Final Thoughts

Somehow, it just did not feel right having the funeral arrangements be the last post on the blog.

So, I contacted Kathy Pruitt and asked if she would allow me to post the eulogy that she gave at Mom's service. She graciously agreed.

For those that were not able to attend the service, Kathy did a wonderful job and captured Mom perfectly.

WHAT’S IN A NAME?

Norma Ruth Smith

Norma once told me how she got her name.  Her mom was expecting her first child and in those days, no one knew ahead what the baby would be.  Trix was in the park and saw a beautiful little girl on a swing.  After watching from a distance and dreaming about her own child, Trix saw the mother help the little girl down from the swing and say, “Come on, Norma Ruth.  It’s time to go home.”  Trix thought if she had a girl,  she’d name her that lovely name, and so she did just that.

Now Norma did not always seem too impressed with her own name, but she accepted it just like she did everything in her life and made the most of it.  “I’m just plain old Norma Smith.  I’m just Norma normal,” she’d often remark.

Knowing Norma for almost 40 years as a neighbor, friend, and fellow teacher, I think I am qualified to say her definition is both accurate and inaccurate, depending on exactly what she meant.

If Norma meant “stable,” then, yes, I agree.  Norma led a very stable life.  She grew up in a small town with a mom, dad, brother, and sister...the Richardsons.  I was always a  bit jealous of Norma’s great family who seemed to love each other so unconditionally.  Norma was an honor high school student and played a crackerjack game of basketball (I saw the pictures).  She graduated from Texas Tech and started teaching.  She married the man she loved and STAYED married to him.  She raised two fine, bright sons. She loved being both a grandmother to her three grand kids and an aunt to her nieces and nephews.  I can still see her in my mind’s eye, sunbathing in her backyard pool and reading her favorite white Harlequin romance novels as she floated.  She paid all her bills on time and incurred no debt. She was a frugal shopper (I’m being nice in my choice of words here!).  After being a master teacher for almost 25 years, she went to work as an educational consultant at Region XI Service Center and forged new friendships there.  Overall, Norma seemed exceedingly content with her life.

If by being “normal” Norma meant “ordinary,” then that is where I beg to differ with her.  She wore a black, form-fitting strapless dress to her prom.  Wow!  She was my heroine.  Also, she rode in the fastest car in Lubbock County and married the driver of that car.  She got her own motorcycle and often road behind James on his as they traveled through the southwest mountains and plains.  Norma was brave.

She tended her beloved rose garden and often shared flowers with neighbors and friends.  On one of several “girl” road trips, Norma became the lead singer of 50’s rock and roll, as well as Motown, songs.  She knew every single word of every single song, so the rest of us in the car gladly became her backup singers since, at best, we only knew the choruses.  She had a clear sweet voice I can still hear.

During the many years we lived next to each other on Mimosa Park, Norma and I walked 3-5 days a week for almost five years.  We chose either the high, sunny road or the low, shady one, depending on the fickle Texas weather.  Once we realized we were lost and almost one and one half miles from our homes.  We didn’t feel lost because we’d been too busy repainting/redecorating the homes we passed so often.  We’d been too busy discussing the funny and poignant events in the lives of our students, fellow teachers, administrators and, of course, our own families.  We were “together,” the operative word, processing our lives as we walked, talked, rejoiced and grieved.  I was never lost when I had Norma by my side.  She was my stabilizer.

You have probably been remembering your own experiences with Norma, as I have shared mine.  If we took all the stories in this room alone, we’d be able to weave a tapestry of a life well-lived, for it’s in the small stories that we see the big picture.  That tapestry would be strong, beautiful, functional, and resilient, just like its inspiration.

I think I can say for many of us that we will never look at a computer monitor again or place our hands on the home keys, without thanking Norma Smith for helping us overcome “tech” fear.

So, I ask you again, “What’s in a name?”

Answer: An extraordinary woman who loved well and was well-loved.

“COME ON, NORMA RUTH, IT’S TIME TO GO HOME.”

Kathy A. Pruitt

And so with that, I think it's time to close up this blog. I know Mom was pleased with my use of this technology to keep everyone up to date and there is a certain amount of therapeutic value in writing that I am glad that I experienced.

Thank you to everyone, everywhere, that followed her story.

Mike Smith
Keller, Texas

Funeral Arrangements

Here are the arrangements for Mom's service.

Date: Thursday, August 19th, 2010
Time: 10:00 AM

Location:
Thompson's Harveson & Cole

702 Eighth Avenue
Fort Worth, Texas 76104
817-336-0345

Open visitation at the funeral home will be from 10 AM - 8 PM on Wednesday, August 18th. I doubt that my Dad will be there, but for those wanting a chance to say goodbye to Mom...

In addition, her obituary is scheduled to appear on Wednesday in the Fort Worth Star-Telegram and the Lubbock Avalanche-Journal.

A Long Journey's End

This was the post I hoped I'd never have to make, even though I knew I would have to eventually.

Mom passed away last night. She fought long and hard, giving it everything she had, and outlasting the doctor's prognosis by several months.

She always said she wanted to win and even though she was presented with an un-winnable situation, she never gave up.

For all of you that have been following, thank you. Mom appreciated all the comments and true to her technology roots, was happy that I chose this way to keep everyone up to date with her situation.

