Overall, an ok day

The surgeon arrived with the resident in tow. They did poke and probe Mary's incision where it continues to do a little weeping. The surgeon explained that there was a knot in the suture material that was probably the reason for the inflammation. The radiation is interfering with the healing process. And, yes, the suture materials is supposed to dissolve but because of the knot, it didn't perform as planned. Absolutely not a big deal.

Overall, the surgeon was very pleased with Mary's condition and recovery from the rather high risk liver trisegmentectomy. He was also pleased with her rather healthy appearance in spite of three weeks of radiation.

Mary was very tired when she got home, so she fixed a quick lunch and laid down. She told me she slept until 4:30 or so. Dinner was Willow Street takeout of a fusili, chicken, artichoke pasta and a Gorgonzola, walnut, spinach salad.

On a totally different note, its is the end of July 2009. Or, 40 years from the first day I reported to work at Fairchild Semiconductor in Mountain View as a freshly minted mechanical engineer. I wrote a couple of weeks ago about the Moon-Landing, Graduation, Going-Away Party my folks threw for me. Well, that was followed by my first day at work as an engineer which was the last week of July in 1969.

I had driven my two year old '67 Mustang from St. Paul to Mountain View, packed with some clothes, books and odds and end. The trip started with my Mother emerging from the house on my departure morning with a suitcase--because she was going to ride cross country with me! Shall I say I was more than surprised and very upset! This was my breakaway and my mother was NOT coming with me. Mom was the reason I was not allowed to "go away to college," and I had been looking forward to starting my career somewhere other than St Paul. The San Francisco bay area seemed far enough away, and was most likely encouraged in my mind by the wonderful stories Mom and Dad told about their years in California before WWII. My sister, for example, was born in the LA area before they moved back to St Paul. Of course, 1969, Haight-Ashbury, Mama's and Papa's California Dreamin' and all of the Beach Boy albums definitely helped too!

The day I arrived at Fairchild, the HR manager welcomed me to the company and then called my new home department--to find out the hiring manager had left the company the prior Friday. That was ok, because Fairchild had offered me two positions, one in the Mark area and the other in the Mask area and the respective managers were Bye and Fry. It turned out I had confused managers and departments and signed up for the desired department (Mask) but it was the manager I really didn't want to work for. The replacement manager was a great guy and a real mentor so it worked out wonderfully.

I also learned the manager who left was a good guy too and I had misread him, easy to do when you are a new college grad. The part I regret missing were the meetings held by the departed manager, who was probably an ancient 50 or so, held frequently, all afternoon poolside at his home during the warm weather. Ah, the California lifestyle! These intense, mentally exhausting, planning meetings were coupled with his much younger, gorgeous, blond, German (second) wife serving as hostess serving snacks and drinks. My co-workers told me wistfully of the experience--as the weather went from the warmth of spring to the heat of summer she changed from a European topless suit to a traditional Munchen English Garden swimsuit. You know the kind...the same kind you don't see on centerfolds in certain adult magazines...

40 years...

What is hospital time, exactly?

Mary was booked for her radiation treatment at 8AM sharp so she could then go upstairs for her 8:30 appointment to see the surgeon.

The technician came out and sweetly said, "We are running late and we'll get you in as soon as we can." Mary reminded her of the doctor visit scheduled for 8:30. In fact, it was radiation that set the appointment to be before the doctor. The tech then said she'd let them know it was their delay and call upstairs to inform them.

We did get upstairs about 8:50, or twenty minutes late. About 10:30AM, they moved us into an examination room. Let see, that is an hour and 40 minutes in the waiting room. I am glad she called so we didn't have to wait long.

A resident came in right away, asked questions, looked at Mary's incision and said she'd be back with the surgeon shortly. Fortunately, she set Mary up with a couple of blankets and as I am writing this, Mary is sound asleep on the examination table. That happens when there is nothing going on for over half an hour. Her body likes to sleep after radiation, no doubt about it.

Ah, its 11:06 and we can hear our surgeon's voice in the next examination room. Soon, we hope, soon!

The Menagerie

Some have asked what Idjit Dawg was barking at...(this is a slightly different set of pictures, so the elephant is missing, sorry.)

What happened?

For those who looked at the blog today, you found a blank entry with a "bing" advertisement. I think I know what happened.

The blog is an open blog and if you read the header, there is an email address to send a message directly to the blog. Well, someone addressed an email, put a topic in the subject line and then hit send--viola! a blank entry with an advertisement for "bing". Whoever you are, you are certainly welcome to try again.

Ingrid drove today and, of course, the schedule went out the window. First, the radiation techs were half an hour late to take Mary into good ol' LA9. Then, after radiation they decided she should see the nutrition/food nurse which hasn't happened this week. Of course, that meant waiting until the nurse was free. Did they tell Ingrid? No! So I start getting SMS messages, "Mary hasn't re-emerged and perhaps something is wrong!" Anyway, after a few exchanges Mary emerged about 2PM (an hour late, so figure a 30 min late start with 30 min waiting and seeing the food nurse.

Ingrid brought Mary home and they sat and had lunch together. Ingrid then left for work. Mary felt pretty good all day today and was even able to Mary avoid napping so we can go to bed earlier than normal. We have to be at Stanford at 7:45 or so, give 45 minute commute for rush hour so that makes the alarm very early. Mary has radiation at 8AM and a follow up with the surgeon at 8:30. The Oncologist made it clear that Mary is now under his care so we assume the visit is just a "quick check" on the part of the surgeon.

Idjit dawg hasn't been bothered by the wild animals roaming around the bedroom since yesterday so things are a bit quieter. And, fortunately, the ball point pen she confused with a chew stick didn't release its ink all over the floor before we found various bits and pieces and confiscated them from her. Mary and I are still wondering how she got a hold of a ballpoint pen. It is one of the cheap ones we have around the house--we have dozens and dozens of this particular type because of brilliant impulse purchasing in a checkout line on my part about five years ago. And we haven't even opened the second box I bought!

