Tuesday September 23 2008

Alpenglow

Five Photo Panorama of the Wind Rivers

Evening Light through Aspens

Glow on the Rim

Today was very interesting and full of surprising turns. Judy called me at 6:30 to see where I wanted to meet the shuttle since I was the only one going. So instead of Daniel I said Pinedale I got ready and met the shuttle at the Pinedale Clinic at 9 a.m. The ride was beautiful with the colors turning along the way. We pulled into the hospital parking lot and Betty had been there for over an hour. I made arrangements with Al that he wouldn't be taking me back home today.

I got into Chemo and again they said "you're early" I was right on time with the appointment card they gave me. Oh, Well. So they weren't expecting me for another half an hour. We sat there just waiting for the ultrasound until nearly noon. They drew blood for my tests and all that was pretty good. Still low on protein and potassium and for the first time Carol said that this could be caused not by my diet but by having diarrhea so often. Ah-HAA!

They were having some kind of disaster drill at the hospital today. I didn't see much of anything different, but guess they were out there practicing for some kind of disaster. They told us the participants could come in at any time, but never did. I had to have a wrist i.d. bracelet this time because of it, and head nurse Judy was gone to a meeting most of the afternoon.

The ultrasound technician came to get me just before noon and Betty went along to watch. She placed the instrument at front middle left side on my neck. She said the pictures are seen in sections all the way through my neck from front to back. After taking the tests in to Dr. Berlin, he wanted just a little different view and we did another look.

They told me verbally there IS a clot in the left jugular vein and it may have been there for a while- I don't know how long a while is or how big the clot is. So..... now I'm on coumadin to get it dissolved. I'll take that at least 6 months and have to go for protime blood tests just like Joe does. The first is to be Thursday when I go to the clinic to get the pump off. They were going to give me a printed copy of the results of the ultrasound, but I don't think it will be written up until Wednesday. I will have to get the printed report next time and hope I remember to do that. They seem sure that it will just slowly resolve and is PROBABLY not dangerous. There are no masses in my neck. So when I get that information I'll write on that again. The clot is not where that terrible pain was located - which is much better now. Maybe I just slept wrong on my neck.

I did get the copy of last week's CT scan. Here are some parts of that. They scanned around the port and catheter but couldn't quite see if there was or wasn't a clot so ordered the ultrasound. It showed here is some diminished density in the lower portion of the left jugular vein. Not clear whether it could be an involvement of the port or not. The port and catheter didn't show any problems and is in the proper place. There is no evidence of adeopathy or mass in this area. The problem with drawing blood may merely be related to reflux of unopacified venous blood from the left upper extremity into the left jugular vein, otherwise unremarkable.

They next went to my chest. Saw other views of the port which showed it to be o.k. There are traces of vascular calcification in the aorta and coronary arteries - that's o.k. No evidence of masses. No significant pulmonary masses are seen (lungs).

Next they scanned the abdomen and pelvis. There is stil evlidence of the previously described mass in association with the pancreatic head. This appears minimally smaller than the last CT scan. Scattered liver lesions are also less apparent on the current exam. There is a mild diffuse increased fatty change to the liver (don't know what that means so will google it soon or ask Dr. Ward at my appointment). Kidneys are o.k. Minimal prominence of upper abdominal lymph nodes which are unchanged in appearance. They saw degenerative disk disease and degenerative changes in the lumbar spine - no lesions were identified there - same as before.

We ordered a nice lunch. Betty had the roast beef dinner and I had the lasagna special with a salad. It was very tasty. They had to wait more while the clot buster drug worked on the port catheter so they could get a blood return. Then started the chemo. It dripped until after 4 then they got the portable pump hooked up and we were free to go.

After eating lunch Betty went to her car for a little cat nap and then drove out to see the Tetons. There were only two patients in the chairs by this time and the nurses started joking around with each other. Most of it had to do with Barbie dolls and Barrie Manilow feather boas. Judy wants a boa for her husband. They were hysterical and it was a lot of fun to experience this side of them. They are usually way too busy with patients to joke around. Carol gave me Wanda, a sparkling blinking wand to bling down from the intravenous pole stand onto the left side of my neck where the clot is. Probably Wanda will work as well as anything else - at least we all had a good laugh. Carol had time to get their new book on side effects of medication and looked up nearly all my symptoms, so see which of the 5 chemo drugs they are giving me would cause some of the things I'm having. Most bothersome right now is that the skin is peeling off my hands and feet. They had always looked a little askance at me when I told them this is happening. I go around with bandaids around all my fingers and on my feet.She found that one of the chemos is causing exfoiliating dermatitis. Another one causes the blistering in my mouth, and another the tearing and nasel drip. Much of it causes dizziness and nausea. So I appreciated learning more and that Carol took time to educate me.

There is another lady named Judy who works there. She had a terrible accident in July where she was going home after dark in July over Teton Pass. An oncoming car came across the line and she drove slightly off the pavement then overcorrected. The car rested on the edge of the embankment for a few seconds and then slid down the hill and overturned into the creek. She was strapped in upside down in three feet of water. She was able to undo her seatbelt and get out the fortunately open window - my what if the window had been shut! She had a very bad concussion, but climbed back up the hill and tried to wave down some help, her hands held in a prayerful position begging for someone to stop. After nine cars passed one did stop and the driver called an ambulance. Judy and I had a very long and heartfelt talk about how when there is a diverging path in your life and you have serious choices to make that we both had always come up with the right plan and that usually someone stepped forward to help.

That is the way it's been all my life. There is just about nothing else to do except tell those people thank you. I know my Lord Jesus has always been by my side since I was a child in every serious or troubled time. And that there are angels on earth to help and just seem to appear with perfect timing. Our visit was really inspiring and I appreciated the time she spent with me.

Judy and I also talked about art and music, her husband is a professional musician, the parallels between fine art and other creative avocations.That most people go through life never seeing the beauty around them. I've always thought the greatest blessing of my art is how it's taught me to look and truly see.

Betty and I stopped at Smiths for prescriptions and groceries. I did a big shopping and got everything on the list, so am glad for that. We drove back to Pinedale through the canyon and valley beauty. We got my car at the Pinedale Clinic about sunset and got home in the dark about 8:15. Unloaded the groceries. It was about 9:30 when we had a really good grilled cheese sandwich for our dinner. Still chatting and giggling, we didn't get to bed and sleep until about 12:30. So it was a very long day for us both.