16 February 2012

Blood Clots

So since getting the baby bottle infusor off last Sunday, I kept expecting to start feeling better. Instead the weakness seemed to carry on. Just walking a few steps left me panting. All I could do was lie in bed, not sleeping, I was all slept out, but unable to even lie on the couch & focus on TV. So frustrating!

Finally on Wednesday 15th February I had my first doctor's appointment with my new family doctor, the super-amazing-wonderful Dr. Kelly. He's amazing, so compassionate, a true old-fashioned family doctor, and I love him already. He told me to keep my spirits up, to keep fighting. Also said really nice things about my oncologist Dr. Katakkar. It's nice to have a new face on my health-care team.

I felt bad during the appointment because just sitting in a chair upright having a conversation was more than I could really handle. So after the appointment I asked Sterling to take me into the cancer centre. I could barely walk from from the parking lot in. One look at me & they had me in a bed, running blood tests & IV fluids. I apologized for bothering them, and they threatened to kick my ass. They said it's always the ones like me who don't want to be a bother who hold out longer then they should before breaking down & coming in. The initial theory because of how pale & weak I was was that I was severely anemic & needed a blood transfusion. So they did the bloodwork & ran IV fluids because in spite of my best efforts I was definitely dehydrated, causing my pulse to race in the 110-120 range. But the blood tests came back negative, that wasn't the problem. So then Dr. Fibich, saying "it's unlikely but I want to be thorough" sent me for a CT scan, where he found what he suspected: blood clots in my lungs. I guess this is very common in cancer patients, developing blood clots. That's why I was so short of breath all the time.

After the IV fluids and the CT scan discovery, they gave me an injection of warfarin (blood thinner) and scheduled an appointment the next day for Sterling & I to learn to give the subcutaneous injections ourselves (once a day, into my belly fat).

So that's what happened. Today Thursday 16th February we went into IV Therapy where they taught Sterling to do the injections, since I'm too chicken. It's pretty simple, especially since he as previously trained to give the neupogen shots I needed for a week that one round of chemo. After that it was back over to the cancer centre for more followup bloodwork & IV fluids; they sent me home around noon.

We stopped at London Drugs to pick up the first weeks worth of shots. Once again thank gods for my drug plan - the deductible for a month's supply was going to be $800+! Instead it's all covered.

I had a bit of a lie-down again once we got home tonight, but am starting to feel better. Hopefully this new treatment of shots will have me back on the mend. Thank you everyone as always for your warm thoughts & prayers, they keep me going when things are darkest.

13 February 2012


So, it's past time to update on the outcome of my ascites. After a week-and-a-half of suffering with them, I had my regular pre-chemo doctor's appointment last Tuesday 7th February. After going in super-early for blood work, at the actual doctor's appointment Dr. Katakkar examined me and felt the ascites had consolidated into a big enough pocket that he could drain it. After a small needle to freeze an area upper-left of my belly button, he was able to easily draw off a small sample of the fluid. Then he hooked me up through a third needle to a hose into a 1 litre vacuum glass bottle. The ascites started zooming out into the jar. It was pretty fascinating to watch. This time the color was like apple juice/beer, complete with foamy head because of how fast it came out. We filled nearly three bottles, 2.42 litres in all. It was a great relief and since then I've been able to go off my pain meds and eat a little.

Chemotherapy #11 - Tuesday 7th February - Tuesday 21st February 2012

We also discussed the change in chemo. I came back Thursday 9th February for treatment and was turned away, as the protocol Dr. Katakkar wanted was rejected by the BC Cancer Agency board in Vancouver. After a day to straighten that out, they came up with a compromise chemo (GIGFOLFIRI) to give me Friday. It involved infusion with two new drugs, Irinotecan and folinic acid (leucovorin) followed by an infusion & 2 day baby bottle infusor of 5FU (fluorouracil) that I've had as a 5 day baby bottle before. There was a 1 in 10 chance I would have a specific allergic reaction to the irinotecan, which I did have, so I had to get a shot of atropine in my arm to combat that too. Other than that, everything went smoothly. I was feeling super rough by the time the baby bottle came off Sunday 12th February. The nurse Ava was sweet enough to come into the hospital on Sunday to unhook me & teach Sterling how so he can do it next time. Today I'm still feeling very rough but hopefully on the mend. Bad diarrhea from this one, so lots of immodium & trying to drink lots of fluids.