Mary says she worries every time I go to Frye's and run the gauntlet. For those who don't know Frye's, its our local version of Best Buy only more techie and far larger selection--with better prices. And, the checkout process has you march down a long aisle with all sorts of tech goodies, junk food and other highly desirable impulse items. We call that long aisle the gauntlet. Hence, the purchase of two boxes of ballpoint pens and two boxes of mechanical pencils. At our current consumption rate, all five of the grandkids can each have a large handfuls of each as part of our legacy!

In the interest of full disclosure, I did buy the two hundred pens and pencils in a check out line but at Office Depot, not Frye's. Turns out all of our big box stores around here are emulating the Frye's gauntlet.

Idjit Dawg is always good for a laugh

As I turn off the shower, I heard the sharp, high pitched bark of Idjit Dawg. As I towel myself dry, the barking continues. Normally, Idjit Dawg only barks when she wants something--food, a rub, or to get up in your lap in the evening. I knew Mary was sitting at the kitchen table and I had already fed the dogs so I could not imagine what the ruckus was about. As I brush my teeth, Idjit Dawg continues her complaint.

OK, OK, its time to find out what the problem is. I turn the corner into the master bedroom and Idjit Dawg is in the middle of the room, barking at what appears to be Mary's iMac...

Now I had moved Mary's iMac into the master bedroom at her request over the weekend. And Idjit Dawg had no problem with the presence of the computer table or the computer itself in the room. What could possibly trigger the barking fit?

As I watch her bark, I realize the iMac screensaver that I had set up earlier in the morning was the cause of Idjit Dawg's irritation. The screensaver was showing pictures of Mary, her granddaughter Charlize and son Tim as we toured the San Francisco Zoo during one of their visits. Only Idjit Dawg was not barking at images of the people. Rather, she was taking great umbrage at the presence of the polar bear, penguins, antelope, tigers, giraffes, prairie dogs et al hanging around on the computer table in the bedroom! When all 17 pounds of Idjit Dawg decided she should attack the elephant, I turned the screensaver off...

Gayla was the driver today, thank you Gayla.

Mary seems to have her best time in the morning after a good nights sleep. She definitely doesn't do to well after the treatment and the afternoon naps are greatly appreciated. I hope they help the speed of her recovery. Last night I fixed BLT's at her request and she ate 3/4ths of a sandwich so that was pretty good considering how little she has had at certain times.

The good news is that she does have an appetite, fruits and veggies are working well for her and small amounts of protein are fine too. The balance of her digestive track is working just fine so she has avoided some of the more common side effects--so far.

If the plan holds for the five and one half weeks of radiation and if that means Wed must be included, Mary has three more weeks to go from today. At that point they give her a 4 week rest from radiation and chemo. In the 5th week, they start her on chemo again and that could be for four months or even six months. We don't know what kind of chemo. She is on tablets right now and the side effects have been minimal. Perhaps they will continue with those?

For those who might be interested, the doc put me on a BP medicine. My after dinner reading last night was 127/78 so it seems to have started working quite quickly.

And I see by the little map on the left, we have a reader from India. Welcome! (I assume it is one of my co-workers on a trip, but who knows?)

Tuesday evening, week three...

First of all, thanks to our drivers this week, Ingrid, Marge and Gayla. Ingrid is doing duty twice and I am driving Friday because its an 8AM appointment, not midday.

Mary did learn that the radiologist's plan is for five and one half weeks of radiation. As I write this, she has almost completed two and one half so we have three full weeks to go.

I had an early meeting this morning so I had to leave before Mary was really up and awake. When I got home, the kitchen was cleaned, dishwasher loaded and run, some of the clean laundry was folded, and there was a fresh load completed in the washer and ready for the dryer. Our girl had a very, very good morning if she did all that!

She fixed her own breakfast, pre-treatment lunch, post-treatment lunch and one snack during the day.

Other than the tiredness, she seems to be handling the chemo and radiation pretty well. We can be thankful for that.

A bittersweet day

The bad news is two of our friends passed away this weekend. Our sympathies go out to Ed in Albuquerque who lost Sandra this weekend at the end of a 13 month battle with a brain tumor. And, to Jane who lost Wendell early this morning. Wendell was taken to the hospital by ambulance earlier this week and as Jane told us last evening, the problem was very serious. Our thoughts, prayers and sympathies go to them in their loss. God Bless.

Sunday appears to be Mary's best day of the week. The radiation really hits her hard on Monday. Each day after that, she seems to be down a little bit further and then Saturday and Sunday allow her to gain back a bit of her energy. Mary does well eating fruit and veggies, and is pretty good with small amounts of protein but has trouble digesting starches. Her tummy size is still pretty small so she eats four or five times a day and its a lot of fruit for right now.

Mary had a good morning. We made it to Farmers' Market and Mary did the bulk of the shopping and, as always, I did all of the hauling. Granted, I cheat and use a two wheeled dolly with an insulated bag to keep the food out of the sun and my elbows from being trashed. I mean, one of the first items she bought was a watermelon and carrying one of those around would have been tough without my cart.

We ran into Dan and Donna this morning and we were glad to catch up with them. Its good to see friends as we get back to our normal routine. Dan plays the hero or martyr, I am not sure which, by carrying all the purchased items. I have noticed him flexing his elbows after he sets the bags down. He claims its his only exercise so its ok. Yeah, right. Hey, Dan, you want the name of a good orthopedic specialist?

After shopping, we walked to The Purple Onion and met with MaryR, her nephew and his wife visiting from 'back East'. They were in this area for a couple days, then they were going to drive down the coast to Ventura to pick up their son. They were then heading back East to be at their daughter's wedding next weekend in downtown Boston and off to a family reunion in the Carolina's the following weekend. I was amazed they actually looked relaxed as we talked and ate this morning.

Radiation starts again tomorrow with Ingrid driving. Marge, Gayla, Ingrid (again) and yours truly will be the drivers for the rest of the week. Thanks to all!

