Treatment

Immunotherapy

I am loving my hair – mainly because I have some, but also because it’s grown enough to look intentional, and yet I can still comb it with a towel. Oddly, it is growing in much thicker and a much darker brown. My phone still doesn’t recognize me.

Tomorrow morning I have chemo, and I also start getting an infusion of an immunotherapy drug called Bevacizumab. I can’t pronounce that, so I just call it Beelzebub.

Beelzebub works by stopping the formation of new blood vessels necessary for tumor growth. It’s side effects, though, are seriously evil. I won’t go into them now, but if you can lob a good thought in my general direction tomorrow morning, I’d be grateful. Who knows, maybe I have met my quota of side effects, and Beelzebub will leave me alone. If I sound a tad nervous, it’s because I am.

It has been a wonderful summer, hasn’t it? – lovely and hot and slow and fabulous. The redhead and I had a great Labor Day weekend, and we hope you did, too.

Lifestyle

Proudly Shallow

Generally speaking, I’m proudly shallow. Whenever I’m in danger of having a deep thought, I tend to pick up a People magazine or watch a British sitcom until it goes away. But something has emerged that I would like to share. WARNING: It concerns death and dying, so read further at your own risk, and preferably over a cocktail.

What a gift it is to have advance notice that one’s life is approaching its end.

I know we are all aware that none of us is getting out of this alive. And we try to live our lives in daily appreciation of that fact. But to be given an irrefutable heads-up that death is on the horizon? With months of time still (with luck) to live and love and say goodbyes? With basic health and energy to get stuff done? I’m telling you, it’s an out-and-out blessing. To say that I’m grateful for this time is to say that the taste of a dark chocolate truffle paired with a Barossa Valley Shiraz is merely mediocre.

Of course, I’m doing everything in my power to stay alive as long as I can. And I will continue to share way too much information about the process. But if you see me laughing and wonder whether it’s denial, or possibly a break with reality – no. It’s just plain old happiness. Or maybe it’s that the redhead has said something ridiculous. But whatever.

As for moving forward with treatment, we have chosen Option #4. Chemo has begun and will happen about every two weeks. So saddle up, and thank you for being here. All is well.

Diagnosis

Options

In bad news, the surgeons weren’t able to reverse my ileostomy last Friday. Instead, they gave me a new and improved one. It splutters somewhat more than Bilbo did. I have named it Krakatoa.

In more bad news, the supplemental exploratory surgery did not end well. The cancer has definitely recurred, and it has recurred so soon that the prognosis is . . . not good. I don’t mind telling you that we shed some tears.

I will be cogitating this week, while recovering from surgery under the redhead’s loving care, about how to move forward. We have four options.

Option #1 is to pursue no further treatment and to let nature take its course. Okay, this sounded idiotic even as I was writing it. We’re not anywhere near there yet. So let’s move on to Option #2. 

Option #2 is to participate in an experimental drug trial. This sounds like it might be fun. 

Option #3 is to start different chemotherapy with two drugs in a combination recently approved by the FDA, with promising results. One drug happens once per month, and the other happens twice per month. Already, this sounds more user-friendly than the weekly dense-dose smackdown that turned the tide last year. There’s a catch, of course. The second drug has some potentially nasty side effects. But like the experimental trial, this regimen has a real chance of extending my life. And oh how I do love life.

Option #4 is to start with Option #3, and if it’s not working, then switch to Option #2, provided it’s still open.

Hmm. I may need a spreadsheet. 

In good news, though, all of the options come with wine.

We are up at our mountain cabin in Angel Fire, processing all of this and making our decisions. Love and hugs on this beautiful summer day.

Uncategorized

Chemo vacation

What a wonderful chemo vacation. Thank you for your good wishes. The time is just zooming past. I can’t believe it has been so long since I posted.

When we last left our drama queen (i.e., me) I was awaiting a second CT scan to determine whether the “nodularities” the radiologist saw in the prior scan were anything to worry about. Were they harmless scar tissue? New tumors? Old tumors in hiding? A gestating alien? Some marbles I swallowed when I was three?

We still don’t know. The scan was inconclusive. The surgeon is convinced it’s scar tissue; the radiologist is worried; and I have lost interest. Even before the second scan came back, I reached an epiphany: I will assume I am in remission unless and until I get conclusive evidence that I am not. No good comes from fearing the worst.

And anyway, there are reasons to celebrate. My CA-125 is still normal. There is wine in my very near future. Alan has learned to tweeze his own ear hair. And I finally have a surgery date. The ileostomy takedown will happen this coming Friday. My preparations so far have included getting my affairs in order and getting a mani/pedi to complement the color of the hospital gowns. I settled on a pinkish neutral with a hint of sparkle.

It was my first trip to the nail salon since September. The peripheral neuropathy and BUMMER syndrome in my feet have made it impossible to have a pedicure without crying in public. There turned out to be crying anyway, though. My manicurist took one look at my nails and broke down completely. No, just kidding. But she did “tsk” so vociferously that I was afraid she would choke.

But buh-bye Bilbo Baggins and hello hair. At the very least, I will be on chemo-vacation for another couple of months. Hallelujah!

I hope you are having a wonderful summer. Thank you for being here with me. I would be grateful if you would please send some prayers the redhead’s way as he carries me through another round of surgery and recovery these next few weeks. We appreciate you very much.

Lifestyle

Takedown

Not that the ostomy bag hasn’t been loads of fun and all, but I’m really looking forward to getting rid of it. The next step towards that goal is getting a date on the surgeons’ calendars. They are apparently a popular bunch. Either that, or I’m just not second-date material.

No, just kidding. They said it’s them, not me. Wait . . ..

