4/30 - Day 1, Cycle 3: A Gleam Hope

I'm not sure if we were more alert this morning after a phase of recuperation or if the gradual transformation of nature in just two weeks time (our last visit to the oncologist) had truly accumulated to a point of enthusiastic recognition. But as we were driving by the Pennsylvania Hospital we were awestruck by a magnificent display of spring bloom in the gardens of the southern edifice. What we were viewing was an enchanting spectacle of landscape at the site of the nations first hospital -- an 18th century building with a statue of Benjamin Franklin (the co-founder of the hospital) as its focal point and the harmonious blend of wisteria vines, azalea scrubs and multicolor tulips surrounding the semicircular lawn.

We didn't realize at the moment of our observation that this scene was an auspicious omen of hope. A symbol of the incredible power of nature's ability to transform while aided by the meticulous and dedicated attention of human care. Our 30 second sighting would soon poetically foreshadow the good news we so badly needed.

There is an escalated, palpable feeling of anxiety with each day before the first day of a chemotherapy cycle. For Kristine, the beginning of a cycle means slipping into a miserable trance where the only recollections she has are associated discomforts of pain, bad tastes and nausea. She held on to her last day for as long as she could by staying awake early into the morning talking to her friend Elaine who was visiting from San Francisco. In the days leading up to today she had become overwhelmed by an intense concern that the pressure she feels in her shoulder had increased which in turn led to doubts about her treatment. This concern had been looming without immediate evidence of her medications' effectiveness. In our early conversations with our oncologists it was discussed that without the success of chemotherapy the odds of survival, statistically speaking, were substantially reduced leaving fewer options.

Our conversation today, even though inconclusive, was very encouraging. Dr. Staddon was very pleased by Kristine's physical and mental demeanor. Review of her scans appears to show positive signs of tumor reduction as well as complete disappearance of any swelling in Kristine's subclavicular lymph nodes (those under the collar bone). Apparently, it's difficult to decipher fully from the scans, but Dr Staddon and his colleagues hypothesize that what looks like a serious of tumors lining the walls of the veins, superior vena cava and the upper chamber of the heart may actually be one central (nucleus) tumor with a long tentacle-like appendage that runs through the other blood vessels. This is good news as it makes for a less difficult surgery. The bad news is that the surgery Kristine faces is likely to be fairly invasive (of the "open-heart" type) though pretty standard procedures these days (Regis was walking within 2 days).

So although the battle is far from over (it sounds like Kristine has 4 more cycles of therapy ahead over the next 3 months followed by surgery to extract what's remaining, this is at the minimum) the odds have flipped back in Kristine's favor with what looks like a successful chemotherapy regiment. And if all works as planned, this is just another example of nature's power to transform with the aid of human care, attention and let's not forget an overwhelming swell of hope.

Also, thanks for voting. It looks like Kristine's wig is pulling ahead but the bald look is not far behind.

4/29 - Vote for Your Favorite

Thank you all so much for your patience. I know a lot of you visit the blog almost daily so I'm sure it's disappointing (and even disconcerting) not to have updates for two weeks. My postings have come in waves depending on the stage of Kristine's cycle but ultimately it all depends on how she's feeling and what new challenge we're facing. However, as I've mentioned before, no news is indeed good news.

Over the last couple of weeks Kristine has been feeling really well. She's been spending time with local friends and even doing some shopping. And although shopping has always been a favorite therapeutic past time for her it has recently become more of a necessity. Kristine has lost weight from the treatment cycles so she's left having either to tighten her belt or to buy some new clothes. For Kristine there's only one solution. It doesn't matter how tired she is she can always muster up the strength to visit a few of her favorite stores.

This past Thursday Kristine had another CT scan and MRI of her neck and chest. Typically these scans are done after the third cycle rather than the second, as was done in this case. Dr. Staddon is taking extra precaution since the cancer type infecting Kristine is considered aggressive. The images will serve as a gauge to determine the effectiveness of the current chemotherapy regiment and potential next steps. Next steps could include changing the chemotherapy drugs, radiation or surgery depending on how the tumors have progressed. On Monday 4/30 we'll be meeting with the oncology team to start Kristine's third cycle and to review the results of her latest scans. This will be a pivotal meeting. It will not only begin to define the next chapter of Kristine's treatment but will also shape our understanding of just how formidable the disease is and the battle that lies ahead.
_____________________________________________
LET THE VOTING BEGIN!

As promised, I have included photos of Kristine's new "cranial" styles as well as a poll for you to vote on your favorites. Kristine wants to hear your opinions so don't be shy. The poll allows you to view results real time so you can see what others think.

