Breathe Easy Lil’ Weezy

Dear Lil’Wayne fans,

I’m sorry if I mislead you. This post is in fact, not about Lil’Wayne at all. I just needed a catchy rhyming title. In order to not totally upset anyone that clicked hoping to hear some news about Holygrove’s finest, here is a gif of Weezy dancing in front of an Audi.

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In other totally unrelated news…

Thoracentesis is the WORST, am I right?!

Otherwise known as a lung tap, a necessary evil after noticing an increase in shortness in breath over the past few months. At first I chalked it up to not being active enough but then it became more frequent and intense in situations that it should not occur at all.

I had this procedure twice before a while back. It is necessary when there is excess fluid buildup (called pleural effusion) between the lungs and the chest wall. Below is the before and after of my actual chest x-ray. Fluid exists on both sides but it is far worse where I circled it in red.

*Please note that the weird gadget you see so clearly on the left side of the image is my chest port. I can’t be totally sure, but I don’t think that having a port is quite enough to make me a cyborg*

Overall they were able to remove almost half a liter of excess fluid in hopes of taking some pressure off of the lung to breathe easier.

Now, the last time I had this procedure I described it in graphic detail and even included a diagram to illustrate. I do recall that this was poorly received by family/friends/readers so instead I will provide a less gross, creative representation of what a lung tap is kind of like.

You know, like if my body is a Capri Sun pouch, and the straw is the tube in my back, and the weird melting kids are fluid being extracted…

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Better?

I must give credit to the best crew: Evelyn, Laura, and Sheila for sticking with me, playing relaxing music, trying to make me laugh whenever possible, rubbing my arms when I was crying or the discomfort was too much, and not giving up even though my body was not totally cooperating.

If anyone was listening outside of the door of that exam room they would be met with utter confusion as the mood bounced pretty quickly back and forth from rip-roaring laughter to hysterical crying with some whale songs mixed in.

I wish I could say that I woke up the next morning feeling total relief but unfortunately I am still pretty short of breath. Not worse than before but not better. The hospital contacted me when I got to work yesterday and urged me to go back to the hospital as soon as possible for another chest x-ray as it appears there may be a “loculation” (jelly like pocket of fluid that happen from multiple lung taps) or “pneumothorax” (abnormal collection of air in the chest cavity from puncture in the lung).

Totally freaked out, I had an involuntary ugly-cry in my office and asked Doug (or front desk advising SAINT) to reschedule my last 6 appointments so I can leave by 2pm.

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Ever the voice of reason, Doug reminded me that my health is priority no matter how busy work is. He found a way to reschedule ALL of my appointments for the day so I could head to the hospital immediately. I am so grateful to my colleagues that always step up to make my life a little easier during tough times.

On my way out I ran into Laurie, a colleague that oversees many offices in my division, and despite her busy day she dropped everything and gave me a ride to Women and Infants. Normally I would drive myself but I was too emotionally drained to be stubborn when she offered. I’m so glad that I accepted the help and we ended up having a nice morning together (considering the circumstances).

I was able to have a speedy x-ray and speak with a radiologist. Luckily, it does not appear that the lung was punctured. THANK GOODNESS! It does appear that there is pocket of air outside of the lung. Because that air is there and shouldn’t be, the lung cannot fully expand which lends itself to the continued shortness of breath.

Sheila and Evelyn suspect that when we did the procedure and were having trouble finding the “sweet spot” where the fluid is and hitting resistance, she hit a loculation (pocket of jelly-like fluid) and that is now where the air is. This is pretty much the best case scenario because it would mean the air is not escaping from the lung and that in time it will just resolve itself. What a relief.

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So that’s that.

At the insistence of my colleagues, I’m taking a few days off to rest and let me lungs do their thing and returning to work on Monday.  I feel guilty for not being there during such a high volume time but as Doug said, it’s not the end of the world and everything will get done. I am no good to anyone else if I’m not 100%. I’m physically and mentally drained. I definitely need this time to get centered and take care of myself.

I’m always reminded of a lesson one of my graduate professors instilled in us:

There is a reason on planes that you put your oxygen mask on first before helping others. If you can’t breathe, you can’t possibly help anyone else survive.

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Also- there is a new treatment plan in the works but to be honest, this post is long enough. I’ll keep you updated soon. What I will say for now is that I will still have two more weeks of Taxol before we switch to something else.

Countdown to real hair begins!

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Chemo Fail

Dear Carboplatin,

It’s not you, it’s me. Actually it’s mostly you at this point. I mean, you’re a great chemo and all- don’t get me wrong. You don’t make me that sick. You only come around every three weeks so you’re not clingy. We’ve had some really mediocre times together. But alas we need to break up. We should see other chemo. I wish you the best but…

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Love always,

Your Platinum Reactive Ex


Ok glad we got that out of the way. I hope Carbo didn’t take the breakup too hard.

