The Cat Lady Pounces On Leukemia

Tuesday, October 30, 2007

Tuesday - October 30th.

Jan concluded her week long chemo last night around midnight. That means less time with her friend......the I.V. Pole. She will still receive antibiotics and fluids via I.V. but that should still free her up from the I.V. pole for several hours each day. That's enough time to take some unencumbered walks, or a shower. She still complains of chest pains, the cause of which has not yet been pinpointed. They have run a chest x-ray, Cat scan, and EKG. They have ruled out any lung or heart ailments. Shingles was on the list of possibilities, but her symptoms are not typical for that ailment. The attending infectious disease doctor is now suggesting the possibility of rib fracture (obviously not trauma related), or a troubled spleen. Orders will be written for an abdominal ultrasound which should confirm or reject either possibility. Her pain is being fairly well managed with analgesics. Tomorrow is Halloween and we are curious to see if any of the nurses arrive in costume.

Monday, October 29, 2007

I will be losing my hair as a result of my chemotherapy. This is called alopecia. I've read that hair can grow back a different color and/or texture. Interesting don't you think? I'm adding a poll so you can vote on what color you think my "new" hair will be.

Monday Update

The chills that Jan experienced resulted in the need to run some precautionary tests to check for possible infection. Her x-ray was negative for pneumonia, and her blood cultures still require another 24 hours to process. She has had some chest and back pain. They ran a Cat-scan, which was also negative. To ensure that the pain was not cardio-related, she was given a nitro glycerin tablet, and an EKG was run. Again, nothing that would indicate that she has any heart related issues. Her pain medication seems to be taking the edge off the chest pain. Her labs are about where they should be, near zero white count. Her chemo will end around midnight, or early Tuesday morning. That will take us to the next critical stage of monitoring her vitals for any signs of infection. Her defense mechanisms have been depleted by the chemo, so quick recognition and treatment of any problems is critical. Her spirits are good today.

Flowers are NOT allowed in Jan's room. Germs, you know. To those of you who unknowingly sent flowers................thank you. We're sorry we didn't get the word out earlier. However, they have placed the flowers in a prominent location outside Jan's room so that she can see them from her bed.

If you'd like to send a card (funny ones preferred), you can be mail it to the following address:

Moffitt Cancer Center
Attn: Jan Scolaro Rm-417
12902 Magnolia Drive
Tampa, FL 33612

Sunday, October 28, 2007

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Saturday, October 27, 2007

Chills

We had an odd development about twenty minutes ago at 10:15 P.M. Out of the blue, like a bolt of lightning, Jan started shaking and shivering uncontrollably. One minute she felt fine, and the next we were calling for the nurse. Her temperature was immediately taken, and from a normal 98.7 just two hours ago, it had jumped to 100.3. A specialty nurse in charge of fevers was called in and ordered a hot blanket to be placed on her to eliminate the chills. Her temperature reduced to below 100 within minutes, but now has spiked again to 100.4. We had been told that an episode like this might occur, we just didn't know when. It's just so odd that she could feel perfectly fine one minute, and be feeling poorly the next. The doctor just came in and assured us that this is not unusual, and in fact is expected. However, protocal now insists that she have a chest xray, blood cultures, and switch from oral to I.V. antibiotics. That process is starting now. It's 11:00 P.M. and she's be readied to go to xray. Don't worry, I'll update you when I know more. She's in good hands.

Port




The implant of a port is standard for chemo patients. I actually had a double port inserted into my upper right chest. The port is covered by a hard rubber. It is surgically placed under the skin, with catheters leading to the heart. The incision is sutured, and remains as long as necessary. It can be surgically removed at a later date. Two needles (which bend at right angles) are then inserted through the skin, through the hard rubber cap, and into the port. This makes for easy access to the circulatory system to administer medication, or draw blood. Periodically, the needles need to be withdrawn, and replaced. This is not a comfortable procedure, but fortunately, the pain is short lasting.

