Monday, March 30, 2009

Oncologist number two

Mom's doctors office got her an appointment for this Wednesday to meet with the oncologist and talk about her cancer. In the meantime, he will receive the pathology reports and have time to go over the information. She could end up having a chemo treatment Wednesday after the consultation, so that's a good possibility.

I was hoping for an appointment today, but given the short notice and also the fact that he will have time in the next couple of days to go over the information, Wednesday doesn't seem so bad after all.

The nurse in the doctor office has been on the phone all morning getting the appointments set up and making sure that the reports are faxed over. She has been a great angel to have on mom's side.

The extra two days will also give mom time to get more questions together, she has a list already but wants to think of more things to ask. I have a few things on my list as well... so the poor oncologist will have a nurse with questions and a non-nurse-but-good-reporter-and-writer with questions. From what others have said (positively) about him, he should be able to handle everything just fine.

Saturday, March 28, 2009

Another brief hospital visit

We checked into the hospital at about 5:50 a.m. and they had her prepped and ready to go for the surgery by 7:15 a.m. They gave her a general anesthesia... they wanted to put her under because they were going to bury the port underneath the skin. She asked for just a local anesthetic at first, but they said no way. She's a tough girl but I'm glad they knocked her out.

The port was inserted and took about 18 minutes total. After the procedure the doctor came in and said that it went in fine. Her skin is thin so she may be a little sore. I asked if there was any maintenance and he said not really. The port will be used for the chemo treatments and also can take blood out for testing of it if needed. In some cases the port would need to be cleaned if it hasn’t been used in a couple of months but that shouldn’t be the case.

They put it on her left side under the collar bone. I imagine that since her right shoulder is still sore from her fall last December, that they put it on that side so it wouldn't interfere with her physical therapy. The round part creates a bump in her skin. The nurse said the area would be swollen and tender.

She told the surgeon that she was going to get another oncologist's opinion on Monday. His nurse was going to fax over the reports first thing. He was supportive of the decision and told her that she needed to do the best for herself. I agree!

Friday, March 27, 2009

Second thoughts

A day by herself to catch up with herself and digest the last four days of whirlwind information brought on some reservations about the oncologist doctor she saw yesterday and the need to get another oncologist’s opinion. She came to the realization that the oncologist may not be the right fit, and called her physician's nurse for some insight. After much discussion she decided that she wanted to go to another oncologist. She got a referral to another oncologist in the Quads and will have her reports faxed to him first thing Monday morning. The nurse was going to call the office and try to get an appointment for that Monday or anytime next week.

She really didn’t have a good feeling about the visit yesterday... not specifically one thing, but many things gave her little red flags and she wasn’t comfortable with the visit. Everyone said that there was certainly time to get a second opinion, and it may create a little hiccup in the treatment process, but not a lot of harm done. I want her to feel at ease about the care that she is going to get, because I think in the scheme of things that is a big part of the healing process.

There is still the issue of more fluid building up in her abdomen, so getting her into treatment soon would potentially prevent the fluid buildup. It’s not a big deal to drain it, but mom doesn’t want to feel uncomfortable like that again.

Thursday, March 26, 2009

Oncologist appointment

Appointment with oncologist doctor 10:15 a.m. After getting the paperwork and insurance details out of the way, we met with Dr. He flipped through some paper reports then reviewed the events, previous exams (vaginal, colonoscopy). He said that based on the reports he has seen (although had not seen a pathology report??) the level of 2500 indicated that the cancer could be ovarian. There are a couple of other possibilities, stomach, peritoneal, but his call was ovarian. "Bet money on it."

He said ovarian is definitely treatable, and suggested that the course of action should be doing two cycles of chemotherapy treatment with the drugs Topotecan and Praxitel. A cycle consists of doing three weeks on, one week off, then another three weeks on, then a week off. Then she would have surgery to take her uterus and ovaries out, plus do a process called devulking - clean out the rest of cancer implants on any other organs around and possibly on abdomen wall.

He went over the side effects, and said that everyone responds differently to the drugs, but that she could expect some nausea. He was going to prescribe some steroids for her to take before the chemo treatments that would cut down on some of the side effects. He said she would definitely lose her hair.

The chemo treatment would stop the growth of the cancer cells, because they divide faster than regular cells, however it would kill of other cells as well. Her immune system will be suppressed, which will restrict her ability to fight off other sicknesses. Fatigue is another side effect she will probably experience. She may be able to curb some of the side effects with the Prednisone/steroid.

