GLITCH

I had my easy chair all picked out in the double row of facing recliners in the chemo salon. My row looked through floor-to-ceiling windows on the trees in the parking lot and the street beyond. Once I got settled in, the nurse extracted four ounces of royal red from my arm pic for pretreatment analysis. She pointed out the baby refrigerator with cool drinks where I could stash my brown bag lunch of cold meatloaf sandwich and red grapes. It would be a 6-hour day, she said. Newbies need to go slower and be watched for adverse reactions to the chemo drugs, which for me would be two different kinds going into my pic. Later, when my abdomen completely healed from all the extensive surgery three weeks ago, they'd pump a third, big-gun drug into a port in my stomach. The nurse also pointed out the blanket warmer, where I could extract a soothing comforter as desired.

After putting a reserve sign on my chair, I followed the nurse into an examining room for a quick update with the physician's assistant before they hooked me up to the drugs. Routine questions followed, including, was I ready to begin. You bet I was! I'm ready to take advantage of those cancer cells when they're down, mercilessly whittled by surgery. I happened to mention a yellow crust on my 3-inch, east-west incision where the abdominal port was installed. Unlike the foot-long, north-south incision that has healed beautifully (according to medical personnel), the port site has not healed. Bummer. Chemo cancelled for the week. Port to come out tomorrow. Follow up next week to see about commencing chemo then and to consider options for new port or not. Sigh. Sigh. Sigh. I gotta tell you, I had all the many kindnesses and good wishes of you all condensed into those chemo bags to run interference for me against the C squad. So, if you could all hold those good thoughts till next week when we get back on track...............

As always, Diane

status update

So, here's the skinny on mom:

She's eating better than she has in a long time. It's good to see her actually eating from a normal sized plate. We're still trying to fill her with protein, however, so yesterday we did a smoothie tasting. What did we have to work with? Three kinds of juice concentrate, five types of frozen fruit, bananas, lime, cream, cocount milk, hemp protein powder, rice protein powder #1, rice protein powder #2. Fortunately, we came up with a couple of decent options before I burned the blender out.

Anyway...so, she's eating better. Her legs are less puffy due to better nutrition and a calf and foot massage from her good friend, Sarah. Seems like there is more fluid building up again in her abdominal area, however. We're all feeling that the chemo probably can't come soon enough at this point; good thing it starts tomorrow.

This afternoon, dad, mom and I head off to the chemo orientation class. Only one of us was supposed to accompany mom to the class, but dad put his foot down (go dad!) and we're both heading in with her. We'll share what we learn.

Valarie

musical shirts

So I'm starting to appreciate what mom has gone through all these years--that is, in terms of shopping. Although neither of us are very good at it (i.e. we primarily look and try on but rarely buy; it drives dad nuts), mom has always had an eye out for me. I can see her in the dressing room trying on pants, estimating that if they drag on the floor about five inches and sit below the belly button by one, that they just might fit me.

Now I know what she's gone through.

Mom simply wanted a few new shirts. So yesterday I found myself in Ross with a huge cart of shirts and pants. I took them in in batches of eight and did a musical chairs of sorts articles of clothing: Red shirt on, gray sweat pants on. Take off gray sweat pants, put on brown pants. Take off red shirt, put on black shirt. Take off brown pants, put on short purple ones (take those off, quick!).

Really, it wasn't that bad (truth be told, I kind of enjoyed it). And I'm happy to report that of the twelve items I took home to mom, she kept five. That, my dear friends, should be considered a great accomplishment.

Valarie

some thoughts on regular eating

Well, as I'm not a very effective food pusher from afar, I can only offer suggestions on this feeding frenzy business. My brainstorm-of-the-day as I talked to mom yesturday, was that perhaps an egg-timer was in order. The idea being that ya eat, ya set the timer for an hour, when it dings ya eat again, on and on, ad full-stomagum. It seems like there should be a balance between protein for the chemo (and water-retention as I read today) and fiber for general GI health. So maybe you alternate food types.

Now, as there's a good chance of Mom 'forgetting' to reset the timer, I propose that every time she doesn't eat at the proscribed and pleasantly chimed hour, she owes me a buck. And at the end of the week, mails me a letter with the proceeds. More righteously, she could donate it to the Vancouver-Val-Petroleum-Reimbursement-Fund.

On my end, as per a previous agreement, I promise not to read the New York Times Online before noon.

