A Painful Cure With Positive Results!

Stomach Problems

I have mentioned throughout this blog that Rene has not been able to eat solid foods without experiencing cramps. This morning was no different, she had a bad night again at the hospital. She ate eggs with toast for breakfast and chicken salad on Friday. That evening the cramps started again and therefore she was facing the same situation this morning that she had last Monday.

Her initial reaction was not to take her Rituxan treatment today because of a fear of cramps again (more on this later!). After conversations with the doctor, he agree to postpone this for a day. Afterwards, we discussed this more and I pointed out, what other alternatives did she have for curing these tumors within her body? The doctor stated that the tumors were in her stomach and they are impacting her ability to digest food and therefore will continue to cause her pain! She agreed to have her treatment and deal with any pain during the process which takes a minimum of 6 hours via her post.

Good Outcome

As predicted, Rene did suffer cramps within an hour of her treatment and this was addressed by administrating morphine and adjusting the amount of Rituxan flow. This is a good thing because a small percentage of individuals experience immediate pain because the cancerous cells are being destroyed by the Rituxan. It is equally important to know that this type of chemotherapy treatment does not impact healthy cells in the body. In the future, pain medicines will be administered first. It took about 20 minutes for the morphine to take affect and she is now experiencing no pain or nausea. This is the only chemo treatment that can be done as outpatient because it will not destroy healthy cells.

Being A Pin Cushion!

Rene slept well last night with no issues at all and she said," time for more needles!". This morning they will drain the fluid out of her lungs and abdomen in one procedure.

Good Stuff!

• Rene is now breathing without any problems!
• The fluid they drained was about one liter out from her lungs and nearly two liters from her abdomen!
• One of the M*A*S*H doctors that put her post in performed this morning's draining
• He warned her that her lungs will act "differently" when they were allowed to get air in them; she stated that differently meant that a sharp pain up the back!
• Different for her abdomen meant that she did not have anymore pressure on her pelvic area!
  
• Now we await the outcome of testing of the fluid to determine if there are any other complications
• Additional testing has been done on her heart also to make sure there are no additional items that could impede her chemo treatments
• She will be staying in the hospital over the weekend because they need to review the results of the fluids and the tests on her heart; better safe than sorry!
• Tomorrow she gets to finish her outpatient chemo treatment that she did not finish on Monday!
  

Mood Update

• She is very perky now, you would be to if you can now breath without any problems!
• Enjoying all the get well cards that have been mailed to her
• I was able to show her the comments posted to the blog; she is very happy and laughing!
  

A Good Night & Bad Day!

Rene got a full night of sleep without any stomach issues or constipation! Let's see how today goes since she is not starting it off tired from the previous night.

New "Chemo Curve Balls"

• The heavy breathing I spoke about in yesterday's blog turned out to be fluid in her lungs and abdomen
• She was re-admitted to the hospital for inpatient instead of outpatient treatment
• The double post that they put in her is getting a workout and she is not happy about it; it has not completely healed and she is still sore (both literal and figural)!
• She found out that she is carrying 20 pounds of water weight because of this!
• For those of you in the Valley, she is at Scottsdale Healthcare Osborn, room 536, 480-882-6536
• I expect her to stay in over the weekend

Tomorrow

• They will deaden her nerves but not sedate her when they drain the fluid from her lungs and abdomen
• They will use fine needles to perform this procedure
• It will take a couple days to assess the fluid to ensure that no other complications exist

Additionally, we discovered a close friend from our hometown in Florida is having surgery tomorrow for breast cancer that was just discovered. Her mother and I will be trading "war stories" between Rene and Cassie as they recover!

Chemo - The Dark Side

Side Effects

Heartburn, bloated stomach, and constipation is never fun! These are side effects that can occur with treatment and Rene got them at the same time! It was a rough night for her as well as this morning. Mylanta to the rescue with a different antacid is beginning to calm things down for her. She is now on the grazing every two hours schedule for eating (liquids/soft only) and if food is not taken then, it is alright. It is more important that drinks plenty of fluids to stay hydrated and I don't get any push back about that one! She should be dozing off any moment now, sleep is always good.

