Another kink, another new treatment

Chemo is never a walk in the park. Each one brings its own set of side effects. The one that I have been on for awhile, Doxil, started breaking my skin down- including my mouth with bad ulcers. The dose of Doxil was increased when we stopped the other chemo, Carboplatin, which lead to more issues with my skin and mouth. The worst of it was the week before we were going to the beach with my side of the family. I came home from work and took my socks off, my feet were bright red and stinging/burning. The back of my arms felt like they were on fire, my left side was the worst.

 My instructions were to keep them moisturized, stay off my feet as much as possible, and avoid the heat and sun. Hard to do all of that when heading to the beach, but sacrifices had to be made. We rented a beach wheelchair so Wil was able to push me for walks on the beach in the cool of the evening. I spent most of my time inside reading or playing games with others. Even though it wasn't the normal beach trip, it was still great being able to spend time with our family. 

 We had to push chemo back a week on June 19th because my skin still needed time to heal. If I would have had chemo too soon, my skin would pay the consequence. That means it would be scheduled while Wil was going to Alaska for a fishing trip. He was going to just cancel it but I convinced him that I had been doing so well that we could make it work for him to go. My sister, Lauren, came up for chemo and helped me get the kids off the morning of. My in-laws helped watch the kids so I could rest. 

Then my mom came up mid-week to help me and the kids. Parker had to stay home from school on Thursday because she was diagnosed with strep. Thursday morning, my stomach started hurting and I started burping, all signs pointing towards a bowel obstruction. Then I started throwing up despite my Gtube draining (this is emptying my stomach contents through a tube and into a bag). I knew we needed to head to the emergency room because I couldn't control the pain at home. 

My in-laws were out of town so I called my friend Marie, who was over in a jiffy to watch Parker until my sister, Lauren, could make it back in town. When they say it takes a village, they mean it, especially dealing with cancer.

 In the emergency room, I was diagnosed with a partial bowel obstruction (meaning some flow through the small intestines) and was being admitted to the main hospital. My mom stayed with me until transport arrived to take me. I knew one of the nurses on my transport team which was nice! I was hooked up to IV fluids and getting IV pain meds and anti-nausea meds. 

Meanwhile, Wil is trying to get home from Alaska and God's timing was perfect. There was a float plane coming into camp the next day and he traveled home to find out that he had COVID. So he had to quarantine for a few more days and then was able to come visit me in the hospital. My sisters, mom, and sister-in-law helped out so much with visiting me and helping with the kids. 

Unfortunately, the air conditioning in my room wasn't working at it was 76 degrees in there. A fan from home helped slightly but it is never a good feeling when you are nauseated AND hot. After having issues with a nurse-in-training not using safe protocols when using my port (my permananent IV), we begged our PAs to get me transferred off of that floor. 

 I was transferred to the 8th floor and had the presidential suite! I had a great view of downtown and large windows and a huge room. The nursing care on that floor was magnificant. My labs came back that I had enteric E Coli, meaning traveler's diarrhea. Basically, any small or large stomach virus I pick up is causing inflammation in my intestines that then leads to it being kinked and blocked. 

Everthing cleared up and I was tolerating a full liquid diet, so I was discharged home after 6 days of being in the hospital. I still didn't feel 100% but was able to tolerate medications by mouth and felt confident in managing at home. I ended up losing 11.5 pounds during my hospital stay. 

 The following week we meet with our oncologist, Dr. Skinner, to get a game plan moving forward. My CT scan from the ER showed that my tumors were growing slowly and had more definite margins. That combined with all my skin and mouth ulcers with the current treatment, we decided it was time to try another avenue. There is a new drug out that was tested on high-grade ovarian cancer (quick growing) where mine is low-grade (slow growing) that acts like a Trojan horse. It binds to these specific receptors on my tumor and sneak the chemo in. The hope is that more chemo gets to the tumors and there will be less systemic (full body) side effects. 

I wanted to have a break and we will start these infusions after our beach trip in August. It will be an infusion once every 3 weeks. In the middle of me writing this update, I ended up having another obstruction this past weekend. Thankfully, I was able to go NPO (nothing by mouth- no drinks, no food) and drain my stomach contents from home and avoid the hospital. The obstruction cleared on its own after about 24 hours. 

 Prayer Requests: 

 1. That my skin will continue to heal and have no further issues with it (my feet are still peeling).

 2. This new chemo will be just the thing my cancer needs to DIE and help prevent more obstructions with a better quality of life with minimal side effects. 

