Wednesday, February 29, 2012

Progress by small steps, not leaps and bounds

Lucy had her TPA procedure this morning. It took less than 90 minutes. She was told they will need to repeat it tomorrow, but they made progress. She still can't get out of bed and she is to keep her leg as still as possible. Lucy seems to be in a little less discomfort today. Lucy doesn't have a firm time for tomorrow's procedure, but it could be as early as 7:30. She is really tired today because of being awakened every two hours for the last couple days, and now has at least one more night of tests.

The hospital plays "Twinkle Twinkle Little Star" when a baby is born. I swear it was playing on a continuous loop today. There is an anecdote stating more babies are born when during bad weather because of the drop in air pressure. The barometer here dropped to 29.23 early this morning and is slowly rising.

Julie called tonight, but Lucy had to get a blood draw a few minutes into the call. Lucy's arms have been poked so much she is bruised. The heparin isn't helping with that either.

We'll see how it goes tomorrow. Thank you for spending some time reading this and have a Happy Leap Day!

Tuesday, February 28, 2012

"You put your left leg in, you put your left leg out..."

 The weather was supposed to be very challenging today. The Twin Cities was under a Winter Storm Warning due to anticipated heavy snow, sleet, freezing rain and high winds. As the morning went on, the storm shifted farther to the north. The Warning was downgraded to an Advisory. As of this writing, it is raining hard. There is still a chance of freezing rain tonight and a chance of a couple inches of snow tomorrow. The day had an unexpected turn of events, but it was in our favor.

Lucy's day had an unexpected turn of events, but in her favor. Marynne from Minnesota Oncology visited with her this morning. Dr. Thurmes was unavailable this morning. Lucy's leg was improving very slowly. Dr. Nashawaty felt that since Lucy had not had a nosebleed in several days, perhaps the TPA catheter option was available.

Her next visitor was Dr. Dittes, an Infections Disease specialist. He felt that Lucy may have celluitis but acknowledged to her that her blood cultures and blood tests show no obvious indication of a bacterial infection. He also told her that her blood clots could be the majority of the fever spikes and redness. He changed the antibiotic she was on to two different IV antibiotics. There is nothing to be concerned about.

Marynne came back a bit later. She was going to see if Interventional Radiology wanted to do the TPA procedure. The best guess was that Lucy would have it done tomorrow morning. They had time today and got to her about 1:30 this afternoon.

The procedure went very quickly. She was done by 2:45. There was a very large clot in her thigh. The clot in her calf was small enough that they were going to let nature take its course. Her left leg was much less clogged than her right leg was a couple weeks ago. We hope that means she will not need subsequent procedures and her recovery time will be shorter. It will be a couple days before she will be able to do the Hokey Pokey.

Of course having the procedure means she also got moved from 8th floor to 3rd floor. The first move was into a two bed room. She got moved again about 20 minutes later to a private room.

Her evening is winding down now that there isn't as much activity. She knows sleeping will be tough tonight because they have to wake her every two hours to do a neurology check. Lucy got to talk to Diane and Julie on the phone tonight which helped brighten her day. I found the beaded owl pictured below in the gift shop. It is beaded and stands about 6" tall.

Here's hoping Leap Day goes well for her. We wish all of you a good evening and have a Happy Leap Day tomorrow!

Lucy's new friend

Monday, February 27, 2012

Holding pattern

So much for Lucy's heparin staying in the therapeutic range. She has had two adjustments and boluses today and will have a re-test at 9:30 pm tonight. It sounds like she is close to where they want her. The tricky part is having her stay in the therapeutic range for a couple days.

Her nosebleeds have stopped, but Dr. Thurmes is very reluctant to run a TPA catheter in her leg. The TPA would speed up getting rid of the thigh clot. Right now she has to stay the course. Perhaps that could change the longer she goes without a nosebleed. Right now she is dabbing saline gel in her nostrils every four hours and that seems to be working.

The two unit transfusion helped a little, but Lucy's hemoglobin was only at 7.9 today. More than likely she will need a transfusion tomorrow or Wednesday. We have not heard how her white count or platelet count were faring.

She has still been having fever spikes today. Her worst one was 102.8° which was taken down with Tylenol and cool washcloths on the forehead. There is still no indication of an infection. The fevers break within 30 minutes.

One nice thing was she got to use a shower today. The disposable washcloths are nice, but having some independence is nicer. She also got a birthday rose from one of the floral shops today. That was a nice present.

It's still wait and see. A lot depends on how fast her body starts wearing down that clot in the thigh. We have no idea how soon she will be going home. It's frustrating, but it is what it is.

Thank you so much for caring! Your comments are like her getting a Get Well card without having to wait for mail delivery.

