Wednesday - December 31, 2014
Sometimes the best times are defined not by significant events but by the minutiae of the everyday. Simply being with the people you love best sustains us - enjoying the ordinary pleasures of sharing meals, laughing over a new game, strolling a new town, dog-handling three pets .... Happiness is spending time as a family at Christmas. Learning to knit, becoming ultra competent (and competitive) at Ticket to Ride, getting into "the mind of the judge" in Apples to Apples, and taking full advantage of every opportunity to laugh and eat and have fun. Together.
Merry end-of-2014 and Happy 2015!
Here's to more family time in the new year!
Wednesday, December 31, 2014
Sunday, November 30, 2014
Precious and Rare Days
Our 4th is behind the lens |
Megan is currently on her way back to Davis and yesterday Jonathan returned to Virginia after a short but fulfilling 48 hours of family Thanksgiving togetherness. As the children successfully engage on their independent trajectories, these interludes become less frequent, tremendously precious, and carefully guarded. Our farewells are easier this time around since we will be reconvening with board games, hounds, and family for a Christmas vacation in only 3 short weeks. Yeehaw!
I am also feeling refreshed after a month of waiting for - and yes worrying about - additional scans and tests to deal with a troubling Oct. 23 mammogram. Yes, I have had flagged mammograms and even positive PAP tests in my pre-lymphoma days but somehow in my new post-cancer incarnation, the uncertainty of those inconclusive, "can't be cleared" tests weighs heavy. After all, prior to every intrathecal (spinal tap) chemo and upon admission to my many in-hospital chemo stays, I was duly informed that my treatment might result in leukemia or - wait for it... - lymphoma! HA! We actually always laughed about the irony of the situation as I signed form after form after form, time after time after time. I confess that with the news of the "concerning mammogram", I worried. It nagged at me....
So our happy foursome gathering soon after my "all clear" felt a bit like a celebration :) But then again, it always is!
Thursday, October 23, 2014
Bamboo Blues
Thursday - October 23, 2014
Today felt a bit like time travel when I entered the newly remodeled UCSF Hematology clinic for my quarterly consult (and consoling hand hold from a professional). See that bamboo grass-infused laminated glass over there on the left? Well, if cancer has a specific decor, in my mind this is IT. My stomach truly dropped when I walked into the clinic's new digs and saw those frosted and clear room dividers. Slammed in the gut. Immediately, I was sucked into a vortex of memories from all those many many visits to VCU's Dalton Clinic with its EXACT same bamboo grass-infused laminated glass. Times when I could barely stand up and walk to get my vitals checked. A visit when I knew that I would not be allowed home that day but would be deemed neutropenic and ushered upstairs to a sterile hospital room. Visits with husband and children and sisters. Autumn and winter visits where the healthy people who I first saw in April 2012 were now in wheelchairs. That bamboo witnesses much terror, pain, disfigurement ... and caring, hope, and love (I need to focus on the latter).
I woke up today prepared for a trio of medical appointments (mammogram, infectious diseases intake meeting, oncology consult) that were simply routine -- procedural -- nothing to write home about since I am fully asymptomatic of lymphoma ... But then... a little bit of redecorating - some pretty panels of free form bamboo - kicked me in the teeth. So... it was a long day at 2 UCSF campuses. My plans for super productivity in the late afternoon have evaporated. Instead, I have cuddled with the dogs and walked outside on eucalyptus lined roads here in Sausalito above lovely Richardson Bay. My goal is to replace bamboo memories with eucalyptus reality. So far so good. Time for another walk....
Today felt a bit like time travel when I entered the newly remodeled UCSF Hematology clinic for my quarterly consult (and consoling hand hold from a professional). See that bamboo grass-infused laminated glass over there on the left? Well, if cancer has a specific decor, in my mind this is IT. My stomach truly dropped when I walked into the clinic's new digs and saw those frosted and clear room dividers. Slammed in the gut. Immediately, I was sucked into a vortex of memories from all those many many visits to VCU's Dalton Clinic with its EXACT same bamboo grass-infused laminated glass. Times when I could barely stand up and walk to get my vitals checked. A visit when I knew that I would not be allowed home that day but would be deemed neutropenic and ushered upstairs to a sterile hospital room. Visits with husband and children and sisters. Autumn and winter visits where the healthy people who I first saw in April 2012 were now in wheelchairs. That bamboo witnesses much terror, pain, disfigurement ... and caring, hope, and love (I need to focus on the latter).
I woke up today prepared for a trio of medical appointments (mammogram, infectious diseases intake meeting, oncology consult) that were simply routine -- procedural -- nothing to write home about since I am fully asymptomatic of lymphoma ... But then... a little bit of redecorating - some pretty panels of free form bamboo - kicked me in the teeth. So... it was a long day at 2 UCSF campuses. My plans for super productivity in the late afternoon have evaporated. Instead, I have cuddled with the dogs and walked outside on eucalyptus lined roads here in Sausalito above lovely Richardson Bay. My goal is to replace bamboo memories with eucalyptus reality. So far so good. Time for another walk....
