious!

Aside from my nasty cold, this was a beautiful Thanksgiving Day. The weather here was beautiful; clear, sunny, crisp, bright. I didn't make it out for my walk; the cold has, as expected, taken over my life. I talked to Cait and Alex and my sister, all of whom were doing some sort of traditional celebration with friends and family. It made me think of Thanksgivings past when would pack up and drive to Santa Rosa for a couple of days to celebrate with old law school friends. We had dinner with the same group of friends for 33 years. The routine was always the same and the things each person brought as offering were the same; the Chaffees brought desserts and fruit breads for the next morning's breakfast. We would eat, play board games or do jigsaw puzzles, spend the night, have another feast in the morning, make turkey sandwiches, hug good-bye and look forward to the next year. The host couple are gone now and the group has fallen apart. I still miss it.

I cooked a yummy meal for myself. The shank was tender and succulent. The potatoes were creamy and sweet. The sprouts were crunchy and pungent. The salad was sweet and crisp with a bit of snap to the walnuts. The only culinary faux pas was, of course, the (gasp!) white wine with the lamb, but I am a Sauvignon Blanc kind of gal and I thought it was very complementary and delectable. No dessert. Perhaps a cookie before bed. I used my mother's wedding china as a treat. I inherited service for 12, including plates and bowls I don't even know a use for! The table was quite festive with the flowers from sisters-in-law and candles in little holders I bought in Mexico. True, it was "Table for One" but it was still very tasty.

Half and hour later, here's what was left.
And even though he could only sit by and watch, Jim did the dishes and cleaned up. I wish he could have rewarded himself with a big bite of something, but alas, not this year.

Jim had a bit of energy this morning, but it flagged by about 11 AM. He slept on the couch for about an hour but has been up watching football since. He is still showing signs of edema in his feet and legs, even though he is taking the diuretic. We'll live through the weekend and talk to the doc on Monday. It has been nine days since he finished treatment and he is impatient for concrete signs of improvement. They will come but not yet. Slowly.

I am hoping my cold will subside and I can get out and walk tomorrow morning. I don't know how long this glorious weather is going to last but I need to make the most of it.

Wednesday, November 22, 2006

For Your Thanksgiving Contemplation

These lovely flowers, sent from Jim's sisters, will grace our Thanksgiving table tomorrow. I have much for which to be thankful. They include all the usual things; health, a roof over my head, three squares, friends, family, etc. But more importantly I am thankful that Jim has gotten through his treatment and will be (WILL BE) returned to health.

Jim had a pretty good day today. He started out strong; sweeping up (yet more) leaves, scooping leaves out of the pool, generally being the tidy-upper outside. This afternoon I went up to Sacramento to see my doc; all is well. A bit of a weight loss so please, no more. The traffic heading east even early in the afternoon was at a crawl all the way. Eastbound was even worse coming back. Surely all those people aren't heading up to Tahoe? By the time I returned home Jim was seriously flagging and is now asleep, head down on the dining room table. It will be an early night for him. The edema in his legs is a bit better after taking his meds this morning, so he is a bit more comfortable. And my anxiety level is back to it's usual tick on the meter.

As I noted yesterday, lamb shanks are on the menu for my Thanksgiving plate. I bought them today and can almost taste them already!

History note: Forty-three years ago today my generation lost the first of its martyrs. John Fitzgerald Kennedy: RIP.

The following is a poem by John Berryman titled "A Minnesota Thanksgiving". I heard it on the radio and thought it hit the spot. Enjoy!

Minnesota Thanksgiving

For that free Grace bringing us past great risks
& thro' great griefs surviving to this feast
sober & still, with the children unborn and born,
among brave friends, Lord, we stand again in debt
and find ourselves in the glad position: Gratitude.

We praise our ancestors who delivered us here
within warm walls all safe, aware of music,
likely toward ample & attractive meat
with whatever accompaniment
Kate in her kind ingenuity has seen fit to devise,

and we hope - across the most strange year to come -
continually to do them and You not sufficient honour
but such as we become able to devise
out of decent or joyful conscience & thanksgiving.
Bless then, as Thou wilt, this wilderness board.

Wherever you are, with whomever you celebrate I wish you the joy of sharing, the warmth and love of family and friendship, a Thanksgiving meal of unsurpassed deliciousness, and the true understanding of all your several blessings.

Tuesday, November 21, 2006

Back to the Hospital

Jim's doc called this morning to say that he suspects blood clots are causing the swelling. He ordered an ultra sound at the main hospital. So after my delicious morning constitutional and an even more delicious foot/leg massage, we packed up and went to Sacramento. The ultra sound was a fascinating experience. When I was pregnant with my daughters an ultra sound was virtually unknown for the in utero examination. Maybe for anything else, too. Now it is run of the mill.