The ostomy reversal surgery, ominously called a “take down,” but apparently only distantly related to the WWE, will be more involved than I had thought. The medical team is saying three to five days in the hospital, plus two weeks of recovery. Sheesh. I’m just now getting my rhythm going again, and I have to let the drums take a random solo. But I guess it makes sense that reconnecting my entire digestive system would be somewhat involved. While they’re in there, they intend to rummage around and see what those “nodularities” are that the CT scan reported last month.

These past few weeks have flown by. I’ve been easing back into work a few hours per day, a few days per week, and oh the joy! Who knew that merely being able to work is such a privilege? Also, I started torture – um, I mean physical therapy and Pilates – to train various muscle groups that have been on the dole since early November. The side effects of chemo are subsiding, and – woo hoo! – people are actually reading my book. All is well. In fact, all is blessedly wonderful.

I apologize for having been AWOL. Thank you for sticking with me. It’s a beautiful spring day in Dallas, and I’m heading out for a nice walk with the redhead.

Just because I can.

Much love to all.

Diagnosis

Good news

The reviews are in: Five stars from everyone except one crotchety radiologist.

In a wonderful test result, my CA-125 blood marker is within normal range for the 4th reading in a row. It even went down a little, to 16.1. It’s still not single digits, but I’ll take it, because for now, NO MORE CHEMO! Oh the joy!

I want to be bouncing up and down and shouting the word “remission” from the rooftops. However, it appears we can’t pop a cork just yet. The CT scan showed a few small “spots.” My surgeon believes that they are simply scar tissue from November’s major surgery. (Go Team Surgeon!) The killjoy radiologist is calling the spots “nodularities,” which is jargon for “I have no idea what these spots are, but I’m not signing off on remission until I’m darn sure they aren’t cancer.” I can respect that. The radiologist wants to repeat the CT scan in 60 days, which is the time period necessary to confirm the spots are stable and not growing. I won’t be able to use the “r” word until Team Radiologist gives the go-ahead.

It’s true that the redhead and I would like to have a more definitive and immediate sense of closure, but hey. Even if they say the magic word, the reality is that recurrence will always be a possibility. Right now I’m looking at 60 days of chemo-free life outside the bubble. I’m looking at easing back into the office to do work that I love. And in a few weeks, I’m looking at some beach time with the redhead. Life is good.

Speaking of the redhead, he has asked me to thank you from the bottom of our pea-pickin’ hearts. I have no doubt that your prayers and positive energy have been helping steer this ship for the past eight months. We are blessed beyond measure at the wealth of friendship and support that you continue to give us. “Thank you” doesn’t really cover it, but it’s all I have right now, so THANK YOU!

And also for now, please know that no news is good news. I hope very much to see you soon. Prepare to be hugged.

Treatment

Chemo-Rex

I have had so much chemo at this point that I think my pee is radioactive. The toilet has started glowing in the dark.

Actually, chemo is a lot like the T-Rex in the Jurassic Park movie. If you recall, the T-Rex couldn’t detect its prey unless the prey moved – and then the T-Rex chomped. Well, chemotherapy drugs hunt and destroy cells that “move” by changing rapidly. Conveniently, that includes cancer cells and tumors. Inconveniently, it also includes normal healthy cells that are merely going about their business of growing, healing, or replicating. You gotta feel for those little guys. There they are, jaunting down the protoplasm path all happy that they’re doing great work, and then out of nowhere: Chomped by Chemo-Rex!

Apparently, red blood cells are particularly chompable. In any event, my veins were a couple of quarts low again, and my energy level has been right down there with a comatose armadillo. So yesterday the medical team topped me up with a nice transfusion. This time, I got smart, though. I asked for the blood of a triathlete, or at least a really good home cook. We shall see.

But lo and behold, here we are at the end of primary treatment for Stage IV ovarian cancer. Next week there will be test results and a medical team meeting that will determine my future, or (forgive the gallows humor) lack thereof. It has now been seven months of dense-dose chemotherapy, interspersed with an additional month’s worth of surgery and other random procedures. Without that treatment, my number would have been up before Christmas, so I am sincerely grateful for every minute of it.

However, I don’t mind telling you that the redhead and I are on pins and needles, hoping for encouraging news next week.

And speaking of hope, I hope you are enjoying these first days of spring. Bluebonnet Season is always my favorite time of year.

Treatment

CA-125 test result (#3 of 4)

Quick update for some great news! The CA-125 ovarian cancer marker test result is in, and it’s again in the normal range. That makes three good results in a row. If I get one more “normal” in three weeks’ time, folks, I will officially be in remission.

Hard to believe it’s so close.

There is an asterisk, of course. There’s always an asterisk. The normal range is 0-35. For those keeping score, the actual number this time was 16.5, which is a hair in the wrong direction from the previous 15.1. In short, this was not the continuing downward-skipping trend to single digits that we were hoping to see. The competition junkie in me is slightly and very ridiculously miffed.

But this is obviously not a game. Remission has been the only goal of the road that began way back in August. And remission is within reach.

So grateful.

Lifestyle

Immuno-compromised

All is well and on track. Apart from chemo fatigue, I have no complaints. Well, I do feel that Glenn Close was robbed at the Oscars, but no complaints other than that.

Back in September, after the first six weeks of dense-dose chemo, my immune system pretty much packed it in. Since then, a germ so innocuous that a healthy person might not even notice it could send me to the hospital for a few sun-soaked days of intravenous antibiotics. Not to be a drama queen about it, but there it is.

So for five months – on doctors’ orders and because sepsis scares the heck out of me – I have been in “boy in the bubble” mode. Only on a handful of occasions have I gone rogue and seen anyone other than my medical team and the redhead. Living on a sailboat for six years prepared me nicely for this degree of isolation, but . . .

