Nearly Normal

Tuesday - July 31, 2012

Yesterday and today feel nearly normal.  Perhaps this normal is a good version of my re-calibrated / lymphoma "new normal" but maybe this feeling has a taste of my old pre-December "normal" when energy and ability seemed without strict bounds.  Yes, I'm still strengthening and working around this recent (surprise) ridiculous lower back issue but other than that?  I am sleeping VERY well and fatigue is virtually nonexistent relative to what I experienced after my first odd round of Hyper CVAD.  Bottom line:  I have energy and am thrilled to be enjoying time with Megan.  Splendid, happy days with my beautiful girl!  We even managed to have a little outing yesterday with some belated birthday shopping for Megan and a lunch.  Oh, and who drove?  That would be me  :)   Just a normal thing to do....

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Sewing projects, livestreaming REAL Olympics coverage (that shows some non-Americans, standings, and real-time results), "Idiot Abroad," lunch out with my girl, and then a round trip drive to Richmond to get Megan aboard a Skinny Dog to Washington DC.  A full, happy day.  Now, time to rest!  Normal, normal, normal ....

Pretty good ... for Neulasta #4 (and NOTHING more!)

Monday - July 30, 2012

Snorkeling scenes and pristine reefs instill calm at Dalton. 

.... pretty, pretty, pretty,  good....  Given yesterday's frozen and painful lower back, I was fully expecting to be stiff and perhaps immobile for today's trip up to Richmond.  We were discussing how I was to get into the clinic from the valet:  no wheelchairs in this journey - yet!  Now I'm up after a luxurious 6 hours of flat-on-my-back sleep and am sore but functional!  Better than yesterday!  Hurray!  So relieved ....

As foreshadowed by an oncologist last week, vivid nightmares roused me more than ever last night.  One of the Hyper-CVAD odd-round chemo agents seems to prompt dreaming and I indeed produced.  Dystopian sequences and separation from my children featured prominently.  Pretty stark imagery.  I do not need a comparative lit PhD to provide some insight into why my dreams surface anxiety and pain about leaving my children.  I may be honestly upbeat about how I'm feeling and where we're going with my treatment but my health does remain a concern. 

Megan will journey west with us for today's post-chemo Neulasta shot.  At this interval (after my first odd round or #2 of 6 protocols), I was deemed to be tachycardic, nailed for lack of hydration, and hooked up for an hour of saline at the clinic.  I am determined not to repeat this unpleasant surprise and am drinking up like a very good girl.

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"Matchmaker, matchmaker, make me a match  ..."

Our Dalton visit was about 2 hours from valet drop-off to scooting back onto the interstate to escape back home.  Two hours!  We still have a full day left in front of us!  Fabulous!  My blood levels are VERY good (for someone undergoing chemo) and my vitals were strong.  Happily, my heart rate remains below 90; no tachycardia (yet).  What a terrific way to start my 2 weeks at home!

Having asked for a week whether my bountiful blood draws were ever channeled toward bone marrow matching, I pushed again today and learned that this process had not yet started.  No worries ... what's another blood draw?  I'm a pro at this point. The process is now officially underway.  Megan had a swab test to begin her match process as well.

Crashing Out and Healing Up

Sunday - July 29, 2012

Often when I return from the hospital, I simply ... crash.  I drop on the couch, the dogs burrow in (while the cat haunts and whines for food), and unpacking and laundry goes waiting... and waiting ... and waiting....  It simply is not a priority.  Eating and cooking are also low priorities.  I am not hungry.  I am just SO happy to be home, comfortable and cuddling, that everything besides "hunkering down" goes by the wayside.  Yesterday, Megan and Joe made this recharging and centering even more rejuvenating.  All of a sudden, the day disappeared in a rush of dramatic rain and storm - wonderful!

My physical fatigue is definitely on the horizon.  When I head up the stairs, I feel my muscles debating me (must we? let's go slow or double step instead) and my heart rate also has a tendency to elevate - quickly!  I am on major warning about moving slowly and avoiding lightheadedness.  The great benefit of going through this chemo round a second time is that my expectations and precautions are clear.  I am more aware.  I am less worried as symptoms arise.  It all feels much more procedural.

Movement is key.  Megan and I shared a (slow) long walk with the hounds in the late afternoon.  Prior to my lymphoma symptoms, these pups were SO accustomed to frequent, long walks - down by the river, around the neighborhood, early morning must-dos, and post-midnight magical saunters.  They are very excited to get out with me on the other (human) end of the leash.

Great news regarding sleep! Six plus hours of rest!  No steroid effect yet  :)

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A huge wrench in my already modest plans;  I just threw out my lower back and am pretty well out for the count.  The irony!  Oh, how I love(d) my Arlington freezer-on-the-bottom appliance and have fussed for years about the inconvenience of living in rental homes where I open the fridge -- and see NOTHING!  I open the fridge but my head remains in front of a closed freezer door and I am required to bend over and dig out food from the fridge at a level below the shoulders.  This design is an ossified holdover from a previous technological necessity.  Why does this relic prevail?  How is it still being sold?  What's the point?  Anyway, this most-vilified appliance finally got its due, revenge for my mocking and rants over the years.  When I bent down to retrieve yogurt from the lower shelf of the fridge (just above FLOOR level of course), my back ... went .... out.   I have been forced to cancel my brunch with Sally and mom and am trying to stabilize my back and reduce the spasms. Drat you, fridge.  At some point I will be back in my own home and will have a fridge that makes sense!

Unexpected.

Pre-noon Bust-Out?

Saturday - July 28, 2012

Olympic viewing before bed

You know....  some days just do not go your way.....  I am now officially rebooting.....
I have been in a computer-induced RAGE for a couple of hours now which has now been topped off by a crash and a full delete of this morning's post.  Irretrievable.  Gone.

Ah, well.  Perhaps it's a cosmic message for me to focus on the positives and shrug off the previously posted raves about grammar.  I shall take advantage of this clean slate and recap the positives.

Megan's crashpad on the couch

• Good sleep!  Megan crashed on the hospital couch and I didn't wish to disturb her so I stayed in bed and dozed.
• I should get out into the fresh air by noon!  Hurrah!
• My steroids-induced puffy face and leg edema remain manageable.  Heartrate is going up (as expected with this chemo round) but I am not lightheaded.
• The internet allows you to feel companionship with other grammar police.  I'm not the only one who reacts to "your v you're" and "too v to" - good to know.

