Monday, December 29, 2008

tis the season for radiation consultations, fa la la la la, la la la la.

so earlier today trish and i headed back to our favorite cancer center in the world.

we met for the first time with trish's radiation oncologist, dr. kate horst. although we had not met dr. horst yet, she was familiar with trish's case as she was one of the many doctors consulted last month prior to trish's surgery.

we had a pretty good idea of what to expect with the radiation, but dr. horst filled in all the blanks of the hows, whens, whys, wheres, whos etc... we both liked her, and trish is once again in good hands.

trish will have a follow up appointment either this week or next to have a CT scan of her upper torso so the docs can begin planning a radiation regimen tailored to her. the scan will take a half hour or so and it will take the docs about a week to plan trish's treatment schedule.

trish will have a team of 3-4 radiation technicians that will work with her for the duration of the treatment, and dr. horst will be checking in on trish at least once a week. since we will be there 5 days a week for 5 1/2 weeks, it will be nice to have consistent team of people to work with trish and know exactly the particulars of her.

the sessions will be quick, and dr. horst said we should be in and out in about 30 minutes (or the next radiation is free... kidding). the actual radiation dose only takes a minute or two, with more time being spent on the setup/posistioning of trish and the equipment.

side effects may be some sunburn type redness that will gradually fade away and fatigue. the worst is behind trish, and i know she will have no major issues with the radiation... shes a tough one.

so we dont have a definitive date yet, but we assume trish will begin radiation the week of january 12th

thanks for checking in... have a great new years... cant wait to get 2008 over with.

Tuesday, December 23, 2008

another day in the ITA...

welcome back herceptin fans...

not too much going on lately in terms of treatment, so there hasn't been much to write about... but we are back at stanford today for a little holiday time herceptin.

we got here around 9:00am, and if all goes well we should be home around noon.

trish had her scheduled every three month ECHO this past wednesday to check her heart's health, and everything came back normal, so we are good to go with the herceptin today.

nurse lea tapped trish's port around 9:30am and the pre-drugs of benadryl and pepcid are flowing.

trish is continuing to do great, her energy level continues to increase and her hair continues to grow. the last few weeks have been filled with shopping, birthday parties, holiday parties, ornament exchanges and meals with friends. last night trish baked a bunch of cupcakes & chocolate nut bark for the nurses here at the infusion treatment area (ITA).

trish started going back to the gym last week. we decided to get a family membership to the PCC . this will work out great... its within walking distance of our house, and they have a sauna & pool that will help with some low impact exercises for trish.

last week's cold front brought a little snowfall up on skyline boulevard above palo alto, so we brought caden up to see his first snow... caden wasn't too impressed.

last night we headed to eucalyptus avenue in san carlos to check out the phenomenal two block display of christmas lights... caden was impressed.

we still need to bring caden to see santa, and we are gonna do that either today or tommorrow... and if this year is like the previous 2 years, he wont be impressed :)

so thats about it from here...

happy holidays to everyone, and thanks for checking in...

trish & caden checking out the snow at the
monte bello open space preserve

caden & i

the big guy & the little guy

Monday, December 15, 2008

another checkup with dr. j

earlier this afternoon we headed off to stanford for a quick checkup at with dr. jeffrey.

the checkup itself was nice and quick, and the doc thinks trish's progress over the past month has been terrific. the checkup was sped up a little bit when the fire alarm went off, and we weren't sure if we would have to evacuate or not...

so dr. jeffrey quickly got to work and examined trish. evacuating woulda sucked, as we had already been waiting in the lobby for 2 1/2 hours for our appointment, so we didn't need any more delays.

anyhow, trish can now lift her arm above her head without much discomfort, and pretty much has her full range of motion back. she is back to lifting caden up, and i think thats what she missed the most.

so all is well in recoveryville. dr. jeffrey doesn't need to see trish again for another 6 months, but we will be meeting with her before then to plane for surgery #2.

this wednesday will be trish's scheduled ECHO, and next tuesday we will be back for some egg nog spiked herceptin...

so thats it from here..

Thursday, December 11, 2008

a quickie..

haven't posted in a while, cause not much has been happening since trish's herceptin infusion on december 2nd. not having doctor appointments all the time is kinda nice.

trish has been feeling really good, the soreness is going away with each day, and her range of motion continues to increase.

this past week trish has been able to relax and have and enjoy herself.

her college roommates, ginger and riley, came into town this past weekend and trish was able to get in some quality time with them. all of us headed up to san francisco for some ice skating in union square (caden and i watched), some shopping (caden and i watched) and then some clam chowder on pier 39.

on sunday we heading up hill to skyline to chop down that perfect christmas tree.

our schedule for the coming weeks pretty much looks like this:
- 12/15: checkup with dr. jeffrey
- 12/23: herceptin
- 12/29: consult with the radiation oncologist
- 12/??: another scheduled ECHO of her heart

christmas tree hunting this past sunday

Tuesday, December 2, 2008

the 10th reindeer, herceptin...

we met this morning with dr. carlson and his physician assistant kathy...

looks like the doc is just as excited with trish's results as we are, cause he came into the exam room clapping with a big smile on his face.

we talked about trish's progress up to this point, and what we can expect in the coming months...

one thing we learned today is the "1 year of herceptin" trish is continuing on, is retroactive to her first herceptin treatment on may 20th, and not the beginning of the "3 week doses" trish began on october 21st.

so this means trish has 6 more months of herceptin to go, and not the 10 months we initially thought..

dr. carlson also scheduled trish for her standard 3 month ECHO of her heart, and a consult with the radiation oncologist, dr. kathleen horst. not sure when we will meet with dr. horst, but we expect radiation to begin in the next few weeks.

trish will continue on the herceptin every three weeks, but we wont be seeing dr. carlson for another 9 weeks... but we will be back here in 2 weeks to see dr. jeffrey, and those daily radiation appointments will be here before we know it..

after doc carlson we headed up to the ITA... and man, this place is busier than a wal-mart on black friday

around 11:45am trish started on her pre-drugs prior to the herceptin... the benadryl should be kicking in at any moment.

herceptin began around 12:45pm, and should finish up 2:30pm

hopefully we will be heading home in about an hour..
trish is doing great... she is taking a little nap right now, and looking forward to the play date this afternoon at our house..

thanks for checking in

Monday, December 1, 2008

another quick checkup...

trish and i swung by doctor jeffrey's office this afternoon for a quick little checkup...

the doc wanted to see how the wounds are healing, and give trish some new stretching exercises to do...

everything was quick and smooth.. the doc was happy with the healing, and wants to see trish back in 2 weeks..

tomorrow morning trish will meet with dr. carlson for the first time in 3 weeks, and for the first time post surgery and post "the biopsies showed there aint no cancer in ya anymore". it will be nice to hear what he has to say...

we plan on talking with dr. carlson about the radiation schedule, and afterward we will head upstairs for some holiday herceptin..

trish continues to feel great...
she is out shopping right now, and after the infusion tomorrow she is having the story time moms/kids over in the afternoon for a little play date...

Thursday, November 27, 2008

gobble, gobble, bloggle, bloggle

trish, caden and myself would like to wish everyone a happy thanksgiving.

2008 is a year in which we have a lot to be thankful for, and a year we cant wait to end.

we appreciate all the love and support we've received from everyone this year, it has made all we have gone through more barrett-able.

trish is continuing to do great. dr. jeffrey removed her drains on monday, and she is healing up quite nicely and feeling better with each day.

things are good around here.

enjoy your thanksgiving,

trish, caden & oak (and bella)

Friday, November 21, 2008

the final pathology report...

one of trish's drains kinda sprang a leak this morning, so we headed over to our favorite surgical oncologist this afternoon for her to take a look.

ended up being a non issue. dr. jeffrey cleaned out some clotting in the tube, put some new bandages on trish, and she is good to go until monday morning, when dr. jeffrey will remove the drains for good.

before dr. jeffrey took a gander at trish's drains, she handed me a sheet of paper, it was trish's final pathology report.

dr. jeffrey asked me to read it aloud to trish, and this is what i read...

No residual carcinoma is seen in the right mastectomy specimen. No tumor is seen in eighteen total lymph nodes (0/18); however, several lymph nodes demonstrate scarring and infiltration by foamy histiocytes suggesting possible involvement prior to therapy.

the english version:
the breast tissue and 18 lymph nodes removed from trish WERE NOT CANCEROUS anymore... not even possible micro-metastasis the pet-ct, mri, mammogram & ultrasound may have missed.

several lymph nodes appeared to possibly have been cancerous in the past, but the chemo, herceptin & trish's determination kicked cancer's ass.

without the mastectomy, lymph node dissections and subsequent biopsies, we would not know with 100% certainty if the cancer truly was gone or not.

now we know.

it brings tears to my eyes as i type:

Trish is in complete pathological remission

it shall be celebration ale tonight...


trish is out & about spending money everyday, so i guess that means she is feeling great.. :)

Thursday, November 20, 2008

do you mish your dish?

we really, really appreciate all those that have dropped of dinners over the past 7 months, but ill be the first to admit we have been horrible at returning dishes.

with the holidays around the corner, im sure you would love to be reunited with you long lost dish.

send me an email and let me know what we have of yours, and ill track it down and get it back to you.