Arrangements are pending right now, but I will have those sorted out today. I will update here once they are in place.

--Mike

Yesterday, the hospice team placed Mom on "continuous care", which is used when they believe that she has had a worsening in her condition. This was prompted by a visit from them at our request because Mom seemed less responsive than usual.

This "continuous care" is initially set up for two to three days, but will remain in effect longer if the hospice people believe it to be necessary.

Mom's nurse did pull my Dad aside this morning and tell him that Mom is in her decline now.

That's certainly not news to anyone, but I have to say, it is still hard to hear.

There is not much new news to report, I am afraid. Mom continues to hang in there, although I believe I have noticed a very slight deterioration over the past several weeks.

Hospice continues to look after her. The aids come five times per week and the nurse comes once per week or whenever dad or I feel like she needs to come. This happened at the end of last week when Mom had a bit of a symptom change involving how she was holding her head as she rested in bed. My dad was concerned, so we got the nurse over there and checked everything out. According to the nurse, and this makes perfect sense, Mom was just trying to get comfortable. No harm, no foul. But it did demonstrate how well and responsive the hospice agency is to any concerns that my dad has.

It's more and more difficult to communicate with Mom and most of the time she won't talk back to me or respond other than to sometimes smile. I know she hears what is said and probably likes hearing it, but there is no feedback anymore. So, I tell her anyway. :-)

If you're still reading this and keeping up with Mom, then thanks. I know she appreciates the thoughts and comments directed her way.

It's been a while since I updated everyone on Mom's situation. Nothing much has changed over the past couple of weeks. She is enrolled in hospice care and they are taking good care of her.

This past week, she was taken to the hospice's in-patient facility downtown. She was taken there because my Dad had to go to the hospital himself. His situation turned out to be a kidney stone. He is out of the hospital now.

All this is happening while I am in Tokyo (where I am now, coming home Saturday). Beth has been managing all of it and doing a fantastic job.

The hospice company is doing a good job and I believe that Mom is getting a good level of care from them.

Mom's cognitive abilities have gone downhill a bit over the past couple of weeks. It's very difficult for her to communicate, but she still laughs at the TV and will appear to recognize friends and family.

We appreciate everyone's thoughts and all the help that has been provided.

Hospice

This afternoon we registered Mom with a hospice agency called Vitas.

Mom, Dad, and I (well, mostly Dad and I) had a good meeting with their RN and went over all of their services and ways of support. They are very thorough and comprehensive in their direction of care.

Mom will be cared for in the home and will not be leaving unless it becomes necessary to do so.

Even though this was a difficult step, it was a necessary step and will provide Mom with the care she needs as she takes those final steps.

I hope that this also provides some comfort to my Dad as he deals with the inevitability of what is coming. I know it is giving me some small peace of mind knowing that Mom will be cared for in the best way possible, given the circumstances.

Results

We took Mom to see Dr. Aurora today and get the results of the MRI and to discuss future treatment options.

Dr. Aurora told us that the MRI showed that the cancer had worsened. There were more spots on the brain, and there was increased cancer on the spine.

Based on this, and the fact that she's had two complete rounds of chemotherapy with two different compounds, plus radiation, she decided that it was time to stop.

So, we are discontinuing treatment. While this news was not unexpected, it was still difficult to hear. But the impact that chemotherapy was having on Mom was not worth the results that she was getting. It just came down to that.

Dr. Aurora said he did not know how much time was left, but that he wanted whatever time that was to be as comfortable as possible.

We will be meeting with a hospice organization this week and more than likely begin that aspect of this journey.

I wish the news was better. But sometimes, it just isn't.

Again, thanks to everyone for their thoughts and good wishes. They are appreciated, as is everything that everyone has done to help Mom and Dad.

Last Friday, Mom went for an MRI. Let me tell you, I was very proud of how well she did with it. The doctor has asked for four scans to be conducted, in sequence. With each scan lasting about 45 minutes, she on the MRI table for about 2 1/2 hours. That is hard enough for healthy people to do.

She did great, though, and stuck it out so that all the scans could be completed. We are waiting on the results, though Dr. Aurora said if anything serious was seen, he would contact us quickly. So far, no contact, so I am hopeful that the scans showed what was expected.

We now have a home-health organization providing care for Mom twice a week (for now). Thanks to everyone who sent suggestions on companies. I hope that Dad will eventually become comfortable enough with having them around that he will get some rest, but if not, he'll just have to deal with it. I'm most concerned about making sure Mom has some help.

Next on the agenda is to get a ramp built at the front of their house. Does anyone know of any companies that specialize in ADA-compliant ramps for elderly people? If so, drop me a note.

Mom is doing about the same as she has been for the past month or so. She is still spending lots of time in bed sleeping. One thing that is different is that there really is no established routine anymore. Some days, she will be up by 10 AM, other days she won't get up until 2:30 PM or 3:00. It's driving my dad crazy. Well, crazier.

Our next appointment with Dr. Aurora is June 28th. We will talk again about whether or not we should resume chemotherapy treatments.

Update

Dad and I took Mom to the doctor today for a regularly scheduled appointment. She had lab work done and we met with Dr. Aurora.