Sunday, September 28, 2014
Summer Memories and Autumn Dreams
28th Anniversary breakfast at Fort Baker. Yum. |
I think that I can state with perhaps 85% confidence that my scourge lymphoma is retreating onto the back burner of my consciousness. Yes, perhaps "the emperor of all maladies" has robbed me of true peace of mind and does occasionally ambush me with ferocious inhumanity. For example, in August my first ever UTI had my emotions convinced that I was symptomatic of uterine or cervical cancer when my intellect knew that it was just a (very uncomfortable) UTI. I suppose cancer is indeed a thief that steals our complacency and assumption that "all is well."
However, think about that.... The flip side of this hyper-vigilance is that I feel even more aware and appreciative than my pre-lymphoma self. Reveling in time with children and husband, happy for summer visits with sisters and friends, content with our cheery and needy hounds, and working to see the positives and eliminate the stresses where I can. I am loving our new cadre of second graders and excited to see those wonderful now-third graders who made life so fun last year. The hills are gold outside my classroom window, Richardson Bay shines in the sun outside our apartment windows, and we are loving the fresh air and ocean breezes in Marin. Life is very very good. I am grateful for health, for connections, for time ....
Monday, August 11, 2014
Back on the Meds!
Watch for the number! A new system made it a crazy morning :) |
Well, all in all, the "off the meds" interlude was quite brief. After one week without the antacid, I was awake once more in the middle of the night fighting to keep my food down. Then Saturday, a week's worth of discomfort in my lower back and groin morphed into shingles. Yikes! There's no mistaking shingles! Who knows if the back pain and the virus are linked but 23 days without Acyclovir was enough of a window to allow the zoster virus to re-emerge into a bloom of blister stripes. We knew I was somewhat vulnerable since my childhood bout of chicken pox had blossomed as shingles when I was 25. Somehow my previous thyroid issues had also signaled an alarm. But 23 days was indeed quick; I was scheduled to get the shingles vaccine this week ... too late :) Very very uncomfortable. Happily, UCSF had a Saturday morning clinic where I rushed for a consult and a scrip for heavy doses of Acyclovir. I am on a week's course of antivirals, going back to the hospital for intermittent blood draws to check for adverse liver interactions. Today's blood draw signaled elevated liver enzyme levels that are above normal but still within my historical levels. So all looks good. As for the shingles? Ouch!
Thursday, July 17, 2014
Off the Meds!
Thursday - July 17, 2014
Today's periodic oncology consult ushered in the latest phase in my recovery: getting off the last of my medications. So long to my prescription strength antacid! We'll see if the GI issues of last year have healed and determine if I can eat (and retain) food without prescription assistance. So long to Acyclovir! This anti-shingles medication is continuing its negative impact on my liver enzymes (still elevated today). Rather than continuing the Acyclovir-induced liver damage, I'll probably opt to have the shingles vaccine in the next few weeks. Shingles is a concern because I actually had a (stress-induced?) bout of shingles the summer of 1986 while working in Taiwan and prepping for our September wedding. Our post-consult homework is to research the shingles vaccine. UCSF has administered it to 90+ post-Bone Marrow Transplant (BMT) patients with no adverse effects. Given the fact that my immune system is stronger than these patients, I should be able to avoid negative impacts. We'll see ....
My oncologist continues to help me "unring the bell" about moving forward -- BMT-free and scan-free -- with hope and optimism. My former medical team insisted that an allogeneic BMT was my best treatment option for long-term remission and cure. This plan was confirmed by a second opinion and is in accord with established and recently-affirmed national protocols. Having absorbed and accepted this information, the lack of follow-through continues to nag at me. I accept and welcome this gift of procedure-free living. But I remain vigilant. "Watchful waiting" doesn't take a holiday. Someday I'll be able to feel a flash of warmth or clamminess and not feel that twinge of worry. Someday ... but not quite yet. Next steps: shingles vaccine decision and continued bloodwork every three months to monitor markers that might signal a relapse.
All in all, that's a reason to celebrate!! Every month that passes without relapse signals a better prognosis. By some measures I am now 2 years NED (no evidence of disease). By my oncologist's timetable, I am now 1 year, 9 months disease-free since my last chemo treatment came to an end. By my own measure, I am now 2 years and 2 months beyond the dysfunction and disequilibrium of unrelenting pain and double vision. By any count, I am still in the clear and life is very VERY good :)
Today's periodic oncology consult ushered in the latest phase in my recovery: getting off the last of my medications. So long to my prescription strength antacid! We'll see if the GI issues of last year have healed and determine if I can eat (and retain) food without prescription assistance. So long to Acyclovir! This anti-shingles medication is continuing its negative impact on my liver enzymes (still elevated today). Rather than continuing the Acyclovir-induced liver damage, I'll probably opt to have the shingles vaccine in the next few weeks. Shingles is a concern because I actually had a (stress-induced?) bout of shingles the summer of 1986 while working in Taiwan and prepping for our September wedding. Our post-consult homework is to research the shingles vaccine. UCSF has administered it to 90+ post-Bone Marrow Transplant (BMT) patients with no adverse effects. Given the fact that my immune system is stronger than these patients, I should be able to avoid negative impacts. We'll see ....