Sunday, February 26, 2012

Land of transfusion

Lucy's hemoglobin was at 6.0 and her platelets were at 50,000. Dr. Nashawaty had rounds this weekend and he mentioned the irony of keeping Lucy on heparin but also having to transfuse platelets. Her Alimta treatment probably caused the platelet count drop and may be contributing to the hemoglobin level being low.

On the plus side, her heparin is in therapeutic range. She will be in the hospital until at least tomorrow. One of the criteria for release is getting her off IV heparin. Our guess is they would also like to see any risk of infection in her leg eliminated and a noticeable improvement in her leg. It appears her leg is getting a little better. Like her last hospital stay, this will be a day-by-day event.

Today saw a steady stream of nurses and nurses assistants in and out. Lucy said one of her arm blood draws was at 3:00 am this morning. Her port has heparin in it so certain blood tests must be done via her arm.

Lucy's appetite is still good. I went the to cafeteria and picked up a grilled chicken sandwich for lunch. She asked to sample it and wound up eating the whole thing.

Steve and Liz came by this morning and brought cookies. Suzy was by this afternoon and left a stuffed snowy owl and a couple magazines. Julie called to see how Lucy is doing. We also appreciated all the great notes from everyone. Lucy and I do read the comments left in the group or in the blog, and we thank everyone for their words of encouragement.

We're hoping her heparin stays in therapeutic range tomorrow. That will put her one step closer to going home.

I found this scrub top in the gift shop. Lucy wants to see it when she is more mobile. I'm sure she will get one.

Suzy brought along a new friend for Lucy

Saturday, February 25, 2012

There will be blood

This morning started with a 75 minute nosebleed. Lucy was supposed to start using Afrin nasal spray but her bleeding started moments after the first spray. She got switched over to a saline gel.

Diane visited Lucy this afternoon. It really helped Lucy's mood. Diane can get Lucy laughing which is really needed right now. Thank you, Diane! She also suggested the title for tonight's post (it was originally Let it bleed). Between the nosebleed and the blood draws, Lucy could have supplied the blood for this season of "Dexter".

Lucy is still running a temperature of around 101°. They are running an IV antibiotic and she is getting Tylenol for her temp.They also drew blood to see if her blood thinner dose needs adjusting. Blood thinners are very touchy. Then they drew blood again looking at her Heparin Factor A. And then drew a third time for blood cultures (again). She also received two large heparin bolus doses.

It sounds like Suzy is going to visit Lucy tomorrow. Unfortunately when Suzy called tonight, Lucy had a lab tech wrapping a tourniquet getting ready for a blood draw and two nurses going over the heparin bolus double check and co-signing procedure. Things do get a little hectic.

Keep Lucy in your thoughts and prayers tonight. Thank you for all your support!

Thank You Everyone

Thank you everyone for your well wishes, gifts, thoughts and prayers. I am truly blessed to have such wonderful family and friends. Your thoughtfulness, prayers and support really helps make this difficult journey a little easier and kicks the Finnish sisu in high gear.


Friday, February 24, 2012

Mondays are supposed to suck, not Fridays

Lucy's leg started getting worse this morning. She called Minnesota Oncology and they set up an appointment for 2:00 this afternoon.

Her nosebleed started at 1:30 and finally let up around 3:00. The nurse practitioner at Minnesota Oncology helped Lucy with her nosebleed. Anticoagulants are so fun. She also was contacted by Dr. Thurmes who was at Fairview Southdale on rounds.

She was admitted to Fairview Southdale as a precaution. Lucy also had some extra blood work drawn along with blood cultures. They need to wait 18 hours after her Lovenox injection before they can start IV heparin. That means she will get woken at 4:30 am. She just had completed an IV antibiotic because they suspect cellulitis. An ultrasound of the left leg found that the clot in her groin was solidifying. We are hoping she will not need a TPA catheter started tomorrow. In the past few hours, she started running a fever which is at about 102° right now. The Tylenol will help reduce the fever.

It is frustrating that this clotting problem flared up again. More than likely she is here until Sunday. We were looking forward to a nice quiet weekend at home and having her leg continue to heal. Now it's back to a wait and see mode. Keep Lucy in your thoughts and prayers this weekend. It helps us get through these setbacks.

At least I don't have to play Nurse Ratched with the Lovenox while she's in the hospital. See, I did manage to find something positive.

Wednesday, February 22, 2012

Blood, sweat and tears

We know that nosebleeds are a side effect of blood thinners. Lucy had one that lasted for almost 45 minutes. She had another this morning that was done in about 10 minutes.

We arrived at Fairview Southdale IV Therapy at 7:30 am for her transfusion. The type and match took a little longer than usual, so her transfusion started at 9:00 and was done at 12:45.