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NOTE TO SELF:  It is NOT summer time in the hospital; it is NOT spring time in the hospital.  It is COOL in the hospital.  I need to forget my capris at home and remember to wear long pants and socks.  My feet get cold every day and I end up wrapping my lower legs in towels, sweaters, or blankets as I elevate them to contain the edema.  This look is ridiculous and is not terribly effective.  Next go-bag?  Autumn-focused long pants and some cozy socks.  Gotta remember!

Kids on the Move! PLUS A Feast!

Friday - July 27, 2012

Was last night my most restful in the hospital?  In my fog of fatigue, I think back on my 23 days in the hospital and can't recall another night where I didn't bail sometime in the dark.  Instead, I maintained an eyes-closed, conversation-lite stance during all of my evening events and ended up napping throughout the night, finally arising at dawn.  Sounds like a successful evening to me!  I'll take it!

Nonetheless, I am seeing and feeling the effects of the dexamethasone (bloated face) and some reactions from four days of cyclophosphamide infusions (flushed / histimine reaction in the face and upper body as well as edema in my lower legs).  This odd round, I have better controlled the edema through more focused exercise on a stationery bike that I am currently hoarding in room 132!  While no one has yet asked for it back, I am not too sure that I am willing to share!

Jonathan and Megan are both in transit today. Jonathan has finished his month of work as an Orientation Leader at Virginia Tech's Freshman Orientation and is headed north to D.C. for his 6th (?) year of volunteering as a scoreboard keeper at the Citi Open (formerly LeggMason) ATP Tennis Tournament.   We will see him on his way back to VT in 10 days!  Megan should just now be stepping into a shuttle at Dulles, on her last leg finishing up a 36 hour travel ordeal from Beijing to VCU!  I hope to be hugging her in about 3 hours!

Sally is coming today - bearing delicious Sally-cooking, a fluffy towel for my weary traveler, a CD of early Carter family photos, good humor, and company!  It is going to be a lovely, epic day!

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What a lovely, happy day!  Megan arrived earlier than expected at 9:30 and gave me the sweetest, warmest, longest hug ever!  She looks amazing after her travel ordeal and has had enough energy to just have crashed for a half-hour nap at 4:45.  Sally came about an hour later hauling a handtruck of FRESH food!









We feasted on veggies, cheese, hummus, and pasta (among other amazing delights) while sharing conversation, anecdotes, and advise about solving all types of world and relationship quandaries.  What a trio!

"I Remember (Sky)" PLUS Saturday's MRI results!

Thursday - July 26, 2012

Quick!  Sondheim fans!  Name that show!  Yup, I'm up at 2 a.m. and I'm going Sondheim on you....  Watch out! Soon, I'll be referencing Shakespeare, Austen, and Shackleton.  Last guess and .... and .... it's "Evening Primrose"!  How many die-hards got it?  Give yourself a prize!  This relatively unknown haunting song first came into our Sondheim-happy house when Megan, our favorite mezzo-soprano, sang it in the showcase of a University of Maryland summer class she took in summer 2005.  Yesterday, this minor key Sondheim obscurity was a constant (and not-very-melodic) earworm as I perched on the couch by my huge window and enjoyed my vantage point.  I have my sky here in room 132; it sustains me, entertains me, and provides me the promise of fresh air and breezes when I next escape the confines of my hospital room on Saturday!  Hospital living is altered greatly when a brick wall looms in one's view (like in the Bone Marrow Transplant Unit).   Indeed, in that case, I might by truly emulating Sondheim's store mannequin.  But not yet!  Save that for autumn!

I pursued the logistics of a second opinion yesterday, doing more web research and phoning Georgetown's Bone Marrow Transplant Unit to ask why marrow.org lists them as "inactive."  After speaking to an RN and even a physician, I learned that they are the only D.C. area hospital actually harvesting bone marrow but do NO transplants.  George Washington does not have a BMT unit, NIH only runs selective clinical trials, and Inova Fairfax has a fledgling, low-volume program that only performs analogous BMTs.  So, if you are a D.C. metro area resident in need of an allogeneic BMT (or wanting a more proven and accredited analogous program), you have to move within 30 minutes of Johns Hopkins or University of Maryland Baltimore or come on down here to VCU (ranked #14 in the U.S.).  Who knew that with all of the top-notch, prominent hospitals in D.C. that no comprehensive BMT programs are available?  I am stunned!

This news torpedoes our thought of returning to our familiar NoVA area community for my BMT and solidified our decision to stay here at VCU near our Williamsburg community for my allogeneic BMT.  Joe, Carolyn, and I are still pursuing the logistics of getting a second opinion about which BMT is best suited to purge my lymphoma.  I cannot travel up to Hopkins but will they consider a skype conference after receiving my file?

Another offshoot of this new information is that we are heightening our Richmond real estate debate.  Purchase or rental?  Do we want the hassle of property management after my 30-minute tether to VCU is released?  Where?  How big?  Many options exist and we are having fun considering the possibilities.  San Fransisco and UCSF remain in the offing for summer 2013.  Will I be re-inoculated with my "baby shots" by that time?  Probably not.  I'll be driving across country (masked when out of the car) without the advantage of vaccines protecting me from polio, chicken pox, measles, mumps, rubella, and all that other fun stuff.  Nonetheless, if I am in "maintenance" phase, I already have a preliminary "okay to go to California" from the head of the BMT unit.  So, San Fran living is still in the mix.  It might certainly be a welcome gift after what will turn out to be a 2-year health journey!

Departure confirmed!

After 2 hours sleep and then 30 minutes tossing and turning, I decided to get up and wait out all the 3 a.m. medical activity (vitals, chemo-hanging, and blood draw) before trying to get back to sleep.  I am yawning - a rare thing - and hoping this bodes well for a solid 3+ hours before morning rounds and visits commence.  In the meantime, I am watching FlightAware to track Megan's now-overdue departure from Beijing.  I hate to think of her stressed out on an already exhausting travel day but that's trans-Pacific travel.  Megan will now have a tight connection through customs in LAX so her arrival at Dulles and door-to-door shuttle down to Richmond and the hospital is a bit in flux.  She'll manage! That will be a focus of our attention for Thursday.

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All tricked out in room 132

Communicating via multiple venues (and a return to a state of sleep disruption and deprivation) has caused me to miss blogging an important piece of news.  Saturday's MRI confirmed the disappearance of my physical symptoms in my cranial nerves.  "Abnormal enhancement in the region of left cavernous sinus is significantly decreased since the prior study.  The size of the enhancing tissue in the sella is also decreased ... and consistent with improving lymphoma."  I'll take it!  A "partial response" is in hand after round 3 of my 6 chemo treatments!

