Carolyn's hanging in there

Seeing Carolyn start to get restless and knowing that soon she'll be itching to work the garden, I was happy to see her doctor release her from confinement and bedrest.  It seemed to me that Carolyn actually did much better at work.  She's been back a week now and looks healthier.  However, she says that she's much more tired than she used to be at the end of the day.  I think she should just plan to come home when she starts feeling beat.

No word from the laboratory regarding her need for or the effectiveness of chemotherapy.

A Tale of Two Remotes

Remember the Dr. Seuss book "Old Hat, New Hat?  I don't want to be a spoiler but I probably should have named this entry Old Remote, New Remote.

Champagne Clicker

There have been so many times when I've been working outside and both the side door and front door were locked.  The cars were all safely locked in the garage. And I needed to get in.  So when we saw the display at we thought this might be a good Fathers Day gift.

I was concerned about compatibility but it clearly named the brand of garage opener we have as one of the brands this switch was compatible with.

It wasn't!  Even a trip to the Internet yielded only disappointing news.  Several people had responded to this product and the overall scoring was high except for a couple having to do with our brand.  They were not happy campers, indeed.

LiftMaster control unit

When I tried to install the new remote it refused to take the new codes.  Nothing we saw on the Internet comforted or enlightened us.  Carolyn thought we should try the old unit that has been sitting on the side of the garage since we bought the house.  I had thought it was broken.  And we had no clue how to program it;

The battery was certainly dead and it was one of those kind that is carried no where but Radio Shack.  And we had no idea how we would program it.  Fortunately I was able quickly to identify the unit and find instructions for it on the Web.  So we ended up with the remote control we wanted. 

Net result, we have a remote unit that does what we need and we got it for the price of a battery, not the price of a new unit.  Old Hat,  New Hat, New Remote, Old Remote.

Waiting for the second shoe....

We just got back from the oncologist's office.  Our hope was to know everything about what is going to happen but we really didn't think we'd be that lucky.  We do know a little more, however.

First the doctor told us about hormone therapy which is quite popular with fighting breast cancer.  Having studied up on all this, Carolyn asked Dr.Duong if all the side effects he was describing weren't very similar to the symptoms of Menopause.  He agreed. Then Carolyn asked if the medication didn't actually increase the occurrence of certain types of cancer.  In other words, this could be a classical win-lose situation   She could win the battle against one cancer only to fall victim yet again to another.  No, Dr. Duong, countered, a new drug on the market has the same efficiency in killing cancer cells without causing additional cancer.  The side effects really are just like going through menopause.  That was good news.

Carolyn steeled herself for the second shoe to drop as Dr. Duong said, "Now about chemo. . ."  Carolyn let her breath out slowly.  "We're not at all sure it would be worth it," Dr. Duong  continued.  Apparently there is a test they can run on the cancerous tissue which will give a better idea about just how effective chemo will be.  They hadn't run that test yet, since they wanted to know first if Carolyn needed those test results to make up her mind about accepting chemotherapy.  The decision really is in her hands but she can ask for a test to help her make that decision.  She  opted to wait for the test results which we can expect in about 2 weeks.

We wait some more.

She's a believer

Carolyn says that if she wasn't a believer before, she is one now - a believer, that is, in having annual mammograms if you are in a moderate to high risk group.  Catching cancer early can make all the difference in the world.

The surgeon just called with the pathology report on the tissue taken during Carolyn's surgery last week.  As you will recall, the surgeon not only removed both breasts in a bilateral mastectomy, she also removed a tumor that had been identified as cancerous.  The tumor was 1.7 cm in length with "activity beginning in the surrounding tissues."  As previously noted the tumor had characteristics of lobular (branches that lead to the milk ducts) and ductal carcinoma.  The surgeon removed 8 lymph nodes - none of which showed evidence of cancer.

Official diagnosis: Breast Cancer, stage 1-B

What is next? Carolyn will meet with the medical oncologist to discuss whether hormone therapy (the tumor  is estrogen sensitive), chemo therapy or something else is most appropriate.

Oh, the unknown.

All is well, all is well

Of all the operations that Carolyn has endured in the past 10 years, I think she's bounced back from this one the quickest.  She has several restrictions from her doctor about things that she shouldn't do and she's staying pretty much within guidelines.  She isn't outside washing the windows or trying to do heavy housework.  I couldn't stop her from making our bed this morning.  She moves much faster than me.

To all those who have asked or are going to ask:  Yes, Carolyn is accepting visitors, phone calls, and email.  She has enjoyed your comments and well-wishes but she'll need visits and phone calls to keep her sitting down.

Thanks for all your thoughts and prayers.

It's good to be back home

We just got back home from the hospital.  Carolyn was discharged this morning with the usual warnings to not do much of anything until her wounds heal.  Her first words on looking over our rain-soaked back yard were, "Looks like the sweet peas sure need  picking."  Wanna bet how long it takes for her to convince herself that she needs to take care of the blooming flowers?