Tuesday, November 18, 2008

first post-op follow up...

dr. jeffrey wanted trish to come in yesterday afternoon, so she could take a look at how things are going. so we pointed the car towards the cancer center yesterday, and trish, ria and myself arrived about 10 minutes later..

it didn't take long for dr. jeffrey to see how well trish is doing. in fact, i think she was able to tell just by the glow of trish's face.

after a quick look, dr. jeffrey was thrilled with trish's progress, and thought she was doing really great.

the bandages are clean, the stitches are good, trish is healing well and the drains should be out by monday, possibly even by friday...

she walked trish through some arm exercises she wants her perform, but more importantly she proved to trish that she doesn't need to be scared about moving her arm. dr. jeffrey had trish put her hands behind her back, bend over and swing her arm in a circle, shoulder shrugs, lift her arms up, touch her shoulders, etc... trish was able to do it all without any problems, and im glad dr. jeffrey showed trish she doesn't have to worry about any range of motion, or be concerned with ripping her stitches or drains out.

not all the pathology reports are back yet, but the results so far indicate no presence of cancer cells in the tissue that was removed.

this is good news, but not the final news..
so we will wait until the complete pathology report is back before we get too excited.
we learned early on not to get too high on the good news or low on the bad news.. stay in the middle and it makes the emotional roller coaster easier to handle.

trish is still sore, but thats a given. yesterday she went shopping with her sister, and she continues to do little walks around the neighborhood and around the house. she isn't over doing it, but she is keeping herself moving and keeping herself healing..

she is doing really well, and looks forward to her healing touch session tonight.

Thursday, November 13, 2008

the update...

11:30am friday update:
im typing this update from home, watching trish hang out in the backyard with caden..

yup.. she is home, and doing great.

the vicodins will take care of the soreness she has, but other than that, she feels really good..

walking, talking, eating, smiling and laughing...

you would never know she got out of surgery last night at 7pm.

its a beautiful day in redwood city... sunny, blue skies, 80 degrees & not a cloud in sight...

a fitting day to be even more cancer free-er...

7:45am friday update:
trish was finally transferred to her room last night around 9:00pm and looked terrific.
she wasn't too groggy from the anesthesia, and aside from being a little sore, she was feeling great.

around 11:00pm we got her out of bed, and took a stroll down the hall. she has good strength, and can move her arm without any problems. didn't have any problems walking, wasn't dizzy, and the anti-nasea medicine they gave her helped ward off any side effects of the anethesia.

trish slept well considering the nurses come in every few hours to take her vitals, but overall it was a really smooth night. she had a pretty good appetite last night and is now looking forward to her breakfast suprise.

dr. jeffrey said she would stop by this morning to check in on trish, and i can only assume that sometime this afternoon she will be discharged.

so everything is good here.. ill post another update later

7:00pm thursday update
dr. jeffrey just came out with a big smile and gave us the update..

trish is out of surgery and she did great.
no complication, no issues, no suprised, everything went smoothly.

surgery ran a little late cause it started late, and dr. jeffrey took her time.

trish is in recovering now, and will be transported over to the hospital in about an hour, and thats when we will be able to see her.

dr. jeffrey still believes trish will be able to go home tommorrow

5:00pm thursday update:

the update is... there is no update..

we haven't heard anything yet

stay tuned

thursday morning update
we arrived at stanford at 11:30am this morning

about noon, trish was brought in for the standard pre-op stuff... gown, iv and most importantly marking the correct breast... right is right in trish's case, but sometimes right is wrong, so you quickly learn to say things like 'correct' and not right..

ria, yvonne, julie, chrissy and myself were all able to spend time with her before she went into the operating room.

about 12:45pm, she was given an anesthesia technique called a parvertebral block, and then brought to the OR.

trish was in really good spirits this morning, and was ready for this.

surgery should have begun around 1pm, and we expect a ~ 3 hour surgery.

she will be in the recovery area for an hour following surgery, and we hope to see her around 5pm after she is transferred to the hospital side of the medical center, and into her private room.

thanks for checking in...
trish really appreciated all the recent comments, cards, phone calls and visits latley. knowing that she has so many people thinking about her is really helping her get through this...

the cancer center's wireless network is currently down, so my access to the blog is limited, but ill try and keep it updated.. i have not heard from any doc or nurse in the past 2.5 hours, and dont expect to hear from anyone until she comes out of surgery..


this morning, right before we left for the hospital

Wednesday, November 12, 2008

surgery info...

we just found out the time for tommorrow's surgery...

check in: 11:10am
surgery: 1:10pm

surgery will be in the ambulatory surgery center located on the third floor of the cancer center, right above the ITA...

trish will be staying the night in the actual "stanford hospital" and not the cancer center, and will hopefully be home friday.

Tuesday, November 11, 2008

ITA, oh how we have missed thee

ahhh... our old friend
the infusion treatment area... the ITA

6 months of coming here every week, sometimes several times a week, and you really get used to it... you get to know the nurses, they get to know you..

now when we only have to swing by about once a month, its nice... but odd.
i still dont think we are use to it, but its great when the nurses stop into trish's suite to say hi and congratulate her on the news, cause they haven't seen her in a while.

nurse chris got trish going on her premeds a little before 10:00am, and she is getting her 3 week dose of herceptin right now, and that should be finished up around noon.
trish is in benadryl-la-la-land, and taking a little nap to get caught up on the sleep caden robbed her of last night.

although we haven't been upstairs to the ITA lately, we have made plenty trips to the cancer center these past few weeks..
yesterday we were back in good old Clinic F on the first floor to visit with trish's surgeon, dr. stefanie jeffrey, to go over the pre-op plan for this thursday's surgery.

as mentioned before, trish is gonna go with a single mastectomy, and remove the leve1 1 & level 2 lymph nodes. we feel this is the best bet for trish, it will allow her to heal the quicker and get on with radiation. a double at this time would mean more recovery, longer surgery, more nights in the hospital, etc...

so lefty gets to hang around for a few more months.

dr. jeffrey is currently doing a research study on identifying cancer cells and their genes in the blood, and asked if trish would like to contribute her blood to the study... trish was more than happy to do so..
while i cant explain all the specifics of the study, i can tell you when dr. jeffrey called last night, she told trish she did not find any cancer cells in her blood!!! :)

after we left the cancer center, we headed home to pick up caden and bring him to the pediatrician.. the little guy got himself his first ear infection... he has been a little grumpy, and (lack of) sleeping over the last couple nights has been an adventure.

anyhow... caden is taking his meds... mommy is taking her meds... and daddy is looking foward to that cold sierra nevada sitting in the fridge..

after the herceptin is done today, we have a 1:30pm meeting with the anesthesiologist to go over whatever it is that anesthesiologists go over with you before surgery.

anyhoooo... trish has been feeling really, really great.
her energy is coming back, her hair is coming back, her eyebrows are coming back... but the smile has always been there.

she is physically and mentally ready for surgery, and slowly but surely we are getting back to normal around here..

dr. jeffrey believes trish will be able to go home friday, so it will be a short stay (in a private room) at the hospital.
trish's out of town support staff will be rolling into town this weekend..
her sister, yvonne, will be flying in from holland..
college roommates, ginger, is flying up from LA and riley is driving down from sacramento.

trish will be in great hands..

thanks for checking in..

Thursday, November 6, 2008

the plan going forward...

so we heard from trish's surgical oncologist, dr. stephanie jeffrey, last night.

as you know, dr. jeffrey, dr. carlson and dr. horst met yesterday to discuss trish's situation. since monday, the doctors have pooled their resources and discussed trish's case with other oncologists at major cancer centers around the united states.

the feedback was unanimous...

based on trish's diagnosis, age and the fact that she has the little guy at home, all the oncologists concurred they all want what is best for her long term health.

what is best is what we have know all along...
a mastectomy of her right side and removal of the first and second level lymph nodes.

trish has surgery scheduled for next thursday, a week from today. she will have a single mastectomy at that time, as well as lymph nodes removed.

5 weeks of radiation will follow a month or so later after she has had time to heal.

the reconstruction process will be begin after she has recovered from radiation.

the first step of reconstruction will be to remove her left breast, and place tissue expanders in both the right and left sides at that time.

several months later, there will be another surgery for artificial implants.

our emotions have been bounced around like ping pong balls lately, but in the end, this doesn't differ from what we had already prepared ourselves for had surgery been this past tuesday.

dr. jeffrey didn't give us any false hope, and i applaud her for thinking outside the box, and questioning "the norm".

it helps reinforce the decision we had already made, when trish's doctors take the time to think about her specific situation, and discuss it with other oncologists at other institutions to formulate plan tailored to her needs, and not come up with a plan "just because that is the way its always been done" .

although we may have wished for a different plan,
this does not change the fact that TRISH IS CANCER FREE.