Improvements

• The heartburn has been relieved with a combination of Mylanta and Prolisec; hopefully by Friday she won't have to worry about this anymore
• Diary products don't agree with her at this stage and therefore they will be avoided for the next several days

Additional Side Effects

• Shortness of breath; have to monitor this one, hopefully she won't require a portal oxygen tank
  
• Edema in her feet; may require a diuretic to be taken to the swelling down
• Emotional; I told her it is ok for her to cry when she feel like it, it will help her and she has earned the right to do it

Additional Information

• Lymphoma
• Staging; Rene has Stage III
• Chemotherapy
  
• Rene's hospital chemotherapy treatment
• Outpatient chemotherapy treatment
  

The Day After

She rested without incident last night and will have tests done this morning. The outcome of those tests will determine if she needs to stay at the hospital. Nothing was found in the ER indicating changes with her so this may be a reaction to the outpatient chemo treatment. Since we don't have all the facts, we will wait to determine if this is was the case.

Afternoon Update

• She was released today because there was no reason to keep her there
• Yesterday may have been a reaction to their treatment; will follow-up with the oncologist about that one!
• As usual, she gets home and takes a bath/shower...because she can!
• Liquid diet for the next seven days to see what that does for her
  

In The Hospital....Again!

Mondays!!!!!

Rene got through her cramping from Sunday and though sore from it seemed to be recovering. She was scheduled for outpatient chemo treatment during the procedure, began to have massive abdominal cramping. Due the severity of the cramps, she was rushed to emergency room at Scottsdale Healthcare. As of 10PM this evening, here is the following:

1. She is no longer having pains due to medications provided
2. All blood work and other testing show no changes from Friday when she was discharged
3. Her blood count is up which is great (the transfusions are working)
4. She is the observation ward of the hospital and a series of additional tests will occur in the morning
5. The results of these test will determine if she has to stay or they can release her instead

Next Steps

• If the abdominal cramps are the result of her chemo treatments, we must determine the "secret cocktail" that allows her to eat food and avoid cramping as well as heartburn
  
• This is important because she has masses in her stomach and pelvic areas

Eye Candy!

• She was upset that the pain caused her not to enjoy the sight of the paramedics that attended to her!
• She made up for it with the ER doctor, even I have to admit he was a handsome man, she enjoyed his company!
  

Diet Is Everything!

Thank You!

Rene and I want to thank everyone for their calls, e-mails, postings to the blog, cards, gifts, flowers, and prayers. She is responding well because of this and she is maintaining a positive attitude as a result.

Medical Front Update

• She is a bit stubborn about having to take pills; it is good thing that she has a linebacker for a caregiver about that one!
• We tried small amount of solid foods instead of soft; we are going back to soft now, her stomach is feeling the bloat because of this and the medicines for discomfort work well
• We need to give her liver a few more days of recovery so it can get back to breaking down foods in the body
• Between her liver getting back to normal and her chemo treatment, food is not being digestive properly
• This results in bloating of her stomach and abdominal pains which means constipation!
• We will have to "experiment" on determining which foods and portions of those foods she can eat without experiencing any bloating and/or cramps
  

Gene Simmons Rocks!

• When you are recovering, you rely on television to past the time away
• Rene has developed a love for a show about the daily life of Gene Simmons from Kiss called "Family Jewels"
• It is quite funny to her as she watches the mad man of rock run a marketing company, be a father, husband and still maintain his persona as a rock legend
• Anything that makes her laugh is a good thing!

No Visitors Day

• Today is not a good day for her and she is not able to talk to anyone that calls or wants to visit
• There will be days like this and she recognizes it and she is not happy that it will occur but it will
  
• She is mad that this can happen when she wants a good day; I view it as positive because she is fighting it and wants to get better
• This is the right attitude to have
  

First Day Back Home

Morning Update

Rene is very happy to be out of the hospital and back home. She is still a bit weak from the chemo and this is expected. The blood transfusions have aided with her breathing much easier and I expect her to be much more perky by this evening. It took a bit of adjusting to sleeping in own bed instead of a hospital bed. She had room, it was flat, and she didn't have wires hanging off her! She has an appetite this morning and ate well, just ate a little last night. Her abdomen is fine with no pain and we will try more solids by Tuesday with her.