Settled Into a Familiar Routine

Wednesday - July 25, 2012

All settled in!

Yes, it's 3:45 a.m. and I am back in my familiar pre-dawn typing spot here in Critical Care Hospital 2 room 132, occasionally glancing at the street lights stretching east below the wide, tall black sky, and awaiting the arrival of a vivid red sunrise.  Why am I back to this ridiculously early schedule?  Perhaps it's attributable to the start-up of mega-steroid dexamethasone; the 3 a.m. meeting with multiple RNs as they hung chemo, drew blood, and took vitals; the vivid images and perseverative thoughts of rescue dogs and strays doomed for euthanasia that linger from yesterday's reading of the Washington Post and lifewithdogs.com; or just an overall deep desire to be back home - snoozing alongside Joe, Sadie splayed between our pillows, Baxter burrowed beneath the duvet at our feet, and Dusk on guard somewhere by the perimeter of the house, hunting frogs and salamanders that he may later deposit at our feet (use your imagination - he does this in various ways).  Anyway, sleep right now is impossible.  I shall try to grab some more downtime before shift change at 7 a.m.

Some comfort level certainly exists when encountering a familiar rhythm, environment, and staff.  Joe and I have this VCU admission routine DOWN!  Joe found the nearest possible street parking spot just across  the street from the Critical Care Hospital entrance- boo-yah!  The Ammiratis all LOVE an optimal parking spot as much as George Costanza!  We then took advantage of the most efficient route and walked (not too quickly) up the back staff stairs to the oncology floor, knocked hard, and were let in by a surprised housekeeper.  Unpacking was a breeze and the bed was soon made, "standing desk" assembled and tricked out, and water bottle filled.  Joe followed Carolyn's earlier precedent and taped closed the flapping adjunct (for extra wide access) to the bathroom before heading out for a hunting /gathering mission for frozen yogurt.  Joe is now a fro-yo connoisseur and I am the lucky beneficiary!  How many lymphoma patients gain weight?  This recent diet seems to confound the odds!

Port accessed?  Check!  Port accessed by a new RN doing the procedure for the first time under the tutelage of one of my most familiar RNs and the silent observation of the attending oncologist?  Check!  (She was terrific).   First chemo hung by 2:30?  Check!  Progress made on organizing my desktop and uploading lesson plans and resources to my cloud?  Check!  R&R by my beautiful wide window appreciating a dramatic sky and cloudscape?  Check!  NYT Crosswords?  But of course!  What's a girl to do?!

I have had two new chemo symptoms creep up.  Before my lumbar puncture on Monday, I showed Kevin the curious white lines that have appeared on my fingernails.  "Ah, tree rings!  They'll grow right out!" he replied.  "Some people actually lose their fingernails during chemo."  And THAT's where I decided I didn't need to hear more just then....  But I couldn't resist a little judicious research yesterday - on the tree rings, not nail loss  :) I learned that "Mee's Lines" are an indication of arsenic and other poisons and do indeed grow out.  I am indeed being poisoned - that is what chemo is.  Some chemo patients manifest each chemo cycle with a separate horizontal line for each treatment thus truly emulating tree rings.  The second symptom may not be as benign; last night I had two (brief) bouts of nausea.  Funnily, the first incident happened 4 hours after I had finished dinner.  Standing up (stretching out my GI track) and a quick dose of compazine settled the problem.  The second bout occurred when I was going to bed - no compazine necessary after stretching and moving.  But could these two moments be harbingers of future nausea?  Hope not!

Jonathan has admonished me about doing too much internet research but I am conflicted about the wish / need for a second opinion and need some informatin.  Joe and I are trying to determine where to get that second opinion (Will I need to travel?  CAN I travel?)  and are also fully vetting VCU's experience and competence on BMTs, particularly allogeneic BMTs.  We are literally putting my life in the hands of the BMT center.  Research is necessary!  And mortality rates are part of that research.  I can't help but absorb and weigh the data.  However, the odds are strong, I am strong, and Joe is my greatest and most affectionate cheerleader.  I think he may believe in me more than I believe in myself.

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Success!  Grabbed more than 1.5 hours (interrupted) sleep AND managed to be dressed before the intern arrived on her rounds!

Halfway? Or not even close?

Tuesday - July 24, 2012

Another "an" artpiece - our surname means "peace"

Steroids cannot be fingered as the reason for this morning's pre-dawn wake-up.  Happily, it wasn't my previous 4 a.m. norm but I didn't enjoy the deep slumber of this last glorious week. Perhaps it's just the anticipation of pulling together my go-bag and checking into VCU today.  Oncology or Bone Marrow?  I'll take anything with a full view of the sky, thank you very much!  Perhaps it's the realization that today would have marked the halfway point of my lymphoma treatment yet now, after yesterday's BMT consult, I am aware that this journey back to health is a MUCH longer haul.  I'm not even close to halfway!

In class this year, I would refer to a change in schedule as a "higgledy piggledy" day, a time when we would encounter a shift from the familiar, predictable, and comfortable routine and roll with the new, the different, and the unavoidable.  Now, here in my new-normal of life-with-cancer I am looking at a sequestration and strength-building timetable that could reach into early 2014.  Wow!  It's funny how slowly this realization  creeps in but how quickly one can adapt to news of the inescapable.  If this path is indeed my best option for controlling and eradicating my lymphoma, then I'm all over it - leggo!  I'm already researching online graduate classes in children's literature (Penn State) and elementary mathematics (Drexel) as a means to keep my mind occupied and my future employability an option.

Joe and I are also kicking around our living options:  Williamsburg?  Richmond?  San Francisco?  Arlington / DC area?  With a BMT, I will need to live within 30 minutes of the transplant unit.  Given my recent experience of the ferocity of an infection while I was neutropenic, I get it.  I need to be close.  I need to monitor myself closely and to roar to the hospital without hesitation (no Yankee restraint).  Our current and future retirement homes are both about 50 minutes from VCU so, yes, we have already begun looking at rentals and purchases in Richmond.  And then there's the issue of my being on lock-down (no crowds for 1 year to 18 months after transplant - WOW!!!!) .... Where would this "incanceration" best take place?  Joe will be managing a new and busier job in San Francisco and I have no social support system there.  However, Megan is a hop, skip, and a jump away, Jonathan has access through a major airport, and Joe and I would have the treat of living in San Francisco.  But could we really enjoy this treat if I needed to be stuck in the house?  Then, there's the temptation of returning to our roots and supportive commuity in (or near) Arlington.  We are researching possible BMT units as well as no-lawn, smaller housing options within 30 minutes of Georgetown?  GW?  Hopkins?  The latter is probably too far for Joe's commute; Tidewater VA has spoiled us in terms of traffic. So much to consider ... and plenty of time to mull it over!