Bone Marrow Biopsy


The definitive test for identifying my problem was the bone marrow biopsy. It's also the test which will confirm when I am leukemia free. I've had the procedure twice in the past two weeks, and will have it performed again in about two weeks. The procedure can be done under a local, or general, anesthesia. I chose to be asleep. The sedation is almost identical to that which is used for a colonoscopy. The only reminder is a sore hip for a few days.

The MUGA Scan


One of the numerous tests that I've undergone was the MUGA. The MUGA Scan (Multiple Gated Acquisition Scan) is a noninvasive test that is performed by attaching a radioactive substance to red blood cells, then injecting the red blood cells into the patient’s bloodstream. The patient is then placed under a special camera (a gamma camera), and with computer manipulation, a moving image of the beating heart is made.

New Name for Blog

The name "Jan's Medical Blog" is pretty boring. There are lots of creative minds in our family and friends so put them in gear and PLEASE suggest a new name for this blog.

Feeling Better

Woke up with a headache this morning. About an 8 on the smiling/crying pain scale.
Took a little white pill and am feeling better now. They don't allow me aspirin or Tylenol since it affects my true temperature, and fever tracking is very important at this stage of the chemo. We just went for a stroll around the 4th floor, just the three of us (me, Tony, and my IV pole). There are large windows that encompass the front of the hospital so we sat for a while so I could remember what the outside looks like. It's gloomy here today with a few drizzles.

Friday, October 26, 2007

In High Spirits

I went and saw Mom this afternoon after work, something I've been fortunate enough to do pretty often since she's been admitted (more in a moment). This was the first time I had seen her since her morning blood transfusion and she seemed as wonderful and lovely as ever. Jabbering on about all of the cards she's received from everyone and showing me pictures she was sent. Since they prescribed some different medication she seems to be feeling well and "in high spirits".

Shortly after arriving I had to bug my folks about this blog and make sure they were still on track to get it online and updating, which they had done a lousy job of doing (I guess they have more important things going on). So I whipped them into shape and now you're seeing the results -- they're doing a fabulous job, now. :)

The hospital, Moffitt, is located on the grounds of the University of South Florida, which is the same place I work for. My office is located roughly a 1/4 mile away, so I have the good fortune of being able to make it to the hospital in under 3 minutes. This just means that Mom and Dad
have to constantly endure my smiling face all the time, but they seem to be accepting the challenge quite well (or at least faking it).

That's all for now -- I'm sure Dad will keep you well informed from hence forth, but I'll see if I can add a little something from time to time.

Love ya Mom!

Tired

Yesterday was a day of fatigue. Most of the day I felt too tired to walk, or talk. Today I learned the reason for my tiredness. My hemoglobin had dropped to 7.1. Anything below 8.0 requires a blood transfusion, so today I was administered two units of blood. I can already feel my energy level returning. I'm not ready for any jumping jacks, but I can get out of bed without feeling light headed. I'm still tired, but much improved from yesterday. I hope to feel better tomorrow so that I can watch the USF Bulls play U. Conn. Since the hospital is on the USF campus, there are a lot of Bull supporters walking the halls. Go Bulls.

Getting Started - October 22, 2007

On Monday, October 22nd. preparations began to begin the actual chemotherapy. Both drugs must be administered simultaneously. The process will last a week, and during that time, I will be hooked to my IV stand 24/7. Where I go, it goes. For me, this was when the depression and anxiety set in. Eight hours after the start of the chemo, I had no desire to eat or drink. I essentially wanted to leave the hospital and go home. The fear of nausea associated with the chemo, and the thought of three more weeks in the hospital, seemed overwhelming. I didn't eat or drink anything the entire day on Tuesday. It was NOT a good day. However, with some counseling, and an adjustment to my meds, the fear and anxiety relaxed, and the days following have been manageable.