Without the virtual contact I have enjoyed with all of you here, I would certainly have lost my mind a long time ago. So in addition to everything else, thank you for saving my sanity, which, of course, my family and oldest friends would argue has been unsalvageable for decades. But be that as it may, I owe you big-time.

Tomorrow morning is double-dose chemo, along with the next lab test for the CA-125 cancer marker. Still aiming for lucky #7! Have a great week.

Lifestyle

Cancer fashion and more chemo

All is well, with an asterisk. The last couple of chemo sessions were serious smackdowns, and also I have had a mild virus. So I have spent much of the last two weeks hanging out in bed. Luckily, I have the wardrobe for it. My stylist (that would be me) has put together multiple sets of very cool pajamas with matching beanie caps, socks, and other accessories. No kidding – I’m a fashion legend in my own room.

In good news, tomorrow’s chemotherapy is single-dose, so I’m looking forward to a happier week. However, the medical team has conferred and believes that I can handle and would benefit significantly by three to six more weeks of chemo. Given that the CA-125 remission testing needs a minimum of four more weeks, it makes sense to me to sprint from here to the finish line. But fasten your seat belts; it may be a bumpy ride.

Sorry about the mixed metaphor.

Thanks very much for checking in. Have a wonderful week!

Diagnosis

Lab results, glasses, and doughnuts

I realized the other day that I have been saving a fortune on hair care. So I sprang for some snazzy new glasses.

The medical team moved me to Mondays for chemo, and yesterday was a double dose, which is generally a 5-day buzz-kill. However, the lab result contained such good news that I have bounded out of bed at the crack of noon today to share it.

As you know, my prognosis depends on the CA-125 ovarian cancer marker, which is determined by a blood test. To recap: Normal range is zero to 35. The marker is calculated every three weeks. Back in late July, I started with a 608.1 – essentially, near death. Three weeks ago, I got a 22.3 – normal.

Well, friends, yesterday I got a 15.1 – normal again. If I get two more normals in a row over the next six weeks, I will officially be in remission!

Better still, the trend appears to be headed downward. I continue to aim for Lucky Number 7. Thank you for your support on the road to get there.

Just FYI — no matter how messy it is, a celebratory doughnut tastes even better when eaten with the fingers than with a fork.

Enjoy your week!

Lifestyle

The bliss of comfort

I woke up this morning to the bliss of being comfortable. Warm and cozy. Good night’s sleep. No pain anywhere. I lay there for a while and just soaked it up. Total bliss.

I should report that another blood clot happened. This time it was in my arm and not serious. Well, it was just serious enough for the redhead to hustle me down to the ER, where we spent most of the night “under observation,” until after looking at the ultrasound, he agreed I could sneak out the back door. The people-watching there is fantastic. One guy walked in with a butcher knife halfway buried through his track pants and into his thigh. I couldn’t decide whether it was an assault or an unfortunate mise-en-place incident.

Book Update: Thank you very much for reading my book. I’m amazed and joyful on a daily basis that you are laughing at and thinking about words I have written. In particularly astounding news, “A Voyage of Heart and Song” is being ranked from time to time in Amazon’s top 100 adventure travel books. This is SO MUCH FUN. What a hoot. I feel awkward asking this, and I deeply apologize if it’s an intrusion, but if you have read and enjoyed the book, would you consider posting a review on Amazon, Goodreads, or Barnes & Noble? Thank you to everyone who has done so already.

I’m off to chemo in a few minutes. Single-dose, piece o’ cake.

Have a great weekend! And Happy Super Bowl, assuming you are not supporting the Patriots.

Diagnosis

I miss wine

I miss wine. It does not play well with chemo.

Last week was a double dose, so I have been hunkered down. I spent the weekend in slug mode with pajamas, the couch, televised football, and the BBC.

Have I mentioned that I miss wine?

In great news, I received the results of a recent blood test for the CA-125 ovarian cancer marker. The normal, non-cancerous range is zero to 35. I started this adventure back in early August with an astronomical readout of 608. After bouncing around quite a bit, my marker is now at – drum roll, please – 22.3. Normal range! If I can get it all the way down to a single digit, though, statistics say that my chances go up dramatically that it will stay there, indicating remission, and for a longer time. I’m aiming for a 7. Please be thinking Lucky #7!

To increase my chances of getting to Lucky #7, the medical team has tacked on more chemo sessions, through February. Fine with me. Welcome, in fact. Bring it on.

And finally, to the tune of the chorus of “My Boyfriend’s Back,” by the Angels circa 1963 (please refer to the chemo side-effect referenced in a prior post):

“Yeah, the BUMMER’s back, it’s gonna need some medication
(Hey-lah-day-lah, the BUMMER’s back!)
I really need to take a tropical vacation
(Hey-lah-day-lah, the BUMMER’s back!)”

Have I mentioned that I miss wine?

I want to thank everyone who has ordered my book. The response has truly lifted me up.

Thank you! – and happy MLK Day. Have a wonderful week.

Lifestyle

Genetic testing results

In wonderful news for my extended family, the genetics department at UTSW has determined that I do not carry any of the genes that are currently known to be associated with ovarian cancer or with breast cancer. On behalf of all my female relatives, I am so relieved.

We had some drama recently trying to get my blood thinner rebalanced post-surgically, but all is now well. The medical team ended up cutting my dosage in half, which has allowed me to take a good five seconds off my personal best injection time.