Monday, November 3, 2008

surgery... postponed.

well today was interesting to say the least.

when we met with dr. jeffrey this afternoon, she questioned why she is being asked to remove the breast of a women who shows no signs of cancer in her body.

this kinda through us for a loop, cause we thought we would be discussing a double mastectomy, and how many lymph nodes would need to be removed...

but rather the day was spent discussing different approaches to trish's (possible) surgery.

as you may recall, the first time we met with dr. jeffrey, she commented that trish might not even need her surgical services because she felt nothing of concern in terms of cancer in her breast and lymph nodes.

she then ordered the pet-ct, mri, mammogram and ultrasound to see exactly how trish's body had responded to the chemo & herceptin.

with the test results coming back a couple weeks agao, we now know trish's body shows no signs of cancer. dr. jeffrey wonders if surgery is needed, and if just radiation would be sufficient.

another thought is to do a sentinel lymph node biopsy to see if there is any trace of residual cancer cells the chemo didn't kill & the tests/scans did not detect;
if there is... continue as planned with the double & lymphnodes
if there isn't... continue with just radiation

this afternoon, dr. jeffrey spoke with dr. carlson, who disagrees, and suggests a single mastectomy and a removing Level 1 & Level 2 lymph nodes.

there are enough questions in the air right now, that trish and i decided to postpone the surgery until we know a little more.

next thursday, ten days from now, is when surgery is rescheduled for, but at this time we dont know WHAT exactly that surgery may entail.

i think its a good thing that doctors are butting heads at this point. dr. jeffrey said if there was any sign of cancer that chemo didn't rectify, she would surely operate. but with trish, there is no cancer...

this goes against "traditional" approaches, as with most folks, you kinda get the chemo, radiation, surgery... that "standard" cancer trifecta.

but it does make ya think for a bit... if there is no cancer, do you need surgery?
if dr. jeffrey didn't know trish was a breast cancer survivor, and based on all her scans and tests, would a mastectomy still be a viable option?

talk about food for thought... it really gets your head spinning.

ultimately, the choice is still up to trish, but we are gonna take the next 10 days to gather some info and decide then...

it may very well be the same exact choice that we planned on taking tomorrow morning.

to help with the choice, dr. jeffrey is consulting with several colleagues tomorrow, including one a doctor at MD Anderson to gather more information of similar situations.
additionally, dr. carlson, dr. jeffrey and dr. kathleen horst, a radiation oncologist at stanford, will sit down on wednesday to discuss trish's surgery face to face.

enough questions were raised today to take a pause for thought...

we are gonna discuss it over the coming week, and re-make a tough decision.
what we do know is that we will not do anything that jeopardizes trish's health. we aren't looking for her to be a guinea pig, we have come too far for that.. but we are open to hearing different approaches, and possibly even more "current" thoughts...

as for the days other events...
our morning meeting for dr. rockson's lymphedema study went quick... no wait, and 15 minutes of measurements, and trish was done..
the radioactive dye and scan was canceled for now.

anyhow... we appreciate all those good thoughts and prayers, we just wont need them tomorrow morning..

thanks for checking in..

its now time to relax and have a frosty sierra nevada (or six)

the beginning of a hectic week...

tommorrow morning is trish's surgery for her double mastectomy.

we have decided the best course of treatment for trish is to remove both, and have tissue expanders placed AFTER radiation. this will result in one additional surgery for the tissue expanders a month or so after radiation, but we feel it will give the best results in terms of radiation effectiveness.

priority #1 is trish's long term health.

so tommorrow, we will be checking in for pre-op at 6am, with surgery beginning around 7am and scheduled for 3 hours. the doc said expect two nights in the hospital, but she might go home after 1 night, depending on how she is doing..

today we have our hands full.

at 11:00am, we have a meeting at the cancer center for a research study on lymphedema that trish will be a part of. lymphedema is a possible side affect when lymph nodes are removed. today is basically a meeting to get trish's pre-surgery baseline.

at 12:00pm, we are meeting with dr. jeffery to go over the plan for tomorrow morning's surgery.

at 2:00pm, trish is scheduled to get pumped full of some radioactive stuff

at 4:00pm, trish will have a scan done to get some pictures of her lymph node system, thus the need for the radioactive juice two hours earlier..

so... we are leaving home shortly to head to palo alto. ill try and leave some updates a little bit later..

Thursday, October 30, 2008

a quicker update...

we got a call from dr. jeffery's office yesterday...

trish's surgery has been bumped from november 11th, to november 4th.

to go from having 10 days to mentally and physically prepare, to a few... its kinda crazy, but we have been waiting for this day all along.

trish is doing great physically.

emotionally she knows this is all part of the plan of living a low maintenance life, but it doesn't mean she has to like it...

the silver lining:
november 11th is a scheduled herceptin day. if she had surgery on that day, herceptin would have been postponed...
she will now be able to stay on her schedule to worryfreetown, usa.

Tuesday, October 28, 2008

a quick and overdue update...

hi all..

its been a little over a week since i last updated everyone.

since we got the good news last, last monday, we have been busy meeting with the docs to arrange the next couple months. so this is basically the run down from the last week..

monday 10/20:
got the great news

tuesday 10/21:
met with doc carlson, and he reinforced how well trish has done... he agreed with the tests, and No Evidence of Disease, and said trish could not be doing any better. he gave trish her orders for herceptin, and headed upstairs for the 1.5 hour infusion (3x the amount now that trish gets it every 3 weeks). we will meet with dr. carlson again in 6 weeks (after surgery), then we will be on a 9 week schedule of seeing him.

wednesday 10/22:
in the morning, we headed back to the cancer center for a flu shot that they forgot to give trish on tuesday. feeling great, trish and ria brought caden and lucas to the woodside library for story time a little later.

thursday 10/23:
trish, jane and i heading back to the stanford cancer center for a cancer fair / survivor celebration.. got some good information on some up coming clinical trials, post surgery bras and saw chemo buddy christine.

in the evening, trish headed to healing touch.

friday 10/24:
trish, ria and i heading back to stanford for our first meeting with the plastic surgeon, dr. gordon lee (scroll to the bottom for his bio). we both liked dr. lee, and we talked for a while about the choices that need to be made going forward. dr. lee has a 1 hour long video of a presentation he gave on the topic of breast reconstruction, and talks in detail of all the options available today. if you are interested, here is the link to it:

What's New in Breast Reconstruction? on

basically the choices are:

mastectomy: single or double

tissue expanders: same day as mastectomy, or after radiation (both have pros/cons physically and mentally) tissue expanders make it more difficult to deliver radiation, but there isn't any definitive study saying if radiation is less effective with expanders in the way, but it is harder getting a good angle to deliver it.

tissue expanders are basically implants that get filled with saline every week to help expand the tissue to the size of implants you will have in the future...
they also help emotionally knowing that "something" is there immediately after surgery.

DIEP-Flap (tummy tuck, and implants using your own tissue) or artifical implants (saline or silicon)... the silicon of today is much different than the silicon implants the FDA banned in 1992. they were reintroduced by the FDA 2 years ago, and 16 years of research has made a difference in their safety, and currently 95% of dr. lee's patients opt for silicon as it feels more natural and comfortable, especially when laying down on your stomach. this is a decision that we will make later down the road, not now.

timing: if trish decides on a double mastectomy, she can choose to remove both at the same time, or just remove the "cancer" side now, and wait to remove the second later

so its kinda information overload. there is no perfect solution, no simple solution.

scenario 1:
remove both and have tissue expanders put in during that surgery, have radiation for 5 weeks, then put in the implants in a second surgery months later.
pros: least amount of surgeries, wake up after surgery with "something" there
cons: radiation effectiveness MIGHT be compromised with the expanders in place. the skin may be affected by radiation, and wont be repairable.

scenario 2: remove one, and do not have tissue expanders put in. have radiation for 5 weeks, have a second surgery to remove the second breast and put expanders in both sides at that time, followed by third surgery for implants several months down the line
pros:best way to deliver radiation, still have 1 breast for the time being.
cons:wake up with "nothing" on the bad side. is having 1 breast really better than having none, or is that worse? most # of surgeries.
symmetry may suffer as mastectomies happen during different surgeries.

scenario 3: remove both, no expanders. have radiation. have a second surgery to put in expanders... have a third surgery months down the road to put in final implants.
pros: radiation can be delivered easier, symmetry will be the same on the left and right.
cons: most # of surgeries, wake up with nothing on both sides.

i think we know what decisions will be made, but its really a lot to absorb, and make a good educated decision on whats best for trish. you can't just take into account the short term, or the long term... you need to take each into consideration.