Its kinda routine

Sorry I haven't written much. Not much is happening. Mary goes for her daily radiation treatment, comes home, has a small late lunch to match the pre-treatment small early lunch, takes a nap and I wake her up when I call late in the afternoon. She is definitely weaker and not able to participate as much in food preparation or other activities. This is only week 2 of the radiation and we have at least 3 to go. The technicians are telling her its a five week program but the attending physician originally told us its a minimum of six weeks and he may go to nine weeks if it seems necessary.

Our team of drivers has been such a blessing: Marge, Terry, MaryR, Bill, Ingrid, Gayla, PatA and PeggyV have all done at least one run and we have more volunteers who haven't matched up yet with needed drive days. It has gone smoothly except the time Mary forgot her cell phone and couldn't call Bill who had run over to the Stanford Shopping Center. We did get him, but it involved a long route to reach him. Now, Mary makes sure she has the phone--and the driver's number.

The week is developing a routine. Mondays are the longest because Mary has to arrive 45 minutes early to have a blood draw, then radiation, then wait for a visit with the attending physician, Dr. Cheng, the lead radiologist on Mary's case. On Tuesday, arrival is at the appointed hour, but then the chief resident radiologist requires a visit and one of the nursing staff who checks her weight and eating problems--or lack there of. Wed-Thurs-Fri are the most straightforward. Arrive about 15 minutes before the radiation appointment. Mary changes, they call her in, they zap her abdomen, send her out, she changes and finds her volunteer driver. Total time is easily less than an hour.

On Thursday evening I cooked a couple of chicken breasts, made a chicken-mushroom pasta dish on Friday, and today served chicken pasta leftovers for lunch and made a nice tossed salad featuring...(are you ready for this?)...chicken. Ok, it was only two chicken breasts but they were huge and Mary isn't eating a lot but does eat frequently. For breakfast today, I managed to make waffles again and this time Mary did not join me in the kitchen to rescue me if things went wrong. I don't know if she now has confidence that I won't poison her by accident or if she is feeling that tired from the radiation.

We had a great video chat with Mary's daughter and grand daughters who are currently visiting Wellington New Zealand. One of the topics was weather--Lara has only lived in Arizona and California and has never lived in weather, especially real winter weather which is what New Zealand has right now. Lara said the wind was so strong as they walked to the store she almost lost Emma as she started to blow away in the terrible wind!

They showed us on the video the currency and also the peanut butter--the brand was not Skippy. Food seems to be the challenge especially because Maddy has always been a picky eater.

Scott was hired to help finish the movie "Avatar" and it is supposed to be released in December. That means they all left on July 20 and Scott will be back by November. Lara and the girls will be back for the girls to return to school in six weeks or so.

That is all for now. Mary intends to do Farmers' Market in the morning and then join Ingrid and MaryR at the Purple Onion. This Sunday morning gather was our 'regular' event before the diagnosis. We are hoping to get back to that if Mary is strong enough. It is her intention, we don't know if her body will let her do it.

Just trying to spice things up a bit...

Mary continues with radiation and chemo and thanks to Terry for driving duties today. Peggy (yesterday) and Terry have a long trek just to get to our house to pick Mary up so an extra big thanks to these two Santa Cruz volunteers!

As for the status report, Mary said it best, "I feel like I have a chuck of overcooked meat in my gut. Oh, I guess I do!"

My contribution to spice things up was a trip to see my doctor today because of some symptoms of tingly fingers and quick, sharp pains in my upper left chest area. After an in-office EKG, she sent me on to ER for an enzyme test. Well, ER doesn't just "do" enzyme tests. So another EKG, frontal and lateral x-rays (which I don't really understand since x-rays and soft tissues are not the best of matches, especially since the heart is always moving) and then they slapped me in a bed for observation. Which meant I was hooked up to a pulse monitor, a different set of EKG adhesive sensors, a respiration monitor and who knows what else. And, the last thing they did? Ah, the enzyme test which happens to take 90 minutes to process. So I spent a most enjoyable afternoon and evening being monitored by the good folks at Good Sam. No crash cart, no big needles in the chest cavity, no nothing like that.

While Mary was not able to join me, MaryR did. My Mary determined I needed company more than she did.

The net, net? You are not gonna believe this as I walked out the door to go home, "Take two aspririn and call your doctor in the morning."

A very routine couple of days--except for Idjit Dawg

Thanks to Bill, Peggy and Terry for driving duties this week. Bill is on deck for tomorrow (again) and MaryR is set for Friday.

The appointment for the surgeon and the appointment for good ol' LA9 were at the same time this Friday. That conflict was solved by delaying the surgeon's visit to the following Friday (31) and not at the noon hour. In fact, its early enough that I will take Mary to the surgeon appointment, take her home and a couple hours later the volunteer driver can take her back for good ol' LA9.

As for idjit dawg, she has apparently decided that going down a flight of stairs to the dog run is just too much trouble. Four times in the past three days I have found her puddle of piddle in the hallway just beyond the staircase. Its as if she decides its closer and easier to skip the stairs and let the tile floor handle it. She knows I am mad and she knows she shouldn't do it, but that doesn't seem to have made an impact.

For those who have visited us at home, and found the living room barricaded off from the rest of the house, and several rolled up persian rugs stored in the secured living room, idjit dawg is the reason why. The original reason was that Wolfie in his Alzheimer's old age was having accidents so we sent all the rugs out for a good cleaning. When they were returned, we simply parked them in the living room until the Wolfie issue was resolved. Idjit dawg, not suffering from old age problems, simply doesn't seem to really internalize this discipline so the rugs remain in storage, and I remain on guard for clean up duty. Idjit dawg...

Ah, the essence of technology

Mary had the long day today with blood test, an extra half hour on her old friend LA9 as they debugged the computer after she had already gotten into the machine, a wait for the weekly doctor visit and then--voila!--no cell phone to call Bill! Seems Mary was a bit distracted when Bill arrived to take her to Stanford, and given it was a long session, he ran errands rather than hang around the Cancer Center. Mary's phone was left on the table at home and she didn't notice it until she went to call him. It is really tough to get a cell phone technology to work when its 21 miles away from where you are.

Mary nor I have Bill's cell phone number memorized, probably because these days once you load a number into a phone and put a name on it, you never look at the number again. Oh how technology frees our minds from clutter!

