31 Oct - Fall Pics

Sarah won a Trader Joe's contest to guess the weight of a giant pumpkin, so we now have a 160 lbs pumpkin in our front yard! Sam's much smaller one from his pumpkin patch visit is on top for size comparison! It is really amazing. The other pic is just a general Fall pic. The colors are really popping out this year and Fall is looking great here.

31 Oct - Happy Halloween!

Sam ended up being Megatron, a Transformer, and Ben was a vampire. Sam loved his costume and Ben loved how his looked, but ended up not liking the feeling of having face paint on and said that the fake blood felt weird. Anyway, the trick-or-treating went great and fun was had by all! Lots of candy... I had to sample a few (just to make sure they were ok to eat). :)
Sarah's doing better. At 3pm today when I left the hosp to come back for trick-or-treating she'd eaten low-in-fiber solid food and tolerated it well. Bilrubin was also down from 7.3 to 3.8 which is a great drop, more even than we expected. The boys and I will be going to see her tomorrow morning.

30 Oct - Another Update

Sarah felt better this afternoon and seemed to be bouncing back from the ERCP very well. She even took a stab at a liquid diet of broth, jello and fruit slushy. Her energy level was also pretty good. Now we're waiting to see what her bilirubin number will be tomorrow. Surprisingly, little to no nausea today despite the anesthesia which has been tough on her stomach in the past.

30 Oct - ERCP Went Fine

Sarah just came out of her ERCP and it went smoothly. The doc placed a new temporary stent in her lower bile duct where pancreas swelling was probably restricting some flow. We're hoping to see her bilirubin numbers improve significantly by tomorrow. Expecting her to be in the hosp through the weekend until she's eating again.

29 Oct Update

Well, Sarah's nausea came back and persisted... so the plan is now to do another ERCP so the doc can go into the bile duct with a camera and verify no strictures - also most likely to place a stent again. It's a bit of a mystery what is going on at this point. All numbers are heading back down towards the normal range (ALT, AST, Lipase) except Bilirubin which continues to climb. Sarah's skin and eyes have a noticeable yellow tint to them at this point. And then there's the nausea which was the problem to begin with -- she needs relief from the nausea so she can return to eating a healthy diet before she can leave the hospital.

So, ERCP and stent and hopefully enough add'l info to understand what's causing the problem. I'll post after the procedure to report how it went. Will be spending all day Friday and probably overnight at the hospital with Sarah.

28 Oct Update on Sarah

Today Sarah feels good again, just like yesterday. She says her nausea has gone and what remains is likely hunger (hard to tell). Also, she seems to have more energy and is in good spirits. After two days of being fed by her IV, we're hopeful that she can try real food again tomorrow. Her Lipase numbers continue to drop (good). Rising Billiruben (usually not good) is giving her a bit of yellow skin, but the docs say that is normal and not a cause for concern. So, after we get the results of a special MRI being done on her bile duct and pancreas this afternoon, we hope that she'll be on the path to recovery. Thank you to all who have called, emailed, sent flowers and helped with the kids this week!

26 Oct - Update on Sarah

Quick update on Sarah. She's hangin' in there, although not really feeling better yet. The docs say the best way to treat the pancreatitis is to let no food at all enter the stomach for a few days, so that's what we're doing. She just started getting fed via IV tonight and we're hoping she starts to feel better tomorrow. Sarah's passing her hospital days with books, magazines, books on tape, , tv visits from friends and hubby, and also her new iPhone. :) It's really a waiting game at this point. She's still feeling some nausea, but without eating food it seems manageable, even though it definitely causes constant discomfort.

Figured It Out

The doctors figured out what is causing Sarah's nausea: she has an enflamed Pancreas. The CT didn't give any reason to believe that it is cancer-related. Probably just something related to the bile duct stent.
The plan is stop all food intake (but she gets nutrients via IV) until the pancreas settles down and then she'll do another ERCP procedure so they can make sure her pancreatic duct is cleared to allow flow. That'll probably be around Wednesday, so Sarah's got several more days in the hospital than we thought. But, we're both very relieved that we have a diagnosis and that it is both unrelated to cancer and that it is solveable.

Sarah In Hospital

Sarah's prolonged nausea caught up with her this Friday. Probably due to not eating and drinking enough, she felt really weak and I took her in to see the doc. Her doc had us admit her to the hospital right away to get some fluids and sugars into her system and she has perked up today. But, we still need to figure out what is causing the nausea so she can eat again, so we'll be here at least for a few days and there is likely another bile duct stent in her near future. Had a bowel xray yesterday (neg) and liver CT will happen this afternoon since Sarah's liver function numbers are back up. Sarah is holding up fine now and is mostly just frustrated that we don't know what the cause is so she can fight/treat it. No internet in her room so she'll be off email for a few days.

15 Oct - Stent Removal Went Well

Sarah had her bile duct stent removed today and everything went very smoothly. We were relieved that the duct was no longer pinched off so no new stent needed to be placed, and she didn't wake up during the procedure this time either! The assumption is that the enlarged lymph nodes outside the duct have responded to chemo and shrunk back. We were on our way back home at 1pm so it was a quick-turn process. Sarah's sleeping heavily this evening as she recovers from the general anesthesia, but she should be feeling good tomorrow.
Also, we learned from her oncologist that her hormone levels support a switch from chemo to hormonal treatment, so instead of getting a final Taxotere treatment next Monday, she'll switch to Faslodex along with the usual Herceptin. This will present a welcome break from the taxing side-effects of prolonged chemotherapy and we're hoping her cancer respond with declining tumor markers - that's what we'll be watching for in the 2 months to come.

10 Oct - Update

The latest set of tumor markers were just a little under the previous set of numbers, so although the CAT scan showed no significant activity anywhere, we know there's some systemic tumor activity and Sarah needs to continue with her treatment. Since it is not recommended to have more than six rounds of the heavy 3-week doses of Taxotere, Sarah will get one more after next week and then switch to either Xeloda or something else. One option may be a new approach of alternating chemo and hormonal treatment. We're going to discuss it with her onc in two weeks after he attends a breast cancer conference where data supporting the approach will be presented.
But, before Sarah's next and last round of Taxotere, she's scheduled to finally get that stent removed from her bile duct next Thursday. We're not sure if another will be placed, or if the duct will no longer be pinched off by the lymph node tumor that was causing the problem before, in which case of course she won't need another one placed. We're hoping for the latter, and also hoping that she doesn't wake up again during the procedure! Sarah dreads that more than anything else about getting the stent procedure. Other than that, it's a day-surgery type setup where you can go home later the same afternoon.