Posts Tagged ‘pneumonia

14
Apr
10

Iowa Stubborn? Nothing Compared to Greenlaw Stubborn.

The song says: And we’re so by God stubborn/we could stand touchin’ noses/for a week at a time/and never see eye to eye

Me? I’m just stupid-stubborn.

I can’t decide if it is a case that I felt as if I needed something I could control – we’re pumping all these poisons into my body to kill something that is out of control, but by God, I’m not going to take any drugs I don’t have to; or if it’s more that I felt I shouldn’t be having so much pain, so I refused to acknowledge (whine, yes; acknowledge, no) that I was nearly crippled by the pain I’ve been having.

Damn it all! I can take care of it by just ignoring it, trying to move through it, blogging about it; but take a pill, NO!

So instead I ended up at the ER for 5 hours last night because the pain in my chest was so bad that I knew Dr. Medici would have a fit if I didn’t go in. His concern is that chest pain could be a sign of another pulmonary embolism. I was guessing that it was just a new and interesting chemo side effect, but was willing to consider that maybe I’d gotten pneumonia again; as it turned out, it was nothing that could be identified, so the (very kind and sweet) ER doctor had a serious discussion with me about pain management.

Initially I refused to have them put a morphine drip into my IV, but they convinced me to have at least a little bit. After that kicked in, my brain (oddly enough, on morphine) cleared, because all of a sudden, I was down from a 6 – 7 on the pain scale to about a 2 – 3. I began to see the insanity inherent in my “no drugs” position – I don’t have to suffer, and if there’s some perverse sense of satisfaction at betraying my body which has betrayed me, then I really do need some sort of mental health counseling. And if it’s just being Greenlaw Stubborn (my maiden name – whatever else we are, stubborn is possibly the number one trait that my immediate family has in common), then it’s stupid-stubborn. I have my moments, but I’m not stupid. Not for long, anyway.

So I asked, “Please Ma’am, may I have some more?”

Today I called Dr. Medici and asked him for prescriptions for day/night pain pills. One of my reasons for not taking pain pills is that I don’t want to have my brain fogged; but I can see now that the pain had my brain fogged at least as much, if not more, than any pain pills will; plus the lack of sleep due to pain has just been fogging it more. I haven’t felt up to driving due to the pain and foggy-brain, so it’s not like I’ll be missing out on anything by not driving because I’m on pain pills.

My biggest worry is addiction. My mother was an alcoholic, and I have sworn that I would never allow myself to become addicted to anything (gaming excluded – not gambling, RPGs). I think this is truly the root of my concern about taking pain medication. Anything that is going to truly help is an opoid, thus addictive. I also have been trying to avoid taking insomnia medication for the same reason, but have been doing so when the pain was so bad that I just couldn’t sleep at all.

The good news there is that the more pain medication I take, the less insomnia medication I will have to take. At least if I do end up having to break an addiction, it’ll only be to one thing!

Also, I think it is pretty likely that a lot of my emotional distress has been caused by the pain – thinking that I’m less than one month into the rest of my life going through some form of treatment or another, and that much of it might be defined by the kind of pain I’ve been suffering has been extremely depressing. Yet another type of fog that should lift with the cessation of the pain.

So I’m waiting to hear back from the pharmacy on when my prescriptions will be ready. I have overcome my stubborn streak, at least this once. Hopefully any brainfog from the pain pills will be less than that garnered by the pain itself, and I can start to feel human again.

And seriously, I understand that I have reason to be depressed even without the pain; but that’s just not like me to be *so* depressed. I’m a strong woman, and typically have an optimistic outlook – it was a road I traveled for many years to get me to that state, but once I achieved it, it hasn’t been hard to find the positive mindset even under significant pressure. I look forward to getting back there.

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25
May
09

Crawling out from under

In this case, out from under the weight of chemo and its side effects.

Because of the pneumonia on top of the chemo, and how wiped out I was, I ended up taking 5 weeks off work, basically all of April plus a little bit of March and May. I spent a good portion of that time sleeping, and pretty much didn’t leave the house at all. Brian ran any errands that needed to be run, and I read when I wasn’t sleeping. Hooray for online grocery shopping with home delivery, and for Dinners Ready!

