April 2, 2005

Diana was still very sick from her chemo treatment on Easter Sunday. However, Diana had an appointment to have a Pleural Drainage Catheter inserted into her Pleural Cavity (left lung) on Monday at 10 AM at MD Anderson. So we had to drive to Houston. We had to go – she needed the catheter to drain the fluid. It had been a couple of weeks since the draining procedure had been performed on her and I knew the fluid was building inside her pleural cavity.

We (well me) wanted to depart as early in the day as we could. With it being Easter Sunday, there would be lots of traffic on the road heading home after spending Easter with family and friends. We waited as long as possible for Diana to get better. It never happened. Diana was still sick and not feeling well. We waited until I could wait no longer. So we did our best to make a bed in the back seat of Diana’s car. With her being sick every couple of hours we knew it would happen in the car. We put down an old carpet first to try and protect the car. We surrounded that with pillows and sheets. Finally, around 4 PM we departed. It was not a fun ride – lots of traffic with everyone returning home on Easter Sunday night and Diana got sick twice (nauseated) during the trip. To top everything off, there was a detour on the Interstate because of construction. We did not arrive at the hotel until 11 PM. The trip took 7 hours – two more than normal. I know it was especially hard on Diana, but I felt we had to go.

We used a wheel chair to move Diana in the hotel Sunday night. She did not complain so I knew she was really sick. Diana was very weak on Monday AM when we left for the clinic. Fortunately, the hotel is in the Houston Medical Center area and had a wheel chair available for us to use. Diana was not strong enough to walk. Not quite as sick on Monday as she had been the day before, but still not feeling well. She was very weak from being so sick the prior three days.

Somehow we made our way to MD Anderson Monday AM. Diana had to have blood tests done first. We then made our way to Cardio-Pulmonary Center where the procedure was scheduled to be performed.

All went well. They drained approximately 350 MilliLiters of fluid (1/2 bottle of wine) from Diana and inserted the Pleural Catheter. The procedure took about 1.5 hours. I was a nervous wreck. I was happy that we were finally at the Clinic and Diana was having the procedure completed. But I was still a nervous wreck. Once the procedure was completed, Diana went for a chest x-rays. The doctor wanted to make sure the catheter was inserted into her pleural cavity properly.

Around 3 PM we met with Dr. Eapen (Pulmonary Dr who performed the procedure). He said all went well. However, he said while they were using the Sonogram on her lung and from the new x-rays – he was concerned there might be more fluid around the heart. He said they would need to monitor the heart. My heart dipped. No we did not need more fluid problems. We had previously inquired as to what if the fluid returns to the heart. Unlike the pleural cavity, a catheter cannot be inserted into the heart. The procedure used is to cut a small hole in the heart lining so the fluid can flow from the heart to the pleural cavity and be drained. That would mean Dian would now have a hole in her heart lining if the fluid returned to the heart. Not something we were looking forward to having get done. I was scared and feeling sick.

The nurses showed us how to drain the pleural cavity catheter. They also gave us a CD to take home with all of the steps illustrated. I did not know how we – I – was going to accomplish the draining procedure. And it had to be done every day. Wow. Dr, Eapen reviewed the x-rays and released us to go back to the hotel. Our plan was to rest at the hotel Monday night and drive home on Tuesday.

While driving back to the hotel (5 minute ride) I received a phone call from Dr. Blumenschein. He had spoken with Dr. Eapen and Dr. Durand – the Cardiologist and they wanted to have a new Echocardiogram test performed on Diana Tuesday morning at 7:30 AM. We had only left Dr. Eapen’s office about 30 minutes ago. How were we going to rest now – impossible.

Diana was in a lot of pain but we rested best we could Monday night at the Marriott. Diana had some chicken soup that I went down to the Marriott kitchen to get and brought back to the room Monday night – the first food she had eaten in 3 days. It was great to see her eating. The Marriott was great. They understood I had a sick patient and really went out of their way to make the chicken soup for her. It was not on the menu but the chef wanted to help. Diana devoured the soup.