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How fortunate am I to have ALL of these options and SO much support!  How do families manage when they are dependent on the wages of a BMT patient?  When they have young children at home?  What if you were all alone?  I feel incredibly lucky.  I am flooded with love and appreciation for my family and friends who are helping me face all of these challenges with optimism, information, and humor.

Rituxan in Richmond

Monday - July 23, 2012

Another title worthy of the Magic Tree House series!

We are off for a full medical day at VCU!  Blood work and THEN Rituxan infusion, intrathecal chemo, and finally our Bone Marrow Transplant consultation.  Rev the engine - we're late!  Let's get started!

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Well, THAT was a long day even by recent measures!  My blood work came back very strong and - after Joe took one for the team and chatted up Reverend Jim thus running interference for me - my rituxan infusion was smooth.  The 2 hours plus went very quickly.

Next came my intrathecal chemo, medicine delivered via a lumbar puncture.  Ah, the downside of a teaching hospital is the actual hands-on teaching.  I do enjoy the collaborative aspect of a medical college but when Kevin, my beloved spinal-tap practitioner, introduced the young oncology fellow and said that she would be doing my procedure, I confess that I was NOT excited.  After ascertaining that I was not her first LP, I hunched over on my pillow, humped my back, and closed my eyes.  One bad moment (shooting pain down my right leg - ouch! - I don't think I cursed!  Hurray for me! ) and 5 minutes later, I assumed the familiar prone position, flat on my back for the 30-minutes of let-the-chemo-spread-around-and-not-pool-below-your-waist.  Not my best lumbar puncture by a long shot but not the fodder of medical horror stories either.

Then we rushed up to the Bone Marrow Transplant Unit for our consultation.  Happily, I already knew the consulting physician from my chemo round #2 admission on the BMT floor.  In addition, my background research was worth the angst as it put me in a good position to understand options and to participate in the conversation. I entered the room with the realization that the aggressiveness of my lymphoma most certainly indicated that a BMT would be recommended.  However, I had thought that the path would be an autologous transplant with my own (clean!) bone marrow harvested and then transplanted back.  Again, given the unique manner in which my lymphoma symptoms have presented and the cancer's involvement beyond my lymph nodes, the recommendation seems to be pointing toward a more aggressive approach, an allogeneic BMT with bone marrow coming from a donor rather than from me.  Essentially, an allogeneic BMT may optimize my long term outcome but in the near term it is a more delicate procedure, raising the specter of graft-versus-host disease and general infections.  I am coming around to "calm acceptance" that I may not work until 2014 and won't be going out into crowds much in 2013.  Oh, my ...  NOT what I wanted to hear!  In fact, the doctor suggested that I may need to preoccupy myself with a mental outlet - perhaps an online Masters!  Hmmm ........  With either transplant, I will need to live within 30 minutes of the hospital and will be visiting the clinic 7 days a week for more than a month after being released from my 4 weeks in the hospital. 

So, much to think about .....  Are we still moving to San Francisco?  If so, when?  Do we rent or buy an apartment or town house in Richmond?  So many things to contemplate .... Yet I remain keenly aware that I am in a very privileged position, with emotional and financial support and the time to devote to my health.  The full BMT consultation panel is meeting on Friday to discuss my case and to put forward an official recommendation of autologous vs allogeneic BMT.  But a transplant is coming.  Perhaps as early as Columbus Day.

Damp, Green, and Humid

Sunday - July 22, 2012

Spot the stag?  Directly above the middle fence post.

Another wet, lush morning where the vivid greens layer texture - and a high degree of personal comfort (for me) - against low, grey skies.  I relish this color palette.  Perhaps it's reminiscent of growing up in the greenery of Connecticut or living in the pillowy clouds of Yangmingshan or tropical growth of Hong Kong.  I find that this intense green cocoons and soothes - just makes me happy!  As an added bonus, for the third day in a row, I have come downstairs to find a large stag sitting alongside a log in the woods just beyond our back yard.  He is positioned facing the house and I can see him clearly as I sit and work in the living room.  The stag remains so still that even our deer-focused, not-to-be-messed-with Sadie does not detect him when she braves the soaked lawn (our IGs do NOT like water) and ventures outside.  While deer are a daily sight around the house, this resting stag is a special surprise and I welcome him as a good omen on this final day of leisure before a busy hospital week.

Today I will repeat last week's preparations for the hospital and also try to ready the house for Megan's arrival (!) at the end of the week.  I have an unsubstantiated fantasy that Jonathan will swing by between his volunteer obligations at Virginia Tech's Freshman Orientation and next week's ATP tennis tournament in D.C.  Will all of us be together when I am discharged from chemo on Saturday?  Unlikely but possible!  AND, there's always Skype  :)

Head MRI: Take 3

Saturday - July 21, 2012

Drenching, pounding rains and intermittent thunder were the soothing baseline for another deep, long, highly-valued sleep.  In the hospital - even in the city - ambient outside noise is rare.  Key exceptions to this norm are the horns of an occasional passing train (always a reassuring sound to me as it harkens back to late nights with my lovely infant in Beijing) and the throbbing beat of the trauma helicopters landing on the VCU helipad (always prompting concern for the patients being transported).  Last night's steady rain against the windows was just what I needed to tempt me into sleep and to restore my sense of calm after my equilibrium had been ruffled by too much surfing on the world wide web....

Dusk snores and "cockroaches" - no internet angst for him!