By the time we got home, the doc had received the results and left a message that Jim did NOT have any clots. His kidney function is about the same as it was last week; no worse. That was very good news but did not answer the question of why he has so much swelling. The doc recommended taking a diuretic for a few days to see if that helps. He will start that tomorrow morning.

Jim has slept away most of the afternoon, gurgling away in the Eames chair, feet elevated. I, in the meanwhile, have been contemplating my Thanksgiving dinner. I have decided that a 27 lb. turkey for one is too extravagant, too wasteful, and I really don't like turkey all that much. The dark meat, my favorite, is always gone by the time I make it to the buffet table. My market has lamb shanks on sale and that appeals to me. Tomorrow I'll go an buy myself one, braise it with some garlic and onions, pour some broth and wine over it and cook it in the oven for a couple of hours. That, with roasted potatoes, some sprouts and perhaps a bit of a fruit salad and I will be more than thankful. As for Jim, he'll pour another 500 calories through the tube and call it dinner.

My cold seems to be progressing as usual. I should be totally laid out by Thursday.

Monday, November 20, 2006

No Walk Tonight

The first thing that caught my eye this morning was the photo on the front page of the The New York Times. Here's the pix.

Remember the TeleTubbies? Well, here they are, George Bush, Chancellor Merkle et al.! I don't know if you can see this photo clearly but if not, go to the Times' home page, click on Today's Paper, and there it is. (If you are reading this on Tuesday, you have to navigate through the Archives to Monday, November 20.)

When I went out for errands today Jim was eager to go. Cabin fever. He wanted to go especially to the market. He tried to slip away from his minder, wandering through the aisles, looking at all the brightly packaged foods, picking up and sniffing at produce. He was like a man either seriously sensorally deprived or an alien from another planet. But within 20 minutes he was exhausted and ready to come home. Just an outing around town to see something except the four walls of the house was enough. Yes Jim, there is a world out there waiting for your return!

Jim's feet, ankles and legs are still very swollen today, so I called the doc and got an appointment for the afternoon. The swelling was down a bit over the weekend, but as of late yesterday and this morning it was worse. So we went to the clinic and met with his doctor. He ordered more tests, in particular to look at kidney function, liver function, and the possibility of blood clots in his groin that are impeding the circulation. And he told Jim to be sure to elevate his feet and legs when he is sitting down. Now, I have been telling him this for several days, but since my medical degree is not from a well-known school he doesn't pay attention. But when a REAL doctor tells him the same thing, he listenes. So much for the expertise of a life-long leg elevater!

No evening stroll. Jim's feet hurt too much. But just as well. I am coming down with a nasty cold and should not be out in the chill night air.

Sunday, November 19, 2006

The Sunday Funnies

If one were to grade Jim's days, I would give this one a "C". Yesterday was probably a "B+" for most of the day. He felt good this morning, less good as the day progressed, and pretty bad late in the day. These fluctuations are to be expected. The doc did say 10 days to two weeks before things begin to turn around. It is been only five days so we have quite a ways to go.

I managed to get in an early morning walk. It was foggy and damp out here in South Davis this morning, but that did not deter me. Then I celebrated a very important birthday with a friend. She is turning 70, although, believe me, she looks about 45! We had a lovely breakfast together, got caught up on gossip and family news. A nice break.

I went to see The Queen this afternoon. Not the old gal herself, but Helen Mirren. What a tour de force for that remarkable actress. I believed it from the opening scene when she looks into the camera with a frank, royal gaze. I liked James Cromwell (Prince Philip) in Babe better; much more sympathetic! The film brought back memories of that stunning event in 1997. The fatal accident of Princess Diana coincided with the death of one of my friends, Elaine, in a private plane accident in Canada at the end of July of that year. As I watched the film, I was transported back to that sad time.

Tonight is the final episode of Prime Suspect on PBS, starring the queen. Or is it Helen Mirren?

Jim did not nap today so that means no evening stroll. Tomorrow I must contact the doctor about the continuing swelling in his feet, ankles and legs. Perhaps another blood test is needed to see how his kidneys are doing. Every day is a new adventure.

Saturday, November 18, 2006

Every Day is Different

Yesterday Jim was very weak and sick. But today he has had what I would characterize as a good day. First thing he wanted to go up to the Farmers' Market to buy tomatoes to make his (family famous) roasted tomato soup. So we trundled off to browse through the various stalls on this bright November morning. I wish I had taken my camera because one vendor had a gorgeous pile of Japanese eggplant in gem-like amethyst purple. I bought several to roast for my dinner. When we got home he dove into the preparations for the soup, chopping onions, garlic and tomatoes, roasting them in the oven, then grinding the whole thing in the Cuisinart. After tinkering with the seasoning, adding the broth and heating, it was done. Superb!

