My Hilly Accomplishment

We are in Asheville having left the Triangle early Thursday afternoon. We wanted to leave early so that we could meet up with Susan for a trip to the Pisgah Brewing Co which has a tasting room open Thursdays from 4p-8p. Pisgah is the only brewery in Asheville that we have never visited. They had a big open field by their tasting room with a bluegrass band playing. It felt like a picnic because they were grilling food for sale while people played horseshoes, bocci ball, and frisbee golf in the field. Jill, Holly's sister, got to sample a real slice of Asheville what with the beer, the music, and all the hanging out.

Yesterday my clinic visit went well; all of my counts are increasing. I am doing well. For some unexplained reason, my doctor and physician assistant want to see me in the clinic next Wed for a regular visit and then start my chemo the following week. I had been told that my next round would start on Tuesday Sept 2, but that has now been pushed back to Sept 8th or 9th. While I will enjoy the extra time as my bone marrow makes more and more blood and white cells, I wanted to get on to the next round of chemo as soon as possible (the sooner to be done with the whole course you see). But I am not in control of these things, and I keep getting reminded of that, darn it.

After my clinic visit yesterday, I drove to Carrboro to see my pal Leo before he moves his family to Texas to start their new lives. They were in their apartment even though the movers had already taken their furniture. I finally got to meet his two girls Isabel and Alejandra. Of course, we took some pictures shown above.

Since we are now in Asheville, I wanted to do my hill run this morning. It was 63F and still a bit foggy when I started. Last w-e when Holly and I did the hill run, it was more of a hill walk for me. I was just too out of breath to jog up that steep hill behind our house. I was quite excited today to be able to jog the entire hill, go down the back side, and then run it again in reverse. What an improvement in one short week-to run 4 miles with 2 rather steep hills. Fantastic!

We'll be enjoying the Labor day w-e here in Asheville. Holly and Jill have just gone off to Beaver Lake to bird watch while I make brownies. You have a good Labor day too.

Incredible Lightness of Being

My friend Susan sent me the blog site of Jane Curran, a chaplain in Asheville who needs a bone marrow transplant to combat her bone marrow diseases. You know if you look around just a little you will always find people worse off than you. Jane has 3 different bone marrow diseases all smoldering along. She needs the definitive treatment that a bone marrow transplant can provide, but her insurance is denying it at present. They say she is not sick enough. I cannot imagine how hard it must be to be fighting fibrosis, anemia, leukemia and lymphoma. She is being treated by the transplant team at Wake Forest but came to Duke for a second opinion. Her doctor here, Dr Rizzieri who took care of me in the hospital, also agreed that she needed a transplant. Maybe the second opinion will convince her insurance company to do the right thing.

Reading her blog gives me much insight and perspective. I realize how lucky I am that I only have 1 bone marrow disease and that I am already on a treatment path. I am lucky to have a timetable for my treatments. I am lucky that I am not waiting for insurance to agree with my doctor's plan. I am grateful for many things.

My counts have continued to climb. My platelets are 309,000, HgB is 9.9, and the white cell count is 3200. They are checking to make sure I don't need to be seen Monday (Labor Day) before I go into the hospital Tuesday to start the next round of chemo. So we will likely head off to Asheville this afternoon for the long w-e. We plan to do some hiking, eating out, enjoying friends, etc.

Jill, Holly's sister, flew in yesterday and will stay with us for the week. Happy to have the help and company.

The Incredible Kindness of Friends

My friend Gail came down to visit while I was in the clinic on Monday. She and Chris had gone to the mtns for a golfing w-e and brought me back a pair of boxer shorts with dachshunds on them. The package says you just drop them in water and they become a full fledged pair of boxers complete with my little hotdog all over them. I haven't done the water thing yet but I will. I am still so amazed that can work. I wonder if they puff up like all those toys we dropped in water at my birthday party. They blew up into sea creatures. Thanks for thinking of me you two.

Also, I have to credit Marty and Deb with bringing back excellent chocolate pecan bark from their trip to Boston (Furlong's cottage candies). Deb's mother turned 90 so they had a big party for her just a while ago. They generously picked up a huge box of the dark chocolate bark for me and Holly. I'll have you know my weight is up to 124#, and I am sure it is all because of you two. We only have a few pieces left, and it was so yummy. Thanks for that. That extra weight will make a difference next week when I have to go back into the hospital again for 5 days of chemo.

We have been getting a good rain all night and this morning. I hope that Asheville and Western NC has gotten some too. They are in an extreme drought and need it even more than we do here. My garden there was very crispy.

Today's photo-tried to capture the box of Furlong's candy and those (dehydrated) boxer shorts so that you could see them.