Fun Observations

• Rene enjoyed standing in the shower this morning with hot water and her own shampoo
• The marks of all the needles from her biopsies could be seen, looks like a rugby player after a tough match on the pitch
• She has the remote control....life just got better!
  

23rd March - Homecoming Day!

Great news, she is out of the hospital and back home for awhile!

Sorry I am late posting new information but I been cleaning the house for her return!

Medical Front Stuff

• The tumors are shrinking and therefore the chemo treatment is working on her!
• Her liver is almost back to normal and her bilirubin count is now 1.1! (I like this, solid foods can be consumed soon)
• Her hemoglobin count was 8.3 today; time for a couple of blood transfusions which were administered today (Dracula is a friend and foe when chemo is used!)

Next Steps

• Rest, let me say it again for her...REST!!
• Continue to take her medicines and vitamins (with iron supplements)
• Florence Nightingale I ain't but it could be worst!
• I have to chart her meds so this will be fun, at least she is used to it now...
  
• Cooking should be easy, but with the chemo we will "wing it" based on what she wants and how her taste buds will respond

Her Mood

• Tired from the chemo and being anemic, this will past as she responds to the blood transfusion, she is already breathing better
• Happy because she is home, she can a real shower, she has her pets, and her belongings (I won't ask where I fit in!)
• Overall, she is positive that she will beat this because she has the support of friends, family, and she is not alone
  

22nd March - So Far

Our "little girl" had an uneventful night and was well rested this morning. No pain, no morphine, and a chance to take a real shower means Rene is happy.

Medical Front Stuff

• Her liver is almost back to normal; her bilirubin is now down to 2.5, this a great thing!
• The tumors are shrinking which means the chemo is working on her
• She will get out of the hospital either on Friday or Saturday and they will perform outpatient chemo treatment next week
• This must occur until she goes into round two which we anticipate to be the week of April 9th (great birthday gift for me...NOT!)
• With any good chemo treatment, her hemoglobins are becoming anemic which is expected and therefore they will monitor and address
• The Cytoxan and Prednisone are her current cocktails with this round of chemo and I have found a new resource called ChemoCare for the various meds
  

21st of March

You can call directly to her room 480-323-1305!

Today is not a good day for visits unfortunately!

This morning has not been great for Rene, last night she was given morphine to address cramping that occurred. This may be related to having solid foods yesterday for the first time and she is going to try liquids today to see if that makes a difference. She is very emotional this morning and feels nauseous which may be the result of the morphine!


Good News Items

• The results of her bone marrow biopsy came back clean, the cancer has not spread any further
  
• Her doctor feels she is at Stage 3 and this type has 4 stages; because the bone biopsy is clean, this is not an issue
  
• Her liver enzymes continue to improve; the bilirubins are now down to 3 from 5.4 on Monday and 8.2 from Sunday
• Though her liver is improving, she will not be eating solid foods immediately because the liver cannot breakdown the solids so it will be soft/liquids for a few weeks...yum...NOT!
• The tumors are shrinking and we hope that they will continue get smaller!
  

Medical Stuff

• She is having a catheter (post) place in her for chemo treatment and will protect her for having to take needles
• Drugs for pain and discomfort are a good thing...she now likes taking them!
• She will be coming home over the weekend and will do outpatient chemo treatment for a week because this type of lymphoma can start back again if she is not treated
• In a couple of weeks she will be admitted to the hospital to begin the second round of treatment and this one will be brutal!
• Her right arm is still swollen and they are checking again to make sure that she does not a blood clot, they checked on Sunday also and did not find one; they think it may be linked to the lymph nodes
• She doesn't have a blood clot in her right arm; they feel that this will heal as the lymph nodes get smaller within her body, until, one arm looks like Popeye at the moment!
  

Virus?

• There is a possibility that Rene got this rare lymphoma via contacting the Epstein-Barr Virus
  
• HIV is another way and her doctor says this is not the case but they will test for this also
• Since she has not traveled to Africa, we can rule that out since it is common there
• Virus is beginning to look good to me ( I am bias and her husband, so I can be this way!)