there are physical and emotional extremes with all of the choices, but we need to weigh both and determine what is the best route to take for trish. although the short term is easiest to think about right now, we need to think about a year, 5, 10, 20 down the road, and the choices we make now, will affect the results later.

this will all be a distant memory in time, and although some choices may to tough to endure for the short term, trish is mentally and physically tough, and it wont be any worse than anything she has faced in the past six months.

needless to say, its a real personal decision.... and a difficult one.

saturday 10/25:
trish and steve took the boys to the redwood parents nursery school for a halloween fun day

sunday 10/26:
trish and cerena took the boys up to burlingame to get their hair cut

i finally got the bathroom countertop complete.. ive wanted to build a concrete countertop for 6 years, and i finally had an opportunity. took a few weeks, but its done. we had the terlet, then the tub and then the shower... its nice to finally have a working sink to go with it all... the bathroom is 98% complete now.

monday 10/27:
trish did some grocery shopping and did some baking for monday's play date.

tuesday 10/28: today... tuesday... and the first time in a long time we didn't have a chemo or herceptin appointment.. it was kinda nice. trish hosted a play date this afternoon with the story time moms and their kids. it was great having a bunch of kids play around in the backyard and decorate pumpkins.. i think everyone had a fun time.

we got a call from dr. jeffrey's office this morning, and trish's surgery is currently scheduled for tuesday, november 11th. we know this needs to be done, and surgery has always been "in the next month or so..." but now we know the day, and it makes it tougher, it makes it real, knowing that the date is closing in. nonetheless, the whole point of this is to get trish 100% healthy so we can get on with a worry-less, low maintenance life..

so over the past week, trish has been feeling absolutely great.
no signs of any sickness, fever, nausea, etc...
she is normal, and her hair is starting to come back, and she is really excited for that.

trish has been getting out of the house everyday, walking, driving and shopping.. just trying to lead a normal life. she pushes herself a little bit more each day, but makes sure she isn't overdoing it. her strength is on its way back and she seems to be smiling a little more these days.

sorry for not updating anything lately, but its been a great week and we just kinda savored it...

it hasn't been like this in a while.

thanks for checking in...

Hay, its today's play date


the missing link, the bathroom sink

Monday, October 20, 2008

the test results are back...

this morning, dr. jeffrey's office called with the results of trish's MRI, PET-scan, mammogram and ultrasound she had over the past coupla weeks.

there are no signs of cancer in trish's body.

yes, i typed that correctly.

mri: found nothing of concern
pet-scan: showed her lymph nodes have shrunk, and they are of no concern
mammogram & ultrasound: could not detect the cancer in trish's right breast, and did not show any signs of cancer in a new lump discovered in trish's left breast two weeks ago.

its been a very emotional day, a good day... a great day. this does not change surgery, radiation, etc, but trish has responded tremendously to the chemotherapy and herceptin. we still have plenty of questions for dr. jeffrey and dr. carlson, as we received the news from dr. jeffrey's nurse over the phone. but for today, we can relax a little.

we have an appointment with dr. carlson tomorrow morning and afterward trish will begin her 12 month regimen of herceptin.

i literally just finished watching 'Living Proof' a few minutes ago. it debuted on Lifetime this past saturday night, and we tivo'ed it. there will be an encore presentation tonight (monday) at 8pm on Lifetime, and i encourage everyone to watch it. even though trish was not part of the clinical trials a decade ago, it was like i was watching my life on tv. many women have benefited from the work of dr. slamon & genentech since herceptin's approval by the FDA on September 25th, 1998.

'Living Proof' is the true story of oncologist and researcher Dr. Dennis Slamon, the UCLA doctor who helped develop the breast cancer drug Herceptin, and his effort to keep the drug trials afloat. His inspiring journey shows the sacrifices he makes in his personal life and the obstacles that he faces to get the drug approved. Thousands of lives have been saved because of his dedication. (Based on Robert Bazell’s book “Her-2.”) Renée Zellweger, Neil Meron and Craig Zadan, and screenwriter Vivienne Radkoff are the executive producers

trish is living proof.

Tuesday, October 14, 2008

now that we have the weekend behind us...

its tuesday morning, how bout a big bowl of herceptin and a side of benadryl.

trish, myself and our special VIP guest star, ginger, headed to the cancer center this morning to get the last treatment of round 3.

its been a long handful of days leading up to today, but trish is doing really well. no signs of any fever. trish was really happy to get home and spend some time in her own bed with caden.

nurse denise tapped trish's port around 8:50am and starting the premeds.
denise also gave us the results of trish's ANC count from yesterday (we left the hospital before we knew the actual number...)

trish has gone way up :)

Absolute neutrophil count (ANC):
friday (trip to the ER): 0.25
saturday: 0.3
sunday: 0.9

the drum roll please...

monday's test results that we received today: 5.2

this is the highest they have been since trish began the FEC rounds of chemo on august 19th. the neupogen is doing its job, and trish's body is recovering nicely. her platelet count is at an all time low, even lower than friday nights trip to the ER, but they will come back up on their own, and it isn't a concern right now.

so.. the deacadron and benadryl and dripping right now, and the 30 minutes of herceptin should begin in the next half hour or so...

later this afternoon trish will have her mammogram and ultrasound.

after today's treatment, i believe she is switching her herceptin schedule from once a week, to once every three weeks. we will meet with dr. carlson next tuesday, but im not sure if trish will begin her new herceptin schedule next tuesday, or three tuesdays from now.

thanks for checking in...

10:30am update
the herceptin is just about done... just a quick heparin flush of the port, and we are out of here... early lunch today, we just cant decide where..

trish & ginger
(taking different kinds of shots)

Monday, October 13, 2008

the weekend update... addendum


guess i put the cart before the blog... or the blog before the horse, or put a blog in my mouth or a foot in my blog.... i dunno what the hell happened...

after we finished the pet-scan on friday ~ 5pm-ish, we headed to draegers to get trish some food, since she hadn't eaten for almost 24 hours.

about an hour after we got home, trish started running a fever up to 101.4ish

we called the emergency "on-call"ogist... and she said....

"bring her into the ER"

and i was thinking

"WTF, SOB, MF, $#!&"

so we headed over to the stanford ER friday evening around 7pm..
again, if it was business hours, we woulda went over to doc carlson, but nahh... couldn't have that kinda luck...
at the ER, they triaged trish in the waiting room and her fever was 99.7.

the benefits of being a cancer chick with a fever is that are pretty quick to get you into a private room, so again, we were put into a pediatric private ER room, and got the same great nurse, monika, we had last trip to the ER.

i kept taking trish's temp every 45 minutes or so, and we saw it go down pretty quick to a normal 98.6 ish an hour or two later..
no drugs, no iv's, no nothing.. hell, we hadn't even seen a real doctor at that point.

dr. oak says it was all part of the long day of no food, some radioactive dye getting pushed into her and her body being a little grumpy at her.

my money was on us coming home that night, perhaps even with a prescription for an antibiotic...

well.. dr. oak was wrong... and glad i didn't wager the 'under' on time spent at the hosptial this weekend.

the real doc came in around 11:30pm (4+ hours later) to let us know that trish's blood counts were really low..

ANC: .25

so... this meant they were gonna admit her to the hospital until her counts went up, and make sure the fever didn't return.

we (well, actually I) weren't too thrilled, but its all to get her better... we are thinking long term here, and if it means a short stay at the hosptial, sobeit..

i left the ER saturday morning around 1:30am, and trish was moved to her private hospital room at 2:30am.

on saturday, her counts had gone up a little..

ANC: .6 (the chemo cutoff is 1.5)

all this time, trish was feeling really good.. absolutely no sign of fever, they put her on some antibiotics to make sure they killed anything that may have been growing in her.

on friday night in the ER, they did a chest xray, and on saturday they told us the results...
the docs maybe saw some stuff that lead them to maybe believe that trish maybe had some maybe little perhaps onset of some maybe pneumonia... i call bullshit, but i aint the doc, and we gotta keep her safe..

so they gave her more antibiotics for the pseudo-pneumonia that may or may not mighta have been there

this meant there was no way they were gonna release her on saturday... ahh another night at stanford penitentiary, oh joy.

its like a little weekend getaway with a craftmatic adjustable bed.

so sunday... no fever, blood counts still creeping up, still on the antibiotics, eating good, looking good, feeling good, walking good...

