1 Down - 11 To Go

His first chemo started Mon. morning and ended this afternoon. They start everything at the infusion lab - takes about 4 hours and then he gets a portable pump "to go" in a pack so he can go anywhere with it. After 46 hours, a home health person comes to our place and disconnects him. He had no side effects until today when he has been a bit tired, but our allergies are going"crazy" and we both feel "blah" today so may not have been the chemo! He had a couple of seconds of nausea and took a pill, but that was it! Tomorrow he goes in for a white blood cell boost shot - it is only $4,000 for one shot! Thank goodness for medicare! That will make him ache all over and some tell us that it is the worst of all the treatment. According to the doctor, our bone marrow is very lazy about making new white cells so after the first few treatments he will get this shot. Then his bone marrow will be awake and when chemo comes will go to work and won't need an alarm shot any more. Guess that is why you ache with the flu - it is the bone marrow getting busy to make new healthy cells to get you well! Friday we go to the cardiology device clinic to check his pacemaker and get further instructions. Tuesday is a followup with his surgeon - we are going to teach him which side pacemakers go in! After the surgeon, off to oncology for labs and meeting with his doctor there. Keeps us busy with appointments!

We are starting with our third wind storm this week. The first one brought down a large limb that was hanging over us. Our luck has changed - it went between us and the rig next door missing all of us by inches. If it had hit us it would have totaled our rig and killed us if we were in the rear. The tree belonged to the home behind us and for the 2nd storm they had ropes to get it to fall back there. It stayed up and it was taken down yesterday. The first 2 storms had winds of 30 to 50 with gusts to 70. Tonights storm is supposed to be worse. Another night of rock n roll! And another storm on Saturday. Enough!!!!!

His Heart Is Fixed

Permanently we hope! He had a pacemaker put in and an AV node ablation done yesterday and had to stay overnight at his favorite "hotel"! The "hotel" is like coming home we know so many of the staff and they all come to say hi! He is now home with his pacemaker set at 80 to 110. They had to start high since his heart was used to fast - go to slow at first and it will rebel. Then in about a month they will start slowing it down over several months. His chemo was put off until Monday as his oncologist wanted his heart rate normal! So there is light at the end of the tunnel! Meanwhile, we have had 3 times the normal rain for Nov. and 10 degrees below normal. Figures, since we are here! We were about ready to build an ark, but we got a break yesterday, more rain and wind last night and then fairly nice today until tonight. Maybe snow tonight...... And they say it is supposed to be dryer and warmer than normal.....waiting.....

We Have A Plan - FINALLY

After another 4 days in the hospital with his heart stopping for up to 4.2 seconds several times a minute, they lowered all his meds and since the doctor to fix the problem was on vacation (yep there is only one EP doctor) they sent him home with a Holter Monitor for 24 hours and lowered his meds some more. This past week he had the monitor again for 24 hours and his heart is still "pausing" and his heart rate is high - surprise with the lower meds! Friday we met with the EP doctor and this week he will have a pacemaker put in followed by an ablation of the AV node. We will know Monday the exact day and time. The atrium will still be in a-fib and can do anything it wants, but can no longer control the ventricle - that is the pacemakers job! He will be on warfarin the rest of his life, but not all the other meds that make him so sleepy. Then the following Monday, Nov. 16 he will start chemo. His oncologist did not want to start chemo until his heart was done so the "heart boys" have run out of time and it has to be done this week! Yea!!!! We are getting used to the rain. At least at this RV park we have a nice patio, gravel parking and paved roads, so no mud to track inside. They have added gravel to the parking area for us, so it is nice and thick and the water does not stay on top. They clean up all the leaves every day on the roads and grass - an endless job right now! They even take out the propane tanks, fill them and put them back in for us for the price of the propane - what a deal. Good thing since after his pacemaker placement he can't raise his arms over his shoulder or lift more than 10 lbs. for 2 months. The lengths he goes to to get out of doing anything!!!!!