M*A*S*H Impact

• The radiologist team at the hospital did a great job in lifting Rene's spirits today
• As she described them, "they were dudes who were serious and enjoyed themselves"!
• Great music, ear rings, and attitudes as well doing a nice job with putting a dual post in her chest for drainage and intake for her chemo treatments; no more needles!
• This morning Rene was emotional from the morphine and this evening, these guys had her laughing and back to her old self
  

20 March Update

1. She is responding well to this round of chemo treatment and her liver counts have come down from 8.2 to 5.4 which is normal
   
2. The next round of chemo will be tougher on her and will likely require blood transfusions
3. Depending on how she response, treatment will occur every three weeks
4. Chemo is required on her spine because this can spread to the brain
5. The target of the treatment is to get this into remission which 80% of the patients have achieved if not successful; a bone marrow transplant is required
6. 50% of anyone getting this form lymphoma after five years is cancer free

New information for March 20th!

1. Rene has been moved from ICU to the oncology ward, she is now in room 3305 and she has a telephone
2. The main number for the hospital is 480-323-3000 and ask for "HaertelEva, Rene" and let them know she was admitted on March 18th
3. She came off her liquid diet today and ate solid food and she go back to liquids because the cramping started up again
4. Thanks to all that came to visit her today, it really pumped her up
5. Very important to her today, she got to take a bath!!
6. The website for the hospital is www.sch.org if you want to know more about the facilities
   

Hospital and time

This will be updated as I get new information.

Where is Rene?
Scottsdale Healthcare Shea, 9003 E. Shea Blvd, Scottsdale, AZ 85260

How long?
At this time, 7 days so she will be out on either Sunday, Mar. 25th or Monday, Mar. 26th

Her room is?
Currently she is in the ICU room 2215 and they will move her to the oncology ward when a room comes available

Burkitt Lymphoma and Treatment

This information will be updated with new information daily!

What is Burkitt's lymphoma?

An aggressive (fast-growing) type of B-cell non-Hodgkin's lymphoma that occurs most often in children and young adults. The disease may affect the jaw, central nervous system, bowel, kidneys, ovaries, or other organs. There are three main types of Burkitt's lymphoma (sporadic, endemic, and immunodeficiency related). Sporadic Burkitt's lymphoma occurs throughout the world, and endemic Burkitt's lymphoma occurs in Africa. Immunodeficiency-related Burkitt's lymphoma is most often seen in AIDS patients.

http://www.stjude.org/glossary?searchTerm=B

As you can see, nature chose to give Rene a real fun one! Per her doctor about this cancer:

1. - it is curable;
2. - it will be a "white water rapids ride" for her;
3. - chemo treatment began immediately (this is an aggressive cancer);
4. - the chemo will be administered both intravenously and orally;
5. - a total of 7 chemo treatments schedules are required;
6. - I have given her a few ideas for wigs...yes she will lose her hair during this!
7. - since her immune system will be a bit off; I get all the housework and cooking!

I think she will be very happy about that one!

• The following link http://www.mayoclinic.com/health/non-hodgkins-lymphoma/DS00350/DSECTION=5 provides even more detail about this cancer
  

History

Hello,

On March 18h Rene was informed that she has Burkitt's lymphoma after visiting specialists for nearly three weeks. In early February she noticed a lump near her throat and had an ultrasound performed on the advice of her family doctor. During this time, she also tweaked her back and was fighting a lingering cold.

She met with a specialist on February 28th and was informed that a mass was found in her thyroid and it could be cancerous. Additionally she was told that she had lymph nodes and an inflamed pancreas and that additional biopsies and scans would be needed.

A PT scan revealed a mass in her pelvic area which was about 12 centimeters and a mass was found on her back. She had her annual mammogram performed and she discovered that both breasts also had masses. The fine needle biopsies done on her thyroid and lymph nodes were inconclusive and breast biopsies were performed on March 15th.

During this time, she was feeling weak and began to have gastric issues in her stomach. She received medicines to address the gastric issues and then she began to have lower abdomen cramping which we could not address. This lead to her being admitted to the hospital on March 18th and were informed after a series of tests that the doctors discovered she was suffering from jaundice! The doctors also discovered that her blood count was very low as well as low oxygen in her blood.

As of March 19th, I am happy to report that they have stabilized her vital signs and she has began chemotherapy. They plan to transfer her from the intensive care unit to the oncology ward for the remainder of her stay. Please go to the Cancer blog for more information about her lymphoma and treatment schedule.