MUCH IMPROVEMENT

Saturday, Nov. 2nd, was not a good day.  Dave was as listless and weak as I've seen him. He felt terrible and could (or would) hardly talk.  He slept most of the day.  We were both so glad the high dosage part of this year-long treatment plan was over!

A turning point came between Tuesday and Wednesday, when we went back to the hospital for more blood work.  Dave was up in the morning, making his breakfast, saying a few cheerful things!  He looked better, he acted better and as we then suspected, his lab report was better.

In an average healthy adult, the total number of white blood cells (WBC) ranges from 4,000 to 11,000 per cubic millimeter - a pretty wide range.  Last Friday, Dave's WBC was 1,600.  On Wednesday it was 3,500.  Almost on the low side of normal!  I'll have to ask what his normal count was before he started treatment.

Dave has now lost 17 pounds.  That's an additional 8 pounds in 10 days.  Rosemary, the NP, was concerned about his weight loss, in terms of him getting enough nutrients.  Dave is not unhappy with the loss.  He is eating healthy meals, just small ones, no alcohol, and no snacking.  She suggested he try to eat some snacks such as nuts, apples with peanut butter, granola bars and even Boosts.  Dave has started with nuts, and I'm sorry to say, some ice cream.  That's my fault.  I bought some Pumpkin Pecan Spice ice cream and darn it is good.

His rash has almost completely cleared up.  He still has some "crackle" as Rosemary says, in his lungs and she gave him exercises to try to get rid of it.  We don't want no stinkin' pneumonia.

Dave has been wearing a fleece jacket in the house for weeks, even though the house temperature has been above 72º and it is usually higher.  He has an extra blanket on his side of the bed.  He's always cold which is so unusual.  Today he graduated to just a fleece vest instead of the jacket.  The weight loss probably contributed to his chilliness.

Dave took a walk yesterday - without me suggesting it - but not today.  I just asked him and he said he'd go with me in a little while.  He's not anywhere near his old self, but there is definitely a change for the better.

We see Dr. S. on Monday and we'll be deciding when Dave will start the injections.  He is not looking forward to it.  I'm hoping this physical improvement will continue and he'll be a little more ready to start Phase II.

CHEMO DAY 20 OF 20!

It's caboose day - the end of the infusion train!  The nurses cheered when Dave walked in the chemo room; either they are glad to see him go or they are happy for him.  I believe it's the latter.

Dave's white blood cell count was lower today, near the 'danger zone' so Dr. S. recommended Dave get a half dosage of INF.  If Dave wanted to forego the last treatment all together, he could have, but the two of them decided to get in the last possible amount of INF while still being smart about it.

Now to back up a little, Dave seemed to have a mild allergic reaction to some spicy food he ate Wednesday evening.  His skin got slightly mottled and red, and this was in addition to the rash he's had.  The rash cleared up some, but has not gone away, in fact he is still getting some new breakouts.  We're not positive his new reaction was due to spicy food, but it is not an uncommon effect, so we suspect that was the culprit.

On Tuesday, Dave proclaimed he was tired of being a slug and agreed to go on a walk around our street/circle.  It's 1/3 mile.  Wednesday HE brought up the idea, and we walked the circle again.  Yesterday, he decided he would do a longer walk, and we went almost a mile.  He said he was struggling by the time we finished, but he didn't feel like a slug!

Dave lost another pound or two.  With all the fluids he gets, it's hard to gauge his real weight because it can vary by two pounds every 24 hours, but he was down over a pound this morning.

Dave will be back for blood work on Wednesday to see if his white cell count has improved, and we'll meet with Dr. S on 11/11 for a review and decision on when to start the 48 weeks of injections.  I've been saying the injections will each be 10 units (of whatever scale is used) but Dr. S. said today they will be 20 units each.  My understanding is that he is getting 40 units intravenously, so going down to 20 units isn't as much a drop as I thought it would be.  I will have to clarify.

Dave is in the chemo laz-y-boy; I hope he doesn't miss these comfortable chairs when he's not coming here every day.  I am not buying one for his den, even though he deserves a treat after this ordeal.  Maybe I'll get him a new pair of walking shoes.

