A Sense of Accomplishment

Today has been one of those days that began with high hopes of getting  several things on my to-do list done.  I  got two of them done, and it exhausted me. I managed to get three loads of laundry  washed and dried and one load folded and put away.  The other two loads   still sit in the baskets reproaching me.

 The job that  took the most time was   our poor little water feature.  The water feature consists of a  big plastic  flower pot  with a fountain pump that sits atop an inverted clay pot. There are a couple of large rocks and a fake frog to anchor the fountain pump. Here's a pic of it  taken in May when it was all clean and spiffy.

Before I got my port and began chemotherapy in late  May I   kept it cleaned out regularly- or at least I cleaned it when it wasn't serving as a frog nursery.  However, thanks to the fatigue that  hits me frequently and the   miserable heat and humidity we've been having  the garden and everything on the deck  have suffered  neglect.  The water feature has been getting nastier and nastier as algae and  who knows what   have formed a thick, slimy black coating on the  container, the  fountain parts, the rocks.  Today I decided it was time to declare war on the yucky black stuff. Mr. G had a meeting, so  I got him to  dump all the water out and   unhook the pump before he left.  I  put on my   long rubber  gloves and began to blast away at  the  container with a jet from the garden hose. Nothing.  I  didn't want to use any  chemicals  to kill the algae because of the frogs visiting it regularly, so  I  began to scrub with  the scrubby side of a sponge. Nothing. Finally I  went in search of a brush of some sort.  The best I could come up with was a little nail brush.  By golly it worked, but it was taking absolutely forever and I kept running out of steam in the heat, so would take frequent breaks, then move  everything  to a shady spot and  continue working. This has become my primary mode of operating lately- work a while, rest a while, repeat.  It takes longer to get anything done, but it does get done, eventually.  I finally got  the container and the rocks scrubbed clean and picked up the pump to remove the fountain.  I was immediately covered in ants! While I had been scrubbing away the ants had been moving into the filter on the pump. There must have been lebenty kazillion of  those nasty little things. I was finally able to  get the pump taken apart, get rid of the ants, clean up the fountain parts and  refill the  water feature just before the rains moved in  this evening. The fountain is  now happily gurgling away on the deck, looking once more   clean and spiffy.  I feel a sense of accomplishment.

The fountain creates so much foam it looks as though the froggie is  having a bubble bath.  Notice the Terro ant bait thingy  at the side of the water feature. 

I wish  I felt the same sense of accomplishment   about the dinner I cooked tonight.  In an effort at variety I decided to try a recipe from an old cookbook for pineapple  burgers with a spicy sauce, served with  buttered noodles and  frenched green beans. Mr. G. was not impressed.  I told him it was a recipe from the  1960s.  He said it should have stayed back in the  sixties. Oh, well, you can't win them all. I have discovered a  great way to  french cut green beans, though- in the food processor! Works like a charm.  You can see how it works on the Clever Carrot Blog.

Queen of the Night

Last night we were treated to a special show.  Five buds on the night blooming cereus, also  known as Queen of the Night, opened.  For the first few years that it bloomed there were usually only one or two blooms  opening at a time, but as it has matured we have been treated to a profusion of blooms all at once.

For those of you who aren’t familiar with this plant, it’s a member of the cactus family, and although it is often called a night blooming cereus, it is not in the Cereus genus but is actually an epiphyte, Epiphyllum oxypetalum.  While  Cereus are tall cacti that grow in the ground, Epiphyllum are flat stemmed, somewhat sprawling epiphytes that live in trees. It is, for most of its life, a rather plain and somewhat ugly plant. But when you notice a tiny bud forming on one of its flat  branches,  you know the ugly duckling is about to become a beautiful swan and  you’re in for  quite  a show. Here’s a tiny bud  forming.

When the buds are fully formed  and ready to bloom, they begin to turn upward on their stems. Once the sun goes down and dusk descends, the show begins and lasts well into the night. The pink sepals  begin to raise up  like fingers,  bending back as the creamy white petals unfurl, revealing the  flower’s delicate anthers and stigma.  As the sepals and petals  unfurl,  the flower emits a wonderful heady fragrance. As the sun comes up, the  blooms close, and by morning, the once beautiful flowers hang,  spent and exhausted, on limp peduncles. Here are some pics I’ve taken of the sequence of events, both from  last night’s performance and some earlier ones. The last pic is  of the little frog who was perched on the garden hose  last night providing background music for the show.    

Odd Shoes and Serenades

Today I went  in for  shot number two of three in this week’s Neupogen series.  Tomorrow is the third shot, then six days with no shots, no treatments, before going in for the sixth chemo session next Wednesday. I have come to look forward to those days when we don’t have to plan our activities around trips to the doctor’s office or infusion center or adjust to the limitations of wearing a portable  infusion pump.

We were almost late for the appointment today, thanks to a poor little hummingbird who couldn’t seem to   figure out how to get out from under the gazebo cover.  For about half an hour he or she fluttered about in a frenzy,  its little wings beating like mad as it kept opening and closing its beak. It would fly all around close to the roof of the gazebo, hitting the cloth top but never swooping low enough to  go through  one of the side openings in the  netting.  We tried to gently coax him to fly lower   with mops and brooms, to no avail, and there were no other hummers around to  help guide him out.  I was afraid he would exhaust himself, drop down to the floor and be pounced upon by  one of the neighborhood cats. We finally decided another hummingbird was bound to show up sooner or later, so we hurriedly gathered up what we needed and headed for the car.  The traffic, which was unusually heavy for the time of day, was slowed down even more by a  heavy rain that had begun to fall. 