She is still really tired. Last night she had problems sleeping and woke up several times. Now she's home, warm, fed and relaxing. Her leg isn't quite as sore as yesterday and the swelling has abated somewhat.

Lucy's next blood test is Monday afternoon. There may not be another update until then. In the meantime, give your loved ones a hugs from us and thank you for your support!

Tuesday, February 21, 2012

Down to once per day

We started today with about two inches of snow. That is normally boring news but this has not been a typical winter. This stuff was like the mashed potatoes served in the school cafeteria. The snow blower had problems with it because the discharge chute kept plugging. I think the snow lovers might be disappointed with the stuff, too.

Lucy's leg puffed back up a bit by almost 2 cm though her pain is about the same. She is really run down today. We had been suspecting her hemoglobin was dropping and it has. She is at 6.8. Her two unit transfusion is scheduled tomorrow at 7:30 am. It will probably take four hours to complete.

She also has to change her injection schedule before the next labs. We were targeting her injection for around 6:00 pm. This would avoid conflicts with work schedules, dinner and TV. Now she is to get her injection at 11:00 tomorrow and work towards 10:00 by Monday's lab appointment. The lab is also getting moved to 4:30. Of course she's going the be at Fairview Southdale IV Therapy at 11:00 tomorrow.

One thing we are happy about is she is down to daily injections rather than twice daily. We also enjoyed Julie's stew tonight. OK, enjoyed is an understatement, devoured is more like it.

 Here's hoping we have a dull and boring day tomorrow.

Sunday, February 19, 2012

Tomorrow will be a better day

Lucy couldn't visit her dad today. Her thigh was too painful. This happened the last time she had a clot in her left leg. The good news is her calf diameter was almost a full centimeter smaller and the erythema is almost gone. Her right calf diameter also was 0.8 cm smaller.

It is astonishing at how painful a blood clot can be. Her clots are maybe the diameter of a single piece of couscous. At times she rates the pain as worse than her post-surgical pain. I'm hoping her leg pain is better tomorrow.

I visited her dad today. On my way there I saw three bald eagles soaring over Highway 100 at Minnehaha Creek. He's in pretty good spirits and enjoyed having company. Suzy and Steve also came by. Lucy's family has treated me so well through the years and I enjoy being with them. I'm very lucky because I know too many people who have issues with their in-laws.

Her first injection went well today and her second one was OK. I must be getting the hang of it or she's learning to lie really well (just kidding!). I picked up one of her favorites from Qdoba on my way home tonight. That helped brighten up her day.

Lucy's next blood testing will be on Tuesday. She was originally scheduled for one on Monday and another on Tuesday, but the two blood tests are combined now. We can't wait for Tuesday because that is when her Lovenox cuts back to one injection per day. It appears she will be receiving injections for at least 30 more days. I do hope that she eventually goes back on Coumadin.

Saturday, February 18, 2012

Laissez les bons temps rouler!

Well, maybe not today. Lucy woke up with stomach problems this morning and was running a mild fever spike because of her blood clots. Her mood wasn't very cheery and she was fairly wiped out. Alimta is fairly well tolerated, but it still can cause a bit of stomach distress and wipe out. That's why she has to take the oral dexamethasone (steroid) twice a day for the day before, day of and day after chemo. The past few months have seen her face a number of challenges and it takes its toll. My guess is today's stomach problems were a direct result of her breakfast choices. She hadn't had Lucky Charms in several months. The whole grains sometimes cause a bit more fermentation in the gut when one is not used to eating them. She started feeling better later this afternoon.

Her first shot Lovenox shot went better than yesterday's. We're probably figuring out the right timing and rhythm. The humorous thing about the Lovenox self-injection guide is the phrase "think love handles". Lucy doesn't have any. Heck, I've dropped 54 pounds in the past year and barely have any remaining.

We hope Lucy will be feeling up to visiting her dad tomorrow. Her left leg circumference was almost a full centimeter smaller than yesterday's measurement. Her discomfort is now mostly from both ankles and seems to be joint pain rather than tissue pain. The pain killers are still effective and she is using fewer of them.

I must be suffering from chemo brain by proxy. I forgot to mention Lucy had a coworker stop by Thursday morning with some homemade soups. Her coworkers have been so wonderful and supportive! They have made meals and sent cards and flowers. It's nice to know there are some good companies left.

And on the subject of chemo brain, I managed to mangle the "Comfortably Numb" lyric yesterday. Sorry about that! How I managed to turn "just a little pin prick" into "you'll feel a little pin prick" is beyond me. I'd like to say "Damn you autocorrect" but I wasn't posting from an iPhone. I have an Andriod phone and there doesn't seem to be an equivalent, perhaps thankfully.

