Sunday...May 31st...2009

Back home tonight.....found the townhouses/condos we liked..the list is DONE.....now we just need to sell something....come on buyers!

Tomorrow we leave in the motorhome....Mrs. Wood has "won" again (as to where we go and for how long)....we are heading down south of Sunriver Resort and park for a week....a Thousand Trails Park we belong to....and drive from there to the medical appointments on Wednesday and Thursday.

And Mrs. Wood is doing well....the extra week off has served her well....

A "PORT" surgically implanted Wednesday and BIG chemo day on Thursday.

A port is a small device with a hollow space inside that is sealed by a soft top. The port is connected to a small flexible tube called a catheter. There are different kinds of ports. The doctor will select the one that is designed for the treatment.

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In a short procedure, the port is implanted, which means it is placed completely beneath the skin, and the catheter is inserted inside a blood vessel. Ports are usually implanted on the upper chest. The doctor will locate it where it is best suited for the treatment.

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The port acts like an IV to the bloodstream. A special needle is inserted just below the surface of the skin and into the port so that medications and fluids can be given, and blood samples withdrawn.

A port allows the doctor or nurse to deliver medications and fluids or withdraw blood samples without having to stick the arm veins directly with a needle. The port makes these procedures more comfortable for the patient, especially if the treatment requires frequent access to the bloodstream for medication delivery or blood withdrawal. One will not have to take any special care of the port.

Friday....May 29th....2009

Weekend in Portland....Linda doing well.....Motorhome on Sunday night heading for a quiet spot in the woods somewhere.....Wednesday.....back to the "medical world"....

Thursday....May 28th....2009

She's back!.....how can I tell?.....well, she's "bossy" again.....she is always doing something rather than sitting....she is alert.....and more....

The Oncologist visit today was another one with much information...

First...he said she had "fallen off a cliff"....in other words, her blood counts "tanked" for no obvious reason this past week....her previous cycles had proceeded well and there was no reason to believe this one was going to be any different.

Second....he said it couldn't "have come at a worse time' with her on vacation and all...but she assured him she still had a good time.

Her blood counts today were good.....she is producing the counts again....

He is still waiting a week to start cycle 6.

He is still cutting back on the infusion amounts in the next cycle.

He is planning on starting a "maintenance program" of Avastin after cycle 6 starting the 25th of June.

Of course this assumes everything goes well with cycle 6 and he has no reason to believe otherwise.

Linda's scan will be on June 23rd....this will be a critical check and we hope it shows again what the scan after cycle 3 showed...ie., "marked improvement".

Linda is entering the hospital next week...June 3rd....to have a "port" placed in her chest...she will do it under local anesthesia and be released the same day. This, she is excited about as there will be no more needles placed in her arms trying to find veins to draw blood or do infusions....life will be easier for her and the nurses around her.

The Oncologist said she should be free to go where she wants on the 26th of June...so Linda is contemplating a trip by RV to Nebraska for three weeks...more on that later.

The Avastin maintenance cycles are also three weeks with Avastin given by infusion on day 1 and then 20 days "off".......

That is a lot of information.....ps....he said in three months she should feel a whole lot better...most of her "side effects" she is experiencing should disappear.

Tomorrow Dave visits the Dermatologist as another follow up to the PDT (Photodynamic Therapy) session he had done a while back....we then travel to Portland for two days for visits and all...then back Sunday...load the motorhome....and hide somewhere.

What is Avastin?

Avastin is a cancer medicine that interferes with the growth of cancer cells by blocking the formation and growth of new blood vessels in the tumor which slows their growth. Avastin is used to treat cancers of the colon, rectum, lung or breast.

How is Avastin Thought to Work?

In order to grow and spread, tumors need a constant supply of oxygen and other nutrients. Tumors get this supply by creating their own network of blood vessels. This process is called angiogenesis (an´-gee-o-jen´-i-sis). To start angiogenesis, a tumor sends out signals to nearby blood vessels. These signals cause new blood vessels to grow toward the tumor. Once these new vessels reach the tumor, they provide the supply of blood that brings oxygen and other nutrients to the tumor. This helps the tumor grow.

Avastin is thought to work by blocking one of the key signals that causes angiogenesis. Specifically, Avastin blocks a protein called vascular endothelial growth factor (VEGF, for short).

