No conclusion means no bad news

We saw the Oncologist, he poked and probed and told us that the blood tests, xray, bone scan and MRI were inconclusive--which means it could be a cancer or it may not be a cancer. To maximize the certainty, he has ordered up a PET/CT scan which may give us the answers IF this is a cancer. If the PET/CT scan comes back negative, then Mary will see the back and pain doctors.

They gave Mary another, different narcotic to attack the pain. This time it is a transdermal patch. Taking that with Celebrex may resolve the horrible pain levels she is experiencing. And, because it is transdermal, it should avoid the stomach problems she has experienced with Vicodin and Oxycodone.

The plan: Mary will see the surgeon as planned on Friday. The next visit with the Oncologist is the 10th. Sometime between today and Thursday the 10th, she is supposed to complete the PET/CT scan--Stanford will call with an appointment. Mary starts the transdermal patch as soon as she and/or Reenie pick it up at Walgreen's today. If the patch isn't having enough effect by Wed, she is to double up on patches because they are starting her on a kid's dose. If adult dose of the patch plus Celebrex together aren't providing the right result, she is supposed to call on Friday for yet a different narcotic. This one is administered by drops into the mouth to be absorbed.

All in all, we are hopeful the new narcotic will knock down her pain at a minimum. And, that if the PET/CT scan does not confirm a cancer, then the source can be easily identified and quickly fixed.

Mary and Reenie headed to Walgreen's and then home.

Thanksgiving and Enchiladas

Thanksgiving Week is almost done. We are looking forward to the visit with Dr. Fisher tomorrow to see if we can learn what is going on with Mary's back pain. Hopefully, he will have some ideas on how it can get better.

Friday was Minnesota Enchilada day--taste great, not too authentic. I am going to make a video out of all the pictures and clips I took during the great enchilada event. I will post that next weekend probably.

2009-11-27 Minnesota Turkey Enchiladas

And, here are our pictures from the few days prior to T-day. You can click on the pictures and it will take you to our picasa album location.

2009-11-26 Thanksgiving

Mary had a rough day

Mary just noted she was still in her pajamas and it's 8pm. Stomach pain all day with moderate back pain was the theme of the day.

She has eaten well but the stomach pain has been difficult.

Reenie did laundry most of the day. I started to work on my movie entitled "Minnesota Thanksgiving Turkey Enchiladas". It's a documentary on Mary's Turkey enchiladas. Hopefully, this will properly record her family's favorite dish.

Friday report

Friday was a pretty good day. Mary took one of the milder narcotics yesterday to help her back pain. It did help a bit but she suffered mild pain most of the day.

Glenn and Michele stopped by for a quick visit and they met Reenie, Tom, Daniel and Kamie during their visit.

Afterwards, Tom and Reenie did the grocery shopping to get ready for the enchilada making party. When our neighbor arrived with a note pad, the team event began. Mary sat at the breakfast area and instructed the team. Tom cut the five bunches of onions, Daniel shredded the two bricks of cheese, Kamie worked the cans of fixings and heated them on the stove top while Reenie shredded the turkey. Once the onions were done, Tom heated the tortillas. At the critical moment, Mary jointed the work team and instructed on how to load the tortillas, fixings, stuffing and roll them into the proper shape in the pan. We did add chili pepper about half way through to create both mild and hot versions of the enchiladas. We had a great dinner and froze a bunch too. Mary will ship a small container to her son Tim a little later in the week.

Daniel and Kamie are flying home this morning. Daniel had a 9AM out of San Jose and Kamie has a noon flight out of SFO. Tom will drop her off and continue on to Pleasant Hill to visit his brother.

We'll work on Mary's pain today and see what we can to to make it better.

Happy Thanksgiving!

Mary toughed it out today and used Tylenol and Advil to control the pain and avoided the narcotics. Her stomach was fine but the back pain was a bit extreme at times. Basically, though, she enjoyed the Thanksgiving holiday and spent a good amount of time in the kitchen helping Reenie preparing the meal plus she was able to eat a very generous (for Mary) plate of food.

She also had the pumpkin pie dessert!

She has lost 5 lbs of bloat since starting the diuretics a few days ago and that has taken pressure off of her abdomen. She has one or two more lbs to lose to be back to pre-bloat weight.

We did video conference with two of Reenie's sons, daughter-in-law today, and d-i-l's family. We also did video conference with Mary's daughter, son-in-law and grand daughters in Pasadena. Mary talked with her oldest son and I talked with my sister and brother so we can good connections all around. I had talked with my son and daughter earlier in the week.

The household is off to bed. Kamie and Daniel are actual doing early black Friday shopping. The oldsters are simply exhausted.

Mary's famous turkey enchiladas tomorrow!

Pat (writing from Mary's computer).

