31 Aug - Update

I spent the evening with Sarah in the hospital today and she's not feeling too bad except for the edema (swelling) all around being very uncomfortable. But her blood test results have a lot of low out-of-range values, so we're not sure when she'll be able to come home and we're also not sure what's causing that. Tomorrow her oncologist will be coming to see her and we'll have quite a few questions for him.

30 Aug - Stent Replacement Went Well

Sarah just came out of her stent replacement procedure. Despite the fact that they gave her a general anesthesia this time, she's feeling pretty good (relatively) after it. The doc was able to remove the old stent, clean out the bile duct and place a new stent of the same size - so it was a full success from our perspective. This will eliminate a possible source of infection and make sure that her liver continues to drain well. The oncologist said that now they'll focus on stabilizing her potassium, calcium, etc so she can go back home - the estimate is Wed and we'll try to beat that. :) She's on three antibiotics, so hopefully that will clean up the C. Diff and anything else causing trouble.
Ben and Sam each had a great first day of school and they are excited about their new classes and teachers. "Grandpa and Oma" have been a big help in taking care of the boys while Sarah's been in the hospital!

29 Aug Update on Sarah

Sarah's got some complications that are going to keep her from coming home from the hospital yet. She tested positive for a GI infection called C. Diff - it's often seen in immuno-compromised patients that take antibiotics. It can be dangerous if not treated and is easy to spread to other patients in the hospital, although it's not as serious for healthy individuals. As a precaution, she is in "isolation" which means anyone in her room has to wear gloves.
Her potassium is now back in the normal range but they want to see if it will hold there or just come back down. Other test results are out of range as well, so I think we'll need have Sarah stay for observation - her albumin is low which causes swelling (edema) and her calcium is now really low at 6.5. Not likely she'll get the stent replacement done tomorrow but we'll have to wait and see. The C. Diff. infection could be related to the stent since it's been in for a fairly long time.
Sarah's very sleepy today and has been dozing hard this afternoon. Reminds me of the last time she was in the hospital - a pattern that I hope we don't fall in to this time.

28 Aug - Staying in Hospital

Well, Sarah kind of got "stuck" in the hospital again. But we both think it's good that she's here in terms of getting the care that she needs. Her potassium is stubbornly refusing to go above 3.0 (3.5 is actually the low end of normal). She's getting her third bag of IV potassium and even took some orally last night. The docs took her off antibiotics in order to try and stabilize her potassium levels first, and in the mean time they are taking some stool and blood cultures to check for signs of infection. Sarah feels more or less ok - just waiting for the tests and IV fluids. The GI doc also has recommended that she go ahead and get her bile duct stent replaced while she's here in the hospital. That would be either Monday or Tuesday, so if that happens then I'd estimate she'll be here through Tues or Wed - longer than the "23hr admission" we were expecting yesterday!

27 Aug - No Chemo Again

Well, Sarah didn't get chemo again this Thursday. She is having intermittent fevers again and gets severe chill/shiver episodes every day or two that last up to 20 min. Doc believes she may have an infected bile duct stent so Sarah skipped chemo and is doing antibiotics again. If the fevers don't get better then we'll probably make another attempt to replace her stent in the coming week. Her potassium also took a nose dive this week so we're spending friday evening at the hospital getting her a potassium infusion. Right now we're waiting on her blood test results to see if I can take her home tonight. If not, she'll have to stay the night and get another infusion, but we expect her stay in the hospital to be under 24 hrs.
Sarah's overall state of feeling bad is still hard to explain, especially given the good blood test results she just got earlier this week: her tumor markers are down and liver function tests came back looking pretty good. But she feels like somehow her body isn't regulating stuff very well like body temp and some body chemistry (calcium, potassium).
On the nanny front, we were sad to see our nanny go but have been fortunate to quickly find someone to take over. She starts in two weeks, right when my parents head back to San Antonio.

22 Aug Back From Vacation

We just got back from a great summer vacation in Florida (Rosemary Beach near Destin). Even though Sarah's mobility was limited by her low energy and tiredness, with the help of a wheelchair and some extra travel time built-in we were able to have a great family vacation together as you can see! Sarah's brother Thomas as well as Kerry and baby Jane were with us, as well. We went out a few evenings for dinner on the town and during the day Sarah sat by the shore while Ben, Sam and I played in the waves - but Sam much preferred the swimming pool. In one of the pictures he's doing a great "nestea plunge" even though he has no idea what that expression comes from. :) We also went to the beach-side bar for ice-creams and beverages to enjoy the beautiful scenery. We are very thankful that we could work out a time between treatments and other commitments to get away for this trip.
After returning last Wednesday, Sarah did her Herceptin treatment on Thurs but did not get chemo - this time because of neuropathy symptoms. The concern is that if you push it too hard with the chemo then temporary neuropathy (numbness in hands & feet) can turn into permanent nerve damage. Strangely, Sarah's calcium level swung to the other extreme and is now low out of range, so she started taking calcium supplements. We're on track to get her chemo this Thursday, we think. Overall, Sarah is not feeling too good. She get's exhausted very easily which is frustrating for her, and it is hard to imagine that her condition will improve when we are not sure what specifically is causing it.
The boys are staying busy - Ben loves his new Karate classes and Sam is starting his guitar lessons next week - we just got him a guitar this weekend which he is very jazzed about! Another change is coming on the nanny front: Marie, who has been a great help to us over the Spring and Summer, was lucky to get a teaching job at a school in the area so we're searching for a new nanny. We've got some leads and are starting to interview some people next week. My parents will be staying with is for a while until someone new can start.

11 Aug - Update

Sarah has been feeling pretty bad so we had a very low key weekend this week and then I went on a quick business trip Monday and Tuesday. But, with a new dose of hydrocortizone and some pro-biotics, Sarah has actually perked up and had more energy over the past two days. We got a wheel chair for her so that we can take her out without her having to walk far, which can be quite a struggle. The doc wants her to recover some more of her strength so we're going to take one week off from chemo. She'll get herceptin and zometa tomorrow on her regular treatment day.

4 Aug - Catch Up

Lots of happenings at our house as you can see. One pic of Sam posing with his baseball gear (although the bat is too big for him). A pic of Sarah and also our friends Jeff and Jen last weekend during their visit. Jeff thought it would be cool to take a picture of me while I was taking a picture of him. Wonder how his pic turned out? And finally the pumpkin vine growing at our front door... we had a giant 140 pound pumpkin in our front yard last year that Sarah won at a Trader Joe's contest around Halloween. We figure one of the seeds must have accidentally landed in one of our flower beds and started growing a new vine - and now we want to see if it will produce giant pumpkins or just regular sized ones!
An update on Sarah: she hasn't been feeling very good over the past few days but it's hard for her to describe how she feels. Mostly it seems to be fatigue and a lack of energy. She got booster shots for her red and white blood cells last week, so that's probably part of it. The plan is for her to get chemo tomorrow and we hope that the continued chemo will provide systemic whole-body treatment that improves her health over time. There's nothing more we can do right now but carry on and see how she feels after a few more weeks of treatment. And the next scan and tumor marker test should also tell us if the Abraxane is helping her.