My oncologist continues to help me "unring the bell" about moving forward -- BMT-free and scan-free -- with hope and optimism. My former medical team insisted that an allogeneic BMT was my best treatment option for long-term remission and cure. This plan was confirmed by a second opinion and is in accord with established and recently-affirmed national protocols. Having absorbed and accepted this information, the lack of follow-through continues to nag at me. I accept and welcome this gift of procedure-free living. But I remain vigilant. "Watchful waiting" doesn't take a holiday. Someday I'll be able to feel a flash of warmth or clamminess and not feel that twinge of worry. Someday ... but not quite yet. Next steps: shingles vaccine decision and continued bloodwork every three months to monitor markers that might signal a relapse.
All in all, that's a reason to celebrate!! Every month that passes without relapse signals a better prognosis. By some measures I am now 2 years NED (no evidence of disease). By my oncologist's timetable, I am now 1 year, 9 months disease-free since my last chemo treatment came to an end. By my own measure, I am now 2 years and 2 months beyond the dysfunction and disequilibrium of unrelenting pain and double vision. By any count, I am still in the clear and life is very VERY good :)
Friday, June 20, 2014
First Day of (my) Summer!
A pattern block eaglet courtesy of some splendid 2nd graders! |
As of 3:45 this afternoon, summer has officially fledged! Yes I may be referencing the onset of summer as heralded by all three of the Decorah eaglets having fledged as of this afternoon (!), but I am also officially and EXPLICITLY in a quieter mode after finishing 3 days of math professional development at 3:45. Since our amazing second graders wrapped up class 2 weeks ago today, life has been chock full with:
- a visit with Jonathan here in the Bay area
- packing out of my classroom
- 2 days of workshops and meetings at school
- travel with Jonathan to Dulles
- moving Jonathan into his new Arlington apartment (read lots of unpacking, Ikea shopping, furniture hauling, furniture assembly etc.!)
- visiting Rachel and family in Winchester
- meeting Megan in Philadelphia and traveling with her to visit Joe's mom in Pennsylvania
- visiting with many family and friends in Northern Virginia
- and then returning to San Francisco to wrap up this 2 week frenzy of action with 3 (very interesting) days of math training.
Megan and Maureen |
Oh, who am I kidding?! I have too much fun prepping and that math training was absolutely great - so inspiring! Exception to the rule: surfing the net and prepping materials on my computer at night won't count against that 1 day/week goal :)
Saturday, May 31, 2014
A Manic Month
At least the hounds are relaxed (most of the time) |
Better to be busy than bored but ... we have been going flat out all month and it doesn't look like we'll return to a normal rhythm until June 27. Yes - June 27. Joe's May 5 trip to DC initiated this manic period and over the next 4 weeks he and I will be continuing a very unusual schedule where we are alternating travel back and forth. It's probably one of the oddest intervals we've had in many many years! Highlights have included Megan and me traveling east for Jonathan's Virginia Tech graduation, seeing my sister Rachel in Blacksburg, and Joe and Jonathan's current midwest Major League Baseball 9 ballpark tour. Upcoming events include the end of my school year (and perhaps a resumption of restorative sleep patterns!), another east coast trip to help move Jonathan into his Arlington apartment and to see Joe's mom, and then seeing Megan off on her summer travels to Kyoto. With all of this commotion, I am marking my calendar for the 2 days and 3 nights that the 4 of us will be all together here in our perch on the hill. One of the kids will be camping out on the living room couch as we cram into the apartment but it's precious time. We'll savor it!
Sunday, May 11, 2014
2 Years (and counting...)
Sunday - May 11, 2014
Finally, my long diagnostic journey ended 2 years ago today with an after-hours phone call from my new oncologist. He used the words "stage 4" as well as "cure" in that conversation. Carolyn and I were taking careful notes so we could share details with Joe, Megan, and Jonathan, all of whom were spread out across the continent and awaiting the news. Today - 2 years after that horrible news/ hopeful news telephone call - Megan and I walked around the Whole Earth Festival in Davis where she had wandered around waiting for that final cancer verdict on May 11, 2012. What a difference to traipse around together on a perfect northern California spring day exploring the craft booths, vegan dining, drum circles, and hula hoop / hackey sack diversions. No migraines. No double vision. Just the opportunity to enjoy another interlude of small pleasures and family company. Another great day of loving being a mom!
I am certainly not going to use the "cure" word anytime soon BUT it is comforting to know that my oncologists hold it out as a possibility and that my odds improve with every month of "No Evidence of Disease." So here's one happy mom on Mother's Day. Grateful. Healthy. Thrilled to have had these 2 years and wishing for many more.
Finally, my long diagnostic journey ended 2 years ago today with an after-hours phone call from my new oncologist. He used the words "stage 4" as well as "cure" in that conversation. Carolyn and I were taking careful notes so we could share details with Joe, Megan, and Jonathan, all of whom were spread out across the continent and awaiting the news. Today - 2 years after that horrible news/ hopeful news telephone call - Megan and I walked around the Whole Earth Festival in Davis where she had wandered around waiting for that final cancer verdict on May 11, 2012. What a difference to traipse around together on a perfect northern California spring day exploring the craft booths, vegan dining, drum circles, and hula hoop / hackey sack diversions. No migraines. No double vision. Just the opportunity to enjoy another interlude of small pleasures and family company. Another great day of loving being a mom!