I asked Carolyn if she'd like to post an entry this morning. Here she is:

Well, I thought I was quite coherent until I listened to a message I left on the telephone and ......
 I'm pleased to report that I am home and feel fine. It is amazing what a good pain pill can do for you ;o). Actually, I haven't really needed the pain meds for more than a headache.
 Depending on who I listen to I am to lounge around and do nothing  much for two to six weeks. I'm planning on two weeks. It  sounds like it is time to read the books and watch all those movies I've been saving up.
 Thank you each for your good wishes, prayers and kind thoughts. They are very helpful.
 Now I just have to learn how to handle the after surgery drains.
 It is good to be alive.
 Carolyn

 I think she summed it all up very well.

On the Road (to recovery) Again

The News

It was a much happier, brighter, and more alert Carolyn who answered my phone call this morning than the one I visited with last night.  She admitted that she couldn't recall a bit of conversation with Ed, Tiffany, or me last night, just a vague recollection of someone being in her room.  I was calling this morning to ask what, if anything, she wanted me to bring to her. I was also interested in what her day was shaping up to be.

By the time I arrived shortly after10 she had begun taking walks the length of the nursing station.   But she also welcomed the reading book I brought.  She informed me that "we" would be instructed at 1:00 this afternoon on the care and cleaning of her drainage tubes coming from her chest cavity.  The doctor had said that after the instruction, Carolyn could go home at any time.

However, as the day wore on and Carolyn continued to feel a little queasy, she decided she would rather stay an extra day; that a couple of extra meals in her stomach might help.  So the plan now is for her to be all packed and ready to go about 9:00 tomorrow morning.


News behind the news

The discharge timing question boiled down to "where would be easiest to get good rest" and which would be the best place for care and comfort if Carolyn were to become more nauseous.   I didn't think there would be any question given the usual hospital environment.  Carolyn's roommate, a woman in her 80's who had fallen and broken her ankle, was quiet enough but when her children and grandchildren came it became a noisy room indeed. One of the hospital staff finally reminded the family that visitors must be 12 and older and that only 2 at a time could visit in the patient's room.  Whereupon the patient's daughter roughly pulled the 2 year-old girl out of the room while saying loudly, "THEY don't want you to visit Grandma!"  Good theater but hardly a peaceful environment.

Finally, in a perverse twist of incentives, by staying an extra night Carolyn becomes an inpatient, loses her outpatient status, and qualifies for a $15 refund of her co-payment.  What a world!  She gets paid for extending her stay!

Under the knife and out again

News bulletin:
Carolyn had a bilateral simple mastectomy this afternoon.  The doctor also removed 5 lymph node specimens closest to the identified tumor in her right breast.  Two tissue samples were frozen and sent to the lab.  The results were negative for cancer.  The doctor wants to see the complete pathology lab report for all submitted tissue before giving a conclusive prognosis but she seemed positive about this afternoon's surgery.

Carolyn is resting as comfortably as can be expected given the assault to her body.  She is sore and slightly nauseous but dozing off from time to time as the anesthesia slowly works out of her system.  She looked a bit like Smurf Grandma when she came out of surgery due to the blue dye used to identify the optimal surgery target but already by 9:00 this evening, her normal color was returning.

The doctor was optimistic about discharging Carolyn Friday afternoon if she continues to improve at her current pace and if the doctor is convinced she can get adequate care for her wounds and fluid drainage.

News behind the news:
Since Carolyn has now had 4 major surgeries in the past 10 years, all at Kaiser, we feel we're becoming somewhat expert at evaluating their systems.  This time it appeared to me that they were continuing to find ways to improve and continuing to fail. For example, there were 4 separate times Carolyn was interviewed as part of the "admitting" process, 5 if you count the pre-op surgical consultation.  There was an interview in the Peri-Operating Medical clinic by a hospital based internist, a billing and fiscal responsibility interview by an admitting clerk, a workup by an RN in the Pre-Op staging area, and a mini-workup by an RN on the nursing floor where Carolyn was placed to begin her healing process.  Each person collected some unique information but they also collected duplicate and redundant information making us wonder if any of the information is really coordinated between departments.

Another example.  As Carolyn left the Pre-Op staging area to be wheeled into the Operating Room, we were given a card indicating what we could expect to see in the OR waiting room.  Similar to the flight monitors in airports, a patient monitor in the waiting room indicates by a code each person scheduled for surgery today.  A color code and legend then indicates where the patient is in the system: pre-op, surgery, recovery, discharged, etc.  Only problem is that Carolyn's coded listing still showed her in the pre-op area 2 hours after we had seen her enter surgery.  And there was no indication why.  We didn't know whether is was a delay with Carolyn or some other patient, or even the whole OR system.  And no one offered to tell us how long the delay might be.   In this case trying harder just didn't help.