11 February 2012

Two Small Tributes to Two Big Men

In the last couple months, cancer has stolen two good men from my mother's life & by extension, from my life. I wanted to write a short tribute to them. Both were solid, salt-of-the-earth decent people who didn't deserve this horrible disease & who are greatly missed. RIP Larry. RIP Uncle Morris.

Obituary for Larry MacDonald
Larry Archie MacDonald
3rd October 1949 ~ 24th November 2011

It is with our deepest sympathy that we announce the passing of Larry Archie MacDonald, 62, on November 24, 2011 in Fort St. John, British Columbia.

Larry was born on October 3, 1949 in Lloydminster, Saskatchewan to parents Malcolm (Scotty) and Rosie MacDonald. As a teen Larry, attended Hillmond High School and later became a businessman with Federated Co-op for 15 years and Redwood Esso for 17. He was involved with the Fort St. John Flyers and a sponsor for many community activities.

Larry is predeceased by his father Malcom (Scotty) MacDonald, his mother Rosie MacDonald and his sisters Helen Charles and Sharon MacDonald.

Larry is survived by his daughters, Laurie and Aarin MacDonald, youngest son Scott MacDonald and grandchildren Tysen and Emily Peacock. He also leaves to mourn brothers, Ray, Graham and Murray MacDonald and his sisters Florence Brown, Catherine MacDonald, Doris Napper and Janet Grant.

Special thanks to Dr. Mark Thompson, Dr. Ilona Amstutz, Hamre’s Funeral Chapel, the nursing staff at the Fort St. John General Hospital and the staff at the Chemotherapy Clinic for their professionalism, care and understanding.

Expressions of sympathy may be made in memory of Larry to the Fort St. John Palliative Care Society 9812-108th Ave Fort St. John, BC V1J 2R3, The Salvation Army 10116-100th Ave Fort St. John, BC V1J 1Y6, or The Canadian Cancer Society #108-9325-100th St Fort St. John, BC V1J 4N4.

A memorial service was held on the 5th December 2011 at 2PM at Pomeroy Hotel 11308 Alaska Rd Fort St. John, BC, V1J 5T5.

Holly's Memories: Larry was the closest thing I've ever had to a stepdad.

I was already off at my second year university when my parents divorced & shortly thereafter Larry & my Mom starting dating & moved in together, so the relationship we had was always as adults rather then him doing any "raising" of me. Still, I like to think that at age 19 when he came into my life, I was still learning lots & that I learned a lot from Larry. I later worked for the better part of a year in his Redwood Esso convenience store & got to see that side of him too.

Larry loved to laugh & have a good time. When he was jolly he always made sure to take everyone around him along for the fun. He was extremely generous, with both his money & time. He was the type who fed a man who couldn't pay, because he could see the guy was hungry & needed a meal. "It sucks not having money," he always said, he had been completely broke himself & he tried to help people out whenever he could. After several years things didn't work out between him & my mom, but we both continued to care for him.

The last time I saw Larry was in September 2009 at Casey's Pub in Fort St. John. Larry had had his first run-in with cancer at that time, but still had the same cheerful attitude, same smile, same laugh. Gave me a hug. I'll always remember this warm, funny man and my heart goes out to my mother, his children, and all those who miss him every day. RIP Larry.

Obituary for Morris Phillips
Morris Howard Phillips
10th February 10 1943 ~ 31st January 2012

It is with our deepest sympathy that we announce the passing of Morris Phillips, 68, on January 31, 2012 in Fort St. John, British Columba.

Morris was born on February 10, 1943 in Edmonton, Alberta to parents Howard & Betty Phillips. As a teen Morris attended school in Calmar, Alberta. Through the years Morris worked hard to become a self employed contract operator for M&H Gas Well Servicing Ltd which he did proudly for the last 50 years. On May 7, 1964 Morris married his best friend Joann Elizabeth Robarts and would later become a father to three beautiful children. Morris was greatly involved at the Lake Point Golf & Country Club, one of his greatest accomplishment was when he shot a hole in one on Hole #5.

Morris is predeceased by his father Howard Phillips, his mother Elizabeth Phillips, and his brother Daniel (Danny) Phillips.

Morris is survived by his loving wife of 47 years JoAnn, his beloved children Shawn, Sherri and Dallise, and his cherished grandchildren Raschelle, Carter, Ryan, Tanniesha and Dayna.

Special thanks to the nurses at the Fort St. John Hospital for all their care and support they showed through this difficult time.