Getting her to the doctor was not as bad as my Dad had feared. In fact, it went about like it has gone for the past several months, so that's a load off my mind. I was expecting, based on some of Dad's input, for it to be a pretty difficult experience. Luckily, that wasn't the case.

Her lab work went well and her results were good. Her weight was stable as well. Both good signs.

We then saw Dr. Aurora, and after his examination and assessment, we discussed taking a somewhat extended break from chemotherapy treatment. The premise is simple: There is a concern that Mom will be further weakened by more chemotherapy and be unable to bounce back, therefore leaving her in worse condition than we started. Dr. Aurora advised that since she has had such a large amount of chemotherapy over the past six months, she wouldn't be hurting anything by taking a break. She will use this time to hopefully regain some strength and stamina.

We will see Dr. Aurora again on the 28th of June to reassess. If her strength has returned to a good level, she may start chemotherapy again. If not, then we will discuss a more long-term strategy regarding her treatment options. Although the options are simple: Either have chemotherapy or do not. We will just have to see how the next several weeks transpire.

Mom is feeling okay, but she is very weak and tires easily. She spends many hours a day in bed asleep. Her cognitive abilities are about the same, and it is hard for anyone to really get a good answer from her about something. If you ask her a question, you are very likely to get a completely different answer five minutes later. In addition, she continues to have very little short-term memory. Her mother, sister, and brother-in-law were here Saturday and Sunday, and she doesn't remember that they came. Such is the way things are.

For everyone who has continued to help, we certainly appreciate it. Everyone has gone above and beyond what most people would have and it has made a huge difference. Thank you.

Just back from a trip to Mom and Dad's house. Mom was in bed resting and reported to me that she wasn't feeling very well. She couldn't go into much more detail than that, however.

She's spent a good bit of time in bed this past week and does appear to not be bouncing back as we had hoped she would by taking this week off from chemotherapy treatment. It's unclear right now whether or not she will get her treatment as scheduled on Tuesday afternoon.

Dr. Aurora did say that delaying two weeks would not make any difference in the effectiveness and it seemed to me that his contention was that if Mom didn't appear to bounce back this week, that we should delay one more to give her a chance to regain some strength.

When she does get up, she is pretty weak and has trouble getting from one part of the house to another. I say "trouble", but I guess I mean it is a struggle and it tires her out.

It's now been six months + ten days since her initial hospitalization and diagnosis.

For everyone who has been thinking of Mom, thank you. For those who have been helping out, in whatever way, be it food, cards, poems, thoughts, yard mowing, or simply saying hello, it is appreciated.

No chemotherapy treatment today.

After examining Mom, Dr. Aurora felt that she wasn't as strong as she should be to receive a treatment, and he recommended that we take a week off. We have a treatment scheduled for Tuesday, June 1. Dr. Aurora said that if necessary, we could even take two weeks off. It wouldn't make any difference in the effectiveness of the treatment, due to the overall amount that she has received to date.

We then discussed quantity v. quality of life again, and all agreed that we are going to have to make some decisions in the near future. Mom understands this and we talked, and she agreed that getting chemotherapy only to allow her to spend all her time wiped out and in bed isn't what she wants. We are probably nearing the point where the treatment could be as bad as the disease.

To be clear: We are not there yet, and we are not discontinuing treatment, but we are thinking about what the future holds.

Dr. Aurora is also concerned about spinal cord involvement, and has ordered an MRI to look at that.

Mom was comfortable with the decisions that were made today and seemed to be in a relaxed mood once we arrived back at their house.

Thanks to everyone for their thoughts, notes, and support. We certainly appreciate it.

It's been quite a while since I've updated everyone on Mom. Sorry for that, but I've been out of town for the last two weeks and haven't had much to add.

Today, I visited for a short time and Mom seemed to be doing about the same. She is noticeably weaker than prior "off weeks" from chemotherapy. It could be that the chemotherapy's cumulative effect is beginning to take a toll. She's not out of bed much any more, but does get up occasionally.

Tomorrow, we are scheduled to see the doctor and get another treatment. It will be interesting to see if Dr. Aurora feels that Mom can tolerate it. It would not surprise me to see him put it off for a week to see if her strength improves. Hard to say.

If I could ask those that are reading a favor: If any of you have had any experience with home health care agencies (self-pay or supplemental insurance pay) could you please drop me a note and let me know the name of the company? I have two brochures from companies that I am going to research, but if anyone has any first-hand experience, it would really help.

More updates after the doctor tomorrow.

Post-chemotherapy Update

Mom's chemotherapy treatment went well yesterday.

We saw the doctor as well, and he was very happy with Mom's condition. Her blood counts are all good, and more importantly to him, her weight is being maintained. He indicated that weight was the single most prognosticative factor for a cancer doctor. And he was very happy that hers was where it was. And no, I won't mention what it was. I don't think Mom would like that.

The plan now is to do two additional treatments with the Taxotere, which Mom seems to be tolerating better than the previous drug combination. Dr. Aurora wants to do the two more treatments and then do the scans to see where we are.

Mom appeared to be pleased with the news and happy with the results of the doctor's appointment. Her cognitive abilities are about the same as before, but the "loopy-ness" that she experiences as a result of the dexamethasone (steroid) that she takes before, during, and after chemo seems to be a little reduced this time around. Hopefully the dosage adjustment that the doctor made has helped with this.