-nate

ode to eyebrows

Mom and I are sitting in the car at Whole Foods Market. I've managed to feed her some pulled pork, the only thing that sounded somewhat appealing to her from the list dad and I rattled off from the deli selection.

She looks at me, tired.

"I can handle losing my hair," she says, "But I don't want to lose my eyebrows."

Valarie

post-op from the doc

Mom, dad and I headed in yesterday for mom's post-op appointment with Dr. Rushing. In general, he's pleased with where mom's at, though he's encouraging her to continue eating gobs of protein. Apparently she needs more not only to build up strength but to reduce retention of water in her legs. Mom's poor ankles and calves are still pretty swollen. (Protein helps draw water into the tissues throughout our bodies so gravity doesn't send it all south to our feet and legs.)

He also outlined the gameplan: chemo starts next Tuesday. Think we were all a little surprised that it was so soon--I still want her to be stronger before getting started--but since the cancer doesn't stop growing, we shouldn't stop moving forward.

Analogy of the day: cancer as parasite. Dr. Rushing used it in reference to mom's need for better nutrition. I realized she likely had increasingly poor nutrition before we even knew about the cancer, as the quickly dividing cells were snagging all the good stuff she was putting in. Hate those nutrient hogs.

Valarie

At Last

Dear Ones,

Today for the first time in two weeks I climb the steps to my studio to be with you for a spell. I run my hand along the new section of railing beautifully crafted and installed for my benefit by a young craftsman who is scoping out the family, or more precisely, our only daughter, Valarie. I pass the doorway to the master bedroom, where the bed lies unmade with pillows on only one side, where Jeff attempts to recover through sleep from the stick thrust through his bike spokes. And on to the studio where son Jesse hastily made up his cot before returning to Seattle on the train yesterday after building me a set of steps so I can get off the back deck for a walk. He also stirred up a double batch of his super-nutritious, peanut-butter, chocolate-chip-oatmeal, everything’s-going-to-be-fine cookies to tide us over till he comes again.

It has been a lovely weekend of small pleasures and settling in after my sweet sister Lorie from Montana spent a week transitioning us from hospital care to self-care. Who knows what planet I might have been on by now without her careful calculating of my medicine schedules. But mostly it’s her tenderness and companionship that has nourished me.

I’m happy to report that I did accomplish my goal for the weekend: to trim’s Jeff’s hair. After 37 years of being the only one to cut his locks, I consider it my special privilege and responsibility to keep him looking debonair. On Saturday night the kitchen was filled with the intoxicating aroma of home-grown tomatoes reducing in a spaghetti sauce-to-die-for on the stove—chef Valarie and her sweetheart in attendance. On Sunday another young friend stirred up some custard for me. I love people cooking in my kitchen –it’s like observing a still-life set into motion, where every sense is awakened and every possibility of further communion activated. Last night we communed around the table with a future poet-laureate, a young Seattle friend who once gave me a pin that says it all: write or die!

Many of you have sent produce from your gardens and the generous fruits of your own kitchens. I can’t tell you how much the whole Hamm household has appreciated them. After a week of hospital food: yellow jello, yellow broth, brown tea and apple juice—I am truly in seventh heaven with all your wonderful dishes, lovingly prepared.

Your visits, calls, cards and blogs—which Jeff has been printing out for me to read downstairs in my little yellow bower—formerly a tiny den—make me feel tethered and remind me nothing is ever lost in our interactions over the years. I am honored by your kindness and loving concern.

Tomorrow we will learn more from the doctor about lab reports, prospects and the specifics of treatment. Things to be dealt with and planned for, but not limited to. It’s Fall, my favorite time of the year, when the nip is in both the apples plucked from our tree and in the air that has never felt so satisfyingly fresh.

Diane

CHARLENE

Hey Charlene, thanks so much for your concern and for following our progress here on the blog. If I could find your e-mail I would get back to directly but I can't seem to conjure it up so will resort to getting back to you through the blog.

Your offer of a Mediterranean chicken dish perked up both Diane's and my taste buds. If you are whipping up a batch this weekend and it's not too much trouble and have some left over we promise we would clean our plates.

With appreciation,

Jeff

the status on mom

So, how is she, you ask? She feels more like mom every day. All the plumbing isn't quite in tip top shape yet, but we're hoping that all falls into place here shortly.