 3. For the kids as it is never easy having a mommy that is sick. 

 4. For strength and endurance for Wil as he carries a heavy burden when I am sick and not feeling well.

Another scan, another treatment plan change

 We had our CT scan in April which showed stable disease. Of course, we would rather see a decrease in tumors but at least there was no further growth of the tumors (around my intestines, bladder, and in my fat by my bellybutton). Carbo is one of the IV chemos that we originally started on back in August and we are unsure if it has been effective since I continued to have bowel obstructions even after being on that for months. It wasn’t until adding Doxil IV that my bowel obstructions slowed and were not as severe when I did have them. My platelets have been dropping lower and lower with each month of chemo, to the point where it could potentially be very dangerous. 

We made the choice to stop doing the Carbo infusions. This was also the chemo that I had to premedicate with a lot of steroids, Benadryl, and Pepcid. The infusion itself was an all day even with even more IV steroids. With it seeming to do more harm than good, it made sense to stop it and remain just on the Doxil. We will have another CT scan to check on progress next month. 

We did learn of two new drug options to keep in our arsenal if we need them. One is a hormone blocker but can take 8 months to see results with it. Another one is a targeted therapy that binds to this folate receptor on my tumors and pulls the chemo into it. This is a huge praise as these weren’t even treatments options a few years ago. Thankfully, there is continued progress in the treatment of ovarian cancer. 

The week after doing just the Doxil infusion, I was mostly just very fatigued. I was in bed a lot and sleeping. I had some nausea but was able to manage it mostly with just my anti nausea meds. I still got my Neulasta shot that week to help boost my bone marrow production to keep my counts from dropping so low. 

The following week, I was up all night with diarrhea, not uncommon for me with all my GI surgeries but it was on a whole other level. Then I was in bed all day Tuesday with abdominal cramping and nausea. I assumed that it was another bowel obstruction, especially after I started vomiting. We call oncology who wanted us to come in immediately. They even kept the office open late to see us and get me examined. 

My wonderful in-laws were able to get the kids and take care of them while Wil and I packed our bags assuming that I was about to be admitted again. On my exam, Dr. Skinner was able to hear my bowel sounds which meant it wasn’t an obstruction (with an obstruction, the intestines aren’t moving so they don’t make noise). With how my pain was presenting, Dr. Skinner thought it may be a gastric ulcer or pancreatitis. My heart rate was high (in the 130’s just sitting) which meant I was really dehydrated. We were admitted back to the oncology floor for fluids, IV pain meds, and IV anti-nausea medications. 

That same night, our son Wilson started having diarrhea and vomiting at his grandparents’ house. Then our older dog, Daisy, started having the squirts too. Ted and Connie are champs and took care of both of them. They tested me and I was positive for Rotovirus, which is a bad GI bug that has nausea, vomiting, and abdominal cramping. Thankfully it wasn’t anything more serious! Then Wil started saying that his stomach wasn’t feeling quite right… and the next morning, he started getting sick. I was going to be discharged that day, so for the first time in almost 11 years- I sent him home! My father-in-law came and picked me up when I was discharged. Then our puppy got sick the following day. We are unsure if Parker had it the week before or if she was just spared. 

This past Wednesday to Sunday, I was in Nashville with my boss, Dr. Summer, and Kristen, the PA an injector too. We attended a laser, dermatology, and aesthetic conference. We gleaned a lot of pearls and got lots of samples! 

As I am typing this, I am sitting in my chemo chair waiting to get my pre-meds. We have a lot going on this week so I am praying and hoping that this round doesn’t knock me down too much. Wilson’s last baseball game of the season is tonight and he has his kindergarten graduation Wednesday. 

We've had a lot of fun since the last post with our church's 5k, Easter, Wilson losing his first tooth, and Parker loving her taekwondo classes! 

Wilson ran with Wil the 5k in 34 minutes!

Prayer Requests: 

1. For the next CT to show either continued stable disease, or even better for a reduction in tumor size. 

2. For endurance and minimal fatigue this week so I feel up to being able to attend all of the fun things we have planned. 

3. Praise for new medications and more things in our arsenal to use if we need them!

4. Pray for overall endurance for our entire family as this takes a toll on everyone. 

Starting to take some trips again

We have been keeping on the same regimen for chemo, every 4 weeks. We did have to push chemo back one week a few months ago because my counts dropped and didn't recover. So now I get the Neulasta shot the Friday after chemo which boosts my bone marrow production. This does make my bones ache and hurt for a few days. 

