This is the Consolidation Chemotherapy plan:
Days 1, 3 and 5 Courtney will receive two doses of Ara-c (Cytarabine) separated by 12 hours. Days 2 and 4 she will sit around and do nothing – as far as chemotherapy is concerned. She will probably do a lot of talking. She’s always been easy to talk to, but lately she’s been especially chatty. It’s been a lot of fun just listening to her. I wish I didn’t have to work, so I could spend more time with her. But I’m grateful for the nights that I’ve been able to stay with her and grateful to my mom for helping taking care of the kids and the house so I can have this time with Courtney.
So, today was chemotherapy free once the 2nd dose finished early this morning. She had a really good day, with the exception of some headaches. Hopefully that will be the worst of her stay here, and hopefully they won’t last much longer. Her next dose of chemotherapy begins tomorrow at noon. Each dose takes about 3 hours to administer. So far, not so bad.
Courtney
taken 8/4/07
Courtney and her kids
taken 8/4/07
Tuesday, October 30, 2007
Monday, October 29, 2007
Day 1 Consolidation
New round of chemotherapy and new hospital. After meeting with Dr. V last Thursday and deciding that we would proceed with a bone marrow transplant, we also decided Courtney would undergo the recommended round of consolidation chemotherapy under her care at UT Southwestern. We figured that since she would be going there for the transplant, we might as well go there now, allowing ourselves a chance to get to know the doctors and facilities, and allowing the doctors the opportunity to become familiar with Courtney. This way they will have a few weeks of first hand knowledge or her condition and reactions to the chemotherapy and other medications before the transplant procedure begins.
The hardest part about switching facilities is leaving behind the awesome nurses, techs and doctors that became like family during our stay at Harris Methodist. However, so far, everyone here at Zales has been great. And we have to admit the room is quite a bit nicer than her room at Harris Methodist. Note to Harris Methodist, the onocology floor is well past time for a serious makeover. A simple fresh coat of paint would go a long way. And get rid of the bump at the entrance to the bathroom; it’s a pain trying to get the IV pole over that all the time. A couple of little extra perks include a small fridge and dvd player. These small things just help ease the burden of being away from home, especially during an extended period of time.
So, the first day of consolidation came and went fairly quickly. We checked in shortly before 8:00 AM. At around 9:00 AM Dr. V came in with her PA (Laura), and the PharmD who will be verifying her chemo treatment. They said they would put a PICC line in, but this time they would use flouroscopy to see the line as it went in. At 9:30, Laura said Radiology was booked for the day and that she couldn't get her PICC until tomorrow, but would have Dr. V call down and use her influence. At 10:15, Laura came back to tell us she was on the schedule for Noon. Five minutes later, her nurse came in and said they were on their way to get her. By 11:30 she was back in her room after a flawless PICC line installation in her left arm. She flew through it without a single sedating drug and only local anesthesia! Much better than last time!!
Less than two hours later, Dr. Rohm came in to give her a spinal tap. This was a precautionary procedure to check her spinal fluid for leukemia. There are some forms of AML that appear in the spinal fluid and have to be treated with specific drugs. While they didn’t think her type would have this, they just wanted to make sure. This was obviously not a pleasant experience for Courtney. The main side effect has been head aches, but she’s doing great.
Laura the PA gave us some for information about the chemo and the duration of her stay. It will be similar to induction, with side affects occuring a week to 10 days later and her counts dropping to zero and going back up at a similar rate to what we saw last time. If she has a fever over 100.6 at any time, she will probably stay in the hospital until her neutrophils are back to 1000. If she looks good after the treatment, she will probably be sent home with instructions to return every other day. If during that time she gets a fever, she will probably be readmitted. Just like the induction treatment, she will need blood and platelet transfusions as her bone marrow goes off line. If she's not in the hospital, they will do the transfusions in the clinic as needed. They plan to leave her PICC line in when she goes home and set up a home health nurse to flush the line as needed. So, while were planning to be able to go home at the end of the week, we’re prepared to stay for the next 3 to 4 weeks if necessary.