This may allow Avastin to affect the tumor in different ways:

Avastin may cause the blood vessels to shrink away from the tumor, blocking the supply of oxygen and nutrients that the tumor needs

Avastin may also cause the existing blood vessels to change in ways that help the chemotherapy reach the tumor more effectively

Finally, Avastin may interfere with the growth of new blood vessels, potentially helping to block further growth and spread of the cancer

Wednesday....May 27th....2009

Sort of a "normal" day today....no big issues....Linda is feeling better.

Tomorrow it's back to the Oncologist....for a blood test only.....

Friday my return trip to the Dermatologist for a follow-up and then off in the motorhome for a few days to enjoy the weather....

Tuesday....May 26th....2009

Quite another day today....

Linda actually talked to her doctor last night ..he was very concerned about her "numbers" (ie. blood counts)...he wanted to see her today prior to the transfusions....

So in we went.....

He was very much scratching his head regarding the numbers....the platelet counts had been consistent all the way along....even rising a bit less than two weeks ago....and the red blood cell counts had been acceptable. Why both had "tanked" was beyond his understanding. The good news is that the white blood cells (immune system) had remained OK.

Anyway, the only answer was that the bone marrow had had enough and stopped producing the cells....which means a change in direction. Linda's chemo (day 1 of cycle 6) this Thursday has been cancelled and scheduled a week later...this allows for a monitoring of the counts and allowing the transfusions to take hold. So Linda will go into the Cancer Center Thursday but only for tests. She also received another Procrit shot today to stimulate red blood cell production. The chemo session in a little over a week will be reduced in size and amount because of this significant "reaction?". The Oncologist believes this is the responsible action to take and does not believe it will "compromise" Linda's "plan of action"

We had already been discussing using Avastin in the followup to the 6 cycles Linda is now in...but with her blood pressure soaring and pulse rising (I forgot to mention that too)....a reevaluation may take place at the end of the cycles....her internist may become involved again to work on the pressure and pulse...Avastin does create those symptoms.

That's about what we remember....there was a lot of information exchanged in a short period of time.

Linda then went to the hospital infusion center and got her two units of red blood cells....that took most of the rest of the day....hopefully she will regain her energy....stop the "bleed" episodes (with the platlets yesterday)...and slow her pulse and pressure.....the pressure was better later in the day.

That's about it....tomorrow we rest.....more cruise pictures below to prove we still did have an incredible time...all in all......

Monday....May 25th...2009

Quite a day today.....

First we went to Bend to the ER (emergency room) as directed to have a blood draw to see the "counts"....the good news is they sent us to the "Heart Center" in the hospital...as this is a holiday and that was the best place to get the "draw" done....did we mind?....nope....the ER costs us $100 before insurance "kicks in" so we we glad to be "kicked out".

The draws were done with effort....per usual as Linda's veins are "trashed"....we then went up to the cafeteria to get a hot chocolate as she was very cold....a combination of "bad blood" and air conditioning in an empty building....well, empty for the most part because of the holiday.

Linda then got the call....go to the infusion room upstairs in the hospital....we did that a few weeks ago for a transfusion so the route was known. Upon arrival she was told her platelets (clotting factors in the blood) were down....not a surprise in hindsight because of the nosebleeds, bruising and blood pooling spots....she was also told she needed transfusions of red blood cells also....two pints as opposed to the one pint last trip.

The platelet transfusion was done today and the red blood cell transfusion will be tomorrow. It took the rest of the day to get the transfusion and all associated with it done. Linda is now resting at home and watching to make sure her temperature doesn't go too high....it is up a bit....

Linda had a chance to talk with her doctor tonight..he wants to see her in his office in the morning before the transfusion to perhaps figure out why all of this happened as she had good counts a week and a half ago.

Thursday she is to begin her 6th cycle of chemo...how all of this impacts that we are not sure.

Again, this was quite a day.....

Sunday....May24th...2009

We made it home to Sisters!

On the cruise, I spotted a sign in a shop window in Ketchikan which said:

"Nothing is worth more than this day...."

On the cruise we ran into a mother with two daughters....the daughters were journalling with the help of their mother and had done so for years....documenting their travels, etc., etc..through words, pictures, drawings and all. They shared with us this by explorer John Muir during the voyage through Glacier Bay National Park:

"Climb the mountains and receive their good tidings. Nature's peace will flow into you, as sunshine flows into trees. The winds will blow their freshness into you and the storms their energy, while cares drop off like autumn's leaves".