Yesterday I was treated in the main hospital oncology floor with the scheduled Taxol/Carboplatin desensitization chemo. Due to the allergic reaction that I had to Carbo a few weeks ago, we had decided to try it again under careful supervision and a painfully slow drip. All in all I was there for about nine hours.

To be honest I had slight reservations about being treated on the 4th floor of the main hospital. Inpatient oncology is where I essentially lived for most of the summer and my memories are not the most pleasant. I didn’t know if it would trigger me emotionally but luckily I did just fine. I’m guessing I was okay because I have positive connections with the nurses that I would be seeing. That went a long way. I mean, if anyone from WIH is reading this and knows Alicia, say no more. You can’t possibly frown with her around. She’s a damn good nurse, keeps it 100% with everyone, has a mouth like a truck driver, and a sense of humor to match. She wasn’t assigned to me but came by throughout the day to check in which I was grateful for.

I was happy to see that Lil’ Kim was assigned to me for the day. I knew immediately that I would be in good hands.

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So this is how a de-sense works…

Based on some crazy math formula that I made Kim explain to me in detail, that I now do not remember in the least, they figure out the quantity and rate of Carbo to administer over the course of six hours. It has something to do with your weight and I think the number 140 was in there somewhere….carry the 2? I don’t know. The extent of my math at work is making sure I can add up 122 credits and calculate GPA when needed. I’ll leave this one to the experts. In any case, how the chemo is administered is incredibly strategic as to slowly introduce the drug to your body in hopes that the smaller amounts at reduced rates will prevent a reaction. They also take your vital signs every 15 minutes.

Unfortunately going into my LAST bag of Carbo I reacted. Same as last time. I felt a little warm but other than that I felt fine. I turned blotchy and red all over my face, neck, chest, back, arms and hands.

This first picture^ was when I decided to see what I actually looked like because I didn’t know last time. It’s not the clearest of pictures but I’m pretty red (except for my cheeks for some reason? Reverse blush?)

Per protocol they immediately stopped the chemo, pushed Benadryl and gave me more steroids. This reversed the reaction and eventually I was back to my normal pasty-pale self.

I am fortunate that the reaction wasn’t terribly severe. Although,when they pushed the Benadryl I had a strange tickle in the back of my throat and momentary trouble breathing. It resolved itself within a minute or so but was a bit scary at the time. I don’t think this had to do with Carbo at all because it happened almost instantly when the Benadryl was pushed it. I’m guessing it was a response to how quickly the Benadryl entered my system.

Sheila got in contact with Dr. Robison and it was begrudgingly decided that we needed to be done with Carbo. I have heard the term “platinum resistant” before so I asked Betsy if that is what I was now due to this reaction. She kindly explained the following terminology to me that cleared things up:

Platinum Resistant = When the cancer is no longer responsive to platinum based chemo (such as Carbo).

Platinum Reactive =When the cancer IS responsive to platinum based chemo but your body rejects it. Hence, allergic reaction.

So I would fall into the latter category. It’s not that the chemo isn’t working, it’s just that my body is giving it a hard NO. We need to listen to what my body is telling me and move on to something different.

As of this moment I am not sure what the next steps are or how soon we will know what the next treatment plan will be. I’m guessing within the next 2-3 weeks we will have a better idea. I’ve been experiencing some shortness of breath lately so we have a chest x-ray planned for next week. I’m unsure if Dr. Robison will want a CT scan but again, we will know more soon.

So, despite having a long and disappointing day it ended on a side-splittingly hilarious note because Cory, Sheila, and I went to see the comedian Tig Notaro in Providence at the Columbus theatre. She had us laughing so hard the entire time- I was in tears. It was just what I needed.

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If you ever have the chance to catch her stand up, please do. Also- she’s a cancer survivor and her book is amazing so check that out as well if feel so inclined.

That’s all I have for now, but I’ll keep you posted as details about a new treatment plan unfold.

Unnecessary Excitement

It wouldn’t be a true Jess Sultaire day at Women and Infants hospital if I didn’t cause a little bit of trouble.

Today began as your average weekly chemo day would. Day 1 of another 3 week cycle: steroid, Pepcid, Benadryl, 1 hour of Taxol, and 3 hours of Carboplatin.

A little background surrounding Carbo. There is a risk of allergic reaction therefore you are required to take 20 mg of steroids the night before and the morning of chemo on the Carbo days. I was pretty confident that I wouldn’t have a reaction. I still took the steroids as a precaution but mostly because I’m a rule follower.

Even so, I was confident that if I was going to react to Carbo, it would have happened already.

Fast forward to the beginning of hour 3 of 3 for Carboplatin.