I did have another bowel obstruction in February, had all my same symptoms of burping and belly pain. We were able to be seen in the clinic, check my labs (which were all good), and get some IV fluids. We were able to manage the obstruction from home using my Gtube to drain and being NPO (nothing to eat or drink). This allows my bowels to rest and unkink on their own. Everything opened back up within the next day and the best part was there was no hospital stay at all! 

The fact that we were able to manage an obstruction and avoid a hospital stay made Wil and I both more comfortable with starting to travel. My amazing boss, Dr. Leigh, took our whole office to Puerto Rico to a mansion with a private chef, bartender, and concierge! I packed half a suitcase with all the potential medical supplies that I never ended up needing to use. 

My Gtube site did get irritated and slightly infected, probably from trying to run the weeks prior. So I don't think it is in the cards for me to run anymore. Thankfully, Doc brought a round of antibiotics which oncology and GI agreed was good to start. It cleared it up within the week. 

We had an amazing and relaxing time. I'm so blessed to have my work family!

 One downside to the trip was I finally got COVID. Took me three years but it wasn't too bad. I managed not to give it to the rest of my family and I took Paxlovid, which made my mouth taste like a garbage can. In the midst of this, is when my lab counts drop. I had to do curbside lab draw since I had COVID so I couldn't use my port. 

My platelets were dangerously low at 28 on Thursday after my trip. Normal is 150-400. Platelets are what help your blood to clot. I had to go back the next day to ensure they were trending up and not continuing to plummet. They came up to 34 so I didn't have to get them checked until Monday. I was bruised like a peach but that's to be expected. By Monday, they were back up to 84! It is crazy how fast your body can rebound. 

We weren't going let this damper our next trip! I won a scholarship through the Dear Jack Foundation which we used to go to Great Wolf Lodge for the first time. This foundation was made from a band I listened to in high school and college called Jack's Mannequin. We got to go for Friday to Sunday with all the upgrades and packages! It was such a blast and such great memories. 

Wilson loved the bowling and mining experience best. Parker loved the wave pool and wore her wolf ears everywhere. They had fun using their wands to open chests and light things up. We had amazing family time and feel so blessed to spend that time together before our week of chemo this week. 

1. Praise: bowel obstruction resolved and no further issues. 

2. Praise: wonderful trips to Puerto Rico and Great Wolf Lodge

3. Pray for my counts not to drop after chemo this time. For the Neulasta shot to be effective especially for my White Blood Cell counts and platelets. 

4. For my next CT scan results on 4/24 to show decrease in all tumor activity for chemo #158 and #159 that week. 

Mixed Bag of Results

It's been awhile since I've posted and a lot has happened. We enjoyed our holidays and had chemo the week after Christmas which I tolerated well. 

I had my 3 month CT scan last week. It was a mixed bag of results. The good: the tumors around my intestines have gotten better. Plus, I haven't had any bowel obstructions or pain in that area. 

The unchanged: the tumors by my bladder have remained unchanged. No better, no worse. 

The bad: there are tumors on the outside of my muscle wall that have gotten bigger. These have less of a chance of causing an issue since it is just in my subcutaneous fat and not around my organs. Right now, we are just going to continue to monitor it. Surgical intervention is an option in the future if it starts causing me pain, which it isn't right now. 

The plan is to stay on my current chemo regimen. The new chemo (Doxil) has given me a rare side effect of darkening my skin. It is mainly on my hands, feet, underarms, and elbows. It doesn't hurt and my skin is intact, just another weird and rare side effect. 

My white blood cell count was too low to get treated this week. So my chemo was pushed out a week. I will be getting a shot (Neulasta) two days after chemo which boosts my bone marrow production to help stop my counts from dropping again. I've had this before and causes my bones and joints to feel achy and sore. 

We also may be a bit crazy but we decided to adopt a puppy! Since we lost Darla in August, we have been thinking about getting another dog and welcomed Sadie to our family a few weeks ago. We are still working on potty training. Our other dog, Daisy, has definitely perked up more and has been very playful with Sadie. 

