Fifth Session

July 6, 2010, 11:17 AM

Well Pat has closed her eyes, although she is not sleeping as yet. The drill was a bit different today because Pat didn’t have to see Dr. Lilly before starting chemo. He had seen her Thursday and cleared her for chemo after blood tests. The celebration of July 4th on July 5th forced the change from our routine Monday visits. As her hemoglobin was up a bit it was full speed ahead, or at least ¾ speed. So this morning began with drawing blood immediately followed by beginning chemo before the results were in. If you remember this differs from the protocol of prior weeks in which chemo was not begun until after the results of the testing were reviewed. This was possible because the session was begun with Rituximab, the only chemo agent that is not affected by the results of the labs. Those results arrived before it was time for the second step of the CHOP chemo. Pat’s hemoglobin, although not normal, was high enough to not cause any alteration in the rest of the poisoning or to call for the blood transfusion that capped her last session.

Oh yes - the change in routine. After dropping Pat off I scooted over to Starbucks to pick up a yogurt parfait and coffee for her. I had had breakfast at home, but got coffee for myself as well. By the time I got back to UCI, Pat was ready to begin. This was at least 2 hours earlier than in our prior visits and so the prospect of a much earlier departure brightened the day which was hazy with a light drizzle. Like clockwork the candy striper, a mature gentleman with a dark blue shirt, appeared mid morning with juice, crackers and all sorts of tummy stuffers. By 12: 30 he was back with lunch. What is the expression? - “too soon old and too late smart” - today we found out that Pat could request something other that the standard lunch of our prior visits - Soup - usually pretty good, a turkey and cheese sandwich, vanilla pudding -yucky, a bottle of water and a chocolate chip cookie. This time Pat opted for a tuna fish sandwich - not bad. I, not being a patient, was stuck with the usual - but it is significantly better than hunger.

12:47 PM

The nurse has just left after switching to the last of the poisons, excuse me chemo agents, cytoxin. That means that in another hour were out of here. I am about ready to close down the computer - to finish this posting at home. Pat has not slept at all this time out. At the moment she is scouting Paris in the National Geographic Traveler.

6:27 PM

Pat is preparing dinner, taking advantage of Trader Joe’s good prepared dishes. We were out of UCI before 2:00 o’clock. The mistiness that shrouded us on our way in in the morning was not diminished by our delight in getting out so early. On the way home we stopped at The Spectrum so that Pat could shop for a gift. Once home, not having slept during the day, she headed quickly for the comfort of the bed. Getting up from what has become her daily rest, she checked her phone calls and attacked the Trader Joe’s special with gusto anticipating the slow down that marks the second and third days after the treatment. How well she has been feeling the last couple of days is the carrot that keeps her looking past those difficult days. And then there is the possibility that the next treatment could be the last one.

As promised

June 27 2:16 pm

Where were we, oh yes, entering the dog days. It turns out that, although not a walk in the park, they were less troublesome than they had been in the prior cycle. And each day found her a little more like her old, I mean former, self. No more swelling and no more intense fatigue, although she does thrive on her afternoon nap and greets the bed like a dear friend each night. The width of her smile is a good marker of the days since her last treatment. Soup and dining invitations abound. Of course we revel in the fact that the next treatment is still another week away.

Dinners at friends’ houses were a treat. In the relaxed setting Pat does not have to draw on her store of energy while enjoying companionship. And she makes sure to get her rest in before the visit. That is a report of fact, not a request for more dinner invitations! You have all been so thoughtful in so many ways and so loving!!!!

We went to an Italian movie,” I Am Love,” with friends. It was quite arty, and though we all enjoyed it, we agreed that it might have spent too much time being “artistic”. But it was worth seeing.

I picked up Pat’s sister Delly at the airport Friday evening. She came in especially for a cousins’ meeting and, of course, to check up on Pat. On Saturday they went to the confab at Salka’s house in Glendale where keepsakes were selected from Salka’s household remains. That assemblage had been planned at Salka’s funeral where Pat, as the eldest of them, had been dubbed “The Queen”. Today Delly joined us in the Sunday morning ritual – a walk then breakfast at Bagels and Brew. Pat did her one trip around the lake in Rancho Santa Margarita. Right now the ladies are down at the pool with one of Delly’s friends who dropped by. Nina will be taking Delly to the airport later this afternoon. As things are going well, I probably will not be posting again until sometime after Pat’s visit with Dr. Lilly on Thursday.

Had I mentioned an interesting coincidence? It turns out that Pat’s cousin Jessica has been involved with a group planning to take part in a fund raising run for The Leukemia and Lymphoma Society. When she found out that Pat had lymphoma, she decided to dedicate her run to Pat. Jessica has adorned the first page of her blog, http://trainingwithpurpose-jess.blogspot.com/ , with the picture that you see above.

Interim Post

Reviewing the prior blog I realized that it may have left you with some concerns. This quickie is to let you know that she is back to what passes for normal. Details to follow.

June 17, 9:43 PM

With the Laker - Celtic game over, I can get back to doing things. By the way, the Celtic loss was only moderately traumatic for Pat in spite of her continued rooting for them. I on the other hand, rooting for the team getting the most coverage in the local press, had long since switched allegiance to the Lakers, smiled. My condolences to our Boston friends.

