It's Time For Hospice

The past several weeks have been rough for Cheryl. As I posted earlier, we came home early from a visit with my family in Thomasville, GA because Cheryl was having intense headaches, nausea and double vision. Friday evening, we went straight to the emergency room in Savannah where they got her pain down to a tolerable level. On Saturday, the doctor called her in a prescription for steroids to reduce what they thought might be brain inflammation. Then on the Monday after Thanksgiving she was admitted to the hospital and was diagnosed with metastatic tumors in her brain and cancer cells in her spinal fluid. She took the first four of ten whole brain radiation treatments while in the hospital and then continued the remainder as an outpatient until December 12th.

During this whole time she has been on Dexamethasone (oral steroid) and various pain killers and endured their side effects. We have both noticed that she has been having increased difficulty in standing, her balance is poor and her muscle tone is poor. She's having to use a walker for support unless she is standing next to a piece of furniture or other stable object that she can hold onto. She's also been commenting that her double vision has been getting worse.

This past Friday, we took her in to the Low Country Cancer Center for a bag of IV fluids and that seemed to help the headache and double vision for a few hours but by Saturday afternoon, she was having trouble reading the scores on her football games.

As the week has progressed, she has gotten weaker and her vision has gotten worse. She is no longer able to read texts on her cell phone and she has trouble focusing well enough to send out texts or read medicine labels. Cheryl had an appointment scheduled for this Friday with the oncologist but I called in yesterday and described her condition and they told me to bring her in today at 2:30.

Dr. Negrea had a short talk with us, looked her over and reviewed her file and let us know that because she has carcinomatous meningitis (the cancer has spread into the lining of the brain and the central nervous system) that there is not much else they can do for her. They had talked earlier of doing spinal chemotherapy but he said that doing that or the alternative delivery of putting a port through her skull directly into her brain would not be effective for very long. At best, going through either of these procedures might add a few weeks of life and that both had a lot of potentially bad side effects.

Dr. Negrea told us that in his opinion, if it were himself or one of his family members with this condition that he would not opt for the treatment. He recommended that we get in contact with one of the local hospice organizations and make arrangements for Cheryl's decline. I mentioned that in my reading and research that I'd seen prognosis for survival at about three months and he agreed that based on his experience, that is about as good a guess as anyone could make.

Before we left, he hugged Cheryl with tears in his eyes and told us to hold on to our faith. Pray for grace for us in the days to come and also remember those that spend their lives caring for people that often don't have long-term survival.

As we figure out what we are doing we will continue to keep the blog updated. Cheryl is up to phone calls. Don't worry about disturbing her, if she is tired, she will let you know that she doesn't feel up to talking at the moment but most of the time she is really cheered up by contact with the outside world.

Together for Another Christmas

Hallelujah, we get to celebrate another Christmas together. We are so thankful for all of our family, church family, friends and neighbors and acquaintances from years past that have dropped by, sent cards, called at just the right time, given rides to treatments, brought over food and have posted notes of encouragement here and on Facebook.

We thank you for being there with us for the celebration of what we thought was remission back in March. We thank you for your continued prayers during her second chemo series. We thank you for continuing to pray and encourage us as Cheryl continues the battle against brain and spinal cord metastases.

Since receiving this diagnosis, she was put on oral steroids to reduce inflammation and went through ten days of whole brain radiation to kill the tumors and treat the lining of the brain. She has continued to battle nausea, headaches and intermittent double vision. Friday afternoon, she lost her balance and fell off the couch. Praise the Lord, nothing was bruised or broken. The owner of one of the local flower shops was coming to the door to make a delivery when this happened. He helped her get situated and stayed with her until I got home form picking up prescriptions on post.

We don't know whether the symptoms she continues to exhibit are caused by the cancer, after-effects of the radiation treatment, or the medicines that she is taking. Cheryl took her final dose of steroids on Christmas Eve and we hope that dropping this plus juggling her pain meds will help get her back on an even keel.

Cheryl has her next appointment with Dr. Negrea, the medical oncologist on the 30th. We should know more about the plans for her spinal chemotherapy after that meeting. I'm off this week, the laundry's caught up and the dishwasher works just fine so we should be able to spend some quiet time together over the next few days.

Keep us in your prayers as Cheryl enters the next phase of her treatment.

She's Not Glowing Yet

The weekend was rough for Cheryl with continued headaches and nausea. The local Wal-Mart pharmacists were able to track down and order the fast acting pain medicine that she needs but it won't be in until Friday. Until that time she is having to get by with ground up pain pills over applesauce to keep the worst of headaches at bay.

Yesterday she was cheered up by a surprise visit from our long-time friends Claire and Woody Reade. They spent the morning with her while I was at church and then headed home after lunch.

Today, Cheryl had her fifth dose of whole brain radiation (out of ten total). After the session, we met with the radiation oncologist to discuss how things are going. He is making some adjustments to the quantity and frequency of the steroids she has been taking for the past week. He wants to taper her down to a much lower dosage before she starts the next type of chemotherapy in her spine the week before Christmas.