Prayer Requests:

1. Praise no bowel obstructions since my Gtube was placed. Pray for continued protection from any obstructions. 

2. Pray for chemo regimen to work and shrink ALL tumors and no allergic reactions. 

3. Pray for protection against any infection as my immunity is low and for my counts to rebound by next week to be able to get chemo. 

Another Kink, New Accessory and New Chemo

My big work event was on October 13th. There were live demos, reps, giveaways, and huge discounts. I was wearing a dress with Spanx and thought my belly was starting to hurt because I was squeezed in tight. To be on the safe side, I decided to make myself NPO (nothing by mouth - no food or drink) to try to give my bowels rest if this was another obstruction. Sure enough, as the day went on, the pain and burping got worse. My oncologist was okay with me trying to manage it at home. 

My wonderful boss went ahead and started an IV (which is next to impossible on me since I'm a hard stick) and gave me fluids so I wouldn't get dehydrated. I was disappointed that I was missing the event but was able to answer phones in the back office. That night, the pain subsided and I started passing gas (meaning the kink was opening back up). The next day, we went to the cancer center for more fluids and to check my labs. They said my labs looked great mainly because Dr. Leigh gave me fluids the day before. My immunity level was in the tank, so it was a good thing I wasn't around a lot of people at the event. I was able to slowly advance my diet from clear liquids to full liquid then finally back to a regular diet over that weekend. 

The following Tuesday (10/18), I started getting belly cramping again. This pain came in suddenly and with great intensity while I was finishing my shift at work. Then the burping started and then for the first time in all my obstructions, I was having massive vomiting. We knew it was time to go to the ER and called on-call oncology to confirm. They gave the Clemmons ER a heads up that I was on my way. Wil's parents went ahead and packed bags and came to spend the night at our house since our kids were already in bed and asleep. 

Clemmons ER was amazing again, keeping me separate from others to keep me safe from catching any infections. As soon as I was triaged, my blood pressure was sky high from the pain and vomiting, they brought me straight back to an exam room. I was given IV anti-nausea meds and pain meds then taken back for a CT, which confirmed a high grade bowel obstruction. I was given another NG tube (the tube that goes down my nose and into my stomach that goes to suction to drain my stomach contents). 

We had a great CNA, Sonia B, who got Wil a reclining chair so he could actually lay back and get sleep since we spent the whole night in the ER. Then my new MD switched out for the morning, my Friend- Ann Batista! We were just waiting on transport to the big hospital- Forsyth Medical Center.

 Dr. Skinner stopped by on her way to clinic to check in on me and give the game plan. We discussed having the permanent drain placed in my stomach (G tube) and taking the time to decompress my bowels and let them unkink. 

Critical care transport took me over to the big hospital and Wil followed behind and met me there. 

We were admitted to the 9th West Oncology floor and had amazing nurses (Ryan, Ashlyn, Alexis, Lexie, TJ, and more!), CNAs , and secretaries. We knew we were in for a long admission due to the severity of the inflammation of my bowels. The soonest I could be scheduled to have my Gtube placed by Interventional Radiology would be the following Tuesday, 10/25. So the NG tube would have to stay in until then since it is needed for the procedure. 

My parents came to visit and go to Wilson's Quickball game, and I convinced Wil to go as well on Thursday while my mommy stayed with me.

Then the biggest surprise, Wil and his sister- Holly- ran their 1/2 marathon in Greensboro on Saturday. They had this planned for months and my best friend Mae came to keep me company and help out while he was gone. 

I was allowed to start having popsicles and Italian ice which was such a relief for my throat. Just having the tube in the back of your throat, it is irritated and sore. My NG tube was still to suction so whatever I swallowed just got sucked right back out. Mae was kind enough to add more popsicles and Italian ice to her grocery pick up that afternoon to drop it off for me. 

We had a much better room this go around with more space and a gorgeous view. 

All day Monday, we were able to keep my NG tube clamped and I was still able to have my popsicles. I tolerated it well with no nausea. Then that night, my nurse injected contrast right into my NG tube. This would be for the procedure the next day to be able to visualize by guts for the G tube (stands for gastric tube). Originally it was scheduled for 1 pm but was changed without us knowing to 8 am. So we were a bit surprised and scrambling to get ready. 

I was wheeled down to Interventional Radiology and was nervous and a bit emotional. This was unknown territory for me and I wasn't quite sure what to expect. I knew I would be put to sleep for the procedure but leading up to that part is always hard. I had my same CRNA, Allison, who has helped with all my surgeries in the past. 