We arrived just a minute before my appointment time instead of the fifteen minutes early  that the clinic  prefers. After signing in, I sat down  waiting to be called, looked  down at my feet and realized I was wearing one brown sandal and one black clog and that my socks were on inside out. This is my  usual footwear at home, but I  change before going out in public.  Or at least, I do most of the time. I have a sore  big toe on my  right foot; wearing socks inside out keeps the  seam from hitting the sore spot.  The sandal  keeps pressure off the toe.  But when I wear  both sandals, they throw my bum hip out of kilter.  The  Slogger  clogs  are just the right height  to  keep the hip  aligned so that it doesn’t hurt and   those are the shoes I normally wear when   my toe isn’t sore and swollen. Before leaving the house I  usually make sure that I’m wearing socks that don’t show whether they’re inside out or not, and I swap the sandal for the other  Slogger shoe.  The hummingbird adventure   made me forget- or perhaps it was chemo brain striking again! Maybe I  can start a new fashion trend where  comfort  trumps  style.

When we arrived home, we were happy to see that the hummingbird had found its way out and that  other hummingbirds were buzzing around the gazebo waiting their turn at the feeder.  It’s dark now,  the rain  has stopped, although we  occasionally hear thunder off in the distance. The hummingbirds have gone to roost and the frogs have moved onto the deck near the water garden, filling the air with sounds of their romantic serenades. I wonder if we’ll see  more frog spawn in the  water garden tomorrow.

Spawn from  one of  Froggie's  earlier romantic evenings.

One of our serenading frogs

Gluttons in the Garden

In between showers this morning (Yes, we have been getting some wonderful, cooling rain!) I stepped out on the deck to refill the hummingbird feeder.  The first thing I saw was a pile of  green pellets  littering the deck.

 If you grow tomatoes you are probably familiar with the sight, but for those of you who aren’t’ familiar, those pellets are frass, or the excrement of the tomato or tobacco hornworm.  This particular frass belongs to a  tobacco hornworm,  the same one, or the relative of  the one, that dashed my hopes of a decent tomato crop this year.

 I planted the  heirloom Opalka tomato seeds in  the Earthboxes on the deck with such high hopes, and  in June they definitely showed promise, as you can see here.

 

 Then, one morning I  looked out horrified.  My once bountiful, leafy, fruit laden  tomato plants  had been defoliated!  The scientific name for this particular hornworm is Manduca sexta. Manduca comes from the Latin word for glutton, a very apt description for this voracious eater!  There, at the base of the plants were the telltale pellets.  Hornworms are notoriously hard to  see because they are masters of disguise and manage to blend right in with the leaves and stalks of the tomato plant, but there they were-  chomping away. They have, over the last few years, become the bane of my tomato-growing existence. I pick them off and  dispatch them- I’ll spare you the gory details, but I don’t want to come back as a hornworm for I have done some despicable things to hornworms, maybe even worse than the crimes I have committed against ants.  Here  are some pics of the nasty little green devils at work. 

The damage  was almost complete by early August.  We managed to harvest a few tomatoes, but not many. Defeated once more, I left the plants there on the deck  for the remaining hornworms to finish off.  And finish them off they have- as evidenced by the  last remaining tomato in the last frame, and the fact that the pellets are much larger than they were  earlier in the summer. But I cannot find the hornworms this time. I have a feeling that they may be in the soil pupating. That  process is magical, and  a year or so ago we were able to witness the metamorphosis of a hornworm  into a  sphinx moth when I  inadvertently   dug up a pupa  while replanting the Earthboxes.  Here are some pics of what happened.The first pic is a close-up of the hornworm in  the larval stage.  See the horn on its  tail end? 

 This is the pupa  I dug up. I put it in a shallow  dish of  soil to finish the metamorphosis and hoped that it wouldn't dry out and die before making the transition.

Finally, we saw that the pupa case was beginning to split

Finally a moth struggled out,  shook off its wings and flew away to lay eggs and begin the cycle all over again.

The  hornworms that ate this year's tomato crop are probably the great grandchildren of  this one. And so it goes. . .

If you'd like to see  some much better pics and learn more about hornworms, here's a  really  nice and informative site from the University of Florida: Hornworms

Crazier in Alabama

I  had writer’s block yesterday.   I also had blocked sinus cavities and a sinus headache all day so maybe the two are related, although the thought of a muse being imprisoned and unable to escape from a sinus cavity is a little unsettling.Thankfully, there are a  lot of very talented bloggers who didn't have writers block, so I’ll share a post from one of them.  

 We have some strange happenings here in Alabama. Many of them, like this one, are so bizarre  they make it into the national press. We do  bizarre, strange,  amusing  and disturbing really well down here.  This is  just the latest happening in the life of Mayor Larry Barton,  mayor of Talladega, Alabama, a town  fifty miles  east of Birmingham with a population of about 16,000. The mayor is up for reelection this year and blames his most recent  troubles on politics, but you can make your own mind up on that.

Back in 1995, Barton was serving his third term as mayor when he was convicted on federal charges of money laundering and defrauding the city of Talladega.  He served  three years in prison, then ran for mayor  again in 1999 and 2003.  Barton  lost the runoff elections both times.  Undeterred,  he ran again, and was returned to office in 2011 after winning a runoff  with   fifty-three percent of the vote.