I am also happy to report that on a few occasions this past week I have felt well enough to be able to kinda sorta see a light at the end of the tunnel. Since about September, I have been too wobbly to drive and too immuno-suppressed to leave home for any purpose deemed not strictly necessary. But on Monday afternoon, I felt so good and the weather was so perfect (70 degrees and sunny) that I said to heck with it. I fired up my little convertible and went for a drive with the top down. It felt like a jailbreak. It was absolutely glorious, except for the part where I sunburned the top of my head. #baldproblems #meandtheRock

Tomorrow is single-dose chemo. Monday is a doc appointment to determine whether I need three more weeks of chemo, or six. Either way, I’m good with it.

Have a great weekend!

Lifestyle

2019

Happy new year! I am feeling great about 2019, but I can’t deny that my appearance has changed. My own phone doesn’t recognize me. Every time I pass a mirror, I wonder what Sinead O’Connor is doing in my house.

Chemo day will be on Friday for a while, and I’m still limping around from a double dose. I had to invoke a wheelchair for the first time last week – very tough on my pride, which although it wenteth before a fall, is plotting a full comeback.

This past year has been, to put it mildly, a challenge. But I have so much gratitude for its blessings as well, particularly for —

  1. The redhead
  2. My mom, still going strong at 85
  3. The wealth of love and support from you, my wonderful friends

My official theme song for 2019 is “Staying Alive.” Cue the Bee Gees, and let’s get this party started.

Lifestyle

Happy holidays!

All is well. I hope you are loving your holiday preparations, and that nobody is stressing at all – hah! I am happy to report that I have been given a week off from chemo, which will resume Friday the 28th.

Also, I now have an official release date for my book: A Voyage of Heart and Song. It will be available January 14th.

For anyone who is so inclined, the book is available for pre-order now online at Amazon (https://www.amazon.com/Voyage-Heart-Son…/…/ref=sr_1_fkmr0_2…) and at Barnes & Noble (https://www.barnesandnoble.com/w/books/1130020711…).

Here is the back cover blurb:
“Take time in the middle of life for your dreams. That is the message of this lighthearted true story of a Dallas couple who, in mid-career, sold their house and cars, bought a boat, and sailed around the world. Author Liza Farrow-Gillespie tells of pirates, storms, sharks, cannibals, and – scariest of all – 24/7 exposure to her husband’s sense of humor. She also relates the joy and personal growth that can come from a zig and a zag along the path of life.”

I wish each and every one of you a joyous Christmas and a wonderful New Year!

Lifestyle

Like a cat

I am feeling a lot like a cat. I’m not supposed to bend over, post-surgically, so whenever I knock something off onto the floor, I just kind of look down at it for a second and walk away. Whenever I pass a cozy spot, all I can think is “ooooh, time for a nap.” If I start feeling an urge to jump up on the Christmas tree and knock it over, I promise I’ll seek therapy.

Part III on the road to remission is in full swing. The current schedule calls for nine more weeks of weekly chemo, the same as before, including three double-dose sessions. It’s going to be over before I know it, and I’m still way behind on my thank-you notes.

I have some good news, though. When I was first diagnosed, one of the many thoughts and emotions that slammed into me was fear that I would not be given time to finish the book I was writing. The redhead and I spent six years (1998-2004) living on a sailboat and sailing around the world, and the book is about that experience. Well, there’s nothing like having a deadline! I have been working on the book every day that I have been reasonably able, and last night I uploaded the completed manuscript to Amazon for self-publication. It will be a month or so before it comes out, but my part is done, wrapped up, completed, concluded, finalized, finito, and in the can. I rested easier last night than I have in many months. No matter what happens, the redhead will have something to read and remember.

Hope your holiday plans are coming along nicely. Thank you so much for being here. Have a wonderful week!

Lifestyle

Slow learner

Rough week. For a while, it looked as if I would get slapped back into the hospital to treat an infection. Even worse, I have had to admit an awful truth: I am a slow learner.

The pendulum has swung something like this . . .

Day 1 – Wow! I feel great! I can jump up and Get Stuff Done.

Day 2 – Ack. I feel terrible. I barely have the energy to lie on the couch all day without moving.

Day 3 – Wow! That rest day did the trick. I feel great! I can jump up and Get Stuff Done.

Day 4 – Ack. I feel terrible. I barely have the energy to lie on the couch all day without moving.

Day 5 – Wow! That rest day did the trick. I feel great! I can jump up and Get Stuff Done.

Day 6 – (well, you get the picture).

Today’s plan is entitled “Moderation.” We’ll see.

Chemo is scheduled to resume on Tuesday. And with regard to today’s Big 12 championship, I will say a hearty “hook ‘em.”

Love to all, and have a great weekend.

Lifestyle

Post-surgical wrap-up

We got home from the hospital yesterday evening after a week’s stay. I’m as weak as a kitten, but it was glorious to wake up in my own bed this morning.
 
As Debra updated earlier, surgery was wildly successful. I thank you from the bottom of my heart for the wave of prayers and support that has helped me get through this part.
 
WARNING: SERIOUSLY GROSS THINGS ARE ABOUT TO BE DISCUSSED. READ FURTHER AT YOUR OWN RISK.
 
First of all, I am going to have the most awesome scar in Dallas. The incision is 14 inches long and closed with 38 giant staples. My torso looks like a Mad Max costume.
 
The goal of last week’s surgery, as you may recall, was to “de-bulk” or trim down as much of each cancer tumor as possible while leaving my vital organs as intact as possible. My surgeon, Dr. Jayanthi Lea (better known by her hip-hop name of J-Lea), exceeded all expectations by removing 100% of all of the tumors. It took her a full eight hours of surgery, but in a result I did not even dare to hope for, all of the little buggers are 100% gone.
 
Of course, there are still about a million microscopic cancer cells down there that could wake up and become tumor factories at any time. Hence, we still talk about remission rather than cure. And hence also, we will be starting follow-up chemo in a week or two to discourage that sort of behavior. Until follow-up chemo is complete, we won’t know whether remission has been achieved, or for how long.
 