CHEMO DAY 16 OF 20

I cannot tell you how happy we are this is the last week of Dave's intensive treatment!  He's hooked up now, and although I wrote less than 24 hrs ago, I thought I would let everyone know things are stable.  His weight is the same as last Monday (down 9 pounds), his white blood cell count, though lower than it should be, has not changed, the rash on his chest is clearing up and the one on his face is almost gone, his shoulder is no longer hurting, and he's controlling his headaches by staying hydrated.  The worse part is the fatigue.  Today he was a little winded walking up the slight incline from the parking lot to the front door of the Anderson Cancer Institute (there is valet parking, but we have not needed to use it).  This, in a guy who walked 1000 miles from PA to ME, through the White and Appalachian Mountains, climbing Mt. Katahdin at the end, just two years ago.

Our dear friend Kathy made us a fantastic cream of chicken soup, full of veggies and of course chicken.  Her hubby Dirke made the delivery, including a nice baguette.  Thank you! We were pooped last night, and it was the perfect meal.  Dave was in bed at 7:15, and I was not far behind.  He fell asleep right away, but I watched 3 episodes of Breaking Bad.  I needed a mental break from thinking about melanoma, but 2.5 hrs of watching meth madness wasn't good for my dreams!  Well, duh.

DALE'S VISIT

Gina and Dale

It's Sunday afternoon, Dave is napping and Dale and Gina are headed back to Atlanta. They arrived very late on Thursday, so we didn't see them until Friday morning.  Dale took Dave to chemo, Gina stayed here to work and I went to my clay class.  We all met back at home about 12:30 pm for lunch and compared notes on how our mornings were.  Dave's was more of the same - getting his treatment, having a very uncomfortable cold spell while getting the interferon drip, and finally warming up when he arrived home.  Dave was feeling no better, but no worse, and with the weekend arriving, we all had high hopes for a bit of a recovery.  In the afternoon, Dave took a long snooze, Dale worked and Gina and I walked to the marina.  It was a beautiful, sunny and slightly cool day.  Dale had stopped to get some hydrocortizone cream recommended by Rosemary for Dave's rash, so I applied it before he went to bed that evening.

Saturday Dave's rash was a little better, but he was not feeling any better.  He doesn't feel sick, he is simply very fatigued, which makes him feel as though he doesn't want to get out for a walk, and he wants to sleep a lot.  Dale and Gina were tired too, so we got a late start to the day.  Dave laid down for a morning nap while Dale, Gina and I went to the Village Art Show. Home for lunch, then Gina and I took Coleman to the Peter and the Wolf concert while Dave and Dale watched Georgia Tech trounce UVA.  When we came home from the concert, Dave took a nap while Gina, Dale and I had drinks on the back porch.  When Dave got up, we had dinner, then by 8 pm, Dave was ready for bed.  It was a late night for him!

Dave and I are enjoying the sunshine

Today is yet another beautiful day, so after breakfast we took a few pictures on the front patio.  We talked Dave into walking around Village Green Circle; we then sat in the sun and looked through some photo books.  We had a light lunch, and it was time for Gina and Dale to hit the road.  Now here we are - Dave in the bedroom, me at the computer, and needing to stop to do the laundry!

Dave hasn't seemed to have bounced back as well as he did last weekend, but we understand the effects of the IFN are cumulative and he has had 15 days of treatments.  One more week of intensive IFN... and we will be counting down the days!

CHEMO DAY 14 OF 20

Getting hooked up

Dave saw Dr. S. today before starting his treatment.  The doctor seemed pleased with the results of Dave's last blood work and vitals.  Dave has not had much change this week; his white cell count is still a little low, his liver indicators are good, his weight has stabilized, his lungs sound a little better, his rash is the same except he now has some on the side of his face.  He has quit using the neck warmer on his chest, so the heat rash theory may have to be discarded.  Dave is still very very tired, but ate a better dinner last night than he has had for a few days.

With his prayer shawl from St. Peter's

Dale and Gina are arriving late tonight and Dave seems buoyed by the anticipation.  Dale will take Dave to chemo tomorrow.  Saturday there is a lot going on - the Isle of Hope Art Show, the Village Fall Festival, and a Peter & the Wolf concert, in addition to the regular weekend activities.  I hope Dave is feeling well enough to walk around a little bit but we'll have to check on his white cell count.  He has had to stay away from crowds in order to not pick up germs.  We also have to see if he has any energy.

We're almost at the end of Week 3, with just one more week to go!

CHEMO DAY 12 OF 20

Dave is currently receiving his drugs and since I intended to write yesterday but didn't, I'll get to it.  BTW, there is internet here in the treatment room.  I just didn't find the right access on Day 1.

