Treatment

Grateful for today

I want to let you know where we are. The current chemotherapy has stopped working, and the medical team has nothing further on the menu to offer us. We will continue comfort care.

There is research out there that once chemo stops working, a terminal cancer patient has about the same lifespan with it as without it. There is also research out there that trying to fix your hand by banging on it with a hammer isn’t very bright. We’ve decided to go with the research.

Please do not construe this move as a decision to throw in the towel. It definitely is not. I will fight as long as I have a single viable hour to spend with the redhead, or a way to add some (perceived) value to anyone’s life.

And I think that’s it for now. There’s way too much to say, and everything I know to say wouldn’t be enough anyway. We still have a little bit of time, Argentina. The redhead and I will make it last as long as we can.

Love you lots, my friends. Thank you from the bottom of our hearts.

Lifestyle

Goals

When January 1, 2020, rolled around, I realized I had done something unprecedented. For the first time in my life, I had actually kept a New Year’s resolution. As you may recall, my resolution for 2019 was, per the Bee Gees, “Stayin’ Alive.”

It was a low bar, but hey.

Now I’m at another milestone for 2020 – my birthday. Today I turn 67 years old. Knowing what I know about my initial diagnosis and what a path it has been to get to 67, it is a miracle to me that today has arrived. I thank you, because I am quite sure that your prayers and support are responsible in large part. And for whatever reason, the good Lord is not done with me yet.

Today, the redheaded and I are also celebrating 36 wonderful years of marriage. Getting married on my birthday was a secret childhood dream of mine. When we were planning our wedding back in 1984, that date was open, and it occurred to me that it would also be efficient and humane. That is, he would have only one date to remember every year. He has done a bang-up job with it, too, over the years, but none better than today.

Today he arranged for us to renew our vows with our pastor, Rachel, of the Oak Lawn United Methodist Church – via FaceTime, of course, because she is quarantined and we are sheltering in place. But what a day it has been – tearful, joyful, and memorable all the way around.

Liza and Alan Farrow-Gillespie 2020-04-07

Chemo went fine yesterday, by the way. After a bit of a scare a couple of weeks ago with bad numbers and a blood transfusion, I am back on a regular schedule as of yesterday, with three weeks on, one week off. So I will be having the Topotecan for the next two Mondays in a row, followed by a week’s vacation. Even though my CA-125 cancer marker is in the three-digit zone, well north of normal, it is holding steady. Who knows – maybe it’s time to set another goal.

New book by the end of the month, maybe, or thereabouts? Working on it. We’ll see.

Stay safe.

Treatment

I’m in!

I’m in! Oh thank heaven, I’m in!

Yesterday my numbers checkout out fine, and the medical team has recommenced my chemo. I will be getting a weekly Monday or Tuesday dose of the chemo drug “Topotecan,” which I might take more seriously if it didn’t sound like a tropical bird rather than a dangerous poison.

But be that as it may, the weekly dose is much better than either (a) no chemo at all, which would not bode well, or (b) the daily dose in February that put me into the hospital and tried to kill me.

So thank you from the bottom of my heart for the thoughts and prayers, and let’s be careful out there.

Treatment

Hardware

Well friends, unfortunately my health has taken a turn south – and I don’t mean towards Galveston for a nice cruise. I have been loving my extension of lifetime on this beautiful planet, thanks to my medical team, the chemo, and yes the Beelzebub. I had even qualified for a promising new drug trial. Then wham! – back in the hospital for two bleeping weeks.

It’s been almost a week now since I got home. With the help of dear friends, I have been able to get some critical things done – like drag my sorry butt to church, get a bunch of built-up errands done, and fulfill some important personal promises. After getting to sleep in my own bed, I am feeling more or less humanoid. Ironically, as far as hardware goes, I am looking more like the Bionic Woman.