Settled in for the Winter

We moved to a larger site last Sunday since we will be here for awhile. Sure is much nicer to have neighbors a bit further away! We met with his cardiologist this past week. At first he didn't feel they should do anything since the meds were controlling his heart rate. That was before he looked at the EKG and the meds he is taking. His heart rate is still high and he raised one of the meds another 120mgs a day. He is now taking enough of these meds to control an elephant! So now he is sleeping 24/7 instead of 20/7! We meet with the electrophysiologist on Nov. 6. He is the doctor that does the procedures, so will see what he recommends. The cardiologist feels the problem is in the AV node and if they fix that he will likely have to have a pacemaker. Then off to the surgeon to have his incision checked. He has had a hole at the bottom to drain an infection. The infection is gone, but needed to see what to do next. Just let it grow together and will be fine now. Yea - no more packing, just bandage everyday! Since we were there the surgeon decided we should schedule his surgery to put in a power port for chemo so he can start taking warfarin again for his heart. So yesterday we spent 4 hours at the hospital and he now has a sporty port below his collar bone on the left! The first time he has been at the hospital for a procedure and actually got to come home afterwards! This week is a CT scan and followed in a couple of days with another meeting with the oncologist to schedule his chemo. All the ducks are finally lining up in a row and we are making progress toward an eventual full recovery! We will have lots of company in this park for the winter - they only have a few empty sites!

Long Term Plan

We met with the oncologist this morning. This doctor had worked at MD Anderson Cancer Center in Houston TX (a leading cancer center in the US) and after talking to him about various treatments Ralph has decided to stay here. The protocol for his cancer would be the same anywhere and the only difference would be if he wanted a clinical trial. This oncologist is the head of oncology at Skagit Valley Hospital and is part of the Seattle Cancer Alliance which includes the University of Washington and Fred Hutchison Cancer Center. His treatment will be 2 days on infusions and 12 days off for a total of 12 cycles (6 months). There are practically no side affects to these drugs. His 2 day infusions start at the center for about 4 hours and then continue at home for a total of 48 hours. He will have a baseline CT scan and then meet with this oncologist for a start date. After treatment they will do another CT scan and then every 6 months. He will have another colonoscopy next August and then every 3 to 5 years for that. The oncologist will work with our travel schedule for follow-up appointments. His a-fib will not affect his chemo schedule which they like to start no sooner than 4 weeks from surgery and no later than 6 weeks from surgery. He will be closer to the 6 weeks since they would like to give his wound as much time as possible to heal. So, cardiologist is next Tuesday and hopefully we will have a time for the ablation. The 27th is the surgeon for followup and consult on a "port" then a CT scan and the oncologist is on the 30th. We will be staying at our wonderful little RV park here in Mount Vernon just 10 minutes from the medical centers! We are getting ready for winter and will be warm and comfortable in our little house on wheels!

Home

Ralph came home Sunday afternoon. He is still moving a bit slow, but getting out and around. He still has a hole at the bottom of his incision that has to be packed and bandaged. Not sure what the long term plan for that is since his surgeon is on vacation and another surgeon saw him in the hospital. He takes naps, but more because of his heart than surgery. Everyday is better!!!!

Coming Home Soon

It has been a difficult few days to get his digestion working again. They finally had to put an IV "pick-line" in his arm and feed him nutrients that way for 2 days. Friday they started on liquids again and he did well on them. Over night they weaned him off the nutrients and yesterday he had solid food and did well. He still has a hole at the bottom of his incision from when he had an infection. Now to get it to heal, they are doing some minor work on it today - they said it needs to wake up again and realize it needs to grow together. Our bodies are amazing! His heart is now between 100 - 140 with very high doses of meds. Cardiology was supposed to see him yesterday and no one came - surprise! Everyone just wants to know what meds he is to take at home. The path report was about what we expected given the surgeons report after surgery. When removing the tumor, they went far enough to get to clean and cancer free tissue. About 1/2 the lymph nodes removed had cancer cells. He will be ungoing chemotherapy at some point. The timeline for everything is a bit fuzzy right now given his heart rate and the need for ablation to correct that. They said he might get home today, but his surgeon on Friday noted in his chart that he would be released probably Monday. They may want to watch the wound for 24 hours to make sure it is OK.