I am certainly not going to use the "cure" word anytime soon BUT it is comforting to know that my oncologists hold it out as a possibility and that my odds improve with every month of "No Evidence of Disease." So here's one happy mom on Mother's Day. Grateful. Healthy. Thrilled to have had these 2 years and wishing for many more.
Saturday, May 10, 2014
An Unscarred Liver
Saturday - May 10, 2014
It has been a quiet week of alone time with the hounds. Joseph is away on travel and I am hunkered down prepping for the upcoming trip east with Megan to celebrate Jonathan's second (and last!) graduation from Virginia Tech. Substitute plans and two weeks of advance class preparations have kept me focused and grateful as I approach tomorrow's "diagnosis day" milestone. I revel in my ability to see out of both eyes and to live migraine-free! To have regained my health! Hurrah!
Peace of mind has also come in the form of good news from UCSF. My liver specialist writes that "I reviewed the pathology and the biopsy did not reveal any specific diagnosis. This is good news and makes me suspect drug-induced liver injury as the cause of your liver enzyme elevation. Are you still taking acyclovir? I have seen mild liver enzyme increases with acyclovir. Importantly, I did not see any evidence of scarring (fibrosis) on the liver biopsy that might have come from your prior high-dose methotrexate use. And good news - your liver enzymes went down too! But now we know for the future that, in the absence of significant scarring, we can be more "tolerant" of liver enzyme elevations if they occur again in the future." So .... that sounds like we're simply not going to worry about those enzyme numbers anymore, yes? I await confirmation that we are now in "watchful waiting" mode #2 for my liver.
Waiting is preferable to treatment. I'll take it ANY day!
Dog walks are fabulous excuses to drink in this phenomenal view! |
It has been a quiet week of alone time with the hounds. Joseph is away on travel and I am hunkered down prepping for the upcoming trip east with Megan to celebrate Jonathan's second (and last!) graduation from Virginia Tech. Substitute plans and two weeks of advance class preparations have kept me focused and grateful as I approach tomorrow's "diagnosis day" milestone. I revel in my ability to see out of both eyes and to live migraine-free! To have regained my health! Hurrah!
Peace of mind has also come in the form of good news from UCSF. My liver specialist writes that "I reviewed the pathology and the biopsy did not reveal any specific diagnosis. This is good news and makes me suspect drug-induced liver injury as the cause of your liver enzyme elevation. Are you still taking acyclovir? I have seen mild liver enzyme increases with acyclovir. Importantly, I did not see any evidence of scarring (fibrosis) on the liver biopsy that might have come from your prior high-dose methotrexate use. And good news - your liver enzymes went down too! But now we know for the future that, in the absence of significant scarring, we can be more "tolerant" of liver enzyme elevations if they occur again in the future." So .... that sounds like we're simply not going to worry about those enzyme numbers anymore, yes? I await confirmation that we are now in "watchful waiting" mode #2 for my liver.
Waiting is preferable to treatment. I'll take it ANY day!
Wednesday, April 30, 2014
Liver, liver, whaddya know?
Wednesday - April 30, 2014
A liver biopsy is quick, painless, and generally complication-free. The only real inconvenience is the waiting and resting before you are cleared to go home. Altogether, Megan and I were at the hospital for 6 hours today. Ultrasound, then biopsy (LONG needle), then hours and hours in the recovery room waiting for any internal bleeding to manifest (it didn't) and for a later blood test to come back clear (it did). I used my medical moxie today to lobby successfully for a liver panel to be added to the customary post-biopsy blood draw. It's always good to have more data points to try to determine where my enzymes are and why they might be at that level. "Good idea," said the doctor. "At this point I am an old-hand, self-advocating, professional patient," I thought. BOO-yah for getting more tests with one blood draw!
Megan prepared for her upcoming qualification exams alongside my gurney while I read and at one point gave in to the temptation of resting supine for hours and just napped. Although we were only curtained off from a very busy and crowded recovery room, it was surprisingly peaceful and free of interruptions. Rather calm.
The liver specialists believe that my methotrexate infusions may have scarred my liver. Perhaps the biopsy will confirm this theory. Results may be in within the week.
A liver biopsy is quick, painless, and generally complication-free. The only real inconvenience is the waiting and resting before you are cleared to go home. Altogether, Megan and I were at the hospital for 6 hours today. Ultrasound, then biopsy (LONG needle), then hours and hours in the recovery room waiting for any internal bleeding to manifest (it didn't) and for a later blood test to come back clear (it did). I used my medical moxie today to lobby successfully for a liver panel to be added to the customary post-biopsy blood draw. It's always good to have more data points to try to determine where my enzymes are and why they might be at that level. "Good idea," said the doctor. "At this point I am an old-hand, self-advocating, professional patient," I thought. BOO-yah for getting more tests with one blood draw!
Megan prepared for her upcoming qualification exams alongside my gurney while I read and at one point gave in to the temptation of resting supine for hours and just napped. Although we were only curtained off from a very busy and crowded recovery room, it was surprisingly peaceful and free of interruptions. Rather calm.
The liver specialists believe that my methotrexate infusions may have scarred my liver. Perhaps the biopsy will confirm this theory. Results may be in within the week.
