Joanie has her say.
April came, and in Bismarck, it marked the beginning of a troubling time at 1205 N. Mandan Street.
Joanie had seen Dr. Thomas on Monday and had been given Zometa for the hypercalcemia, along with some IV fluid therapy. By Friday when we went back to see him, the blood work showed the Zometa had done the job. Her calcium was back in the normal range.
That was good news, and Thomas told us there would be no chemo this month, and to come back in a few weeks for lab work. Joanie was relieved. She was relieved mainly because she still wasn’t feeling well. She wasn’t eating, pain was still an issue, and she was tired. She really needed some time off from the treatments that take so much out of her.
My notes from the first few weeks reflect what was going on with her.
Tuesday, April 3rd.
Not eating much this morning. Has about half a turkey sandwich at noon. I drinking fluids, water and Sprite Zero. Pain seems to be under control. She is still taking Dilaudid and wearing a Fentanyl patch. Still having a problem with indigestion and swallowing.
Wednesday, April 4th.
Appetite low. Fluid intake is adequate, I think. She had part of a turkey sandwich for lunch, and some leftover sloppy joe mix for dinner. Went to the office for a couple of hours.
Thursday, April 5th.
Appetite low. Fluid intake is adequate. McDonalds wrap with chicken for lunch. Threw up shortly. Said she felt over heated. Felt better. Took her to her office about 1:30.
This routine was repeated for most of the next six days. My notes on Wednesday April 11th showed things hadn’t improved either.
Joanie stayed home today. Her appetite is still non existent. She has eaten all of one or two cherry popsicles and some Jello in the past two days. Before that she only had some ice cream on Monday. Has thrown up at least once a day.
Tuesday, April 17th.
We had spent a quiet weekend.. Joanie hasn’t left the house since last Tuesday. Appetite has been terrible. Energy level really low. Esophagus has cleared up. Upset stomach has abated. I called Kathy at Dr. Thomas’ office and told her I would keep an eye on her today, and if I didn’t like what I saw, I would call her.
I didn’t have to call, Joanie seemed to rebound enough to ease my concern that day, but it seemed she wasn’t recovering as she should have been.
Things didn’t improve much over the next ten days either. She would go into her office for a few hours in the afternoon, but was still extremely tired, and was losing weight.
I was at a loss. She had handled six weeks of radiation in 1998 with few problems, and that was one of the main reasons we hadn’t worried about doing it again. The situation was not unlike the one with the chemotherapy treatment we had tried last year that resulted in so many problems. We had figured that since she had handled the chemo combination of Ifex, Taxol and Carboplatin in 2003 so well, and it had worked, she could handle it again.
As I thought about it, I realized that in both cases, the situation that dictated the treatments had changed. The cancer was back with a vengeance where it hadn’t been before, and with it came a whole new set of problems we hadn’t anticipated.
When we met with Dr. Thomas on the 27th, it was to do a complete blood count, and other lab work, and prepare for the next round of chemotherapy. Dr. Carson had prescribed Gemcitabine, or as it was known by its trade name, Gemzar.
He was well aware that Joanie was not 100 percent. He noted in his report that she was experiencing a low energy level, fatigue and was still losing weight. Her pain was still an issue, and he took care of that with another prescription of Dilaudid.
When it got around to talking about the next round of chemo, Joanie took charge, much to my surprise. She told Thomas she wasn’t ready to start chemo again, and said if she feels better in a couple of weeks she’d be ready. She told him she would let him know.
I was proud of her. This was another example of her taking some control over what was happening to her, and I think it made her feel better right then. I knew how important it was to her to feel that she had something to say about her treatment.
When we left Thomas’ office that day, I could see in her face, a renewed determination and despite how tired she was, a new hope.
It gave me hope too.