ANC: .9 (still low, but going in the right direction.. frame of reference, she was .36 and at home, the day before my sisters wedding that she didn't go to..)

we took a walk around the hospital, and again... she was feeling really good, laughing and in good spirits.. just disappointed that she was still stuck in this fine facility...

part of her was comfortable with the fact that she was in the right place if her health decided to go south, but man... a 2 hour long fever that went away by itself 2 days ago.. dr. oak remained skeptical and was lobbying for the doctors to vote her off the island... but i kinda think trish was getting too attached to the awesome nurses she had... julia & patty

the real docs came in on sunday morning and basically said "you should be home by tuesday"... WTF, tuesday? whats wrong with monday... doc oak was wrong again.

anyhow... better being safe than sorry... trish's health is the priority and i guess we gotta make sure her 2 hour fever from friday doesn't come back sunday night or even monday.
so another night at the st. regis stanford, another night of anitbiotics, another night of hospital food.

so now as i pull my foot out of my blog, its monday morning, and the docs just came in... her monday blood test results are still pending, but her white blood counts (different than absolute neutrophil count) are back, and they are way up, so they are assuming the ANC will be within normal range..

the docs and nurse said trish should be paroled out of here by 11:30am... doc oak is happy.

literally 5 minutes before the parole board walked in to release trish, trish rubbed her nose cause it felt dry, and it sprung a leak. nose bleeds haven't been common for trish, but neither has 4 days of conditioned, dry, hospital air... i thought for sure the docs were gonna put her in solitary confiment for another week, but the docs didn't feel it was caused by anything but her nose being dry..

so thats that.. she, i , everyone is looking forward to getting her home.. she misses caden, and caden misses his mamma... she isn't sick, so lets get her the hell out of here..

i thought the friday night, saturday night, sunday night stay was a little overkill, but thats what i get for getting my doctorate from the local junior college...

ya can never be to careful with our favorite little cancer girl...

anyhow... trish's friend ginger flies in tonight from LAX, assuming the airport hasn't burned down by then...
we have herceptin, mammogram and ultrasound tommorrow...

just another (normal) hectic week...

trish & the nosebleed kit

i believe the C stands for Cell, as in jail...

Friday, October 10, 2008

the weekend update...

a quick update

we met with dr. jeffrey, the surgical oncologist. she ordered a few tests/scans for trish before we decide how to proceed with surgery.

trish had her herceptin as scheduled.. we didn't realize it until we got into bed that night, but it was trish's 6 month anniversary of her diagnosis...

trish, ria and I went back to stanford for an MRI...
scheduled at 8pm, it finally started around 9pm, and we left around 10pm... long night, but we did swing by town & country to check out the pink lights (but i forgot my camera)

trish picked up her new (to us) car... a little soccer mom volvo suv rig..
her current car goes bye bye on monday, so we needed to get her something to drive as i dont trust her riding a bike with my son.

back at stanford right now for her PET (positron emission tomography) scan...
they are gonna pump her with a radioactive chemical and it will be absorbed by any cancerous cells.. she will then go into a scan, and the resulting image will show the extent and location of any cancer.. she went in about 2:30pm, and they said it would take 2 hours... so another waiting game for ria and i.

trish is doing good today, just a little grumpy and tired.
she hasn't been able to eat anything before the scan today.. it woulda been nice to have it scheduled in the morning, rather than mid afternoon... but she is looking forward to a deli sandwich and a caesar salad when this is done.

tomorrow is kinda of weird day for trish.
she is basically getting fired from work. her 6 month short term disability is up, and she will now go onto long term disability, but her employer, GlaxoSmithKline, will terminate her employment tomorrow.

so no more company car, laptop, etc...
but more importantly, trish is disappointed that she is losing her job. she has spent 7 years with GSK as a pharmaceutical sales rep in several different specialty areas, and has enjoyed the interactions and friendships she has made with co-workers, doctors and staff over the years. although she hasn't been able to work in the past six months, she will miss her job and being part of the GSK team.

maybe she can start pushing Herceptin, a Genentech product, once we get all this stuff behind us. :)

speaking of herceptin and genentech..

trish has been asked by genentech to give a presentation about the benefits herceptin has on her type of cancer, Her-2/neu Positve. the audience will be 100 or so genentech employees and trish will be introduced by the senior vice president of bio-oncology.
trish has been planning her presentation for a couple weeks, and looks forwards to share her story with the fine folks of genentech.

unfortunately, this is NOT a public event, so you wont see me out front scalping tickets for triple face value.
whats on tap...

trish will get her scheduled herceptin, as well as a mammogram and ultrasound of her boobies.. trish's college roommate, ginger, is flying up from LA to visit for the day, so she is really excited to see ginger, but having a machine smash her boobies... not so much.

the herceptin talk with genetech

next, next monday
the plan right now is to meet back with dr. jeffrey on monday, october 20th, to go over the results of the mri, pet scan, mammogram and ultrasound..

anyhow, trish is still feeling really good.. by far the best couple of weeks in a while. the biggest issue she is having these days is the heartburn... and if thats the biggest issue, we will take it..

she has been doing a fair amount of walking this past week, and its helped her emotionally and physically. she has also been able to hang out with some girlfriends, outside of the house, this week and she really enjoyed the time doing that.

thanks for checking in, enjoy the weekend...

Tuesday, October 7, 2008

H-Town, USA

herceptintown, antibodyville, 94305, ITA...
whatever ya want to call it, we are back..

today should be a relatively quick day... 30 minutes of herceptin, and we should get home before caden goes down for his nap...

its 9:30am and nurse shelby is gonna tap trish's port, and get some premeds going in..
herceptin will probably/hopefully start in about an hour or so..

trish, jane, cerena and i made a trip to the cancer center yesterday to have our first meeting with trish's surgical oncologist, Dr. Stefanie Jeffrey.

we went over a rough time line of when surgery will be... 4-6 weeks away, as we already knew. as for the exact surgical strategy, dr. jeffrey wants to make that decision after an updated round of scans are performed. she wants to see how trish's body has reacted to the chemo, but after a physical exam of her boobie and lymphnodes, dr. jeffrey was really happy with how trish's body has responded to the chemo, saying things such as 'great' and 'this is awesome'.

the doc ordered several scans that trish will have in the coming week or so. starting off with an MRI on wednesday night, and a PET-CT friday afternoon. next week there will be a mammogram and an ultrasound.

the results of the scans will will give a better insight on exactly how we should proceed with the mastectomy and determine the extent of the lymph node removal.

this was the first time any of us have met dr. jeffrey, and we were really happy with her. she obviously knows her trade, but it was really easy to talk with her about different options/methods/philosophies, etc..
all four of us left with a good feeling, knowing that trish would be in great hands, and i think having a female surgeon will help ease trish's anxiety a bit.

the highlight of the day for trish was when we were on our way to meet dr. jeffrey, we saw another chemo buddy, cindi, in the waiting room for her doctor.
trish and cindi have only met once, while getting chemo months back, but they have exchanged many emails since then. both the the girls are looking and feeling good.. its really nice to see others around ya getting better as well.

after we left the cancer center, we headed over to town & country village in palo alto for a little lunch at Douce France, a french cafe and pastry shop.

october is breast cancer awareness month, and town & country village is hosting a fundraiser called "Town & Country Goes Pink", and all proceeds go to a local organization called Breast Cancer Connections.

During the month of October, Town & Country Village in Palo Alto will be draped in 5,600 pink lights in support of National Breast Cancer Awareness month. It's the first year Town & Country management and the shopping center's 20 tenants have partnered with the Palo Alto-based nonprofit Breast Cancer Connections to "shine a light" on the disease and broadcast the availability of helpful services.

The shopping center presented a kickoff reception for "Town & Country Goes Pink" on Wednesday night, and general manager Joan Fantazia invited the community to purchase a light for $10 to honor a friend or loved one who has experienced breast cancer. One hundred percent of the funds raised by the lights will go to the free support services provided by Breast Cancer Connections.

Douce France's owner, victor, and trish's coworker rochelle, purchased a pink light in honor of trish... since it was lunch time, we didn't get to see the lights turned on, but we plan on taking a look tomorrow night after we finish up the MRI.

the last few days have continued to be good to trish...
she is eating well, and is just battling a little bit of nausea..
nothing too extreme, nothing unexpected.
she is getting sore from the neupogen shots (this is a good thing, unfortunately)

so, considering by this time, last round, we were sitting in the emergency room...
trish is doing much better in her 3rd round (insert cliché here).

thanks for checking in...

a quick update...

11:15am: herceptin is done... just waiting on a quick flush and we are outta here..