Back before I got pneumonia for the second time, Brian and I had planned a celebratory trip to the coast for the beginning of May – we hadn’t been able to properly celebrate Valentine’s Day, our 12th anniversary in March, or my birthday in April; and we wanted to celebrate the end of my cancer treatment. So we made reservations for three nights in Cannon Beach, the 1st, 2nd, and 3rd of May, at the Tolovana Inn, just two weeks after I had my last chemo treatment.

On the 1st, we packed up ourselves and Robin and headed to the coast. We had lunch at Camp 18, and checked into the Inn around 2:30. Our room was on the third floor, and so Robin had his first experience with an elevator. He was fascinated by the opening door, cocking his head, and stretching his neck to get a look at the inside. He walked in with no hesitation and sat down on command, but when the door started to close, it rattled and clanked and freaked him out so that he tried to back away from it as far as possible. The movement of the elevator itself didn’t seem to bother him, and by the end of the weekend, after we started rewarding him with treats for sitting and staying sat while the door was closing, he got over his worry and was perfectly fine with it. The noises of the elevator moving and the pings at each floor made him tilt his head in interest, so all in all, his first experience riding an elevator turned out to be a positive one.

Our room didn’t have a bedroom, it had a murphy bed in between the kitchenette and the living room. It was pretty comfortable, but I kept stubbing my toes on it when it was down.

We didn’t do huge amounts of stuff, because even though I was starting to feel better and the chemo side effects were diminishing, I was still pretty much a lump of pain and exhaustion, only with brief spurts of energy. Happily, my sense of taste and smell were well on the way to getting back to normal, so our meals were enjoyable even though I didn’t have much appetite. Each day we took Robin down to the beach to let him run around – he loves to run on the beach, so Brian would throw a stick for him or chase him around, or we’d get him to run back and forth between us. On Saturday there was a major wind/rain storm (same as in Portland), and the wind was blowing so hard that it was parting his hair on his side – fortunately, since I had so little energy, we were only spending 15 or 20 minutes on the beach at a time, so we were on the way back to our room when the rainstorm started. It was nice and cozy in our room watching the heavy rain blow sideways; but kind of creepy listening to the wind screech and howl through the front door, and clang something on the roof.

Other than that, we took a brief turn around the downtown area, windowshopping and stopping for lunch – Robin got lots of attention and several people wanted to take pictures of him; Saturday night we went to a musical put on by the local community theatrical company (quite fun!); had a nice romantic dinner at Newman’s at 988; played cards and word games in the room; read; napped; and just generally relaxed. We drove home on Monday the 4th.

Tuesday the 5th I started back to work half-time – that first week, I came home and took a couple-hour nap each day, and still slept through the night.

As I was going through my e-mail inbox that first day, I came across an e-mail from my friend and co-worker Jenny – she’d once again set up a team from work called “Supporting Julie” for the annual Making Strides for Breast Cancer walk on the 9th of May. Brian signed up to walk, and I went with him, although I wasn’t up for actually walking. Many of my friends from work came – Leah, Carrie and James, Kristen and her husband Bill, Jenny and her family (including her in-laws, who were nice enough to go walking on their vacation!), and Becky, who started at Schrodinger just before I started medical leave, so I haven’t gotten to know her yet – wasn’t that sweet of her to walk for me? The company I work for is called Schrodinger, and the team t-shirts always feature the name of the team and the company name if there is one. This year, the way they printed the shirts, the team name came out looking like this: Supporting Julie Schrodinger – all on one line, so it looks like the team was supporting Julie Schrodinger ;-} Thank you, Jenny, for taking the time to organize the team and to walk for me! I waited at the plaza that was both the beginning and end of the walk, and had a nice little nap while I waited. It was a beautiful day, and Brian took Robin on the walk – Robin had the usual freakiness about walking on the Broadway Bridge (it’s very noisy, and shakes and rattles from the traffic – heaven forbid that a big truck or bus should pass over while he’s on it!), but other than that he enjoyed the walk, and all the attention he got – one lady came over to pet him at least 4 times over the course of the morning!

I worked half-time again the next week, and it was better – I didn’t end up having to nap each afternoon once I got home, although it was tempting.