Wednesday wasn't so great either

Mary is really wrestling with the pain killer and the stomach meds. Too much pain killer for her back and her stomach heads to Antarctica. Not enough painkiller and her stomach is ok but her back approximates the treatments handed out during the Inquisition. Tonight she is going to minimize the narcotic and increase the OTC (over the counter) stuff to see if she can find a happy medium.

Although her day wasn't great, she joined us for dinner at 7PM and was with us past 10PM so she was feeling better. Other than an excursion while The Maids were here, Mary spent most of the day just resting in her lounge chair.

Kamie and Daniel went shopping in the late afternoon. Reenie has been buzzing in the kitchen with a wonderful pasta dinner. She also made the pumpkin pie and some bread stuff for appetizers tomorrow--yum!

When The Maids were here, we went to Oak Meadow park for a while and then headed for The Onion for lunch. At about the 2.5 hour mark we headed home which was Mary's limit at that point.

We are hopeful Mary can join us for the bulk of tomorrows festivities!

Tuesday wasn't as good

Mary had a bit of a rough day. Not so much back pain as stomach difficulty. We are back to trying to optimize pain killer, food intake and back pain. Most of her tummy difficulty happened in the morning and Reenie did a good job providing "grazing" food for Mary all afternoon.

Daniel and Kamie headed for Monterey today and spent it at the Aquarium. Reenie and Tom did the shopping to get ready for T-day. I went to work and Mary spent most of the day resting in hopes of getting her tummy to settle.

Mary joined us for dinner and had the pot roast and veggies. A smaller portion that normal but then again, Reenie was feeding her all afternoon.

All in all, it was ok and we are all focused on making sure Thanksgiving is a great day for Mary.

Kamie arrived per plan

Kamie arrived from Pennsylvania as planned. Reenie fixed a great salmon dinner last night and we emptied at least one bottle of wine amongst the five of us who are imbibing right now. Mary is abstaining because of the heavy duty painkiller she is taking.

We have no word from Stanford about the results of the X-ray taken on Friday. And, we are adjusting the dose of the painkiller within the bounds of the prescription. The doctor wrote it for one or two tablets every six hours as needed. So far, Mary has only done one tablet. Last night as she went to bed, she let me cut a tablet in half so she took 1.5 at bedtime. She slept pretty well but she did wake up from back pain in the wee hours of the morning.

Tom and Daniel are spending a lot of time together. They have been banished to the front yard when they have their buddy-buddy time with their red Marlboro's.

Daniel hijacked Mary's computer yesterday and posted an item on Mary's Facebook page, claiming Mary was so excited to see her FAVORITE son for Thanksgiving. I have a feeling Daniel will pay the price for that the next time he sees Mary's number 1 offspring, his brother Tim.

All in all, things are good. We just have to make sure Mary doesn't overextend herself trying to keep up with the visitors. She did that a bit last night by not having a late afternoon snack. By the time dinner was ready, she was not able to eat because her tummy was giving her great discomfort. Today, Reenie promises to make sure that doesn't happen again.

The next major medical step is the visit with the Oncologist on Monday at 1PM. We don't expect to hear anything before then.

Monday!

Daniel arrived late at San Jose so we left directly for SFO to pick up
Reenie and Tom. We managed to get to baggage claim about 1minute
before they did. When we got home, Mary had prepared bean soup and as is
the case when Daniel is here, no leftovers!

No word on Friday's x-Ray.

Mary's family arrives today

Pick up for Daniel is 3:45PM at San Jose and for Reenie and Tom its 4:30 at San Francisco. Depending on how Mary feels, she may join me at San Jose with a 2nd car and take Daniel home. We'd like to do that because he is recovering from surgery on his foot and I am pretty sure he won't be feeling good after two plane flights and a change of planes in Phoenix. And, although we have three cars--if you can call a Honda Element a car--they are all limited to four passengers.

As for Mary, its been a couple of rough days. Her rate of bloat has stopped but she is uncomfortable--bloated. She is now back on the two diuretics she has been on before and we know those work. As Mary said, it takes about 36 hours and then the flood gates open--if you get my drift.

The switchover from painkiller #1 to painkiller #2 has not been smooth. Friday morning she took #1 because the prescription was not available yet. In CA, a narcotic requires a script obtained from the doctors office--no phone in or email allowed. Mary picked up the script during her run to Stanford for the x-ray. But, she ran out of energy and did not deliver it to our Walgreens during the day. I took it down and waited for it after our takeout dinner from Willow Street. Mary insisted I pick up dinner before fetching the painkiller. Her tummy needs the presence of food to avoid undue pain. Mary has become a "grazer" in order to make sure the stomach pain doesn't roar in on her. And, I had left work a couple of hours earlier than normal (5PM instead of 7PM) on Friday to make a Costco run.

