Janette has been doing great since she had a liter of fluids on Monday. In many ways, she's been better than I've seen since I've been here. She's still often tired, but everything else is improving. Well, her voice is getting worse, but that is probably a side effect of all the treatments.
We saw the oncologist today. He's lowering her chemo dose slightly but staying with the same formula. The protocol is every 21 days, so the next chemo session is July 8th. We also all decided for Janette to get fluids twice per week, each Monday and Thursday. Even though she's now drinking at least 40oz of water a day, it doesn't seem to be enough. Before our very eyes, she shrivels up like a raisin. No joking, we see the difference day to day and even as the day progresses. Fluids and electrolytes via her port seems to be the easiest solution.
Aunt Judy, Jill and Casey will be visiting for a few days. They're driving from Mississippi and will get in tomorrow night. This means no more blog entries for a while...again.
Next appts: Fluids, Thursday, Monday; radiation doctor follow-up, Wednesday; chemo and oncologist, next Wednesday.
Wednesday, June 24, 2009
Monday, June 22, 2009
Last Week: Wendy Visit, Chemo
Wendy and Mike were here for several days last week. Wendy visited with Janette and made plans to fly back here in August. Aunt Eliska also spent time visiting. We had a full, lively house for a while.
Janette also had chemotherapy the Wednesday of their visit. The steroids in the mix leave her with lots of energy and good feelings and she was able to participate more with Wendy and Mike. They made chilli, talked, watched TV shows together and we all went for a visit to my father's site at the Veteran's Cemetery.
This chemo is a completely different batch, no more cys and carboplattins. I don't have the names in front of me, but the chemicals are newer and specific to adeno (lymphatic) cancers. The side effects for Janette were much milder. I thought she might not have any at all, but unfortunately, they did start up this weekend. She has mild nausea, food aversion and extreme exhaustion. Aunt Eliska and I are already plotting to take Janette in for fluids (saline and anti nausea meds via her port) late this morning. We see the pattern and want to stop it before Janette gets so sick and dehydrated. [Update: We got fluids, she was very dehydrated, and she got a shot to increase white blood cell production in her bone marrow. Her white cell count was low. No nutrients and no fluids make cell production difficult.]
Oh yes, I forgot, the oncologist also prescribed medication to get Janette stomach muscles working again. On Wednesday's visit, I told him how Janette stomach aches more and more often. Each time she ate the portions became smaller and she complained more frequently of fulling full and sick. Apparently, some illness like cancer and diabetes can cause gastroparesis.
From the National Institute for Health web site
Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. Normally, the stomach contracts to move food down into the small intestine for digestion. The vagus nerve controls the movement of food from the stomach through the digestive tract. Gastroparesis occurs when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally. Food then moves slowly or stops moving through the digestive tract.
The medication "stimulates stomach muscle contractions to help emptying." It's been working well...when she eats.
Janette also had chemotherapy the Wednesday of their visit. The steroids in the mix leave her with lots of energy and good feelings and she was able to participate more with Wendy and Mike. They made chilli, talked, watched TV shows together and we all went for a visit to my father's site at the Veteran's Cemetery.
This chemo is a completely different batch, no more cys and carboplattins. I don't have the names in front of me, but the chemicals are newer and specific to adeno (lymphatic) cancers. The side effects for Janette were much milder. I thought she might not have any at all, but unfortunately, they did start up this weekend. She has mild nausea, food aversion and extreme exhaustion. Aunt Eliska and I are already plotting to take Janette in for fluids (saline and anti nausea meds via her port) late this morning. We see the pattern and want to stop it before Janette gets so sick and dehydrated. [Update: We got fluids, she was very dehydrated, and she got a shot to increase white blood cell production in her bone marrow. Her white cell count was low. No nutrients and no fluids make cell production difficult.]
Oh yes, I forgot, the oncologist also prescribed medication to get Janette stomach muscles working again. On Wednesday's visit, I told him how Janette stomach aches more and more often. Each time she ate the portions became smaller and she complained more frequently of fulling full and sick. Apparently, some illness like cancer and diabetes can cause gastroparesis.