For those of you that are able, we hope you enjoyed a walk today. Lucy should be able to be walking normally soon.

Friday, February 17, 2012

"OK...just a little pin prick..."

Lovenox was not what was referenced by the lyric snippet from Pink Floyd's "Comfortably Numb". Lucy survived my first injection attempt and I still have my nine fingers. We found some advice on the Lovenox web site along with a handy PDF to assist with the injections. We'll be glad when Tuesday gets here. She gets reduced to once per day starting Wednesday.

Lucy has her appointments scheduled for the next three weeks. I think the phone got a workout today.
Lucy's left leg looks better than yesterday. The erythema is smaller and a bit less red. Her right leg is back to normal except for some flaking skin. We took measurements of both calves so we have a reference point as was suggested by Dr. Thurmes. I'll be taking twice daily measurements until her leg gets better.

Lucy's dad had minor surgery this afternoon. His surgery got bumped for an emergency, so it started at 3:00 instead of 11:00. Lucy had a Neulasta shot appointment at 4:30 so we couldn't make it to the hospital tonight. She remembered how out of it she was when coming out of general anesthesia, and how it was nice that people cared, but she would rather have had some time to get reoriented and rest up. We're going to visit him tomorrow. It sounds like he might be getting released tomorrow late afternoon.

It was a very nice day outside today. We hope you had a chance to enjoy it.

Thursday, February 16, 2012

Stop me if you've heard this before...

We fretted about today's oncologist visit, but Lucy's left leg stole the spotlight. We did not even get a chance to discuss the PET scan or CA125 level. Her rash is an erythema and is a sign of a blood clot. Her leg also ballooned up this morning.

Lucy did get her Alimta treatment, so something went right. She can take her multivitamins instead of the prescription folic acid since the multivitamins contain the requisite 400 micrograms folic acid. Lucy's next vitamin B12 injection will be during her next treatment in three weeks.

She was supposed to visit Dr. Thurmes tomorrow, but he saw her while she was getting chemotherapy. Lucy had an ultrasound on her left leg at Suburban Imaging at 6:30. As a precaution, Lucy will be getting twice daily Lovenox injections for a week followed by daily injections for around six months. Her Coumadin was stopped immediately.

We had about 45 minutes between the end of chemo and the ultrasound, so we had a quick dinner at Leeann Chin's about eight blocks from Southdale Medical Building. The Heartland Cafe in the medical building closed several months ago and a Subway is supposedly going in to replace it.

The ultrasound confirmed multiple clots in her left leg. However she was not admitted to the hospital. We'll find out more tomorrow. Apparently the belief is the Lovenox will work on the clots such that she won't require hospitalization or TPA catheters.

I will be administering the injections. It looks like the syringe has a short small bore needle. Lucy has no abdominal fat remaining because it was removed in her debulking surgery. The "tummy poke" is best for her, so I'll have to be careful. It's funny, I could probably give injections to anyone else, myself included, but the thought of giving Lucy a shot worries me. I know it's irrational.

So yes, you've heard the blood clots stuff before. Believe me, we hate reruns, too!

Wednesday, February 15, 2012

You've got to smile for the camera

Lucy is pretty wiped out today. Getting her driver's license renewed wasn't too bad. She did have her picture taken three times. Apparently they have a new camera which can take an awful picture and make it even more dreadful. I have never seen a bad photo of Lucy so they were really trying hard to end that streak. Tax dollars at work, don't you know.

I doubt either us will sleep well tonight. Keep Lucy in your thoughts and prayers tomorrow.

Tuesday, February 14, 2012

Happy Valentine's Day!

A PET scan might not have been the most romantic way to spend Valentine's Day, but battling cancer sometimes causes inconvenient lifestyle changes. The scan took almost 90 minutes overall at Lifescan Minnesota in Edina. An hour was spent for prep and the scan was about 20 or so minutes. The results will be available to Dr. Boente tomorrow afternoon.

Lucy had a bit of an upset stomach today. We're both apprehensive about Thursday's appointment. Lucy has had a series of set backs since November. Her CA125 level has been slowly increasing which necessitated stopping the Taxol/Avastin treatments. The waiting is the hard part.

For the positive news of the day, she did get the latest Coumadin dosing for the upcoming week. She is on a three day cycle of 5 mg, 5 mg then 2.5 mg until next week's blood test. We did not get her hemoglobin level in the voice mail message, but there was no mention of a transfusion.

Tomorrow will be a test of how well Lucy can maneuver a walker. I'll be taking her to the Bloomington Deputy Registrar's office to get her driver's license renewed. Maybe she'll feel up to a belated Valentine's Day lunch or dinner. I did pick up some carnations for her tonight. She likes carnations because they last a long time.