You can either view the photos below or see high resolution photos at http://picasaweb.google.com/ryanshawnmacdonald

4/15 - Day 7, Cycle 2: Another Cycle Down

It's been raining all day today (Sunday) in Philadelphia, one of the more relentless Nor'easter we've seen in a while. Kristine's spirits haven't been dampened though, the toughest part of her 2nd chemotherapy cycle is behind her. She finished the last of her intravenous hydration fluids this afternoon. No more flushing her port with saline (a process that leaves a nauseating taste in her mouth) and no more being attached to an IV for hours at a time. The feeling of nausea will begin to subside and she will reclaim a fairly normal appetite.

She received high fives from her sisters and me as the last remaining drops of potassium chloride were funneled into her port. It's a small milestone but one that symbolizes the upcoming two week stage of freedom and rejuvenation before entering her next cycle. Like the last cycle she'll need to be cautious for the next two weeks. Her white blood cell counts will remain low making her susceptible to infection and illness.

On Saturday we reached another milestone when Kristine, her sisters and I headed North to Ginnie G's, a salon and day spa that specializes in wigs and hair replacement. Ginnie, the owner, showed us to the wig room down a short set of stairs. The walls were lined with shelves of styrofoam busts crowned with cranial prostheses of various colors and lengths. Ginnie asked the standard set of questions: Real or synthetic (I couldn't honestly tell the difference), match your existing hair style and color or try something new? After trying on several pieces Kristine set her mind on one. It isn't electric blue, nor bright red, nor is it fashioned after Sanjaya's pony-hawk (although these were all great suggestions). It is, however, similar in color to her existing hair but a bit longer. She chose real hair over synthetic to improve her styling options (with real hair you can cut and style the wig just like you would your own hair).

After having her wig styled, Kristine moved on to the second step. She had her head shaved. Surprisingly it wasn't as traumatic for any of us as I would have expected. Kristine handled it with amazing strength. She looks very cute with her shorn cranium, even a little bad ass (pardon the profanity). Ginnie didn't shave down to the skin, more like a buzz style cut. Having worked with a lot of cancer patients Ginnie informed us that one shouldn't cut the hair down to the scalp during treatment due to the risk of infection and irritation. It's better to shave the hair short to avoid the mess and let the rest fall out on its own.

As for pictures and voting on the new styles, you will have to wait a bit longer. Kristine's not quite ready to reveal her new hair-do. She prefers to wait until her head is completely bald to conduct the voting. I did insert a little teaser for you all -- the remnants of Kristine's lost hair. It's up for sale on EBay but I don't think we can get the same million dollar asking price that Britney Spears' did. :)

4/12 - Days 3&4, Cycle 2: Chemo

The last couple of days were good for Kristine, at least as chemotherapy days go. Kristine's fluid retention levels remained low with the help of the diuretic she's taking. Her energy, although diminished, is healthy. Her appetite is sporadic -- things like oranges and smoothies that she would eat when nothing else sounded good have grown insipid from repetition. Overall though her health is as expected given all the medication she has absorbed.

As it seems for most days, the last couple have not come without their set of challenges. On Wednesday night we came back from the treatment center after another long day, started Kristine on her home intravenous medication and hydration fluids, and started watching the results portion of American Idol. (I am particularly engrossed in this season having taken part in an office pool where, I might add, I've consistently been among the top 4 out of around 50 participants. Sad I know, but it's one of my few guilty pleasures these days and serves as an excellent distraction.) In the middle of the show the power went out in our surrounding area and we were left in the dark for the rest of the night. No electricity meant no computer, hence no blog post.

Thursday was emotional for Kristine as well as her support team. Connie (Kristine's mom) will be leaving on Saturday and that reality has been difficult for Kristine. Mrs. Becker has been an enormously indispensable asset over the past month. Kristine and I could not have held things together as well as we have without her help. It will, however, be good for her to rejuvenate and get some semblance of her life back, even if it is just for a couple of weeks. (Lucas especially will miss the challenge of trying to steal her knitting yarn.) Emotions ran high into the night. Although Connie's impending departure was the catalyst for the day's emotions it seemed that even the smallest gesture of love or sympathy was met with tears.

For today, Friday, we are preparing to shave Kristine's remaining hair. The special voting blog post to determine the most popular head treatment will likely be installed in the next few days. As for my standing in the American Idol pool, I moved up the 3rd place after choosing the bottom three and the loser correctly (I'm sure you were itching to know).

4/10 - Day 2, Cycle 2: Chemo

Not much to report today. Kristine is doing well. She's very tired but is able to awaken for short periods to talk or even play a short game of hearts with her mom and sister Colette.