Sunday....May 24th....2009

Today we got back to Seattle and off the cruise...right now we are in Portland at daughter Janine's watching a taping of the Indy 500.

Linda's "nose bleed" problem developed further and became clear last night (Saturday) what might be going on....it seems Linda's blood is not doing well...she bit her lip and it created a very large dark looking mess....and she had a hematoma on her shoulder...and...and. It became clear that her blood was not clotting properly...also her red blood cells are most likely down...and it became worrisome that maybe her immune system was compromised (no evidence of..but with 2000 people in close quarters on a ship.!.!).

Anyway, as soon as we got off the cruise ship this morning, Linda called the Cancer Care Clinic number and an Oncologist called her back....she is scheduled for blood tests at the hospital in the morning followed by transfusions, if needed, immediately following.

Other than that, we had a good cruise..great weather in each port...great night in Victoria.

Pictures of Victoria..learning the game of Mahjong...etc..
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Friday...May 22nd...2009

Great beautiful day in Ketchikan!....great day yesterday cruising Glacier Bay looking at all the glaciers....we have not had one bad weather day!!!!!!!!!

Great cruise..no problems..nice crew...good entertainment...even the jugglers were great (Linda hates jugglers!).

One wee bit of a problem...ok...a big problem..after the posting on Wednesday, we went to dinner in a new restaurant on the ship....got an incredible seat back at the big window...and then Linda got a major nose bleed...not a small one but a big one...how...many theories...the main one seems to be high blood pressure because of the changing of her medication...combined with the chemo sessions...and then...and then she was blowing her nose to clear out clots of blood (spare you...spare me..I told her many times..don't blow your nose!!!)...and then she used the Nettie pot to clear out her basal and sinus areas...major mistake!!!!!

A quick trip to the ship's doctor..they put a thing up her nose and then inflated it to put pressure on the area...and then back down two more times to control the bleeding...and a plug in the other nose..and..and.

Yesterday they took it all out with direct instructions not to BLOW HER NOSE!!!!! DUH!!!! She finally quit..although she wanted so much to do so...so no problems since...the crisis is over...finally.
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We did get another nice seat last night as we told our woeful story......and a nice dinner..

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All is well...tomorrow Victoria...

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Wednesday....May 20th....2009

Well...we are in Skagway, Alaska....weather..SUNNY!!!!!!

Yesterday....Juneau...weather...SUNNY!!!!!!

Linda is doing well....walking a lot....some nose bleeding....blood pressure up at times..but we are managing both..or at least she is....

Tomorrow we cruise Glacier Bay all day and then down to Ketchikan on Friday.....

Our impressions.....well....if you can get beyond the "tourist stuff"...it is pretty neat....but...BUT...the tourism stuff is big...that's all about making money...the cruise companies (4 ships in port as we speak)....are in on it...everyone is in on it.....

Juneau is a very small central community....which surprised us....the size is in the "greater community".....300 square miles of people (spread out for sure!).....

Pictures:
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Saturday....May 16th...2009

Today Linda did very well...not much of a nap...and held up well...tomorrow it's cruise time!

Today daughter Wendy, son in law Chris and grand daughter Taigen, went with us to Puyallup to have lunch with my aunt Pat and cousin Cathy.....I refer to myself as the "long lost nephew" as we were apart for many years by location.

We also had a short period of time to visit Ron and Kathy Morlan...old smokejumper friend...in Lakewood Washington....off we went as son in law Chris had to take the cat to the groomer before he got to see his two favorite baseball teams play each other....the Seattle Mariners and Boston Red Sox....he accomplished all with a little help (on the cat not the game).

Miss Taigen put on a puppet show for us..see below...and had fun goofing around with her grandparents. Bottom is lunch with all...
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Friday....May 15th...2009

Well....we made it to Seattle...by way of Portland (spent Thursday night with daughter Janine and saw son Jim and daughter in law Jenn)(and Friday morning looking at condos with daughter in law and realtor Jenn)....and then up the freeway, doing quite well until the last 25 miles to Tacoma that took an hour and a half because of two accidents.....and then dinner with my Mom and step brother Mick and step sister Kelly.

We had a great dinner and visit and then a quick drive to Seattle to spend the next two nights at daughter Wendy and son in law Chris and grand daughter Taigen's home in West Seattle.

Linda held up well but was ready to "cash it in" for the night pretty fast...in fact she is snoring very loudly as I type this...don't tell her I said that! She really enjoyed seeing relatives and is looking forward to the cruise.

