Sunday, June 27, 2010

Last Week of Work

I have officially finished my last week of work at St Mary's. I was very glad to be able to return to work for several reasons. 1. I actually like my job and like working. 2. I was sick of being the patient and happy to be the practitioner again. 3. I've loved working at St. Mary's. I have great co-workers that I consider family and really wanted the opportunity to say Goodbye. Many of my co-workers haven't known what I've been going through over the past 2 months. I had a lot of questions to answer. So many thought I had already moved. It was nice to see everyone and have some closure.

I can't believe it has been over 2 years since I first started working at St. Mary's. When I first started, I was scared. Scared of medicine (I had a general surgery background) and of how large St Mary's is (approx 350 beds). I took the job cause I thought it would help expand my knowledge base and because there weren't any other great opportunities. I am so glad I've worked here. I have worked with great physicians and nurses whom have taught me so much. I have made great friends whom I will never forget. I definitely feel like I have a work family. I have also worked for a great supervising physician. He has taught me so much about medicine, the business of healthcare, and life. I have appreciated the autonomy he has given me. He has entrusted the care of his patients to me on many occasions and we have worked well together. I also appreciate the way he has respected me and my opinions has a professional. He has listened to my recommendations and actually used them!!

I joined the hospitalist when the program first started and I feel like the team as a whole has grown a lot of the past 2 years. Yes, we have had tough times when we have been under staffed and worked long hours. We have had growing pains. As a PA, my role and job function has changed more times than I can count. However, I've worked with great people and taken care of good patients. I feel like my comments, recommendations, and advice have been listened to and contributed to our improvement.

I did well this week. I had been off for 6 weeks. After day 1, I felt 'back in the saddle'. My energy level has surprised me. I have only napped 1 day this week and it was Saturday. I made it through each 12hour day impressed that I was still going.

I am enjoying my going away presents of a St. Mary's polo shirt & St. Mary's pens! I will also enjoy my St. Mary's golf umbrella to keep my wig dry when it is raining and my head free from sunburn when it's sunny. I thank all of my St. Mary's Family for a great 2 years!! Good Bye!

Tuesday, June 22, 2010

Wig

Today was the first day I wore my wig to work. It felt great on my head and looks good on me. My coworkers all agreed that it is very natural looking. Several co-workers who weren't aware of my treatment commented on how nice my hair looked today and how they liked my new hair style. Little did they know it isn't my hair at all! I'll definitely continue to wear the wig even as my hair grows back.
Meanwhile, my hair is still falling out. I now understand why men complain of itchy necks when they come home after hair cuts. Those pesky little hairs like to hide under shirts and on the back of your neck and even on your head. Then they itch all day long. I joke that I traded my hairbrush in for a lint roller. But, the lint roller really works. It feels good catching all those stray hairs and helps cut back on the shedding. I think I'm more bald then hair now.
I also am happy I cut my hair. I'm sure other women who have gone through chemo will agree that it is nice to have a little control in an uncontrollable situation. I'm glad my hair shortened in phases. Plus, it is so much easier having it all come out when it is an itch long instead of itches or a foot long.
Kinda cool thought: the God who created us loves us and knows us so well that He knows the number of hairs on our heads. Seeing all those hairs going reminds me how much He loves me. He knows how many I've lost and how many are yet to go. Plus, He'll bring them all back when this trial is over. Amen!

Monday, June 21, 2010

First Day Back to Work

I returned to work today for the first time in 6 weeks. The day went well. Thankfully we weren't too busy and it made for a good day to ease back into things. I didn't want to come back to Huntington after moving into my new home in Roanoke. However, I'm happy to have an opportunity to say goodbye to my coworkers. Many of the nursing staff had thought I had already moved and finished working since I had been gone so long. Plus, many of them didn't know about my diagnosis. I just wore a scrub hat and scrubs today to hopefully induce questions today. That way I could get all the questions and talk over with and get on with work the rest of the week. We'll see how it goes. So, at the end of my first day I'm beat and ready for bed. Hope tomorrow goes as well as today.

Saturday, June 19, 2010

Hair loss

My hair is falling out. Like, a lot. I first really noticed it when I showered. I'd shampoo and end up with a handful of hair. Yuck! It would clog my shower drain. It made me cry. So, I had my husband buzz it all off. He didn't like the job, but I needed someone to do it. He wouldn't take me to nothing so I got a buzz cut at level 3. Well, it's still falling out and now I have bald patches. However, it feels so much better not having it. At least now when it falls out it is only about 2-2.5 inches long. I now understand why men say their necks itch after a hair cut. My neck itches by the end of the day from all my short hairs that have fallen out.
I go without head coverings when I'm hanging around the house. I wear a hat when I go out. I have some really cute ones thanks to my Aunt Terry. (Shout out!) I also have a really nice wig. I have my bases covered when needed. My father-in-law is also a great sport and jokes with me that at least my hair will grow back after treatments.