From the National Institute for Health web site
Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. Normally, the stomach contracts to move food down into the small intestine for digestion. The vagus nerve controls the movement of food from the stomach through the digestive tract. Gastroparesis occurs when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally. Food then moves slowly or stops moving through the digestive tract.
The medication "stimulates stomach muscle contractions to help emptying." It's been working well...when she eats.
Thursday, June 11, 2009
Graduation from Radiation
Janette had her last radiation treatment yesterday. They even gave her a diploma of completion. While radiation was not painful and the therapist, nurses and technicians were wonderful, it was wiping her out. Janette is glad to begin recovering.
We are also glad because Janette was not eating or drinking much. Her weight has dropped to 126.5 and she was dehydrated again. The radiation nurse and doctor sent her to chemo for fluids yesterday. 3 hours and 1 liter of saline later, she felt much better. Perhaps it even helped something shift inside of her. She's eating much more and she carries around with her a big sippy cup full of ice water. She feels so awful when she's dehydrated and undernourished and so much better after being rehydrated from a bag through her port, I think she finally has motivation to eat and drink no matter what. We'll see if this keeps up through chemotherapy.
When does chemotherapy begin? We see the oncologist next Wednesday. I have a feeling he'll want to wait a couple of more weeks to let her recover more weight and strength, but he could decide to start her that day. We'll know in a week.
We are also glad because Janette was not eating or drinking much. Her weight has dropped to 126.5 and she was dehydrated again. The radiation nurse and doctor sent her to chemo for fluids yesterday. 3 hours and 1 liter of saline later, she felt much better. Perhaps it even helped something shift inside of her. She's eating much more and she carries around with her a big sippy cup full of ice water. She feels so awful when she's dehydrated and undernourished and so much better after being rehydrated from a bag through her port, I think she finally has motivation to eat and drink no matter what. We'll see if this keeps up through chemotherapy.
When does chemotherapy begin? We see the oncologist next Wednesday. I have a feeling he'll want to wait a couple of more weeks to let her recover more weight and strength, but he could decide to start her that day. We'll know in a week.
Thursday, June 4, 2009
A Long Pause in Chemotherapy
Wednesday, we had our regular meeting with the radiation doctor and the oncologist. Janette is in the home stretch with her radiation therapy. The originally planned series is finished and they've moved to a new angle and narrow focus on the lymph nodes in her chest.
All this radiation seems to help with many of Janette's symptoms. It's also created more side effects. Her esophagus is irritated and probably inflamed. Eating and drinking irritate further the irritated tissue. Eating more than four bites is a huge chore rather than a relatively unconscious act. She's not eating much and her weight has dropped to 129 lbs.
"Just 5 more days," the nurse and doctor say, "and when it's all over you will recover quickly."
Since she can't eat easily and she's so tired from the radiation, the oncologist has decided to wait 2 more weeks before restarting chemotherapy. We see him again June 16 and then he will decide if she's ready for more.
Janette has adenocarcinoma. Here's what I found on Wikipedia.
Currently, the most common type of lung cancer in lifelong non-smokers is the adenocarcinoma. Adenocarcinomas account for approximately 10% of lung cancers. This cancer usually is seen peripherally in the lungs, as opposed to small cell lung cancer and squamous cell lung cancer, which both tend to be more centrally located. The adenocarcinoma has an increased incidence in smokers, but is also the most common type of lung cancer seen in non-smokers.
Here's an excerpt from an article from abc News.
Ill Despite Healthy Lifestyle
While no national studies have yet been done, many lung cancer specialists say they're seeing a disturbing trend of more and more non-smoking women with the disease.
"Many of them have done an excellent job of taking care of themselves," said Dr. Joan Schiller, who specializes in lung cancer in non-smoking younger women at the University of Wisconsin in Madison. "They run. They eat right."
Ten percent to 15 percent of lung cancer victims are non-smokers. Among that group, women are two to three times more likely than men to get the disease. Doctors don't know why. Hormones, second-hand smoke, diet and air pollution all are believed to be factors.