Friday, April 25, 2014
A Thought - full Day
Friday - April 25, 2014
Today - my father's birthday - is always bittersweet. Our father, Herb Carter, would have celebrated his 82nd birthday today but he died suddenly of an aortic aneurysm shortly after celebrating his 63rd birthday. So many years have passed, milestones commemorated, grandchildren born, all without his cheery, impish, supportive presence. Herb Carter was truly a marvelous man. I miss him, I miss him, I miss him and yet - daily - I am heartened and amazed by the abiding strength of his love and connection. A cherished legacy. What a remarkable father! He can still make me smile through my tears. I thank God that he did not suffer a long death and that he did not endure the anxiety and grief of facing a long illness. One day he was excitedly enjoying family travel in Australia and the next day after a brief hospital visit he was gone - within minutes - in a Sydney ER.
This year's ache of his loss is deepened and refracted by the news that a dear YOUNG friend has relapsed a second time with Hodgkins Lymphoma and is now preparing for an allogeneic Bone Marrow Transplant. Our prayers and thoughts are focused fully on her and her family and our anxiety is channeled into action. Bone Marrow donation remains the exception rather than the norm yet it is not the invasive bone marrow biopsy technique that exists as common knowledge (NOTE: my bone marrow biopsy was equivalent to the painfree pressure / discomfort of my c-section and remember that this invasive procedure was done by a MED STUDENT with an oncology fellow telling him what to do step by step sotto voce right behind my manhandled hip). Today's bone marrow donation is essentially a longer kind of blood donation. If we simply spread the word that the common image is OUTDATED and WRONG, perhaps more people will register and more of us who suffer from blood cancers will have an opportunity for treatment and for long-term survival.
An allogeneic
Bone Marrow Transplant still looms for me as my next
step in case I relapse. And yet, I have already batted ZERO off the
Bone Marrow Registry. There's nothing quite like that knife-slice
knowledge that you have NO MATCH coming off the registry. That's it.
An allogeneic bone marrow transplant is the last medical step and
recommendation to thwart that scourge cancer. But no one matches you.
You have come up EMPTY. What next? You're on your own. Just you, your
own oblivious malfunctioning bone-marrow, and that conniving cancer
that has duped / invaded / hijacked your body. There's nothing equal to
that pit in your stomach as you face mortality straight-up, as you see
your kids' terror as they try to stay strong for your sake. And yet,
you know that there MUST be a match somewhere - in someone. If only a
donor would come forward with a quick cheek swab and then perhaps an
outpatient simple blood donation process. If only ... if only. Have
you registered as a donor?
Megan says it better.
"Some difficult news has struck a community that is very dear to me and the next few months might be hard for all of us. If you see that I'm sad and you're looking for something that you can do I have MANY suggestions:
* Please, please, please if you are considering signing up to be a bone marrow donor and have not yet gone through with it, go to be http://bethematch.org/ and get a kit to swab your cheek for free
* If you need any information that might make you more comfortable with being a donor, feel free to ask me. The normal, outpatient procedure if you're asked to donate is a week of shots and a few hours donating blood in a chair.
* If you've got some spare change, donate to Elizabeth Stone's efforts to fundraise for the Leukemia and Lymphoma society or drop some running hints before her *half marathon* in two days. http://pages.teamintraining.org/nca/nikewhlf14/elizabethstone
* If you're already on the registry or you're not able to donate, see if you can spend some time this week dispelling the misinformation about donation. No big needles. No nights in the hospital. No long term health risks.
* Pause and take some time to get some perspective on your day. Life may be difficult, unfair, and heartbreaking, but we are here and we have the opportunity to share so much gratitude and hope! Keep the faith. Take care of each other. Believe in magic. Those words have never been more true."
Today - my father's birthday - is always bittersweet. Our father, Herb Carter, would have celebrated his 82nd birthday today but he died suddenly of an aortic aneurysm shortly after celebrating his 63rd birthday. So many years have passed, milestones commemorated, grandchildren born, all without his cheery, impish, supportive presence. Herb Carter was truly a marvelous man. I miss him, I miss him, I miss him and yet - daily - I am heartened and amazed by the abiding strength of his love and connection. A cherished legacy. What a remarkable father! He can still make me smile through my tears. I thank God that he did not suffer a long death and that he did not endure the anxiety and grief of facing a long illness. One day he was excitedly enjoying family travel in Australia and the next day after a brief hospital visit he was gone - within minutes - in a Sydney ER.
This year's ache of his loss is deepened and refracted by the news that a dear YOUNG friend has relapsed a second time with Hodgkins Lymphoma and is now preparing for an allogeneic Bone Marrow Transplant. Our prayers and thoughts are focused fully on her and her family and our anxiety is channeled into action. Bone Marrow donation remains the exception rather than the norm yet it is not the invasive bone marrow biopsy technique that exists as common knowledge (NOTE: my bone marrow biopsy was equivalent to the painfree pressure / discomfort of my c-section and remember that this invasive procedure was done by a MED STUDENT with an oncology fellow telling him what to do step by step sotto voce right behind my manhandled hip). Today's bone marrow donation is essentially a longer kind of blood donation. If we simply spread the word that the common image is OUTDATED and WRONG, perhaps more people will register and more of us who suffer from blood cancers will have an opportunity for treatment and for long-term survival.