The hardest part about switching facilities is leaving behind the awesome nurses, techs and doctors that became like family during our stay at Harris Methodist. However, so far, everyone here at Zales has been great. And we have to admit the room is quite a bit nicer than her room at Harris Methodist. Note to Harris Methodist, the onocology floor is well past time for a serious makeover. A simple fresh coat of paint would go a long way. And get rid of the bump at the entrance to the bathroom; it’s a pain trying to get the IV pole over that all the time. A couple of little extra perks include a small fridge and dvd player. These small things just help ease the burden of being away from home, especially during an extended period of time.
So, the first day of consolidation came and went fairly quickly. We checked in shortly before 8:00 AM. At around 9:00 AM Dr. V came in with her PA (Laura), and the PharmD who will be verifying her chemo treatment. They said they would put a PICC line in, but this time they would use flouroscopy to see the line as it went in. At 9:30, Laura said Radiology was booked for the day and that she couldn't get her PICC until tomorrow, but would have Dr. V call down and use her influence. At 10:15, Laura came back to tell us she was on the schedule for Noon. Five minutes later, her nurse came in and said they were on their way to get her. By 11:30 she was back in her room after a flawless PICC line installation in her left arm. She flew through it without a single sedating drug and only local anesthesia! Much better than last time!!
Less than two hours later, Dr. Rohm came in to give her a spinal tap. This was a precautionary procedure to check her spinal fluid for leukemia. There are some forms of AML that appear in the spinal fluid and have to be treated with specific drugs. While they didn’t think her type would have this, they just wanted to make sure. This was obviously not a pleasant experience for Courtney. The main side effect has been head aches, but she’s doing great.
Laura the PA gave us some for information about the chemo and the duration of her stay. It will be similar to induction, with side affects occuring a week to 10 days later and her counts dropping to zero and going back up at a similar rate to what we saw last time. If she has a fever over 100.6 at any time, she will probably stay in the hospital until her neutrophils are back to 1000. If she looks good after the treatment, she will probably be sent home with instructions to return every other day. If during that time she gets a fever, she will probably be readmitted. Just like the induction treatment, she will need blood and platelet transfusions as her bone marrow goes off line. If she's not in the hospital, they will do the transfusions in the clinic as needed. They plan to leave her PICC line in when she goes home and set up a home health nurse to flush the line as needed. So, while were planning to be able to go home at the end of the week, we’re prepared to stay for the next 3 to 4 weeks if necessary.
Saturday, October 27, 2007
I would have to say, and Courtney is sitting here agreeing with me, that today is the best day she’s had, physically and emotionally, since September 15th, when she first started feeling sick. She was up and about quite a bit, as witnessed by many of our friends we were able to see at our church’s Trunk or Treat.
The Trunk or Treat has become somewhat of a tradition for us. Each year around Halloween, families gather and park in the church parking lot and hand out candy to trick or treaters as they walk from car to car. We really enjoy it as it’s a safe and easy way for kids to trick or treat. You don’t have to worry about crossing streets, about strangers, or about dark houses. And everybody is home. And with cars only separated by a foot or two, the kids can hit a lot more cars in an hour than they ever could houses. This year the Trunk or Treat was especially great, since it allowed Courtney the opportunity to see the kids in their costumes and be with them trick or treating before she has to go back to hospital where she will be when Halloween actually comes around.
So, here’s the revised plan:
• Monday, October 29th, Courtney will be admitted to the hospital for five days of consolidation chemotherapy. Her doctor expects her to be released from the hospital on Saturday if all goes well.
• Next Friday, November 2nd, we should find out if any of Courtney’s other siblings are matches for a stem cell transplant.
• About four weeks after her consolidation treatment, Courtney will go to the Bone Marrow Transplant clinic for a couple days of physical examination, where they will make sure she is physically and emotionally fit for the transplant.
• If she passes her physical, she gets to play ball, and about a week later she’ll be admitted to the hospital for hopefully the last time.
• Eight days after admission and after a few days of more chemotherapy, Courtney will actually receive the stem cell transplant, which is more or less a blood transfusion.