I am happy to report, however, that her appetite has improved, enough so that when she saw me scooping up a carefully-selected spoonful of casserole for myself--with just the right ratio of chicken, kalamata olives and artichoke hearts--she sweetly said "Oh yes, that looks just right for me."

She and Aunt Lorie also headed out for mom's first acupuncture treatment today. My hope is to get her going regularily to help with any symptoms, like bloating or naseau, and to help rebuild a battered immune system. Sounds like a couple of the needles really hit some important spots, including Aunt Lorie's ear. (Apparently Christina knows caregivers need a bit of love as well :)

Mom is also walking around more outside. She and my good friend Emily made about twelve million laps on the front porch this evening as Aunt Lorie downloaded me on mom's med regime. (One oxie every six hours, one tylenol every eight--don't miss this one--naseua pills as needed, gas ones before every meal and--nate, this one's for you--I added in the "de-lish" fish oil. Tasty.

Our plan this weekend is to get a few more things organized as we gear up for the chemo coming shortly. Dad, mom and I will be at the doctor's on Tuesday to get a sense of what the treatment will really be like. I'm anxious to get a better sense of what that picture looks like.

Valarie

a word from mom to all of you

Last night dad printed out a few pages of this blog and read them off to mom. She's not quite ready to make the trek upstairs to the computer herself, but dad wanted her to hear what you all have been saying and sending.

She asked me to tell you all how much she enjoyed your comments and that as soon as she's keyboard ready again, she's looking forward to reading and responding herself. (Honestly, I'm a bit worried what sass she'll post regarding the whole passing gas entry...hee heeeee!)

Valarie

back in the swing (literally)

You know when you pull up in the driveway after a long roadtrip? That's what it feels like to have mom at home again, a sense of "ahhh, at last."

She's been doing laps around the living room, and she's documenting everything she eats or takes and when and how much. Aunt Lorie and mom have even nicknamed the meds--"oxie (for pain); "comps" (for naseau). I'm wondering what she'll call the fish oil she's started taking...

Last night, mom sat outside on the front porch swing in her nightgown. I stood behind her and massaged her shoulders; they ache. We didn't talk a whole lot before Nathan called, but we had just enough time to take a breath or two together.

She's already talking about how she and dad may need to adapt and change their lifestyle. "It's not like I want to pickup and go to New Zealand," she says, but there's some shift she's feeling . I tell her I expect her to spend more time on the porch swing. Maybe we'll even outfit it with some cushions and an outdoor heater, I say. She visualizes a cup of hot cocoa in her hands.

It's a peaceful picture.

Valarie

rumor has it...

...Mom is homeward bound today. We now have two-three weeks to fatten her up before chemo starts. Commence with Operation Body Build.

Valarie

Who's who.

Our favorite troublemakers at Christmas last year--glamor shot by Jesse.

arg (and blah)

it's aunt lori calling. "how close are you?", she says. "your mom is starving."

mom finally has an appetite, and she knows what she wants: fingerling potatoes, with some walla walla sweet onion, and irish cheddar cheese. oh, and some homemade vanilla custard with "lots of eggs."

a pot of water has never boiled so slowly. i'm rushing to cook the potatoes, and once they're in, i keep poking them with a fork to prod them along. finally, they're soft enough to eat. i toss them into a container and rush out the door to vancouver.

at the hospital, mom eats. i mean, really, she actually eats. granted it was one potato (no skin) and two teaspoons of pudding, but i still consider it a small victory.

and then this morning, an email from dad:

"Mom had a rough night. Pain and couldn't sleep. She threw up this am too although Kendra (she is here today, hooray!) is not too concerned, thinks it may be because the pm nurse ended up giving Mom too many of her meds at once (she was late on a dosage)."

i'm glad kendra (one of our favorite nurses) isn't too worried, but i'm still frustrated with the night nurse. seems like mom gets better with some nurses and then regresses with others. mom hasn't eaten in a week. i'd like whatever she eats to stay put.

valarie

a call to protein!

so, a small request for help from you all out there.

having undergone surgery, and with chemo on the horizon, mom is going to need as much protein as possible. in fact, according to our favorite nutritionist--adelle davis--that means six servings per day. one serving is 26 grams.

that's a lot, and she can't actually consume straight protein at the moment, but once we get her home, we'll be doing our best.

we've brainstormed some ideas--salmon burgers, tuna fish salad, chicken soup--but would love some additional ideas. of course, we want to make it a bit challening, so here're the limitations:

no milk or yogurt
no beans
no soy

many thanks!