Megan says it better.
"Some difficult news has struck a community that is very dear to me and the next few months might be hard for all of us. If you see that I'm sad and you're looking for something that you can do I have MANY suggestions:
* Please, please, please if you are considering signing up to be a bone marrow donor and have not yet gone through with it, go to be http://bethematch.org/ and get a kit to swab your cheek for free
* If you need any information that might make you more comfortable with being a donor, feel free to ask me. The normal, outpatient procedure if you're asked to donate is a week of shots and a few hours donating blood in a chair.
* If you've got some spare change, donate to Elizabeth Stone's efforts to fundraise for the Leukemia and Lymphoma society or drop some running hints before her *half marathon* in two days. http://pages.teamintraining.org/nca/nikewhlf14/elizabethstone
* If you're already on the registry or you're not able to donate, see if you can spend some time this week dispelling the misinformation about donation. No big needles. No nights in the hospital. No long term health risks.
* Pause and take some time to get some perspective on your day. Life may be difficult, unfair, and heartbreaking, but we are here and we have the opportunity to share so much gratitude and hope! Keep the faith. Take care of each other. Believe in magic. Those words have never been more true."
Thursday, April 17, 2014
No More Scheduled Scans
Wednesday - April 17, 2014
Today's big (good) news from the oncologist is that he does not advise scheduling regular and routine PETs and MRIs. Given the fact that I remain symptom-free 18 months since my last chemo round, the danger of excessive radiation outweighs the potential of early red flags. The plan going forward is that I will visit clinic and see my oncologist every three months while staying (hyper) vigilant for symptoms such as night sweats, fever, and any lumps. So I am off the hook for full body x-rays for the near future!
Today's other (not-so-wonderful) news from the clinic is that my liver enzymes are all way back up - back to the post-methotrexate highs of Virginia. I have no symptoms of liver disease. Without the steady iterations of blood tests, we would have no clue about the liver enzymes. But the blood doesn't lie so the time has come for that much debated liver biopsy to try to determine what inflammation or disease is producing these stubbornly elevated levels. I'm scheduled for the day-long, out-patient procedure in two weeks. Can you believe that we're on yet another diagnostic journey? At least we know that scans have shown that my liver and other nether regions are tumor-free. Cancer won't be the answer in this case. But what exactly is causing these stubborn liver enzymes to be so out of whack?
Today's big (good) news from the oncologist is that he does not advise scheduling regular and routine PETs and MRIs. Given the fact that I remain symptom-free 18 months since my last chemo round, the danger of excessive radiation outweighs the potential of early red flags. The plan going forward is that I will visit clinic and see my oncologist every three months while staying (hyper) vigilant for symptoms such as night sweats, fever, and any lumps. So I am off the hook for full body x-rays for the near future!
Today's other (not-so-wonderful) news from the clinic is that my liver enzymes are all way back up - back to the post-methotrexate highs of Virginia. I have no symptoms of liver disease. Without the steady iterations of blood tests, we would have no clue about the liver enzymes. But the blood doesn't lie so the time has come for that much debated liver biopsy to try to determine what inflammation or disease is producing these stubbornly elevated levels. I'm scheduled for the day-long, out-patient procedure in two weeks. Can you believe that we're on yet another diagnostic journey? At least we know that scans have shown that my liver and other nether regions are tumor-free. Cancer won't be the answer in this case. But what exactly is causing these stubborn liver enzymes to be so out of whack?
Wednesday, April 16, 2014
Best MyChart Message Ever
Just got that most excellent clear-scan news via UCSF MYchart! Hurrah!! Time to breathe!!
"Subject: MRI and PET/CT normal
Hi Ms. Ammirati,
Hope you are doing well. I wanted to let you know that both your MRI and PET/CT were normal.
I think we should discuss decreasing the frequency of the scans at this point. See you in clinic on Thursday."
And that's all we needed to know, thank you very much!
Monday, April 14, 2014
2014's Scan Day #1
China Basin looking towards the ballpark |
6 months is a long time to wait but this morning the opportunity came once again to get that precious sneak peek inside body and brain via IVs, contrasts, PET, and MRI. Watchful waiting is UP! It's time to reconcile my lack of outward symptoms with the internal evidence. It's time to rule out any lymphoma lurking in bone, blood, and organ. It's time to get that delicious go- ahead to once again breathe easy and get on with it.
The all-morning scan routine is now familiar, almost procedural, but it is still a jolt to bear witness to the visceral fears and manifest tears of a radiology waiting room. Families huddle in the hall on cell phones parsing allowances and details with insurance companies. Hospital-braceleted patients sit in chairs looking more exhausted than worried. It's the families that seem to show the strain. Going in with hair and energy brings on feelings of both gratitude and guilt. I am very very fortunate indeed and I count my blessings.
My predictable pre-scan anxiety has been somewhat dissipated by activity -- work (of course), a happy visit from Arlington friends, excitement and vicarious nerves for Megan's qualifying exams (today!), and planning for Jonathan's May graduation and June move to Arlington to begin his job. Now comes the wait for my oncologist's phone call. Or will he just tell me the news when I see him on Thursday? Time for some more watchful waiting.