His fraud and money laundering activities pale, though, in comparison with his latest escapade involving a   beating, a baseball bat, a bicycle and some reportedly seamy sex tapes that purportedly  show the participants, both of whom are  well past  sixty, getting it on in the  back room of a liquor store. But I’ll direct you to Marianne Arensmeyer’s blog.  She tells it much better than I can:

Sex and Politics, Southern Style

Pondering Pumps, Pigs and Peppermint

The day my pump gets unhooked has become a mostly wasted day. Today was no exception.  I got a few calls made and a few chores done this morning, but after Mr. G unhooked me, flushed the lines and injected the Heparin that prevents clotting  I pretty much zonked out for the rest of the day. I don’t know what causes the fatigue when I come off the pump, but it hits me every time. It’s not all lost time, though because on the days I’m too tired to do much else I can always read and learn new things.  And play on the Internet.

 The 46 hours on the 5 FU aren’t too bad, except for the nasty facial flushing that makes me look and feel like my face is on fire. The rest of me can have chill bumps, but my face feels like I’ve had my head in a furnace, so I spend a lot of time peeping out from behind a cool washcloth. The other side effect that is most bothersome for those 46 hours are the jaw spasms that are most likely caused by the Oxaliplatin rather than the 5 FU.  Whenever I try to eat or drink after getting a treatment, my jaw locks up.  It lasts only for the first few bites, and finally goes away so I can eat normally, but it’s a really strange sensation, especially the very first time it happens. Fortunately,  I was given info sheets before  my first treatment that listed all the  possible side effects from the various drugs and  advised which  side effect were not normal and should be reported immediately. So far, I’ve been lucky in avoiding most of the side effects and those I have gotten are more annoyances than anything else.  A lot of chemo patients are not so fortunate and suffer really debilitating effects; some are unable to continue treatment because of them.  So as I said, I’ve been very fortunate, and the oncology nurses have been very  helpful in giving out tips on how to deal with some of the problems chemo patients encounter. 

One of the best tips so far has been to suck on a peppermint candy while I’m getting the heparin flush. Whenever  that heparin injection began to go in, I could smell it and taste it and it was most unpleasant. When I found out that heparin is an animal derived product, made from mucosal tissues of porcine (pig) intestines or  bovine (cattle) lungs, it set my mind going off in all directions. But anyway, as long as I don’t get so full of the stuff that I begin to oink or moo and get a wild desire to wallow in mud, I guess all is well. And the peppermint really does help mask the smell and the taste, thank goodness.

 One thing I did wonder about when I discovered that the heparin came from pigs and cattle was whether that presented a problem for people whose religions had restrictions on the use of certain animals. I discovered that this issue has been studied extensively. The results of one study, conducted by researchers at the Herlev Hospital, University of Copenhagen were published in the journal, BMC Medical Ethics 2013, 14:48.  The researchers contacted religious and spiritual leaders of the six largest religions worldwide (18 branches) and sent them a questionnaire regarding their position on the use of human and animal derived products in medical and surgical treatments. They received ten responses representing the six largest religions worldwide. The researchers reported “that among the largest (by number of adherents worldwide) religious branches, several of them had restrictions regarding the use of animal derived medical products. Hindus and Sikhs did not accept the use of bovine or porcine containing products, and Muslims did not accept the use of porcine drugs, dressings or implants. Christians, Jehovah’s Witnesses, Jews and Buddhists accepted the use of all animal or human derived drugs, dressings and implants. Interestingly, all religions accepted the use of animal derived products if there were no alternatives or if they were used in an emergency situation.” 

So now we know.  This whole chemo experience has been a learning opportunity so far, and that’s a good thing I think.

A Rant About ANTS!!!

My day began at 5AM when Patches, the hungry cat got right in my face on the bed to let me know she wanted her breakfast. No amount of talking to her would convince her to wait, so dragging my pump and tubing with me, I trundled off to the kitchen, fed her, made sure she was eating, then stumbled back down the hall and back to bed. But try as I might, I could not go back to sleep.

 When Mr. G got up later I could hear him up in the kitchen cussing and carrying on. Evidently the cat had left some food in her dish and an entire army of ants had attacked it and were swarming all over the floor and in the dish. There was a long line marching in under the back door, across the baseboards and along the wall all the way across the kitchen to the cat's dish. It was horrible! I swear we could hear them beating their tiny drums and making little swishing noises as they  brandished their miniature swords while marching resolutely forward. We sprang into action, attacking them with the peppermint oil solution I had mixed up earlier. Usually, you can spray peppermint oil to deter ants and interfere with the pheromone trail they use to signal each other. But I've discovered that it also seems to kill them on contact it you spray the ants directly. So that's what we did.  We sprayed it all over the ants and the trail and set more Terro traps outside the door.I prefer to  use  Terro and have them carry the bait back to the nest  to kill the ants we can't see, but seeing the huge number we saw this morning called for immediate action and the use of deadly force.

We have had a terrible time with ant invasions this year, worse than any year I can remember. They've crawled in all the kitchen windows and under the doors. Every time we think we've seen the last of them, and go without a sighting for a few days another battalion turns up in full battle gear a few days later.

But I think we have the problem under control on the  window ledge above the kitchen sink, at least. I have positioned an entire jagu of minions  on the window ledge, plus a green koala bear to give them moral support and tell them Aussie jokes.  They have been charged with sounding the alarm at the first sign of an ant so that a new dose of Terro can be administered. Here is a pic of  home guard.  Mr. G purchased  the minions as a joke some time back when I said that I needed minions to do my bidding.