Mary called me at work about 30 nanoseconds after I had instructed my pc to shut down because I was in a meeting. Do you have any idea how long it takes a corporate computer with all those corporate background programs to first shut down and then reboot? I think Mary was on the line for 20 minutes or so. Eventually, I got to the phone directory for Mary's Taxi team and looked up Bill's number.

Mary did get home so I assumed they connected! She is fine today, feeling the radiation a bit and taking her sleeping-nausea medications. Apparently, the one that has no side effects is not generic so the insurance company doesn't reimburse as much and Mary is trying to save a few $$. I'm gonna talk to our girl about that!

Now, a technology marvel was the moon landing 40 years ago. My sister, Maureen, reminded me that my folks had a combined graduation and going away party for me on July 20, 1969. We had a house full of people and a good time was had by all. But, it was the party that would not end.

We had set the hours for a kind of open house on Sunday afternoon to align with the planned moon landing and moon walk--approximately 2PM to 5PM, Minnesota time. Our buddies Buzz and Neil landed at the right time, 3:17PM Minnesota daylight time--it sure made for a memorable party for my career send off! But, Buzz and Neil blew us off and delayed the moon walk a few hours. The net result is that no one, and I mean no one, would leave because they didn't want to miss the moon walk. Hey, no video recorders or TiVo's or any of that back then. My Mom was going nuts. We were out of food, out of drinks, out of everything and no one would even run to the store to pick up some more goodies. They might miss it! So Dad kept a pot of coffee brewing so our guests' choice became coffee or water.

My sister reminded me that my dear Aunt Peggy was in great spirits, telling stories, laughing and generally being really upbeat as the evening wore on and we couldn't figure it out. I mean, the anticipation and tension among the rest of us was so thick you could cut it with a knife! Much later we learned Aunt Peggy was the reason the coffee was disappearing--and the whisky at about the same rate! She was, shall we say, relieving her tension with the aid of some good Irish stock my Dad kept around the house.

As I write this, I am listening to the JFK Presidential Library's replay of the audio tapes from 40 years ago. They have them synchronized so they are exactly 40 years plus or minus a second later from when they really happened. They just announced the EVA (External Vehicle Activity) would begin in 36 minutes. Well, that means the EVA happened at roughly 9PM Minnesota time--which means the afternoon open house ran a bit late, like maybe four hours longer than we planned? (The JFK library is making the tapes available for on-line replay after the sequence has been fully run.)

The wonder of it all. Those guys were nuts! I recall the worry that the moon dust and rocks would come back carrying an unidentified virus or bacteria that would wipe out life on earth as we know it. Or, that the moon walk suits would fail and we'd watch in horror as a brave astronaut died on live TV. Or the LEM (Eagle) would not be able to take off and reconnect with the capsule (Columbia). It was truly an amazing feat. And, given that we have not returned to the moon since then, it is an indication of what a tremendous accomplishment it was.

I've looked it up and Neil Armstrong started down the ladder at 9:39 CDT and stepped foot on the moon at 9:56PM CDT. They walked for about two hours until just after midnight, 12:11AM CDT on Monday.

Ok, now for the trivia bit. Do you realize that reality, more often than not, is far more reaching than we can imagine it. How so, you ask? For decades, perhaps longer, science fiction writers imagined traveling to the moon. And, for decades, science fiction writers imagined TV (or some instantaneous image transfer device). But no writer ever put the two together that a TV image would be broadcast back to earth while the first man stepped on the moon.

OK, time to go.

A Really Quiet Sunday

We did make it to Farmers' Market and bought our fresh salmon, tuna and corn. The Los Gatos Farmers' Market has a fish vendor who comes up from Santa Cruz on Sundays. Its really great fish!

Mary was not sharp during the shopping, and in fact, took a walker with her because she felt unstable. I thought it was radiation effects. Turns out the docs gave her four different kinds of nausea meds and told her she should optimize them taking no more than any two at a time. In preparation for Monday's radiation treatment and to test the effect of one of the meds, she took a proper dose of a generic for Phenergan at breakfast. We now know what the side effect is. She was standing on her feet sleepy (and loopy) and when we got home, crawled into bed and didn't wake up until almost 4PM. This is now her nausea-sleeping pill medication.

Once the effects of that wore off, she was fine. We cooked up a nice salmon dinner with fresh corn on the cob and broccoli. We went for a nice walk about sunset, met some neighbors and had nice chats before we finished the walk and headed home.

Our taxi team this week is Bill (x2), Peggy, Terry and MaryR. Monday is a long day because it starts with a blood test about 45 min before the radiation treatment and ends after seeing the radiologist which can take some time--waiting for him, of course. Tues-Wed--Thurs should be straightforward if the machine (LA-9) is available. (Trivia bit--LA probably stands for Linear Accelerator, and I assume this is their 9th version of same.) For a 12:30 appointment, Mary is out of there by 1:00 to 1:05--if it runs on time. Of course, there is no way to know if they are on time until you show up. On Friday, its another long day as Mary has an appointment with the surgeon in addition to her radiation treatment.

Mary's daughter, son-in-law and two granddaughters head off for New Zealand tonight! Scott has an assignment to work on some new super-duper movie and he will be staying until November. Lara and the girls will be back before school starts. The only bad news is that these California residents are traveling during the winter months down under...get your mind around that, eh?

All in all, it was a very nice weekend although I wish Mary hadn't reacted to the nausea medication the way she did. Sunday was a lovely warm day and she missed most of it.

A Nice Visit!

Thomas, Susan and Joki stopped by for a visit today and we really enjoyed having them stop in. Joki brought an Elmo doll made out of balloons from the San Francisco wharf and that was a special treat! I hope you enjoy the pictures. This week was the trade show, Semicon/West, held in San Francisco and that is the draw that brings our German friends to the area.

The day started with Mary declaring she wanted waffles for breakfast. I didn't know if they made frozen waffles and if they did, if Mary would be willing to eat them. She then informed me that I would make them here. Uh-huh. We are talking about the man who burns water while trying to boil it.

