Yesterday, Faina was outfitted for TPN, intravenous feeding. She had not been able to keep food down for days and the situation was getting worrisome. She finished the first dose of chemo. Next round, November 9th.
Big event today - National Cancer Institute-National Institutes of Health. We met with Dr. Avital who is heading up a study that is a combination of surgery and chemo. He painted a none too rosy picture of Faina's prognosis, paused a bit, and, recognizing that this was a reality with which we have already grapled, continued to present the pros and cons of treatment. We are talking about buying time, months, at best. He is devoted to leading edge treatment. His work ethic, "We don't do standard." We are going to have to wait a week to hear if he will be able to treat her.
Friday, October 29, 2010
Wednesday, October 27, 2010
A Rough Day
Today was exhausting. Faina began chemotherapy this morning. Two hours stretched into five. All beginnings are difficult and this is a re-start of a process we have been engaged in for over a year.
Many aspects of her health have started to change quickly. Over the last few days Faina has suddenly become unable to keep food down. To counter that, tomorrow she will have a PICC line put in and will begin to get nutrition intravenously. Since cancer cells produce a lot of water, she will be undergoing a paracentesis procedure for the second time in less than a week. On Friday, two liters of water were drained from her abdomen. Two weeks ago we were strolling down the Las Vegas Strip. Now, walking to the stop sign at the corner is a challenge.
We were in touch with Hopkins to get medical records. The people we spoke to were somewhat less than warm and fuzzy about getting this information ready for our Friday appointment at the National Cancer Institute. They will try to get the material ready was as far as they would go in making promises.
Before turning in for the night, I sent an email to Religious School families informing them of what is now going on in my life. Hitting "Send" bordered on the physically painful, a concession to a new reality.
The encouagement Faina has been getting from Dental Care Alliance has been great. The same goes for my colleagues at Beth El. We are moving forward, mostly into a thick fog of uncertainty.
Many aspects of her health have started to change quickly. Over the last few days Faina has suddenly become unable to keep food down. To counter that, tomorrow she will have a PICC line put in and will begin to get nutrition intravenously. Since cancer cells produce a lot of water, she will be undergoing a paracentesis procedure for the second time in less than a week. On Friday, two liters of water were drained from her abdomen. Two weeks ago we were strolling down the Las Vegas Strip. Now, walking to the stop sign at the corner is a challenge.
We were in touch with Hopkins to get medical records. The people we spoke to were somewhat less than warm and fuzzy about getting this information ready for our Friday appointment at the National Cancer Institute. They will try to get the material ready was as far as they would go in making promises.
Before turning in for the night, I sent an email to Religious School families informing them of what is now going on in my life. Hitting "Send" bordered on the physically painful, a concession to a new reality.
The encouagement Faina has been getting from Dental Care Alliance has been great. The same goes for my colleagues at Beth El. We are moving forward, mostly into a thick fog of uncertainty.
Tuesday, October 26, 2010
Shaken To The Core
Faina had checked out of the hospital on September 10, 2009. For almost a year her health was good. We took advantage of the open window catching Baltimore Symphony Orchestra concerts, many memorable restaurant meals, more than a few exceptional films, a Mediterranean cruise, visiting family in Israel, and enjoying a wedding weekend with Faina's Leningrad medical school classmates in Seattle.
In August, an MRI indicated a growth on the liver, the region that defined the original gastric cancer as stage 4. Dr. Schulick thought that it could not be cancer and advised against surgery and a biopsy. He proposed waiting a month, redoing the scan and planning based on that data. We felt that a bullet had been dodged.
After an anxious month, we received a blood test report that was "Off the Charts" for cancer. The Carbohydrate Antigen 19-9 score, which had been 21 on July 22, 2010 was now at 2619. The report read "Results cannot be interpreted as absolute evidence of the presence or absence of malignant disease." The CT scan removed all doubt, among the statements, "peritoneal carcinomatosis should be considered."
We have entered an entirely new phase. We have renewed our communication with Sloan-Kettering. We are developing a relationship with National Cancer Institute-National Institute of Health. Dr. Koutrelakos at Maryland Oncology/Hematology is once again our rabbi. Chemotherapy begins tomorrow.
Between monents of calm I reach out to two cultural icons that have been the background track of my adult life, Allen Ginsberg's poem Howl and Edward Munch's canvas Scream.
I saw the best minds of my generation destroyed by madness,
who drove crosscountry seventytwo hours to find out if I had a vision
or you had a vision or he had a vision to find out Eternity.