On a more pleasant note- as I was assembling the minions, I looked out the kitchen window and saw a hummingbird flitting all over the fuchsia basket. Much nicer to look at than the dead ants that littered the floor behind me. If there is such a thing as reincarnation, I hope I don't come back as an ant, because I have done terrible things to ants. And I have felt no remorse.

Treatment Number 5 is History! Well, Almost History. . .

Chemo treatment number five is done- well, except for the next day and a half on the portable 5-fu pump. When that gets unhooked on Friday,  five will be history.   Three more to go, then a scan to see how well the chemo has worked and what the next step will be.

One of the other patients in the infusion room today was getting his last treatment in a series of twelve - - he’s been going to the infusion room  for chemotherapy since February and has endeared himself to the doctor, the nurses and the other patients.  He is always so upbeat, with a smile and greeting for everyone. He was there for my first treatment and today I was there for his last. We had one other treatment day together. On that day we had chairs next to each other so I got to know him a little better. Like me, he is a stage 4 colon cancer patient, and like me he has managed to escape the worst side effects of treatment.  He is more than happy to tell everyone that he didn’t even lose his hair while doffing his cap to show us his  still healthy gray curls! We  were all  happy to see him come to the end of this particular leg on his cancer journey, but  we will definitely miss his smile and his good humor and the hope he dispenses liberally.

A stage four diagnosis can be devastating because at that point, once the cancer has metastasized treatment is geared  more to managing the cancer as a chronic condition rather than an attempt to “cure” it. But with modern treatments, there’s a really good chance that the cancer can be subdued and held at bay for months or even years. While many people think of a diagnosis of stage four cancer as a death sentence, this is no longer necessarily true. There are many stage  four survivors who continue to lead active, meaningful lives for many years. I hope  my friend  is one of them.  And that I am, too.

In the meantime,  Tim McGraw's “Live Like you were Dying” gives some pretty  good advice for all of us, with or without a cancer diagnosis. We may not all be able to or even want to go rocky mountain climbing, nor ride a bull named Fumanchu, but we can love deeper, speak sweeter, watch the eagles fly and live each day to the fullest. Carpe Diem!

Costs, Chemo and Beelzebub

Tomorrow I go for my fifth chemo treatment.  I had hoped this would be the next to last treatment, but evidently I misheard when Dr. Vance told me how many sessions were planned- I heard six, she said eight, so we still have four to go. I’m keeping my fingers crossed that the three Neupogen  shots  last week  did their job of stimulating my bone marrow to produce more white cells, I really don’t want another delay.

Today I have been trying to make sense of the billings for all this treatment. Thank goodness I’m on Medicare and  have a supplemental  policy because  we would be bankrupt otherwise, I’m sure. There have been several  news reports and TV segments about the high cost of cancer treatment, but until you actually begin to see the bills, you have no idea!  At least, I didn’t.  And once I did see the bills  I could see how very little sense the whole medical billing process makes.

Take, for instance, my visit to the clinic and infusion center two weeks ago.  I had the usual bloodwork, a visit with the doctor, and then the chemo treatment in the infusion center.  The amount billed to Medicare/the insurance company by the medical providers was $15,130.00.  Of that amount the insurance allowed amount was $3562.95, and the amount paid by Medicare/ the insurance company was $2849.71.  My copay share is $655.09. Fortunately, because our income makes us eligible for some assistance a foundation pays a portion of that copay, greatly reducing our out-of-pocket expenses. The Neupogen shots are billed at $1243.00 each, but only  $498 of that is allowed by the insurance company, they pay $395 and my copay amount is  $95.00, so at three shots every other week,  it is really going to add up and I’m unsure whether the foundation covers a portion of the Neupogen copays.

 What is interesting is the huge discrepancy between the amounts billed and the amounts allowed and paid by insurance. The providers have agreed to the amounts paid, so there will be no additional billing to us to make up the difference. I wonder if those without insurance are also billed at the high amount and are not entitled to the discounts, or whether they can negotiate a lower cost closer to  that amount the insurance companies allow. It boggles my mind that a provider   can bill   over $11,000.00 more than   the allowed amount and then simply write off or absorb the difference or bill that amount to someone without insurance. It’s a very crazy system.  When families are dealing with the stress of a cancer diagnosis and the side effects of the treatment, the last thing they need to worry about is how and if they are going to be able to afford treatment without going bankrupt.  In fact a 2013 study reported by CNN found that “Bankruptcies resulting from unpaid medical bills will affect nearly 2 million people this year—making health care the No. 1 cause of such filings, and outpacing bankruptcies due to credit-card bills or unpaid mortgages, according to new data. And even having health insurance doesn't buffer consumers against financial hardship.” 

 I really intended to be a little more upbeat in my post tonight, but with all the political rhetoric floating around about cutting "entitlements" and social services,  with politicians  using Medicare and Medicaid as political footballs and the legislature of my own state, Alabama,  attempting to  gut Medicaid in order to  make up for massive  deficits brought about in part by their own refusal to deal with or change a ridiculously regressive and inefficient tax structure, my  upbeat and humor buttons are stuck tight and won’t work. Maybe  the oncology nurses will give me an infusion of humor along with  the Bevacizumab and Oxaliplatin tomorrow.   Although, now that I think about it,  the name Bevacizumab  always puts me in mind of Beelzebub and it’s unlikely anything  humorous can come from something with a name like that.  But hope springs, so wish me luck tomorrow. 