5,000 meters

My counts looked so good yesterday that they gave me a few days off from the clinic. I don't have to go back until Thursday morning. Once the counts start trending up and I don't need a transfusion of blood or platelets, they start spacing out the clinic appts. I always wonder what the cell count numbers are doing exactly while I'm staying home. Prior to this I never thought about my cell counts. I guess you could say that I took them for granted like so many other things in my life (good health, a terrific job, being able to travel whenever I want, that I'd have all the time in the future to do whatever I want...). But like all things we take for granted, a small change in circumstance erases all of that. Now I care whether my white cell count is above or below normal because it determines whether I can fight off infection. I care whether my red blood cell hemoglobin mumber is 8 or 11 because it determines how much energy I'll have; how easily I can do something strenuous like jogging or rowing without getting short of breath. I have to say that it's made me more appreciative of all the ways our bodies keep us going by regenerating all those important cells, by making us rest so that we rejuvenate ourselves, by making us feel good when we move or exercise so that we work different parts of our body and spread the blood around.

On that note, I went for a little jog yesterday morning around the neighborhood. Just 3 miles with my fuzzy bald head wrapped in a bandanna to catch the sweat. I had to walk at one point to catch my breath, but it felt good. My legs are a little sore from not jogging enough lately. This morning I did a row and felt so good that I did 5,000 meters instead of 4,000 m. Ah, progress. I'll try to build up as much as possible before I have to go back into the hospital next week for the next round of chemo. It does seem that I lose less fitness if I really try to make progress in between the chemo rounds. So that is what I am doing.

My pal Leo from the Drew clinic is leaving soon to go back to Texas to take a faculty job with his old residency. We have been pals at my clinic in Burlington and did lots of lunchtime walks together before I went out with my leukemia. I think that tomorrow is his last day in the clinic. I am really going to miss him and all of his interesting stories from Columbia (the country), becoming an ER physician there, and his long journey to get through learning english, extra tests & a second residency so that he could practice medicine here in the US. Our clinic will really miss his humor and positive energy. But I know that he and his family will enjoy this next phase as he and his wife teach at the residency and medical school way out there in El Paso. Good luck, Leo!

Luv That Asheville Experience

We did indeed go to Asheville on Friday after Holly got home from work. The poor girlfriend had a hard day and has a talk she has to give on Sept 16th. So she worked on her computer putting her presentation together during the trip over and back to Asheville. We went to our favorite pizza place Friday night. I enjoyed their spinach burger and french fries while Holly had a big ole pizza to herself.

Saturday was a perfect day. We ate pecan sticky buns and chocolate croissants then went hiking at Graveyard fields on the Parkway. It was one of those ideal weather days with low humidity and cool temperatures (63F at the top). The clouds were those fluffy white puffballs that are so nice on a clear day. We hiked for about 2 hours then did some scouting for the Team Event we are planning for April with folks. We want to hike the Shut -In trail that goes from Mt Pisgah to the Bent Creek/Arboretum area. So we looked at the trailheads for both the start and the finish checking on parking and planning logistics a bit for April. The Graveyard fields trail has water falls at both ends of the trail, so we saw it all. The views were very scenic up on Mt Pisgah because of the low humidity and lack of haze.

Then we met up with Susan and Donna to go try out the new tasting room at the Wedge brewery. Asheville has really become a microbrew beer town with 5 locations to tour a brewery and taste their recipes. This one is in the River District, an area that has been reclaimed for artist studios. After that we went to dinner at that fabulous Cuban fusion place, Salsas, that always gets written up in magazines. Yummy food as always. We walked by the Goombay festival downtown then went to the Hop ice cream place near the house for ice cream sundaes. Of course, the best part of all was getting to spend the evening with Susan and Donna. It was such an unexpected treat.

Sunday morning Holly and I walked up the hill that we usually do as our run together. I was out of breath but happy to be doing our regular thing. Then I met Billie for a walk and lunch. It was so good to catch up and to see her Mom doing so well too. Again Holly had to do the work thing and put that talk together for her conference coming up. We headed back after cleaning up the house a bit.

I'm in the clinic now just waiting on a copy of my labs. All of the counts are doing great- my white cells are up to 1200 from 400, the platelets are now normal at 155,000, and my hemoglobin is 10.3. I won't have to return to the clinic until Thursday. They are tentatively planning to put me back in the hospital next week on Tuesday Sept 2nd for the next 5 days of chemo.
Hopefully we'll head to Asheville again this w-e and celebrate labor day there.

Todays photo-this was waiting for me spelled out on the kitchen counter when I went to fix my morning beverage. Jelly beans of all things!

All Blood Counts Rising, Yippee!

They gave me the w-e off from the clinic. All of my blood counts are rising again. Yippee! My platelets were up from 24,000 to 32,000. My hemoglobin increased from 10.3 to 10.7 (giving me an especially good row workout this morning), and my white cell count was up from 300 to 400. So I am officially on the mend. Holly and I will probably head to Asheville later today with all of this good news.