The recipe starts with a quick trip to the supermarket to pick up waffle mix and syrup. Then you follow the instructions on the back of the box! Of course, you need to pull the waffle maker out of the cabinet and pre-heat it but that pretty straightforward. Mary did the duty of putting the batter into the waffle maker and the waffles were very good.

We also went out for a shopping trip before the visit. We dropped off and picked up the dry cleaning, hit the bank teller machine, picked up some killer goodies at the bakery and then did some shopping for more comfortable undergarments for Mary. She was successful and found the items she had in mind in a little shop in Los Gatos. We headed home and a short while later Joki and Elmo arrived to start the visit.

Overall, Mary gets tired quickly, but she is eating well. Its nice to have two days off from both the chemo and radiation. That will start again on Monday.

The week is done

The cable company only rescheduled the appointment twice...and finally did show up and fix things. I wasn't home so I don't know what they did, but the new cable modem is working just fine! We are back on line, our TiVo-Netflix on-line and our VoIP phones are also working. Success!

Mary finished the first week of chemo and radiation. She is eating well. Although she feels tired, we did go for a walk after dinner. Again, I want to thank our first taxi team: Marge, Terry, Bill and MaryR. Thank you so much!

Milt and Dilip did stop in for a visit and that was very nice. I was late, unfortunately, because of a meeting that ran late but we had a good time talking, laughing and telling stories.

Joki called, and he'll be over tomorrow afternoon with Thomas and Susan. That will be a good visit, we haven't seen them since Joki and Ute were married in Germany last November.

Next week's radiation is set for 12:30 for all five days. Monday will be longer because Mary has to arrive a bit early because she needs a blood draw prior to the radiation and has to wait to see the radiology doctor after the treatment. On Friday, Mary has a radiation treatment and the follow up with the surgeon set at the same time. That will be reset to optimize the time. The team for next week is Bill, Peggy, Terry and MaryR. An extra thanks to Bill who has graciously agreed to do two days next week.

Don't you just love the cable company?

We have been off-line for most of the past 72 hours. The first technician I chatted with was convinced my modem had failed. No, your people were in the neighborhood and were working on the lines in my block and to my house. That's when the failure started. He wouldn't hear of it. It had to be my modem. Yeah, right!

You cannot win that discussion until you buy a new cable modem. So, I bought Motorola's super duper high speed modem and installed it last night. You have to give Brand, Model, Serial Number, MAC ID, first born and two units of whole blood to Comcast to get them to authorize it on their network. So I contacted Comcast and got Technician #2.

Technician #2 was very impatient with me, was convinced the new modem would work and signed off before I had completed the install. His Comcast chat name was Butch. What my mind's eye imagines...

Technician #3 was more patient, listened to everything I did and has ordered a technician to the house to check the Comcast wiring. Of course, I was only on the chat line with #3 for almost 2 hours. And, that was to get to the point that I knew was required when this all started on Tuesday.

Anyway, we use VoIP phones for the house, Skype and Yahoo phone service and none of them work when the internet connection is down. But, the home phones are programmed to call my cell phone so you can still reach us. Or, call Mary's cell directly if you need to connect.

Otherwise, a normal day. We expect Milt to drop in late this afternoon for a visit and tomorrow afternoon will be Thomas, Susan and Joki from Germany. Mary was up with me, ate breakfast, showered and dressed on the assumption the cable guy will arrive as scheduled. We are optimists, yes?

Another simple day

First, thanks to Bill for his taxi duties today.  We really do appreciate it.

 

Second, the rest of the day was very ordinary.  Mary is feeling tired and going for an after dinner walk led to some discomfort so we made it a short walk. 

 

Third, Comcast is still not functioning right. I purchased a new modem, installed it, contacted Comcast to activate it. The analyst at their end assured me it would work great. Wrong. I am now with a 2nd analyst who has asked for the same info I gave to the first one about an hour ago.  You have to give them Manufacturer, Model Number, Serial Number and MAC address.

 

They analyst just asked for all the same data--again. 

 

And, the new modem has the same non-functional indicator as the prior modem. 

 

That's all for tonight. MaryR is up for driving duties tomorrow. 

An uneventful day

Mary was driven to her radiation therapy by Terry, thank you! Marge did duty on Monday and Tuesday and Thank You! Bill is Thursday and MaryR is on deck for Friday.

The radiation department does give parking passes so we don't have to cough up the $6. Nice.

Mary and Terry arrived as planned a few minutes before the appointment. They then called Mary's name and told her they were running about half an hour late. Terry had brought a book so, like Marge, she did some reading while Mary went through the procedure.

We had a nice dinner of a shrimp salad and Mary ate very well and has no problem holding her food. The Zofran is working nicely. We went for a nice walk after dinner. She is feeling a bit tired but that is expected with radiation.

Mary just asked me to do her eyedrops (for her glaucoma) and then I am going to run down to the drugstore to pick up one of the Zofran generics we missed on Monday.

Ciao!

Normal returns

Mary saw the doctor again today, this time the radiation fellow instead of the radiation attending physician. Man, Stanford has a lot of doctors running--scratch that--rambling around.

Anyway, the recommendation is that because she is feeling ok on the Zofran, she should limit herself to just that unless it is not doing the job. Then she can start with some of the other meds we picked up. Zofran apparently works best in advance. Yesterday, she took it after the nausea hit and that is basically too late to have a real impact. Being on the regimen today has brought her back to where she was before the first radiation.

For dinner, I baked the fresh caught salmon from Sunday's Farmer's Market and also baked some small red potatoes. Mary ate well and kept it all to herself. No more sacrifice baseball caps, I hope.

Marge reported that waiting in the radiation waiting room was just fine although it was a long session because the radiation fellow wanted to see Mary after yesterday's episode. It turns out that radiation gives out parking passes so we don't have to pay the $6 to park the car for about 50 minutes. Marge delivered yesterday and stuck for the whole program today. Thank you Marge! Tomorrow (Wed) Terry is on deck. I don't remember the rest of the week and Comcast is down so I am using a phone card to connect. Its slow and I am not about to go surfing the web on these supposedly fast speeds.