Amparo, our medical assistant, happened to walk by my room. It was nearing the end of the day so she popped her head in to say goodbye. Mid-sentence she interrupted herself to say: “you are all red!”. A look of concern came over her face. Of course, not realizing how I actually looked, I responded (perhaps a little too casually): “Nahh. I’m fine, it’s just hot in here.”

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With growing concern in her voice she called in the first infusion nurse she could find.

It turns out it was a potentially far more serious situation than I knew. All of the sudden EVERY chemo nurse had surrounded my bed. I’m not joking- there were 8 medical professionals crammed into this room. Everything happened so fast. I was having a reaction to the Carbo and the protocol is to act quickly.

*I should clarify before you get too concerned that luckily my only symptom of this reaction was turning Heinz ketchup red from head to toe. My airway was not restricted and I did not experience itchy palms.*

They swiftly hooked me up to the blood pressure cuff and pulse oximeter to continually monitor my blood pressure, pulse, and blood oxygen. I they pushed a dose of steroid and Benadryl directly into tubing to reverse the effects of the reaction.

Even though I was physically okay. Something happened, in my mind I was triggered.

The sudden rush of nurses and their collective looks of concerns tapped into a buried trauma. It was so reminiscent of the fear and confusion I felt when I went into septic shock earlier this past summer. I didn’t have a visual “flashback” but I very intensely tapped into that deep seeded fear and confusion where I didn’t know what this all meant. I began to experience an involuntary physical reaction to that fear- increased heart rate, shortness of breath, tears.I can’t be sure because I don’t believe I have had one before, but I think this could be classified as an anxiety attack. They placed oxygen under my nose to help me catch my breath while Betsy and Caryn rubbed my back and reassured me that I was okay.

I know I speak incessantly about the stellar care I receive at Women and Infants but it cannot go unacknowledged just how well they support their patients. In addition to every single nurse coming to my aid and knowing just what to do, they were incredibly warm and compassionate. One of them even ran upstairs to get Sheila because she knew we were close and thought she would help to make me feel comfortable.

If this blog ever ends up in the hands Mark Marcantano (President and COO of WIH), the following infusion staff deserve a massive raise and recognition as a result of this  particular incident: Amparo, Betsy, Caryn, Ann-Marie, Ivone, Beth, Susan, Sandra, and of course Sheila.

(Sidenote: Unsuccessfully tried to find contact information for Mr. Macantano to email him directly. If anyone has it, send it my way. Between GYN onc, the 4th floor of the main hospital, and the infusion center, senior leadership NEEDS to know the level of care that is being provided by these angels)

Anyway…

Over time the redness came down, I was able to catch my breath, and the fear subsided. Betsy told me that she would stay as late as it took for the redness to disappear. By about 6pm I was back to normal.

So after all of the months that I’ve receive platinum based chemotherapy dating back to 2013, why now? Why would I react all of the sudden?

While I had assumed (wrongly) that the more exposure to something, the more your body gets used to it, that is not true in this case. Over time your body can start to view the Carboplatin drug as an antigen, meaning a toxin/foreign substance/allergen. As a result, your immune system reacts by sending antibodies to fight against the antigens.

I kind of see it going down like this:

What now?

The next two weeks of my chemo cycle is fortunately only Taxol. When my new cycle begins we will likely do a “desensitization chemo”. This protocol is considered when a drug is seemingly working but a patient reacts like I did to it. Instead of going to the infusion center I would receive the treatment in the main hospital oncology floor. I wouldn’t be inpatient (I can go home when it’s done), but the infusion would be incredibly slow.

~1 hour for predrugs: steroids, Pepcid, Benadryl

~1 hour for Taxol

~6 hours for Carboplatin (normally it is 3 hours)

It’ll be a pretty long day but it’s a safer way to infuse and reap the benefit of a drug that could be working under close supervision.

Now, if this desensitization chemo still causes me to react, we will probably have to break up with Carbo. We could potentially just continue with Taxol only or maybe Dr. Robison will have another chemo up her sleeve to try.

So that’s that. I’m totally fine. Aside from feeling fatigued, I’m feeling okay today.

I will need to have Cory bring me to Providence to pick up my car from the hospital. I ended up needing so much Benedryl yesterday that they told me I couldn’t operate heavy machinery for 24 hours. Sarah Breen is an incredibly selfless human and no questions asked picked me up from chemo and drove me the 45 minutes home even though she worked all day (an hour away as it is). THANK you Sarah. I love you more than you will ever know for all you do and all you are.

I’ll end on a less dramatic, happier note:

My CA-125 dropped from 843 to 642 🙂

Progress.

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Notorious O.V.A.R.Y. in Action

September has great energy. A new academic year begins, the seasons start to change, and one of my favorite annual events takes place- the Silent No More 5k to benefit the Rhode Island Ovarian Cancer Alliance.