Early and Busy

We are already up and at it at 8:30am sitting in the Duke blue recliner. This is the earliest appt I've had since I started coming to the bone marrow transplant clinic. They have already taken my blood pressure, temp, and all of that as well as my lab tests. Now we are just waiting for the lab results to come back to see which, if any, blood products I need. And of course, I need to be seen the provider who is taking care of me today. They use several mid-level providers to staff the clinic, a mix of Nurse Practitioners and Physician Assistants. Most of them have been working with the team for 5 years or more. They are quite adept at dealing with all the weird things that pop up in these immune suppressed patients. One guy has so many different infections, both bacterial and fungal, that they collaborate with the Infectious Disease service to take care of him and email back and forth referring to him as "Mr Bugs."

Yesterday, they asked me if I wanted to have Friday off and come back over the w-e or come to the clinic on Friday and be off on the w-e. Well that's an easy choice for me. So here I am on Friday being seen. I do hope to get the w-e or even part of the w-e off. If we do get the w-e off, Holly and I may head for Asheville. We haven't been to the mountains in a while, and it would be good to get away. We haven't exactly had a vacation though we did get to the beach for 2 different w-e's earlier. That was so nice.

I don't have my numbers yet. Maybe I'll update once I have them. One good note, the blurry vision seems to be resolving on its own. That certainly argues that it was due to the chemo I had 2 weeks ago.

Unaccustomed Earth

Mom and I just got back from the clinic. They were short staffed so although I didn't need any blood products, we were there for about 2 hours. I guess they just need to cogitate about the lab results and decide what to do with all of the numbers. Nothing had dropped to the point where I needed a transfusion today. My white cell count is down to 300 (normal is 8000) which I'd expect. Seems I haven't hit the absolute bottom yet after the chemo.

I realized today (thursday) that I had my days all confused yesterday. Somehow I thought it was thursday when I wrote in the blog that we would be climbing Mt LeConte. No, the hike and cabin stay was to be August 21 and 22- today and tomorrow. I think I got all out of whack because I had time off from the clinic and then went back last Sunday. Somehow that reprogrammed my feeble brain into thinking that was a Monday when it was really Sunday. Scary - those chemo brain moments. Anyway, today is truly the day we would have been hiking up, staying in the little wood cabin and eating in the lodge up there. We'll all get to do it again in the future I feel sure.

I finished a great book recently by the terrific Indian-American writer Jhumpa Lahiri. It is a collection of fabulous short stories, some with interconnected characters, by the same woman who wrote "The Namesake." I really like her stuff including her first work of fiction another short story collection called "Interpreter of Maladies." This one is called "Unaccustomed Earth" since many of the characters are Indians who move to the US to start a family and put down roots in different soil. She is one of the best observers of human nature and family interactions. Beautifully written.

Not sure if the photo turned out, but these are geese in the garden of a house I pass on my walk around Hillsborough.

Historic Hillsborough

I got 2 units of red cells yesterday in the clinic for my low blood count. I feel all zippy and energetic now with all that extra blood. When I look at the bag of blood hanging there it is pretty remarkable that our bodies can make that and more to spare so that someone can give me extra. And when the chemo gets out of my system or stops exerting its effects on my bone marrow, I'll make my own bag of blood and more to restore my blood count back to its starting level. It really is pretty remarkable when you think of it that way. I am so glad they gave me the blood instead of waiting for my levels to drop below 8.0. It is nice to feel all zippy and have an easier time rowing in the morning, like I did this morning. Soon I'll be at the nadir for this cycle of chemo and my bone marrow will be building all those calls on its own. Cool.

I walked down to Weaver St Market to get some breakfast goodies from the day old section to share while my mom is here. They had lots to choose from, but I bought us some chocolate croissants and pecan sticky buns. Those should go nicely with my anti-fungal medicine that I am still taking for the (now old) pneumonia. That med is supposed to be taken with a full meal or high fat food. Those treats should fit the bill perfectly. And yes, Shannon (my MD pal from Aville who asked some medical questions) I am on the anti-fungal med for another 2 weeks. They wanted me to have a month more of the med after my last doctor's visit. Yes, the blurry vision thing is both eyes. They think the chemo is relaxing the muscles of my eyes. If it's like the other muscles in my body, they don't seem to contract as hard or as forcefully. No big deal. It will get better eventually.

I took my camera with me on my walk downtown so that I could take some pictures of historic Hillsborough. I am running out of good pictures to use with my blog each day. I haven't been able to go too many new places recently, so I am not replenishing my stock very well. This photo is the old slave cemetary that is on our run. I think of those two big trees as an old slave couple buried together and reicarnated as two big beautiful trees side by side.