• After the actual transplant, she will experience a couple of weeks similar to what she experienced after receiving her first round of chemotherapy (the induction chemotherapy.)
• Two to three weeks after the transplant, when her bone marrow is back to working properly and her WBC’s are back to normal, Courtney will be discharged from the hospital for the last time!
So, if you look at your calendars and follow the above timing, she will likely be in the hospital through Christmas, but coming out sometime before or after New Year’s. Courtney keeps saying she’s looking forward to starting 2008 cancer free! What a great blessing that would be!
We know for a fact that prayers work and have been answered throughout this entire process. We are again so thankful for the countless blessings that have come to us by way of so many wonderful friends and family members. We truly couldn't have made it this far so easily without all of the prayers and support. Thank you again!
Here are some pics from tonight!
The Trunk or Treat has become somewhat of a tradition for us. Each year around Halloween, families gather and park in the church parking lot and hand out candy to trick or treaters as they walk from car to car. We really enjoy it as it’s a safe and easy way for kids to trick or treat. You don’t have to worry about crossing streets, about strangers, or about dark houses. And everybody is home. And with cars only separated by a foot or two, the kids can hit a lot more cars in an hour than they ever could houses. This year the Trunk or Treat was especially great, since it allowed Courtney the opportunity to see the kids in their costumes and be with them trick or treating before she has to go back to hospital where she will be when Halloween actually comes around.
So, here’s the revised plan:
• Monday, October 29th, Courtney will be admitted to the hospital for five days of consolidation chemotherapy. Her doctor expects her to be released from the hospital on Saturday if all goes well.
• Next Friday, November 2nd, we should find out if any of Courtney’s other siblings are matches for a stem cell transplant.
• About four weeks after her consolidation treatment, Courtney will go to the Bone Marrow Transplant clinic for a couple days of physical examination, where they will make sure she is physically and emotionally fit for the transplant.
• If she passes her physical, she gets to play ball, and about a week later she’ll be admitted to the hospital for hopefully the last time.
• Eight days after admission and after a few days of more chemotherapy, Courtney will actually receive the stem cell transplant, which is more or less a blood transfusion.
• After the actual transplant, she will experience a couple of weeks similar to what she experienced after receiving her first round of chemotherapy (the induction chemotherapy.)
• Two to three weeks after the transplant, when her bone marrow is back to working properly and her WBC’s are back to normal, Courtney will be discharged from the hospital for the last time!
So, if you look at your calendars and follow the above timing, she will likely be in the hospital through Christmas, but coming out sometime before or after New Year’s. Courtney keeps saying she’s looking forward to starting 2008 cancer free! What a great blessing that would be!
We know for a fact that prayers work and have been answered throughout this entire process. We are again so thankful for the countless blessings that have come to us by way of so many wonderful friends and family members. We truly couldn't have made it this far so easily without all of the prayers and support. Thank you again!
Here are some pics from tonight!
Thursday, October 25, 2007
Day 34 - The BMT Visit
Courtney had a lot of ups and downs today – literally and figuratively. She started off with her best night’s rest in a long time (thank you, Barb), but woke up in the wee hours of the morning with more stomach aches. The pain and discomfort continued throughout the day until we left for the appointment at the Bone Marrow Transplant Center.
The BMT Center was very nice. Everyone, from the receptionist, to the Physicians Assistant, to the Doctor were very accommodating and extremely likeable. We received more information regarding Courtney’s condition and treatment in less than an hour than we have since she was first diagnosed. They laid out the plan for more chemotherapy and ultimately the bone marrow transplant. It was a lot of good information to digest, bringing with it some big decisions to make.
By the end of the visit, Courtney was feeling much better. We had a nice dinner, courtesy of Courtney’s mom, who actually flew in for the day to attend the appointment and help us to gather information and ask the right questions. Courtney was feeling so well when we got home that she was actually able to walk up and down the stairs in our house for the first time since returning home. This was great as she was able to tuck the kids into bed for the first time in over a month. It’s funny how the seemingly small things become cherished moments when you’re not able to do them for such a long time.