SKIP THIS PARAGRAPH IF YOU ARE SQUEAMISH. For example, I now have a “tunneled central line.” It’s a cousin to the port I once had. The redhead accesses it twice a day to give me my meds. In the event I qualify for more chemo (and we won’t find that out until Tuesday), the chemo and pre-medications will be much easier to receive with this setup rather than depending on an IV.

CONTINUE TO SKIP. And not needing to depend on an IV is excellent news, by the way. The docs found a deep vein thrombosis in my arm, so I’m down one usable appendage.

CONTINUE TO SKIP. Also, I now have a “gastrostomy tube.” I’m trying not to panic about that. The tube’s purpose is not to feed me (at least for now), but rather to aid my digestive system in processing the nutrition I am able to take in myself. I have developed a “tumor ileus.” That is, a cancer tumor is interfering with my upper intestine by kinking or partially blocking it. After some basic research, I have had a change of mind and heart about feeding tubes in general. It would be entirely possible for my digestive system to continue to jack me up, while the rest of me – brain, heart, lungs, mobility, etc. – continues to chug along reasonably functionally and even well.

AND CONTINUE TO SKIP IF YOU DON’T LIKE SOPHOMORIC HUMOR. The most awesome part about the gastrostomy tube, however, is that it has given me a brand new skill. I can now fart from my stomach. The reason I know this is that I just did it. [Giggle.]

The redhead and I continue to appreciate your friendship and support. Thank you.

Treatment

Cleopatra

Just call me Cleopatra, ‘cause I’ve been the Queen of Denial.

For a while now, I have felt so good – so practically normal – that I could pretend to myself that I’m healthy, and that this whole cancer thing is really just a mistake. (“Oh my goodness, I’m so sorry, we got your medical records confused – whoops!”)

The vacation from reality has been nice, I have to say. Thank you for helping me enjoy it. The vacation, however, has come to a crashing end. IF YOU PREFER CLEOPATRA’S WORLD, READ NO FURTHER.

Because included on Beelzebub’s new side effect hit list, we now have . . .

  • Shingles! Yeah, baby, all over my torso, and they hurt just as much as people say. If you had chicken pox as a child, please run, don’t walk, to your nearest pharmacy for the Shingrix vaccine. For me, shingles then led to . . .
  • Neutropenia! – which sounds like a small musical instrument, possibly related to the calliope or autoharp, but which is actually an immune system malfunction. Which led to . . .
  • Shots to stimulate my bone marrow! Good times. Followed by . . .
  • A full day at the E.D. with pneumonia symptoms! – which turned out to be respiratory syncytial virus, or “RSV” as we in the inner circle call it. And which now means a stretch in bed with a crate of kleenex.

But all this pales in comparison to a potential game-changer. My new CT scan came back with a radiology report of brand new tumors. The report meant that my current second-line treatment of Doxil/Beelzebub, like its predecessor first-line treatment of Taxol/Carboplatin, was no longer effective and would be terminated. And that would be one more giant step down the path to “I’m sorry, there’s nothing further we can do.”

But law school turns out to have been worth it after all. I blurted out some questions. Was it possible that this CT or the prior one was misread? I mean, we’re talking teeny tiny spots on a blurry x-ray here. Did the same radiologist read both? Was it someone seriously experienced in ovarian cancer? Was it reasonable to get a second radiology opinion? My medical team said “absolutely.” Well, hallelujah, the second reading came back and was vetted. It showed no new tumors, and only a 10% growth of old tumors. A reading of less than 20% growth classifies me as having “stable disease.” And that means the Doxil/Beelzebub is working well enough to extend my life, so I get to keep it.

Because better the Beelzebub you know, right?

More importantly, even with the best of medical teams, it pays to advocate and question.

I hope you enjoyed this beautiful Christmas Day and Hanukkah in good health. Happy holidays and much love from the redhead and yours truly, who henceforth shall not be known as Cleopatra.

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.

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.

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.

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

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!

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

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

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

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.

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.

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.