On Saturday, she was still feeling the effects (stomach pain) from #1 and feeling pain from the bloat although her weight has been constant for three days. She hasn't taken #1 since Friday evening when I brought #2 home. We did run errands but in the middle of shopping at Lunardi's, she hit the wall. I took her out to the car and she waited there while I finished the shopping. She never really recovered so we did Chinese take out last night.

As for the back pain, painkiller #2 is doing its job. I could tell for the simple reason that after dinner last night, Mary continued to sit in the chair at our breakfast bar. For the past week, she is out of that chair and back in her lounge chair or in bed because of the pain of sitting up for the time it takes to eat.

Mary is still asleep on Sunday morning as I write this so we don't know what today will be like. We do know that her sister, Reenie, is here to be Queen of the Kitchen and, more importantly, to provide additional moral support.

How is Devil Dawg, you ask? Well, given everything else going on, we can't say we've observed anything new. She does demand her chewsticks after meals but you've seen those clips. Oh, and Costco had a sale on lint rollers this week. While there on Friday, I picked up the package of 5 rollers. Now, each of our guest can have their own lint roller to remove white dog hair!

RE: This watcher continues to watch, God love ya!

Hello, Lameys!

I have so much sympathy for backpain, I don't know what to do.
All I can say is that you do recover. Not completely, but you recover.
If you have the fracture, it will heal. It'll be interesting if the
doctor gang will want you to jump into exercise therapy after two weeks
of healing. Don't let 'em rush you. You've done plenty all ready.

Albany is turning colder, but slowly this year. We had snow
before Halloween last year. This year we'll probably get through
Thanksgiving without white stuff on the ground. The grand experiment
continues here. The initial 450 equipment is on the grounds now. It
raises no threat to Applied's preeminent position of tool maker. Intel,
Samsung, and Taiwan continue the great push forward at bargain-basement
prices. No conclusion about where 450 joins the Roadmap. Same can be
said for EUV.

Ob, la, dee, ob, la, da, light not strong, ooooooh, la, la, la,
the light not strong. (apologies to John and Paul).

Love, Milt

Mary did get her first phone call

And a 2nd call from a different doctor's office.

The first call indicated that the MRI and bone scan of the upper back, where all the pain is located, was inconclusive--surprise, surprise! Basically, the 11th vertebrae didn't absorb enough radioactive goo to allow a crisp image. Tomorrow, Mary is having a plain, old, vanilla X-ray to see if they can figure it out that way. What the scan did show is a fracture in her lower back so they are evaluating putting her back on her osteoporosis meds which she stopped taking in June after the major surgery. We'll hear soon on that.

They did put her on a stronger pain killer, the same one she used after the major liver surgery. Yes, its the same one she had to 'step down' in daily dose over several weeks to terminate. The opinion is "If it helps you feel better and minimize the pain, we'll worry about stepping down after we figure out the source of the pain." Mary has a few of those left over so she took one this afternoon and is feeling much better. Back pain is down and her stomach is much more settled. Good news there!

The second call from Stanford makes sure we cannot end today's story in a simple way. Today's complexity is Mary's gain of 5 lbs (2.3 kg) in three days--water retention i.e., bloat. This triggered another prescription for diuretics which I will pick up on my way home tonight. And, the surgeon, who seems to be committed to track Mary's progress, has asked her to return for a visit on Dec 4th. That is too bad, Reenie leaves on the 2nd and won't be able to tag along for visiting her favorite MD.

Still silence

Mary didn't get a call yesterday. Which could be good news.

Mary is feeling pretty good overall. She has the pain, painkillers and
stomach reaction to the pain meds in balance.

Sent from my iPhone
www.Lamey-Hughes.com

The silence is deafening

Mary did not get the hoped for call from Stanford today. Bummer, Hal.

Unfortunately, I am in a real time crunch at work and didn't really spend any time with Mary today so I have nothing to report. She did sound fine when I talked with her which is always good. Tomorrow is also crazy at work (5AM wake up alarm and I am just leaving the office tonight at 11:30PM).

Mary had a rough night last night but finally fell asleep about 3AM. She woke up before I left for work at 9-ish and her back was ok then. It was very painful last night as she went to bed. Fortunately, I can do email and telephone calls from home in the AM while she is sleeping so I am "at work" but not physically in the office.

Here is hoping we learn something tomorrow.

A pretty painless procedure

Mary and Gayla were so fast with the morning injection they got in and out of the Stanford parking garage in less than 45 minutes. That's good because there is no fee for 45 min or less. For the 46th minute to six hours is six dollars and over six hours is 12 dollars.

Marge, of course, doesn't have the parking problem. As soon as she drops Mary off, she zooms over to the Stanford shopping center and returns when Mary calls. Interestingly, the campus is so large they have their own bus system running around the campus. You can, theoretically, park at the shopping center for free and then take a free bus to the hospital and avoid the parking fees altogether. If you have the time, of course.