We hope you had a wonderful Valentine's Day. Take a moment to think of the people that love you and remember how lucky you are to have them in your life.

Monday, February 13, 2012

One person's curse is another person's blessing

We have a number of friends who are not fond of our mild (thus far) winter. The ice isn't thick enough on many lakes and rivers to skate on much less drive across; several drownings and near-drownings have occurred in the past couple weeks. Brown grass is not conducive to cross country skiing. No majestic icicles, very few days of watching snow slowly blanket the ground, and no fools getting tongues stuck on frozen metal objects. Boring indeed for them.

For us, the mild winter has been a blessing. Lucy has been battling leg swelling and blood clots for several weeks and didn't have to additionally battle snow and ice. She was on a weekly chemotherapy regimen until January, and there have been a number of medical appointments we attended on dry roads. Anyway, last year we had nearly double our seasonal snowfall and had some brutal -20°F mornings. Maybe Mother Nature was tired from last year? Today's snowfall was little more than a dusting, but at least our neighbors could have a bonfire without burning down the neighborhood.

Lucy's aunt and uncle, Ardelle and Dale, were here for a visit yesterday afternoon. They brought some stew Lucy's sister Julie had made plus a couple other goodies. It was nice seeing them!

Lucy's left leg is puffing up very slightly and she has a rash on it from the capillaries under the skin ballooning up. Her right leg is almost the same circumference as her left leg and the reddish hue is fading. The skin peeling has almost completed. She is able to walk a few steps without her walker albeit slowly and with some discomfort. Her right ankle still does not have full range of motion and may not for another few days. One of the catheters inserted into her leg was inserted in her ankle. There is still some bruising in the area which is probably the cause of her ankle stiffness. As such, driving is still out of the question for her.

The rash and swelling is not a set back. She had a lot of fluids pumped into her during her hospital stay. Now that she is moving around, those fluids are getting flushed. Lucy still is not as physically active as she was, so there will be some lymph pooling, too. She is maintaining the physical therapy exercises she was doing in the hospital and moving around the house as much as possible.

We are noticing Lucy's energy level is decreasing and she's puffing a little after walking around. That usually indicates her hemoglobin count is dropping. She had her blood work done for the Coumadin dosing and was told to stay the course. A Complete Blood Count (CBC) is also drawn. Since nothing was said about her hemoglobin, we're assuming it to be above 7.5.

Today started the busy week of appointments. Her other appointments are Valentine's Day (PET scan), Thursday (oncologist and hopefully a treatment) and Friday (hematologist). At some point she needs to renew her driver's license. That might be Wednesday.

Enjoy your evening and thanks for your support!

Thursday, February 9, 2012

Blood tests

Lucy's other amaryllis opened while she was in the hospital. There are six flower on the stalk.

The tulips Lucy received from Annette and Al
I completely spaced out mentioning the tulip bouquet Lucy received from Annette and Al on Tuesday. Mea maxima culpa! Annette and Al own Carver Country Flower and Gifts in Carver. Tulips are so cheery and get people thinking about spring. Even though we have had an unusually mild winter in Minne-snow-ta, it will be nice getting back into the gardens soon!

This afternoon she had her blood drawn to determine if her Coumadin dose is still effective. She now has an alternating daily dose of 5 mg and 2.5 mg until Monday.

Next week is booking up quickly: Monday is her next blood work to see how well the Coumadin dose is working, Tuesday is the PET scan, Thursday is her appointment with Dr. Boente and Friday is her appointment with Dr. Thurmes. As far as we know she will get her next Alimta treatment on Thursday.

We take simple things for granted. Our bodies are amazingly complex bio-mechanical wonders governed by amazingly complex electrochemical networks. Nerves trigger muscles, muscles and connective tissues move joints, joints move limbs, limbs move the body. (Anyone who has studied anatomy or kinesiology in detail will notice this is a simplified 50,000 foot overview.) Lucy's leg is looking less swollen and the redness is slowly turning pink. She still has some stiffness in her ankle and finds relief when she can prop her leg up. She can manage a few steps without the walker and her right ankle is more stable because of some regained flexibility. The pain level is also subsiding. She is hoping to be cleared to return to work a week from Tuesday (her company observes the President's Day holiday on the 20th).

There probably won't be an update until Monday. Until then, thank you for taking the time to read this and showing your support for Lucy!

Wednesday, February 8, 2012

Home sweet home

Yesterday was spent getting settled in at home. Lucy wanted to how her ankle would react to the home setting. That went better than either of us expected. No problems navigating with the walker, she can stand for more than a couple minutes, and she has cut way back on the pain meds. She is still doing her physical therapy exercises and her energy level is still pretty good.