A memorial service was held Saturday, February 11, 2012 at 11:00am from the Royal Canadian Legion Hall. Morris will be laid to rest at the Woodlawn Cemetery at a later time. If so desired expressions of sympathy can be made in memory of Morris to the Fort St. John SPCA.

Holly's Memories: Morris was my mother's oldest brother & my oldest uncle.

I remember Morris from all the family events growing up. He was part of the tapestry of my young life, a large extended family that wrapped around me like a soft comforting blanket. Uncle Morris was a lot like my grandpa, his father: a gruff-on-the-outside man with a big heart just under a slightly crusty exterior. He was always there for my mom when she needed help or support, and I always loved & respected him for that.

In his last months Morris was in a great deal of pain, so although we're all sorry to see him go I am comforted by the idea that he has rejoined some of his favourite dogs & is walking the clouds with them now, in full health & strength and without any pain.

My heart goes out to my Auntie Jo, my cousins, and of course my mom who is having a horrible time dealing with his passing. RIP Uncle Morris.

04 February 2012

Pain in the Ascites

Chemotherapy Round #10: Wednesday, 18th January - Tuesday, 7th February 2012

When updating people about my health, whether here or on FaceBook, I always strive for "honest-but-upbeat". I hate that cancer has made me a constant source of stress & anxiety for everyone who cares about me. I know worrying is the price for caring about someone, and that my loved ones pay it gladly, but still, it sucks. Stupid fucking cancer really, really sucks.

Which is why this update has been one of the hardest to share. It's been a very rough couple weeks.

When last I updated the blog, I'd had the PET scan showing that the cancer was still active rather than just scar tissue like the CAT scan suggested. This wasn't a huge surprise, because I'd been having more & more aches & pains, which although I diligently reported them to my doctors, I tried for the most part to write off as other things. I hoped that round #10 of chemo, full chemo, would knock the pain out again. That hasn't happened.

The chemo itself was one of the easiest rounds I've had - after 9 weeks since my last full chemo, my body had recovered more of my strength & energy than I thought. Just the pain was a problem, trying to find a new pain pill regimen that worked for me. At first I was hoping to manage with just over-the-counter stuff, like Tylenol, but that wasn't controlling it. So when we went in on Tuesday, 24th January to get the baby bottle off, we met with the pharmacist and she put me back on the Dilaudid.

We went home, expecting to be entering the recovery phase. Normally with chemo every day is a little better at this point. Instead, I struggled, and vomited a couple times, and by Thursday night in the wee hours I was tossing & turning, in pain, unable to get comfortable enough to sleep. I got up to go the bathroom and caught a glimpse of myself in the mirror, and was shocked by how distended my belly was, especially my upper abdomen. Starting right under my boobs I had a giant curve, like I was pregnant. I realized then that my ascites had gotten much worse and were what was causing a lot of my discomfort.

What are ascites? It's fluid in your abdomen. It's similar to a blister - your body tries to protect itself by building a layer of fluid over the injury. In this case, the growing cancer. I had ascites at the time of diagnosis; they were drained off during the exploratory surgery that found the cancer, and hadn't come back because chemo had worked so well. Dr. Katakkar had mentioned months & months ago that the fact that they hadn't come back was one of the surest signs that chemo was working. When I'd had my exam this round on the Wednesday right before chemo, he'd commented that there was a little fluid back, but nothing like this.

What did this mean? That the ascites had gotten so much worse, right after chemo? Ascites are a common complication from stomach cancer, and I had read online about a woman who had to have hers drained regularly. At this point, in the wee hours of Thursday night, having a giant needle stuck in my abdomen sounded like sweet relief. I decided to call the cancer clinic about this new complication first thing in the morning, and had a fitful sleep where I dreamed about jabbing myself in the belly with a giant bbq fork and draining the fluid off that way.

Friday morning I called the Cancer Centre & asked about the possibility of draining the ascites. Dr. Katakkar was out of town, but the new oncologist, Dr. Fibich was in, and agreed to get me an ultrasound & see me. So Sterling & I headed down to the hospital. We went to the Cancer Centre for some bloodwork, then upstairs for the ultrasound, where both the technician & doctor called it a "moderate" amount of ascites - I hope I never have "severe"! The problem was (is) that it's not one giant pocket; like my cancer, it's spread throughout my abdomen in isolated pockets. They can't drain either of the two really painful ones, in my upper abdomen, because of all the organs up there (stomach, liver, etc.). They end up marking an "X" in sharpie on my lower left, down above my hip, and "2.5 cm", which the technician explains is where the pocket starts; the needle has to go in at least that far, probably more like 3-3.5 cms. Gulp!