She's giving the fight all she can and is holding her own.

I'm sorry for the lengthy delay in posting an update on Mom.

I was over at their house yesterday, doing a grocery run, and Mom seemed to be doing pretty well. She had physical therapy in the morning and was happy that she was able to do all that was asked of her by the physical therapist. She looked good, seemed stronger than she has in the past, and we had a good bit of conversation. She asked about the kids and was able to talk back and forth with me about them, and also about some other things.

This is pretty typical for the days leading up to a chemotherapy treatment. She will have her next one on Monday, May 3rd. These have been going well and she is tolerating the Taxotere just as well as she tolerated the cisplatin and Alimta.

So, things aren't really changing much, which in her circumstances is probably a good thing.

Thanks to everyone for the continued support, thoughts, and visits.

Not too much has changed over the past week. Mom had her chemotherapy on the 12th, as I mentioned, and has spent this past week recovering. She is extremely tired and we wonder if the effects of the chemotherapy are cumulative (they probably are) and so recovery takes a bit longer each time.

Her physical and mental states have not appreciably changed, either, with the exception of her being so tired.

We have a lab appointment this Thursday for blood counts and then the next chemotherapy treatment is scheduled for May 3rd.

Mom had her chemotherapy treatment today. It was a bit of a challenge, actually.

Her cognitive function was significantly less than it has been recently, and whether that's due to the steroid that she gets prior to, and during, her treatment or the disease, is unknown.

At any rate, we did get her to the oncology office and get the treatment done. I'm not sure that she said anything that made any sense the entire time.

That said, you can tell it's not delusional or demented in any way. What she is thinking is up there, but she just cannot get the words to match up with the thought. She has expressed to me in the past how frustrating it is, and you can see it when she tries to say something.

The human mind is a remarkable thing, but when there is a short somewhere in that circuitry, the strangest things can happen.

Mom's lab work looked good, and physically, she is doing pretty well. She's begun using her walker to get around the house and is very good with it. She has mentioned that it gives her more confidence when she is walking around and makes her feel more comfortable.

I took her outside Saturday afternoon to sit on the back patio. She really enjoyed it and we talked about the flowers and the overall condition of the yard. She had enough going on to tell me that something needed to be done about "that backyard" and that her flower garden "needed seeing to". It was a nice time and one that I'll remember. She loves being outside and one of her goals early on was to be able to go swimming this summer. We'll see how that turns out.

Mom had her doctor's appointment today and we reviewed the results of the latest series of CT scans.

The scans showed no growth of the cancer (no shrinking, either) and Dr. Aurora indicated that he was happy with this as it showed that the cancer has stabilized. So while this may not be extraordinary news or even outstanding news, it was good news. Mom was happy with the results and excited to have "won" something again.

Now, what she has "won" is three more chemotherapy treatments with Taxotere. Dr. Aurora feels that this offers the best chance at continuing to keep the cancer stable and not growing.

So, we will have these three treatments over the course of the next ten weeks, culminating in another series of CT scans to see where things are.

Mom is doing okay physically. She actually gained weight since her last doctor visit. Don't let her find out I posted that. Her blood counts are good, her blood pressure is good, and she is not in any pain.

Mentally, her cognitive function continues to be about the same. Not much changes there except when she takes her steroids during her chemotherapy treatments. At that point, and for a few days afterwards, she is completely off her rocker. But we expect that, and the benefits outweigh the negatives.

We are now set for an infusion next Monday and we will continue with the program.

Thanks for all the support. We really do appreciate it.

Beth and I took the kids over to visit Mom and Dad yesterday afternoon. My grandmother, aunt, uncle, and his wife (my aunt as well) were visiting from Lubbock.

Mom was doing okay, but you could clearly tell she was putting on a show for company. She tries really, really hard to make sure that everyone gets the impression that she is doing fine. Sometimes I wish she wouldn't do that because it becomes pretty obvious that: a) She's not doing fine, and b) It really makes her tired. But, that is the way she is.

I think overall her condition remains about the same as it has been for several weeks. I don't know if that's a good sign or bad sign, or even any kind of sign at all.

We have a doctor's appointment on Monday to discuss the results of the CT scan that Mom had on March 29th. I suspect we will be making some decisions about future treatment plans then.

I realize that the updates here have become less frequent and I wanted to make everyone aware that the reason for that is pretty simple: things aren't changing as rapidly as before. I guess we've reached some sort of plateau.

I also want to continue to express our thanks to the people from the ESC Region XI Service Center. You are amazing. The help and support that you have provided has been so important and well-received. Mom and Dad (and I) really do appreciate everything.

I am sure I will have an update after our appointment on Monday.

Today, we're supposed to be heading to the hospital for a CT scan to help gauge the effectiveness of the newest chemotherapy treatment.

We have an appointment with the doctor next Monday to review the results and see where we go from there.

Mom is hanging in there, although I don't think she is particularly thrilled with the idea of yet another test.

Today's chemotherapy treatment went well for Mom. Her blood counts were good, and even though she was a "long way 'round the bend" mentally, she kept on smiling.

There does seem to be a correlation between the dexamethasone (steroid) that they give Mom to combat the nausea and her cognitive ability. Depending on who you talk to, either me or my Dad, the correlation is small to gigantic, respectively.