Back to the saga. On Tuesday Pat woke with her feet swollen and a moon shaped face. It was time to head back to UCI for the 2nd unit of blood and the white blood cell booster. In response to our concern we were visited by a nurse practitioner who, after consultation with Dr. Lilly added a diuretic to blood drip. Lest you be concerned, Pat felt well enough to go out for dinner with friends. I suspect that eating with someone besides me is good for her spirits. Pat awoke on Wednesday with essentially unchanged swelling. She was anticipating calling the doctor, but he beat her to the phone. On hearing of the continuing swelling, he scheduled Pat for an echocardiogram and a visit with him on Thursday. That was intended to ensure that the swelling was not the result of congestive heart failure, even though Pat had no other relevant symptoms. Resting all day, Pat summoned enough energy to go to a lecture on the new health care bill at a friend’s house. Yes, food was involved as well. We did not stay long after the presentation, as she was tired. On Thursday, after some discussion, Pat drove to UCI by herself. Everything proved normal and she was sent home with an Rx for some more diuretic. Pat rested in the afternoon and the swelling seemed to decrease a little. We’re now headed into the post chemo days when fatigue and discomfort tend to peak.

June 14, 2010 2:41 PM

Pat has just awoken refreshed from her first nap of the afternoon. She was really out of it. I’ve delayed updating the blog, mostly because nothing dramatic has happened and by now you pretty much know the drill. As was expected, little things like the tingling on the tip of her tongue faded away as the week progressed. By and large Pat has learned to husband her resources - bursts of energy to accomplish “I gottas” , and naps preceding social engagements. Yesterday morning Pat did a slow one lapper around Lake Santa Margarita before our usual Sunday group breakfast. Back home, a quick check of the plants and then a rest before we picked up the Gross’s and headed off to a concert. It featured Andre Watts performing the Grieg Piano Concerto. At the risk of sounding like a teenager - “we were blown away”. Watts played so beautifully. The fluid ease of his attack wonderfully complemented the beauty of the music. Afterward it was a short drive to the Capital Seafood Restaurant in Irvine. Although one of a chain, it offers excellent Chinese seafood. It is in the Diamond Shopping Plaza in a very Asian neighborhood. Interestingly, the developer of the center insisted that contracts include the stipulation that all signs be in English.

A summary of this morning’s visit with the doctor that preceded the start of her chemo will fill out the picture. Her blood test showed a very low hemoglobin so that the doctor has ordered a transfusion of 2 units of blood. One of these will be tacked on to today’s visit and the second will be administered tomorrow when she comes for her white cell stimulant. There was some swelling in her legs due to the suspension of one of the meds used to lower her blood pressure. It had a diuretic effect as well. That combined with the increased fluid intake that the doctor had recommended probably accounts for the swelling that should readily be resolved. Most significantly, Dr. Lilly has come to the conclusion that, at least for the present, we are on a three week cycle.

The transfusion having been finished, we are now home, and have finished dinner as well. We are looking forward to the 2 units of blood picking up Pat’s energy so that we won’t have to cancel the plans we have made for the coming weeks. Stay tuned for the further “PERILS OF PATSY”. 22:13:27

June 6

Where has the time gone? Delly and Peter arrived Friday and will be off early tomorrow morning. Pat has been doing better each day. Today included another trip to Crystal Cove. Once again it was sunny at home with some mist obscuring the sun at the beach, but not as densely as it had on our last trip there. The wait for “blunch” was only 5 minutes so that the stroll on the beach had to be deferred until after we had eaten. After a significant walk it was home to get the sand out of our clothing before heading off to “City Island”. Pat liked it and I thought that it was a terrific picture. Then to Hatam’s for dinner. Pat made it through the entire day without a rest and feeling good all the way. By 9:30 though, she was ready to "pack it in." Delly and Peter have gone to bed to be ready for an early drive to Scottsdale tomorrow. I’m taking this quiet time to bring you up to date. The bottom line is that the combination of the deferred continuation of the chemo and her sister’s visit have put Pat in a very good place.

June 4

The week started with Pat’s fatigue more intense and tenacious. It eased up a bit on Wednesday, and, as Pat described it, she felt almost human on Thursday. The most significant news of the week was the decision, at Thursday’s scheduled visit with Dr. Lilly, to take a week off. Thus we are going onto a 3 week cycle, at least until Pat’s next visit on June 14. Testimony to Pat’s present status was her decision to go to the Wine Club dinner last night. She had scheduled it, with only the hope of being able to attend. She was very busy socializing - without fatigue. The only down element was people commenting on the frequent mentions of food on the blog. I hope that the prior sentences pass the scrutiny of the censor who had forbidden the mention of food. But Pat IS busy preparing lunch for us and her Sister and her husband. When I started typing they were expected momentarily, but a just concluded phone call advised us that they were hung up in traffic and were probably at least an hour away. The rest of the weekend will be busy, but I think that Pat will be just fine with it. I’ll leave the details to a post-hoc posting.