Susan, Donna Z, Holly and I were to be hiking Mt LeConte in the Smoky Mtns today and tomorrow. Mt LeConte is one of those glorious hikes that winds its way up to 6000 ft or so over 5 miles. The views are incredible. We would have been staying in one of the little cabins up there tonight and hiking back down tomorrow. Donna Z changed her job situation recently so she couldn't go. For obvious reasons, Holly and I couldn't make it either. Well, fortunately Susan is going with our friends Donna W and Ellen. You guys have a terrific climb and tell us about it. Bring back fun and funny stories. We'll do it again next year.

Rowing for Endurance

My Dad asked me yesterday when we talked if I was doing any kind of workout these days. I realized that I hadn't mentioned it recently, but I am still rowing in the mornings, 4000 meters, which takes about 23 mins. I am still able to do pushups and leg lifts and yoga stretches so I do those too. I get more short of breath doing the workout than I did 3 months ago but so what. That is good training too-for my mind and my body. I think I am really benefitting from the endurance and stamina that comes with exercise. I don't quite have time to do a walk prior to coming to clinic so we walk about 2 miles after dinner each day. Quigley likes to get out then too. Beth and Becky joined in, of course, and we even made it to Locopops a time or two. That is a fun incentive for walking after dinner. It is very pleasant out at that time too.

My CT scan from yesterday afternoon turned out fine. I don't have any bleeding in my eyes or anywhere else. That is good news, of course. My labs came back with a low hemoglobin (8.8) so they have ordered me some red blood cells to transfuse. I'm still waiting on them to arrive from the hospital. My platelets got a good bump from the bag yesterday (to 34,000) so I don't need those. My counts are near bottom, which means I'll be building back up soon too. Yeah!

Today is another switch day. Beth is flying back to Georgia, and my mom is coming later. Another week another handoff.

The Summer Time Warp

Yesterday after clinic we had a great visit with Laurie and Julia who had been hiking in the Occoneechee area in the morning. They brought us a whole round of food from Weaver St Market, and we sat outside on the screened porch. It was so fun to have friends visit and get to hang out. Thank you both for taking it upon yourselves to set it up.

I was telling Julia and Laurie that I now realize summer is almost over (Labor day is in 2 weeks), and I barely feel I had a summer. I was diagnosed with this leukemia in late May, and since then it's been all leukemia, all the time. Not really, but it has been mostly leukemia, most of the time. Julia pointed out that I was in my own little time warp. That did capture it pretty well. At the end of last week I'd been feeling down about losing all the time, not being able to work, not really accomplishing anything, getting help from EVERYONE but not being able to help anyone in return (like I do in my job). It has felt a little like a retirement where all you can do is hang at home and read books-no travel, no gardening, no extracurricular work or volunteering to give your life meaning and purpose. It has been very illuminating actually to realize that I'd need more structure and work in my retirement to feel good about myself and to be fulfilled.

I am still at the clinic waiting on a platelet transfusion. My level yesterday was 5,000 so I got a bag. But they are only 12,000 now so they are giving me another bag today. My hemoglobin is down to 9.0, but they hold on the blood transfusion until it gets to 8.0 or lower. My white count is down to 600 so I am back to the whole no fresh fruits, veggies, or flowers thing again as well avoiding anyone sick. Oh yeah, I gained 2 pounds today. I am up to 120.5 #.

Over the weekend, I developed some new blurry vision which may be due to the chemo I had last week. But they want to make sure it is not a bleed into my eye(s). I'll get a head CT later today to check for that. Guess it will be a longer clinic visit today. Beth and I are just making up for all those days last week when we buzzed in and out in no time.

Here's Gracie back when she was a wee kitten (photo).

A Speedy Visit

Beth and I just got back from the clinic. They were short staffed, so it took them a little while to take my blood pressure, temp, etc and to draw my blood. Fortunately, my counts were (just barely) high enough that I didn't need any blood products today. They gave me a reprieve from the clinic until Sunday morning when they predict I'll need my next platelet transfusion. And the best thing is that my white cell count, though lower than normal at 2000, is still providing me some protection from infection or feeling bad. It feels so good to feel good.

Karen P. came down to visit while we were in the clinic. Very nice of her to take time from her workday to do that, and she even brought us lunch from the Thai noodle place. Very yummy and thoughtful.

Beth is taking my car to drive to Fayetteville this w-e to see her best friend from their time at Fort Bragg. Her family was stationed at Bragg for several years before her husband took this job with the rangers at the Army base in Georgia. Nice that she can get something fun out of this trip instead of having to babysit her older sister (me) and cart her around for a week.

This photo is some yardart from one of my long runs in Asheville. I just loved it so I took a picture of it one day. If I've used it previously, sorry for the repetition.

Better Than Yesterday

My sister Beth and I have been hanging out at the house today since I didn't have to go to the clinic. We walked to Weaver St Market to get her some Moroccan couscous and chicken for lunch. Thankfully, I didn't have any problems walking today. None of the weakness and dizzyness I kept getting yesterday. Excellent! Nice to feel better than yesterday.