Her mental faculties should improve as the effects of the steroid lessen and hopefully in a day or two, she'll be closer to what counts as normal nowadays.

We really appreciate the continued thoughts and help that we are getting from everyone. There really is no way to adequately thank all of you for everything that you have done. We are humbled every day by the way people that are close to Mom come through.

I'm mom-sitting this morning while Dad goes to a doctor's appointment.

Mom is doing okay, at least physically. She's tired and fatigued, but all this is to be expected as a result of the chemotherapy.

I arranged to have a nurse and home-health aid come by every so often to try and help out a little bit and give my Dad a break. The nurse can do blood work, which would help us alleviate one trip to the doctor's office.  The home-health aid is going to help with ADLs (activities of daily living) such as baths and the like. I hope it works out like it should.

Mom's cognitive ability is about the same. She continues to have issues with short-term memory and basic recollection, but I can still communicate with her pretty well. Probably easier than Dad at this point.

Monday, 22 March will be our next chemotherapy treatment. After that treatment, Dr. Aurora wants to take some additional scans to gauge progress.

Mom had her lab work and doctor's appointment today.

Her blood counts are good and the doctor said that the fatigue and weakness that she is experiencing is consistent with the new treatment that she is getting.

He wants to do one more treatment on March 22nd, then do another series of CT scans to see what effect, if any, the new drug is having.

If the new drug is performing well, then he will schedule another treatment. If it is not, we are going to have to discuss whether or not to continue chemotherapy.

We reviewed briefly the results of the comparison between Mom's initial brain MRI and the one taken a couple of weeks ago. He said that there were still numerous spots, but that overall, they were smaller than before. This indicates that the radiation was effective. However, chemotherapy has no effect on brain mets due to the brain/blood barrier.

This led me to ask his opinion about Mom's cognitive difficulty and whether he thought it was caused by the brain mets or by the chemotherapy treatment. His opinion was the brain mets. This means, if true, that we can expect little to no improvement in Mom's cognitive capability.

So, where do we stand? Mom is tired, weak, and not all there some of the time. But she continues to express the opinion that she wants to continue treatment for as long as it is practical to do so.

The next two weeks may see an improvement as the effects of the last chemo treatment fade.

I hope so.

Mom continues to tolerate the new chemotherapy medicine without too many adverse side effects. In fact, her condition with this new medicine is similar to her condition while taking the cisplatin/Alimta combination.

She is tired, of course, but that is to be expected. Her appetite remains good and she has not experienced any nausea to speak of since the treatment on Monday, March 1st.

From a cognitive standpoint, she is up and down. It is unclear, and probably will remain so, as to whether the chemotherapy is causing more cognitive difficulty than her brain mets, or not. I will try and ask the doctor about that when we see him tomorrow. For those of you that have visited, thank you. It seems to me that when Mom is able to visit with someone besides Dad and I, she perks right up and can actually seem to be a bit more "together" than usual. I know she enjoys it and I believe it makes a difference to her.

Speaking of tomorrow, we go have the normal lab work that is done one week post-chemotherapy treatment, but this time we will also see Dr. Aurora. He wanted to see her and assess how she has been tolerating the new medicine and I suspect after this visit we will have our appointment for the next treatment, which should be on March 22nd, if the schedule holds true.

I feel like we are approaching more rapidly the time when difficult decisions will have to be made. That said, we continue to make the best out of what we have, and Mom is still determined to continue to fight as much as she can.

Today was chemotherapy day for Mom and overall it went smoothly.

We met with Dr. Aurora (Mom's oncologist) this morning and he was happy with her condition and was quite insistent that we go ahead with the treatment today.

Mom's blood counts were all good, too.

The only real concern that we discussed was the effect of the steroid that Dr. Aurora prescribed for before, during, and after this new chemotherapy drug. The dosage causes Mom to be more confused and less lucid than normal. We ran into this last week, but did not recognize it as related to the steroid. To that end, Dr. Aurora recommended that we halve the dose from now on and see how that works. He doesn't want to suspend the steroid, because it does help to reduce the physical discomfort that could be brought on by the Taxotere.

After the doctor visit, Mom went back to the infusion room and got her treatment. This included the Taxotere and Zometa, a drug given to improve Mom's bone density. Dr. Aurora is concerned about that due to the progression of the cancer in the bone.

These drugs do not take as long as the prior combination of drugs that Mom was getting, so she was finished after about three hours or so.

She's resting comfortably at home and now the wait begins to see what side effects present themselves with this new drug.

I spent some time with Mom today and I will say that she was doing better than usual from a lucidity standpoint. She and I talked and had several good conversations, all with her making pretty good sense. Was she normal? No, but it was much improved over Monday.

This might just be one of those "good days" that you get every once in a while dealing with this situation. It's hard to say.

We are still planning on starting the new chemotherapy on Monday, March 1st. Mom reiterated to me today that she still wants to do that, provided it doesn't make her feel miserable. She agreed with me that we would just have to wait and see how it goes.

I can't imagine what it must be like knowing that you want to say something, having a thought or idea, and not being able to articulate it. Mom experiences that to some degree every day. I believe that the ideas and thoughts are in there, and I (and Dad) just have to work some to get them out.

Well, "good day" or not, we'll take it.