Though lung cancer is deadlier to women than other types of cancer, breast cancer gets almost 10 times more research funding per death than lung cancer, Schiller said.
"These women are tragic victims of the fact that they have a disease that is associated with smoking," Schiller added.
Adding to the deadliness of lung cancer, the symptoms, which include shortness of breath and a chronic cough, often are misdiagnosed as asthma.
Here's another excerpt.
How Can Non-Smokers Develop Lung Cancer?
Researchers believe that second hand smoke plays a prominent role in lung cancer development in non-smokers. Limiting first hand and second hand exposure is essential for both men and women to reducing the risk factor for lung cancer.
Lung cancer can develop because of radon inbedded in dirt below residential homes. Tests are available to check the radon level in and around your home. Many of these tests are available free of charge from you local health department.
Estrogen may also be a factor in lung cancer development, just like in breast cancer development in women. Studies suggest that blocking estrogen may prevent lung cancer from growing.
All three of these points have been long term factors in Janette's life: ~42 years of second hand smoke, lots of radon in Florida and 20 years of estrogen replacement therapy. Quite the set up for developing lung cancer.
All this radiation seems to help with many of Janette's symptoms. It's also created more side effects. Her esophagus is irritated and probably inflamed. Eating and drinking irritate further the irritated tissue. Eating more than four bites is a huge chore rather than a relatively unconscious act. She's not eating much and her weight has dropped to 129 lbs.
"Just 5 more days," the nurse and doctor say, "and when it's all over you will recover quickly."
Since she can't eat easily and she's so tired from the radiation, the oncologist has decided to wait 2 more weeks before restarting chemotherapy. We see him again June 16 and then he will decide if she's ready for more.
Janette has adenocarcinoma. Here's what I found on Wikipedia.
Currently, the most common type of lung cancer in lifelong non-smokers is the adenocarcinoma. Adenocarcinomas account for approximately 10% of lung cancers. This cancer usually is seen peripherally in the lungs, as opposed to small cell lung cancer and squamous cell lung cancer, which both tend to be more centrally located. The adenocarcinoma has an increased incidence in smokers, but is also the most common type of lung cancer seen in non-smokers.
Here's an excerpt from an article from abc News.
Ill Despite Healthy Lifestyle
While no national studies have yet been done, many lung cancer specialists say they're seeing a disturbing trend of more and more non-smoking women with the disease.
"Many of them have done an excellent job of taking care of themselves," said Dr. Joan Schiller, who specializes in lung cancer in non-smoking younger women at the University of Wisconsin in Madison. "They run. They eat right."
Ten percent to 15 percent of lung cancer victims are non-smokers. Among that group, women are two to three times more likely than men to get the disease. Doctors don't know why. Hormones, second-hand smoke, diet and air pollution all are believed to be factors.
Though lung cancer is deadlier to women than other types of cancer, breast cancer gets almost 10 times more research funding per death than lung cancer, Schiller said.
"These women are tragic victims of the fact that they have a disease that is associated with smoking," Schiller added.
Adding to the deadliness of lung cancer, the symptoms, which include shortness of breath and a chronic cough, often are misdiagnosed as asthma.
Here's another excerpt.
How Can Non-Smokers Develop Lung Cancer?
Researchers believe that second hand smoke plays a prominent role in lung cancer development in non-smokers. Limiting first hand and second hand exposure is essential for both men and women to reducing the risk factor for lung cancer.
Lung cancer can develop because of radon inbedded in dirt below residential homes. Tests are available to check the radon level in and around your home. Many of these tests are available free of charge from you local health department.
Estrogen may also be a factor in lung cancer development, just like in breast cancer development in women. Studies suggest that blocking estrogen may prevent lung cancer from growing.
All three of these points have been long term factors in Janette's life: ~42 years of second hand smoke, lots of radon in Florida and 20 years of estrogen replacement therapy. Quite the set up for developing lung cancer.
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