30 Nov - Stent Replacement Went Well

Sarah had her bile duct stent replaced today and it went well. Her bilirubin was at 7.1 before the procedure (normal is below 1 and must be below 3 to get chemo). The doc said the old stent was definitely 100% clogged and he was able to put a new permanent metal stent in that should not clog and is about 3 times as wide. Sarah came through it fine although she's dealing with some post-anesthesia nausea tonight. Over the next few days her yellow coloring should fade away and by next week we hope her bilirubin will be back in range so she can restart her chemo treatments. On the not-so-good side, the doc did notice that the upper ducts were much smaller than earlier this year, presumably because of outside pressure from liver tumors, which are also are putting pressure on her stomach and small intestine. Looks like Sarah's liver mets have progressed, which we knew might be the case since she's only been able to get chemo on and off due to a string of other issues - C.Diff. neuropathy, colds/infections, etc. We plan to discuss this with her oncologist and ask what our best options are for chemo treatment. At least for now we are fairly confident that her critical bile duct issue is resolved and she can feel better soon as we head into the Christmas season.

29 Nov - Another Bile Duct Stent

Sarah is scheduled to get her bile duct stent replaced tomorrow (Tues). Her bilirubin was 7.5 last Friday which is already sky-high and it probably went up over the weekend. Despite the high number and her yellow eyes and skin, she's managing ok and the plan is to have the procedure tomorrow be outpatient. The doc says Sarah should get a metal stent this time vs. a temporary plastic one since the permanent kind should not clog up like the past ones have. Sarah was relieved that we could get this scheduled right away on Tuesday.

27 Nov - Thanksgiving

We enjoyed our Thanksgiving meal with visitors Elizabeth, Thomas, Kerry and our niece Jane. Here we are, ready to dig in!

Today on Friday, I went to treatment with Sarah. She didn't get chemo again because now it looks like her bile duct stent may be plugged again. We started noticing day before yesterday that her eyes were getting yellow and it is much more noticeable today, plus her skin is getting a yellow tint. It's likely that we'll have to take Sarah in for a bile duct stent replacement some time in the coming week, but hopefully it will be an outpatient procedure. She's feeling tired but decent overall, and she was really happy to be able to celebrate Thanksgiving at home and enjoy the meal!

21 Nov Update

First some pics from Ben's birthday last week. One with Sarah and Ben and another of Ben blowing out the candles on his cake.

We've had an eventful week. Ben's been playing with his birthday presents, especially the Sony PSP game console he bought himself with some of the gift money he received. He also bought himself a "Rip Stick" caster board (a kind of skateboard) and has quickly gotten the hang of using it - can't keep him inside; he's really determined to master it. Sam got some new things as well after we realized he still had some gift cards back from his birthday - I took him out shopping and he got to pick some things for himself as well!

An update on Sarah - she didn't get chemo again this past week, which we were not happy about. Her white blood cell counts were very high and she was clearly fighting off some bug, so the doc gave her antibiotics and said we have to take another week off. If she's doing better, we're expecting that she can get another chemo treatment this Friday right after Thanksgiving. Overall, Sarah's not feeling too good this week. The neuropathy is making it challenging for her to stay steady on her feet. She's stumbled and fallen twice in the past two weeks. It's still ok if she takes her time walking and is careful - I know Sarah would rather do that than go back to using the wheelchair right now. We were excited to hear that a new drug called Eribulan has been approved for breast cancer treatment, but it also has neuropathy as a side effect. Sarah's profile fits the new drug's treatment focus, so there's a good chance she'll try that when it is time to move off the Abraxane.

13 Nov - Ben's Birthday

First a quick update on Sarah - she didn't get chemo this week since she and her onc agreed that she needed a week off to let her body recover a bit. Neuropathy seems to be getting a little worse. But her blood test results are coming back good and holding fairly steady.

So Ben's birthday was today and he had a great time. He got some birthday wishes via phone and was also able to have a part this afternoon at the movie theater (we saw the new movie "Megamind"). And he reached his goal of buying a new Sony PSP game device - with the help of his monetary birthday gifts, we've already ordered one and now he can't wait to get it! :) I'll get some pictures of the birthday uploaded but I'm having a little camera trouble that I need to resolve first.

5 Nov - Chemo Day

Sarah got another 80% abraxane treatment today. Her blood test results were again fairly good so we're hoping that the chemo is helping her. Sarah's doc said we should get scans after 6 treatments have been completed - so 2 more. But if her tumor markers continue to go down, he's thinking there really isn't a need to do a scan yet - although we want to know how things look in her liver, it makes sense since the results of the scan would be unlikely to change her treatment if markers are dropping.