The weekend of the 16th/17th we spent in Tacoma – way back months before, we had purchased tickets to the Fleetwood Mac show at the Tacoma Dome (I actually bought insurance on them in case I wasn’t well enough to go, knowing it would be just a month after my last chemo). We had planned to leave Robin with our friends Sharon and Gary, but when I called my 93-year-old aunt to see if she was going to be in town for a visit, she not only insisted that we spend the night with her instead of at a hotel, but that we bring Robin, and she would dog-sit while we were at the concert. We got there around 2:30, and Robin just went nuts when he saw Aunt Julia – he remembered her from previous visits, and really thinks of her as part of his extended herd. We had an early dinner, then Brian and I headed off to the show – she only lives about 15 – 20 minutes from the Tacoma Dome, so it was no problem to get there, and traffic wasn’t too bad. The show was awesome – Lindsey Buckingham’s voice and playing was as good as we expected (we saw him solo in Portland a couple years ago, so had a pretty good idea what to expect); John McVie was the quiet stalwart he always is; Stevie Nicks was her usual lacy, floaty self, but I don’t think her voice has held up as well as Buckingham’s – she no longer was hitting the high notes on her songs, opting instead to harmonize with a lower note, which was kind of disappointing; but for me Mick Fleetwood made the show. I’d seen him in 1993 or ’94 with Fleetwood Mac, although neither Buckingham nor Nicks were touring with them – he was incredible then, and he was incredible this time, also. He is so into what he’s doing, you can just see it on his face, and he’s obviously having a blast. Our seats were good, but low enough that we couldn’t see him over the drums, so I found myself watching the screens a lot in order to watch him play. Wow – he’s intense!

When we got back to Aunt Julia’s, she said that Robin spent the first hour sitting and watching the front door, and both times he asked her to go out, he wasn’t interested in going potty, but wanted to go in front to see if we were out in the car. He spent some time lying in the guest room where our suitcase was, but then came out and lay down against her feet and they spent the evening watching TV. We chatted for another hour and watched part of Saturday Night Live before heading to bed. Sunday, we slept in, had a lovely breakfast and visit, then headed home. I napped a good portion of the way.

Last week I bumped my hours up to 3/4-time, and the first day I worked from home, which was good, because I was so wiped out I needed a couple hour nap once I logged out. The rest of the week went pretty well, and although I was tired, I wasn’t exhausted, so my stamina is slowly coming back.

Friday we had my one-month follow-up with the oncologist. He started me back up on the Femara, the anti-hormone treatment – I’ll be taking it for about 5 years (he said by then they’ll probably have a study that shows that 10 years is even more effective, so don’t plan on stopping then. . .). His only real concern was that since I’m still having muscle and joint pains that I might get worse because that is also one of the common side effects of the Femara. I don’t remember having a lot of problem with that – maybe some when I first started, but I don’t think it was too bad. I started taking it again on Sunday, and so far it isn’t getting worse, so hopefully that won’t be an issue.

He also said that I could get my port taken out any time – I had to wait at least one month post-treatment because the Avastin can cause bleeding problems and wound-healing complications. It’s an in-office procedure for the surgeon, so even though I’ll probably have to take a mild sedative, it’ll only be a local anaesthesia, and I can just take an afternoon off work to get it done.

Other than that, I asked him about my vision – I’d noticed that I was having some vision change during the treatment, and was having trouble reading the computer screen – he said that any chemo-related vision change should be gone for sure in 3 months. It’s definitely been getting better, but my lenses are getting old and the coatings are coming off, so I need to get new glasses, and wanted to make sure that I didn’t get my vision tested while there was still some chemo-related effect.

My peripheral neuropathy has been diminishing significantly, to the point where I haven’t been noticing any numbness or tingling, although the motor control is still not back to normal. I decided to stop taking the Glutamine, and took my last dose Saturday – as of this morning (Monday), I’m starting to feel some numbness and tingling in my fingertips again. Guess I’ll keep taking it for a while, although I think I’ll start with a lower dose and increase it if that doesn’t take care of it.

This weekend we have just been lazing around the house, relaxing, playing with the dog, and enjoying the weather outside.

So there’s the update – I’m caught up, and believe that with my stamina starting to increase, that I’ll probably be better about posting. No promises, but I’ll try!

08
Apr
09

Closing in on the endgame . . .

Yesterday Brian pointed out that there were only 10 more days before I’m done with chemotherapy.

Sadly, even though that was a happy thought, I then focused on how I’m going to feel crappy for at least 2 weeks afterwards.

Sigh. I thought I was getting out of that mental state. I really *want* to get out of that mental state. All the sun for the last few days made me *feel* like I was getting out of it, but apparently once the sun is back behind the clouds, so am I.