We watch the TV show House tonight. At one point during the show, the patient exhibited liver failure so the team started rattling off all sorts of strange terms: bile duct blockage, Klatskins, PSC, ERCP, etc. Mary looked at me and said, "I know exactly what each of those terms means!" After the commercial break (love TiVo, that only takes a few seconds), they were doing an ERCP on the patient. Mary's comment, "That isn't how an ERCP is done" and then proceeded to describe the real method. Of course, the other part of the Hollywood treatment is that they appeared to solve this problem in two working days. Oh yeah, sure.

Mary had a pretty good day overall although by the time I got home, her back was really killing her. She is taking her meds by the clock and not by the pain level so when she got to the proscribed hour, she was really hurting. She took the meds on time and within a few minutes was feeling better but then she was feeling pain by bedtime. I gave her a back massage and tucked her in. I hope she can rest comfortably tonight.

The bone scan was two trips, one for the IV that took less than 45 minutes. The second trip in the afternoon was to do the scan. Mary said it was kinda creepy because you lay quietly on the table and this machine moves around but it doesn't make any noise. No shutter snapping like an x-ray machine, no banging on a tube like an MRI, it was just eerily quiet. Mary told me they scanned her abdominal area twice, and then a whole body scan. All in all, it took about 45 minutes on the machine. And, she was wearing her street clothes. Easy.

Now we wait for the doctor's call. Hopefully tomorrow (Tuesday) with some indication of what this back problem really is.

And lastly, for all of our non-California friends, winter is starting this week. Cold temperatures at night--under 40! High's below 70! Rain starts on Thursday! Rain!

When I grew up in Minnesota, we always had a big blizzard in March. March is also the month of St Patrick's Day, St Joseph's Day, the State High School basketball and State High School hockey tournaments. So depending on the year and the predisposition, the annual March blizzard took on the name of the closest major calendar event. The St Pat's blizzard of 82, the hockey tournament blizzards of 79, 81 and 84--that kind of thing. I made up these years for telling the story, I know my Minnesota readers will shoot back with "Oh you know, 82 was the basketball tourney blizzard fer shure. St Pats was in 81, you betcha!" Anyway, you get the idea.

Why am I telling you all this? Because I call our terrible November weather "Thanksgiving Weather". Fortunately, this only happens when we have out of state visitors coming for Thanksgiving. It started years ago when my parents would come to visit. Dad would wait until late October to buy tickets--remember when airfares were fixed and didn't change? Anyway, he'd wait to make sure "Your weather is good, right? I don't want to buy these tickets if the weather isn't good." Well late October, early November is stunningly beautiful most years as I have reported in this blog. And, Dad and Mom would get off the plane in a rainstorm every time they came for Thanksgiving. Never failed.

So Reenie and her husband, Tom, arrive from Da Loot next Sunday. Reenie is Queen of the Kitchen for her visit. Mary's youngest, Daniel, has leave from Fort Bliss (no, not Ft Hood and Ft Bliss is in Texas) from Sunday to Saturday. And Daniel's girl friend, Kamie, arrives from Harrisburg PA for a Monday to Saturday visit.

Let see, the weather report showed the rain starts on Thursday this week and it is at least two storms coming in off the Pacific. Thanksgiving Weather!

Bone Scan Day

My first question was, "What is a bone scan and what is it likely to find?"

I looked it up on WebMD (click here) and on Mayo Clinic (click here) websites.

The very short description of the procedure is this. First, they inject Mary with a radioactive goo that migrates to her bones over a 3 to 5 hour period. After the nominal four hours, they put her on a table with a camera that is sensitive to radioactive materials. She lays there, perfectly still for up to an hour while they image the skeleton. And they get pictures that look like this: click here or here (the second one is a popup and may not display).

The MRI last Wednesday showed a 5 mm "something" (less than 1/4 inch) on her vertebrae L11. The MRI could not resolve the thing so the radiologist classified it as a TSTC (Too Small to Classify). All we know is that there is something there. The bone scan may confirm there is a TSTC or it may confirm something else. Who knows?

Oh, I love the semantics in the medical community. If you have a cancer on your bone(s) and that is the only cancer you have, then its called bone cancer. Now, that is clear and logical. However, if you have another cancer (say cholangiocarcinoma aka CC) and develop cancer on your bone(s), you most likely do not have bone cancer. Say what? Apparently, the convention is to say the cancer on the bone is a metastized cancer from CC or whatever but its not, technically bone cancer. Until they do a biopsy and confirm the cancer cells are from the whatever cancer. If they are the same (most probable), then its metastized. If different, then you have two cancers--the bone cancer and the original cancer. Somehow, this adds clarity.

Many thanks to Gayla who is doing the round trip driving duty this morning and to Marge who is doing the duty for the round trip this afternoon.

Overall, we seem to have found the right point of food and pain killer. I reread this blog from last April and found that they had recommended Benedryl with the pain killer then. Both of us has forgotten about it. Last night Mary took that with her pain pill and slept thru the night nicely. We're figuring it out!