Small Change in Plans

Mom wasn't doing well at all last night and this morning, from a mental/lucidity point of view, so Dad and I spoke with the doctor's office and we all agreed that the best course of action was to let Mom rest some more and start the new chemotherapy treatment on Monday, March 1.

No one is sure at the moment if this is a permanent change in her mental capacity, or if this was something brought on by the stress of the situation yesterday. We will keep an eye on things to make that determination.

Progress Report

Mom, Dad, and I went to see Dr. Aurora today to get the results of the MRI and CT scans that were done last week. This was in preparation for chemotherapy treatment today.

Dr. Aurora reviewed the results with us, and they were mixed. The cancer in her lung and liver has "stabilized", meaning that it has not grown. It has not shrunk, either, as hoped for by the doctor.

The cancer in the bones has increased significantly since the last scans were done, at the outset of the treatment in November.

The net result of this is that Dr. Aurora is recommending a change in chemotherapy drugs. He is recommending Taxotere now. He says that this drug will better combat the disease in the bone as well as continue to combat the disease in the lungs and liver.

Regarding the brain involvement, the MRI still shows lesions in the brain, but the comparison between the initial MRI done in November and this one has not been completed yet. So it is unclear as to the amount of effectiveness of the radiation treatment.

We also had a very frank conversation with the doctor regarding quality of life versus quantity of life. He was very straightfoward with Mom this time and told her that there was no cure for her condition and that all they could do is "knock it back" for a period of time.

He wanted to make sure she (and Dad and I) understood. We do.

So, at this point, Mom is still interested in getting treatment. She is, however, thinking about the ramifications of that decision. For the first time since all of this started, we briefly discussed what might be the result of stopping treatment. A great deal depends on how well Mom tolerates this new drug. That is unknown, of course.

For now, we will go back to the office tomorrow and get the new drug started. Where that will take us remains to be seen.

We appreciate everyone's thoughts and support.

Mom is having a pretty good day today. I am over here "mom-sitting" while Dad goes to his doctor's appointment.

She is pretty alert and spending time watching curling at the Olympics.

She also had a good lunch today and tells me that she is feeling pretty good.

That's nice after the day she had yesterday. I think some of the medications she received while getting her scans on Monday had an effect on her. She did not feel well yesterday at all.

But today seems to be better. So we'll take that.

Just a very short note to let everyone know that the MRI and CT scans were completed today without any issues.

We do not yet know the results and may not know until we go and visit the oncologist next Monday.

Mom continues to hang in there, resting and doing the best that she can.

Not much has changed in the four days since I've updated the blog. Mom is still hanging tough and doing the best she can.

She has good days and not so good days, from a mental point of view.

Physically, she is slowly getting stronger and is getting around pretty well.

This weekend, she is being visited by her mother, sister, brother, and sister-in-law. I know that Mom is happy to have them come visit and enjoying the time with them.

Coming up on Monday is a CAT scan and MRI at the hospital. These are routing screenings that her oncologist wants to have performed in order to gauge her progress. I hope that we will have encouraging news to report on the state of the cancer.

People continue to bring food by the house, and it is very much appreciated. You folks at the Service Center are really amazing. Thank you.

The Tired's

Mom is fighting the "tired's" right now, but she's resting and working on getting built back up after the third chemotherapy treatment. It appears that maybe the side-effects are cumulative as this bout with fatigue seems to be worse than the prior two.

She is not eating as much as before but still is maintaining her weight. She has had some nausea after this treatment (see cumulative effects above) and she has mentioned to me that she is afraid sometimes to eat because she doesn't want to get sick. Dad and I have talked with her about this and over the past couple of days, there has been an improvement. She ate a little more and hasn't had any nausea to speak of.

We are scheduling a brain MRI and upper body CAT scans for next week sometime. Dr. Aurora (her oncologist) wants to do those now, instead of after the fourth chemotherapy treatment. Hopefully, the results will be positive. We'll just have to wait and see.

For everyone that continues to help out and support Mom and Dad, we say thank you.

Working Through

Mom is hanging in okay after the third chemotherapy treatment. I think the side effects are beginning to accumulate. She's still extremely tired and her appetite is suffering a bit, now. But, she eats when she feels like it. It's just that she doesn't feel like it very often.

Her physical strength continues to improve. Pretty soon, she'll probably be able to outrun my Dad.

For now, it's just rest, rest, rest.

A Frank Discussion

Mom, Dad, and I spent a good deal of time this morning speaking with Dr. Aurora (Mom's oncologist) about her concentration and memory loss issues. Mom wanted to make sure that he knew how upsetting this was for her and how much of an issue it has turned into.

Dr. Aurora listened closely and then made some points. He said that the confusion and short-term memory loss were caused by three things:

1. The brain metastases that Mom has
2. The radiation treatment that Mom received to combat the above
3. The chemotherapy that she is receiving know. This is commonly referred to as "chemo brain". It's a foggy condition that most people have when undergoing chemotherapy.

He then went on to reassure Mom that she was getting everything that she was supposed to get and getting it on time. He made a very clear point that the treatment that Mom is receiving is designed to do two things (in order):

1. Keep Mom alive
2. Hopefully help her feel better

Now, when Mom heard point one about keeping her alive, she jumped to the conclusion that she had been very near death at the beginning of this whole ordeal. That is not the case, but Mom thought it was, and therefore spent most of her time in chemo today very tense and upset.