Today we took a trip to Lions Tap in Eden Prairie. It got her out of the house for a bit, they have great burgers, and she had a birthday coupon. We took her walker along, but it turned out she managed OK without it. I noticed she didn't need much support when I held her arm. She still has discomfort in her ankle and her knee is still a touch stiff. There is no way she can drive yet. Her leg bothers her more if she sits for extended periods of time.

Tomorrow she has some blood tests to ensure her Coumadin dose is still correct. The test is later in the afternoon so the results may not be known until Friday.

We know this posting isn't as action packed as the hospital posts, but we're having a lot more fun!

Monday, February 6, 2012

Goin' Mobile

Discharge day! We're thrilled! Today went like this:

10:45 am: It sounds like the heperin level in her blood is making the doctors happier. The heperin IV could come out today. Because her Chromogenic Factor X test takes several hours, we will not know if she gets discharged. If she does stay, she will get moved to a different room on 8th floor. Fairview is stripping and cleaning the floors and performing maintenance checks on the rooms. "Hurry up and wait" is the theme for today.

2:00 pm: The expectation of a hospital stay is for the patient to focus on recovery. Fairview Southdale has been exceptional in that regard. Certain administrative obligations pop up which detract from recovery, like dealing with the short term disability people. "Benefits coordination" is an oxymoron in that company. Lucy was passed to three people so far and got asked the same questions. They were just as clueless after her surgery nearly two years ago.

3:00 pm: Lucy's Chromogenic Factor X result was at the midpoint of her therapuetic range. Her Coumadin dose was set and she has her instructions. The IV lines were removed and she got dressed. Everything is loaded and she has her walker. All that remains is waiting for the pharmacy to fill her prescriptions.

5:30 pm: The pharmacy finally asked for her prescription insurance card. She has a new drug plan this year and the old information was still on file. Plus there always seems to be a delay when painkillers are involved. Lucy is moving with more confidence after the IV tree went away. Her friend Diane called while I was loading the vehicle. Lucy also called her siblings during the wait. The sunset was nice.

6:10 pm: Lucy headed home wondering what sort of mess awaits after me having full run of the house for the past eleven days. She didn't cringe after touring the house, so I think I did all right. I think the chicken strip dinner I picked up for her at Dairy Queen also helped.

Our house is a rambler with a basement. The basement has a rec room, laundry room, office, ¾ bathroom, and a storage area. The bedrooms are on the main level. One of the guest rooms is now an office for her. She doesn't need to go downstairs until her leg is better. Most of the main level has laminate flooring. She is navigating the walker quite well in the house.

I picked up some of the wet wipe style washcloths hospitals use for cleaning up a patient in bed. I also picked up a couple of the shower caps that have the shampoo in them. Lucy does not have to worry about slipping in the shower.

Lucy's next blood test is Thursday. Next week she will get a PET scan since it has been about a year since her last one, see Dr. Thurmes about her leg, and see Dr. Boente about her next Alimta treatment. There is a possibility she may need a break from chemo until her leg fully recovers. Even though her leave was extended until February 13th, she may need another week added. Her next assessment may not happen until after that date.

We're happy to be home and are grateful and humbled by the outpouring of love and support you have given us through this ordeal. Thank you!

Sunday, February 5, 2012

Sunday, Sunday

The yellow bouquet is from Steve and Liz, the elephant is from Diane and the pink rose bouquet is from Anh-Thu and Karen. And yes, the flash on my phone camera stinks. Motorola puts a 5 megapixel camera on the phone and uses a kid's toy LED for the flash. Go figure.

Lucy had a chorus of nurses and nurse's assistants come in and sing "Happy Birthday" to her this morning. That was really nice! Steve and Liz brought a strawberry tart cake. Julie and Suzy came by for a few hours, so Lucy had all her siblings here. Everyone got to see Lucy go for a walk with the Occupational Therapy person. Lucy also had someone from Physical Therapy come by. They worked on some exercises and Lucy has some new ones to add to the mix. Lucy's dad called to wish her happy birthday and see how she was doing. Lucy didn't wear a hat or scarf today so everyone got to see how much hair she has. I think that is the first time she went "topless" since she lost her hair in the first cycle of chemo.

Suzy and Julie did get to see Lucy's leg and it may have been a bit unpleasant. Lucy assured them it was a lot worse and much more painful eleven days ago. Her leg looks like it had a sunburn with a little peeling in a couple areas. There are areas on her lower leg where the color is getting towards normal. Her leg is slightly warm to the touch rather than hot. She has full sensation in her leg and it is not painful to touch it.