I am pleased to share that with the support of family, friends, and friends of friends, team Notorious O.V.A.R.Y. raised $2890 (exceeding my goal of $2000). As a whole, this event raised over $32,000 with donations still rolling in!

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I’ll chat more about the walk in a minute. For as many times as I’ve had to write about being in the hospital, needles, pills, NG tubes, and general unpleasantness, it’s important to highlight when life is just normal. That includes visits with friends, good meals, professional growth…pretty much any moment that is not spent clinging to life on my couch. So weekend recap- commence!

The weekend began with a visit from two of my childhood best friends, Stacey and Michelle. Our time together was filled with good food, a carnival on the beach, hot tubbing in the back yard, and several moments where I laughed so hard that I almost cried.

At the carnival we may or may not have shamelessly ridden a kiddie coaster and the “bear affair”. I’m guessing three 28 year olds are not the target demographic for these rides but hey, if we fits, we sits.

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Living in three different states and starting the majority of my weekends with chemo makes it difficult for the three of us to be together at the same time very often. That said, my heart was very full this weekend with these goons.

In the midst of their visit I did have to work on Saturday to facilitate a training for the MyPath mentors. The mentors are (mostly) juniors and seniors that serve as resources for students that are exploratory. Exploratory meaning, undecided about a major/career path, questioning their path, etc. It’s a fantastic program made better by these incredibly motivated student leaders. Despite falling on an already busy weekend and me running it for the first time I was very pleased. The mentors blew me away with their insight, discussion, and willingness to share their personal experiences. I’m looking forward to the upcoming year with this program.

My ability to be at this training without stressing over leaving my transportation-less guests home was made possible by Cory continuing to be the best human. He cleaned, made sure Michelle was caffeinated (super important), and picked up Stacey at the train station without complaint. What a gem, right?

Our weekend wrapped up with the Silent No More 5k to benefit Rhode Island women touched by ovarian cancer. To give you a little background on the name of the walk, one of the most grim nicknames of this disease is “the silent killer” because it’s symptoms (bloating, feeling full quickly, GI issues) can mirror a massive number of other, more minor, ailments. That said, many women are not diagnosed until later stages when the disease has spread from the ovary to other parts of the body. Being “silent no more” flips the script on that ugly nickname because as a small cancer community we are educating women on how to listen to their bodies and spreading the word. The more preventative we can be, the more women will thrive in the face of this disease.

Speaking of thriving, there were FORTY survivors at the walk this year. That is incredible. That means forty women that are either still kicking some OC keister or in remission. That is forty more women that are defying the odds, blowing up the statistics, and truly thriving.

It was nice to see familiar faces from previous years and exchange big hugs. The Rhode Island OC community is truly full of kind and remarkable people. I wouldn’t wish this disease on anyone, but I’m glad that it brought us together. (Shout out fellow cancer crusher, Dorinda for my new favorite bracelet!)

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I was lucky to round up a great team to come together as Notorious O.V.A.R.Y. (team name credit to Sarah Breen). Thank you Mom, Dad (Peepaw), Cory, Stacey, Michelle, Sarah, Zack, Kerri, Monica, Robin, Becca, Maddie, Joseph, Austen, and Ginger for waking up early, going full on teal, and braving the humidity for this cause. It meant the world to have you there.

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Congrats to Donna Ricci (President), John Morris (Vice President), and the rest of the RIOCA board members on another successful year. So many bear hugs, so little time! Jessie was most definitely proudly smiling down on you today through the sunshine.

Before I wrap up, I have a minor health update but it’s nothing exciting. One of the small incisions from the port placement wasn’t healing quite right and became infected so I completed one course of antibiotics. Unfortunately it still isn’t better so they have extended antibiotics for another two full weeks. So far they aren’t wreaking havoc on my life like the mega-antibiotics I had to take over the summer. On Friday, they drew blood cultures from my port just to rule out another infection in the port but they’re pretty sure that the infection is superficial.

CA-125 will be drawn this week, I see Dr. Robison for a check up on Thursday, “big” chemo on Friday. I’m not banking on a great CA-125 considering this infection business but here’s to hopin’.

Now that I have survived and chronicled such an eventful weekend, I’m going to plop down on the sofa, watch the Packers (hopefully) crush the Vikings (sorry Larz Barz), and restore my energy for work tomorrow.

 

 

 

Port on the Starboard Side

Holy insomnia. I actually did sleep for a few hours last night but it was one of those sleeps where your dreams are so intense and bizarre that you don’t feel rested. Full disclosure- I don’t fully remember all of the details but it was some combination of being part of being a newly retired olympic gymnast and Big Brother contestant. Neither of which I’d be very good at in real life (can’t do flips, bad a comps, not competitive). Although it beats my Stranger Things inspired dream from the previous night that left me a little hesitant to find my way to the bathroom in the dark (note to self: string Christmas lights and befriend Eleven for protection).