Back down to the Cancer Centre to see Dr. Fibich. He was very nice. He had read a lot of my file, we talked about my case for a bit, he showed me the ultrasound. Unfortunately, he wasn't very optimistic about what drainage would do for me, since they couldn't touch the pockets that were really bugging me, and just in general he said he's found it usually only gives minimal relief. But after studying the pocket they'd marked, he was willing to try. He froze the area, and tried twice - managed to get a small sample which he sent for tests. It looked like thin blood. After the second attempt he gave up, saying that the relief wasn't worth the discomfort the procedure was causing. He told me to take as much pain killer as needed, and to come back in, even over the weekend to the emergency room, if things got worse, or if the ascites started causing breathing problems. Dr. Katakkar would be back Monday & he would discuss with him.

Dr. Fibich confirmed the ascites were a bad sign. The most likely explanation is that the chemo regimen is no longer working. However, given the timing, it's also quite possible that this was just where the cancer was heading, and my switch back to full chemo was too little, too late to stop it from happening. In that case I will hopefully get better with the next round of chemo. There's also a tiny possibility that the chemo itself, killing the cancer, caused the flair-up in irritation & the ascites. It will be Dr. Katakkar's call whether to switch my chemo, or to try at least one more round with this protocol. But bottom line, there's little to nothing anyone can do until the next round of chemo. I called back Monday, and Dr. Katakkar concurred with all of this. Nothing to do but wait it out.

That weekend, 28-29th January, was awful. I was restless, squirmy, no position was comfortable for more than a few moments. The best that could be found was lying on my left side in bed in a semi-fetal position. I couldn't even lie comfortably on the couch. So it was pretty much a total bed rest weekend, so boring, so uncomfortable. The way I describe it is, that feeling of being completely bloated after you've eaten way, way too much at a holiday meal. But you're actually hungry, because you haven't been able to eat anything. And what little I eat, I can't seem to keep down. I've puked more in the last two weeks than in my entire 33 year life before that. There's just no room for food, and/or the fluid is pressing on my stomach, causing me to heave.

I did get some relief late Sunday night. In the wee hours, lying there, trying to get comfortable, it was like something suddenly shifted, and some of the pressure fell away, maybe 10-20%. It's not a lot, but it's something, and I've been grateful. It's meant that in the last week I've been able to sit or lie on the couch some & watch TV, more than I was able to do last weekend. I can also lie on my other side as well, giving me in general more options of "comfortable" positions. I've barely been on the computer though. I can't find a comfortable way to sit in my computer chair. Twice already, writing this blog post, the pain's gotten so bad I've had to go lay down in bed for 10-15 minutes to let it pass before another short session in the chair.

I managed to make 48 hours without puking. But that ended abruptly yesterday. Friday 3rd February I was awakened out of a dead sleep at 5AM to run to the bathroom & worship the porcelain god. There is something oddly sweet about both cats coming in the bathroom & hanging out with me while I retched. Either that or they wanted to see Mommy hacking up a hairball, or most likely wanted to be fed.

Sterling woke up around 6AM, after the first 2 rounds of puking but before the 3rd. He's so sweet, he brings me gingerale & rubs my back while I hurl. I'm sure if I had any hair he'd hold it back for me. I am so lucky to have him.

Yesterday (Friday) was the most puking day yet - in addition to the 3 times in the morning, I puked up my dinner (a few bites of taco) right before bed. Then I was up every half hour, 4-5 times last night, pooping water as well. (I've also been struggling with constipation even before this, so have to try to get some laxative in between all the other meds as well). And then this morning, I took my morning meds, and immediately puked them up as well, in spite of there being absolutely nothing in my system at all. I was crying this morning, clutching the toilet, Sterling rubbing my back, and I just kept saying, "I'm so scared." I've been really lucky with my quality-of-life so far, but this... this is just not good.

I'm OK, really. I will get through this. This morning I decided to stop trying to be a hero & just take more meds already: more breakthrough pain medication when I need it, and the anti-nausea pills on a regular basis, since I'll be fine fine fine & then suddenly horribly nauseous & puking. Hopefully these measures will help.

Everyone I've told "offline" has been so sweet, and expressed such feelings of helpless. "If there's anything I can, just let me know." I wish there was, but at this point there's just nothing anyone can do. Just knowing I have all your good thoughts/vibes/prayers is a great comfort. Thank you. And I hope for better news to share with all of you after chemo next Thursday, like the ascites going down.