Internet research is a double-edged sword.  After yesterday's information hunt, I feel decently prepared for Monday's Bone Marrow Transplant (BMT) consultation,  However, I was (am?) also rather shaken after getting into the nitty gritty details of BMT, criteria for selection, and of course survival rates.  I have assiduously avoided aggregate survival rate data since my diagnosis, focusing instead on our conversations with my oncologists as well as my optimism and belief in my own underlying health and the aggressiveness and appropriateness of my treatment.  Yesterday's research and preparation put me face-to-face with data that - naturally - did not report 100% survival rates.  Here is a case where my Type A research bent does not serve me well.  So, enough!  Joe persuaded me to take a break and to get out for dinner and a change of focus.... Still, I find it hard to push this data to the back of my mind lickety-split.... A bell cannot be unrung but in time perhaps the sound will fade away  :)



This afternoon is the first of my mid-chemo evaluations.  We are traveling up to Richmond for a follow-up head MRI.  In my first MRI in February, the lymphoma "hot spot" behind my left eye was masked by prednisone and the test was inconclusive, not leading my neuro-ophthalmologist to a definitive conclusion.   Graves Orbitopathy, Trigeminal Neuralgia, a cranial cavernous fistula, and Tolusa-Hunt Syndrome were all debated causes of my crippling symptoms before Diffuse Large B-Cell Lymphoma was diagnosised.  My second head MRI in April was excruciating.  I stupidly went into the loud, piercing, throbbing MRI with my crushing migraine (perhaps a 7 or 8 on the pain scale), not thinking to ask for morphine or some other heavy duty pain killer.  That pain turned out to be worth it as the MRI showed an abnormality between my brain and my left orbit.  My notes of the conversation with my neuro-ophthalmologist read "not a liquid and not a solid mass" but "definitely suggestive of lymphoma." Now, with this third MRI we are hoping to see ... nothing!  Something good has certainly happened behind my left eye, yes?  I can now see (hurrah!) and my migraines have vanished (glory be!) and we are simply awaiting this MRI's confirmation of good news.  We may have the results by Monday's BMT consultation.

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The MRI experience always brings out my number nerdiness.  I tend to count the bangs, clangs, whirrs, snaps, bongs, gongs, and rapid machine gun sounds during the procedure.  How many of each sound occurs between pauses? Is there a pattern?  Growing or repeating?  Is the pause between a change in noise pitch or rhythm the same?  If not, does it change in a predictable manner?  In defense of my confessed number nerdiness, there is precious little to DO during a MRI when your head is encaged in a narrow enclosure and you are further hemmed in by padding and barriers tucked carefully inside the cage.  I am not at all claustrophobic, just a wee bit in need of distraction.  Today, I began to drift from counting MRI sound blasts to wondering about the musical possibilities of these sounds.  After all, the pitches and rhythms vary.  Has anyone ever been inspired by an MRI to compose?  The answer is YES!

De-accessing Day

Friday - July 20, 2012

Fourteen days is my new record for having my port accessed - a 3/4 inch needle inserted into the port, gauze and bandages taped in place to cushion the needle, aquaguard secured to protect the entire site, and tubing hanging 6 inches down my collarbone.  [NOTE: educational / illustrative photo considered but then decided against.  You're welcome, folks.]  You get used to anything after a while and after two weeks I hardly notice this medical accessory.  Yes, I continue to protect myself with a pillow when Baxter and Sadie swarm me on the couch for cuddles and, yes, I continue to have a recurring nightmare of jerking a tube and inadvertently de-accessing my port (read:  ripping out).  During my first few days of hospitalization and living with a port in mid-May, I mentioned this isn't-it-a-silly-worry "rip out" scenario to my RN and she replied,  "Oh, it happens."  Yikes!  Let's just say that I am VERY protective of my port.  Whether negotiating my way around a hospital room as I push my chemo-laden pump and pole or redirecting my intensely-loving hounds to my (unencumbered) left side for kisses and strokes, I am keenly aware of my tubing, its slack, and the potential tension on my valued (but still creeping-me-out a bit) port.  One more IV antibiotic infusion late this morning before the home health care RN arrives to de-access me.  Then - joy! - two and a half days of freedom!  I can shower at will!  So ... a new record:  I am hopeful that this fourteen day mark of port access is not soon equaled or surpassed!

This morning my foot pain has definitely lessened.  The timing is consistent with the last interval between my even and odd chemo protocols; halfway through that first odd cycle, the foot pain tapered off.  I have taken the advise of a Bone Marrow Transplant (BMT) unit physician (and then actualized by Carolyn) who suggested Bag Balm to relieve this neuropathy.  I have been applying it regularly even when my right foot was too sore to touch without pain.  Who knows if it has hastened the timeline but my skin is certainly benefiting!

To prepare for our Monday afternoon consultation with the BMT team, I have been entering previously-avoided internet sites.  All in all, I prefer to keep clear of any generalities about survival rates and years.  These numbers are aggregates and every case is individual.  For example, stage IV but with clean bone marrow?  That factor is not necessarily reflected in the numbers.  Nonetheless, this morning I steeled myself, revisited the International Prognostic Index breakdown, and worked through myriad articles discussing the determining factors for a BMT.  Educating yourself is always critical BUT it is not always easy.  My goal is to be conversant and knowledgeable so we can fully understand and respond intelligently during our (two and a half hour!) consultation on Monday.  We need to advocate and inquire with a strong knowledge base.

"Birds flyin' high you know how I feel..."

Thursday - July 19, 2012

"... and I'm feeling good!"

Newborn Megan in Hong Kong

Megan, all grown up, skyping from Beijing! 

What a difference an extra week of recovery makes!  What rest and refreshment after another healing full night's sleep!  What a sense of normalcy meeting up with Gina in a familiar haunt, enjoying comfortable conversation and laughs!  What a sense of satisfaction knowing that I surprised Carolyn on her birthday eve!  What a boost celebrating Megan's 24th birthday - thrilled with her happy life situation and choices, reflective of all the fabulous birthdays we have enjoyed over the years (and around the world), and perhaps a bit nostalgic for that cheery, chatty wee girl cuddled up in my lap.  Such a happy day :)

Taking Advantage of Found Time

Wednesday - July 18, 2012

Ele-phonse is NOT enjoying a "great week"

I truly feel that I am enjoying a vacation from all things medical ....  Well, not quite.  I am still infusing myself with an IV antibiotic every day and I delved (perhaps stupidly) into a rather chilling internet wormhole about neuropathy that continues or recurs after chemotherapy ends.  Does this mean that my fingertips will indefinitely be tingly and without full sensation and function?  Or that this debilitating pain in my feet will crop up intermittently and cause me to hobble like a babushka?  Hmmm.... Carolyn alerted me to this possibility and encouraged me to get some answers when I am next at Dalton.  I am organizing some information and questions for my next consult. It goes without saying that we are active advocates who are educating ourselves as we go along this cancer journey ....

ANYway, I was musing about my lovely unexpected break from this week's hospitalizations .... Joe and I have been tackling some chores, catching up with friends, but mostly just resting up.  I have been banking sleep, taking a two hour nap yesterday with Sadie burrowed in along my side.  After venturing downtown for dinner and frozen yogurt, I managed a short walk with the dogs before my foot pain compelled me to return to my leg-up position on the couch.