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I’ve been awake from 3am-6am to embrace the weird/non sleep and get caught up on Big Brother.

Non-fans of any of these shows…just move on. Clearly the sleep deprivation is not conducive to a clear and concise actual treatment update.

Anyway, I’ll keep the rest semi-short and sweet.

Monday I had the new port placed. I was told it would likely go on the left side of my chest but they did an ultrasound beforehand and determined that despite scar tissue from the previous port they would still have no problem placing it where it was before on my right.

The port was placed under VIR (vascular and interventional radiology) at Rhode Island Hospital. It was the same place where the first port and PICC line were put in so I had an idea of what to expect. I was under conscious sedation so although I was awake sterile barriers prevented me from seeing what was happening and IV drugs prevented me from feeling it.

I will be honest, leading up to that day I wasn’t nervous or concerned but when I was in the waiting room after check in I had a mini-moment where I was feelning pretty overwhelmed. Cory was with me and talked me through it like the champ he is. I don’t even think it was the procedure itself that freaked me out, I just felt triggered by simply being there. Remember, my only experiences at RIH have involved getting ports placed or the ICU for septic shock. Not a great track record for fond memories.

The night after surgery I didn’t sleep at all. I was in a lot of pain and nothing seemed to take the edge off. I can best describe it like Conor McGregor slugging you in the collarbone as hard as he can. 513972668-conor-mcgregor-punches-nate-diaz-in-their-gettyimages

I returned to work the next day, which happened to be “moving day”. Our office was renovated over the summer so we were moving back in from our temporary space in the library. I couldn’t have been more useless on moving day. As always, I’m fortunate to have such compassionate co-workers. Shout out to Doug Hillis for moving my boxes for me. I was able to slowly but surely get unpacked and I am so thrilled with the new space. The office layout will be a little different to get acclimated to but my actual office looks phenomenal.

The pain has subsided over the past few days and luckily I can say it’s no longer sore. At chemo yesterday, Rosa removed the big bandage and revealed that it’s healing nicely. We were able to use the port with no issues for my Taxol infusion.

New Port…not Newport.

Final notes-

Thanks to Stacey for the chemo visit (I owe you a better hang out…Eskimo King stat). Double thanks to my parents for the post-chemo surprise visit yesterday!

Anyway, it’s a decent hour and I need to get ready for work.

Happy Friday!

The gift of momentary inner peace

Yesterday after chemo, I officially had no use for the PICC line and it was pulled from my arm. It didn’t hurt, actually, it felt like a long piece of wet spaghetti slide out from under my skin. Within seconds I was free. Free from the tubes, the daily saline and heparin flushes, the sickening smell of alcohol wipes. My arm could just be my arm and a shower no longer had to involve a sandwich bag and medical tape.

After work today I was fortunate to have one of those crystal moments of clarity where nothing serious mattered. There was no fear, no countdowns until something unpleasant ends, and thankfully no overwhelming nausea or exhaustion. I mean, all of those things exist steadily in my life, sure, but they were out of my head at least momentarily because yesterday’s PICC pull was symbolic. It was freedom.

With my new found “freedom”, I stopped home briefly, threw on a bathing suit and charged to the beach. The 80 plus degree weather at 6pm was certainly a gift as I was determined to get in the water. The waves were huge and crashed around me. The water was chilly but not biting, typical Atlantic in August. I eventually just sat down where the waves calmed and met the sand and let the water wash over me. I soaked in the smell of the ocean, let drifting seaweed cover my lap, and watched the searats sea gulls scavenge.

To put it not-so eloquently- I was happier than a pig in shit.

(This also resulted in about 3 lbs of sand in my bathing suit bottom when I got home soooo, souvenier?)

Now you may be asking yourselves, Jessica- why are you going to such great lengths to describe an incredibly average evening at the beach? Well friends, because I was denied a true summer. The powers that be filled this summer with hospitals and limitations. In short, more days than not were a total suckfest. I say this not necessarily to dwell on the nightmare that was but to highlight a single evening that brought pure, natural joy.

Tomorrow or the next day I’ll worry again. I’ll drag my feet to the hospital on Monday to add to the collection of scars for another port placement. I’ll begrudgingly sit through another chemo infusion on Thursday. I’ll take things for granted. I’ll continue to yell expletives through closed windows on the highway at oblivious fellow motorists… We’re only human right?

But for tonight tonight, I was cut a break. Nothing in the world stopped me digging my swollen ass feet into the sand, cracking the binding of a new book, and drowning out the world as the waves collided.