This afternoon he managed to sweep some leaves, watch the Ohio-Michigan football game, then the news. But now, at 7 PM, he is sound asleep at the dining room table, unwilling to actually go to bed. I salute him for making every attempt (mostly successful) to have a "normal" day.

As for the movie (see yesterday), I enjoyed it more for the performances of Meryl Streep and Lily Tomlin than for the alleged plot. Who knew Meryl was such a singer? I remember the first time I laid eyes on Garrison. I wished I never had. Better that he remain unfleshed. Some things should dwell in the imagination, like your first love. For God's sake don't disturb that fantasy and make it real! You get my drift.

Friday, November 17, 2006

Shape of the Day

Today has shown me just how bad it is going to be for the next 10 days to two weeks. Jim is very weak. He is not particularly disoriented; just disinterested. He has spent most of the day napping -- a very good thing -- and trying to clear out his throat -- a very painful thing. Remember the Magic Mouthwash I mentioned? One of the ways to use this is to put the solution plus water into a small spray bottle and spray the inside of the mouth and the throat to numb the tissue so he can swallow. Forget eating. Just to swallow a bit of water is now extremely painful. He thought that if he could numb his throat a bit he could at least sip liquid. It hasn't worked too well, partly because the spray tastes so bad it makes him gag. Yes, he'll get through these next days, but what a terrible experience it is.

I gave him another Procrit injection to encourage those red blood cells. This stuff also raises his blood pressure, although it has been pretty good for 24 hours. He took a half dose of the meds the doc prescribed for him -- Lisinopril/HCTZ -- and it seems to have worked. I am going to be really irritated if he comes through this terrible treatment and then has a heart attack because of the Procrit!

I am a real Garrison Keillor fan. I have listened to A Prarie Home Companion for probably 20 years. I remember in the old days when listeners would send in old camp songs and he would sing them. I knew them all! Jim knew all the old church songs (as opposed to the Anglican hymns that I knew). Tonight I am going to watch the movie. I'll report. I don't think Jim will be awake and aware for it, but who knows.

Thursday, November 16, 2006

The Man in the Mask

This is the mask that was made for Jim before he started radiation. He wore it every day when he went for treatment. It is made of a mesh material that was originally wet and pliable. Like volleyball netting or a strange pasta. It was molded over his face, neck and shoulders, then left to set, removed from his body to dry. Then it was mounted on a metal frame. For treatment, he was laid out on his back on a metal table. This "cage" was put over his face and bolted down to the steel table to keep his head immobiliized. If you are claustrophobic, ask for a different treatment!

Today passed with spurts of energy -- some vaccuming action and some bathroom cleaning -- followed by extreme fatigue and naps. Whatever he wants to do is fine. I talked to his regular physician this morning about the blood tests Jim had yesterday to check on his kidney function. Numbers are coming down. A BIG relief. He won't have any further blood work done for about a month, before he sees the oncologist. Meanwhile, tomorrow he gets another Procrit injection to spur the bone marrow on to greater production of red blood cells.

I went off to Sacramento this afternoon to do a bit of shopping. When I left, Jim was asleep. When I returned an hour later he was up and about, but soon thereafter fell asleep again sitting on the couch. After dinner (mine) we went out for a short stroll,  always a good sign that he has a bit of energy to spare. As I noted earlier, all the docs have said that fatigue is the biggest problem AND that exercise is the best curative. So we are two for two.

Tuesday, November 14, 2006

The end and the beginning

Today marks the end of Jim's treatment and the beginning of his healing and restoration to good health. The treatment part took seven weeks; seven long, painful weeks. The restoration part is going to take about three months; three long, but decreasingly painful months. Dr. Schmidt met with us after Jim's final treatment to talk about healing and restoration. It will take at least two weeks before Jim notices any improvement. Gradually he will be able to swallow more than water; perhaps a little yogurt, a smoothie, some Jello or pudding. His voice will come back but maybe not fully; he may have a sexy gravel voice! He will get his strength back although he will be very tired for the next month. The doc also thinks the kidney issue will resolve over the next few weeks but encourages us to keep a watch out for swelling. Jim got a nice send off from the medical staff at the clinic, including a bead lei to wear as we left.

Tonight we have had a bit of a walkabout, just down to the end of the block and back. We have not done this for a few nights, either because Jim has gone to bed about 6 PM or because he felt too weak. So this is progress. I cooked myself a celebratory meal tonight; Jim poured something through his feeding tube. But no matter how it is marked, this is a day to celebrate. He still has a long way to go, and the next few weeks are not going to be easy. In fact, the doc says that the next week or 10 days are going to be very bad as the radiation is still "active" even though he is not getting more of it. It is a cumulative treatment.