When Dave had his vitals checked yesterday (Monday) he had lost a total of 9 pounds in two weeks, his white blood cell count was fractionally better than it was Friday, his blood sugar is in the normal range, and there was some number related to his liver (I'll have to find out what it was) that is creeping up but not at a problem stage.  He had an itchy rash develop over the weekend and we're treating it with Benedryl gel. Today Dave came up with the idea that it may have been from his microwave-heated neck warmer, putting too much heat on his chest, so we'll watch the heat.

Dave's appetite has been decreasing and he didn't eat dinner last night.  Rosemary (NP) said to not worry - yet - and gave him a couple of bottles of Boost and Glucerna to try.  He has some "crackling" in both lungs so he is to do some deep breathing and coughing to prevent any fluid buildup that could lead to pneumonia.

Those are the vitals - now for the fluff.

Trying out a rocking chair 10/19/13

Dave had a pretty good weekend.  He slept well Friday night and was willing to go to a patio furniture store Saturday after breakfast.  Now that we have an awning to cool off our patio, I think it's time for a couple of comfy chairs.  We weren't out long, and went home for lunch.  We need to be careful about Dave being around too many people, and I give him the hand sanitizer every time we leave a public place. I knew this small store would be quiet, and we were the only customers there.

Coleman came to play after lunch, and wanted to get out the "bone and arrow."  Dave obliged and had him shooting for a while.  Our priest came by for a visit, so Coleman and I played kick-the-target-box while Fr. Sam and Dave visited.  Afterwards, Dave napped until suppertime.  Later, we walked around the Village Green circle.

Sunday was a similar day except we didn't go anywhere, not even to church because of the number of people.  However, flowers were delivered from our alter, and one of our friends came by to visit.  As he was leaving, Coleman arrived for more playtime (Chase had swim meets Saturday and Sunday).  He wanted to play more kick-the-box, so he and I were outside while Dave watched football.  Chad came to pick Coleman up and had a few minutes with Dave.  Dave napped in the afternoon then we went to our neighbors' home for a wonderful dinner.  We were home by 7 pm and Dave went right to bed.

Yesterday was breakfast, treatment, lunch, another visit with Fr. Sam who brought a prayer shawl, nap time, and as I said, no dinner for Dave.  He is a little slower today but hanging in there!

CHEMO DAY 10 OF 20 - MIDPOINT!

We're halfway through the daily chemo treatments - thank goodness!  From our daily discussions with Rosemary the nurse practitioner, and Dr. S today, we're led to believe Dave is doing extremely well.  Although he has acute fatigue and occasionally has muscle aches (the typical flu-like symptoms) he has not had any nausea.  In fact, the anti-nausea medication he was getting through the IV has been deleted from the orders, as it was causing other uncomfortable side effects.

If you are wondering what acute fatigue is for Dave, consider -- after getting dressed and having breakfast, he sits on the sofa or chair waiting for it to be time to get in the car.  He may or may not be watching the news.  (Although this morning he ventured out to our patio to talk to our neighbor who came to finish a paint job on our back wall.)  He falls asleep while getting his chemo.  He comes home, eats lunch and takes a nap that lasts from 45 min. to 3 hours. He may or may not take a walk around the block.  He's back in bed at 7:30 and after some time with his iPad, sleeps 9-11 hours.  He has trouble reading and talks slower than usual. He is eating healthy foods in small amounts and has lost 6 pounds in two weeks.  He is not drinking any alcohol but is drinking 1-1.5 liters of water a day in addition to his IV fluids, a cup of coffee and some hot tea in the chemo room.

I hate to think I may be exposing Dave's 'frailty' in a way he or I would later regret but if you know us, you know I'm doing it only out of my desire to keep our family and close friends informed about how he's doing.  He doesn't complain, but today he said, "I'm tired of being tired."  The fatigue seems to get worse every day, but now we have a weekend to recuperate. We were comforted by the doctor telling us, in spite of the low white cell count, the spike in his blood sugar one day, and the fatigue, compared to other people who have gone through this regimen, he is doing extremely well.  Dr. S did not believe the INF dosage needs to be weakened.

Thanks to everyone for your prayers, emails, cards, flowers, meals, and offers to help - taking Dave to chemo, painting our back wall and in your words "anything and everything." Sometimes I just cannot believe how fortunate we are to have such great friends and families. Here's to a wonderful (and relaxing) weekend for all of us!