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Thank you universe for this taste of summer and utter peace.

 


I dig my toes into the sand. The ocean looks like a thousand diamonds strewn across a blue blanket. I lean against the wind, pretend that I am weightless and in this moment I am happy
-Incubus

Eat, Work, Chemo

Knock on wood…

I’ve managed to stay out of the hospital for over two weeks now.

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Let’s let that one sink in for a minute.

I’m grateful for every second that I can live my life on the outside. We take slow, incremental steps to reestablish a sense of normalcy. It’s not easy…but it’s lightyears better than where I was just weeks ago.

1.) Going back to work

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Although have been working remotely throughout medical leave on projects, reports, etc. I’ve been transitioning back to the office little by little since mid-July. Part in person/part telecommuting. The nature of summer in undergraduate advising (after orientation of course) involves some sparse phone appointments but mostly administrative work to gear up for the next academic year. Degree audits to make sure your rising seniors are on track for graduation (and to light a small forest fire under the ones that aren’t), adjusting freshmen schedules to account for their AP/transfer credits, finalizing study abroad course contracts, prerequisite reports, and general ‘i’ dotting and ‘t’ crossing. It’s pretty low-key stuff but keeps me busy and isn’t terribly draining. That said, my return is well timed.

The fall semester is full on. Two straight weeks of walk-in’s during the add/drop period, classroom presentations and workshops, probation meetings, study abroad advising, registration advising, collaboration with other departments on projects/events and “other duties as assigned”. Student contact is high and this is where more of the student development piece (my favorite piece) comes in. It can be intense, but it’s truly the part I love the most.

Part of living with chronic illness is having to make tough choices about your limitations. As someone who fiercely cares about the work I do, I don’t like “scaling back” or not taking advantage of opportunities to grow in my role. One tough choice came recently when I decided to take a step back from a teaching opportunity in the fall. To be clear, no one at work made me feel as if I had to do this. I’ve gotten nothing but support to take on this additional role. I just knew that in light of this summer from hell, I didn’t want to put my students or the rest of the staff in a tough position if these secondary health issues were to persist. It’s just not fair to anyone.

For now I’m going to keep focusing on my advising role, partnership with the Honors Program, and advising the Colleges Against Cancer club. That keeps me plenty busy.

2.) Om nom noms (…eating)

Reteaching your body anything that is supposed to come naturally is nothing but frustrating. When you’re a baby learning how to eat solids you aren’t worried about the capacity of your stomach or if/how certain foods will digest. Babies eat, poop, occasionally throw up, and move on quickly into hysterical laughter when someone blows a raspberry on their belly.

When I say relearning how to eat, in this case, I don’t mean relearning how to chew or swallow. I’m referring to my atrophied stomach slowly growing to increase food intake and the intestines absorbing nutrients and passing the food without obstruction. It is easy to get in your own head and stress yourself out. There is a sense of urgency to gain weight because I’m super underweight but you also walk a fine line of taking in calories but not so much that you exceed the (very small) capacity of the stomach.

I have been off of TPN for just over a week now and luckily, I didn’t lose weight. I thought that my dietitian would be concerned that I didn’t gain this week because she really hammered home the importance of a 1400 calorie per day diet. Knowing that I didn’t even come remotely close to 1400 calories per day or even 1000 for that matter, I put myself in a tizzy and shed some involuntary tears when she asked how the week went. She was incredibly encouraging and reminded me that this is a process and that I have a lot to be proud of. Getting off of TPN and not losing more weight, actually digesting the food I can take in, eating at a restaurant, are all victories. I felt a huge weight lifted after that conversation.

So things I’ve mostly been taking in that have agreed with me: Stonyfield whole milk baby yogurt, blended fruit/vegetable pouches (yes also for babies), smoothies, cottage cheese, rice cereals, milk (cow or coconut), soft fruits without skin or seeds, very soft cooked vegetables without skin or seeds, bagels, grilled chicken, rice, noodle dishes (lo mein, pad thai), hummus, pita chips, soups, ice cream…

Oh and I was able to eat half of an insanely good reuben (sans saurkraut) the other day. I was in love and proud of myself for keeping it down.

I am fortunate to have a damn good cook in the house so it’s nice to enjoy Cory’s creations as tolerated in small portions. This week I actually ate a small helping of braised short ribs, crispy polenta, and mushrooms:

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Not bad for an architectural lighting salesman, eh?

I’m sure most people could house the above meal in two bites but that’s just about how much my stomach can take right now. It was perfect. I look forward to my stomach normalizing even more to take advantage of Cory’s natural culinary talents.

3.) Getting rid of the PICC

The PICC line was supposed to come out yesterday and I was supposed to have the new port placed this coming Tuesday BUT a scheduling miscommunication has pushed both back. I won’t have the port placed until August 15th which means I need the PICC for another week to receive chemo.