valarie

how to comment on the blog...

thanks to all who have sent along emails and posted to this blog. it means a lot to us to hear from you out there.

in case you want to post but don't know how:

- click on the title of the entry you want to comment/respond to
- scroll down to the bottom of the screen and click the small link that says "post a comment"

valarie

there she is!

at last. it feels as though mom is emmerging.

on friday, i arrived late after work to find her sitting upright in a chair. her eyes were clear and her cheeks rosy as she chatted on the phone with her brother david in canada. seeing her there, looking like she did, made me realize how "off" she's looked over the past couple of months. i don't think i consciously knew or identified it at the time, but i do remember thinking she seemed tired and drawn even though she seamed to have most of her usual stamina. now she honestly appears younger and fresher.

yesterday, she settled into a wheel chair and we took her outside to the beautiful outdoor rock garden just outside the hospital entrance. i was tempted to zip around the hospital corners and corridors to get her there, but she's still battling some naseua, so i held myself back.

taking her out for a stroll reminded me of the time when my mexian step grandmother, Linda, took my stroke-immoboilized grandpa for a wheelchair stroll outside of the nursing home. when it came time for linda to take him back inside, grandpa stubbornly put his feet down and resisted the push of the wheels. he couldn't say it verbally, but his message was clear--don't take me back in there. mom, of course, is in a slightly different position. but i wondered if that thought was running through her head.

valarie

Passed Gas

Quite by surprise the colonic event occurred late last night. This is the best news of the week. Her intestines and colon are waking up. It's causing pain but it's the good kind because as you all know the lower tract has to be in working order before they will let you go home.

Her spirits have returned as has the color in her cheeks (.......well, yes those too). Her laps now extend out into the hallway and around the nurses station. The nausea has subsided, and I am to purchase some chicken consomme from out little neighborhood restaurant, "La Bottega" for her dining pleasure tonight.

If I were a betting man I would say she comes home late Monday or early Tuesday.

Jeff

Two Back, One Forward

Thursday continued downward for Diane as nausea settled in, pain got out of control and fluid began to build in her abdomen and under her lungs. Dr. Rushing said later the post operative "honeymoon" was over. Her traumatized digestive tract has 'gone to sleep'. Not only did that mean whatever meager amounts of sustenance we had managed to get into her went nowhere but the absence of protein in the intestines had caused the fluid accumulation in the abdominal cavity. She was miserable, listless and unaware. Cause for concern.

However Thursday ended and Friday has dawned on the upside. She is now back on an IV, strong pain medication reintroduced and sometime this morning an intravenous catheter (pic) will be inserted in her arm and threaded up close to the heart. The pic will be used to deliver nutrients until the food processing unit is back in business. Drugs have so far kept Diane from throwing up but if that unpleasantness occurs they have a plan and will put an ng (I guess that stands for nasal-gastro?) tube into her stomach. In addition Diane's sister, Lori, arrived from Missoula. These two are very close and I could feel the energy when I walked into the room yesterday and found Lori by Diane's side. Lori and Valarie are a formidable duo. Valarie as master chef and Lori as trainer, "No you don't Diane! I said 10 complete laps. I saw you cut that corner and steer for bed. You get back here!"

We are also supremely fortunate to have the right doc. You all know Diane. You may not know, but can certainly imagine, how she might have strong views on the medical profession. Two days after our Labor Day weekend Saturday emergency room marathon we found ourselves seated in Dr. Rushing's office as he discussed the diagnosis and treatment. He said he could get Diane in for surgery the next morning. We continued talking logistics, etc. but Di grew quiet. He watched her closely and then said, "Diane, I'm not sure you are ready for this. Would you like to put it off?" He read her well. She put it off. Then last night, after a long day, he was bedside with her working through the complications and what to do about them. When all the medical steps had been discussed and agreed to by Diane, he sat close to her and asked how she was doing emotionally. He then ended the visit by asking her if she would give him a hug. It brought the biggest smile to Diane's face I have seen in days.

So we count ourselves fortunate. Thanks to all of you who have called, e-mailed, and written with your words of love and support and your offers of help.

This is a journey you always know may await you. There is a heaviness to actually starting it. But we remain hopeful and are resolved to make the most of whatever lies ahead.