Dr. Aurora also said that we would do a CAT scan and an MRI after this third treatment to gauge the treatment's effectiveness.

He did say to Mom, "I am very optimistic that the treatment you have received has made a difference with the cancer. Now, we need some pictures so I can show you that."

So we will get those scheduled.

That said, the chemo treatment itself was uneventful and went as it should have. After getting Mom back home, she began to calm down and understand just what was going on with what Dr. Aurora said.

As many of you know, Mom's desire when it comes to speaking with the doctor is, "I want to know, but I don't really want to know."

Today was the most frank discussion that she has ever had with Dr. Aurora and it affected her quite a bit. She mentioned that hearing those things caused her to really think about her situation more and come to some realizations about her condition.

It was, however, a good discussion with the doctor and one that I know Mom would have wanted to have had she been completely together mentally. So, I don't regret at all that it was discussed.

Tomorrow, we go back to the office for a white blood cell booster. Maybe by then the appointments for the scans will have been made.

Third Chemo Coming Up

I just wanted to let everyone know that Mom's third (of four) chemotherapy treatment is coming up on Monday, February 1st.

Her side effects continue to be limited to fatigue and a little loss of appetite, but beyond that, nothing else.

She is getting physically stronger by the day and continues to want to do more things for herself. This is a big deal to her and I hope we can find a way to make that work out for her.

Mentally, she is still confused at times and not able to communicate what I know she is thinking. This is frustrating to her and I can see that it bothers her. We're not sure at this point if that is something that will work itself out and get better or not. We will just have to wait and see.

Continued thanks to the ESC Region XI team for their dinner support for Mom and Dad. You just don't know how much this helps and how much we all appreciate it. Thank you.

Going Along

Sorry for the lengthy delay between posts. Things have been busy.

Mom had a very good visit with her mother, sister, and brother-in-law toward the end of last week. She enjoyed it so much. It was great to see them as well.

She continues to do as much as she can do, and is pushing herself daily to do more things. You can see that she misses being independent and wants to regain a sense of that independence as soon as she is able to.

There are struggles, of course, but she is tolerating the chemotherapy treatments extremely well. Hopefully after the complete regimen, we will see some improvement in her condition and have a positive medical report. We will see.

Thank you for all your continued support and thoughts. Mom and Dad truly appreciate all the help.

Nice Day Today

Mom had an appointment this morning for blood work. This is a quick trip and has gone well in the past.

Today was no exception. In fact, Mom did very well. I am very happy to report that she walked the entire way into the doctor's office and back out again. Normally, for something like this we will use the wheelchair, but today she was absolutely determined to walk. I take that as a good sign.

Also, speaking of determination, Mom is becoming more and more determined to do things for herself. She explained to me today that she was very frustrated having my Dad and I wait on her all the time. She feels like she won't know what she is capable of doing unless she tries. Makes perfect sense. And another good sign, in my opinion.

I am happy to see that she is reaching towards goals and trying to move ahead as best she can. I would be worried if she suddenly changed into someone who was uninterested in trying things or competing. It just would not be her nature.

She is also excited that her mother, sister, and brother-in-law are coming to visit. I hope she will get an opportunity to spend some quality time with them.

A Bit Rough

The last couple of days have been a little rough for Mom. This treatment has hit her a little harder than the previous one.

I don't know if that is because the effects are cumulative or if it's just that way sometimes.

She's very tired and just a little bit cranky. But cranky is not necessarily bad, just different than usual.

We have a trip to the doctor's office tomorrow morning for labs. I'll see how she is doing then and how well that trip goes.

The Beat Goes On

Not much different going on with Mom over the past couple of days.

She is really tired, resting most of the time, and hanging in there. Her appetite is not as good as it was over the past several weeks, so she is eating a bit less than before.

I suppose that could be another side effect manifesting itself.

Overall, this chemotherapy treatment is treating Mom much the same as the last one.

She continues to give it all she has.

Continuing On

Mom is having an average day today. No big side effects or anything, but she is extremely tired. This matches what she experienced after her first treatment and if it holds true, she will be fatigued like this for the better part of the next week to ten days.

After that, about a week before her third treatment, things should improve.

She is eating well, and continues to have a good appetite. These are good things and should help her recover from the chemotherapy that much faster.

Mentally, she is about the same. I told her today that she was good at using lots of words and not actually saying anything. She does that when she is trying to get a thought across. Dad and I are used to it, but for anyone who doesn't visit with her regularly, take note.

Our next appointment with the doctor's office is Thursday, for lab work. Should be a fast visit.

We continue to be so appreciative of the people, especially from Region XI, that are helping out. Thank you.

Not Bad Today

Mom felt pretty good today, although she was tired. Still no unpleasant side effects from the latest chemotherapy treatment.

My aunt and her husband are coming to visit this weekend, which will really make Mom happy. I know she will enjoy seeing them.

Maybe we will even play some dominoes. It's been a long time since I've played 42.

So Far So Good

Mom is doing pretty well today. She is tired, but beyond that, no major side effects have shown themselves.

We took her over to the oncologist's office to get her white blood cell booster shot. That trip was quick and uneventful. Thankfully.