My nurse Hayley was holding my hand as I cried. Then my X-ray tech introduced himself as Chris. I could only see his eyes but he looked so familiar and sounded familiar too. Then I realized he goes to my church and plays in the worship band too! That was such a comfort to have a believer with me. Then I asked if I could pray out loud before I was put to sleep. It is a blessing to be able to pray for those helping with my procedure and for God to guide their hands and help to heal me. Then I took a few deep breaths and was out like a light. 

I woke up in recovery, having some abdominal pain where the tube was placed. But a wonderful surprise was that the tube was out of my nose! 

Wil had to stay up in the room but I kept my phone so I was able to send him updates via text and talked to him on the phone once as well. Once my pain was under control, we just had to wait for transport to take me back up to my room. That part took 1.5 hours to get someone to take me up. 

Trying to show Wil that I was more lucid and not cocooned up as much in the recovery room. We stayed overnight and was able to advance my diet as my bowels had started working again. 

We met with a dietitian to go over my new restrictions having the Gtube. The point of the tube is to avoid having to get a tube down my nose with any more obstructions. Then possibly be able to hook it up to drain at home to decrease the need to go to the hospital. I would need to be on a mechanical soft diet. This means no peanut butter (too sticky), no gummies, no raw veggies or fruits, no steak/pork, and all other meats cut into very small pieces. It has definitely been an adjustment but getting use to it now. Eating smaller and more frequent meals to lower the work load at a time for my digestive tract. 

The Gtube is about 6 inches long and I keep it clamped except for one time when we first got home. It will take about 4-6 weeks for the scar tissue to heal around it for it to fully heal. I keep gauze around it for any oozing that happens and an abdominal binder to keep the pain down and keep the tube safe from being tugged on. 

I have to use Saran wrap and tape to protect it while I shower but after a month or so, I won't have to do that since the scar tissue will protect any water from getting around the tube. 

The other change will be my chemotherapy plan. I will stay on the one drug, Carboplatin, but Dr. Skinner thought it would be necessary to add another one just with this being my 6th obstruction since April. So we added Doxil which is a new med I havent had before. It still works on the bone marrow and since I was already having issues with my platelets dropping with Carbo, I was changed to a four week cycle to help give my bone marrow time to recover between treatments. 

We saw Dr. Skinner this Monday (10/31) for an exam and labs. Thankfully, I felt up to participating in Halloween with our family and friends from church. The Hudson's and Jungle's neighborhood was much more conducive for little kids to trick or treat. Parker was a true princess and was carried around by her daddy most of the night. 

We all had a blast! It was a huge blessing that I felt up to walking around as well. 

Wil and I were back at the cancer center Tuesday (11/1) for my first infusion of Doxil. It couldn't be done the same day as my Carbo since that infusion takes 7:00 am until about 5:30 pm. Doxil is typically tolerated really well but can have a rare side effect of the skin on your hands and feet peeling off and mouth sores. During the infusion, I have cold packs on my hands and feet to decrease the amount of chemo to those areas. This medicine is also called "The Red Devil" as it is the color of Koolaid. I tolerated the infusion well and keeping my hands and feet well moisturized. 

I was still premedicating Monday and Tuesday for my Carbo infusion on Wednesday. This is round the clock (8 am, 2 pm, 4 pm, 8 pm, 12 am, 2 am... Then repeat). 

We had our wonderful nurse, Rebecca, again for our all day Carbo treatment. I did just fine with the first bag but during bag #2 of 4, the dietitian came in to see how we were doing with the new changes to my eating. Wil noticed that I started scratching my ears, and then my face and neck started getting flushed. So he hollars for Rebecca who runs in, stops the infusion while Wil pulls the "SEND HELP" call bell. In comes the PA and pharmacist and more nurses. Thankfully the reaction never moved to my chest or lungs. I was given IV Solumedrol (another steroid) and the itching died down. I was able to complete the infusion with no issue after that. 

Well, until I was taking my abdominal binder off to show my nurse navigator my Gtube and I accidentally pulled my needle out of my port. First time I have done that in over 10 years! I quickly clamped the line so the chemo wouldn't get all over me. I even managed to scratch my skin! 

Rebecca came in and was able to reaccess me and taped the snot out of it so I wouldn't do that again! The rest of the infusion went just fine. I still get more premeds before my last bag of chemo, and was able to get a good Benadryl nap. I don't get a lot of sleep the two days prior since I'm on high dose steroids all around the clock. 