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I was disappointed but in the grand scheme of things, living with a PICC line for one more week is nothing in comparison to anything else I’ve had to do this summer.


So that’s it for now. I have a big weekend lined up with both Cory’s parents and my parents coming to visit. Should be a lot of fun to get everyone together 🙂 It’ll be good to see family after having a slightly emotionally challenging week.

Perhaps next week will turn around as flawlessly as Meyhem Lauren.

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Six Days Strong

Almost a week has passed since I was released from the hospital for the most recent bacterial infection. I can’t believe I even need to qualify that with “most recent” as if it is totally normal to go into septic shock then a few weeks later acquire two other infections. I don’t know if I should be terrified that this has happened on top of the other ailments or super impressed that despite it all I’m back home doing relatively well. In any case, I digress…

The point is, I’m home and all things considered I’ve had a pretty decent week. I was fortunate to not have to go home on continued antibiotics this time. I actually had a chance to slowly start to feel human at home without added intensive medications.

On Thursday it was back to chemotherapy. Prior to chemo I had a check up with Dr. Robison and it held some promise!

I had expressed that I was very ready to be finished with TPN. Due to the fats/lipids/dextrose in TPN, it isn’t hard to unknowingly create a little petrie dish in your port/PICC that bacteria thrives on. It just worries me to continue putting myself at risk for infection if we continue. I understand that TPN was necessary, especially given the issues I had with intestinal obstruction, but I’m at a point where my guts are improving and I’m ready to try to nourish myself the good old fashioned way…

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Now-

I was expecting my request to be met with some resistance since:

1.) I have easily lost 10 lbs since all of this nonsense began in May (at a point where I was already under weight)

2.) TPN provides nutrients that I cannot fully get by mouth while I work on slowly increasing calorie intake

Dr. Robison was in agreement that if I felt ready, tapering off of TPN would be our next move. That said, TPN has been reduced by 50% this week which means that I only need to infuse TPN every other day.

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I’m certainly not able to house over 1000 calories at this point (or anywhere close to that) but a small victory is that I have had a few small meals each day and without nausea or vomiting. This is a massive deal. In fact, I haven’t even needed to take nausea medication since Thursday when I had chemo. WIN.

Assuming the remainder of the week is equally successful, no TPN would mean no further need for the PICC line. That could potentially come out in the next week or two. That also means that a new port would be placed in my chest in the next 2-3 weeks.

Again, all of this is dependent on continued progress of eating by mouth and keeping it down. Let’s hope this vessel is up for the challenge.


On a final and unrelated note, many have asked me how I’m settling into my new home. It has been great! That is, when I’m actually home and not living at the hospital…

It’s a comfortable, cozy place to melt into when I’m feeling my worst and a cute beach community when I’m feeling human enough to venture out. One of those rare “feeling human” nights happened last night so we decided to capitalize on it with a beach picnic just minutes from our house.

 

Cheers to many more beach picnics, feeling like summer is actually happening, and for the love of all that is holy- STAYING OUT OF THE HOSPITAL.

 

I should just pay rent to the hospital

Tuesday was a gorgeous day. I was working from home in the backyard under the patio umbrella. As my creative juices were flowing in front of my lap top I got a chill. More than a chill really, it felt like winter inside of my body. I chalked it up to sitting in the shade and threw on a sweatshirt. Finally I couldn’t take it and moved into the warm embrace of the sun. I let it soak into the fibers of my sweatshirt like a little oven. Eventually I just went inside and piled myself under blankets. A couple hours later I felt feverish so I took my temp. YUP…104 temperature. CRAP.

I knew what my fate was. I would have no choice but to check into Hotel de Women and Infants pretty much kicking and screaming.

Cory drove and stayed with me in the emergency room. Around 11pm I was admitted and moved to a room on the oncology floor. Prior to that they did a chest x-ray and drew more blood cultures. The end result is that I have another/still have the same (?) blood infection. I am neutropenic at the moment which means that I am low on white blood cells that would normally fight against bacteria and infection. This is common in cancer patients undergoing chemo. Our immune systems are just shot.

That said, if you are sick or even suspect you have a cold- GET THE HELL AWAY FROM ME.