Silver Clouds, Black Skies, Stormy Monday

It's a stormy Monday evening. We’re having a regular sound and light show now so I had better make this a short blog post and switch the computer off before the storm does it for me! As we were driving to my yoga class in Sumiton tonight Mr. G and I commented on how beautiful the sky was, and how the clouds gave the appearance of a mystical landscape with mountains and shorelines. The sun hiding behind the clouds gave them a diaphanous silvery sheen, while the edges shone with a luminous golden glow. It was almost dreamlike in its loveliness. That all changed while I was in yoga class, though. As we were doing our final relaxation meditation we could hear the ominous deep rumblings of thunder getting louder and louder signaling that a storm was moving in.  By the time the class was over, the rain had begun to fall. As we drove towards the highway we could see that the sky just ahead of us was gray and rain laden but as we looked to the west we saw that the sky was an angry pitch black and the darkness was moving rapidly towards us. As we got a few miles down the road we managed to get in front of the storm clouds and outrun them, but we could see  bright flashes that lit the sky as the storm behind us threw spears of lightning to land in front of us.

We got home and into the house just in time to let the dogs out and get them back in before the rain came pouring down. Here's hoping the rain cools things down a bit and doesn't just create steam as it has been doing lately.  We desperately need a break from this unrelenting heat.

Lost Muses and Reincarnated Roosters

I often feel that when I lost Sam I lost my muse. He spend his early chickhood as a timid little chick who would hop on my boots for a ride around the back yard.

He grew into a most handsome fellow who took very seriously his job as guardian of the flock.

 He was the inspiration for most of my humorous tales about life with an ornery rooster. I miss him in more ways than one and we miss the lovely eggs the girls provided.  But I don’t miss them enough to get another rooster! Besides,  several of our old neighbors have moved away and new  neighbors have moved in and  I’m not sure they’d be as tolerant of some of the  shenanigans the critters got up to. Like the  time he put on an X-rated show  in the back yard. Sometimes I think feisty little Agatha  is channeling Sam.  She’s certainly as ornery and bossy as he was (just ask poor, long-suffering Victoria who puts up with Agatha stealing her  toys and  giving  her hip slams), and she DOES eat hornworms – well, she ate ONE hornworm, which may have been her first and last because it made her a little crazy as you can see in the pic  to the left. Sadly, Agatha doesn’t have  Sam’s comedic flair or sense of timing, but she does have the same ability to aggravate  Mr. G That Sam had.  Fortunately, she doesn’t have spurs! I think Mr. G may still have the scars from some of those encounters, like this one.Meanwhile, we're enjoying the relative peace and quiet- or at least Mr. G is. Until Agatha  barks- Mr. G says it is the  shrillest, most annoying bark he has ever heard and he's sure she's out to make him go deaf or crazy, whichever comes first.  Yes, I do believe  she might be Sam, reincarnated as a dog. She  just hasn't perfected her act yet.

Ugly Babies, Barking Dogs and Powerful Art

Almost a year ago to the day I made a Dutch baby pancake for the first time. It wasn’t the most beautiful pancake in the world, but filled with a mixture of fruit it was really quite delicious. Here’s a pic of it  as it was being filled with  the fruit.

Well last night I was making Dutch babies in my dreams, only they were very small, very flat and very burned around the edges. They hadn't puffed up at all. I was fussing at how awful they looked and moaning that I had just created ugly babies when a shrill, piercing noise filled the air. I woke immediately, looked at the clock, saw that it was 1:41 AM and realized that both dogs were barking  and jumping around as though someone was trying to break in. By that time, Mr. G was also wide awake. We determined that there were no prowlers, that Agatha  might have been dreaming and woke Victoria, who joined her in barking because that's what Victoria does. We let the dogs out into the back yard to chase whatever demons they were after, then let them back in. They were both back to sleep in no time. I, however, lay there awake in the dark wondering how the ugly babies had turned out and whether they tasted good. I will never know, but may make some Dutch babies for breakfast tomorrow and hope for the best.

All that was to let you know that the day began much earlier than planned, which could be why I am so tired now. Mr. G and I did spend an enjoyable hour or so at the museum today enjoying the traveling exhibition of "Rising Up: Hale Woodruff’s Murals at Talladega College.” The murals are absolutely wonderful- so powerful and so vibrant in the depiction of significant events in the journey of African Americans from slavery to freedom. Some of Woodruff’s other work was also on exhibit, and his use of color was breathtaking, with some paintings having an iridescent quality that made them come alive. Seeing these paintings on line or  in a book  doesn't do them justice and I was so glad to be able to experience them up close.

We also visited the exhibits of Far Eastern art, and were particularly intrigued by the "Lethal Beauty" exhibit of samurai weapons and armor from the Clark Center for Japanese Art and Culture. We would have stayed longer and seen more but I was really beginning to drag and we still needed to stop by the grocery store, so we left. I do hope we can make visits to the Birmingham Museum of Art more often and explore the may treasures on display there. We are very lucky to have such a wonderful facility so close by.

We ended the day by watching the film, “ The Woman in Gold” starring Helen Mirren as Maria Altmann. Based on the true story of Maria’s struggle to reclaim the artwork stolen from her family by the Nazis, then appropriated as national treasures by the Austrian government and displayed in museums, the film was well acted and very interesting. Today was a day for enjoying art and escaping from the heat. I just hope that tomorrow doesn’t begin quite as early, that I am able to finish any dreams I start and that any food I cook in my sleep will not have to contain the word “ugly” in its description.

Let's talk about hummingbirds and veggies instead of chemo

Today was another hot, humid day under a colorless sky that threatened rain all day but never delivered.  The heat doesn’t seem to have slowed the   little hummingbirds down.  They have been flitting about on the deck, dive-bombing each other, and occasionally surprising us by  hovering very close to the kitchen window, looking in, then zooming back and forth while their tiny wings  making  loud humming noises. They are amazing little creatures and are quite aggressive and territorial, frequently chasing each other off the feeder so they can eat alone.