Now I'm still recovering from my Gtube and my stomach is sore. I'm hoping to start back at work at the end of next week and slowly add my hours back in. It will be nice to have a 4 week chemo cycle and get more recovery time in. 

Prayer requests:

1. Pray for minimal side effects from my new chemo and for this combination therapy to help shrink my tumors faster to help decrease my bowel obstructions. 

2. Pray for my platelets to have time to recover and be ready to go before my next treatment. 

3. Praise for all my wonderful nursing staff inpatient and outpatient. For my amazing oncologist who takes amazing care of us. 

4. For my amazing work family that is helping me in so many ways and being so understanding of all I'm battling. 

Allergies Reaction, Obstruction, and Low Platelets, OH MY!!

Hold on tight, this is a long post as a lot has happened in the last three weeks! 

We had our first outpatient chemo on September 14 with our wonderful nurse Rebecca. Since I have to do the desensitization, I am a 1:1 ratio for patient:nurse. We were so happy to be back in the outpatient chemo room instead of having to be admitted to the main hospital. 

Here I was getting my baseline vital signs. 

The regimen was the same where I premedicated with Dexamethasone 8 mg (steroid) and Pepcid twice a day for two days before the infusion. Then I get IV medications before the chemo bags with 1/1000 of the chemo, 1/100 of the chemo, and 1/10 of the chemo. Then another round of IV medications before the remainder of the chemo. 

15 minutes into the FIRST bag of chemo, I started getting chest tightness, shortness of breath, and turned bright red and itched all over. The chemo was stopped, the emergency bell was rang, and all the nurses came running. Thankfully, I had amazing staff and Nurse Practitioner that handled everything quickly. I was given a different IV steroid (Solumedrol) and more IV Benadryl and placed on oxygen. My oxygen saturation was good but that was done out an abundance of caution. 

We waited until all the symptoms had resolved and Rebecca started my chemo back at a slower rate and I was able to complete the rest of the bag with no issue. 

Once the second bag of chemo was running, I started getting an itchy neck and hands. My face turned a bit red but nothing like the first reaction. So repeat the whole thing over: stop chemo, Solumedrol, Benadryl, wait for reaction to pass. 

We were able to finish the rest of my infusions without a problem: all the rates were slowed down and I had a lot more Benadryl and steriods on board. This also meant that we opened the chemo room at 7 am and didn't get out until 5:45 pm. So what better place to do my penguin face mask my best friend Susan gave me?? Of course this got some laughs. 

Wil and I have been praying for God sightings during these tough times of treatments. We were able to be there after hours when another patient came back needing help having severe nausea and vomiting after her IV iron infusion. We were able to pray for her and the staff and hopefully give her comfort. She was worried that she was the reason the staff had to stay late, so we were able to let her know they were already there for me! 

Since I had some pretty bad nausea for days after my first round of chemo, a medication was added for me to take after to help reduce the side effects, Zyprexa which is an antipsychotic... Weird, I know but it worked! It did absolutely knock me out where I slept so hard I straight peed the bed that night. Ah the joys of side effects that are so glamorous. I'm waiting for one of the side effects to be a six pack, thick hair, long eyelashes, something good! 

Fast forward to Sunday 9/25 at 12:30 am when I am awoken with a sharp pain right below my breast bone. I assumed it was acid reflux (which I am on prescription medicine twice daily) since I had burping too. I was up until about 4:30 am with the pain that wasn't relieved with Pepcid, Tums, and milk. But I powered through the pain because I was going to this awesome training by Shelby Miller and Galderma (an aesthetic drug company) in Charlotte with the doctor and PA I work with. 

The training was great but the symptoms persisted and we're beginning to worsen. Then it dawned on me and Wil at the same time that this could be another bowel obstruction. So I called my on-call nurse for oncology. I was given the option to try to wait it out at home or if the pain was bad enough, I needed to go to the ER. 

I got home around 3 pm, and we decided to go ahead and go to the Clemmons ER so wer weren't doing all this late at night. Wil's parents are amazing and came and got the kids after we packed all our bags for a possible 5-6 days stay. We let the registration lady know that I am on chemo and could have low immunity, they worked with us and let us sit separately from all the other sick patients. 

Here we are waiting in a back hall waiting to be triaged. 