Although separated by miles and individual responsibilities, we are very fortunate to be in such close contact with Megan and Jonathan.  "In the olden days"- when Joe and I were first in China in 1981 - 1982 - phone calls were expensive, cumbersome, and rare ordeals.  I recall telephoning my grandmother for her birthday and not being able to dial direct, having to wait for our Beida dormitory "concierge" to place the call, waiting for almost an hour to get through.  Mail took weeks!  Now, we are able to be in touch with Megan via Skype, blogs, Facebook, and email.  In addition to these avenues, Jonathan texts regularly when he finds time during his 19-hour workday at Tech.  If I have an update or a question, he responds immediately. So ... while the children are not HERE in person, we are up-to-date and connected.  I hope that such regular communication dispels most worries they may have about my treatment and health.

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Hurrah for COOKING!

Hurrah for lunch with Tama and Natalie! Yay Matoaka friends!

A great day in my "great week" meant more energy than I have felt in ages!  In fact, I am officially declaring that I have not felt this good for 204 days - since I was felled (a la Greek myth) by a sudden onset crippling migraine on December 28th -  the first (and welcome) sign of my lymphoma.   What a lovely day!
Hurrah for energy!
Hurrah for minimal discomfort (in my feet) versus pain!
Hurrah for being fully alert!
Hurrah for feeling healthy and for being HAPPY!

Visitors Signal a "Great Week!"

Tuesday - July 17, 2012

With Henry, Mary, Alexandra, and Antonia!

My "good week" was supposed to be last week = hospital week = E.coli infection / neutropenic fever week = not so good!  NOW, I have the gift of a hospital reprieve for this upcoming week, a 5 day span that was supposed to be spent being infused with the Hyper CVAD "odd cycle" protocol.  Instead ....  I have a bit of a staycation.  Yes, I am still on IV antibiotics, my port is accessed, and I am streaming tubes underneath my shirt (and tucked into my bra).  BUT doesn't it make sense that this "found" week - with the extra recovery time between chemotherapy regimens - should be a comfortable, fine health week?  I am feeling very optimistic!  It is a gift of a week!

At the very least, I am SLEEPING!  Yesterday, I built off Sunday night's nine hours' rest with two long afternoon naps and now I have just roused after almost ten hours' sleep.  Until I begin steroids in this next chemo round, I believe that I can say adios to 4 a.m. morning wake-ups!  That routine definitely wore me OUT!  As an added bonus, my mucositis and muscle fatigue are gone and my neuropathy / tingling in my fingertips has just become par for the course.  As for the omnipresent pain in my feet, I'm sure it will dwindle over the next few days and I take this discomfort as a positive sign that the Neulasta is fulfilling its long overdue (and expensive) obligation to grow my bone marrow.

With Naomi and Colleen!

This week, I am also feeling functional enough to get out of the house and to interact with the world.  How lucky to have visitors!  On Sunday, Mary and family dropped in on their way to Virginia Beach.  Joe and I met everyone in town for breakfast where we enjoyed fresh air, sunshine, and family conversation - most notably, wireless fence options for Maureen's young dog.  And yesterday, Naomi and Colleen came down from Richmond!  It was so wonderful to share some of our first-year teaching experiences and to mull over education issues - a total escape from medical concerns! Venturing out solo, having the chance to revel in the VW's manual transmission and handling, was also a happy injection of normalcy.

At some point -- not in the short term, not until I have possibly weathered a bone marrow transplant, not until I regain strength and stamina -- I can envision having more than one "good week."  I can see a "good month" where I can finally make the long trip up to New Hope and visit my mother-in-law and her rambunctious canine.  I can imagine a "good year" where I can actualize my planned refinements and adjustments for my second (delayed) year of teaching.  Thank you Colleen, Naomi, and Mary!  Having visitors puts me in touch with the world that continues and thrives beyond the incessant rhythm and requirements of this lymphoma battle, a reminder of what is awaiting me at the end of this chemo road.

A Return to our Richmond Routine (+ Schedule Change)

Monday - July 16, 2012

The last week seems like a month - or maybe 6 weeks!  Ten days since our last trip to Richmond and its unexpected day of platelet and red blood cell infusions.  Today we are hoping for GOOD BLOOD work!  If my levels are strong, then chemo cycle #4 will officially begin with a Rituxan infusion and intrathecal chemo and I will be cleared for a Tuesday morning hospital admission.  I am eager to stay on schedule and on track.

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Dalton's decor.  I see it in my dreams.

Jilted!  Stood up!  The best analogy I can come up with for today's unexpected schedule change is drawn from a dating scenario....  After getting my blood work done and reported at a record pace, Kevin (oncology clinic nurse practitioner extraordinaire!) told us that chemo round #4 is going to be pushed back one week.  Bummer!  The delay is due in part to my still-rising (but still low) platelet level as well as the need for me to recover from my E.coli infection.  As Kevin reminded us, this entire treatment protocol was penciled rather than inked in because it is a rigorous regimen that takes its physical toll.  Non-chemo hospital stays can shift the schedule.  And of course, I am still on IV antibiotics through Friday.  Sigh....

The biggest negative of this delay is that Megan is arriving in D.C. from China on the 26th and I will now be in the hospital for the first 1 or 2 nights of her brief Williamsburg visit (that realization kicked me in the gut).  The biggest positive of this delay is that now I can enjoy a "good week" at home.  Last week was supposed to be my "good week" and I missed it in the hospital!  What a shame!  Now Joe and I can have a quiet week together with the hounds before his long summer break comes to an end next Monday.  We can SLEEP IN, I can reduce this nagging sleep deficit, and I can recoup my strength before returning for another (welcome) chemo assault.  Hmmm....  maybe being jilted isn't such a bad thing after all!

Heparin (and more) at Home

Sunday - July 15, 2012

My sleep pattern has been restored, mucositis has dissipated, energy and large muscle groups have rebounded, and I am THRILLED to breathe fresh air and feel a breeze on my face.  Walking the dogs around the circle in front of the house feels like an epic accomplishment!  Yesterday was a magical interlude where my energy surge met a nadir of chemo side effects.  It couldn't have come on a better day as the house emptied out and I reflected on "what could have been" in terms of classroom teaching work, our move to San Francisco, and - of course, despite the use of the word "curable" when medical professionals discuss  my diffuse large b-cell lymphoma - mortality.  Ah well, another great night's sleep makes EVERYTHING better!  Bravo for sleep!  I have been utterly and deeply exhausted ....