Tuesday morning we got up early – had to be at the clinic for 7:30 AM Echocardiogram test.Diana had some juice and yogurt as she was starting to feel a little better before we left for the clinic. However, mentally, neither of us was looking forward to the Echocardiogram. Diana was still in lots of pain from the pleural cavity procedure. We once again used a wheel chair to move her about the hotel and the clinic. The Echocardiogram was very painful for Diana because of the pain in her side do to the Pleural Drainage Catheter procedure.

The Echocardiogram test took about 45 minutes, Diana was finished about 8:30 AM. About an hour after the test was over, Dr. Durand called me on my cell phone. I spoke with Dr.Durand – he had viewed the test results and said the amount of fluid found around her heart was not a problem. Great news!!!!! And we could go home.

We flew back to the hotel, packed up and checked out. We immediately drove home Tuesday afternoon. I felt as if the weight of the world had been lifted from my shoulders. It is amazing how good news will perk one up. Diana had an uncomfortable ride home. She was still sore from the procedure and now had this tube coming out of her side.

As soon as we arrived home, it was time to drain her Pleural Cavity thru the Catheter. This must be done daily. It is a 2 person job so I am the assistant. We played the video CD and we did each step while watching the CD. We used the CD the first few times we drained Diana and are getting pretty good at the procedure. So good in fact and have enough confidence that we did not use the CD as a guide today. we each have our own steps which we accomplish in a sequential order.

It is a very sterile process as you can imagine and a little painful for Diana. We have drained approximately 200 Milliliters of fluid each day this week. Once the fluid drained is less than 100 Milliliters for 3 days in a row, Dr. Eapen will consider having Diana’s Pleural Catheter removed. Could be a few weeks to a few months or longer.

Our procedure has been for Diana to shower each day around 1 PM I go to her office every morning and I come home around 1:00. After her shower, we remove the dressing and drain her pleural cavity. We then apply a new dressing. Takes about 30 -45 minutes. Once completed, we eat the food for lunch that her mother has prepared and I go back to her office and work.

Diana is still very sore. She has been sleeping propped up in bed every night. Her appetite has returned and she is eating well. She did not leave the house this week. Still very sore from the insertion of the Catheter. Hopefully, next week, she will feel strong enough to resume some normal activity.

While Diana was resting in bed earlier this week, she asked me if I thought she could play golf. I stopped in my tracks and looked at her and said what? After some verbal interchange with her – I realized what was in her mind was her Stonebriar Women Golf Association (SWGA)annual member-guest golf tournament. It is held in June every year but you must sign up by March 31 which was only a couple of days away. After a practice round of golf on Tuesday, there is a theme party on Tuesday night, The tournament is held on Wednesday and Thursday and closes with an awards luncheon after golf on Thursday. One of the rules to be eligible for the tournament is the Stonebriar member must play 5 practice rounds before May 1 to be eligible. Diana has played in every Member-Guest including the inaugural in 1991. Obviously she wanted to play again.

I let the President of the SWGA know that Diana was interested in playing in the Member-Guest Golf Tournament, but she probably could not play the required 5 practice rounds because of her physical condition. She immediately sent Diana an email saying that the 5 round requirement had been waived for her. I showed Diana the email. She thought it was a fake email that I had created as a joke. When Diana finally realized the email was authentic, Diana was ecstatic. Diana called her golfing friend in Oregon inviting her to play in the tournament. We immediately filled out the entry blank and I went to the post office to make sure it got mailed.

Picture this – Diana is resting in bed. Has a catheter in her side that we have to drain every day. She barely can walk and she is determined to play golf in June for three days. Diana was convinced that she would be able to play by June. I was happy that she had such a determined attitude, but I don’t know if I would have bet very much money on her playing in the Queen’s Quest Golf Tournament in June.

