The Evolving of Care and Procedures

Yesterday, July 28, I think that I came close to walking my 10,000 steps.  My fitbit tracks these things, alas that device didn't come with me yesterday but I am sure that 10,000 steps would have shown up.

  Bob and I spent 7 hours walking the halls of the Tom Baker Cancer Centre with an odd foray into the main hospital.  Yesterday was the longest day of blood testing and x-raying that Bob will have prior to the stem cell transplant.  We were starting to think that if he survived the day, Bob would be healthy enough to have the transplant.  What we found most interesting was how much the approach to this work-up has changed since we walked this route years back.  It could be us and our  better understanding of  things cancer.  We came home feeling much better about the process.  It is still going to be a tough go for Bob but many of the details became so much more clear.  

The dentist visit was so good.  An oncologist dentist and what a super guy he is.  Bob has now become his patient for at least 6 mo. for anything at all related to the mouth.  Dr. Ricky explained all about the mucositis---how painful it will be and how to care for the sores.  We must be the only people that didn't know dry mouth means--no saliva!!!  We were educated about all of that.  Any sign of thrush we get in to see the dentist.  Feeling very cared for.  The biggest killer is infection and often that begins in the mouth. The last time Bob prepped for the transplant the dentist pulled 2 teeth and said he was ready to go.  

When the chemo is being given it has been said that Bob will be given ice chips or shaved ice to help in the mouth.  Yesterday we bought one of those sno-cone type machines that shaves ice.  Bob is going to work at conditioning his mouth and body to the cold so he can do it well when he is in the hospital.  I am going to sprinkle grape juice on my sno cone.  ;-} .  Once this is all over the grandkids can have it ........

We also saw a psychologist in the Dept. of Psychosocial resources.  Dr. Tsai was also a wonderful lady to talk with.   She could be a friend.  She will go up and see Bob when he is in hospital.  She will be available to me/we anytime we need to talk.  We got to share our faith in Jesus with her and how we believed in prayer.  To her, our faith is a positive in our lives that helps deal with stress.  She is ok with it.    (The word of the Lord does not return void).  Lovely, lovely lady.  The last time we were in this dept. we were taught breathing techniques for relaxing.

Bob thinks he "passed" the heart and breathing part of the prep.

This is the point that the first transplant attempt was stopped.  The road of drugs then began.

Bob still has 3 big days.  Sat. is the CTscan but we don't think that would stop the process.  We have 2 big days next week on Tues and Fri.  they are meetings with the doctors, pharmacist, teaching, and touring. We will know on Tues if Dr. Bahlis will go ahead with the transplant.  On Fri.  Bob will receive  velcade infusion, more bloodwork and wait for the Transplant Journey beginning Aug. 10.

It is kinda, sorta ironic that it was Aug. long weekend 7 years ago that Bob had the back surgery fusing T5andT6 together where a tumor had broken his back.

Please pray for clear direction for Dr. Bahlis, the continuing great care, that Bob will not  be as sick as it seems folks are, that I will have the strength of the Lord to do all the driving, hospital time and care at home.

Evolution/Evolving/Changing????

What is evolution?

This question may conjure up many things in my mind.  Did humans come from monkeys???  I don't believe so but the word evolution brings that thought first to my mind.

This past weekend Bob and I were fortunate to celebrate our 45th wedding anniversary.  I know, it hardly seems possible that two youngsters could be married that long.  It was a delightful celebration.  We drove to Spokane for the weekend.  Not to long ago we could be heard saying "no, for any holidays we won't be leaving Canada.  What if Bob needed medical attention?"  So here we are in Spokane with no idea of what is in the city or how we will spend our time.  We did have a place to sleep, booked tho!!!!!  Spokane turned out to be fun.  We are a bit of history buffs so we had our anniversary dinner in a renovated steam plant.  The restaurant is called The Stack.  It is also home to a micro brewery, pub and a number of offices.  The way this was done leaves much of the steam"stuff" in place and the booths and tables etc are filled in around pipes and dials etc.  We were able to walk around most of the whole building reading the plaques that explain the history.  There is three stories of cat walks so we could go pretty much right to the top of the building. The food was great and the beer? while the flavor I choose will not become a favorite.

On the first day of married life together we ate in a pancake house.  Sooooooo...  Bob found a pancake house for us to have breakfast at called:........Frank's Diner!!         Bob told me that the reviews were really great so off we went.  Well, this diner is a renovated train car.  The plaques once again explained the history of the car.  There was a fairly long counter, some two people booths, and three, six people booths.  The wait was about half an hour for us but some folks were going to wait almost an hour----we were early!!!!  Great food, great service and very cool surroundings.

We did not know that Spokane is the smallest city to host an EXPO.  The Expo 1974 was held in Spokane. There is a one hundred acre park in the centre of the city where the fair was held. This park has been left as a legacy to the city.  We took the "little train" ride around the park.  The tour guide explained all of the various parts of the park.  Canada"s pavilion was on an island.  We left them a totem pole!!!!  It was most interesting and some very beautiful buildings remain.

A gondola (redone and made longer) took us out over the river and the hydro dam that the city uses for power.  The gondola was also given by a country,( the name of which I cannot remember), to Spokane (not the new gondaolas!!!).

I will get to evolution, patience, my dear.!!!!!!!!

Then I rode on the carousel that was left by Germany for the city. This was part of the German pavilion and I think the beer gardens------41 years ago!!!  It is a beautiful, carousel, well kept and goes fairly fast for a grandma.

We also walked through a three story Nordstom store just to say we did!!!!!!!!!!