Ingrid's Picasa Web Album - Mama&Papa

Mama&Papa2009-11-15 Nov 5, 2009 by Ingrid View Album Play slideshow Message from Pat & Mary: Ingrid took a few more pictures of her Father and Mother--and then labeled them Mountain View although most of them were taken in Los Gatos.

Ingrid and her parents

Visiting in Los Gatos from Munich.

Ingrid's parents, Marie and Jacob, arrived last night at SFO for a visit with Ingrid and Maurice, who will fly out for Thanksgiving. Ingrid took them to the Los Gatos Farmers' Market so her Mom could load up on the fruits and veggies needed for their multiweek visit. We then joined them at the Purple Onion for a nice visit.

Afterwards, they stopped by the house as Ingrid needed to borrow a couple of items, and we ended up running a garden tour. Munich is in the early stages of winter and the simple fact we still have flowers (roses, morning glories and others) in full bloom kinda blew Maria away. Jacob took a chili pod and plans on growing his own plants from the seeds when he gets home.

As for Mary, we seem to have dialed in the pain med vs food grazing formula pretty well. Splitting the pills and making sure she is eating smaller amounts frequently really seem to help. The smaller pain dose does not totally eliminate the back pain like it did on Tuesday but it is far better than she was doing on advil and tylenol alone. I wish we could find a pain killer that would really knock it down to zero like it was on Tuesday so Mary could become more active again.

Tomorrow, Monday, is bone scan day. A trip to Stanford in the morning to load her up with the goo that enhances the imaging and a 2nd trip in the afternoon for the imaging process. A long day.

Susan dropped in for a visit

And mastered the deef dawg training device...

Nothing like a spray bottle to get the attention of a hearing impaired dog when she is ignoring hand signals. Susan, visiting from Dresden Germany, quickly learned how to control the deef devil dawg!

As for Mary, Saturday was a pretty good day overall. We seem to be learning how much and when she should get the pain killer along with eating (grazing) so her stomach doesn't start those massive pain shots that had Mary during her great distress on Wednesday.

Visiting the Good Doctor

Actually, as Reenie says, Mary likes to see the surgeon because he is "really hot and cute". Reenie will be glad to know that I told the doctor what Reenie's opinion is. Mary can confirm!

He gave us the quick read of the MRI results and Mary has a 5mm (less than 1/4th inch) spot on her 11th vertebrae. The radiologist's report was "Too Small To Characterize" aka TSTC. He said that its behavior is not indicative of a cancerous growth. Mary has had this upper back pain on and off since June. A cancer generally does not have an off cycle, it simply continues to grow. And, the size vs the length of time would indicate that it isn't really growing.

The bone scan scheduled for Monday may add further clarity but because this thing is so small, it may not. All we can do it step through it and see where it leads us.

Mary had not taken the prescription med since Wednesday morning--it caused her to reject her breakfast. Tuesday evening for bed she took a full pill and that dose seemed to send her into the painful stomach regime that carried into Wednesday. Her tummy was trashed for the rest of Wednesday but her tummy was fine on Thursday and so was her back with just advil and tylenol. She was preparing our dinner as I got home last night so she was doing pretty good. She was still avoiding the prescription pain med.

Mary woke up this morning about 4AM because of the terrible back pain. At 4:30AM today, Mary fixed herself a protein rich breakfast with a half-pill pain med chaser. It cut the pain down and taking the pill with a protein rich meal appears to have substantially helped the tummy problem. She is cutting the pills in half to minimize the dose. That seems to work. I think Mary needs to "graze" so there is always food in her stomach. My amateur opinion is keeping the stomach from never really being empty is a big benefit to preventing the pain cycles.

All in all, she is doing pretty good. We do want to know what this 5mm thingy on the vertebrae is and hopefully Monday's bone scan will shed some additional light on the subject.

Pain meds are a pain

Ingrid drove Mary to the MRI facility yesterday, stopping for lunch at the German Bakery in Mountain View. The MRI was the "Imagine yourself trapped in a giant aluminum can while elves stand outside and bang on it with heavy hammers in irregular rhythm for 90 minutes" variety but Mary toughed it out and made it work. The results should be available this week but we probably won't hear from the doctor until after the bone scan that is scheduled for Monday.

The downside is that Mary's digestive track does not play well with the pain meds. Tuesday was a great day for Mary as she started the pain meds and we cut the pills in half so she was on half-dose amounts. Wednesday she went to full sized pills and it was not good. Breakfast did not stay with her and she had strong stomach pain all day long. She did eat a bit of the take-out I brought home and it stayed down. Later last night she was feeling a bit better but that was 14 hours after she took the last pain pill--which she is not going to take again.