It has been a lazy day and I got very little accomplished.   I’m never quite sure whether I really am tired from the chemo or whether I’m just becoming lazy and lethargic. I certainly seem to move more like a sloth than a hummingbird lately.  I did cook a tasty meal for supper tonight: poached flounder with herb sauce, rice pilaf, and braised  kale with  garlic and Parmesan.

I had bought the kale with the intention of making kale chips, but  knew that I wouldn’t get around to doing that for a couple of days, and it really did need to be used up, so I decided to make  braised kale instead of the spinach I had planned on. Produce should keep a little longer in the fridge now since the  FreshPaper I ordered arrived in the mail  today.  We had run out and I kept forgetting to order more, but having to toss out some nasty wilted, slimy greens last week reminded me.  The greens had  morphed into an alien  life form in the crisper drawer.  I read about  FreshPaper a couple of years ago, ordered some online and discovered that it really does work to keep food fresh longer. Fresh paper comes in eight sheet packs, with each sheet lasting about a month. The sheets, which resemble thick paper towels, are five and a half inches by  four and a half inches. According to the company website  FreshPaper is infused with spices that inhibit bacterial & fungal growth, as well as enzymes that cause over-ripening. One of the spices used is fenugreek, which gives the sheets a maple  syrup scent. One sheet tossed in the crisper drawer will keep produce fresh and crisp much longer, cutting down on wasted food.

Now if I could just find something to keep me fresh and crisp longer.  Maybe a good night’s sleep will do the trick. I hope so, since we have a trip to the art museum planned for tomorrow.

Gut Feelings- Half Way There!

When I went back for my third chemo treatment  on  June 24th the blood tests came back with flags all over the place because my white  blood cell count was  way down. This is known as neutropenia and is not all that uncommon while on chemo. The oncologist seemed to think that an extra week would give the white cells time to build back up, so treatment was rescheduled for the next week.  Sure enough when I returned the following week, the blood test showed the counts were back up.  They weren’t up a lot, but enough to continue the chemo. 

I was also beginning to   feel the effects of yet another side effect of chemo. Researchers call it chemotherapy-induced cognitive dysfunction/impairment or cancer-therapy associated cognitive change. Those of us who have it call it chemo-brain. On the one hand, it's quite frustrating to keep experiencing memory lapses and brain farts. On the other hand, it's nice to have something to blame besides old age!  It’s as though your brain is a big, overstuffed, disorderly filing cabinet: everything is in there, but it’s in no particular order. So in the middle of a sentence, the word that was on the tip of your tongue just disappears, or you  forget the name of someone  you’ve known for years.  You have to go digging in the recesses of your brain file to find it, sometimes successfully, sometimes not. 

 We ran into the same problem of low white cell counts  when I went for  my fourth treatment. This time the three week wait hadn't helped, so  the oncologist decided I would benefit from  Neupogen shots and another week's delay.  Neupogen is known as a granulocyte colony-stimulating factor analog , which means that it is a substance that stimulates the production, maturation and activation of neutrophils (a type of white blood cell) from the bone marrow. It also causes some pretty nasty side effects, including   bone pain. I was scheduled to receive three shots over three days. When I  went in for the second shot I had mild to moderate low back pain, and the nurse told me that  many patients find that taking a Tylenol before receiving the shot  seems to help, and others have reported that an antihistamine  like Claritin works also. If only I  had known that BEFORE I  got the shot! That night I woke up with every bone in my body hurting, even my skull, which felt like it might split open.  It was horrible. I took a Tylenol and was  able eventually to go back to sleep.  Heeding the nurse's advice, I took another Tylenol before going in for the third shot.  It worked like a charm- no more bone pain! My blood test  the next week when I went in for the fourth chemo treatment showed that  my white cell counts were back up.  Both my lymphocytes and granulocytes were almost back to normal. So now I’m halfway through the  chemo! Four more to go! You can see how happy I am about that in this pic.  

The infusion chairs are pretty comfortable, but I'm so  lightweight that I need help getting mine to recline. I usually take a shawl or pashmina to put round my shoulders and the center supplies us with blankets to keep us warm- the purple fleece blanket was made by some volunteers, and I was told it is  my blanket to keep and bring back every week. We also have a good wifi connection so  we're able to use our electronic devices.  I  take my Kindle Fire so when I'm not   talking to  my infusion mates or the nurses, I can  check e-mail, play on facebook, stream movies from Amazon, Netflix or PBS, read or listen to music.

 I received three more Neupogen shots this week.  I had no bone pain, thanks to the Tylenol, and was able to attend yoga class Monday night. I  got the third shot in the series yesterday and  am hoping  everything  will be on target when I go for my fifth treatment next Wednesday.

Gut Feelings Part 7

The second chemo treatment, two weeks later went off without a hitch, and I’ve been lucky that  the usual side-effects haven’t been a problem.  The worst  side effect has been fatigue-but that’s manageable and I’m fortunate in that I’m able to   do what I can, then rest when I need to.  Some people, especially those with children or other family responsibilities don’t have that luxury, and I’m sure that adds to their stress level.