Dr. Singh came by to check on Lucy's progress. Lucy's Chromogenic Factor X reading today was in therapeutic range. She will have the heperin drop through the night and will have blood drawn for another test tomorrow. The results will be back in the early afternoon. If the Chromogenic Factor X test is in the therapeutic range again, Lucy could be discharged. The transfusion last night took her hemoglobin up to 10.7. It's been awhile since it was close to normal.

We will have some questions for the discharge meeting. There will need to be some appointments set up to test her blood. The hospital will lend her a walker for a week or two. We will also need a list of symptoms that necessitate a call to the doctor or a trip to the hospital. It is very possible Lucy will need to extend her disability leave another week.
There is a minor issue with pain management that still needs resolution. Lucy knows that she will not be totally pain free tomorrow. It will take a week or two for her leg to get back to normal. Her pain increases when she puts weight on her ankle. After she sits down, the pain starts subsiding. It sounds like the pain increase is not much. She describes it as annoying when she walks. It does not keep her awake at night and it does not distract her when she is sitting with her leg propped up. Lucy has been fortunate to never require hospitalization until her surgery in April 2010. She has never broken a bone or needed stitches. All the stuff she is going through is uncharted waters to her. It's hard for her to describe what type of pain, or how much pain she feels. Now that she has told them when she feels an increase in pain and when it starts to diminish, some of the concerns have abated.

We're cautiously optimistic about her going home tomorrow. It really depends on the blood test. Please keep your fingers crossed for her!

Thank you for all the birthday wishes today! Lucy is lucky to have such an amazing group of supporters!

Saturday, February 4, 2012

Room with a View

I have been parking in the Skyway Ramp and I walk past this stained glass panel every day. The flash on my phone's camera causes a lot of flare. The gnome is not lighting flatulence (though he looks guilty) and the owl is not looking for the culprit.

Lucy took a short walk this morning. It helps clear the fog of the pain pills. Her leg color has gotten noticeably better in the past day. Her right calf circumference is within 3 cm. (about 1.2") of her left calf. She says her ankle is stiff but is getting a bit more range of motion. Lucy has been working on her physical therapy exercises. Her Braden risk bracelet was removed because she is more active and her skin can air out.

Dr. Singh from Minnesota Oncology came by. Lucy was moved back to 8th floor this afternoon. Her hemoglobin dropped after yesterday's increase so she will be getting a two unit transfusion. This means the four transfusions she has had since being admitted have required eight units of blood. She will be here until Monday at the earliest. The rest of the blood work sounded OK. Her Coumadin dosage was dropped to 2.5 mg and they did not have to administer a quick "blast" of heperin (called a bolus). We hope this means she is getting close to being removed from the IV heperin and her Coumadin dose is getting set.

I did get to take Lucy to the Meditation Sanctuary before she was moved. We used a wheelchair because it was a quick trip. She liked the fireplace and water feature. Changing her scenery also helped.

The view from her room is great. For those of you in the Twin Cities area, she overlooks Crosstown and France Ave. The fog lifted and the sun came out and we can see all the way to Highway 100.

Lucy's birthday is tomorrow and she will be spending it in the hospital. I'm grateful for getting to celebrate another birthday with her! I do wish she could have been released today. Comments are working, so please feel free to send her birthday greetings tomorrow. Thank you so much for your support!

Friday, February 3, 2012

"The ankle bone is connected to the shin bone..."

The ankle is more complex than a single bone and "Dry Bones" was not intended to be an anatomy lesson in song.  It is sort of applicable because Lucy is walking better. Her ankle is pointing forward (12 o'clock) instead of away from her body (2 o'clock). Yesterday she would walk mostly on the ball of her right foot. Today she can get her foot flat and bend it forward towards the ball. She is getting the hang of it. Today she managed to use the bathroom. Two days ago she couldn't walk but half that distance. The walker will be temporary

Her hemoglobin went up from yesterday. It is now at 8.7. It's been a couple months since her hemoglobin has stayed steady or risen a couple days after a transfusion. Her platelets were 212,000 and her white count was at 5.6. Those counts are vastly improved from when she arrived nine days ago. It sounds like she is in "therapeutic range" for her INR. The Chromogenic Factor X test results were not quite in therapeutic range. Dr. Thurmes came by and explained the results. His feeling is Lucy will be in the hospital until at least Sunday now. Lovenox injections might have been an option, but Lucy was on those for her clots. The heperin is working and it can be monitored and adjusted as needed.

Lucy managed a walk of about 100 feet tonight with only a small stop to turn her walker around. The Physical Therapy people commented on how pleased they were with the distance. She got her exercise in tonight. There is a Meditation Sanctuary on this floor that she wants to see because of the water feature.