We finished putting up our fall/Thanksgiving decorations today and have decided to do just some very basic decorating for Christmas. I assembled our tree that is lit with all white lights. We hung our 2011 ornament and an ornament Cheryl received from our friend Rachel. I made a simple paper ornament that has the words Faith, Hope, & Love printed across it that we hung facing in toward the den. Those are the things that we are holding on to as we enter the Christmas season this year.

We continue to covet your prayers for her recovery or at least for her to have freedom from the headache pain and nausea of the past few weeks. Don't just keep Christ in Christmas, keep Him in your heart.

Home from the Hospital--- Good News Bad News

When Dr. Negrea, Cheryl's medical oncologist came by to see her this morning, he let her know that she was being discharged today. That's the good news. Then he gave her the bad news. They discussed her condition and he told her that even though the preliminary report on the fluid pulled from the lumbar puncture looked okay, the cytology report showed that the fluid tested positive for cancer cells. He told her that this is the most likely cause of the continuing headaches that she is having since the tumors in her brain are so small.

He is going to have her continue the ten whole brain radiation treatments (she took number four today). Cheryl should finish up radiation on December 12th and then she will return to the Low Country Cancer Center to receive her first dose of intrathecal chemotherapy in the spine. She will continue to receive this chemo every two weeks. At this point we do not know how long they will continue with this therapy, but by God's grace we will handle it one day at a time.

She still has a persistent headache but it is much better than it was when she went into the hospital on Monday. The doctor sent her home with prescriptions for some strong painkillers, steroids and anti-nausea meds.

Please be in prayer for us as we continue to face whatever may come next in Cheryl's battle against ovarian cancer.

A Better Day

Cheryl had a much better day today even though she is still experiencing a lingering headache. The nurses all took note of her improved color and general appearance. She was able to eat three full meals and her nausea has substantially cleared up. She enjoyed talking to several friends and family members on the phone. To see and hear her chatting away on the bed, you would never know the seriousness of what she is facing.

The preliminary results of her lumbar puncture looks good, though they are still waiting the cytology report to declare the spine clear of any disease. She had her mammogram today, but don't yet have those results either. She had her third radiation treatment today and thus far does not seem to be suffering any ill effects from it.

When Dr. Burke came by today, he explained to her that the brain lining is also being effected by the cancer and the fluid that this produces is part of the cause of the headaches along with the tumors. If she continues to progress, he anticipates letting her go home on Friday but neither she nor I want her to leave the hospital before she is ready.

Please continue to be in prayer that the radiation treatments will be effective at destroying the tumors and giving her relief from her headaches.

Wednesday Update

Cheryl had a rough morning. Still fighting the nausea and headache, she only had a few bites to eat up through lunch time. They got her on an IV with fluids as the day progressed and this seems to be helping the nausea quite a bit.

They took her down for the lumbar puncture (spinal tap) today but we have not yet received the results of that biopsy. The good news is that she had enough pain meds in her that she barely felt the local anesthetic they gave her before doing the procedure. Cheryl did not have the planned mammogram today so we are expecting that to happen tomorrow.

Dr. Burke came by and spoke with her this morning and explained how rarely he has seen brain metastases with ovarian cancer. He said that she is responding well to the current course of meds and that we will know more about what is going on when we have he other test results. I went to work today so I did not have a chance to ask him any questions.

This evening Cheryl was able to eat part of a serving of mashed potatoes with gravy and about half a chicken tender. It stayed down and the fact that she was finally able to keep something on her stomach did perk her up a bit. I left out a little before 9 PM and she was already drifting off to sleep. I'm so glad that they are finally getting the headaches and nausea under control.

Please be in prayer that this improvement will continue. Also, pray that the results of the lumbar puncture will not show positive for cancer.

Day 2 Current Stay Update

The radiation oncologist came in this morning and told us that the MRI showed five small tumors in Cheryl's brain. There are two at the back, two in the middle and one in the front. He said that the largest is about the size of a Raisenette. The standard treatment is to do two weeks of whole brain radiation. Each daily session will last about 15 minutes. She can expect to lose her hair and may have some nausea and mild confusion. He checked her CT scans from last month and said the goods news is that the chemo appears to be working from the neck down and that her torso and abdomen show no signs of tumor activity.

They gave her the first radiation treatment today and will continue to do so until she gets out of the hospital. Then, she will continue daily (Monday-Friday)on an outpatient basis. Dr. Pederson (Radiation Oncologist) said that they usually have great success using radiation on brain mets and are able to stop the cancer's spread. They will do a follow up MRI in three months to make sure that they've got it all.

Tomorrow, she will be having a lumbar puncture (spinal tap) to check for cancer cells in the spinal fluid and a mammogram to make sure that it has not spread that route.

She is still experiencing a lot of nausea and headaches as soon as her meds wear off. I told the nurse that we can almost set a clock by her since she starts asking for the next dose right on schedule. The past several days have been really rough for nausea as she has gotten sick on almost everything she has tried to eat. She was finally able to keep down a bowl of soup at lunch and a little jello this evening.

Please be in prayer that the radiation treatments will be effective at killing the tumors in her brain and that the other tests will be negative and that the meds will keep the headaches and nausea under control.