The hospital has therapy dogs visit the patients periodically. Today, Annie, a young Chocolate Lab, came by the cancer center (we really should have gotten a photo).

Colette did some research on wigs for Kristine (at the rate she's losing her hair she'll likely be bald by week's end). Apparently, many insurance companies cover the cost of a wig for cancer patients with a prescription. That's right a prescription. And like any prescription it can't just be written in English, the wig needs a medical term -- cranial prostheses. So, at some point when Kristine's feeling up to it she'll be fitted and fashioned with a new cranial prostheses (a wig) to treat her condition of alopecia (baldness) courtesy of our insurance company.

I also thought that I would share one last thing. I ran across a great article in the April 9th addition of Newsweek entitled, "My Life With Cancer." The author, Jonathan Alter a Newsweek corespondent, shares the story of his battle with cancer. His story is candid and honest and he offers some great insight from his own fight against the disease. It's worth the read http://www.msnbc.msn.com/id/17888476/site/newsweek/.

4/9 - Day 1, Cycle 2: Here We Go Again

Counter to what most would imagine the anticipation and anxiety surrounding this second cycle of chemotherapy, which began today, was far greater than the first. The limited experience we brought with us this time around gave us the knowledge and understanding to mitigate our fears. However, we were now burdened with the acute awareness of what was about to begin -- another week of chemotherapy.

For those surrounding Kristine this week meant more than just a hectic itinerary, long visits to the cancer center and remembering medication schedules. After all, we have become fairly accustom to these minor inconveniences over the past several weeks. Instead what lie ahead was much less superficial. The week of treatment represents the implausible reality of this disease and its occupancy. The dynamic and vivacious Kristine that brightens our mood, for a few days slips into an altered state, dopey and listless as the medication takes affect.

For Kristine, chemotherapy week has a different connotation. It holds needles, nausea, hazy sight, night sweats, breathlessness, the almost instant metallic taste of saline solution as it’s injected into the blood, the uncomfortable pressure of fluid retention, the prospect of another visit to the ER and the many other discomforts that the week seems to bring.

Kristine was able to enjoy her last few days before this next cycle of chemo with good friends from San Francisco (Alison, Leah and Megan) who were in visiting for the weekend. Their visit provided a needed distraction in the days prior to treatment. As Sunday neared and friends traveled home, Kristine’s anxiety about her treatment intensified. Although she knows logically that it will ultimately benefit her, emotionally it is difficult to get past the discomfort associated with the days to come. And who can blame her? I would most definitely be crying like a school boy if expected to endure such circumstance.

The first day of cycle 2 has come and gone and I'm happy to report that it wasn't so bad. Kristine is much more alert than she was at this time last cycle. She still has a very short memory for any activity that took place even a few minutes prior (a common side effect of the chemotherapy medication). But she is functioning well with a great appetite and energy level. She’s even bossing me around when she’s awake (a common side effect of being a Becker). However, I've adapted and figure that if I just hold out long enough she might just forget.

Until tomorrow.
Ryan

4/1 - Day 14, Cycle 1: Heading into Her Good Week of Cycle

As the adage goes, "no news is good news" and it certainly fits Kristine's story over these past few days. Kristine's been getting outside walking and enjoying the fresh air. Her weight is nearly back to normal (most of the retained fluid has disappeared) and her appetite is equally healthy. She still gets exhausted at even the mention of household tasks. Although I suspect that this is more a mental side effect of being waited on hand and foot over the past two weeks than it is from the chemo. Of course, I can't prove this with any certainty. So her mom and I will continue to do the chores when they need to be done and dance around like trained monkeys when Kristine needs a laugh -- after her miserable week of chemotherapy, I think we would do almost anything for a glimpse of her brilliant smile and laugh.

Kristine's cousin Cris (left inset) was in over the weekend and her Aunt Jan is in for the next week. Her mother will remain in town for a few more weeks until she heads back to Texas for a short reprieve. Having family in town has really helped keep her spirit high and attitude positive. And as you can image it's been incredibly helpful for me to distribute some of the burden. You can see just how helpful Kristine's dad Jim was with our dog Rufus and foster dog Lucas in the photo to the right. (In all seriousness he really was helpful... when he wasn't napping.)

I mentioned in the last blog that Kristine hasn't yet lost any of her hair. She had it cut shorter to minimize the "mess" (her words) when it does start coming out. She said this morning that her scalp felt a little funny... tingly -- the first sign of imminent alopecia (i.e., hair loss). And a few times throughout the day as she ran her hand through her hair more than a few strands detached freely into her fingers. She said that she will likely avoid brushing or washing her hair for a few days to prolong the feeling of a full head of hair.