As for my innards, J-Lea and her team were able to avoid damage to lungs, liver, spleen, pancreas, and just about everything else I need – all except my intestines. My poor intestines had to be carved up and then put back together like Legos. Until they heal, I will be wearing the latest in fashionable ileostomy bags. That is, a portion of my intestine (called the “stoma”) has been pulled through my side and now reports to an exterior bag rather than to the rest of my digestive tract. The ileostomy is temporary, and given the overall result of the surgery, dealing with it for a few months is – though definitely gross – okay by me. I have named the stoma “Bilbo”; and the bag, of course, is “Baggins.” Sometimes I call the whole thing “Little Buddy.” It gurgles a bit, but no more than the redhead does after fried food.
 
Speaking of the redhead, and on a serious note, he spent virtually every minute of the past week at the hospital with me. I am more blessed than I have the words to say. Yesterday he kneeled down in front of me, and I was reminded of the day he proposed 35 years ago. But this time, he was kneeling to help me empty my ileostomy bag.
 
No words.
 
Please have a wonderful Thanksgiving holiday, and know that my love and gratitude will be right there with you.
Lifestyle

Weekend Update

Update from Alan: Liza made incredible progress over the weekend.  Walked the length of the hallway, eating solid food, and hopefully discharged fairly soon. Wonderful news!!!!

Lifestyle

Day after surgery

Morning update from Alan: Liza is awake, smiling, and doing well. Vitals all stable. Will try walking later today. (8:55 am)

Update from Liza and Alan on the results of the surgery: Best possible outcome in terms of removing the visible tumors!! Now, this doesn’t mean that she is “cured,” but the chances of meaningful remission are now greatly enhanced. She’ll have more chemo to try to make sure those nasty cancer cells don’t make more tumors, but this is about the best news we could have gotten. Liza and Alan both wanted us to pass on thanks for all the prayers, good vibes, support, and caring. (12:03 pm)

Treatment

Surgery Day

Update from the redhead: In pre-op now, scheduled to go in around 10. It will likely be a long surgery (5-6 hours), so don’t be alarmed if we don’t post any updates for a while. As Alan said, right now, no news is good news. (9:20 am)

Update from the redhead: “Liza just taken to surgery. Smiling & doing well with a little pre-op cocktail on board. Surgeon said about six hours.” (11:05 am)

Update: Surgery in progress. Liza is stable with a few more hours to go. (2:05 pm)

Late-breaking news: Stable and coming out of surgery! (6:30 pm)

Unbelievably good news, y’all: Liza is awake and extubated and doing well!!!! Hallelujah!!! (6:43 pm)

Lifestyle

Cleared for surgery on Tuesday

Well, my hair hung in there for a good long while, but it has now said goodbye. Why is chemo so selective, though? It appears I would still have to bikini-wax and chin-pluck. This does not seem fair.

I am extremely happy to report that after several rounds of testing and consultations, I have been cleared for surgery on Tuesday. In even better news, the surgeon canceled my last two chemo sessions, because she says I am where I need to be at this point. The goal now is to be as strong as possible for surgery.
 
So here ends Part I of the proceedings (dense-dose chemotherapy) and begins Part II (surgery and recovery), which will be followed by Part III (follow-up chemo). As I may have mentioned, it’s a marathon.
 
If you are the least bit squeamish, STOP READING NOW and skip to the last paragraph. The surgery set for Tuesday is called a “de-bulking” procedure. The chemo has prevented the cancer from spreading further, and it has reduced the size of the tumors. Now the surgeon will go in (1) to do a hysterectomy, of course; and also (2) to remove or reduce as much additional tumor as she can. With Stage 4 ovarian, the cancer will have spread well beyond the girl parts. There are many, many additional tumors – like hundreds of the little buggers. It’s a tumor convention in there. Some of them are attached to, or wrapped around, various vital organs and whatnot that I would prefer to keep – such as lungs, liver, intestines, and so forth.
 
Remission depends entirely on how much tumor the surgeon is able to remove. My quality of life during remission depends entirely on how much of the rest of me she can avoid removing in the process. It’s a complicated deal. I did ask the surgeon whether she could go ahead and do a little liposuction while she’s in there. She was not amused.
 
I have been told that I will spend a post-surgical day or two in the ICU, probably on a ventilator while fluid in my lungs dissipates; and then I will be in the hospital for about another week. Until I’m up and around, my law partners Julie and Debra are in charge of posting updates. The redhead wanted to do it, but he’s going to have his hands full. Also, he is still a little fuzzy on how Facebook actually works.
 
Your prayers and friendship have been and continue to be a comfort and inspiration to the redhead and me both. We have not for a single day felt alone in this. Thank you.
Lifestyle

Homestretch

All is well. Monday was single-dose chemotherapy with Taxol. Next week is the last double-dose with Taxol and Carboplatin. Homestretch on the road to remission! There’s a country song in there somewhere.

“Got my weekly dose of taxol
Headin’ down to the local dancehall
Double dose of carboplatin
Barkeep, make mine a Manhattan
‘Cause I’m on the road to remission tonight

Gonna dance like a barbarian
Gonna beat this dang ovarian
‘Cause I’m on the road to remission tonight”

Hmm, needs work.

As you might imagine, I have been doing a lot of thinking and reading about living one day at a time. The bottom line for me is this: Nobody is promised a tomorrow. What I have is today, to live the best and most useful, joyful, loving day I can possibly live. What will I do with this gift?

Apparently, write bad country songs. But I’ll try to up my game this afternoon.

Happy Halloween, and please be safe.