Tuesday, June 15, 2010

Welcome to Roanoke!

The movers came and packed our house up on June 10th. We traveled to Roanoke that evening. The drive was long and even longer thanks to me not feeling well. The drive down was the longest I have been in a automobile since my surgery. We eventually made it and had a nice couple of nights at the Roanoke Sheraton.

On June 11th we closed on our house!! Yippee!! I was still very tired from chemo and was unable to help much with preparing the house for the movers to unpack. Once again, I am thankful for a husband that is full of energy. He scrubbed the carpets in the house the night before the movers unpacked. The movers came with our stuff on June 12th and my in-laws arrive later that day to help unpack. That evening we quickly learned that we had no cold water to either of the showers in the house. So, what do you do in a new town where you know no one on a Saturday evening?? We called our realtor who knew a local plumber who was willing to come to our house and fix the problem at a very good rate. (We'll keep his phone number in our back pocket for next time.) The next day we learned that the storm door to the garage was rotted. So, off to Lowe's to buy a new door and all the other supplies for making the house our own home. We've had several days of unloading boxes and putting things were I'd like them. My mother-in-law also surprised us with some nice decorations for our kitchen to match my color scheme of cobalt blue/Santa Fe feel.

After a nice evening out to dinner and trip up to the Roanoke Star tonight, I am preparing to travel back to Huntington tomorrow for my weekly Bleomycin infusion. I'm not eager to go. In fact, I don't really want to go. I'm thankful for in-laws who are willing to drive me to Huntington and bring me back to Roanoke to spend more time at my new house and with my husband. So, off to Huntington in the morning.

Tuesday, June 8, 2010

Cycle 1, Day 5

Yes, today was the last day of cycle 1 infusions of VP 16 and cisplatin. Yeah! Plus, I felt good today. I ate a good breakfast during the infusion. Had energy to help around the house when I got home. Packed, did laundry, washed dishes. I even ate lunch and dinner.

So, I have to go back to the infusion center tomorrow for my first infusion of bleomycin. This chemo medicine was delayed because I had to have the lung tests done first (I did those on Sunday). This infusion will only take about 10mins instead of the typical 5 day run of 4hours. It should be a quick in and out. I'm scheduled to receive this infusion every week. I'm told that it shouldn't make me feel as badly as the VP 16 and cisplatin. So, hopefully I'll start feeling better over the next couple of weeks.

Monday, June 7, 2010

Cycle 1, Day 4

I'm not gonna lie...yesterday sucked. I felt horrible. I was nauseous all morning. I couldn't throw up cause there wasn't anything in me. If it weren't for Jonathan I would have never made it to the hospital yesterday for my pulmonary function tests (ie breathing tests). We made it and I got it done. I spent pretty much all of yesterday in bed. Better sleeping then trying to be sick.

Thankfully I feel better today. I've been going to the infusion center at the hospital around 9am cause it takes about 4hours for me to get all my medicines. This way we can come home and eat lunch. I wasn't nauseous today. Yeah! And, no hiccups...yet.

I'm starting to get to know some of the other patients that are getting chemo while I'm there. Some of them have sad stories. I start to feel lucky. They are all such nice people. The nurses in the infusion center are also great. They are upbeat, cheery, and joke with us. There is always someone to check in and 'see how you're doin'.

On a good note, we found out that we were approved for our mortgage and will be able to close on our new house on Friday. Jon called and movers to confirm the pick-up date and it turns out that they had us down for a 'complete pack'. Which means we don't have to worry about packing anything else!! One less worry is a blessing right now. I still have a lot to juggle with getting fully licensed and credentialed for my new job. But, that will come in time and is mainly out of my control.

So much is out of my control right now. I'm letting God do it all cause there isn't anything I can do. It's times like this that you fully realize that you are nothing without Him. I pray He builds me back up to be the woman He wants me to be. Like the Jars of Clay song "Worlds Apart", He has taken my world apart and I am on my knees.

Saturday, June 5, 2010

Hair cut

I'm really lucky to have a good friend who is a cosmetologist. She is great at cutting hair. So, last night, she cut my hair. I have a cute new hair do! I'm hoping to post pictures soon. After my hair cut, we enjoyed a nice dinner out at O'Charleys. It was good friends and good times.