 The woman in the treatment chair next to mine was having her first chemo treatment.  She sat there with tears rolling down her face.  I couldn’t tell whether she was in pain or scared or what, probably both. The nurses tried to cheer her up, and her daughter or another relative would come back to the treatment area for a few minutes, but she would go back to the silent tears as soon as they left. I asked her if this was her first time and she opened up a little.  She told me that her husband had suffered a stroke last year and wasn’t able to do much for himself and now, in addition to having to deal with her own cancer diagnosis, not knowing how the treatment was going to affect her and her ability to care for her husband, she felt quite overwhelmed. And then she was worried about whether she’s  get nausea or be too tired to do anything and how she  could take a shower while hooked up to the pump at home. My feeling is that sitting in a chair  for three or four hours with nothing to do but watch  fluids drip into your veins gives you too much uninterrupted time to dwell on the negatives, so  I decided to keep asking her questions and answering any she asked me.  I was eventually able to get her onto some other subjects and managed to make her laugh a few times.  My treatment finished up before hers did; as I was getting hooked up to my pump getting ready to leave, she thanked me for making her laugh.  I haven’t seen her in the treatment room since then, but my schedule got messed up after that treatment, more about that later.  I hope she was able to come to terms with her situation and get some of her stress and worries relieved.

Speaking of relieving stress, I decided to take up yoga.  My first class was on June 22.  It’s quite wonderful, and the emphasis is on doing what you can do, and what you feel comfortable doing, not in trying to keep up with what everyone else is doing. Since I’ve been having   a little dizziness when I lie down or bend over, I did mostly chair yoga, but did manage a warrior pose, although I did feel like a somewhat wimpy warrior J. The breathing and relaxing meditation we did at the end of class was SO relaxing that I’m surprised I didn’t fall out of the chair.

Gut Feelings Part Six, The Chemo begins

I was up bright and early on the morning of May 27, arriving at the  oncology department at around 8:30 AM.  I was nervous, anxious and in desperate need of unloading the cup of coffee I’d had earlier, so went in search of a restroom.  I found one down the hall, seated myself in the stall and was nearly scared out of my wits when I heard a great whooshing noise- the stupid toilet was flushing violently with me sitting on it! Quite unnerving! I returned to the waiting room and was telling Mr. G about  the scary experience when I was summoned to the lab, where I was weighed, had my blood pressure and temperature recorded, and then was  asked, “Do you have a port?” Out came syringes, tubing and a can of icy cold stuff they sprayed on the port area before sticking in a needle with tubing attached then using a syringe to withdraw blood.  I turned my head during that part because I’m a wimp. After they taken all the blood they needed (which seemed like a lot to me at the time) they flushed the line with a saline solution, handed me a little plastic cup and told me they needed a “sample.” I wish they had told me that before the experience with the wildly flushing toilet. Thank goodness they directed me to a rest room that had a normal, non-threatening toilet that flushed only when the flush lever was pressed. I returned the tiny sample to the lab, asked for a copy of the blood work results and was told to go down the hall to the treatment room where the doctor would meet with me.

Dr. Vance, the oncologist went over the results of the PET scan and an earlier blood test that showed my CEA (carcinoembryonic antigen) level as 8.7, quite a bit above the normal level as a result of the cancer.  She said we were using a more aggressive form of chemo in an effort to shrink both the rectal and liver tumors.  She was pretty confident that I was a good candidate for either a liver resection or for ablation to get rid of the liver tumor. We discussed the possible side effects from the chemo, one of which is peripheral neuropathy, numbness, tingling and cramping of the hands or feet, often triggered by cold.  Thank goodness it’s summer! After she checked my heart rate and   such, she sent me across the hall to the infusion room.

  There were several people there already, including one very young teen-ager who was apparently there for her first treatment too and an older woman, a baseball cap covering her bald head, who was in a very good mood because this was her final treatment. 

 I picked out a chair and the nurse came and gave me papers to read, describing what drugs I would receive, what side effects to expect, etc. She then stuck a name label on me and began to hook up bags to the line going into the ports.  The first infusions are of corticosteroids and antiemetics to help prevent nausea and allergic reactions to the chemo drugs.  When it was time for the actual drugs to be infused, which in my case are Oxaliplatin, Avastin and Fusilev, the nurse donned a sterile gown in addition to the gloves and hooked up the bags containing the chemo drugs.  Since there is an excellent wifi connection in the clinic I was able to pass the time by reading and watching a video on my Kindle Fire, checking in with facebook, unplugging the pump attached to the IV stand and wheeling it into the rest room.  Evidently, all of the liquid   being pumped into me was overtaxing my walnut sized bladder.   By the time the four hours were up, I was pretty adept at navigating the IV stand past the other infusion patients, around the corner past the nurse’s station and into the rest room.

Finally, the bags were empty and the nurse once again donned her sterile gown and gloves and brought out a portable pump that I am to wear around my waist for the next 46 hours. The pump is inserted into a pocket on a waistband after being hooked up through my port. We were able to run the tubing  under my shirt to avoid  having it catch on something and get pulled out This pump will infuse a drug called   Fluorouracil (5 FU for short) into my vein over the next 46 hours. I was instructed to return to the clinic on Friday morning to have it unhooked.  After some final instructions: stay out of the sun, do not drink or touch anything cold, do not reach into the fridge or freezer without gloves, avoid people with  colds or coughs, etc. I was sent on my way. Here’s a pic of the pump- it reminds me of the jetpack Wonderman wore, but other than that Wonderman and I have little in common! 