Treatment

Surgery date

It’s a beautiful day today in Dallas – 65 degrees and sunny. Truly gorgeous. This past week has been rainy and cold, which suited me just fine for a low-key flannel-pajama bed-to-couch double-dose recovery kind of week.

As you may recall, I had to skip one chemo session while in the hospital for the mediport infection, and now I see that two new sessions have been added to my chemotherapy schedule in its place. Apparently, oncologists have questionable math skills.

However, they have given me an official surgery date, which is both productive and heartening: Tuesday, November 13. More about that later, and I promise to warn you before discussing anything gory.

Hope you are enjoying this glorious day!

Lifestyle

May no new thing arise

I said a fond goodbye today to my oldest, dearest, go-to sweatpants, a Target purchase circa 2005. They have been called into service even more often than usual these past weeks, and today they came out of the dryer basically in shreds. As I stood over the waste basket to commune with them one last time, I stuck my fingers through holes until I ran out of fingers. The redhead said a few words – specifically, “You’re not throwing those away, are you? They’re still good! – to which I made a mental note to monitor his leisure wardrobe more carefully.

We had some drama this past week though. I woke up Monday morning with signs and symptoms of an infection, which for a chemo patient is a medical emergency. I duly presented myself to my doctor, who within the hour had slapped me into the hospital and hooked me up to two broad-spectrum intravenous antibiotics. Turns out, my implanted mediport – yes, the same mediport of blood clot fame – had developed a bacterial infection, as 26% of them do over time. Luckily, we caught it and avoided sepsis. The docs removed the port, and I may have fired off an obscenity in its general direction as they carried it from the room.

While in the hospital, I received a variety of tests and treatments, including a blood transfusion. Getting a blood transfusion is an odd feeling. As it began running, I wondered aloud who the blood might have belonged to; and my wonderful redhead reassured me that it probably came from some meth addict. He (the redhead, not the meth addict) spent every night on the couch in my hospital room and worked during the day; and by the time they sent us home Thursday night, he looked worse than I did.

The Spanish have a saying: “Que no haya novedad.” May no new thing arise. It is now my mantra.

In the unlikely event you did not get the memo, October is breast cancer awareness month. Girlfriends, please get your mammogram no matter what your age, even if you have to pay for it out of pocket; and while you’re at it, swing by your gynecology specialist – and if you don’t have one, get one – for a quick cervical cancer test and a discussion of any risk factors you may have for ovarian cancer. Please.

Treatment

Hand and Foot Syndrome

The most surreal phrase I have heard to date in this process has not been “you have cancer.” No, the most surreal phrase has been “you need to keep your weight up.” This is an alien concept, but a lifetime of experience is finally paying off. I may be the only person in the history of humankind to actually gain a pound or two on chemotherapy.

This past week a new side effect appeared. The good doctors at the UTSW dermatology clinic and immunology department diagnosed it as “hand and foot syndrome.” My first thought was wow, that syndrome needs a better name. So I have rechristened it Bilateral Unspecified Magenta Macro Extremity Response, or BUMMER. Basically, BUMMER consists of large patches of vivid fuchsia-red blistery skin covering the hands and feet. The patches are quite painful to the touch – so painful, in fact, that I may start concealed-carrying for the sole purpose of warning people off if they get anywhere near my appendages. Luckily, the pain is easily managed with Tramadol, a prescription painkiller. I have so far in this process steadfastly resisted taking anything stronger than Tylenol, but I’m not a crazy person here.

In other status, I still have some hair (#combover). Also, I have an appointment with the surgeon tomorrow to discuss surgery timing and logistics. There are at least three more weeks of chemo to complete, so my earliest date with the O.R. would be in early November.

All is well and on track. Have a wonderful week! Sending lots of love and gratitude your way.

Treatment

Chemo is working

Well I don’t mind telling you that this double-dose week has well and truly kicked my butt. Luckily, I found a whole new season of the Great British Baking Show to binge. I love that show. Nothing bad happens. The contestants help each other out. Drama is generated by watching things bake. They say “puff pastry” in reverential tones (and I won’t even get into “rough puff”). I am saving the final for later today. Everyone will cry and congratulate everyone else, and then have a nice cup of tea.

In the interest of continuing to report with reasonable candor, I will share that I started experiencing a potentially serious chemo side-effect this week – peripheral neuropathy. That’s tingling and numbness in fingers and feet. Worst case, it can progress to significant pain or paralysis; and it can be temporary or permanent. I have gotten some freezer-gloves and -socks to wear during chemo to minimize escalation. The cold restricts blood flow to the affected areas, and is reported to work; or at least it can’t hurt, so why not. But my eyes are on the prize: Kill the cancer, manage the side effects.

And speaking of killing the cancer, I had a CAT scan late last week, and — oh the relief! — the chemo is definitely working. We’re not there yet, but it’s working! Also, medical science has made great strides in the barium you have to drink beforehand. It used to be pretty nasty stuff. This time, I debated among four flavors, chose the chilled mocha, and it was delightfully refreshing.

Thank you for continuing to share this chapter of my life with me. Truly, it makes a world of difference.

Lifestyle

Halfway through Chemo

We are nearing the end of Week 6, and all is well – halfway done! My medical team tells me that my labs are holding up fine. They also warn me that chemo is cumulative, and that I should expect some additional challenges in the second half. My plan is to channel Aaron Rodgers.**
 
(**For non-Cheeseheads, Rodgers went out with a knee injury in the first half of the Green Bay/Chicago game last Sunday, and then gimped back in the fourth to throw three touchdown passes for the win. For extra credit, compare and contrast the Cowboys.)
 