In August, an MRI indicated a growth on the liver, the region that defined the original gastric cancer as stage 4. Dr. Schulick thought that it could not be cancer and advised against surgery and a biopsy. He proposed waiting a month, redoing the scan and planning based on that data. We felt that a bullet had been dodged.
After an anxious month, we received a blood test report that was "Off the Charts" for cancer. The Carbohydrate Antigen 19-9 score, which had been 21 on July 22, 2010 was now at 2619. The report read "Results cannot be interpreted as absolute evidence of the presence or absence of malignant disease." The CT scan removed all doubt, among the statements, "peritoneal carcinomatosis should be considered."
We have entered an entirely new phase. We have renewed our communication with Sloan-Kettering. We are developing a relationship with National Cancer Institute-National Institute of Health. Dr. Koutrelakos at Maryland Oncology/Hematology is once again our rabbi. Chemotherapy begins tomorrow.
Between monents of calm I reach out to two cultural icons that have been the background track of my adult life, Allen Ginsberg's poem Howl and Edward Munch's canvas Scream.
I saw the best minds of my generation destroyed by madness,
who drove crosscountry seventytwo hours to find out if I had a vision
or you had a vision or he had a vision to find out Eternity.
Thursday, April 29, 2010
CT Scan
Monday was the long awaited CT scan. Hopefully, for the next two years, this will be an every four months experience. Faina pretty much puts all planning on hold in the weeks leading up to the scan and then is a little more open to contemplating trips, concerts, and medium term planning after seeing the report. Monday's scan was clean, other than some thickening of the intestinal walls, an indication of anything from irritation to a recurrence of the disease. A colonoscopy is on the Friday calendar. Thank you Dr. Silverman for finding time on your schedule for a pre-op check-up ("How soon can you get over here?") and Dr. Gertner for the discovery of a warp in the time-space continuum. And so we ride the waves, from crest to trough, up and down.
Faina has been working, three days a week since the beginning of the month. Her energy level is good. She rarely makes it through the first segment of the Daily Show.
Faina has been working, three days a week since the beginning of the month. Her energy level is good. She rarely makes it through the first segment of the Daily Show.
Wednesday, April 7, 2010
Back to Work
Faina is back at work. She was warmly greeted by her colleagues with flowers, cake and cards. She is feeling comfortable with a syringe and a drill in her hands and is thrilled to be back in the frenzy of a busy office.
We are in an uncomfortable anniversary zone. It was on April 6, 2009 that an endoscopy discovered a growth and on April 13th that we got word that it was cancer. All of this was woven into Pesach, Hag HaHeruteinu, the Festival of Our Liberation. My hopes are that this coming year will be one of liberation from this insideous disease.
As I sat in shul on Shabbat, the reading of Shir HaShirim led me to reflect on Faina.
Arise, my beloved, my fair one, and come away.
For behold, the winter has passed; the rain is over and gone.
The blossoms have appeared in the land, the time of singing has arrived,
and the voice of the turtledove is heard in our land ...
Arise my beloved, my fair one, and come away. (Shir HaShirim 2:10-13)
Ahead will be a coming away from a year-long winter. The landscape has changed, as has our perception of it. It is a time to sing, to open up our senses and to give new expression to our experience of the world. It is time to arise, to greet the dawn of a new day.
We are in an uncomfortable anniversary zone. It was on April 6, 2009 that an endoscopy discovered a growth and on April 13th that we got word that it was cancer. All of this was woven into Pesach, Hag HaHeruteinu, the Festival of Our Liberation. My hopes are that this coming year will be one of liberation from this insideous disease.
As I sat in shul on Shabbat, the reading of Shir HaShirim led me to reflect on Faina.
Arise, my beloved, my fair one, and come away.
For behold, the winter has passed; the rain is over and gone.
The blossoms have appeared in the land, the time of singing has arrived,
and the voice of the turtledove is heard in our land ...
Arise my beloved, my fair one, and come away. (Shir HaShirim 2:10-13)
Ahead will be a coming away from a year-long winter. The landscape has changed, as has our perception of it. It is a time to sing, to open up our senses and to give new expression to our experience of the world. It is time to arise, to greet the dawn of a new day.
Wednesday, February 3, 2010
The Caregiver
I'm lucky to be writing this now. Fortunate to have waken up in my own bed only with bruised muscles, a mild abrasion on my right arm, a left arm that I can almost raise to full extension, and a Volvo sitting in a lot awaiting a representative from the insurance company to decide its fate.
Irony of ironies. In my job description, I'm essentially the one who makes the decision on whether or not to hold school or cancel classes. My first consideration is the risk factor to my teachers. Many of them drive greater distances than the boundaries of Bethesda. They hit the road well before the students and often sufficiently after they have gone home, time to face even more treacherous road conditions than their students.