By the weekend after Thanksgiving, things should begin to turn around. I am hoping we will be able to make it all the way around a couple of blocks for our evening walks, that he will be able to sip something other than plain water, and that he will be able to sleep more than two hours at a stretch. He still has a long way to go, but this is the beginning. And I fall on my knees and give thanks that this beginning is finally here.

I will keep writing this blog even though he is finished with treatment. I will continue mainly because it is theraputic for me. Since I am now living with a completely silent partner, with someone who can no longer speak, this is a way for me to "talk" about what's happening. I can just hope that before too long, I can change the focus of this blog to what's going on in beautiful Cuyutlán and our Mexican life. Until then, it's winter in Davis and Jim's healing.

Happy Thanksgiving to everyone. This year, count all of your blessings.

Monday, November 13, 2006

And then there was One

Yes, it's almost over. But if today is in any way typical of what happens at the end of this treatment it is going to be quite a long road before Jim is restored to anything resembling "health". He is about as bad as he has been through the entire treatment. I talked to the doctor this morning who reported on yesterday's blood work. Jim's kidneys are not functioning well and it is of concern to everyone. The nephrologist has said that this situation arises frequently with patients who are receiving Cisplatinum for chemo. It is possible that it will disable him for some time. Not enough to warrant dialysis but serious enough that we must pay attention to intake/outgo and do frequent blood tests to check on his progress. He does say, however, that the condition will most likely be resolved successfully. He feels absolutely rotten. His feet and ankles are still swollen as are his legs and even his knees. He is exhausted but can't sleep any longer than about two hours before he wakes up choking and has to get up and clear out his throat. The pain level is greater than ever and he is plagued with gagging. So he has to anesthetize his mouth and throat with morphine in order to take anti-emetics. The only thing that has kept him going for the last couple of days is the knowledge that it will be over tomorrow.

Then the long, slow road to recovery begins. The symptoms he now has will stay with him for about a month. Fatigue will be the biggest issue, along with pain and the effects of the feeding tube. But as long as they are no longer bombarding his body and pouring poison in him he'll at least have a fighting chance.

It has been a cold, wet and dark day, one to match how everyone feels. But tomorrow is another day and when noon rolls around you will know that he has made it through these past seven weeks still alive, still kicking, but feeling like hell. We meet with Dr. Schmidt tomorrow for the final check before Jim is sent off to recover. We'll see him again in about a month.

All the medical personnel have been just terrific; available, concerned, present. Likewise the doc I spoke to this morning. One hears horror stories about the care one gets from Kaiser. We have been impressed by all we have dealt with. Especially receiving a call at 8 AM this morning from a doctor Jim has never seen, with yesterday's lab results, inquiring about how he is feeling, etc. That doc was the one who called the nephrologist, got all the info about the chemo reactions. We were told at the outset that patients under treatment for cancer are given priority attention. Indeed, this morning when we went to the lab for another blood test Jim was ushered right in and didn't have to wait along with the other folks. Of course he looked like death so they may have decided to get him in and out in a hurry. Who knows.

It's time to do more blood pressure work and get him tucked up. I would say "for the night" but it is really only for a couple of hours. Then he'll be up, prowling around the house, reading on the internet for awhile. Then back for a couple more hours of sleep. He (and I) will be very glad when his sleep-o-meter gets reset.

Until tomorrow. . .

Sunday, November 12, 2006

A Sunday Diversion

The body is a wondrous thing. If you assault it in one place, other forces amass to ward off destruction. If you poison it or try to fry it, the poor body tries to fend off such assaults by improvising protection. For instance, Jim's throat has been irradiated for almost seven weeks. The protective instincts think he is being sunburned from the inside so they try to coat his throat with thick mucus to keep the flesh soft and moist. This, of course, means he can't swallow and makes him gag. And since he can't, or shouldn't swallow in order to protect the damaged throat, and since, too, the taste buds get fried, nothing tastes good so he is not even tempted to eat. But perhaps some protections are overwhelmed by the treatment.

When Jim has chemo he is thoroughly hydrated with saline solution along with the poison. Typically the water goes right through him and he traipses back and forth to the loo many times. As fast as it drips in it drips out. But this time it appears to be different. Both during treatment and since, the plumbing has not been working properly. Yesterday he noticed that his feet and ankles had gotten a bit swollen. This morning, after being outside puttering in the garden, sweeping up leaves (see yesterday's post!), and fussing with the pool, he came in and said that the swelling was much worse. I took a good look and decided not to fool around with this. If his kidneys are compromised we need to know this ASAP. I called the emergency advice nurse at the hospital. She got him an appointment for 2:30 this afternoon. I was insistent; Jim was compliant. So we bid Alex good-bye, got in the car and tore off to Sacramento.