On a serious note, I would like to thank the department of anesthesiology at Children’s Medical Center for their support, both emotional and logistical, of my sweet redheaded husband. The entire department has been there for him. I won’t name anyone, because there are too many to name everyone, but I’m particularly grateful to the leadership team, including the department chief and the Supreme Boardrunner Commander, as well as the awesome staff, for giving the redhead a schedule that allows him to be there for me. And his colleagues could not be kinder or more supportive towards him every single day. They are even taking his call. I am profoundly and a bit tearfully grateful to all of you.
 
And hey! – I still have hair. It’s sparse, but it’s hanging in there. With liberal applications of gel and half a can of hairspray, I can get it to cover my whole head. It’s a medical muhrkle*, and the talk of the chemo clinic.
 
(*Texan for “miracle.”)
 
Y’all have a good weekend.
Lifestyle

Steroids, etc.

Prior to each chemo infusion, I receive an intravenous aperitif of high-dose steroids, followed by three days of steroid pills. The chemo nutritionist has told me to consume at least 100 grams of protein per day. The question is: Am I missing a major body-building opportunity here?  I feel like I should be pumping iron.

Be that as it may, the redhead has – in the kindest way possible and on a mellow Day 6 of the weekly chemo cycle – mentioned that my communication style may be a tad more aggressive than usual during this Day 1-4 steroid time period.  I scoffed.  He provided examples. I now have a policy on Day 1-4 of declining to respond to any Facebook post, email, or verbal statement that ticks me off. Instead of counting to ten, I count to Day 5.

Speaking of aggression, my medical team has tacked on an additional three weeks of presurgical chemo, and, beginning last week, has upped the intensity of each dose. I deduce from this turn of events that my body is tolerating the chemo well and that the medical team is taking no chances and no prisoners.  That makes me very happy.  Of course, Paranoid Liza is like ruh-ro . . . does this mean that the little tumor-buggers are not lining up to die as expeditiously as one might have hoped? But it’s still too early for that kind of assessment, so I have gently walked Paranoid Liza back into her she-shed and have given her various other conspiracy theories to play with.

Plus, there is preliminary good news!  I have observed some changes – and I refrain from going into detail in case you are in the middle of a meal – that give me a subjective, anecdotal, non-binding but reasonable belief that the abdominal tumors have begun to recede. Also, my vital signs have moved from marginally acceptable to squarely healthy, which carries all kinds of positive cancer-reduction connotations.

I continue to be moved by and profoundly grateful for your prayers, thoughts, support, and friendship.  Thank you, thank you, thank you.

Lifestyle

Napping skills

As I sit here sipping a cocktail of Ensure on the rocks (with a sprig of mint), I am mindful that some of you are cancer survivors or currently in treatment, or are primary caregivers. If you feel comfortable sharing in the comments [on the Facebook page], I would love to hear about it – including any advice.

This week was a double-dose, take-it-easy kind of week. I had plenty of time to work on my napping skills, which are coming along nicely.

Have a safe and wonderful holiday weekend! All is well.

 

Lifestyle

Status and Stomach Jabs

All is well. This was a single-dose week for chemo, so I feel like I’ve been on vacation. We used the time and energy to make our home more comfortable and well-equipped for the weeks ahead. I also played a little bridge and got my nails done! – and continued to wrap up a few last work items. I want to thank my firm again for stepping up and freeing me to concentrate on treatment and recovery.
 
The blood thinner stomach jabs are going just fine, by the way. I have it down to about 10 minutes. First, there is the mandatory 4-minute procrastination period. Then, there is about a 2-minute prep, followed by 10 seconds for the actual injection, followed by a little after-party and the clean-up. Easy peasy, and more fun with the right music. However, I have gained new respect for my friends who have lived with insulin and other self-injections their whole lives.
Diagnosis

How did I just skip to Stage IV?

All is well. I have been successfully avoiding chemo nausea with a strict daily regimen of Zofran (anti-nausea medication) and Blue Bell (cookies ‘n cream). Next chemo is Monday, followed weekly thereafter for another couple of months.

Friends have asked me whether I had any warning signs of cancer, or whether a routine check-up should have picked this up. The answers are nope and nope. My particular version of this cancer has special and challenging characteristics (more on that later, because of course I think I’m special and challenging). However, it is essentially Stage IV ovarian cancer. Only about 20% of ovarian cancer is caught in early stages.  That is, almost 80% of women who present with ovarian cancer are already in or very near Stage IV. This should send a chill up the spine, girlfriend.

At Stage IV, there is no cure. There is a great probability of remission for a satisfying period of years, but there is no cure.

A couple of months ago, I started noticing some fatigue (but I’m getting older and still working 10-hour days, so not unexpected, right?); some bloating in my gut (constipation?); some shortness of breath (need to get back on the treadmill?); and that was it. Figuring it was time for a colonoscopy anyway, and since I was having some throat issues as well, I made an appointment with a GI doc.  She duly performed an endoscopy/colonoscopy, top to bottom. All was well with my digestion, but she found a significant stricture of the colon at one spot, and in light of that and the now-unexplained bloating, she ordered an MRI for the following day. Literally two business days later, I had a diagnosis of Stage IV ovarian/peritoneal cancer and was hustled immediately into the care of a surgical oncologist.  So soup to nuts, the time between initial vague symptoms to diagnosis was maybe 3 weeks, max 30 days. Cancer had been growing for many months, and probably for several years. By the time I noticed anything at all, it was waaayyy too late.

I have Googled this conundrum to death and conferred with my docs and the redhead. There is no good answer for early detection.  Genetic testing is not a bad idea – with the caveat that a positive hit does not necessarily mean cancer and may give you a lifelong “preexisting condition” for insurance purposes. There are some blood tests that can identify cancer markers. These are not routinely done in blood work and would have to be requested specially – again, with the caveat above. Even a hysterectomy is not necessarily the solution, because the same cells that are present in female reproductive organs are also present in the abdominal lining (peritoneum) – hence, the same exact cancer can just grow there instead.