I forgot to mention the Oncologist changed her doses of heart medications yesterday and her pulse is no long racing like it has been...much relief for her.

Pictures below....dinner with my Mom, Mick and Kelly.....and the last picture...."Sadie the Lady" telling us goodbye as we leave her with daughter Janine for a week while we cruise.
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Wednesday...May 13th...2009

Tomorrow Linda has her chemo treatment and then we head to Portland ....she has had an "uneventful" day..pulse up a bit..hair coming out faster now (actually it is coming out at the same rate for weeks but is at "critical fallout" as we speak).

Linda is looking forward to the cruise...it has been one of her goals and we are doing it....a bit earlier than we had planned but the timing and the price (great great price) was right.

Friday we go to Tacoma for a Mother's day dinner..a bit late, I know...then on to Seattle to stay with daughter Wendy and son in law Chris...and Miss Taigen, the precious grand daughter.

Saturday it is lunch with my aunt and cousin(s)...I am calling myself the long lost nephew as we were disconnected for many years.

Sunday ....North to Alaska.....remember the song by Johnny Horton?
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Monday...May11th...2009

Linda had another "down" day with high pulse and tired and all....BUT then we had company come over and her energy went up....great news....great company....we hope for a good tomorrow now. Talked to the neighbor about the dog....hopefully that is all worked out...they are good neighbors...so are we...the dog just has to be a good neighbor too!

Tomorrow we go to Brasada to finish doing the bark dust on the spec house...we want everything looking good for a potential buyer...should one miraculously come by....one wants to be ready no matter what the market looks like.

Sunday......May 10th...2009

Not such a good day for Linda....perhaps too many activities...too much company.....an accumulation of chemo....or a combination....who knows....tomorrow she is going to "lie low"....we have company tomorrow night and she has agreed to sleep in (if our neighbor's new dog allows it....his persistent barking woke us before 8 am this morning) and take naps during the day....she did take two naps today.

Hopefully tomorrow will be a better day.....

Why Dogs Bark
The first step in obtaining peace and quiet is to realize that most dogs bark for specific reasons. Some reasons include:

Solitary Confinement. A dog left alone or confined for long periods without supervision is likely to bark because he feels anxious or sad and is afraid the owner may not return. (Will your dog be left along for much of the day? Some dogs adapt to this better than others.)

Who's in Charge Here? Your dog may bark excessively for your attention because you unintentionally trained him to do so. One "woof" and you open the door to let him out. Another and you let him in. A polite bark is rewarded with a treat. A loud one brings praise for alerting you to stranger danger. Too much barking brings censure. To a dog, humans are consistently inconsistent.

Inactivity. Lack of exercise can easily result in a dog that has pent-up energy and barks out of frustration. A well-exercised, happy dog is more likely to sleep when you're not there.

How to Stop the Barking
So, what can you do about your dog's barking? Here are some tips:

Let's get physical. Dogs that spend most of their time in the backyard or in the house probably need an exercise outlet. Even if your yard is large, dashing around it in circles is not the equivalent of exercise and interaction. Take your dog for a long walk, or head to the park for a change of scenery and a game of fetch.

Love the one you're with. Bring your dog into the house when you're home. It's important that he feels he's part of the family and is loved. Develop a relationship with him through play and fun.

You've got a friend in me. Dogs are social creatures. Take your dog to the same park daily or weekly and let him make doggy friends. Dogs romping around together tire easily and sleep soundly.

More Strategies
Once you've tried some of these doggie deterrents, if your dog still insists on barking his heart out, then you may need to employ a more serious at-home training strategy like this:

First, teach your dog that barking is okay until he is told to "Be quiet." Each time your dog barks, command him to "Be quiet." Simultaneously, hold a treat in front of your dog's nose. Most dogs get quiet immediately because they can't sniff and lick the treat while barking at the same time.

Praise your dog continuously during his quiet time with petting and words of encouragement.
After three seconds of no barking, let him have the treat. As you continue with your training, increase the amount of time you require him to be quiet before giving the treat.

When your dog makes a mistake and barks (and he will) reprimand him immediately. Never strike your dog, but do something that will catch his attention, such as clapping loudly or squirting water in his face. As soon as your dog stops barking, you must instantly reward him.

Saturday...May 9th...2009

Linda is doing nicely...walking every day....taking her medications...good spirits and all...Daughter Janine is here ...son Jeff was here last night and will come again tomorrow.