The appointment went so fast (really about 20 minutes) that I barely had time to type. The doctor's office did the chemo right there but in another room. The Dr. was ready to start chemo as soon as mom could get a port catheter inserted. She set up another appointment for Monday 3/30 and his office would call tomorrow with a specific time. If there were any questions she could give him a call at any time.

So she was probably looking at ovarian cancer. I can’t say that was a relief, because it still could be something else. I wish there was some way to know. The only real way to know was surgery, and that isn't in the plan right now.

Back in Geneseo, surgeon doctor met with us and we told him about what the oncologist had said. She decided to set a time to put the catheter port in on Saturday, no use waiting. If things didn’t work out for Monday or if there weren’t a time available, then at least she would have the port in, ready to go for treatment.

Wednesday, March 25, 2009

One more day in the hospital

Mom felt better in the morning and had a big breakfast. Nurses came in and out to take vitals and such. One nurse was good about calling the lab to find out when the results would be back. They thought about 1:30 or so. Quite a few people stopped by to see mom and that made her feel good. One of her good friends who lives across the street (literally) was in every day, along with Jazzercise buddies. The neighbors from Hazelwood came in for a visit... then Aunt Carol came by. It was a busy place. She is a popular woman.

Late in the afternoon she got a phone call from the surgeon who did the fluid removal. He had preliminary test results and there were malignant cells in the fluid. He was going to set up an appointment with an oncologist for Thursday, and then she was to see the surgeon again back in Geneseo after the oncologist appointment. Even though the term cancer was out in the open, we still didn’t know what type.

One of the visitors during the day was the interim pastor from mom's church. He had stopped by in the morning, and then again that afternoon. It was a great comfort to her to have him check back, and he immediately sensed that the news was not good, and had us (me, Aunt Carol and Mom) all in prayer.

The hospital discharged her after dinner and I took her home. She was in good spirits for the most part, and just wanted to find out what needed to be done next. She had an appointment with the oncologist Dr. for 10:15 a.m. on Thursday.

One of her neighbors came by for a visit and I think we ended up talking for an hour.

Tuesday, March 24, 2009

The doctor removed the fluid at about 10:30 a.m. They did the procedure in the room with a local anesthetic and took out 5 bottles (500cc each) of fluid – close to a gallon. She started to feel a little discomfort and then they stopped draining. They left a little bit in her abdomen just to keep the buffer between her organs. It was definitely easier for her to breathe without all of that pressure.

They were going to send the fluid to a lab somewhere in the Quads that had the equipment to analyze the pathogens to determine what was in the fluid and maybe how/why it was filling in her abdomen. The fluid was light yellow in color, kind of clear, not very cloudy. Dr. said that since there was no visible blood color, that was a good sign (however does not mean that there isn’t blood in there). He also said that they could find malignant cells in the fluid, which would indicate that cancer was growing somewhere inside her abdomen. More testing would confirm what the fluid contained. Mom had malignant cells in the back of her mind, but still wanted to keep an open mind and see what the test results would bring.

I went down to the cafeteria and brought her back a chicken salad sandwich. She ate the whole thing and enjoyed it. With all of the pressure gone, she had plenty of room in her stomach now for food.

They decided to keep her overnight again just to be sure that she didn’t go into shock from the fluid being removed. That was fine by me, and I felt better knowing that she was around people who could respond if something happened. They thought that they would have the results back the next day.

Monday, March 23, 2009

Checking into the hospital

Mom called me after work because she was feeling so terrible and had been very bloated in her abdomen for quite a few days…I knew she was still having problems and really had been not feeling well for about the last three months. She had a colonoscopy done on Feb. 26 to rule out some lower bowel issues, so I was at least hoping that the bloating was related some sort of infection that needed clearing up.

Earlier that day she went in to see her doctor to determine the bloating problem. The x-ray and CAT scan showed that the bloating was caused by the buildup of fluid (medical term: acetis). She needed to check into the hospital that night so they could monitor her and remove the fluid in the morning.

The fluid buildup had decreased her appetite so much that when she weighed in, she was 106 pounds (after the fluid, she dropped down to 99 pounds).

After seeing her big belly (I joked that she looked pregnant and if she needed to tell me something she’d better tell me NOW) I was very glad that she was in the hospital where if something happened, there were people there who knew what to do about it. My medical knowledge consists of CPR, Bactine spray (still the best) and a box of band aids. I never had an inclination to follow in my mom’s footsteps and go into a career in the medical field, however wished I knew more than layman’s view about diagnostic terms.