Friends, if you have any knowledge or insight into this issue, please post forthwith. Otherwise, this is all I got: Hug often, live joyfully, and value time as a gift beyond price.

Treatment

Tales from the Clot, Part Two

It was a fully obstructive clot of the freakin’ jugular vein, and I don’t mind telling you that the instant they finished setting up the heparin drip and hooking up the monitors, the redhead and I pulled out some paper and started planning my funeral. However, the score at this point is Modern Medicine – 1, Clot – 0. I was visited yesterday morning by squadrons of specialists with their residents and fellows in tow, just like on TV. The upshot is that with the massive heparin infusion, blood flow was sufficiently restored; hence, vascular surgery was off the table (sorry for pun); injectable blood thinners will continue to dissolve the clot over time; the mediport is still viable; hence — and most importantly — chemo will not be interrupted. And during these consultations by highly learned medical professionals, I learned many great new Scrabble words.

Plus, there is actually an upside, and bear with me on this. The dastardly Clot was formed in part by the propensity of certain versions of peritoneal cancer to randomly coagulate blood and thus form clots. We know now that I have a version that does that! It’s sort of like being grateful you found that termite hill in the side yard, because now you know to treat the whole house. In any event — and if you don’t want to be grossed out, STOP READING NOW — I will be self-injecting blood thinners into my stomach twice a day for about 6 months to keep the clots at bay. Eww and ouch and say whaaat and #imalawyerjimnotapincushion. But I guess it’s good to learn new skills.

People have asked why, since I am married to a doctor, that my husband doesn’t just do the shots for me. And we considered that. After some contemplation, I decided that the image of the love of my life coming at me with a needle twice a day is not something I want to see. Bit of a romance killer.

Treatment

Chemo snacks and other consultations

I am a Central Texas girl. When someone tells me I will need to pack a snack for chemo, my first thought is to take a mayonnaise sandwich. For those of you not from Central Texas, a mayonnaise sandwich is Miracle Whip and bread and that’s it. So I’m sitting there in chemo, and no sooner had I broken out my mayonnaise sandwich — I mean, within seconds — than the cancer nutritionist strolls into the room for my nutrition consult. I was so busted.

But wow what resources UTSW provides. In addition to the nutrition consult, I was visited by chemo nurses with much info on what to expect; by the chaplain (Tammy, who is an absolute sweetheart); and by . . . wait for it . . . a music therapist! UTSW provides music therapy to its chemo patients.

I am definitely in the right place.

Treatment

Chemo #1

The first chemo session went well yesterday. They put you in a recliner, and there’s a TV on the wall. It’s a lot like going to the nail salon, except the chemo technicians are far less judgmental — not a single “tsk” or eyeroll at the condition of my cuticles.

Earlier that morning, the wonderful folks at Interventional Radiology, at UTSW Clements Hospital (shout-out to Dino), installed my mediport device.  The device is implanted internally.  From yesterday on, all blood draws, IVs, and chemo will be accomplished using the mediport.  I happily consented to one 30-minute sedated procedure (and 48 hours without a shower) in exchange for many dozens of a la carte bloodwork sticks and IV hole-punching.

Lifestyle

Chemo cut

In preparation for inevitable billiard-baldness, I decided to get my hair cut, so there won’t be long straggly strands of hair everywhere when it does start falling out.  Many thanks to Brannon at Matthew Tully Salon for working me in on short notice.  For some reason, getting a “chemo cut” (and it’s the shortest my hair has been since I was about 10) makes me feel strong and ready for action.

Diagnosis

Core biopsy and paracentesis

In addition to another paracentesis today, the fine folks at UTSW Interventional Radiology performed a core biopsy.  Although I have already received a diagnosis of peritoneal carcinomatosis, the core biopsy is intended to allow the oncologist to fine-tune the chemo cocktail to be as effective as possible.

By the way, today’s paracentesis makes a total of just over 6 liters of fluid drained from my abdomen — 5 liters last week, and 1.25 liters today. For the last couple of months, as that fluid built up, I was thinking wow am I old and fat.  (Now, of course, I’m thinking wow I have advanced stage cancer.)  But draining all that fluid, which was shoving up against everything, including my lungs, certainly has made it easier to breathe and work.

Diagnosis

Dear Extended Family, Law Firm, Friends, and Colleagues:

As you know, I received the unwelcome news from my doctors last week that I have Stage IV peritoneal/ovarian cancer. The purpose of this blog is for me to be able to communicate my status without being intrusive.  That is, you can check here whenever you like, and I won’t worry about how often would be too often to communicate with you directly.  (I don’t want to be a bore.) Plus, who knows, perhaps someone out there with a similar diagnosis will feel connected. In any event, I will be posting updates and cancer ramblings here periodically, so you will know I’m still alive and kicking.

Barring unforeseen complications, this will be a marathon. Best case is 3-5 months for treatment (chemo, followed by surgery, followed by chemo), with a great chance of remission thereafter. My law firm has very generously allowed me to take an extended leave of absence to concentrate on treatment and recovery.

This is not my first rodeo. After surviving breast cancer in 1991, I have received 27 bonus years, and those years have been glorious. Please know that if my time is up now, I’m okay with that. However, the plan is to throw everything at this that medical science and I have at our disposal, and to achieve many additional bonus years (is that redundant?) with my sweet redheaded husband, and with my wonderful family, law firm, and friends. As I have said to all, the highest probability is that I will be back in action by the end of the year, with no hair and a terrible attitude.

If I become temporarily unable to post, the redhead says he will take up the slack.  As unlikely as that would seem to actually happen, I know his heart is in the right place.