On my way home last night from the evening classes I thought we could fit in before the storm made road conditions dangerous, I hit a patch of ice, slid across four lanes of highway, came to rest in the right lane just in time for an 18 wheeler to pound into the passenger side door. The engine had stalled out and I had a second or two of watching the truck bearing down on me, make contact, and push me 20-30 feet.
So, a quick recap of some Groundhog Day highlights:
1) AM appointment with Faina at the oncology center.
2) Get home: Toby the cat's illness has advanced, his breathing is labored, quick run to veterinarian who presents options, including euthanasia, which we go ahead with.
3) Highway mishap. (Roadside rescue - David Q - Get home, pop open a Lucky Cat IPA, the caption on the inside of the cap - "You're In For A Surprise" - L'chayim)
Irony of ironies. In my job description, I'm essentially the one who makes the decision on whether or not to hold school or cancel classes. My first consideration is the risk factor to my teachers. Many of them drive greater distances than the boundaries of Bethesda. They hit the road well before the students and often sufficiently after they have gone home, time to face even more treacherous road conditions than their students.
On my way home last night from the evening classes I thought we could fit in before the storm made road conditions dangerous, I hit a patch of ice, slid across four lanes of highway, came to rest in the right lane just in time for an 18 wheeler to pound into the passenger side door. The engine had stalled out and I had a second or two of watching the truck bearing down on me, make contact, and push me 20-30 feet.
So, a quick recap of some Groundhog Day highlights:
1) AM appointment with Faina at the oncology center.
2) Get home: Toby the cat's illness has advanced, his breathing is labored, quick run to veterinarian who presents options, including euthanasia, which we go ahead with.
3) Highway mishap. (Roadside rescue - David Q - Get home, pop open a Lucky Cat IPA, the caption on the inside of the cap - "You're In For A Surprise" - L'chayim)
Monday, February 1, 2010
Thirteen Days In
Faina is now thirteen days into her first post-surgery cycle of chemotherapy. The plan is for three three-week cycles. The chemo is supposed to get progressively more difficult as there is a cumulative toxic effect. The treatment is hitting her a lot harder this time around, but she has no doubt that she will make it through the nine weeks. Tomorrow will be a hydration appointment at the oncology center. Next week, the second cycle will begin with the three letter bomb, ECF. Throughout, she has a Walkman-like pump steadily administering the F of the three, fluorouracil. In the still of the night, or at quiet moments, the pump's intermittent dosings break the quiet like a subtle reminder of its presence.
It has been interesting having Margo home mending from her bunionectomy at the same time. Together they have burned through every DVD or On Demand offering of Dexter and are working through Michael C. Hall's earlier work, Six Feet Under; the HBO production set in a funeral home. Yea, put that image in your pipe and smoke it.
Faina is still working on the whole eating thing. Not having a stomach anymore re-writes that playbook. Certainty is out, unpredictability is in, big time. Sometimes foods go down easy, othertimes she is practically catatonic, just lying still waiting for a wave of discomfort to pass by. The five course meals of old are out, lots of small meals are in; concerns about weight are out, noshing over the course of the day is in; Coffee is out, tea is in; Sugar is out, honey is in; Crackers are in; almond biscotti is in; and, to her even greater pleasure, gin and tonic is still in. Every morning her night table bears the signs of a nocturnal field trip to the kitchen, a banana peel, an apple core, occasionally a wrapper of one kind or another.
Every day is a gift, a new adventure, a never ending string of surprises.
It has been interesting having Margo home mending from her bunionectomy at the same time. Together they have burned through every DVD or On Demand offering of Dexter and are working through Michael C. Hall's earlier work, Six Feet Under; the HBO production set in a funeral home. Yea, put that image in your pipe and smoke it.
Faina is still working on the whole eating thing. Not having a stomach anymore re-writes that playbook. Certainty is out, unpredictability is in, big time. Sometimes foods go down easy, othertimes she is practically catatonic, just lying still waiting for a wave of discomfort to pass by. The five course meals of old are out, lots of small meals are in; concerns about weight are out, noshing over the course of the day is in; Coffee is out, tea is in; Sugar is out, honey is in; Crackers are in; almond biscotti is in; and, to her even greater pleasure, gin and tonic is still in. Every morning her night table bears the signs of a nocturnal field trip to the kitchen, a banana peel, an apple core, occasionally a wrapper of one kind or another.
Every day is a gift, a new adventure, a never ending string of surprises.
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