This morning as she woke up, she said her stomach felt better and, for the moment, her back was not giving her pain. Let's hope that stays that way all day.

Mary's system does not like narcotics. She has known this for years. When she checks into hospitals, they put big warning bracelets on her to not use morphine et al because of what it does to her digestive system--not only nausea but severe pain in the stomach area even if delivered by IV. And, in spite of this, doctors want to believe it will not happen with this particular narcotic--which is what the doc told us on Monday. Wrong! (For my long-term readers, I refer you to the dilaudid episode after the liver surgery. Click here.)

Mary will talk to the doctor today about the pain meds. If she still needs them, hopefully they can find another solution that won't cause the severe abdominal pain.

No pain, lots of gain!

Mary had a full day yesterday! She made dinner without any assistance from me, did a quick drive to the store for some necessary kitchen items, prepared the house for The Maids cleaning service today and all in all behaved like there was no medical issue whatsoever! She was exhausted last night but in a good way--from being active and doing stuff all day long.

Mary's comment, "Its amazing how good you can feel and how much you can do when a stabbing pain in your back is no longer there."

We had talked about her driving. The warning on the prescription is to avoid driving until the full effect of the pain medication is known. Given her response so far, we figured driving a couple of miles to the grocery store in local, low speed traffic would be ok. The concentration needed to drive the 20+ miles on the freeway to Stanford should be deferred until we know how she is affected (or not) by the pain meds. Hence, Ingrid is doing taxi duty today.

For Thanksgiving this year, Mary's sister, Reenie, and husband, Tom, are coming to visit and Mary's youngest son, Daniel (below) aka DP aka Cheeseball, with his girlfriend, Kamie (no picture), are also coming.

From 2007-10 El Paso Texas

We planned that Reenie would be Queen of the Kitchen on the assumption that Mary would be suffering from chemo and not be very functional at all. Now that the doc has set aside the chemo for a while and the back pain is under control by the meds, Mary is going into turbo mode preparing and planning for the visitors. An unexpected turn of events but a welcome one, nonetheless.

Thanksgiving dinner will be spectacular, I am sure, especially given that Reenie proved her culinary skills during her two visits this year as primary care giver. With Mary in the kitchen too, it should be a blast. The highlight, however, will be the day after when Mary teaches both Reenie and Kamie her turkey enchilada dish. Mary's kids like this dish so much that in the past Mary has frozen the enchiladas and FedEx'd them to her offspring.

Today is MRI day. We won't hear results for a couple of days.

Heading Home

Just called Mary to find out how she was doing.

This incredibly perky voice answered the phone! Her comment, "Its amazing how good you can feel when you don't have this horrible pain in your back."

The prescription, in other words, is working its magic!

Tomorrow is the first procedure to ID the source of back pain. I think its the MRI but it may be the bone scan. Our taxi team is helping out getting Mary to the imaging clinic and then bringing her home. Thank you!

She passed her blood test and more

I managed to previously post the headline for this entry while deleting all the text. Sorry about that!

Mary's blood test indicates that her bone marrow has fully kicked in and is producing all those really good red and white cells and the platelets too! Good news. And, because she has been off chemo for three weeks, she can go back to eating fresh fruit and veggies that are not peeled. I have a feeling tonight's dinner will be a festival of lettuce.

The doc also said that the trade off of the uncertain benefit of Gemzar versus the certain damage it does to Mary causes him to set aside the chemo for a while. He wants her to be feeling good again, like she was before the chemo started. Hooray! I agree with that.

He was very concerned about the recurring back pain. He ordered a bone scan and an MRI which we expect will be done this week. His concern is straightforward.

In his own words, "Because I am an Oncologist, I am concerned that any long lasting pain is caused by a cancer. I want to rule that out as soon as possible." Once cancer is ruled out, then other diagnosis and therapies can be applied--including a deep tissue massage from Ingrid who is on standby waiting for a green light.

As I have reported previously, I give Mary a back rub as she goes to bed and that benefit will last until 1AM to maybe 4AM then the pain wakes her up. Yesterday, we heated the hot tub and while Mary floated, I also rubbed her back hoping the heat and the weightlessness would have a big impact. She said it did but it also didn't last very long. Within a couple of hours, the pain was back in full force.

The doc also prescribed Dr. House's favorite mint. (If you don't watch House on TV, you probably won't get it.) I am having that prescription filled on my way home.

Getting ready for Market

Mary wants to go to Farmer's Market today and that is a good sign. Yesterday, we went to the bank and to Lunardi's grocery store and then I took her home and did the rest of the errands on my own. She was tired from the walk through Lunardi's--and she didn't even walk into the bank with me.

This recurring back pain appears to be in the muscles between the shoulder blades. I do give her back rubs just as she goes to bed and that seems to help her sleep. It is a concern, of course, that the pain recurs daily and doesn't seem to go away.