The BMT Center was very nice. Everyone, from the receptionist, to the Physicians Assistant, to the Doctor were very accommodating and extremely likeable. We received more information regarding Courtney’s condition and treatment in less than an hour than we have since she was first diagnosed. They laid out the plan for more chemotherapy and ultimately the bone marrow transplant. It was a lot of good information to digest, bringing with it some big decisions to make.
By the end of the visit, Courtney was feeling much better. We had a nice dinner, courtesy of Courtney’s mom, who actually flew in for the day to attend the appointment and help us to gather information and ask the right questions. Courtney was feeling so well when we got home that she was actually able to walk up and down the stairs in our house for the first time since returning home. This was great as she was able to tuck the kids into bed for the first time in over a month. It’s funny how the seemingly small things become cherished moments when you’re not able to do them for such a long time.
Wednesday, October 24, 2007
Day 33 - A Donor!
This morning Courtney received a call from her sister, Tracy, who is now back in Italy. Tracy found out today that she is a match for a bone marrow transplant for Courtney! So far she is the only one to be tested. Courtney has two other sisters and a brother who are all planning to be tested as well. It's nice to be 1 for 1.
We’re not sure how having a donor will affect the chemotherapy treatment schedule, or how soon the transplant would take place. We have an appointment with the UT Southwestern Transplant Clinic tomorrow afternoon. Hopefully we’ll find out exactly what to expect in the coming weeks.
Courtney continues to see physical improvements daily. Today was by far her best feeling to date. She was up and about quite a bit and even got out of the house for awhile. Her biggest issues continue to be abdominal pain, tiredness and muscle fatigue. These are more than likely due to a combination of the lingering effects of the chemotherapy, the lengthy hospital stay, and the medications she’s taking. All of these will hopefully subside before her next round of treatment. In the meantime, she continues to eat fairly well and does what exercises she can. She was shown some great little exercises by the physical therapist at the hospital.
Her spirits are lifted daily as she’s able to visit with more friends and reconnect with her “normal” life that was suddenly and drastically put on hold more than five weeks ago. She’s also lifted up by the many small and not so small acts of kindness by friends and family near and far. This evening we received a surprise visit from the Young Women of our church. Unfortunately their visit had to remain on the doorstep and free of much wanted hugs as Courtney still has to be vigilant is staying away from germs. The wonderful young ladies brought over cute blankets they had tied and stuffed animals for each of our four children!! Thank you!!!
Also this evening, Courtney received a much needed professional massage that she described as “awesome” from a friend from church. I honestly haven’t seen her smiling so big and looking so content in a long time. After so many nights in a hospital bed, her back has been quite achy. It’s amazing what good rub down can accomplish. I think she’s really going to sleep much better tonight.
So, despite the horrendousness of cancer and all the pains that come with it, we continue to count our blessings and are constantly amazed by the plentitude that continue to come our way. It is our firm belief that God’s love is expressed through the kind actions and generosity of those around us. We are so very thankful to all of those who have given their time, talents, energy, money, and prayers (so very many of which have been answered), helping us to feel an overwhelming amount of God’s love at a time when we most need it. We hope and pray that your lives are blessed tenfold in return.
We’re not sure how having a donor will affect the chemotherapy treatment schedule, or how soon the transplant would take place. We have an appointment with the UT Southwestern Transplant Clinic tomorrow afternoon. Hopefully we’ll find out exactly what to expect in the coming weeks.
Courtney continues to see physical improvements daily. Today was by far her best feeling to date. She was up and about quite a bit and even got out of the house for awhile. Her biggest issues continue to be abdominal pain, tiredness and muscle fatigue. These are more than likely due to a combination of the lingering effects of the chemotherapy, the lengthy hospital stay, and the medications she’s taking. All of these will hopefully subside before her next round of treatment. In the meantime, she continues to eat fairly well and does what exercises she can. She was shown some great little exercises by the physical therapist at the hospital.