I, for one, am glad the nausea meds are working. It was a shock to see her system react so strongly to the first day of radiation so its good to see her more like herself.

The good news and the bad news

The good news is that the biphasic CT scan was absolutely clean. Further good news is that Mary started her radiation therapy on Monday as planned. In fact, Mary even started the companion chemotherapy last night and continued this morning.

The bad news is that the radiation made her seriously nauseous on the way home from the hospital--we didn't even have time to get to the drugstore to pick up the medications. And was certainly a lot sooner than the doctor's advice, "You may start feeling nauseous and tired in 10 days to two weeks." Hah! More like 10 minutes to two hours! It was a good thing we were driving Mary's convertible (top up in yesterday's high temperature) because we have baseball caps at hand for wind or sun and now for nauseous passengers who need a spittoon.

The doctor had written two scripts for nausea meds while we were there. With the immediate nausea and our call back to the hospital, they wrote two more scripts and Mary is to optimize the nausea meds to her best benefit. Stanford sends the prescriptions electronically to our Los Gatos Walgreen's store. We don't have to run around with paper prescriptions (aka script) nor have the doctor "call it in."

After she started the medications, she has been able to eat a bit. She admits that nothing appeals to her except fresh fruit and cottage cheese. I fed her two plates of cheese and fruit several hours apart once the meds kicked in last night. She was able to keep it down along with the chemo drugs and had a successful night's sleep too.

Dancing on the ceiling!

First off, we are both so relieved! It could have gone so bad at this point and instead it is very good. The Fellow said that all three doctors plus the radiologist plowed over every image from the biphasic CT scan. And they found nothing of importance! There were a couple anomalies but they had nothing to do with the cancer situation. Hey, no one is perfect!

Let me be clear, even in the area of the liver and modified plumbing, there were no cancer sites observed. Talk about your dancing on the ceiling!

So, why is Mary doing radiation and chemo therapies (details below)? For the simple reason that the biphasic CT scan can only find things that are a certain size and larger. Remember, the pathologists, working under microscopes, did find cancerous material in the removed bile duct tissues. And, the margin between what they observed and what Dr. Visser left in her abdomen was inadequate. The CT scan cannot find cancer cells of that size--they are much too small. If there is cancer present and it is microscopic, the biphasic CT scan will pick it up after it grows a bit larger.

Dr. Fisher spent quite a bit of time with us. He did a poke, probe and listen to Mary's lungs and abdomen. He then informed us that chemo would be done simultaneously with radiation. The particular chemo is known to enhance the affect of radiation on cancer cells. It may also enhance the reaction by some normal tissue as well but we'll just have to be on guard.

Mary will likely have some side effects with this chemo. He gave us a rundown of what to expect and when to start or stop certain of the therapies to make sure there is no exacerbation of the problem. The chemo will likely cause some skin problems, mouth sores and loose bowels--although none of these are absolutes. The brand name for this "mild" chemo is Xeloda. Mary will take a dose morning and evening after meals.

What happens after the radiation is completed in about 6 weeks (or perhaps a bit more)? No one knows yet. About a month after the last radiation treatment, Mary will have another biphasic CT scan. At that point, if it is also clean, they may or may not put her on chemo and it may or may not be mild or aggressive if she goes on it. If she does go on it, it could be for four to six months of chemo depending on what they proscribe. Basically, cholangiocarcinoma (bile duct cancer) has not been studied in depth for a lack of cases--it is just too rare--so there is no statistically derived protocol for treatment. No matter what, she will be on a surveillance schedule to provide early detection of any subsequent cancer.

Now, just to let you know how hospitals teach patience to their patients. The blood order had not arrived at the blood draw station. Someone didn't submit it correctly, apparently (the same someone, we think, that messed up the CT scan order from a few weeks ago). So instead of a 9:30 blood draw, it was more like 10:15. Which, delays the Oncologist for he wants the results before he is willing to see Mary. So, the 10:30 appointment slipped a little bit--we saw the Fellow at 12:10 and the Oncologist at 12:40. As a result, we finished the 10:30 appointment at 1PM and grabbed a sandwich from the Cafe in the Cancer Center. We arrived at the radiation department at 1:25PM, Mary changed into a gown and promptly at 1:30 they called her name--to tell her they would be 15 minutes late. At 1:45 they called her name--to tell her it would be another 15 minutes. At 2PM, they called her name and Mary is in having her treatment as I write this.

I still don't know what time she is scheduled for tomorrow. Our corps of volunteer drivers would like to know and hopefully that will be confirmed today.

But all that doesn't matter! The outcome is the best possible! No detected cancer sites. We are feeling more than pretty good right now. In fact, dancing on the ceiling doesn't describe it!

Preliminary Report!

The fellow just stopped and did what fellows do. We are waiting for Dr. Fisher. 

What the fellow has told us is that the biphasic CT scan was clean.  No potential cancerous sites anywhere in her abdomen!  

Clean. 

Nothing visible. 

Great News!  

Really great news!  

Yes, she'll have to do follow on scans, etc., but basically the radiation is targeting the liver area where cancer was seen at the microscope level in the pathology analysis.  

More later. 

Mary's progress

Hi Pat and Mary,

I just wanted to check in and see how Mary is progressing. My best to you both.

Dee

Taxi Team Schedule

If anyone is wondering if we need more drivers, this is a view of the taxi team's availability. You cannot edit this directly, you need to send me an email and I can make adjustments, including adding you to the authorized list.

Pictures!

Ok, ok, I am just working on my blog and programming skills.

She's Baaaccckkk!

It is such a good feeling to see Mary back in the kitchen preparing food. She made a tossed salad with some of yesterday's sliced chicken for tonight's dinner. This first picture is the "Veggie Dogs" getting their romain lettuce treats. What can I say, our dogs like veggies! Looks like idjit dawg uses her tail to stand for her veggies. Not true, she stands, jumps and leaps just cuz its food.
I took this picture just because it is so normal and conventional. And, frankly, that is a very good feeling. I realize we are going to hear news from the Oncologist on Monday but until that news is delivered, I want to celebrate a very normal part of life today! Now, I must admit that I take a much more active role in the kitchen than before all this started. Mary still doesn't have all her energy and strength back but she is making good progress. We hope that continues although six weeks of radiation will impact her quite a bit, we are sure.