Mary's appetite is good. She dove in on the baby back ribs last night and is eating a variety of foods for each meal easily. She must keep food in her tummy to minimize acidic stomach and she has a menu of snack foods to help keep that problem at bay. Her body weight is absolutely stable, varying no more than 1 lb over they last several weeks so no bloating or other issues.

Tomorrow we are back at Stanford to see the Oncologist, Dr. Fisher. We hope to get answers to the back pain as well as the efficacy of further chemo given Mary's reaction to the first two treatments. Recall that all the prior literature searches have said that there is no meaningful impact on cholangiocarcinoma from chemotherapy.

On a final note, Mary turned on the TV to watch the Stanford football game yesterday. This may have been because my coworkers hail from schools with nicknames like Trojans, Bears, Ducks and Cardinal (definitely singular because it refers to the color, not the bird. Hey, it works for Tiger Woods, the Stanford dropout, on Sundays!). This football season, there has been a lot of email chatter about the Trojans nosediving this year. Given that USC fans have tattoos on precious body parts attesting to team loyalty, its extremely entertaining to watch their pain and agony--equivalent to the emotion shown while Stanley screams "Stella" in Streetcar Named Desire. While USC fans scream in epic pain, the Ducks were flying high--for a week. The Ducks ran into the Cardinal yesterday and the pecking order has been reset--again.


Time to get ready for market.

Friday heading home

Last night Mary was suffering from very tight back muscles again. I gave her a back rub right after dinner and then later as she went to bed. She said today was a bit better, perhaps because she took a Tylenol when the muscles started to tighten up.

We are assuming the muscles are reacting to a low level of red blood and will get better as her cell count improves. We'll learn on Monday at Stanford because they start with a blood draw and that will tell us where we stand vis a vis the health of the bone marrow and the continuation of chemo.

The blood draw will be at 11. The visit with Dr. Fisher is at 1PM. Then, if she gets a green light and Mary elects to continue, the chemo will start after that. I expect to be there to see Dr. Fisher. Otherwise, Mary's taxi team will get her to Stanford and bring her back.

I am on my way home and Mary asked me to pick up a loaf of Acme bread! Pasta tonight! My Friday favorite!

Doing pretty good

Mary has had two good days in a row.

Yesterday was a bit strange. She got up, ate breakfast, and then took a nap. She got up, had a shower and then took a nap. Got up, got dressed, had lunch and took a nap. After that, the urge to nap was pretty much done and she stayed awake until bedtime around 10PM.

She did fix the pork tenderloin, carrots and sweet potatoes for dinner before I got home so she was clearly feeling better.

She woke up today feeling pretty good as well. She reported that she did not have the overwhelming urge to nap like she did yesterday. And, she has set plans to have dinner ready by the time I get home.

I take all of the above to mean she is feeling pretty darn good. And, that is a good thing. I am really hoping the blood tests on Monday show that her bone marrow has really kicked into high gear.

As for Devil Dawg, she found a new chew toy yesterday earning a new name--Post-it Note Dawg. We don't know how she acquired a pad of Post-it Notes (that she did figure it out is a bit of a concern) but she did--it may have involved using intermediate surfaces to get up to the Post-it Notes, i.e., cat-like behavior. And, she proceeded to demolish the stack of notes quite successfully. Mary had the job of pick up the pieces and that is a bit of a challenge. Her scar makes it awkward/uncomfortable to bend at the waist.

All in all, a good couple of days.

Devil Dawg and Develish Spouse

As we were going to bed last night, I asked Mary about Devil Dawg's dragging clean clothes all over the house.

"How many items did the dawg drag out of the basket?" I ask.

"Oh, maybe a dozen altogether" says Mary.

"Did Devil Dawg have a preference? I mean, the clothes were all clean so there wasn't any odor other than the smell of detergent."

"But she did show a preference" said Mary "for smaller items. The basket was pretty much all white items so your shorts got the royal treatment." Ah, that makes sense. Devil Dawg isn't too much larger than a good size cat and she doesn't really have a good strong jaw like many dogs. If she grabbed a t-shirt and it was entangled with other clothes, she probably wasn't able to drag it out of the basket. Then I started thinking. Where did the clothes used as dawg toys go? I had put my dirty clothes into the hamper when I took them off last night and I didn't notice a pile of any clothes already there.

"You picked up the clothes?"

"Yes"

"And what did you do with them?"

"I put them back in the clean laundry basket" says my wife, sweetly. What could I do? What could I do? Here is this woman who is beating the odds on one of the most deadly cancers known to man, the woman I love, and she tells me that! I swallow air and slightly change direction.

"But wouldn't they be full of dawg hair?"

"I told you" she says "before we got married that living with me meant living with four footed creatures and that you should not complain when you find dog hair in the butter!" It turns out that is what she said 14 years ago. And, in all these years, I have only found dog hair in the butter one time! I also know that "dog hair in the butter" line is a trump card and any further argument is futile. So now my mind snaps back to the spit, drool and dribble issue.