Her spirits are lifted daily as she’s able to visit with more friends and reconnect with her “normal” life that was suddenly and drastically put on hold more than five weeks ago. She’s also lifted up by the many small and not so small acts of kindness by friends and family near and far. This evening we received a surprise visit from the Young Women of our church. Unfortunately their visit had to remain on the doorstep and free of much wanted hugs as Courtney still has to be vigilant is staying away from germs. The wonderful young ladies brought over cute blankets they had tied and stuffed animals for each of our four children!! Thank you!!!
Also this evening, Courtney received a much needed professional massage that she described as “awesome” from a friend from church. I honestly haven’t seen her smiling so big and looking so content in a long time. After so many nights in a hospital bed, her back has been quite achy. It’s amazing what good rub down can accomplish. I think she’s really going to sleep much better tonight.
So, despite the horrendousness of cancer and all the pains that come with it, we continue to count our blessings and are constantly amazed by the plentitude that continue to come our way. It is our firm belief that God’s love is expressed through the kind actions and generosity of those around us. We are so very thankful to all of those who have given their time, talents, energy, money, and prayers (so very many of which have been answered), helping us to feel an overwhelming amount of God’s love at a time when we most need it. We hope and pray that your lives are blessed tenfold in return.
Monday, October 22, 2007
Day 31 - Home At Last!!
Courtney is finally home and hospital free – at least for the next seven nights! It was such a great sight to see her and the kids together again after more than two weeks. The look on their faces when they saw her walk in the door was priceless. They all had a nervous look to their exuberance, not sure what to make of a bald mommy. They all quickly overcame the uncertainty of Courtney’s new look, and quickly started showing her things they had made and telling her all they had done while she was away.
As far as Courtney’s physical condition is concerned, the past two days have been superbly uneventful. She did have a couple of fevers Saturday night and into Sunday (none last night or today!), that made us question whether or not she would get to come home today, but, other than that there is really nothing worth noting. Her blood counts are almost completely within normal. Her WBC’s and neutrophils are within normal, as are her platelets and hemoglobin. After more than 30 days of abnormal results, it’s really nice to finally see some normalcy.
Last night was difficult as Courtney had to say goodbye to her sister Tracy as she left early this morning to return to Italy, where her husband Shawn is stationed with the Army. She really enjoyed having her around this past week. It had been over two years since they last saw each other, and they had a good time reconnecting. It’s just too bad that it couldn’t be under circumstances that were more fun. It’s hard saying goodbye to the ones you love, especially when you’re not sure how long it will be until you’re able to see them again.
Tonight will be the first night in over a month that Courtney won’t be woken up at 4:30 AM to have blood taken, nor at 7:00 AM to have her vitals checked. We’re hoping she gets a really good night of rest in her own bed without the disturbances. She’s had a long day and really needs it.
Her main battle this week will be trying to regain some of her strength that she lost while confined to her hospital bed for so long. It’s amazing how quickly muscles atrophy when not used. She was unable to go up our stairs or pick up Aidan today. I think she’d really like to be feeling better physically before starting the next round of chemotherapy. This week she’ll have to balance getting plenty of rest while doing what she can to use her muscles and build them back. I have a feeling this next week will fly by. For once I wish we could slow down the clock – at least for the next seven days.
As far as Courtney’s physical condition is concerned, the past two days have been superbly uneventful. She did have a couple of fevers Saturday night and into Sunday (none last night or today!), that made us question whether or not she would get to come home today, but, other than that there is really nothing worth noting. Her blood counts are almost completely within normal. Her WBC’s and neutrophils are within normal, as are her platelets and hemoglobin. After more than 30 days of abnormal results, it’s really nice to finally see some normalcy.
Last night was difficult as Courtney had to say goodbye to her sister Tracy as she left early this morning to return to Italy, where her husband Shawn is stationed with the Army. She really enjoyed having her around this past week. It had been over two years since they last saw each other, and they had a good time reconnecting. It’s just too bad that it couldn’t be under circumstances that were more fun. It’s hard saying goodbye to the ones you love, especially when you’re not sure how long it will be until you’re able to see them again.