The doc read through all of Jim's file, noting the drugs, injections, etc., then ordered lab work. He ticked off the symptoms of kidney failure, most of which Jim has. But these symptoms are also the side-effects of both radiation and chemo. So how can we tell? He also noted that Jim is a bit on the jaundiced side. However, he felt that, overall, Jim was doing OK and these symptoms are probably the accumulation of all the treatment and drugs. We went down to the lab for tests for kidney and thyroid function -- after all, they are frying everything in his neck -- and a urinalysis for albumin. We will get the results tomorrow when we go to radiation.

When we got back home Alex was just about to leave for the airport, ferried there by the father of the bride (see previous posts about the wedding). Jim went to bed shortly after our arrival home. Even though we did not get any definitive answer as to why he is swelling up, I am glad that we got it on the record. Perhaps it is just a conjunction of time and treatment, as the doctor suggested. Perhaps it is "normal" under the circumstances. Tomorrow we will talk to Jim's regular doctor to see what the tests might show him.

Jane Tennison returns tonight on Prime Suspect. Yet another diversion on this wet, cold Sunday.

Saturday, November 11, 2006

The Harvest of Leaves

Friday morning the roofs of South Davis were frosted over. The leaves got a good icing and, during the night with wind and a bit of rain, they all fell off. This morning the back deck, the front terrace and the street were covered in yellow, red and brown leaves. I hope that one good sweeping will mean the end of the 2006 crop of leaves from the Chinese Pistache and the birch. What a wet, soggy mess!

Jim has had a pretty good day. He built a fire in the den fireplace and we hunkered down for a cold, drizzly "indoor" day. He wanted to go up to the library, which we did, and managed to stay up until about 4:30 when I finally urged him to sleep in the bed instead of slumped over on the couch. He slept about two hours before he had to get up to clear his throat and mouth. During the "awake" time we watched Mel Brooks' "Twelve Chairs" which we had seen about 40 years ago. It was better then. Since this is Saturday, there is the obligatory football to take up the silence. Overall, I would say he has had a good, restful day. There is something about "resting" that is against his nature. Whether it seems a waste of time, a sign of weakness, boring, or the perfect opportunity for someone to pull a fast one, I don't know. But the doc has told him that he should rest at every opportunity. It's the body's way of saying, "Help me out here. You need to stop so I can recoup." But even the doc is fighting an uphill battle. Jim has some swelling in his ankles and hands today, but his blood pressure was good. He got pumped full of fluids, including saline solution during chemo, so that may be what is causing that situation. If it doesn't go down tomorrow it will be an item for discussion with the doc on Monday.

Alex will return home tomorrow after a week here. It has been wonderful to have her here. Both girls have been a real source of strength to both of us.

Travel Request
We have been talking about getting away to someplace warm before we go off to Mexico in February. The name "Hawaii" came up. We have never traveled there together ~ I spent two weeks on Oahu at the East/West Center for work many years ago ~ and consequently know nothing about which island to visit or which part/coast of an island is best. We want to rent an apartment or condo for about a week or 10 days. Any suggestions?

Good night and good luck.

Friday, November 10, 2006

The Final Friday

Jim seems to have the morphine miasma under control and the pain, too. Today was the last Friday we have to go out to Rancho for radiation and we are all mighty glad of it. He weathered the night after chemo pretty well. I woke up at 2:30 AM and he was up too, but went back to bed shortly. Alex and I had a brisk walk this morning. There was frost on the rooftops and on the hay bales in one of the unbuilt lots. By the time we got home my hands were completely stiff. It's glove weather at last. She tore off to have her hair cut, I went to have a massage. Then to treatment. We had a wonderful visit with Jordan Davis, himself recovering from a serious injury to his foot and ankle. He is quite at home in the hospital environment!

Two more treatments and we are finished with this business. I gave Jim an injection of Procrit tonight.  We'll see how well it works.

Alex has taken the evening off to have dinner with a friend. Jim has finished his visits to various web sites that support his political point of view, and it is time for all to rest and restore. It has seemed like a very long week, probably because we are so close to the end that we want to hurry the time along. It will not be hastened, however.

This picture is of Cait, Alex, the mother of the bride of last weekend's wedding, and yours truly. Amidst all this travail, there is great joy to be found.

Thursday, November 09, 2006

Oh, the indignities

The first one came from his radiation oncologist. He told Jim that he thought he was doing very well and was in the 75th percentile of patients regarding reactions to treatment and maintenance of "health." 75th percentile? This to 99th Percentile Chaffee? The cheek of the man.

Then next came this morning. When I left on my morning constitutional Jim was sitting at the computer doing his morning reading. When I came home 45 minutes later he was face down on the keyboard! I tried to rouse him but he was really out cold. I finally got him to his feet and was moving him across the room to the bed when he collapsed on top of me. We hit the corner of the bed and there was about 140 lbs. of dead weight on top of me. I called for Alex and together we got him up and over onto the bed where he slept for about an hour.