More heritage sites were part of the days events but I don't want to be a bore.  ;-}

We talked about a large number of things over the weekend but a lot about how our lives have evolved.  We talked about how we have evolved as individuals from those two young people who got married to who we are today and how we interact together.  The dictionary says that evolution is: a process of slow change and development.  I believe that!!!! 

For Bob and I this evolution played out on the trip home.  We have GPS, his name is Mordecai.  Mordecai showed the way out of the city of Spokane and theeeeeen we turned him off as now, we knew the way. "Of course the terrain looks different, we are going the other way.  Oh yeah we didn't see Silverwood, that was on the other side of the highway, it was raining when we came...of course it looks different,  I don't believe we drove through all this construction, must have, uh oh we aren't suppose to be in MONTANA.  Where are we???  Turn Mordecai on and he can only say: turn around, turn around-----not helping Mordecai."  So we were as calm as can be and thought we have gone to far to turn around on the Interstate 90.  We landed in St. Regis, Montana.  Mordecai was asking us to take a very similar route back, only through some serious looking mountains on roads less travelled.  The lovely lady at the gift shop provided us with a free paper map (I know, I know who uses paper maps?)  We voted against Mordecai and also chose not to go into Glacier Park but north to Kallispell and Whitefish all the way north to Hwy 3 (in Canada) and the ice cream stop.  It was a long journey, instead of getting home around 3:00  we got home at 10:00pm.  Our evolution is that this became fun and an adventure, not an anxious wife or a husband who was ticked off.................evolution.  We also learned that the Flathead Lake area has a micro climate that grows cherries!!!!  

Evolution also occurs as I learn from the many life situations Bob and I have walked through and walked alongside other folks in their journeys.  I have learned to trust the Lord, truly believing that everything passes through His Hand before an event happens to me or those I love.  My relationship with God is a very personal, intimate one.  I know that Bob's relationship is also very intimate.  The Lord is only interested in who we are as people, as followers of Jesus.  It becomes important then, how we react to life, how and who we trust with life situations.  Bob and I are choosing that our desire is to bring honor to the name of Jesus and to trust Him in this cancer walk we are on.  We do not want to be bitter, angry, ungrateful or try to lay blame.  We are grateful for the years that have already been added to Bob's life.  We are so thankful for the employment, benefits and the people in the company that Bob works for.  We are thankful for God's leading when I made the decision to leave my job at the preschool.  I wasn't totally sold on any one reason but knew leaving was what I needed to do.

Evolution also came to our thinking about one of the first line procedures in treating multiple myeloma cancer.  That would be stem cell transplant.  We heard about it and prepared for it early on in this journey.  Bob was disqualified for the reason of a heart attack which we believe he suffered during the time he was in immense back pain, prior to the back surgery.  Over time we decided that this procedure was just to horrible for Bob to undergo.  Bob had the regime of the first line drugs and lived with the side affects.  The first line drugs have now run out and Bob's numbers are once again on the up swing.  The stem cells have already been harvested.  As we listened to Dr. Bahlis and Dr. Neri's presentation this time, we understood everything much better, some things they have changed to hopefully make the transplant more acceptable physically.  Bob's age is also on the up swing.  Right now Bob is in reasonably good health and the transplant is the BEST option.  It will give him at least a couple more years and in the mean time there are more drugs in the development stage.  One of these drugs is noted on FB today from a friend of ours--Gloria---who also is battling multiple myeloma.  I shared that write up on my FB page.  I copied, below, some of what is written.  This is the type of research that gives hope.  God in His mercy gives these doctors and researchers more and more glimpses into the amazing bodies He created.

In the one-year study, UCLA researchers analyzed the effects of an experimental drug called compound 11 in myeloma cell lines. They combined it with another drug, bortezomib (Velcade), which was approved by the U.S. Food & Drug Administration in 2008 for use in the treatment for lymphoma. Results showed that the drugs working in tandem targeted a specific protein to stop cancer cells in the bone marrow from replicating, and eventually causing them to die.

“Compound 11 will prevent the transmission of the Myc RNA into Myc protein, and prevent the Myc protein from being synthesized in the multiple myeloma cells when those cell lines are being stressed by the drug bortezomib,” said Lichtenstein, a UCLA professor of hematology and oncology. “Though this research is only in the preliminary phases, we hope that it will eventually lead to human clinical trials and the development of new treatments for this devastating disease.”

 We really needed to get back from Montana as the appointment with Dr. Bahlis was this morning!!!!  Our special weekend away included lots of talking about this option and praying that the Lord will lead each step.
Sooo in our evolution of thinking, the process of Bob having a stem cell transplant has begun.  Bob will need to pass all of the tests that will take place in the next weeks. Plans need to be made tho, so Bob will finish work on Aug.7 and start on short term disability and then if needed long term disability down the road.  The central venous catheter will be put in on Aug.10.  The large dose chemo (melphalan) will be given on the 11th, Bob will also receive 2 doses of velcade.  Blood cells transplanted on the 12th.  He will be able to come home until his blood counts disappear and then will be in the hospital, pretty much in isolation.  This will also be his sickest time.  Potentially he could come home by the end of the month depending on the recovery of the blood counts.  Until Dec. Bob will be avoiding germs and resting. Infections of any type are the biggest worry.  We are not sure what this will look like but Bob is thrilled he will not need to go to a mall or do any Christmas shopping.  At first for sure, no germs from other people or other homes.  We will be travelling once for sure but perhaps 2x a week to Tom Baker during this time.  Fresh flowers, fruit baskets are not allowed in the hospital for sure. They suggest cards, pictures and non latex balloons.

Please add Bob and me too! to your prayers.  We will see Dr. Bahlis on Aug. 4 at which time we will know for sure if all of this evolution-----of planning----- will take place.