While I was driving to the post office, I called Diana’s friend without Diana’s knowledge and told her that yes, Diana had signed up to play in the Queen’s Quest as the tournament was called, but please don’t buy your airline ticket until May when we would have a better idea if Diana could play at all. Anyway, Diana set this goal for herself and she was determined to make it. I was really pleased that she set the goal – but looking at the reality of the situation – I was not as convinced as Diana that she would be able to play golf in June.

Her next chemo treatment is scheduled for April 14. We will drive down to MD Anderson on 4/13 and have her blood tests done that afternoon. We will see Dr. Blumenschein on 4/14 AM and she will get her chemo treatment that evening. If all goes well we will return home on Thursday. We will bring supplies to drain her pleural cavity in the hotel each day.

Thanks again for your support and prayers. Diana really appreciates the support she has received. It has helped her mental state immensely.

April 18, 2005

We have been draining Diana’s Pleural Cavity daily for the past 3 weeks. Diana is still speaking to me which means that I am doing a good job. The first week home we drained approximately 200 Milliliters of fluid each day. The second week, the level went down to an average of 150 ml per day. This past week the level dropped again. On Thursday (4/14) we drained 90 ml. On Friday 75 ml. We skipped Saturday ( 2 days in a row below 100, so the procedure calls for draining every other day once you are below 100 ml 2 consecutive days). Today, Sunday we only drained 30 ml – even after 2 days accumulation since we skipped Saturday. Today was kind of a milestone – only 30 ml after 2 days of fluid collection. We were both excited. Diana had gone below 100 ml 2 days in a row once before last week. We skipped a day at that time. However, the next day we drained 150 ml. As Dr. Blumenschein said – this is a good sign. I am getting very good at the draining process. We have only messed up once or twice with the vacuum sealed bottle that helps draw the fluid from her pleural cavity assisted by gravity.

 

We drove to Houston on Tuesday April 12. Diana had her blood test Tuesday night Her appointment with Dr. Blumenschein and her chemo treatment at MD Anderson were on Wednesday & Thursday (4/13 & 4/14) of the past week Dr. B was pleased with how she looked and her blood test results. Dr. B was really pleased that the fluid level was decreasing. He was not anxious to remove the Pleural catheter and will probably make Diana keep it until our next visit. As a result of all the tests he decided to continue with the Alimta chemo treatment. Thus Thursday afternoon, Diana had her next chemo treatment.We spent Thursday night in Houston at the Marriott. We finished her treatment at 6:30 PM. Too late for a 5 hour ride. Spent the night in Houston and left the next AM Diana was fine on Friday – the day we returned to Frisco from MD Anderson. Saturday she was also up and a little active – but tired very easily.

Dr. Blumenschein prescribed a new anti-nausea medicine for Diana to take this time. She started on the medication Thursday morning before receiving her chemo treatment. So far it appears to be working better than any other anti-nausea medicine that she has taken previously,

This morning(Sunday 4/17), she didn’t feel well and is extremely tired. She got sick for the first time around noon today. Although her reaction to the chemo is kicking in as expected – usually 2-3 days after the chemo treatment – she is much less sick this time than she was with her last treatment. Hopefully, this will only last a day or two, and Diana will be feeling better again.

Diana’s next chemo treatment is scheduled for May 4, She will have tests on May 2 & 3 to measure progress of this new chemo against her cancer tumors. We will meet with Dr. B on 5/4 prior to the chemo treatment.

Diana has been busy looking at clothes (in catalogs) that she will need to get for her Queen’s Quest Golf Tournament. She needs an outfit for the theme party on Tuesday and she and her partner will dress alike for the tournament. She has been feeling better and is still convinced she will play golf in June. I certainly do not discourage her. Secretly, I am hoping that she does get to play golf. It would be huge mountain for her to climb. The odds look better each day. Maybe I should have placed my bet when the odds were higher.

Thanks for all of your support and prayers.