Saturday, March 29, 2014
Family Is Where You Make It
Saturday - March 29, 2014
My thoughts are in Colorado today, remembering and feeling appreciative of a quick-as-a-whip, no-nonsense, gracious, and game-for-adventure lady who occupied a special familial role in my sister's life. She and Carolyn shared a unique and intimate connection that transcended their neighborly status. They shared the daily rhythms of the children's activities, special events such as a recent roller derby outing, and (over the last 18 months) the debilitating and depressing routine of chemo, doctors' appointments, and medical tests. Yes, Carolyn was there for her... but over the years she was there for Carolyn - a motherly figure ready with opinions and hands-on support and laughter - and for that I am profoundly grateful.
This morning, this strong woman succumbed to the cancer which had reappeared only one month ago. She had faced her relapse with unflagging grace and tremendous faith. I am so terribly sad. Sad for my sister's dear friend and for her sons and grandchildren, aching for my sister and her children and their loss of such a force and touchstone in their lives, and yet tremendously grateful that this relationship existed - exists! Family can be found anywhere if a bond is sparked and hearts are open. Family can be found in the light shining through a front window in the house across the street. Family bonds can be forged by shoveling walks, putting newspapers on the front stoop, checking to see if you went to your college class when you spy a car in the driveway, and being available at the drop of a hat for dinners, errands, activities, and company. Family means running to an open pharmacy at 3 a.m., cuddling in hospital beds, and holding a hand in hospice. Family is where you make it. Family is to be celebrated and treasured. Thank you, Mary. Thank you for being family to my sister. She needs you.
My thoughts are in Colorado today, remembering and feeling appreciative of a quick-as-a-whip, no-nonsense, gracious, and game-for-adventure lady who occupied a special familial role in my sister's life. She and Carolyn shared a unique and intimate connection that transcended their neighborly status. They shared the daily rhythms of the children's activities, special events such as a recent roller derby outing, and (over the last 18 months) the debilitating and depressing routine of chemo, doctors' appointments, and medical tests. Yes, Carolyn was there for her... but over the years she was there for Carolyn - a motherly figure ready with opinions and hands-on support and laughter - and for that I am profoundly grateful.
This morning, this strong woman succumbed to the cancer which had reappeared only one month ago. She had faced her relapse with unflagging grace and tremendous faith. I am so terribly sad. Sad for my sister's dear friend and for her sons and grandchildren, aching for my sister and her children and their loss of such a force and touchstone in their lives, and yet tremendously grateful that this relationship existed - exists! Family can be found anywhere if a bond is sparked and hearts are open. Family can be found in the light shining through a front window in the house across the street. Family bonds can be forged by shoveling walks, putting newspapers on the front stoop, checking to see if you went to your college class when you spy a car in the driveway, and being available at the drop of a hat for dinners, errands, activities, and company. Family means running to an open pharmacy at 3 a.m., cuddling in hospital beds, and holding a hand in hospice. Family is where you make it. Family is to be celebrated and treasured. Thank you, Mary. Thank you for being family to my sister. She needs you.
Monday, March 10, 2014
Waves of Fury (Tinged with Fear)
Enjoying the beauty of California is a salve |
Carolyn has suggested that I might have a twinge of PTSD and, while I believe she may be onto something, sometimes the blues are 100% valid. Trauma is justified. My armor of good cheer and optimism has been battered in the last week by ... news of a cancer death, a cancer relapse, and a cancer diagnosis in my small little slice of the social universe. Relentless. Insidious. Horrible cancer. Too many families suffering too much pain. So I try to refortify my armor by holding my family close, smiling when thinking about friends, snuggling the hounds, working way too much (but sleeping far too little), counting the days until my April 14 scan, and praying for these families fighting this scourge. Battle on.
Friday, February 28, 2014
Farewell to a Happily Uneventful February
A UCSF diversion |
Well, isn't it nice to have so little medical news to report? Thankfully this medical blog does not require much updating these days and for that lack of reporting I am deeply grateful. That being said, I can't say that I am sad to bid farewell to February. I suffered through another horrible Christine-typical month-long cold and cough (my third of the school year), some major blues (perhaps due to Jonathan's return to the East Coast? perhaps due to missing my East Coast communities?), and epic fatigue caused by what now appears to be systemic sleep-deprivation from 2 a.m. awakenings.
But as I have drilled into the children, we "focus on the positives" in this house. So I affirm that I am blessed with a strong loving family and sustained remission from the scourge of Stage IV lymphoma. My liver enzymes are elevated but not increasing. My GI issues seem to be responsive to meds and under control. I am living in a glorious locale, very close to Megan, immersed in nature, and enjoying perpetual spring and glorious views of sea, land, and sky. I have hounds to cuddle and caretake, friends to keep me cheery by keeping in touch, meaningful work to keep me fully engaged, an amazing cohort of energetic (and funny) second graders to fill me with joy, and continued good news on the medical front to stave off those pesky mortality statistics. My next scan and oncology consult is the week of April 14 - only 6 weeks away. If (when?) I clear that milestone, I think I will settle down. The anxieties may dissipate. Longed-for nights of elusive sleep may return. Wow. Six weeks once meant 2 rounds of in-hospital chemo. Now I am free to be looking forward, to be port-free, and to be positive. I am tired but I am positive :)
Sunday, January 26, 2014
Statistics
Sunday - January 26, 2014
Thursday was a full day of medical appointments - bouncing around between 2 UCSF campuses. Appointments focused on my lifelong inability to shake coughs/colds, the continuing mystery of my elevated liver enzymes, my (improved but extant) gastro distress, and of course the specter of stage 4 DLBC lymphoma. So while I am very happy to have a new game plan to address my persistent colds and am relieved to put off a liver biopsy for at least another month, I am most contemplative about my conversation with my oncologist.