Jeff

it hasn't been an easy Thursday morning

we thought she was on the up and up, but she looks worse, has less energy and is more naseous than she was yesterday.

she sits on the side of the bed, eyes closed, and says "sometimes i wonder if i'll ever feel better." she states it without selfpity or drama--that's not her style--but with misery and disorientation.

you will, mom. you will.

valarie

the menu

found mom awake and perky this morning. seemed like she and her roomate, Debbie, had bonded overnight. i'm guessing it was over the terrible food offerings, the good nurses, the not so good nurses, the challenges and triumphs of getting out of bed.

mari, the caring and attentive night nurse, informed me that mom had been up and out of bed multiple times already. made me think of the sense of triumph children experience when they first walk and the pride their parents feel. i know it's not the same, but i was so proud of mom.

and i cannot explain what a relief it was to see her cheeks rosy and her clear, rich, brown, beautiful eyes looking at me...but when i headed back this evening, i could tell she was tired. and soon she seemed so out of it. it took us a while but we finally figured it out--she needed more oxygen. when i talked later to nathan on my way home, i realized that she was basically exhibiting altitude-sickness like symptoms: lack of mental clarity, naseau, inability to make decisions. we got her back on some air and she perked up.

also finally got some food (sort of) down her. i don't blame her for cringing--who wants to eat this stuff. alex, dad and i spent a good hour conncocting all sorts of mixes from the protein powder, applesauce and other sundry ingredients we brought from home or dug up (yes, that terminology is intentional) at the hospital. when we were done, mom's bedside table looked like a science experiment.

the resulting menu?

homemade applesauce a la protein powder
water a la protein powder
rice milk a la protein powder
homemade appleasauce a la fortified vitamin powder
cranberry juice
cranberry juice applesauce protein powder

and the fan favorite (if you can call it a favorite):

gatorade with protein powder--and just straight gatorade

looking forward to the rest and healing tonight will bring her...

valarie

she's made it out of bed

good news to report. mom was pretty out of it for most of last night and this morning, but she's weaned herself off of the morphine and is making some progress. she looks more like mom--and has a bit of her sass back, too. dad offered her a dry saltine (really, she needed to eat it) and she wryly told him to "go to hell". we all took it as a good sign.

she also made it onto her feet. the goal is to get her up and walking a bit more throughout the night. i expect her johnston side--the one that's able to clearly express what she wants--to become increasingly more present the better she feels.

thanks to all for checking in on her and sending healing thoughts.

valarie

the word from the doc - this afternoon

An update on mom...she's in the recovery room right now. Been there about two hours so far. The doctor said the cancer was pretty extensive (stage IIIC). A tumor the size of a tennis ball on her ovary, with outcrops pretty much all over her peritoneal cavity. Spots on the diaphram, in the lymph nodes, appendix. Also had a big mass on her colon. Dr. Rushing opted to scrape off as much as he could instead of removing that part of the colon. There was (is) a lot of trauma to the area so it's likely she'll be here longer, anywhere from 3-6 days. They gave her a couple units of blood, too.

Main thing: he's optimistic that she'll recovery well. He "debulked" the tumors to the 1 cm or less size, which is what they aim for to begin chemotherapy. He did say that she won't get the chemo directly into the pertoneal cavity until later, given that she needs to heal up first. She'll start with the IV therapy only, then add in the localized chemo.That's it for the moment. We'll keep you posted.

valarie

Waiting for mom - this morning

valarie

i'm sitting here in the sunny lobby at the hospital. a pager--like the ones at the olive garden that light up when you've made it to the top of the waiting list--sits on the table. they'll beep us when she's out or the doctor wants to talk to you, explained the lady at the front desk, "and make sure you keep it in a pocket. it doesn't ring loud." sometime--in two hours, three hours, four hours, five--that little pager will light up, and we, hungry for information, will hustle up the steps and into the waiting room to meet with the doctor.

but for now, nathan and jesse are sacked out on the couches even though the sun is streaming through bright and cheery. dad has run off to work to grab some "stuff". somewhere upstairs, mom is asleep, the meditative music playing through her ipod. it's funny, but one of the things i'm most proud of her for, or maybe it's just what strikes me most, is how quickly she embraced that little music device. propped up in the hospital bed, she easily swirled the control around, fit the earpieces into her ears, and closed her eyes--peaceful, calm, on top of it in a very gentle way. i bent down to give her a final kiss before Ken the nurse wheeled her away, she looked at me: "don't be scared."