In addition to the various hospital staff in and out of her room today, Lucy had some visitors. Her supervisor and supervisor's supervisor came by for about 45 minutes. Anh-Thu brought in a beautiful flower arrangement that she had designed. Lucy has some really great co-workers!

Lucy's sister Julie came by tonight for a couple hours and brought us some lemon chicken from Leeann Chin. The hospital food is alright, but the menu selection is limited. Lucy does not have dietary restrictions. It was really nice seeing Julie!

Lucy is staying positive. She does get frustrated at times, and so do I. We know this journey will be a battle and there will always be unknowns. That is why the victories both large and small are cause for celebration.
Thank you, everyone!

Thursday, February 2, 2012

Eight days on the road...

There was a little additional news from last night that didn't make the post (and I was too tired to do the update). Lucy got to sit on the edge of the bed last night for almost a half hour. I got to give her a long back rub which helped her relax. Her calf diameter went down another ½ cm. Her pain level has stayed the same, but it is significantly better than a week ago. Her blood work is showing normal values except for her hemoglobin being low. Adult women are supposed to be between 12.1 and 15.1 grams/deciliter (g/dL). They want Lucy's hemoglobin to stay above 7.5. If it goes below that, she will get a transfusion.

This morning was incredibly foggy. It has been a very mild winter here unlike last year's near-record seasonal snowfall and unusually cold temperatures. We earned a break after last year. I normally can drive from home to Fairview Southdale in about twenty minutes for the six mile trip. France Ave. has a bunch of unsynchronized stoplights once I cross into Edina from Bloomington. Today I needed fifty minutes. There is a large lake and marshy area near Normandale College at 98th St. and France Ave. The fog in that area reduced visibility to about fifty feet. Even the inside of the hospital parking ramp was a bit foggy.

Dr. Thurmes stopped by to see how Lucy was progressing. Her Coumadin dosage still needs a tweak. She had noticible improvement in her hemaglobin after yesterday's transfusion, rising from 6.1 to 8.4. Lucy will probably be here until Saturday at least. Dr. Thurmes wants to see two consecutive acceptable results before disconnecting the IV heperin.

Lucy had the PT and OT people here today. She ran through her exercises and has a walker to use. She can get out of bed without needing a handrail. Her right ankle is still very stiff. She walked close to one hundred  feet in total today, half with the walker, in four walking sessions. Now she has a recliner to sit in so she spent most of the day in the chair. It still takes her a moment after she stands up before her ankle loosens up enough to slightly work.

Thank you for taking the time to read this and for your concern for Lucy!

Wednesday, February 1, 2012

And on the seventh day...

Lucy's Coumadin dosage needs adjusting upward, so she will be here at least one more day. Unfortunately, her hemoglobin dropped from 7.8 to 6.1 so she needed a two unit transfusion. Lucy's birthday is Sunday the 5th and I would love to see her home by then! It is a day-by-day holding pattern.

Molly, Dr. Nashawaty and Jackie from Minnesota Oncology were by to see her progress. Acute anemia can show up in patients receiving chemo. Lucy was originally scheduled for her next Alimta treatment on Thursday, February 2nd. The treatment has been moved to February 16th. Her body will get a little more chance to recover. Her white is stable and in the normal range, and her platelet count is normal and stable.

So maybe today didn't start great, but there is still good news. Molly noted that Lucy's calf skin is less taut. It no longer looks like it is going to split open. She still has quite a bit of swelling in her right ankle and a slight amount in her left ankle. The left ankle swelling will reduce as she becomes more active. Her right leg still cannot be massaged and they can't put a "puffer" on it because there are still a couple small clots. They do not want the clots to dislodge and start travelling. A "staycation" is good enough for the clots.

Lucy only needed one Dilaudid shot last night for pain. She is taking oxycodone tablets to manage pain. Her pain pump was removed last night.

A Physical Therapy specialist came by this morning and checked Lucy's strength and range of motion. She also had Lucy do a series of simple exercises that can be done in bed and left a booklet detailing how to do the exercises. Lucy is supposed to do them twice a day.

An Occupational Therapy specialist came by about an hour later. She assisted Lucy out of bed. Lucy managed to walk around the bed. Lucy's pain doesn't increase very much when she puts weight on her leg. Her ankle still has a limited range of motion so getting her foot flat on the floor is a challenge. After a couple minutes, she can stand flat footed. Walking is very slow. She is not unsteady on her feet. Lucy has surprising physical strength for someone so petite. The goal is to keep her from losing strength while her leg gets better. She will try using a walker tomorrow.

Give your loved ones a hug from us, and thank you for your support!