Last night we had planned to join Miriam and Alex for dinner here at one of the downtown restaurants in Hillsborough. But I was worried that my counts are too low to merit eating out so we all had pizza in. It was fun to see them and visit, talking about their new running regimen (You go guys!) and all the news from the Olympics. Thank you both for coming over and being flexible about dinner.

I don't have much to report since I didn't go to clinic today. Tomorrow my appt is at 11am. It will be interesting to see where my cell counts are. Today's picture-Beth and I trying to get a decent self-photo.

Do Muscles Melt?

I promptly got to it this morning thinking I'd get a little workout in before my sister Beth woke up. Holly had left early for work so it was just me and Beth left to fend for ourselves. Yesterday I did a workout on the rowing machine so I decided to jog this morning. Whoa, what a difference from Monday. I couldn't get as far along the route I usually do before needing to stop to catch my breath. And I had that trembly muscle thing again too, but worse. I think it is fair to say that this is the part where the chemo really takes its toll. I had to finish the route alternating between walking and running. I suppose it might get worse to the point where I am only strong enough to walk. Oh well, I got stronger after a few weeks last time and I am sure this time won't be different. But golly, it's amazing to me how different the very same route could feel in only 2 days. That's why I wonder if muscles can melt.

I do have a plan though. I am trying again to add that Whey protein to my diet. I think I might need more than just calories for the weight thing. For example, I need fat to better absorb my anti-fungal pneumonia med (still have to take that one for a month). Someone said you are what you eat. With this leukemia and its treatment you get some very real feedback on that. If you don't eat enough in general, your weight drops. If you don't have fruits and veggies, your potassium and magnesium drop. If you don't eat enough protein, your muscles dwindle. Wildy. So I am trying to be good and take in all of my building blocks.

Well gotta go have some lunch to rebuild.

Back in the Saddle Again

Well I'm back in my saddle, umm, recliner at the clinic waiting for my labs to come back. This is the start of the outpatient part of my treatment with visits here daily to follow my blood counts. It is really quiet here today with far fewer people than I usually encounter. I don't mind; it's nice to have lots of room and the nurses all to ourselves.

I had a better night last night, sleeping well. It was so cool and crisp at our house that we slept with the windows open. It actually got down to 55F-almost mountain weather. I did a row on the rowing machine this morning and then went for a short walk around the neighborhood. Today, I can feel the effects of the chemo on my muscles, which feel all trembly. I think the chemo must punch holes in the muscles, and then it's hard to use them. It is much more of a struggle than I'd like. But I will accept that the important thing is to try, to move the blood around, to combat all the fatigue and not to be exactly where I was before all of this happened. It's just not going to be for a while.

I don't know how all of the other patients in the clinic deal with their fatigue and weakness. I don't know if they exercise or walk or just succumb to it. We are all friendly with each other as we pass in the clinic but no one shares much about their own struggle. It's like there is an unwritten rule that you keep it to yourself. Of course, the nurses ask us specifically about our symptoms-nausea, appetite, pain, fatigue, etc-and we tell them in full detail. But there is something about sharing it with another patient that is a no-no.

I just met the new Oncology fellow here in the clinic. He seems so young-they all do. Guess they have started taking people straight out of High School into the medical school programs. Naw, it's just the way it is as they get younger and I get older.

Today's photo is my sister Becky and her toy poodle Ariel. They will be on their way back to Atlanta in about 2 hours. Thanks for everything!

Monday Not so Bad

I had alot of trouble falling asleep last night even though I was in my own bed for the first time in 6 days. It felt like a medicine thing-maybe too much decadron from the pre-meds for chemo. Dunno. Once you're home and in your own bed, you assume you'll rest really well, but it doesn't always happen. Oh well, all of those meds are slowly making their way out of my system. I like to think about my liver detoxifying all of that goobly-gook that got infused twice a day. Of course, my bone marrow and any stray leukemia cells are also reacting to the meds. The marrow is dumping off the ability to manufacture those precious platelets, red blood cells, and infection-fighting white blood cells. Fortunately, that is temporary.

When I got home yesterday, I had a few packages and nice notecards waiting for me. My pal Peggy, the potter, and her partner Naomi sent me a belated birthday package with a cool book about Max the dog and a new ceramic mug. I took a photo of the mug to put here on the blog. I plan to have my morning beverage in it everyday- you know the one that mixes Carnation instant breakfast drink with Ensure to fatten me up. I haven't actually gained any weight, but at least, I didn't lose more this last go round of chemo. I also got a book from my pal Billie in Asheville ("Full Catastrophe Living") and a hand written letter from Karen Nelson who did internship with me at UVa all those years ago. It's nice to come home to real mail and packages and notecards because believe me the bills and other unwanted mail accumulate too. Funny how I'm trying to just get done with chemo and get this leukemia thing behind me, and all the regular rigamaroll like bills continues on unabated. Well that really is how life is. It just keeps marching on. I know that I am exceedingly lucky. I am surrounded by people who love and support me. I have good doctors. I am relatively healthy if you exclude the leukemia. But most of all, I have a positive spirit that takes me beyond all of the here and now to a better future.