As was the case just before my last "odd" Hyper-CVAD admission (my round #2 of 6), neuropathy in my feet has grown over the last two days.  When this pain first surfaced in late May, I thought that I had bruised the bottom of my feet, as if I had hiked long and hard in unpadded street shoes.  When the pain shifted suddenly from heel to ball, I realized that I wasn't bruised or footsore but simply healing /combating lymphoma / feeling the Neulasta kick in and stimulate the growth of my precious bone marrow.  Now I am at the hobbling stage and will probably have my feet up for most of the day.  I am not graceful!

Infusing my IV antibiotic at home has been smooth.  I seem to have made some degree of peace with my port and, even with my perpetual neuropathy in my fingertips, I have enough dexterity to manage the aligning and screwing of all the tubing. The rhythm of the infusion itself is familiar after all of the fine modeling by the dozens of RNs who have cleaned and cleared my tubing in preparation for an infusion or a push.  Skills I never thought I would need or develop!

"Absolute silence leads to sadness."

Saturday - July 14, 2012

And the house suddenly feels quite still ....  Joe and I are all alone in a house that is far too empty....

The Alzamoras met their 8 a.m. departure goal: trunk packed, bikes strapped onto the back of Carolyn's Subaru, various electronics, NPR podcasts, and music selections ready to go for their long 3 day drive back to Colorado.  Danny flew in last night to make the drive back home with Carolyn and the kids.  Last night Sally and Rachel came up from Hampton Roads to join us for dinner and to say farewell but it was this morning in the driveway, hugging tightly, that farewells were truly made.  What a gift these past 7 weeks have been!  I am truly a fortunate woman to have Carolyn share her energy, smarts, time, and love with me!  This morning's tears will not dry quickly....

Today is also a bit of a melancholy anniversary.  This time last year, not only were we enjoying a phenomenal sojourn at Lake Tahoe, but it was the day when I received that oh-so-welcome-I-have-waited-so-long-to-get-in-the-classroom job offer from WJCC!  Joe rushed up the stairs to give me a huge hug when he heard the news; we were all so very pleased.  A new beginning that had been well anticipated by the entire family.  Now, having had to resign from my position to focus on my health, I am certainly not at any "beginning."  While I'm determined that I am not at an "end" point, "pause" doesn't feel that great either.

So, a weird day -- a potentially blue day.  The best defense is a good offense, isn't that the way it goes?   I am pre-emptively embarking on some long overdue projects with the intention of infusing myself with a sense of productivity and thus combat any potential pity party.  It helps that I am coming off another solid 8 hours sleep and have an energy surge.  Remember, this week was penciled in as a "good week" and my stamina SHOULD be better.  I intend to take full advantage!  Perhaps a date with Joe out to a DoG Street restaurant?  Fat Canary anyone?

But even the best meal with the best of company will not keep my heart from aching for my sister.

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A 20 year (and counting) tradition!

• Skype with beautiful brainy daughter in China?  Check.  
• Long phone call with sweet gonzo-volunteer son in Blacksburg?  Check.  
• Checkbook balanced?  Check (always a huge thrill for this numbers nerd).  
• Amazon sales (kids' textbooks) packed and ready for media mail?  Check.  
• Laundry started?  Check.  
• Family calendars (finally) completed and ready to mail?  Check.  
• Lunch date discussed with willing husband and preparations made for imminent departure?  Check.

Bull grabbed by horns?  Check.

Pity party averted?  Check!

Ten Terrific Hours on a Tempurpedic!

Friday - July 13, 2012

SLEEP!  The best in at least a month!  Puppies burrowed in, Joe snoozing alongside, FAB mattress that I appreciate every night, and the sounds of insects singing outside the window -- bliss, bliss, bliss!

Sadie's "Belly Belly" welcomes me home

My port remains accessed during this 5 day interlude between hospital stays as I am on a regimen of IV antibiotics to combat my E. coli and sepsis.  Luckily for those of us who have a port (yes, I seem to be reaching some kind of truce with my implant), I will enjoy the relative convenience of my sensation-free, manageable, out-of-the-way port rather than an arm IV.  A home health aide will come this afternoon to tutor me through the process.  Given the number of times I have seen an IV hooked up to my port access, I think it will be a snap! And yes there is an intentional pun in "snap" - it's one of the sounds of success in accessing the port.

Discharge Day?

Thursday - July 12, 2012

One of my art pieces featuring "an" - our family surname meaning "peace"

Five nights in Sentara and I am certainly ready to go home - to the company of family, to the comfort of routines, to the coziness of the couch, to the cuddles of the hounds.  On a tangent (and we all know how I love I good tangent!), yesterday Baxter learned to breech our backyard fence and nonchalantly scratched and barked to be allowed re-entry to the house at the front door - not once but three times! ....  Okay, back on topic.... I am hoping that this morning's bloodwork and the 48 hour check of Tuesday's blood culture will show enough progress that I will be discharged by early afternoon.  Time to go!


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The oncologist brought good news on my white blood cells;  as of 8:30 I was no longer deemed neutropenic.  How lovely to see everyone's full faces!  Reading eyes can certainly give a sense of expression but a mask truly masks full communication.  I so appreciate getting a complete view of naked faces.  And now the countdown is on for my discharge!  IV antibiotics?  Check.  Platelets?  Hmmm....  Platelets?  Excuse me.  May I please have my last infusion of platelets to creep my count above 20 so I can go home?  Hello?  Platelets?  ... Still waiting and waiting....  Yo!  Platelets, please?  Please?  sigh .....

And THEN!  Who should Joe find in the hall?  Who does Joe usher eagerly into my room?  Who must Joe photograph as he rummages for the camera (and Joe RARELY pulls out the camera)?  Why... it's "the cart."  Yes, "the CART" that my ex-RN, hospital-experienced mother-in-law has been talking about since early May.  She has sent me dollar bills as well as shared advice about possible purchases and we have had phone conversations about the perplexing lack of such a cart on both VCU's oncology floor and Bone Marrow Transplant Unit.  And now, JUST as we are chomping at the bit here at Sentara and packing our bags, the CART appears, administered by two young teens who are game but somewhat bewildered by our manifest excitement.  Joe and I were giggling like idiots.  The kids must have thought we were mad!  Such fun!

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6 hours since the oncologist ordered platelets and I am STILL WAITING!  My RN says the bottleneck is at the blood bank.  I am NOT pleased.