It really was much easier to have a positive attitude the first time I had cancer – although I do recall have some pretty grim days as I progressed through the chemotherapy back then too. Fortunately, back then I didn’t have to deal with all the illnesses I’ve been coping with this time. I’m not sure what to think about the pneumonia – I finally was feeling a little better earlier this week, but as of yesterday, I seem to be back to the same place I was the week before. Chest pain, still extremely fatigued (where even walking up the stairs exhausts me) – if it weren’t for the chest pain, I might think it was just (!) the chemotherapy. The doctor will probably want me to go in for another CT scan since I’m still having the pain. I just don’t want it to put any delays on finishing my chemo.

At any rate, here’s to 9 more days! Woot!

04
Apr
09

pneumonia vs. chemo

I’ve been really wiped out the last couple weeks – even though I started the antibiotic over a week ago, things were worse at the beginning of the week than before. As of yesterday, I felt about the same as I did last Friday when I was diagnosed, so the antibiotic doesn’t seem to be helping, which could mean that this is viral pneumonia.

I don’t remember if I went into this before, but pneumonia isn’t a description of a single illness – basically it refers to any infection of the lungs, usually involving inflammation and collection of fluid. It can be bacterial, viral, fungal, or parasitical. So even though I had a pneumonia vaccine in November 2007 that is good for 5 years, the vaccine doesn’t cover every possible source of infection – as a matter of fact, it only covers bacterial infection by the pneumococcal bacterium; and then only about a quarter of the varieties of pneumococcal bacteria out there. So even with its protection against the most common bacterial infections, there’s a ton of other stuff out there that could get me; and with the compromised immune system, even the ones that are covered under the vaccine could still be suspects.

At any rate, when we went in for chemo yesterday, the oncologist expressed concern that I wasn’t feeling better on the antibiotic, and that my white blood count was so low – however, he decided to proceed with the chemo, with strict instructions to report any increased chest symptoms immediately. And if I’m not feeling better by next week, he will probably send me in for another chest CT scan.

Even with the already low white blood count, but with a good neutrophil count (the bacteria-fighting white blood cells), he decided against having me get the daily Neupogen shots next week – they are one of the two ways of getting your bone marrow to start producing white blood cells. The other is only given when there’s at least two weeks between chemo sessions. However, the bet is that as of next Friday, when I go in for my !!SECOND-TO-LAST!! chemo, I will probably have to have them the next week. That’s kind of a pain, since I really don’t feel up for driving these days; fortunately Brian is usually working from home in the mornings, so it’s just a matter of struggling out of bed earlier than I usually can.

I’ve been sleeping a lot, although the last three or four days I’ve started waking up in the middle of the night and being unable to get back to sleep for 3 or 4 hours, but then sleeping hard until late in the morning. I’m not sure if that’s a good sign or not – I’ve been trying to avoid daytime naps since they’re probably one of the culprits (I was only up for 5 hours one day, usually around 8 hours most days for the last week and a half before that). But maybe it’s a sign that I’m finally going to start getting better?

But then there’s chemo. It really has sort of rocketed to my brain this time – I was talking to Brian last night and didn’t remember something that we’d talked about just 5 minutes ago. Hmmm. I’m having more stomach and intestine problems this time around, and the pains are already calling for the good stuff – the morphine. Fortunately I only seem to need it at night, since Tylenol is currently managing it during the day. But even sitting typing, I can feel the tingling in my fingers that means the peripheral neuropathy is escalating. Thank goodness I’ve only got two more sessions! Yay!

Thank you to everyone who is sending all the love, good wishes, positive energy, and prayers – I appreciate them all. It is both motivating and healing to know how many people care and are thinking of me. I think of you-all often, myself, even though I haven’t had the energy to make contact. Hopefully that will be on the mend soon ;-}

27
Mar
09

OK, this is not funny anymore. . .

. . . I have pneumonia. Again.

The doctor doesn’t know why – I don’t think he really cares why, he just wants to get me over it so he can keep poisoning my body.

Which, most likely, is one of the reasons I have pneumonia again – the compromised immune system can’t beat back those germs that healthy people shrug off every day. At least we caught it early again; apparently I am ultra-sensitive to the pressure of fluid building up. Interestingly enough, it is only happening in my left lung, which is the same as the last time. The pulmonary embolisms were one in each lung, but I’ve long had pain in my left chest (heart problems ruled out); and the cancer was in my left breast. No wonder they call it sinister!