We've got a busy weekend coming up with some activities for the boys and taking down the Halloween decorations... :) And we'll lay low some of the time, too. Since it's the fourth week in a row, it looks like the chemo is hitting Sarah a little harder this week - she got very tired after treatment today and crashed early tonight.

4 Nov - 3-Day Walk For The Cure

Sarah's friend Nicole is doing the Susan G. Komen 3-Day Walk For The Cure in Dallas. She's got a picture of her and Sarah at the 3-Day walk last year posted on her donation page at http://www.the3day.org/goto/Nicole.Smith - and please consider supporting the cause while you're there! The walk is this weekend but donations are also accepted for a period after the race.

Sarah should be getting another 80% chemo treatment tomorrow. She's feeling about the same as she did last week and we're hoping that the chemo treatments are doing some good in shrinking her liver tumors. We won't know for sure until Sarah gets another CAT scan, which we need to talk to her doc about.

28 Oct Update

Here's a video of Sam at his 1st grade music program, singing a song called Witches Brew. Ben's doing well, too. He's continuing with karate and also busy with many school projects. 4th grade is really ramping up on homework and at-home projects!

Sarah got an 80% Abraxane dose again yesterday and her neuropathy has held fairly steady (maybe just a little worse). She also got tumor marker results yesterday - her CA27-29 and CEA were both around 250. That's a bit high for CEA but not for 27-29. Basically, it's not a lot lower but also not a lot higher than they were before, which didn't surprise us since she's only intermittently been able to get treatment. Overall, we see it as good news and indication that we're holding ground despite the challenges with C.Diff.

Sarah continues to build energy and maybe some strength, too. She's driving more and walking short distances. Hasn't used the wheel chair in the last two weeks. :)

24 Oct - Eventful Weekend

First an update on Sarah: although her neuropathy didn't get worse, it also didn't get better. But that and a little weight gain plus decent blood test results allowed her to get another 80% Abraxane dose last Thursday. She felt relatively ok over the weekend and continues to feel more energetic overall. Our plan is to keep on with this chemo as long as her neuropathy doesn't get worse.
The boys have had quite a weekend - we went to the Fall Indian Guides campout where Sam tested for the "Haylushka brave" qualification and passed. He worked hard to memorize many things for the program over the past few weeks and we also did several projects together that were part of the Haylushka requirements. In one picture you can see him proudly pointing to the official Haylushka hat that he gets to wear to Indian Guide events now! :) In the other two pictures Sam is enjoying a cup of camp cocoa and Ben and I are checking out a tee pee that was set up at the camp.
In the last picture, Sam is next to our big pumpkin. It didn't get as large as it's parent, our giant pumpkin from last year, but it does seem large for a pumpkin that hasn't received any special care and nurturing. Just in time for Halloween!

17 Oct - Sarah Got Chemo

Overdue for an update! Sarah's C.Diff. test was negative last Thursday and her weight seems to have gone up 2 lbs. Her gastro stuff hasn't really returned to normal, but based on the negative test the doc went ahead and gave her an Abraxane treatement, which is a relief for us. Due to continued neuropathy, she got an 80% dose so we can see if it makes it worse or not. But that's still pretty good. Sarah is perking up a bit now and seems more energetic. She's also in a less anxious mood now, which is a relief for her as well.
On an unrelated note, the rest of us are under the weather big time. Sam caught some kind of stomach bug on Friday and was throwing up most of Friday night. Now Ben and I have it as well - but Sarah's got no symptoms so far. We're keeping our fingers crossed!

12 Oct Update

Quick update on Sarah: she's feeling stronger and her weight held steady this week, but other symptoms of C.Diff. are persisting. She'll get another C.Diff. toxin test tomorrow to determine whether she can get chemo this week. We don't like having to take this multi-week break, but the doc said chemo treatment during a C.Diff. infection would put her in the hospital. If her test is negative, we'll have to see if maybe something other than C.Diff. is causing her digestive tract issues. We'll know more later this week.

1 Oct - No Chemo Again

Well, we went to see the doc treating Sarah's C.Diff. this week and were surprised to discover that she tested positive for C.Diff. again - so, now Sarah's taking the other antibiotic called Vancomicin. She's still slowly losing weight, and her oncologist doesn't want to give her chemo while she has an active C.Diff. infection - so it is very important to get this to clear up.
Overall, Sarah is struggling to improve. Trying to build strength, but her body's reduced nutritional absorption (due to C.Diff) and worsening neuropathy make it a challenge. She's eating fairly well but it just goes right through her body because of damage to the lining in the intestines. Over the next week we'll be anxiously watching whether the C.Diff. starts to go away. Not likely she'll get chemo next Thursday but we are going to talk to the doc about the overall chemo treatment plan for when she can resume it.
On the bright side, Sarah's bilirubin level came down from 2.8 to 1.8 which is good, and her tumor markers are only up a little bit from the last check despite intermittent chemo treatments.