Labs were drawn and X-rays of my belly were taken. Then I got a room pretty quickly. My portacath (permanent IV in my chest) was accessed, pain meds given, and a partial bowel obstruction was seen on the x-ray. For a better view, I had a CT scan which verified the partial bowel obstruction. This is occuring because the tumor is sticking and causing the bowels to kink off. This time, it wasn't all the way kinked which was the good news. Unfortunately, this is treated the same way with getting the tube down my nose that goes all the way into my stomach to drain my stomach fluid (NG tube) and I was put on NPO diet (meaning nothing by mouth). I started getting a nosebleed right before they put the tube down so I asked for Afrin which helps to close the blood vessels off- it worked and I had no bleeding after having the tube shoved down my nostril. 

Trying to stop my nosebleed 

My friend, Jennifer McBride, from my ICU days is the house manager and stopped by to see me and help me getting a bed at Forsyth Hospital. 

At about midnight, we got the news that I had a bed on 9th oncology floor. When the ER nurse called to give report, she said they responded with "Oh we know Katie!" 

So I get loaded into the critical care ambulance and Wil follows in our car after stopping to get my pillow from home. 

I spend the whole night so nauseated that I am continuing to throw up, around the tube despite the tube being hooked to suction to drain stomach contents. Finally, I get IV Phenergan (anti nausea medication) at about 5 am which finally works. I sleep for almost 12 hours (all day) but I had been up the last two nights and needed the rest. 

Our hospital room was a weird triangle shape so the only thing that fit for Wil to sleep in was a recliner, which didn't lay all the way down. He never complained and is such a wonderful caretaker. 

By Tuesday, we get the go ahead from my PA Emma and oncologist that we could clamp my NG tube and start clear liquids. It is SO HARD to try to swallow with the tube going down the back of your throat. 

When my oncologist came by that afternoon, I asked if we could pull the NG tube. We got the green light to get it out knowing that if I didn't tolerate the clear liquid diet, I would have to get it put back in. I was up for the challenge. I did make Dr. Skinner pull it out, I wanted it out ASAP and plus my surgeon (Dr. Stuart) pulled it out last time, so it was tradition! 

We did discuss it/when I get another bowel obstruction, we will have to consider getting a permanent drain in my stomach (G Tube- stands for gastric). This would be a valve that would be on my abdomen and allow me to drain my stomach without having to get the tube shoved down my nose. I could even try to manage the obstruction from home and only need to go to the ER for medication management if I needed. 

It is such a sweet relief to be able to swallow, clear your throat, and drink cold water! 

I was discharged Wednesday afternoon after I tolerated advancing my diet and did well with regular food for breakfast. 

The plan was still on to meet Dr. Skinner on Monday, 10/3, to go over the game plan and get labs for chemo on Wednesday, 10/4. Unfortunately, my platelets were only 81- they need to be over 100 for treatment. My premeds we're changed back to the old protocol to ensure no further allergic reaction. This increased the steroid from 8 mg twice a day to 20 mg every 6 hours (around the clock), adding Benadryl, and increasing the Pepcid to every 8 hours all for two days prior to treatment. 

Dr. Skinner gave us the option of stopping the premeds and holding chemo for a week to allow my body to produce more platelets or stay on the premeds and recheck my platelets Wednesday and try for chemo, knowing that if they aren't high enough, I would be sent home and have to wait a week anyway. My bone marrow doesn't work as well as the average Joe's due to all the chemo I have had over the last 10 years. We have to be really careful as platelets are essential for clotting your blood. Getting a platelet transfusion wouldn't help as it doesn't fix the underlying issue that I'm not producing any of my own. There is nothing I can do to increase platelets other than time to recover from chemo. 

Wil and I both wanted to at least try especially as my platelets last round increased from 105 on Monday to 258 by Wednesday. 

So here I am at 3 am, wide awake from taking my meds at 2 am, and with a gnarly headache to boot. 

Prayer Requests:

1. Praise my bowel obstruction was able to resolve on its own and resolved quicker than my previous obstructions. 

2. Pray for protection from bowel obstructions while we wait for chemo to shrink the tumors, so I can avoid getting the permanent stomach drain. 

3. Pray for my bone marrow to kick it into high gear and my platelets to be well over 100 Wednesday morning! 

4. Pray the change in premeds helps prevent any allergic reaction with the next chemo. 

5. Pray for wisdom, guidance, and protection for our kiddos as it isn't easy having to deal with all the effects of having a mommy with cancer.