The urgency of VCU's Bone Marrow Transplant plan hovers uneasily above my current health, undermining my piece of mind. VCU and our second opinion at UMD placed such an emphasis on securing that allogeneic BMT. I was even considered for an NIH clinical trial as a means to get me that (dangerous) life-saving BMT. But no match came off the Be the Match registry. And it turned out that I was NOT eligible for the NIH trial (because I had not relapsed - thank God). My last option was a mini-haplo at John Hopkins where the lymphoma specialist said I should not undergo a BMT unless/until I relapsed. UCSF strongly concurs with Hopkins.
My oncologist emphasizes that statistics are my friend. As every month passes without relapse, my odds improve. As noted in yesterday's wrenching article in the New York Times, "these survival curves, called Kaplan-Meier curves, are one way we measure progress in cancer treatment, plotting the number of patients surviving over time." In my case, the greatest chance of relapse is (was?!) in year 1. I am acutely aware that I am certainly not out of the woods. I am semi freaked out every time I awake slightly damp or feel tired at the end of the day. Can you imagine my angst if I ever got a headache? Particularly on my left side? However, the radiation of the PET and MRI scans carry their own risks. What to do? Well, given statistics, we are going to wait until April vacation for my next round of scans. We are going to wait for 6 months rather than our previous 3 month interval. And I am going to try to shake the worry and those jangled nerves.... Focusing on the positives of my health.... Being mindful of my many continued blessings....
Thursday was a full day of medical appointments - bouncing around between 2 UCSF campuses. Appointments focused on my lifelong inability to shake coughs/colds, the continuing mystery of my elevated liver enzymes, my (improved but extant) gastro distress, and of course the specter of stage 4 DLBC lymphoma. So while I am very happy to have a new game plan to address my persistent colds and am relieved to put off a liver biopsy for at least another month, I am most contemplative about my conversation with my oncologist.
The urgency of VCU's Bone Marrow Transplant plan hovers uneasily above my current health, undermining my piece of mind. VCU and our second opinion at UMD placed such an emphasis on securing that allogeneic BMT. I was even considered for an NIH clinical trial as a means to get me that (dangerous) life-saving BMT. But no match came off the Be the Match registry. And it turned out that I was NOT eligible for the NIH trial (because I had not relapsed - thank God). My last option was a mini-haplo at John Hopkins where the lymphoma specialist said I should not undergo a BMT unless/until I relapsed. UCSF strongly concurs with Hopkins.
My oncologist emphasizes that statistics are my friend. As every month passes without relapse, my odds improve. As noted in yesterday's wrenching article in the New York Times, "these survival curves, called Kaplan-Meier curves, are one way we measure progress in cancer treatment, plotting the number of patients surviving over time." In my case, the greatest chance of relapse is (was?!) in year 1. I am acutely aware that I am certainly not out of the woods. I am semi freaked out every time I awake slightly damp or feel tired at the end of the day. Can you imagine my angst if I ever got a headache? Particularly on my left side? However, the radiation of the PET and MRI scans carry their own risks. What to do? Well, given statistics, we are going to wait until April vacation for my next round of scans. We are going to wait for 6 months rather than our previous 3 month interval. And I am going to try to shake the worry and those jangled nerves.... Focusing on the positives of my health.... Being mindful of my many continued blessings....
Monday, January 20, 2014
A Wonderful Month
Jonathan birthday gift unwrapping (in the ER) |
Today is the official end to our fabulous month of our winter holiday and simply being together. I've just returned from driving Megan back to Davis, Jonathan left for his final semester at Virginia Tech on Friday morning, and Joe and I will now recalibrate and return to our comfortable empty nest routine. Our month was marked by explorations of Marin, lots of fabulous meals around town and at home, movies, board games, and of course much cuddling with the hounds and watching sports. Much downtime, lots of hanging out, with Joe taking time off work and me succeeding in holding off lesson planning for large swaths of time. Jonathan hunkered down on the living room couch as we stretched the limits of our tiny apartment above the bay. It was all worthwhile. Who knows when we'll have this luxurious block of time to relax and spend time together?
We wrapped up our month with Jonathan's 23rd birthday celebration on Thursday. With Megan coming back from Davis to share the day, the kids went into the city for a meal and movie (while Joe and I worked) and then returned to Sausalito with the plan for dinner birthday festivities. However, it's good to be flexible and - long story short - we ended up unexpectedly celebrating Jonathan's 23rd in the hallway of San Francisco General's ER. This surprise diversion was just a precautionary observation of Joe and some extant issues yet it still raised the adrenalin. And an inner city ER is QUITE a scene, giving us ample reasons - once more - to be grateful for our good health and connection. All's well that end's well. A birthday to remember :) A month to cherish.
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