Tomorrow we do the twin switcheroo. Becky flies back to Atlanta after being here with me 12 days, and Beth flies in not a half hour later to help me for the next week. I don't know what I'd do if I didn't have all of this support and sacrifice from everyone getting me to and from appts, helping me with meals, groceries, and all the household duties. I simply couldn't do this alone. Thank you all for helping me with every step of this.

I did run this morning. Boy I had one rough patch where I was so out of breath that I had to walk a bit. But I kept going after that, and it made me feel I'd accomplished something. It's hard being out of work, feeling like I don't accomplish anything (except trying to beat this leukemia but you know what I mean). So running gives me an accomplishment to better myself, to move just that much closer to being over all of this and back to my old life.

Home Again, Home Again

Jiggity-jig. I got up at 7am since it's the day I get to go home. I was up alot last night with pre-meds for the last chemo, then the chemo, then labs, and lots of hot flashes that made it hard to sleep. I think I was up at least once for each hour from 1am on. Oh well, I'll have plenty of time to get real rest at home. I am hoping the hot flashes will back down again after some of this strong chemo med gets out of my system. I had gotten so much better with the hot flashes in the last year. They were awful right after the breast cancer chemo but then seemed to dwindle in this past year. Not sure if these new surges will persist or go back into hiding until the next round of chemo.

I am hoping that Holly and I can go somewhere to celebrate being out of the hospital. Maybe some brunch at Elmo's or a similar haunt. Definitely worth celebrating. I'll have a bit of a w-e anyway.
Hope everyone enjoys their Sunday too!

The Last Double Dose of Chemo

Today is my final day of double dose chemo for this round. My counts haven't plummeted yet so I won't have to follow up in the clinic until Tuesday morning. That is also the day Becky flies out and Beth flies in. We'll have to figure out how to juggle all the places we have to be and the times we have to be there. I think Beth comes in 1 hr or so after Becky leaves. We'll get it.

Yesterday they took me off the fluids again and I got to wander around. I went for a nice walk around campus in the morning. I went to see my old undergrad haunts, the Chemistry department building and my old dorm. Well the Chemistry building is now the Law School annex. The Chemistry department is now in a new bigger general science building a little closer to the student center and main campus. My old dorm is still there but now there are several other dorms around that have filled in the open spaces. It is amazing to me how much building has gone on here at Duke in the last 25 yrs. Building all over the undergrad campus as well as the medical center. They are still putting up new buildings in the medical center, even though you wonder where they will go.

If all goes well, I'll be going home tomorrow morning after the doctor team rounds. I can't wait. I am happy to be feeling pretty good. I don't have much appetite but then that isn't new. I've had that problem since the last chemo. I try hard to eat as much as I can but I get full really fast.

Last night Holly went by Pop's restaurant and picked up wood fired pizzas from their new venture. We went over to the Duke gardens to eat dinner. Ah, the advantage of being off fluids and being free to wander. It gets pretty boring in this small room all the time. Well I'll be able to eat on my own covered porch soon enough. I hear the weather is cooler and less humid. I hope that keeps up until I get out and at least get to experience that for myself.

2/3 of Chemo Done

Last night I got my fourth dose of the ARA-C, infused from 11p-1am. So today is a rest day. Hopefully they will unhook me from my IV pole and the fluids they are giving me (just sugar water with some salt in it). Then I will be free to roam, wander, walk around and go back down to campus or the gardens. Becky and I did that 2 days ago and it was good to get out and strectch my legs in the afternoon after being cooped up in this small hospital room. The days that i get the chemo I don't notice quite as much since the ativan med they give for nausea makes me nap for several hours each time. Today I should just have my regular stuff-nothing to make me extra special drowsy.

I've been up for about an hour and a half now. Just waiting for Holly to pop in for her morning visit before work. I wanted to be up and at em before she got here for a change. They wake me up so much in the night it's been hard to get up early and beat her visit. But I did it today. I've already been down to the treadmill, which they fixed from yesterday. I did 2 miles at a 3.5 mph pace with the incline set at 8%. That got me sweating and breathing so I am happy. I am also trying to keep up with my push up regimen while I'm in here. Last time I was too weak to do them and after starting back 6 weeks later I could only do 5. I am hopeful I can keep building back up to my 50 per day and maintain even when my counts drop, and I feel weaker.

The nausea and stomach symptoms have been pretty good this time. I have little twinges here and there but nothing major like last time. Maybe I'll even be able to eat enough to gain wt, although the food here is pretty awful, very samey. Those treats from home are the highlight of my day.