It has been pleasantly surprising how well she has tolerated this treatment. I think that is a testament to her physical condition before she found out about the disease. I believe it has made a difference in her ability to handle the drugs.

Mentally, she still struggles a bit, especially with short-term memory and immediate recall of things. Also, she still has some issue with explaining things to me. If she gets confused, instead of stopping or saying she's confused, she will just string together some big words. Makes no sense, but sounds damn impressive. I think that's the teacher in her.

She remains convinced that she is going to fight this and be in it for the long haul. Based on how things are going right now, I think we would agree.

Half-Way There

Mom's chemotherapy treatment went off as scheduled today, and went smoothly.

She was there for about four hours, which was longer than the first time, but still within our expectations.

Mom did very well and is resting tonight.

She has two more treatments remaining over the course of the next six weeks. After that, the doctor will evaluate the effectiveness of the treatments and see what the next steps are.

Tomorrow, we go back to the office for a white blood cell booster shot.

Mom is still in good spirits and happy to be half-way through with the chemotherapy treatment.

Thanks to everyone for the support and kind thoughts. Mom really appreciates it.

Chemo Fail

Today was the day that wasn't.

Mom's chemo treatment was postponed until tomorrow because the machine the doctor uses to check her kidney function (via a blood test) was broken. According to the doctor, Mom is "delicate", and this was an important test that needed to be run before he could okay her for treatment today.

So, we'll get wrapped up and go back tomorrow. Hopefully, they can skip the lab work and just go straight to the infusion. That would certainly be nice.

It was not a total loss, however. Mom's other blood counts all looked good and the doctor was very happy with how she was handling the treatment.

I guess the only real downside to the visit today was the removal of the stitches from the site where Mom's chest tube had been. Mom didn't enjoy that, but it needed to be done.

So, provided the staff up there can keep the lights on and the water running, and the machinery functioning, we'll give it another go on Tuesday.

Still Here

We're still all here, but not much is happening right now that necessitates an update.

Mom does her second chemo infusion tomorrow, so I expect to have some things to add after that is complete.

She's doing okay, given the circumstances, and trying hard to build up her strength and endurance. Sometimes, too hard. But she is hanging in there.

Beth, the kids, and I are going over this evening. We're taking a pizza. Mom has been craving a pizza for a little while, so we'll indulge her.

PT

Today, Mom went a little over the top with the physical therapy. Everyone knows how competitive she is, and how much she wants to do whatever she is doing, well.

The physical therapist was out today and switched Mom over to a stronger rubber band, which Mom uses to work on leg strength. She didn't let that bother her, though. Mom just went right on through and worked just as hard as she had been.

Then, Mom exercised on a set of bicycle pedals that are placed on the floor in front of her. She went nearly twenty minutes on that, and probably would have gone longer had the physical therapist allowed it.

All of this exercise resulted in a tired individual and so she spent the balance of the day resting and napping.

But you have to give her credit. She really gets with the program.

Not Much Changes

Sorry for the delays in updating the blog, but there really hasn't been much change over the past couple of days.

Mom is still resting a lot and doing her PT. When I've talked with her, she is fairly lucid and able to carry on a good conversation. Her short-term memory is still rather inhibited at the moment, so it can be a challenge sometimes having to repeat what was said 15 minutes ago.

But if that's the worst of it, then we'll take it.

Beth, the kids, and I will probably go over there towards the end of the week and take Mom a pizza. She really lit up when I mentioned we could bring one with us.

I know I've said thanks quite a few times to everyone for their help and support, so please indulge me one more time: Thanks. It is so appreciated.

Nap-less

It was an interesting day for Mom. According to Dad, she was up at 7:30 AM and did not go back to bed the entire day. That is a significant change from prior days.

Maybe it is a sign that the effects from the first chemo infusion are fading. That would be nice. Of course, it's only seven days until the next one, but if she could get a week where she had more energy and felt a little better, that would be great.

Otherwise, it is the same song, different verse. We await the 11th of January.

How many of you are familiar with the phrase "never let them see you sweat?"

I think Mom has. In fact, I know she has, and it is pretty obvious that is how she is conducting herself as she goes through this ordeal. 

Mom is trying really hard to make sure that no one sees just how difficult this is for her, mainly to keep people from worrying so much about her. People worry anyway, but at least this gives Mom something to focus on.

Today was a day much like the last several days. Not much has changed, which represents some good signs if you choose to see it that way. Still no real adverse effects from the chemo treatment, outside of the intense fatigue. But that is one side effect that is easy to deal with: Nap. Mom's great at that.

Next week is a light week with respect to doctor's appointments. Mom doesn't have any. Her next chemo infusion is scheduled for the 11th. That will be the second of four planned infusions.

Her spirits remain good and she continues to push onwards towards whatever goal she sets her mind on. Those goals often switch back and forth between the aforementioned never letting on, and looking cute.

She tries really hard at both. And generally does well.

New Year

Mom welcomed the New Year pretty much the same as she said goodbye to the old one. Either watching TV, doing her PT, or taking a nap.

The periods of time between doctor visits are becoming monotonous, but that can be a good thing with a distinct lack of fires to fight.

She is holding her own, doing the best she can, and still interested in fighting as hard as she is able.

She appreciates the comments from everyone and all the good thoughts sent her way.

2010 is here. Let's get on with it.