Tonight will be the first night in over a month that Courtney won’t be woken up at 4:30 AM to have blood taken, nor at 7:00 AM to have her vitals checked. We’re hoping she gets a really good night of rest in her own bed without the disturbances. She’s had a long day and really needs it.
Her main battle this week will be trying to regain some of her strength that she lost while confined to her hospital bed for so long. It’s amazing how quickly muscles atrophy when not used. She was unable to go up our stairs or pick up Aidan today. I think she’d really like to be feeling better physically before starting the next round of chemotherapy. This week she’ll have to balance getting plenty of rest while doing what she can to use her muscles and build them back. I have a feeling this next week will fly by. For once I wish we could slow down the clock – at least for the next seven days.
Saturday, October 20, 2007
Day 29 - I Will Be Here
Courtney's first full day in the hospital, free of tubes and IV's, has left me little to say or update regarding her treatment. She did start a new medication that had interesting side effects that affected her vision, thoughts and speech. She's supposed to take it for the next 21 days, but is going to ask for something else if the side effects persist.
Her WBC's are still increasing steadily upward, approaching the normal range. Her neutrophils were actually within the normal range as were her plateletts!! Also, her day was fever free. If she keeps this up, 48 hours from now she will be sleeping soundly in her own bed.
Today was, for the most part, a great day of visiting with family and friends. My sister Molly arrived this morning for the weekend. Also, Courtney's brother Chris came back to town, this time with his wife, Leticia, and their two precious children, Lindsey and Christiana. Courtney spent most of the day with her parents and had a really nice visit with Leticia.
I took the kids, my mom and sister to the second garage sale held for Courtney. It's still so overwhelming to see all the people giving so much of their time to help us! Thank you, thank you, thank you for all your support!!! Later, I was able to take the three girls one at a time to our local fire station for flu shots. It's so much easier when they can't see the others getting theirs. The flu shots are one more thing that will help Courtney and ease some of her fears of coming home. She gets hers tomorrow.
We really had a lot of fun today. It's always so bittersweet to have a good day without Courtney around, knowing that she's stuck in the hospital and knowing that she would give anything to be with us. I can wait for the day that we can go back to having our normal family fun.
On the way home from visiting her in the hospital tonight, I listend to a song for the first time in a long time. It's on a CD that I made for Courtney shortly after we were married. The lyrics were significant then, but their significance today brought tears to my eyes. I couldn't resist putting it here, to share with her and with all of you who have been here for us.
Steven Curtis Chapman - I Will Be Here
Her WBC's are still increasing steadily upward, approaching the normal range. Her neutrophils were actually within the normal range as were her plateletts!! Also, her day was fever free. If she keeps this up, 48 hours from now she will be sleeping soundly in her own bed.
Today was, for the most part, a great day of visiting with family and friends. My sister Molly arrived this morning for the weekend. Also, Courtney's brother Chris came back to town, this time with his wife, Leticia, and their two precious children, Lindsey and Christiana. Courtney spent most of the day with her parents and had a really nice visit with Leticia.
I took the kids, my mom and sister to the second garage sale held for Courtney. It's still so overwhelming to see all the people giving so much of their time to help us! Thank you, thank you, thank you for all your support!!! Later, I was able to take the three girls one at a time to our local fire station for flu shots. It's so much easier when they can't see the others getting theirs. The flu shots are one more thing that will help Courtney and ease some of her fears of coming home. She gets hers tomorrow.
We really had a lot of fun today. It's always so bittersweet to have a good day without Courtney around, knowing that she's stuck in the hospital and knowing that she would give anything to be with us. I can wait for the day that we can go back to having our normal family fun.
On the way home from visiting her in the hospital tonight, I listend to a song for the first time in a long time. It's on a CD that I made for Courtney shortly after we were married. The lyrics were significant then, but their significance today brought tears to my eyes. I couldn't resist putting it here, to share with her and with all of you who have been here for us.
Steven Curtis Chapman - I Will Be Here
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