Day 3 for Chemo

Holly stopped by this morning on her way into work and found me fast asleep at 7:30am. Last night, my nurse woke me up at 1am to take vital signs, 4 am to get my weight, labs, and more vitals, then 6am to restart my IV fluids that were on hold from yesterday. I sleep great between the wake ups, but dang, they wake you up alot.

Since I got up, I've done my 45 mins of exercise. I tried to do the treadmill again today, but the thing needs servicing. Some error message about Lubing the Belt. So I did the other aerobic machine they have in the small gym room, a recumbent cross trainer sort of like a sit down stepper. It moved my arms and legs so that was good. I am trying to spend more time moving around and just being upright and out of the bed (whether sitting or lying) that I did last time. So far it seems easily doable. Maybe getting this stuff every other day is truly less of a drag on the system. My stomach felt pretty queasy and bad last night, but it seems better this morning. I'm now having my Carnation instant breakfast, and I just finished some fruit.

My next dose will start at 11am, and they will come to give the pre-meds at 10:30am. So not much time now before the next treatment. I am sure there will be some cumulative effects and effects next week as well, but right now I am doing okay. My counts haven't dropped much yet so I am not having that flu feeling yet with all the fever and chills and body aches. Thank God!

Bear with me-another picture from the beach. The sound side again.

2 Doses Down, 1/3 done

They gave me my second dose of cytarabine yesterday at 11p-1am. The doses are supposed to be 12 hours apart, but they bent the rules a bit to get me on the regular 11a and 11p schedule. I did have them pre-medicate me with the ativan again as well as the other two medicines. It helped because I slept and didn't experience nausea during the night. Right now I am a little queasy but not bad.

I've already had a Carnation instant breakfast drink and some raisin bran for breakfast. Also, Sandi and Amy stopped by bringing me a cache of Dunkin Donut holes. I'll eat some and share the rest with my excellent, friendly nursing staff.

I don't have chemo today; it's a rest day. I am focusing on eating and drinking alot in case or if I get sicker later. I've done my 2 miles on the treadmill which I prefer to tackle in the morning while I still have energy. They said that I could leave the floor/this unit since my counts are good. Maybe I'll get downstairs to walk around a bit and enjoy the gardens or the outside. It is supposed to be hot today but cooling off the next few days, I understand.

Thought I'd include another picture from the Carolinas beach trip courtesy of Debra and Sherry. Thanks again you two for the mini-vacation.

1st Dose of Chemo down

Just wanted to report that they did finally get my chemo started about 12:30p. It ran for 2 hours and so far I feel okay. I took them up on their offer for some IV ativan to cut down on the nausea (and to sleep through it). I did sleep in that groggy, chemically way for about 3 hours this afternoon. Woke up to see Holly walking in with 3 Locopops we shared (cookies and cream, bananna cream, and mexican chocolate).

This chemo med (Ara-c or cytarabine) can be toxic to the brain at these high doses so they do what they call neuro checks to make sure I am not getting goofy. I know that I am already goofy and that chemo affects my thinking (and so do plenty of you who sent me emails or e-photos that I couldn't remember getting the last time I was here); this time probably won't be different. Anyway, they do a number of tests before and after the 2 hr infusion to make sure that they aren't hurting my brain. They make me sign my name, touch my finger from my nose to their finger, walk in a straight heel to toe, balance on 1 foot, balanace standing up with my hands out flat and my eyes closed, etc. It's a little like the tricks a state trooper might use to see if you've had too much to drink. So far I've passed but I bet it can get a little dicey on those 5th or 6th doses. I'll report back for sure. And if I fail to return any emails or seem out of it, you'll know I have a good excuse.

In the Hospital Now

My sister Becky drove me to Duke this morning, and we swiftly moved through the admitting process about 8am. We headed up to my new room, #9210, and got situated unpacking my clothes for the next 5 days. So far I've had my ht, wt, blood pressure, and temperature measured. My nurse, who is very new to this unit, has hooked me up to some IV fluids, but I am still waiting on the chemo to arrive from the hospital pharmacy. One can never be in a hurry at the hospital. Everything happens on hospital time. If I start this dose at 1pm then the next dose will be at 1am. Ouch! They are going to pre-medicate me with 2 different drugs prior to the chemo to prevent as much nausea as possible. This time my same Nurse Practitioner Student, Brian, advised that I allow them to medicate me with Ativan to ward off the nausea and stay a little sleepy during the 5 days. I'll try that once things get going and see if that improves the symptoms.

Becky just came back yesterday morning from Asheville where she had spent the w-e with my mom and step father. They all stayed at our Asheville house, doing all the fun Asheville things we like to do. They went around the corner to our favorite Pizza and Brew place, shopped for pottery and other handmade crafts down at Biltmore Village, and even had dinner Sunday night at our favorite Inn. I had asked Becky to pick me up some of the special soap they sell at the Sourwood Inn because it reminds of so many good times that Holly and I have had there (you know that old Remembrance of things Past...). To my great surprise, Susan Curtis who is the owner, innkeeper, and just the nicest person you could ever meet, gave Becky 2 soaps to bring to me as a gift. She also sent many well wishes as I take chemo again.