Then came a scene at the hospital. I dropped him and Alex off and went to park the car. When I made it back to the waiting room Jim was in a seat next to Alex but there was a strange looking wheelchair pushed to the side. It resembled a market shopping cart. Apparently after I dropped them off Jim's legs just gave out and he fell into Alex's arms. She called for some help but the security guard stationed outside the hospital said he couldn't get a wheelchair for her because it cost a quarter! Some kind guardian angel appeared with 25 cents, liberated a chair from the rack and gave it to them. Alex folded him into the chair and off they went. But in the waiting room he kept slipping in and out of consciousness. When the nurse called him in to see the doc he tried to stand up, fell back into the chair and was out like a light. Much hustle and bustle and the doc appeared, took Jim's pulse, and we were ushered into the back. Jim was mortified, once he "came to" and was mightily embarrassed. The problem? Blood pressure of 89/47. That will do it. The reason? Most likely the collision of pain meds with anti-emetic meds.

The doc finally examined him, gave him the OK to proceed for chemo. He has prescribed injections of Procrit for one month because Jim is anemic; one shot a week for four weeks. Then we left and tore across town to the radiation clinic for the Thursday zap. Then we retraced our steps to the hospital for the 3rd and FINAL chemo. Jim's blood pressure was still very low but they went ahead anyway.

While he went through all of that nastiness Alex and I had a lovely lunch, did some smart shopping, and had a generally leisurely afternoon. We went back to the hospital about 3:30 and waited until Jim has finished his infusion. We finally got away from there about 4:15 and made it home through Thursday afternoon commute traffic by about 5:15. Just in time to hear some warm tributes to Ed Bradley.

This day marks the end of chemotherapy. That is something about which to rejoice BIG TIME. Tomorrow is one more radiation before a blessed two day rest during which the worst effects of chemo will either be evident or, once again, he will have dodged that bullet.

But now it is time for him to go to bed and try to get the rest that he needs. He just needs to go easy on the morphine. It does strange things to him.

Wednesday, November 08, 2006

The Last Wednesday

We never have to go there on Wednesday again.

The issue now is pain. As of around midnight it became clear that the Vicodin is not strong enough. Next is either a pain patch or a liquid pain killer taken by mouth or through the feeding tube. The most important thing is to get the pain under control. The doc prescribed both; the patch is Fentanyl; each patch lasts for about 72 hours. The liquid is morphine sulfate; it lasts about three hours and you can take it as often as you need it. The patch doesn't kick in for about 48 hours so the morphine gets you there in relative comfort. He put on the patch as soon as we got home, took a swig of the morphine, and feels pretty good right now. Perhaps the morphine will help ease the pain of the election results, too.

We took a short walk this evening. First time in several days. That morphine is a little bit of OK. I can see why there are some who want to make it very hard to get. As long as it offers relief from extreme pain I'm all for it. The doc even talked to us about addiction! But it causes serious constipation. Why would you get addicted to something that does that, unless you also get addicted to Ex-Lax?

Tomorrow is going to be a rough day with both radiation and chemo. But again, it's the last Thursday and the last chemo. In the wake of all of this is one very sick, debilitated guy who is sick and tired of being sick and tired.

Tuesday, November 07, 2006

The End of Week #6

It doesn't seem possible that a week has gone by since I wrote The End of Week #5, but here we are, Tuesday afternoon again. Jim now has five more treatments at the rad lab, one chemo on Thursday. He is in the home stretch. The nutritionist commented on how well he is doing, compared to what I don't know, but I will take her word for it. He is no longer losing weight; he is gaining a few ounces a day after having lost a total of 20 lbs. As of last Friday. Yesterday he was up 3/4 of a pound; today up almost one pound. I guess if you pour 2600 calories into yourself and are fairly sedentary you will gain weight no matter what else is going on.

Anyone who is squeamish need not read this next part! We are going to get a new device in the house tomorrow. It is a suction pump, the kind the dentist uses when working on your teeth to keeps the saliva out of the way. Well, Jim can't swallow any saliva anymore mainly because it has become too thick, so he has to clear his throat and spit. But it is now too painful to clear it out so he will remove it with this handy little machine. Even though he swishes water in his mouth he can't swallow what accumulates. It should now be much easier and no longer painful to keep his throat clear. These folks have thought of everything to help a patient be more comfortable. Now they really need to work on better treatments!

I had another day off today. Alex took Jim to treatment and I tried to catch up on keeping the house presentable. For what, I don't know, but you never know when Publisher's Clearinghouse is going to ring the bell. The weather is still holding here. It's actually shorts weather.

Here is our beautiful Hawaiian Umbrella Tree. I think the picture is a bit on the tilting side. Actually, our floor is level; the photographer was not.