The first round of pneumonia responded to Levaquin, which is a very potent antibiotic. On second thought, maybe Dr. Medici is gleefully rubbing his hands together going “mwa-ha-ha-ha” that I have pneumonia, because seriously, this stuff has the potential to be as bad as Taxol and Avastin – it can cause temporary or permanent nerve damage, bleeding problems, seizures, hallucinations, and tendonitis or tendon rupture, amongst the five pages of warnings that came with the cute little bottle.

At any rate, one of the problems it can cause is sleeplessness, and right now, as tired as I am, I cannot sleep. Of course, I couldn’t last night either, so it may be totally unrelated to the Levaquin.

So anyway, that’s how *my* week is going. I’m mildly depressed, and massively annoyed at being sick again – hey, chemo by itself is enough. But Brian is back home from his trip, and that’s wonderful, and the cats have been very cuddly recently. . . hmm, I seem to recall that they were pretty cuddly back the first time. I guess they’re pretty sensitive to this, also. Great – now whenever one of the cats wants to sit on my lap, I’m going to get paranoid. I mean, I woke up this morning with a cat lying on top of me purring – and today I’m diagnosed with pneumonia. Cats as diagnotic tools – guess I won’t go there about whether he was doing a scan or not. Oops, sorry, I went there.

10
Feb
09

February 10, 2009

Oddly enough, this week seems like more of a struggle than last week. Perhaps it’s because I’ve started my second month of chemo; or maybe it’s just that I’ve started my second month of chemo before I’ve really recovered from the pneumonia.

Admittedly, it hasn’t been too bad a case of pneumonia, but I’ve been so tired, and feel pretty much as bad this week as I did last week.

I had a couple things I really needed to be *in* the office to do, and so commuted in yesterday and today; I’m having warning signs that the mid-week switch from one intestinal catastrophe (hint: “The Big C” is not Cancer in this scenario) to another is heading my way, so I’ll probably end up working from home for the rest of the week. Around my next chemo on Friday, of course.

As of last Friday, the doctor said that I’m currently not immune compromised; probably by this Friday, my White Blood Cell count will be down (leukopenia), but even that is not enough to make me immune compromised – it’s only when the type of white blood cells called neutrophils falls below 1000/mm3 (normal is 1800/mm3) that I need to worry about catching stuff. So pretty much after my next chemo round I’ll probably want to stay away from sickies and crowded places like the train.

I’m also having quite a lot of bone pain again – the doctor had recommended Glutamine, and I thought it was to help with this, but he said to take it for the first three days after chemo. Looking it up on the Internets, however, that it may not really have to anything to do with that (Glutamine). All I know is that I wasn’t having so much bone/muscle pain while I was taking it, and today it got worse. I’m going to start taking it again, to see if it helps.

We’ve got an appointment with the vet on Friday to discuss further diagnostics on Robin – he’s been fine ever since, but I want to make sure we’re not missing anything.

Other than that, life is going on, and we like it that way ;-}

04
Feb
09

February 4, 2009

Update on me: nothing much different – more tired, more pain in my left lung, but no fever or coughing. The pain is due to accumulation of fluid, but I believe that the antibiotic is causing more activity in the lung, thus more fluid, so it probably isn’t a bad sign. If it continues to get worse (it’s still at a fairly low level in spite of the increase), I will, of course, call the doctor.

And my feet feel sweaty. Go figure.

Update on Robin: His various blood and lab tests came back mostly normal – there are a couple things that are off. His cholesterol is 561 (normal is 324 or below), and one of his thyroid numbers (I think it is the T4) is at 4.2, normally 4 or lower. The vet is processing another thyroid test – if he turns out to be hypothyroid, that could explain the high cholesterol (this is a dog who has *never* been given people food, and is actually on a weight control diet (thus less fat) already). The vet seemed to think that it might explain the problem with his hind end, although he seemed dubious about that.

He doesn’t think it was a seizure of any kind.

So until we get the next test back, we don’t really know if there are more diagnostics in the works or if we will end up treating him for hypothyroidism, and waiting to see if the problem recurs.

And that’s about all I know (or feel capable of knowing, right now, at least). Time for another nap.




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