Otherwise, I'm doing ok. Everyone keeps asking me, "How do you feel?" I feel ok. I'm tired all the time. I have hiccups for 3 days in a row and thus far that is the worst side effect. Appetite is less. I just don't feel myself.

Friday, June 4, 2010

Cycle 1, Day 3

I thought I would take a minute to explain what actually happens when I go for my chemotherapy infusion. I arrive in a open room with comfy chairs around the parameter of the room. Each chair is paired with an IV pole. First, I get my vitals taken. Then I start my IV infusion with half a liter of IV fluids to keep my kidneys well hydrated. Then I get all my premedications: 1mg Ativan, Alloxie (anti nausea medicine) every other day, tablet of Emend (anti nausea medicine), IV Pepcid (to protect my stomach), and an IV bag of benadryl and decadrone. That is a lot of medications and most of them make me really sleepy. I usually fall asleep afterward and end up sleeping through the infusion of VP 16 and cisplatin (the chemotherapy medicines). After the chemotherapy medicines, I get the second half of the liter of IV fluids. Then I'm finished. However, I'm usually fatigued throughout the rest of the day. I usually come home, eat lite lunch, and then take a 3-4 hour nap. Other than the fatigue, the only other major side effect I'm experiencing is hiccups. I've had them for the past 2 days in a row. The PharmD recommended adding thorazine today to help relieve the symptoms. Well, I'm getting tired. Time to sign out for a nap.

Thursday, June 3, 2010

Cycle 1, Day 2

Some thing today as yesterday. I slept through the infusion of both chemo meds. Came home and ate lunch. Still tired and eager for a nap. On a good note, Jonathan is getting alot of chores completed while I'm asleep and since Tundra is with his parents. I feel otherwise pretty good. I'll keep you all posted on the updates.

Wednesday, June 2, 2010

First Day of Chemo

Today started with having my PICC line placed. A peripherally inserted central catheter (PICC) is a fancy IV line. It is usually inserted by an interventional radiologist. I work closely with a Physician Assistant and a Nurse Practitioner who work for the interventional radiology team. One of these fine gentlemen placed my PICC line this morning. It was a interesting procedure and didn't hurt accept for the "pinch and a burn" of the numbing medicine. My line is in my right arm. It doesn't hurt. I'll have to monitor if for signs of infections and keep it clean. I can't shower with it, so we will have to cover it with Saran wrap to shower. Jon and I will also have to flush it regularly to help prevent blood clots.

After having my PICC placed, we went to the infusion center in the outpatient building. It will become my home away from home. The nurses are very nice. There isn't much privacy. Picture a room measuring approx 12x50 feet filled with comfy recliners for patients, IV poles to hang medications, and typical office chairs for family members organized around a circular perimeter. Since it was my first day, I had to do a little paperwork and met with the PharmD who specializes in chemotherapeutic medications and the PhD counselor. I know both of these doctors from working with them to care for inpatients. They were both nice and explained their roles and gave me recommendations. It's just odd being in the patient seat when I'm used to being in the care giver seat. The PharmD also explained the medications ordered that I would receive prior to transfusions to help minimize side effects.

So, here is my chemotherapy regimen: 5 days in a row I will receive VP 16 and cisplatin via IV infusion in the infusion center. Since I'm getting a late start this week, I'll receive infusions on Weds, Thurs, Fri, Mon, Tues. I believe the next cycle will start on a Monday so I can get all the infusions completed in 1 week. I will also receive an IM injection of bleomycin (my 3rd chemo medicine). I have to have pulmonary function tests completed prior to starting this medication because of the risks of pulmonary disease with this medication. I'm scheduled for those tests on Sunday and will have my firsts bleomycin injection next week ( hopefully on Weds).

Today's infusion went very well in my opinion. Prior to the infusion of my chemotherapy I received half a liter of IV fluids to keep me hydrated, IV pepcid to protect my stomach, IV antinausea medicine, IV ativan for relaxation, and an IV infusion of benadryl and decadron (a steroid medication to help reduce risk of infusion reactions). The combination of pre-treatment medications made me very sleepy. I basically fell asleep through the infusion of both chemo medicines and my post treatment half liter of IV fluids for hydration. I still felt tired at home afterwards and took a nice nap. The good news is that I don't feel any side effects except fatigue. I don't have nausea and I've been able to eat ok. I still don't have a huge appetite, but I'm eating well. I'm assuming my side effects may get worse with more treatments because I assume they compound. I'll keep you posted on how I'm doing.

Meanwhile, it's time to get ready for tomorrow.