Monday, November 06, 2006

The End of "Restorative" Weekends

Those blessed relief days are over for awhile. In fact, I think Jim got worse during this weekend; much weaker, more trouble with his throat, more coughing, more pain. It's true, we were warned, but he had been doing so well up until this point. The blood pressure is still an issue; too high, then too low. And he's gotten very weak all of a sudden. For some reason I don't quite understand, a cold pack on his head is soothing. Perhaps they have fried his brains by mistake? His entire mouth is now so sensitive and sore that he can't use the soda/salt gargle they prescribed. The "magic mouthwash" with lydocaine to dull the pain makes him gag. I have smelled it and I know why! It may be time to ramp up the pain meds. He has stopped speaking altogether; hand signals and pointing now get the job done.

Amid all this destruction and death -- dead leaves, dead flowers, dead cancer cells and hair follicles,and dead tired -- came glorious life in the form of a green plant, a bonsai schefflera. This tiny "Hawaiian Umbrella" tree sits in a beautiful blue plate-pot. It is covered with tiny, shiny green leaves of varying hue and it as cheering and spirit-lifting as you can imagine. We're moving it around the house from spot to spot to see where it likes to live best, and where we can see it at it's best advantage. It will probably end up on the kitchen counter where it will be constantly admired, have a daily dose of indirect light, and will remind us of the good thoughts of the sender. I will put up a photo of this lovely greenery tomorrow.

The consensus at the lab this morning was that the dosage of the blood pressure med was too high. Unless he has a reading over 150 he will not take any medication. Then he will halve the dosage. Since he has been home the readings have been good. We will monitor him every few hours just to be sure he doesn't go too high or too low.

After today's treatment Jim has six left, or seven if you include chemo on Thursday. Since he got home at about 12:30 he has been sleeping. It is now after 8 PM, and he is still asleep. This is the way it is going to be for the next two or three weeks. Meanwhile, Alex and I have had a lovely dinner and it is now time for everyone to sleep and prepare for another day tomorrow. I will again have a day off as Alex will take Jim to treatment in the morning. I can get the beds changes, the bathrooms cleaned, the larder restocked. It is again wonderful to have someone to take the daily commute off my plate.

Tomorrow is election day. Vote early and often.

Sunday, November 05, 2006

The Sunday Times

Fatigue is beginning to take over. Jim slept off and on all day, with breaks to sweep up some leaves and go to the university library for a short visit. He was looking for Peter Carey's new book "Theft." He watched the film Pollock yesterday and it reminded him of Carey's latest novel which he read a few months ago. Alas, they did not find it but came home with a pile of art books about Pollock instead. These will keep Alex amused for the next few days. When they returned home Jim went directly to bed, where he has been ever since. It is now 7:15 PM and I think he is done for the night. Tomorrow morning we head up to the rad lab to begin  another week of treatment. Things are piling up on him as the radiation piles up. His blood pressure is still all over the map, but quite a bit lower than just a few days ago. His heart rate is high, however, and that is troublesome. We'll check with the doc tomorrow. He is having more trouble with the saliva issue, and will continue to do so until about two or three weeks post-treatment. This treatment is not for sissies.

As I mentioned last night, we went to the lovely wedding of friends' gorgeous daughter. Here she is with her equally gorgeous husband. Both of them are police officers; she into forensic investigation, he a plainclothes officer. They were surrounded by very loving and joyous friends and family, and a good time was had by all. The wedding was outside, and the weather cooperated beautifully. The ceremony was performed by her uncle from Vermont. Her aunt was present here from Cairo. Guests from near and far. Her parents, one Greek, one Italian were gracious and generous hosts. Caitlin used to babysit the bride!

And here are a couple of swell guests who were there to share in the festivities. Caitlin flies back to Bozeman tomorrow morning (where it is currently about 40º) and Alex will stay with us for another week. It will be such a treat to have her here to talk to and to help me care for Jim.

I can remember visiting with my mother and asking her to make old favorites for dinner. Things like baked split pea soup, bread pudding, meatloaf. So for these two lovely children I made an old childhood favorite for our dinner tonight. It turned out just as they remembered it and they helped themselves. It was a rich and succulent reminder of better days gone by. And which will come again I am sure.

Saturday, November 04, 2006

Happy the Bride . . .

We (Alex, Caitlin, Susan) are just home from the wedding of our friends' daughter. It was a lovely celebration of love, youth and hope. Here's to the triumph of hope over experience!

It has been a day of rest with no treatment, always a positive. Everything they told me last week is beginning to evidence itself; extreme fatigue mainly, more discomfort, more swallowing problems. But tomorrow is yet another day without treatment and by tomorrow evening Jim will feel even better. The blood pressure is now quite low, more so than I like. He is still taking the meds and they seem to be working. Either that or the blood pressure would have come down anyway.