Clinical Trial - October 20, 2007

The Clinical Trial is a blind study which will track the results of the chemo drugs. Patients will be divided into two groups. One group will be administered the traditional dosage of both chemo medications, Cytarabine and Daunorubicin. The second group will receive double the dosage of Daunorubicin. The groupings are strictly random, with no input by patients or doctors. The primary benefit of the Clinical Study is that follow-up tracking and progress will be strictly enforced, well documented, and done under the umbrella of the Moffitt Hospital and research facilities; and any issues or problems will be quickly addressed. I was placed into the group receiving the double dosage of Daunorubicin. We hope more is better.

Quack Quack


Don't I look like a duck with my mask on?

Wednesday, October 24, 2007

The Begining - July 15 thru Oct 19, 2007

Leukemia. Not a word I ever thought would be in my vocabulary. My story begins in mid-July with a routine physical, and normal blood work, including a CBC, cholesterol, glucose, etc.......all of the normal tests that always come back within normal range, or close to it. However mine was returned showing that my white count was around 1.8 (which is really 1800, but reduced to a decimal on lab tests). A normal WBC range is 4.0 to 10.0. Leukopenia is the term used to describe a low white blood count, and it can be due to many causes, most of them quite benign. Some of the more common causes may include infection (viral or bacterial), arthritis, vitamin deficiency, or medication. In my case, my GP suggested that it might be related to medication and suggested that I reduce my dosage of Paxil from 20 mg daily, to 10 mg. After three weeks, a re-test was ordered. My white count had risen to 2.7 and it appeared that we might be on track to identifying the cause of my leukopenia. We continued this course for another few weeks, re-ran the lab work, and were surprised to see that the white count had reverted to a 1.7. At this time it was recommended that I make an appointment with a hematologist.

That was done on October 1, 2007. More extensive lab work was ordered, all with negative results. I continued to feel in perfect health, with excellent lab results. The only anomaly was the leukopenia. A precautionary bone marrow aspiration and biopsy was performed on October 12th. I received a phone call three days later from my hematologist asking to see me that afternoon. I was told that, to his amazement, and that of the pathologist who performed the biopsy, that the preliminary results revealed that I had Acute Myelogenous Leukemia, or AML. My hematologist informed me that this type of leukemia required specialized attention. He said he had already conferred with an old friend, another hematologist/oconologist associated with Moffitt Cancer Hospital. This was unexpected news. All of the fears, anxiety, and disbelief that you've read about hit me all at once. Why me? The tests must be wrong! How am I going to handle this? Will my life ever be normal again? So many questions, so few answers. It was a day almost too overwhelming to describe. At some point you realize I need a plan of action. That plan included my Wednesday appointment with the oncologist. In the meantime, my husband Tony and I agreed that we would not use the Internet to research AML. There would be too much information, much of which may not apply to my case, and the added stress was not welcomed. So we resisted and kept the appointment. The doctor said, almost immediately, "you need to be in the hospital". He wanted to admit us to Moffitt, but that is not an easy task. Moffitt is one of the most respected cancer hospitals in the Southeast U.S., and demands for a room are great. The oncologist said it may take many days before a bed would be available.

The next day at 6:30 P.M. we received the unexpected call......."we have a room for you". I was shocked at the quick call, and not nearly ready to go. I asked if admission could be delayed until morning and they said the room would be gone by then. This was just three days after receiveing the news, and one day after meeting with the oncologist.

At midnight on October 18, 2007 I was admitted to Moffitt Cancer Hospital to begin my journey to better health. At this point, I still felt fine, and had no symptoms, and exhibited none of the 'early warning signs'.

The next day, Friday 10/19, was a whirlwind of activity. They took me down to radiology for a heart exam at 09:00, then to the surgical room at 1:00 P.M for another bone marrow biopsy, and finally a port was inserted into my chest at 4:00 P.M. for easy administration of I.V. and chemo drugs. I had no food or drink for the entire day.

On Saturday I was approached about the possibility of entering into a Clinical Trial. More on that next edition.