28 Sept Update

Sarah didn't get chemo last Thursday which is what we were planning, but her white blood cell count was low anyway so it wasn't an option. She's gaining strength physically but her bilirubin is up to 2.8 and her neuropathy is pretty bad despite taking a few chemo breaks. Sarah can't feel much in her hands and feet and that's one of a few things making her more anxious about how things are trending. The doc gave her some Adavan to take as needed to smooth things out when the anxiety gets too hard to ignore and that has helped.
On the flip side, Sarah has been walking up and down the stairs on her own more often to build strength and even walked down the street with a friend today while holding on to the wheel-chair for support. She hasn't been able to do that for a while, so I consider that a real victory! The plan is to get Abraxane one more week if possible and then talk to her doc next Thursday about what other chemos we could try that don't have nerve damage as a side effect.

20 Sept Update

Sarah got chemo last Thursday and has continued to build a little more strength. Still not putting on weight yet but she's trying to exercise and eat more in order to get that turned around. We were fairly active over the weekend - Sarah came out shopping with the boys and me. Browsing in Costco is always interesting, and she hasn't been able to do it for quite a while. We made use of the electric carts that stores have so she didn't have to walk, but it was tough to keep the boys off the carts. They really wanted to drive them!

15 Sept - Update

We had our new nanny Donna start this week and things are going well so far. We put her to the test right away since I had to go on a short business trip (just got back) but everyone survived ok.

Sarah's feeling some of her strength come back very gradually. Good trend! She's able to make it up and down the stairs with no help now, which is a huge step forward in terms of feeling a little more independent again. There are so many little things that we often take for granted. It's a victory for Sarah to be able to walk up steps (slowly!) normally rather than place both feet on every step and pause for a breather on each one. Chemo this week didn't make her feel too bad and since her C.Diff. toxin test came back negative, she can stop taking the antibiotics for that. We'll be vigilant for signs of the C.Diff. recurring - we've heard that it typically happens a few times before it's really fully cleared up.

11 Sept - Got Chemo

Sarah got an Abraxane treatment this past Thursday, which is good news but something she at the same time was not looking forward to. It will be a tough weekend for her as the effects of the chemo kick in, but hopefully well worth it in terms of fighting back. Sarah is still very weak but we think there's some improvement in her strength. As the C.Diff. infection slowly goes away, she should be able to gain more energy. A test is in progress to see if the C.Diff. is still active and we should see the results on Monday.

6 Sept - Labor Day

Catching up with some pics. You can see Ben's and Sam's first day of school, Ben on a paddle boat this weekend, and our Labor Day cookout meal in the back yard. It was a very nice day so we got to spend some time outside! Sarah laid pretty low this weekend but enjoyed having a few friends visit to catch up.

3 Sept - No Chemo This Week

Sarah went for treatment yesterday and go her weekly Herceptin but no chemo. Her body is still too weak and she's not yet fully recovered from the C. Diff. infection. As we look back and do more research, it's possible that most of Sarah's recent symptoms can be explained by the C. Diff., which is actually good news since we know that it is treatable. C. Diff. is a tough infection to shut down completely, but with several longer courses of a certain antibiotic it should go away (which she is taking now) - and Sarah should be able to gain some strength back and recover her Albumin level and blood counts. We'll have to be patient. Hopefully next week if her gastro process is working better we can get her a chemo treatment.

We'll be spending the 3-day weekend close to home so everyone can relax and recuperate.

1 Sept - Sarah Home From Hospital

Sarah's oncologist decided she should be fine at home and approved her discharge from the hospital. I brought her home tonight. She's still feels pretty weak - more than before we left the house last Friday - and she'll have to stay on the special antibiotics for 2 weeks in order to try and clear up the C. Diff. infection. Could be she's had it for a while and it is possible that it's been taxing her system the whole time. We're hoping that clearing it up will allow Sarah to gain some strength back! Her blood test results still have quite a few "low" values but they steadied out and with the right nutrition and a cleared up system we also expect those to creep back into their normal ranges over time. For now, Sarah's just happy to leave the hospital and be back home - even though the stairs do look pretty daunting to her.

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.