At the Farmers' Market today there were several craftspersons I had not seen there before. Potters mainly. Beautiful stuff. Bought apple juice (best ever), enough eggplant to get us through several days, gorgeous green beans, a carton of raspberries which we devoured before noon, interesting "designer" squash for the coming week,

I have several pix from the wedding. I'll sort through them and put them up tomorrow. Although it's not particularly late, I am signing off.

Friday, November 03, 2006

My Day Off

Jim, of course, does not have the luxury of a day off. Caitlin took Jim to all his appointments this morning, giving me a day off to get things done around here. First he went to see his regular physician about the high blood pressure issue. Even though he has started on a medication it will take awhile before any improvement is noticed, but the doc wanted to see him anyway. Then out to the rad lab. Going to the clinic is not really a burden; it's thirty minutes away, an appointment of about twenty minutes, then home. However, not having to go is sweet relief.

I have moved the computer into the bedroom so Jim can consult with it during the night. I have thus moved into the office to sleep as he is very restless, wakes up several times during the night for one or two hours, and likes to surf. When he sleeps it sounds like he is sucking on a water pipe or hookah. All that gurgling and bubbling keeps me awake. He has gone to bed -- it is early -- so I will finish this post in the morning.

Alex has arrived from Long Beach to stay for a week. We are all together, a show of solidarity and strength in the midst of adversity. It's a family armed and dangerous against the enemy.

Thursday, November 02, 2006

The End of Double Digits

Today marks the end of double digit days for treatment. As of tonite, Jim has nine more treatments; eight for radiation, one for chemo. I can't believe we are at this milestone already.

I have been concerned about Jim's high blood pressure for awhile. Despite his protestations I talked to the doc this morning and told him I thought the numbers were way too high. He agreed. He doesn't want to see anything up in the 180's and that's what Jim was having. So he urged (ordered) Jim to contact his main doc and get checked and get a blood pressure medication. After treatment we went to the Davis office. Right away they took the info, sent us over to his doc's office, and he was seem immediately. What a miracle, in these days of "take a number" medical care. The doctor took his blood pressure (200/99) and prescribed a medication to deal with the problem. Jim goes back tomorrow morning for another check after having used this stuff for 24 hours. I am relieved; Jim's younger brother dropped dead from a massive coronary in April, probably due to high blood pressure. I am not about to have this happen on my watch.

We had a lovely downpour this afternoon, much needed and much anticipated. Tonight the skies are clear and the air is clean and soft. Caitlin arrived from Bozeman around 7 PM so was here for dinner and for the evening stroll.

It's back again tomorrow, then two blessed days of rest and relief. Alex arrives tomorrow evening. We will all be together for a few days to care for the patient and the caregiver, both of whom are doing very well, thanks.

Wednesday, November 01, 2006

Welcome to Week #6

Last night Helen (l) and Linda (r), our friends from Canada who are on their way to Cuyutlán, arrived just in time to trick or treat. Their appearance was all treat. Even the patient got up to say (actually, whisper) hello. For me it was wonderful to see someone who is NOT in the medical profession or is NOT ringing up my groceries. This morning they headed south for a few days, then they will turn east to El Paso, cross the border there, and in a jiffy -- perhaps 3 days +/-  they will be lolling around their pool and basking in the warm sun. We, meanwhile . . .

Today was "see the doctor" day. We asked him about post-treatment care. We especially wanted to know about travel. Six weeks after treatment ends they will do another CAT scan to check out the tumor. Depending on what they find, or don't find, then we can make our plans. If all is as they hope it will be, we should be able to get on the road in early February. If anything further needs to be done we may be delayed. But the doc is optimistic overall, thinks Jim is doing well, again offered stronger pain meds which Jim declined politely at this point but will keep in mind over the next few days. Right now he is up to about 6 Vicodin in 24 hours and that seems to keep him relatively comfortable. I keep reminding him that pain is not a sign of moral weakness, but you know how he is!

As of today he has lost 18 lbs. in 5 weeks. Better than Weight Watchers. And this treatment will also thin out your hair, dry up your skin, destroy your vocal cords, shut down your taste buds, and make you gag. What a way to lose weight. The liquid supplement has also driven up his blood pressure because of its sodium content. So that's something else we have to monitor and chart. Tonight he tried some Popsicle; just a bit of strawberry flavored. He got it down, thought it was soothing, but the taste was enough to make him quit. I made some raspberry Jello, which seemed like a good idea to him at the time. Maybe tomorrow.

We've had a lovely evening walk. Although the weather is turning colder there are low clouds tonite so the air is warm. He is still quite cold all the time so the heat in the house is cranked up. PG & E is going to love us this month.