Friday, October 3, 2008

last call for chemo...


its friday, and we arrived back at chemoville around 9:45am for trish's second (AND LAST) dose of 5-FU this week.

im not gonna be able to call this place chemoville anymore, as TODAY IS THE LAST OF THE CHEMO... i guess ill have to call the place "monoclonal-antibodyville"

we are in suite B2 today with nurse margaret.
trish is currently taking a little nap while she gets her hydration IV. i dont think she needs the hydration, but might as well be safer than sorrier, as we are here anyhow for HER LAST DOSE OF CHEMO (in case i hadn't mentioned that)

we still need to come back to the cancer center to hang out with our favorite nurses, and to get trish's IV's of herceptin (an antibody, not chemo), over the next two tuesdays, and then continuing every 3 weeks for the next year...

but as for any and all of the actual "chemotherapy" drugs she has received in the last 164 days (since april 22, 2008)

- the adriamycin
- the cytoxan
- the 5-FU
- the taxol
- the epirubicin

she will be done with all of it in a couple hours :)

trish has felt really good this week... much better than round uno y dos..
we are hoping this continues, but we know it takes 7-10 days for the tuesday's "big dose" of chemo to really start kicking her ass..

on wednseday trish put up all the halloween decorations in the morning, and monica's mom, melissa, stopped by to visit deliver a beautiful blanket made by one of her coworkers.

yesterday, she went shopping at whole foods with her dad in the morning, and to healing touch with her mom in the evening. her stamina has been pretty decent, nausea has been under control (she took the last of the 3 emend pills). she has had a good appetite and continues to be relatively regular..
so far, so good..

so today:

at 10:20am, the hydration IV began

at 11:50am, nurse margaret began the manual push of the 5-FU

five minutes later, on October 3, 2008 at 11:55am, trish completed her chemotherapy.

so how bout a big FU to the 5-FU and its friends

today is a big day, a huge milestone... today is a milkshake day...

still plenty ahead of us, but its really nice to utter the words


trish getting her final push of 5-FU, while cuddled up with her new prayer blanket handmade by Pam of the Valley Church of Cupertino

Tuesday, September 30, 2008

tuesdays with trisha...

so today is the first day of the last round of chemo...
a couple more tuesdays and the weekly treatments will be complete.

its 10:40am the blood draw just completed, and we are heading down to doc carlson's office...

hopefully trish's counts are chemo ready...

more updates later..

1:40pm update
12:40pm: dr. carlson and dr. pose came in and examined trish. dr. carlson continues to be pleased with trish's progress, and informed us that her white counts are back up to a range in which she can get chemo.

after we finished with our visit with dr. carlson and dr. pose, we headed to the pharmacy to drop off some prescriptions and pick up trish's prescription of emend.

its 1:45pm and nurse denise is getting trish started on her typical three predrugs.

we are hanging out in suite c1 today and trish is getting comfy on the bed.
we were joined for the morning hours with special guest star nicole, but she had to leave to go do real work... but it was nice having her around so trish and her could gab.

this past week has been an interesting one...
trish's ANC counts were really low, but on their way back up.
they are still technically low, but good enough to get her infusions.
the past week has by far been the best trish has felt since beginning the FEC+H regimen.
again, her ANC counts have nothing to do with how she feels, just how well her body reacts to germs/virus/infections. its been really nice to see her feeling good.

we still need to keep trish healthy, so we will keep her in a mini bubble... bella is gonna get kicked out in a week, and we will put the house on mini lock down again... the period of 7-10 days after the "big chemo day" is when her immune system will be its lowest, so we will be extra cautious during this time.

we have switched trish back to the "old" white cell drug, neupogen. so instead of coming in to the cancer center on saturday for her 1 shot of neulasta, ill begin giving her shots of neupogen again... 10 days in a row... oh joy.

trish has felt really good this past week, but we have been making sure we keep her in a clean environment. sunday we broke all the rules and had a party for caden's 2nd birthday. we had the part out front, and kept the house off limits, so most of the germies stayed outside..

so the week in review....
wednesday, thursday and friday:
pretty uneventful as i cant even remember what went on. i know we spent most of the week getting things ready for caden's birthday.

saturday 9/27:
hmmmm... saturday was a rough one, a really emotional day for us.

september 27th was the due date of our baby girl.

in the morning, trish, caden and I headed out to find the perfect tree at the redwood city nursery, so we could plant it in our backyard in memory of our little angel.
as we searched for a tree, it was obvious when we found the perfect one...

a 'pink weeping cherry tree', that will someday look like this as it grows up and begins blooming its flowers in the springtime.

we also came across an evergreen shrub that blooms small pink flowers in the winter and spring, called a 'pink breath of heaven' and felt this would be perfect in our front yard.

both will be beautiful additions to our home

ive spent the last couple weeks making a decorative concrete block that holds a recessed plaque inscribed with the touching words trish's brother, steve, wrote on april 17th, that will sit beside the tree.

the baby will forever be in our hearts.

sunday 9/28:
with the downs, comes the ups...

sunday was caden's 2nd birthday party, and it was pirate themed complete with a pirate bounce house and pirate's chest full of treasures for the kids to dig through and discover, eye patches, bandannas (trish had a nice pink pirate one on)
it was a really nice day with a bunch of caden's little friends. the kids had fun, and i think the parents did as well (even if we didn't have a tv with football on... sorry... house was on lock down from the germies). trish was able to get caught up with a lot of folks she hasn't seen in a while since she has been staying away from story time and the caden's gym class.

monday 9/29:
caden officially turned 2 on monday at 2:13pm.
at 5:30pm i brought caden to the pediatrician getting him looked at for a little cold. caden woke up with a really sneezing, runny nose and a puffy eye. we decided he shouldn't go to his gym class at the rec center. he was a happy little camper, but we wanted to get him looked at, more for trish's sake, in case it was an onset of pink eye or something funky... dr. lynch said it was just a typical kid cold, and not surprising since there was a bunch of kids together the previous day. his eye was just a little puffy from being congested, and nothing crusty or oozey to worry about.

tuesday 9/30:
its today again... and about 2:45pm now..
nurse denise has given trish her predrugs and zofran, and is gonna get started on the rest of the stuff soon.

we will be back tommorrow for a quick hydration, and again on friday for trish's second dose of 5-FU and another hydration...

ill post another update later, once the chemo is a flowin...

trish and i just want to congratulate trish's chemo buddy, christine, who finished up her chemo today!!
trish and christine have seen each other every other tuesday for several months here at the cancer center, and have shared a lot with one another. its great to see both of them on the home stretch.

4:15pm update
nurse denise is finishing up the push of trish's chemo drugs, and she will soon hang the 1 hour bag of cytoxan... after that we should be good to go home...

till then, we are watching christina applegate talking with oprah about her breast cancer & double mastectomy.

for our angel

Tuesday, September 23, 2008

the last day of round two...

so trish and i got to the infusion center today around 8:20am...
by 8:30am, we were sitting in window seat C4 awaiting the beginning of the end of round 2.

we are waiting on getting orders from the dr. carlson to run a blood test for trish.
typically trish doesn't get her blood counts on the 'herceptin only' days, as she can basically get the herceptin regardless of her counts.

her counts have been really low recently, so we want the piece of mind of knowing exactly where they are at... for better or worse..
so.. we will wait until we get the ok from the docs..

so the weekly rewind... let me see what i can remember..

last tuesday morning, we headed off to the stanford ER.. it ended up trish has a bacterial infection that some antibiotics knocked out. trish's blood counts were really good, eventhough she felt like crap for a little bit... but she did get her herceptin, and stayed on schedule.

she was released after an overnight stay in the hospital, and one of the dishcarge orders was to watch for any sores in her mouth. trish has been lucky throughout the chemo, and has only had one or two small sores that didn't last long.

a cold sore began developing on her lip, so we watched it.. she felt good, no fever, eating and drinking well. she heading to healing touch that evening for her standing appointment with chanda..

we went to the cancer center to have a doctor take a look at her cold sore. dr. holbrook kohrt was the oncologist on call, and he came in to take a gander at trish's cold sore.. he saw it, he wasn't concerned, said there wasn't any reason to prescribe even more meds.. he said it was more to do with the infection still lingering in her body than any chemo related stuff.. he said to keep it clean and it will go away in a few days, no biggie.. nice to know it wasn't anything to worry about.

the nurses also drew blood for some blood tests to make sure everything was looking good.

this past weekend was my sister, monya's, wedding in the san francisco. friday was the rehearsal, and trish was one of the bridesmaids. we decided trish has walked down enough aisles in her life that she could skip rehearsal, stay home and rest up for the big show on saturday. caden was the ring bearer, so caden and i drove up to SF on friday afternoon for the walk through. on our way up, trish got a call from the nurses at the cancer center letting her know the results of her blood counts.

unfortunately, trish's white counts had dropped to their all time low, 0.36, although her reds remained consistent hovering a bit above 33.

there was no way we could let trish be around so many people, without fearing for her health. a simple cold would surely result in days in the hospital battling it.
the wedding on saturday was sadly just not an option for trish. it was heartbreaking for trish, as she really wanted to be by my sisters side for the big day.
but trish's health is the most important thing right now... and that even meant kicking our dog out of the house for a while... sorry bella..

wedding day... trish felt great, looked great so it was crappy that she had to stay home. as much as we tried rationalizing a plan for her to make the ceremony, in the end, common sense prevailed.

caden and i left trish in the early afternoon to head up to the city.
it was sad heading up there without trish, but everyone, including monya & trish, knew it was for the best.

my sister looked beautiful, her husband, russ, was dapper, caden did a great job walking down the aisle/beach at crissy field, much to the aide of his new cousin in law, zoey... the adorable flower girl.
(my money was on the caden seeing the crowd and burying his head in the sand like an ostrich... dad was wrong & zoey kept him moving..)

it was a really nice day for monya & russ, and i have since shown trish plenty of video and pictures so its was almost as if she was there...

lazy day around the house.. the low counts haven't changed how she feels, again trish felt great and looked great... the cold sore is drying up and going away... trish finally gave in and tried out the new master shower.. (each of us wanted the other to use it first, so its sat unused for the last couple weeks).

caden, having never taken shower before loved it... once he realized he had a shower head that fit him... and it was removable... it was tough getting the kid out of the shower..

another good day.. trish was up early and did some chores around the house, some watering out back and playing with caden in the front...

our friend lyndee was nice enough to stop by and drop of some din din, and the (masked and purrelled up) newlyweds stopped by prior to their drive back to LA.


and here we are.... today...