Gut Feelings, Part 5

 

My port placement was scheduled for May 19 at 6:30 in the morning, about the same time that Brian was scheduled to fly back to Illinois.  Fortunately his brother, Jonathan , was able to drive him to the airport  that morning.  Mr. G and I arrived at the outpatient surgery  clinic in the hospital, filled out some paperwork and waited, along with a roomful of other patients.  A hospital worker came out and   said a prayer (this is a Baptist hospital) and shortly thereafter I was called back to prep for the procedure. After disrobing (isn’t that a lovely word?) I attempted to  don the gown they had provided but had a devil of a time trying to figure out how to get it on- it seemed designed for someone with  more than two arms. With some help from the nurse I finally got in on, along with some lovely little fuzzy lime green socks.  The anesthesiologist came in   to ask questions about my health and the surgical nurse hooked me up to some monitors.  I was finally wheeled across the hall to the operating area where I was transferred onto a narrow table.  The doctor came in to tell me not to worry; they were going to take care of me.  I wasn’t actually worried up until that point. I told him I’d heard mafia bosses say the same thing in movies and it wasn’t a good thing.  The anesthesia nurse began cracking jokes as she   put some tubes up my nose and soon I was out like a light. I woke up in the recovery area, where someone came around with a portable x-ray machine, and  put a metal plate   under me.  I discovered later that this was to make sure that the port catheter  was  placed properly in  the vein.  All went well  and I now have this funny  hard bump on my upper chest.  It reminds me a little of the stories of  alien implants and I envision it one day coming to life and  trying to break through my skin. What is really neat, though, is that from now on, no more needle sticks for blood tests or injections- it will all be done through the port.  Another neat thing was that I was not allowed to drive, lift anything (not even a skillet, the nurse said) or exert myself for a week, so Mr. G had to wait on me hand and foot.  I  played that part for all I could get out of it! Mr. G was  good humored, though.  He bought a package of little plastic minion figures and told me to call them when I needed anything!

Once home, I phoned Dr. Vance’s office to let them know the port was in so they could set me up with the portable pump and coordinate with the radiology dept.. A nurse came on the phone and told me the plan had changed and I would not be getting the radiation therapy after all and would be coming into the clinic for infusions on a different chemo regimen of  several drugs in addition to the 5-FU.  This of course, freaked me out, since they didn’t give me a reason for the change. Dr. Vance phoned me back, apologized for the lack of communication and explained that the PET scan showed that the spot on my liver was indeed cancer – metastasized from the rectal tumor.  Under the circumstances, she and the radiation oncologist had decided that the best course of action would be to try to shrink the tumors with a stronger dose of chemo and forgo the radiation for now.  My first chemo treatment was scheduled for May 27 at 8:45 in the morning. I was told to expect to be there for 4 1/2 hours. I was also told that the copay for each chemo session would be between $600 and $700 dollars.  That came as quite a shock,  but the clinic’s financial adviser told me there was a foundation that covered the  co-pays for eligible patients and that she would put in an application on our behalf, so I kept my fingers crossed.

Gut Feelings, Part 4

I met with the medical oncologist, Dr. Vance, on April 29.  I had blood drawn, asked for a copy of the results for my files, and was weighed.  I’ve lost weight, was down to just over 81 lbs. Dr. Vance was concerned about the spots on my liver and said she wanted to rule out liver metastasis so she scheduled a PT scan.  She explained the treatment plan to me, which called for the drug 5-FU (Fluorouracil) to be delivered via an infusion pump worn 24/5. Once I have the port in place, I’ll go to the clinic on Mondays to have the pump set up and return on Fridays to have it removed. She said she would work with the radiation oncologist to coordinate the radiation therapy with the chemotherapy. The PET scan was set for May 11 and the appointment with the radiation oncologist for May 12.

I was given a set of instructions to prepare for the PET scan, including what to eat and not eat and was instructed to avoid strenuous exercise such as jogging or weightlifting.  Since I have become more akin to the tortoise than to the hare lately,  this should not be a problem.

The night before the scan was scheduled I had a dream that I lit up the scanner like a Christmas tree and knocked out the power to the entire wing of the building. Needless to say, I was a little apprehensive!  I arrived for the PET scan and was shown into a small room with a reclining chair.  The technician asked some questions, then injected radioactive glucose into  my arm.  He   accidentally dropped the syringe on my leg, which meant my pants were now radioactive.   He brought me a pair of scrub pants to change into. I think they were designed for someone built like a linebacker, but I dutifully put them on, cinched them as tight as I could, rolled up the legs and waited in the chair for an hour while the radioactive stuff seeped through my body.  I then waddled across the hall in my Bozo the Clown pants  and climbed onto the scan table. If you close your eyes in a PET scanner, it's easy to imagine you're on a farm listening to noisy machinery while a neighing, whinnying, snorting horse tap dances all around you. At least that was my experience. The whole experience took a bit longer than the CT scan but wasn’t too bad and the power didn’t go out, after all, thank goodness!

The next day I met with the radiation oncologist, who  gave me yet another digital rectal exam,  and explained what the radiation would involve. I was directed to a lab for another CT scan and I was marked to show where the  radiation beams  were to be directed. I mentioned to the  doctor that I’d  had a PET scan the day before, and his nurse suggested that the results might be available on the computer, so she  pulled them up.  I sensed, from the expression on her face that all was not well, but they didn’t say anything and I, uncharacteristically, didn’t ask because I was determined to enjoy the next week.  Our son, Brian, was due to arrive that afternoon from Illinois and would  be leaving the day I was scheduled to have the port placed. We did enjoy that week, we fitted in a  ball game to watch the Birmingham Barons play at Regions Field, and a Sunday afternoon spent enjoying blues music by Earl Williams at Daniel Day Gallery downtown.