"OK, but what about dawg drool? Were my shorts all wet?"

And my sweet, lovely, good hearted spouse responds, "As far as I could tell, they weren't too wet so that is why I put them back in the clean clothes basket."

I am hoping she is pulling my leg, but just in case I plan on re-washing that basket tonight.

Tuesday's Devil Dawg

Mary didn't have the best of days today. She is having very strong back pain in the muscles of her back. This could be due to lack of oxygen delivered by red blood cells. She takes Advil and Tylenol (dr recommended) when she goes to bed and that usually allows her to sleep. Last night it didn't work so she took a few cat naps and just kinda hung out all day. A big difference from the industrious Mary who was with us on Monday.

Devil Dawg devised a new activity. We ran all the clothes through the washer and dryer over the weekend but we (ok me) have been laggards at getting it all put away. I had left a laundry basket on the floor filled clean clothes, mostly mine. As Mary turned from the breakfast table after finishing her meal this morning, she found a most interesting pattern of shirts, shorts, socks, towels, etc., had been dragged from the bedroom to the dining room and all points in between. Devil Dawg would take an item from the laundry basket and carry it towards the kitchen. If it fell, she left it and went back to the basket to get another item. Mary reported she found things in the other direction towards our bath and closet too. Now all my clean things are full of dawg hair and I can live with that. But then I started thinking about the dawg spit and dribble...

Knock me over with a feather

Mary called me about noon today to let me know she had confirmed Monday's visit with the Oncologist and the subsequent visit with the Surgeon on Friday. We are locking down all our drivers and the surgeon is adding to the blood tests on Monday to double check some items in Mary's ongoing status.

The feather part? As she told me about the confirmed appointments and tests, she said, "I'm going to make the rest of the cookies today." Just her ability to commit to do that was astounding, but was not the knock me over with a feather part.

I figured if she was successful in doing the cookies, I'd be on deck for full chef duties for tonight's wild caught salmon we bought at market yesterday. She'd be so tired, I expected to find her totally wiped out in her lounge chair--her best day last Thursday was like that. I called to let her know I was on my way home.

When I walked in the door, the potatoes had been baked and put in the warming drawer. She had seasoned the salmon and was putting it in the oven. The beans were all prepped and waiting to start cooking in the microwave. The table was set. As impressive as that was, and it was impressive, even more impressive was that all the cookie baking utensils, bowls, pans, trays, etc., had been hand washed and were in the drying rack waiting to be put away.

I was stunned. Mary hasn't been this strong for several weeks. And, hopefully, this means her body is producing the needed red blood cells. Go marrow, go!

I must admit I had a moment of fear for as Mary came over to give me a welcome home hug, I saw this rather large skin defect on her cheek. My fear was some sort of a lesion or weird thing appearing out of the blue. After careful inspection and even more careful attempts to remove it, it turned out to be the remnants of a chocolate chip! She gave me a big grin and said, "Chef's prerogative, got to check my own work!"

Oh, and I mislead you. We topped out today at 79F, not 80F, and the forecast is still 82F tomorrow.

Two corrections

Although Mary is not feeling great, I should not make it sound too dreary. She did go to the Onion for lunch and at dinner last night we were both active in the kitchen preparing our Sunday meal. She prepped the veggies and cooked the shrimp while I did the potatoes, feed the dogs and did the kitchen clean up duty. A week ago, she only got out of bed on Sunday to come and eat. This Sunday she was clearly better but not as good as she had been on Thursday.

The second item is that I am sorry to report that our weather is changing. The radio report this AM was for a high of 80 today with 82 (28C) tomorrow and then cooling to the mid-70s by the later part of the week...

A Beautiful Sunday

We are having that wonderful fall weather with a crystal clear blue sky and temperatures hanging in the mid- to high- 70's (26C). We had lunch at the Purple Onion with Ingrid and MaryR for the first time in an age yesterday. It was good to get together again and catch up on all the doings and events in everyones' life.

We are seeing a progression from Mary's overall health that is not flat or up. On Tuesday, Mary had the transfusion. By Thursday, she was in the kitchen baking cookies and feeling really good! Since Thursday, each day has been a bit of a downer from the day before. The primary manifestations are low energy and muscle pain in her back both of which show up in the late afternoon and by bedtime she is in in real back pain as well as just dragging.

Our non-professional theory is that the benefit of the transfusion is tapering off while the bone marrow is not fully recovered and creating new red blood cells after the trashing by the Gemzar. Mary has instructions from the staff at Stanford and she will be reporting her status as appropriate to the Oncology Nurse (ON) this week.

When we see the Oncologist on Monday, one of the topic is clearly going to be the benefit versus the downside of this chemotherapy given how it has attacked Mary's red blood producing ability. More later.