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7 hours after the order went in, my irradiated platelets have arrived from Norfolk and the 1.5 - 2 hour infusion has begun!  Yay!  My patience muscles have been well exercised today and I have succeeded in retaining my zen.  Soon, I will be OUT!  I am excited about breathing some fresh air before sunset!

An Unencumbered Night's Snooze (but a Grumpy Wake-up)

Wednesday - June 11, 2012

For all of you keeping up with my sleep totals (read: Megan and Jonathan in particular), I am happy to report that Monday night gifted me with five hours of slumber and that last night I slept unencumbered - with no tube connection between my port and my infusion pole.  Freedom of movement is a wonderful thing  :)

My night nurse was so unobtrusive and skillful in quietly doing my 6 a.m blood draw that I was able to fall back asleep!  And then ... a half hour later ... my door opened with a whoosh as the nursing assistant came in to introduce herself, change her name on the whiteboard, and tell me that she would be on all day.  Did she not notice that I was SLEEPING?!  Okay, I get it.  I am a hospital veteran.  Vitals MUST be taken on a schedule.  I replied as my normal chatty self,  roused myself from my restorative slumber, but was confused that I couldn't see her moving towards my vitals' cart.
"Don't you need to take my vitals?" I asked.
"Oh, I'll be back for that later.  Do you need anything before I leave?" she replied.
Ummmmm ... what do I NEED?  NOT to be woken up without CAUSE, perhaps!  To get as much REST as possible.
*** Nursing assistant introduction = epic FAIL. ***
Grump, grump, grump.  Yo!  Listen up!  Sleep-deprived cancer patients do NOT want to be roused simply to say hello! Grumpity, grump, grump.  Yes, I am happy to have enjoyed 6.5 hours sleep last night but OH perhaps it could have been more!  I am GREEDY for sleep.  I am EXHAUSTED. Grump, grump, grump.... GRUMP!!!
"Oh, I'm fine, thank you." I replied politely.

Okay.  All done now....

Street clothes are on, the bed is made, and I am now awaiting an 8 a.m. phone call from my VCU oncologist to review this week's sepsis and blood work.  Will I still be on schedule for next week's chemo?  I'll find out soon  :)

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Chemo should be green flagged for next Tuesday.  Final decision will hinge on my Monday morning bloodwork up at Dalton.

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My blue sky / green tree view!

 Evening update: A long, happy conversation with a college friend, a friendly conversation / consult with a hospitalist who is the mother of a former student, many visitors, only short interludes connected to my antibiotic-infusing pump, TWO milkshakes (!), a two hour nap (made possible by Carolyn's door sign), and blood work that indicates that my Neulasta may finally be stimulating some bone marrow activity:  my white blood cell count improved from 0.7 to 2.1.  I am back into single digits!  BOO-yah!  All in all, it has been a very fine day  :)

P.S. Can you believe that despite the 6:30 a.m. introduction / wake-up, I never again saw the nursing assistant?  Well, it was lucky that she didn't come back when Carolyn was here; she is more ... direct ... than most of us  :)

"Get to know other worlds, if only for comparison."

Tuesday -  July 10, 2012

A happy surprise!

Surprise!  Rachel and Casey arrived this afternoon with smiles behind their masks (as well as a delicious smoothie in hand!  My sisters know what my mucositis can tolerate).  When Rachel walked in, I did a double-take.  She was supposed to be in Williamsburg on Thursday so I immediately thought that I was lost in my timeless cancer world.  What day WAS it?  If Rachel was here, then it was Thursday, and therefore shouldn’t I be discharged?  I truly had a few moments of confusion.  So, was my lapse evidence of "chemo brain", inattention, fatigue, or simply losing track of time?  I’m going for the latter three - combined!.  After all, my wordplay skills remain (epically) sharp and improving (given all of my practice time)!  Nope, not chemo brain.

As someone who until Dec. 28, 2011 enjoyed very good health, I have certainly racked up hospital days in 2012.  Three of these six hospital stays have been unexpected surprises.  The first being that oops-we-nicked-your-bladder-while trying-to-harvest-a-lymph-node-surgery on May 2 that led to two weeks of limited function.  Then came my two unwelcome neutropenic fevers.  This last hospital stay has given me a chance to evaluate my inner city 781 bed VCU home-away-from-home against the suburban services provided here at Sentara’s newly constructed 145 bed Williamsburg location.

Sentara preferences

• The vibe is generally lower key with much less activity and personnel in the halls
• Everyone – without exception – asks “Is there anything that you need?” before exiting the room
• The facility (opened in 2006) “feels like new” throughout with simulated wood floors giving a nice homey touch to the room
• Better parking (just find a spot on the blacktop and walk right in; no waits at the garage)
• Better location (1 stop up the interstate)
• Better patient entrees (patient has control of timing as well)
• Huge windows in every room (but points off for bulky, obscuring curtains rather than completely retractable Roman blinds)
• Evening blood draws are at 6 a.m. rather than 2 a.m.

My nifty Sentara standing desk!

VCU preferences

• The vibe is generally more energetic with more life, activity, and personnel in the halls
• Everyone – without exception – knocks on the room door and then waits for acknowledgement before entering
• The RN shift change includes a patient introduction and bedside report with request for patient input
• The bed is firmly under control of the occupant who knows how she likes to sleep, thank you very much!  I have had to unplug the Sentara bed in order to disable the anti-bedsore, “it thinks it knows what I want / need” autopilot position adjustments multiple times an hour.  No WAY!  Where's that damn plug?
• VCU's teaching hospital status means that many physicians are present / dropping in to touch base about care and treatment status (as a fundamentally social animal who is still in good enough health to welcome visitors, I embrace the energy, company, and information)
• Better in-hospital food options for guests / visitors
• Both hounds are welcome to visit at the same time IF I am not neutropenic
• Free WiFi that blocks fewer sites than Sentara’s free service

Pick 'em

• Room size and amenities (IF comparing against VCU’s Adult Oncology floor)
• Standing desks available at both hospitals (that’s for Megan’s FYI)
• No HDTV.  Yes, at this juncture, I am spoiled - particularly when watching Wimbledon

It’s good to have options, yes?  Chemo?  Get me back to Floor 2 of VCU's Critical Care Hospital.  But for this E. coli surprise, I am happy to have Joe, Carolyn, and the thundering herd just down the road.  It's been lovely to be more relaxed close to home and under such fine care (and the frozen yogurt has been great since we know all the local haunts!).