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This is currently on my hospital door with a box of super attractive bird flu masks

So I’m not going to dissect every  detail of my time here so far because it’s exhausting. Here are the cliff notes:

  • I will most definitely be here for a few days 😦
  • My port just stopped working yesterday. Can’t flush it, can’t get a blood return. Nothing. That said I’ve had to have a couple peripheral lines put it (like normal IV’s) and that sucks a lot. I’ve had more needles jammed into me in the last 48 hours than I can count.
  • Since my port was infected previously my doctors are erring on the side of caution and having it removed. It will happen sometime today but we’re at the mercy of whenever Rhode Island Hospital can do it so until then I must fast.
  • They have two interventions to give me a boost and make me a little stronger. First it an injection to bump up my white blood cells. The other I am having as we speak and that is a blood transfusion. My hemoglobin was low so that should help too.
  • Again, no port = tubes hanging from each arm uncomfortably. I’ve never missed my port more. I’m not afraid of needles but I certainly do not enjoy getting stuck with them multiple times a day.

    With all this tubing hanging from my arms I’m tempted to recreate the fake party scene from Home Alone:

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  • No chemo this week so we can deal with the infection first
  • Once the infection is gone they will be putting in a temporary PICC line (Peripherally Inserted Central Catheter).  Eventually they will come out they will place a new port like the one I have now. Anyway, the PICC looks like this (photo cred: Happy Colon):

 

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So those are the facts, here are the feels:

My initial reaction was anger. I’m actually still pretty angry which isn’t my typical response to something like this. I have just had so many hurdles thrown my way in such  a short period of time, it’s exhausting. You are just always playing catch up to feel well. When will the day come that I can do that? If the last few months is any indicator it’s going to be an even longer road than I imagined.

I explained my frustration in these terms to a social worker on the floor. Most everything I do now has an asterisk next to it-

  • I can go back to work but I can only be physically there 4 days a week
  • I can take a shower but I have to spend 10 minutes taping a plastic bag over my port needle to keep it dry. (and DEFINITELY no swimming)
  • I can go to that barbecue but I can’t eat any of the food there

You get the point, everything is conditional- at least for right now.

I get complimented often on my positive attitude which I sincerely appreciate. It’s still in there somewhere! I’m just salty at the moment. For now I need to honor and acknowledge the pain/anger/frustration because those feelings are authentic and part of the process.

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Don’t worry George, it’s not the summer of Jess either.

Maybe there will be an autumn of Jess? Hope so.

 

 

Because nothing is easy

Because nothing is easy, my “wimpy” little bacterial infection actually landed me in the hospital for eight days and seven nights. My last entry was a week ago and that day I was SURE that I was going to be discharged the next day but because it’s me, I had to complicate things a bit.

A few factors that delayed discharge:

Vancomycin  (vanco) gave a mild skin reaction. Due to that the doctors had to play around with the rate in which it was administered and the dosage. With this drug you also need to draw blood just prior to the next dose to see exactly how much vanco is in you. It can’t be too much to too little. Pretty much every blood draw I had except for the last missed the mark on either end. In short there was a lot of tweaking that had to go on before they could send me home with the drug.

-Daptomycin (Dapto) is a much better antibiotic that can be used as a second line treatment if vanco is not working or an allergy exists. Switching to this drug took a few days because your blood cultures need to be sent to a lab with a sample of Dapto and they watch it to see if the bacteria is sensitive to the drug. The results took 48 hours to yield but luckily it came back in my favor and we could make the switch. With Dapto, I was required to do one infusion in the hospital to monitor me for any reaction. We did that yesterday and after that I was cleared to go home. I didn’t even think it was real that I was going home (this is how jaded I have become in regard to my own health).

-My port appears to be the source of the infection which means that we had to be aggressive and consistent with antibiotic that would flow through the central line. The goal is to save the port. I will have blood cultures again in a week and if the sample from the port is still coming up positive for bacteria then the port may need to be removed and replaced. I am very much hoping this isn’t the case and honestly don’t think it will be.

Right now I feel okay but not as well as I felt last week before going to the hospital. A week of antibiotics, antihistamines, and other necessary medications can kind of knock you down a little. The antibiotics have torn up my stomach so I’m slowly getting my appetite back. I do have TPN at home that I have returned to so at least I’ll get the appropriate calories and nutrients while I build up my food by mouth. In short I’m just really fatigued.

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That said, I’m grateful for the care I received at WIH. From the ER to 4East I was in the hands of people who know me, provide the best care, and care greatly about the work that they do. Despite how much longer I was inpatient than anticipated, we could find comfort through frustration that everyone was working as hard as they could to find a solution to the various challenges that arose.

Thank you as always to my parents and Cory who made many a long drive to be with me in Providence and help me keep my head on straight.

So I’m home now. Again, writing this from my back yard with the chirping birds and the abundant garden.  Thank goodness.

From here on out the plan is-

1.) Administer IV antibiotics through my port at home from now until June 30th

2.) Continue TPN until further notice

3.) Start chemo again June 30th after a check up with Dr. Robison. That day I will receive Taxol and Carboplatin in the infusion center in Providence as I would normally.

and most importantly…

4.) STAY OUT OF THE DAMN HOSPITAL!

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