9:20am: nurse kyla got the 'ok' for the blood tests, drew blood, gave trish her premeds of benadryl, decadron and pepcid... she will get her 1/2 hour of herceptin beginning around 10am..

trish is looking and feeling good. keeping her in a bubble the past few days has really helped keep her healthy. we are hoping her white counts are up... her bones have been realy achy the past few days and this has typically been a sign of her blood marrow working in overdrive to produce some whiteys...

the blood tests will give us some piece of mind of how drastically we need to treat bubble girl over the next few days... hopefully they are high enough where things are normal, and maybe the dog can come back home..

thanks for checking in... ill update trish's blood counts when i get them..
but this is the last treatment of round two... only 3 more weeks of visits to the infusion center before chemo is OVER.. 1 more big day next tuesday, followed by 3 short trips on friday, the following tuesday and the following, following tuesday!

only 21 days of chemo left, but who's counting...

caden & zoey heading down the aisle...

caden watching auntie M & uncle R
take pics after the ceremony

caden giving the new shower a try...

the afternoon update...
trish finished up her herceptin around 11:00am, and we headed home.

trish's neutrophil counts are still down, so we are gonna need to continue being careful with her.

blood counts:

white blood cells, Absolute neutrophil count (ANC):
was 0.36
is 0.78

* 1.4 is about the lowest she can go and still receive chemo. although she is low, the good news is that she more than doubled her count since friday. we expect this to continue to increase as the infection disappears and she finishes up her antibiotics in a few days.

nonetheless, we left a message for trish's nurse asking if we can get back on the neupogen shots that i was administering... they seem to keep her ANC counts more consistent than this once every three week neulasta shot..

red blood cells, hematocrit (HCT):
was 33.1
is 31.6

the white counts dont really have any bearing on how she feels...
aside from being tired (mentally and physically), she is feeling well.. eating/drinking relatively normal, but the infection has made her gums sore, so hard breads, cereals, etc have been uncomfortable for her.

the big concern with the low counts is that she is very susceptible to getting sick, and not having her immune system strong enough to fight off even common coughs, colds, flus, etc..

so as long as we keep her not sick... she will be fine... so while the stock market is a little shaky, it may be a good time to invest in purel & lysol cause we are going through it pretty quickly.

thanks for reading..

Wednesday, September 17, 2008

the update on why no update yesterday...

so yesterday was kinda hectic...

trish woke up at 3am with really crazy chills that she couldn't shake... we have seen plenty of side effects in the past 5 months, but nothing like this...
sweatshirt, sweatpants, down comforter, nothing helped get her warm...
after a long overdue trip to the bathroom, she felt much better was able to go back to sleep for a little bit.

the chills returned at 4am along with a fever, so we headed to the stanford ER.
trish got a nice private pediatric ER room, complete with an Apple computer on the wall with games and music, and a tv with some on demand disney kids movies.

so while i was honing my race car skills on some video game intended for 5 year olds, trish was catching the latest nancy drew movie.

meanwhile, the docs drew blood for tests and cultures, gave some IV's of antibiotics and hydration, and tossed in some ativan and zofran (meds trish takes each day) for good measure.

once 8am rolled around, i walked over to the cancer center and canceled trish's 8am appointment for her herceptin infusion, and talked with dr. carlson to let him know that trish was over in the ER.

by this time, trish's chills were long gone... fever was gone... she was warm, and she was feeling much better. she had an appetite, and felt 100% better than 3am.

the blood test came back, and her red and white counts were good, but some other test revealed she did have an infection and she was gonna continue on the antibiotics.

the nurses recommended we bring caden to his pediatrician to get him looked at as as a preventative measure...

so i left the ER at 1pm and went home to bring caden to his doctor, Dr. Lynch at the Palo Alto Medical Foundation. dr. lynch examined caden, and said we had nothing to worry about with him... he is a healthy, happy almost 2 year old. dr. lynch even gave trish a call later last night to check in her, as she was unaware of trish's diagnosis since caden has not been to see her since february.

caden and i then went home, and i dropped him off with my mom, and i headed back to the ER.

we were hoping the docs wouldn't admit trish to the hospital overnight, but they decided to. around 4:30pm, trish was moved to an actual hospital room and continued on her antibiotics and hydration. after the "hosptial" docs conferred with dr. carlson, they agreed to give trish her dose of herceptin to keep her on her tuesday schedule.

around 7pm ria came to hang out with trish, and i headed home so i could hang out with caden a little bit before his 8pm bedtime.

around 8:30pm, trish began on her typical trio of predrugs of benedryl, pepcid and decadron. the herceptin finished up around 10:30pm.

so now its today, wednesday...

im sitting in trish's hospital room and while we listen to the thunder of the life flight helicopter taking off, we are also counting the hours before her supposed 1pm release.

she is still feeling good, no fever, the typical nausea that she is taking zofran for, and thats about it... she is a little sleepy tired, and she didn't get as good as night rest as hoped, but trish said she had a really nice hour long conversation with her nurse at 3am.

trish woke up and ate a good breakfast, and is looking forward to heading home and hanging out with the little guy. until then, she is reading her new, new favorite book.. the follow up to Kris Carr's first book Crazy Sexy Cancer Tips, called Crazy Sexy Cancer Survivor: More Rebellion and Fire for Your Healing Journey...
looks like its as much of a workbook as a book to read. lots of spots to put down your own thoughts, goals, experiences, etc... trish has really been enjoying the book.

so its been a long 32 hours, but things are much better.

at 11:00am and dr. heather wakelee, along with her crew of med students and doctors, just gave trish the go ahead to head home... she is gonna prescribe some antibiotics to continue on for the next week, but thinks trish is fine.

now we just need to wait on the paperwork so we can do as the sheep herder does...

get the flock out of here..

just another crazy sexy cancer day...

12:50pm update:
supposedly we will be out of here in 20 minutes or so...

so much for being 'released' at 11am

1:20pm update:

we are on our way out... here is a pic from a few minutes ago...
looking good and feeling good..

Friday, September 12, 2008

a quick update...

this week has been completely different for trish compared to the first week of round one. trish's appetite has been good, and she has been drinking plenty of liquids.

while she still has some nausea, its been manageable and she hasn't thrown her cookies around anywhere. trish says the nausea is consistently 4-5 on the "1 - 10" scale, but may have spiked around 6... much better than the perfect 10 she scored a few weeks back.

her big infusion day... tired and nauseated at night, as expected... but no fever and she slept well.

woke up feeling decent. went back to cancer center that evening to get hydration. she went to the restroom twice during the 1 liter hydration IV, and once right when she got home. peeing it out is a good thing... it means she is well hydrated, and her body isn't absorbing much of the fluid, cause its already got fluid... but we would rather make sure she is well hydrated, than not.

trish finished up the last of her emend pills in the morning, relaxed during the day, and went to healing touch in the evening...
another day of feeling decent and controlling the nausea...

8:30am: we arrived back at stanford sitting in the infusion treatment area for trish's second dose of 5-FU & another round of hydration.

8:45am: we had the pick of the liter as we were the first ones in the "C" room, and chose window seat C5

9:30am: nurse jackie started trish on her hydration, which should take 90 minutes

9:45am: trish got a zofran shot into her IV

she will get her 5-FU shot in a bit... that only takes 10 minutes, and she has another hour or so of hydration to go... so its no rush.

although trish is feeling pretty good so far, i think it will only get better over the next 17 or so days.

we will come back tommorrow (saturday) for trish's neulasta shot, and then come back each of the following tuesdays for herceptin.

she is not scheduled for any other hydrations, and to my untrained eye i dont think she needs them.

thanks for checking in...

Thursday, September 11, 2008

Happy Birthday Oak!!

We just wanted to send a very big happy birthday wish to Oak today!! He has done such an awesome job keeping everyone updated on all the happenings at the Barrett home, all the while managing to insert a bit of humor in a very unfunny situation (and it works!). We appreciate all that you're doing. We know life has thrown you all quite a curveball but you're hitting it out of the park every time.

Oak, have a great one!


Your family

Tuesday, September 9, 2008


round two of three of the FEC+H is underway at Six Flags ChemoLand...

9:00am: arrived for blood draw, yep... stairs...