It's not a big deal

The surgeon took a series of Q-tip like thingys and pushed and probed through the skin into the area of interest. He agreed we should have come in, it is an infection, and he feels that his poking and probing has done what is necessary to break things up so it can heal. And, he is glad she will be back in 2 weeks for her regular appointment so he can check up on it again--plus he can see how Mary is handling the first two weeks of radiation.

He did feel the infection would have no impact on the radiation next week.

Mary did ask about the results of the three doctors discussing her case with the biphasic CT scan results. He said that he, Dr. Chang and Dr. Fisher were scheduled to review three cases tonight and Mary was one of them. That means we learn it all on Monday morning.

Mary did tell the doctors she feels she "turned the corner" and is feeling very close to normal. I have to agree! We saw it turn as the grand daughters arrived on Friday and she hit the high point Wed this week. Yesterday she had a rough spot either from missing a dose of the remaining pain killer or from waiting too long for her afternoon snack.

As for the pain killer, she is down to three pills a day and getting to two is not easy so instead we are going to increase the hours between pills: 10 hours between pills for a few days and then to 12 hours, etc. I am amazed at the impact the narcotics have on her, but that may explain why she reacts so intensely to any narcotics or opiates.

Many members of Mary's book club have volunteered with taxi duties and we're adding them to the schedule now. The difficulty is that the hospital keeps moving things around. For example, the radiation lab called today and moved the 12:30 appointment on Monday to 1:30PM. We'll need to be flexible!

A little thing

Along the incision, Mary has developed a rather ugly spot that is sore to the touch. Frankly, I think its some kind of infection that has/is congealing under the skin. However, because its looking uglier than better, I asked Mary to call the surgeon's office just to be sure.

Net, net we have an appointment on Friday afternoon at 3PM. They want to be sure it is nothing or if it is something, to do something about it. Lance it? Remove it? Who knows but it is apparently not a good idea to assume it is ok as one starts into radiation.

MaryR has again agreed to deliver her to the hospital. I'll join at the appointed hour and take her home.

For those who don't know our geography, our home is pretty much due south from my office and that is about 11 miles to drive. Stanford is about 14 miles in a west northwest directon from my office. Having a volunteer take Mary to Stanford saves me a lot of wear and tear and gives me another 30 minutes at work which is good given all the time I've been taking off.

Joy is in the simple things

Tonight, as I was driving home, Mary and I talked about dinner. She had decided on dinner as a baked sweet potato, chicken and a green salad. My commute time is about 30 minutes and it was a touch longer tonight because I had to stop and get dog food for Shauna. And yes, we have bluetooth in all our cars so we can talk hands free and comply with California law.

A call--Mary reports the chicken is badly freezer burnt and probably will prove to be inedible. After picking up the dog food, head to the grocery store to pick up a cooked chicken. And while there, throw together a salad at the salad bar for dinner as well, Mary requests.

When I get home, she asks if we can go for a walk before dinner. I agree but mention that the sweet potato ought to go into the oven. Mary reported it was already in the oven. That is the first of the simple things--its the first thing she has cooked since May 10th!

I change and we go for a walk. That is another simple joy. Mary was full of enough energy to walk before dinner. A great feeling.

When we return, I set about the task of feeding the dogs and that involves putting the new supply of dog food into the storage container plus the protocol of doggy meals in our house. When that is all done, I walk into the kitchen and see that Mary has set the table, has tossed and dressed the salad and was carving the bird! What a joy! Mary fully engaged in preparing the meal was absolutely wonderful!

She exhibited a healthy appetite and ate without any difficulty. That just tickled me to see her being so normal.

And the kicker? I cleared the table and then put our garbage bins at the curb which took a few minutes as I had to cut down several large cardboard boxes. When I came back into the house to put the dishes into the dishwasher--it was done! Mary had rinsed and loaded the dishwasher.

It is absolutely amazing how much joy one can find in the simple things. This is so far from where she was one week ago, it is nearly mind blowing to see the progress. Oh, she did express one complaint...the kitchen utensils had not always been put away in the proper drawer. Let see, we've had how many cooks in that kitchen since March? What is the expression? Oh yeah, "get over it!"

As for medical issues, there are none to speak of. We haven't heard a peep from Stanford so we hope that means the CT biphasic scan has not detected any inter-peritoneal disseminated cancer sites.

That's all for now.

Quiet Time

We really have no news for a while--unless Stanford calls.

We have the visit with the oncologist on Monday morning at 10:30 to discuss the results of yesterday's biphasic CT scan. At 12:30 on Monday, Mary starts her radiation therapy assuming there is no change dictated by the results of the CT scan. Marge has agreed to be the Taxi Service for Monday.

There is the possibility they call and tell us they radiation is being rescheduled. If that happens, it would be a clue that the CT scan results show that chemo will need to be done first. Unless and until that happens, there is really nothing to do except work on Mary getting stronger.

Speaking of Taxi Service, we now have a strong line up consisting of Marge, MaryR, Bill, Ingrid, Marite, Terry, Ingrid and me, too, when possible. Hopefully, that means that of the 25 planned radiation visits, our drivers have no more than four trips each over the six weeks. I have a shutdown week during the six weeks and that adds five days to total 30 visits.

Mary has survived my cooking for some time now. Last night was ahi tuna grilled to perfection, I might add. Sunday night was giant prawns sauteed nicely. We also had corn on the cob and broccoli. All the ingredients come from our Farmers' Market on Sunday--yes, even the fish from a fish monger based in Santa Cruz who does only Los Gatos and Los Altos Farmers Markets. Mary has done a bit prepping food for cooking and has done a lot coaching and answering my questions. It is good to see her in the kitchen and actively participating. Heck, she made herself a prawn salad for lunch today with an extra I cooked Sunday evening.