I forgot to mention a very important thing at the Oncologists the other day...Linda has been worried about her lower back pain...being tied to the cancer..after the OHSU doctor mentioned an unidentified spot on the spine...well anyway, all is well...the pain is in the lower back...the spot noticed is up the spine....so no connection.

That's about it......

Thursday....May 7th...2009

Big day today.....

Linda's first day of cycle 5 started today with the visit to her Oncologist. He noticed and said immediately that she looked "cushingoid"....which means she was exhibiting the signs and symptoms of Cushing's Disease...ie..her face looked fat. This doesn't mean she has the disease..it means she has the same look...if that makes sense. This "look" is caused by the steroids she is taking...I noticed it a while back but she said she didn't notice anything...well today the doctor did. The solution...cut the steroid use in half and examine again next week.

If you look closely at the pictures I've taken of her in the last week or more, you will surely agree she is "cushingnoid".

The Oncologist told Linda her blood counts were back, ie..... "good".....this is great news as it has been a while...it seems the Procrit shots have done their job...no need for a shot today.

The Oncologist also discussed the finding by the 2nd opinion in Portland at OHSU.....the only thing that may be different is a recommendation of possible treatment after cycle 6. Also the possibility of a "port" for future infusions was discussed as Linda has difficulties with the needle "pokes"...ie., finding a good vein for the blood tests and infusions...we are not sure where that will go.

Linda did her 4 hours of 3 infusions without any difficulty...the $17K infusion we have talked about.

Then it was off to the Dermatologist as a followup to her Moh's surgery to remove the basal cell cancer on her face..remember the 30 stitches? the doctor was very pleased with her progress and felt that with another two months or so of massaging the area with petrolium jelly, there should be little evidence of scaring...he will do a followup check in six months.

A few more chores in Bend and then home we came...a bit worn out from the long day. Tomorrow night son Jeff comes for dinner...then Saturday daughter Janine and son Jim come for the weekend.

Next week another chemo session and getting ready for the Alaska cruise...and the trip to Portland and on to Seattle...seeing family and friends along the way.

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Tuesday...May 5th...2009

Things are OK here. Linda is a bit concerned about intermittent pain in her lower back...since the Oncologist at OHSU indicated a note on the Scan had indicated something there....too early to define what it was. Linda has had back pain since she fell on ice several years ago...and since Vioxx was removed from the market. We shall discuss all this with the Oncologist on Thursday (Chemo Cycle 5 Day 1).

We just booked an Alaska cruise....we waited until we got old..and we are old....so we are booked. We leave on the cruise out of Seattle on May 17th and return to Seattle on May 24th..it also allows us to visit relatives and friends in Portland, Tacoma and Seattle. We had some ship credits and a great sale on Norwegian Cruise Lines, so we are going "on the cheap".

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Sunday...May 3rd...2009

We are back home from a short ski excursion to Mt. Bachelor...me ski...Linda rest and read books. We didn't expect snow in a late spring date..last night we got 4 new inches..and more to come tonight...so we "bailed" and came home early. It was nice to get away in the motorhome..first time out this spring.

Linda felt pretty good...her blood pressure and pulse were high this morning...her blood pressure medication brought things down to normal in short order...it seems the chemo does weird things with her blood pressure and pulse.

Tomorrow we go to Brasada Ranch to work on the 1.5 mil spec house...house cleaning..new bark..etc...etc.. Anything to attract a buyer....
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Friday ...May 1st...2009

I did have another thing on my mind I wanted to talk about.....when I worked for the Oregon Education Association as a consultant, I agreed to mentor an intern, Sandy Bushek. Sandy turned out to be a great consultant herself and is a wonderful person. Her husband, Dan, was a great guy too. Anyway, Dan was diagnosed with Stage III Lung Cancer last August and passed away the other day. I want to share his obituary in honor of him.....I know his fight was a tough one.
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Friday...May 1st...2009

Not much to report today...Linda doing OK...pulse up a bit...so she wears down easier.

Tomorrow bright and early, we take the motorhome to Mt. Bachelor for a couple of days of skiing....nice to have your home out the front door to the ski lifts. So if no Internet signal wandering around, it will be Monday before we are back.

Today was "bark dust day"....with a Ranger pickup, it takes two loads to do the job, so we are half way done...another load on Monday. Linda insisted on helping so the best thing to do was give her a whisk broom and have her clean the bark dust off the rocks...which she did wonderfully.

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