9:20am: nurse terry finished up the blood draw

9:30am: went downstairs and checked in with dr. carlson's office

9:35am: got into an exam room

9:40am: angela, a medical student working with dr. carlson came in to examine trish

10:30am: dr. carlson came in and examined trish

11:00am: heading upstairs to the ITA with a prescription of emend

11:30am: trish got a bed in suite B6

12:00pm: pepcid & decadron done

12:25pm: benadryl done

12:45pm: zofran done

1:10pm: nurse chris finished up the manual push of the epirubicin & 5-FU, and hung the cytoxan up on the rack...

2:00pm: cytoxan done, herceptin nextin

so we met with dr. carlson this morning. he continues to be pleased with trish's response to the treatment, but was a little concerned with her rough couple weeks. he believes the sickness getting tossed around the family had a lot to do with trish's discomfort, but nonetheless we are taking a coupla extra steps this week to make sure the next coupla weeks are as smooth as caden's ass.

1. trish took the emend pill about a couple hours before any chemo entered her bloodstream (she will take this pill again on wed & thur)

2. we will be coming back for hydration twice this week... once tomorrow, and again on friday when we are here anyway for the second dose of 5-FU.

hydration will be a one liter IV of some fancy medical grade gatorade and will take an hour or so. this will help ensure trish has plenty of fluids in her whether she needs them this week or not. at this point, we would rather be proactive as opposed to being reactive and trying to play catch up with fluids at 2am in an emergency room.

we also talked to the doc about what the next few months hold for us, and this is pretty much the break down:

october 14th: last day of chemo

surgery will be at least 3 weeks later

radiation will begin at least 3 weeks after surgery (radiation will be 5 times a week, for 5 weeks

so theoretically, if my public school calendar math is correct, and we can get all the appointments scheduled on the perfect 3 week intervals... trish could be finished with surgery and radiation two days before christmas.

in reality, everything would need to fall into place scheduling wise, moons would need to align, doctors from different departments would need to have open schedules, etc..
let alone the fact that this is all driven by trish's body... the three weeks after chemo is to allow her blood counts to come back up... the three weeks after surgery is to allow for her body to heal... there is no need to be rushing things just so we can hit a certain date.

we already knew that trish will continue on the hormone therapy, herceptin for a year...
what we found out today is that will be once every 3 weeks, not every week... so that will make the coming year a little easier. 18 trips to stanford sounds a lot better than 52.

trish's blood counts are up and down...

blood counts:

white blood cells, Absolute neutrophil count (ANC):
was 2.14
is 1.63

* this is the second week that it has dropped, but dr. carlson told us not to worry.
trish will get her neulasta shot on saturday that will help increase her white counts.
the doc said as long as trish is within 'chemo range' and is feeling good, that's all that maters. playing the numbers game each week will just drive us nuts.

so with that said, lets play the numbers game... :)

the reds are WAY UP... !!!!

red blood cells, hematocrit (HCT):
was 26.1
is 35.2

* trish began chemo weeks and weeks and weeks ago (april 22) at 34.5, so that two unit blood transfusion this past friday really helped her out. her energy is back, and is feeling the best she has in weeks.

so... for the week in review... its been yet another hectic one...

tuesday 9/2:
back at stanford for her last herceptin treatment of Round 1. trish had fever that night of ~ 100.8

wednesday 9/3:
after talking dr. carlson's nurse, jan... we went back to the cancer center for some blood tests. jan lectured us (in a loving nurse kinda way) about not calling her sooner when trish's temperature was running towards the hot side.

we found out today that the two blood cultures they took, 1 from her arm, 1 from the port, came back clean... nothing funky grew in them. but they wanted to make sure there wasn't any type of infection in her port.

jan sent us home with the augementin, and that night trish began taking them when her temperature went up to 101.7.

we had a great dinner of stuffed chicken and rice, courtesy of trish's old co-worker sarah.

thursday 9/4:
the fine folks at GSK make a great antibiotic, as the augementin has rid trish of her fever, and she is feeling better, but still fatigued.

friday 9/5:
an emotional day... we woke up early and headed up to the cow palace in daly city to wish the 3 Day walkers well. later in the morning we headed back to the cancer center for trish's blood transfusion. again, no fever.. the blood went smoothly and took about 3 1/2 hours

you can see pictures from Day 1 of the 3 Day here

saturday 9/6:
trish took it easy... the benefits of the transfusion had't hit her yet, so she relaxed around the house... again, no fever... trish had a suprise visit from birthday girl becky, brie, monica and christina... so the girls got to sit and talk about the boys for a little bit while this boy was busy playing plumber. our master bathroom shower is nearing completion... all we need now is a shower door.
the 3 shower heads, 4 body jets and 24 square feet of body cleansing goodness is working... plenty of room for trish, caden, me and bella... ok, i agree... thats just plain weird...

toilet: check
tub: check
shower: check
sink: yeah, yeah... im working on it.. wash your hands in the tub for now :)

sunday 9/7:

it was a big day...

sunday was the 5 month anniversary of trish's diagnosis.
sunday was the closing ceremonies of the 3 day walk.
sunday was the best trish has felt in weeks.

this cancer stuff is weird.

in many ways, the last 5 months have flown by... but at the same time the last 5 months have felt like an eternity.

our lives have been consumed by the this cancer thing...
we have learned a lot, received a lot, and hopefully we have been able to teach a lot as well...

all in all, i think we have been doing really good with it, buts its been all the friends and family, all of you, thats helped make it easier on us.

trish has her ups and downs, and given the choice, we would all choose not to have any of this, but in the big picture, we all are doing well and hanging in there.

we have learned to adapt, learned what to expect, learned what not to expect, learned how to better manage our time and learned how to make it as "normal" as we can on caden...

he will turn two at the end of this month, and is at a great age where he doesn't really care whats going on...

he doesn't care if there is hair or no hair.

he doesn't care if we are home all day long, or if we need to sneak of to the cancer center, as he loves spending time with grammi claudia, oma ria, opa judas & cousin lucas.

as long as caden has a sippy cup with some juice, a toy truck in one hand, a toy tool in another and some fruit to much on, he is a happy camper...

even if his mama is a little tired, he loves to hang out with her all day long, whether it be in bed or in the back watering the garden, or our in front playing in his swimming pool.

caden loves his mama, regardless.

every day is a great day for him, and thats what we think as well.

so on sunday, trish was feeling much better than the previous couple weeks. in the early afternoon, with caden in tow, we headed up to san francisco for the closing ceremonies of the 3 Day walk, and to congratulate all the members of "Trisha's Trailblazers". about 20 minutes into our search for a parking spot, caden decided to choke on a tortila chip and toss his cookies all over himeself, his clothes, the backseat & the carseat...

just another normal day in our not so normal life.

later in the day, as the closing ceremonies were about to the begin, trish headed off with her mom, ria... ria was asked to be the flag bearer for the "I walk for my daughter" flag. so during the closing (and opening) ceremonies, ria walked out on stage, in front of the thousands of walkers/supporters/volunteers, waving the the flag in support of her daughter.

the closing ceremonies were a little bit more special, as trish was on stage with her mom.

it was a very emotional day for trish... for all of us...
trisha's trailblazers and every other team in the walk all did such a tremendous job of raising money and awareness of breast cancer.
i think the final tally for the SF walk some north of $4 million dollars.

it was a very special experience to be able to witness.

you can see pictures from Day 3 of the 3 Day here

we got home sunday night around 8pm to a beautifully decorated house. we later found out the secret decorators were none other than Mr. and Mrs. P.
Ron & Dianne Puccinelli, the in-laws of one of the Trailblazers, anna.... and the father of our longtime friend ron, who was a groomsman in our wedding.

thanks guys, the pink streamers, balloons, signs, etc... were a great end to an emotional day. trish got a little teary eyed (again), but we had to push them tears back in so she didn't dehydrate herself... ;)

monday 9/8:
feeling really good, trish spent the morning shopping with her dad, judas, and the afternoon hanging out at home with caden. we had a nice brisket stew and spinach salad lunch brought to us by trish's old boss, kim, and we had a tasty meatloaf dinner from neighbor bonnie and family... im sure all that red meat and iron helped push trish's red count over the top :)

tuesday 9/9:
feeling the best she has in weeks, we are back at stanford getting knocked down again.. but this week is gonna be different... its gonna be better... and she is gonna kick ass.

the cytoxan just finished up... trish has been sleeping like a newborn for a couple hours..

we should be out of here in the next 45 minutes..

our special guest star today is long time family friend, steph... she stopped by at the perfect time, right after the nurses woke trish, and 30 minutes before the end of the day.

all in all, the day went smoothly... and sometimes it odd how fast a 6 hour day at C-town can be..

thanks for checking in...

trish & ria, on stage at the 3 Day closing ceremonies

trish & steph

the work of mr. & mrs. p

thanks ron & dianne

the almost done, but functional i might add, master shower

inside the shower