Tomorrow is the day for The Maids to do the biweekly house cleaning and Mary said she'd just go hang out on the back deck with the dogs. There is both sun and shade on our deck and they'll be there from 11:30 to 1:30 and our weather has turned mild so that is not too bad.

What do we know now?

Not much that is new, unfortunately.

We have an appointment with the Oncologist, Dr Fisher, Monday at 10:30AM. That is when we learn if Mary will be doing radiation or chemo first. And, if it is chemo, if its mild or aggressive.

Today's test, the biphasic CT scan, was from her neck to her groin. As one Stanford web page said, cholangiocarcinoma can seed itself to other organs: pancreas, lymph nodes, duodenum, bowel, bladder, rectum, ovaries or lungs. This seeding is called intra-peritoneal dissemination and is quite common with this disease. You can read a description of the biphasic CT scan by clicking on this link under the paragraph entitled "Evaluation of Liver Cancer." Apparently, the biphasic CT scan can detect very small tumor sites that would be missed by other imaging techniques.

If nothing is found in the biphasic CT scan, does that mean Mary is clean of disseminated cancer cells? OR, does it mean they are too small to detect now? If they are too small, when can they be detected? Or, do they blast Mary with aggressive chemo because they cannot find microscopic cancer cells? Only time will tell. Hopefully, we'll know more on Monday with Dr. Fisher.

Progress!

Mary and I are in the biphasic CT Scan waiting area. MaryR delivered
her and I'll be taking her home.

The hangup was insurance paperwork and that is now fixed. They have
also moved her first radiation treatment to Monday. That gives another
week for Mary to get stronger plus allows the doctors to confer during
their next round of golf. Well, maybe in a conference room.

Monday Morning

I am up early (for me) because I have a 9AM meeting. In a few minutes, I'll be on the phone trying to figure out when/how Mary can get the biphasic CT scan done.

Our taxi corp has confirmed a good number of the days in July so I think we are generally ok, but if anyone else wants to offer let me know and I'll add you to the team and send the info. Send an email to (type into your email address without the spaces): pat @ lamey - hughes . com


Mary really enjoyed having her granddaughters here for the 4th. My favorite pictures are the Sunday morning bed buddy picture and the sister act picture. Enjoy the entire album if you prefer.

Mary enjoyed the weekend with the granddaughters and now she is resting. I snapped this picture this morning after Mary and I returned from Farmers' Market in Los Gatos. It was Mary's first trip to the market since the day before surgery on May 10th. She said she would be back in July and she made it! On the first available weekend, too!

The 4th comes to a close

Scott and Lara picked up some safe fireworks on their drive from Pasadena. Here are a couple of night shots. If you would like to see more of our 4th of July, click here to go to our photo album for July 4th!

A very nice walk on the 4th!

Mary's Granddaughters Maddie and Emma visited for the 4th. Here are a couple snapshots from the walk with the girls and the three dogs. Maddie and Emma brought their dog, Rosie, who tired out quickly and snatched a ride in Mary's walker.




I should note that Mary uses the walker because it has a built in seat and if she feels tired, she can sit for a minute very easily. She doesn't need it for stability at all anymore.

Maddie is 9 this year and Emma is 5.

More pictures when you go to www.lamey-hughes.com and click on the link to "Our Most Recent Albums" near the bottom of the home page.

All of a sudden, things are moving

We had not heard about the CT scan ordered by the oncologist, so I called today. The radiation folks didn't know about it so they referred me to the doctor's service. We got a quick callback and they said that it really needs to be done ASAP. The reason is that they want the results before the scheduled radiation begins which is now set for Wednesday. It may be set over the weekend or on Monday, we shall see.

This test plus others will form the basis of a conference among the oncologist, surgeon and radiologist for the optimum course of action. The Stanford website cites the "seeding" of cancer sites caused by cholangiocarcinoma and its termed intra-peritoneal dissemination.

Mary's digestive system ran into some difficulty for a few days caused by the painkiller but with some help from over the counter medicines, everything is ok again. That is good because her daughter, son-in-law and two granddaughters arrive tomorrow from Pasadena for the 4th weekend. We should have a good time with the girls!

A New Experience

Today is another day at Stanford in the Cancer Center. Mary is having a PET Scan of her abdomen to help the radiologists determine where and how much radiation to hit her with. Stanford's PET Scan itself takes several hours--the technician estimated 3 to 4 hours. Mary must be dying of hunger, she was not allowed to eat or drink prior to the beginning of this procedure at 9AM. At some time during the procedure, they will also make a body mold of her back so she can rest comfortably and totally still for the eventual radiation treatments.

There is a small snack shop in the Cancer Center with tables in the lobby for eating, waiting, or like me, using the wireless system. So far, I have said hello to Dr. Fisher and Dr. Visser (there is a limerick in there somewhere, I can feel it coming on), the Oncologist and Surgeon respectfully. Seems this is their latte station and I am camped out at the front door.

As I wrote on Monday, we still need to schedule the high resolution CT scan per the order of the Oncologist, Dr. Fisher. They have not called yet so I suppose we need to bug them today. Typically, an order gets processed within 24 hours so Wednesday is a bit long. Given the recommendation for Mary's next steps in treatment are dependent on those results, we are anxious to get that test done so we can set a plan.

The snack shop faces a door labeled "Staff Area" from which a Ramble of Residents appeared being lead by a senior person in a white lab coat. July 1st is rumored to be day 1 for this year's crop and that would make sense. They stopped while the senior person was pointing in different directions explaining the layout of the facilities and, in particular, the snack shop behind me. It's kinda obvious, facing the staff area door, with window displays of food and drinks proudly displayed and the label on the door stating "STANFORD CAFE" but maybe that is ambiguous? Newbies are newbies the world over, eh?

Anyway, its a good thing this is a shutdown week. Its too bad we couldn't get the CT Scan done too so we don't have to make arrangements for next week. We may have to call upon our corp of volunteer drivers--Marge, Ingrid, Terry and Mary. We'll know more once the appointment is confirmed.