Holly and I went to the Sourwood Inn for dinner our last Sunday in Asheville. They are a B and B but also do terrific dinners on Thursday through Sunday nights. Kacia, the chef, does magic with food. The setting is incredible, just up the mtn from Asheville and off the Blue Ridge Parkway. They have the best view down the mtn and into the valley below. The Inn itself has many big stone fireplaces and is decorated in the Arts and Crafts style. Every room has a sweeping view down the mtn both from the bedroom and the soaker tub in the bath. And they stock the rooms with this great smelling soap, as I said. Holly and I try to go there for dinner once each month or two and stay at the Inn several times a year. Our last visit that Sunday when we went for dinner, Susan let us stay at the Inn for free since she knew that I would be starting treatment soon. It was an incredibly gracious gift and one we appreciated very much. They have been very, very good to us over the years.

If you are looking for a place to stay in Asheville or just a short 15 mins up the mtn, consider the Sourwood Inn. Susan Curtis and Kacia will take good care of you, and you'll feel like you're staying at a real retreat. This photo is Holly sitting on the covered deck in the back of the Inn as we wait for our dinner time. We usually go up early to have a glass of wine and enjoy the view or sunset.

Carolina Beach Courtesy of Friends

Holly and I had the opportunity to stay at Debra and Sherry's new condo on the spit at Carolina Beach. They had offered some time ago, but we weren't sure when or if we'd have the chance to take them up on their offer. This week they are all gone to the mtns outside of Boone with Debra's family, and we took them up on their offer.

Friday night we headed down to the beach, which is just outside of Wilmington, arriving just as the sun was going down. We managed to find a local pizza joint for dinner after we got all of the bags settled from the car to the condo. Their condo is pretty amazing. It sits right on the spit with a view of the ocean out the back and the soundside or marina out the front. Both sides have decks, but we really liked the top deck on the front on the house where we could see the sound, more birds, and all the slow moving boats. Their condo is quite large with essentially 2 master suites, one on the first floor with the other 2 bedrooms and one on the second floor with the main living room-dining room-kitchen combination. We stayed on the second story since the views were so spectacular out the gigantic living room windows that faced all sides of the sound.

Saturday we walked down to try the famous donuts from Britt's, which has been at the boardwalk since 1939. It was pretty warm and muggy Saturday so we didn't do any formal exercise except our 2 mile walk to see downtown. We headed for the beach in the morning and then did a tour of Fort Fisher in the afternoon. It was blazes hot by then but with a nice cool breeze. Neat to see all the bunkers that were supposed to protect the confederate troops in 1864 from the Union army that was trying to capture the Cape Fear River and shut off the port of Wilmington (they succeeded eventually). We also visited the Aquarium there at Fort Fisher even though there was only an hour until it closed for the day.

In the early evening, we sat on the deck of the condo overlooking the sound for a bit before heading to downtown Wilmington for dinner. There were plenty of other people doing the same thing, as well as walking ghost tours and just general bar hopping. I guess Wilmington has become more of a destination than it used to be; it sure is busy at 10pm in the nightlife district.

Sunday we walked again first thing then headed back to the beach to soak in the rays and surf. Sunday the air was much cooler and far less humid than Saturday. It was really nice. The water felt great. Cool at first but then so comfortable. And there were far fewer people on the beach with us. A great day to be there.

We have been very blessed the last two w-e's with trips to the beach courtesy of our generous friends. I know that we'll be able to carry that feeling and fun into this next week in the hospital. I really do appreciate the generosity of our pals who have shared their places and friendship in such wonderful ways. Thank you all.

Photo is the sound area where the ferry takes off from Fort Fisher headed for Southport.

Friday

We got a nice peaceful rain here at the house last night so the air is cool and clear this morning. I had a good run though it is still difficult. I am happy just to able to run and be outside though. I feel sure that next week when I am in the hospital that I will be wishing I could be struggling with a run through the neighborhood. Quigley will be missing me too because I like to take her for a spin around the loop here in our subdivision so she can get out a little too.

I'm going to pick up my sister from the airport early this afternoon. Then she is driving to Asheville to be with my Mom and her husband just for the w-e. They are taking a mini-vacation to the mtns from their home in Charleston. I've already gotten a phone call from my mom that her old car has broken down (it's done that 3x recently), and they hadn't even made it out of town yet. I guess they will have to take the truck and haul Dixie their chocolate lab in the cab or back of the vehicle. Hope they make it there okay. It'll be good for me to have Becky here next week-someone to visit me in the hospital and take my mind off things.

Everyone have a good w-e. I'll write more on Monday. Maybe I'll know the hospital schedule by then.