Slight improvement today

Cheryl's regular doctor and nurse practitioner won't be in today because it is Saturday and one of the other doctors is covering the weekend. I did get the blood counts from the floor nurse and they show very slight improvement. Her hemoglobin was at 8.8 vs. 8.6 yesterday (normal is 12 to 16), her platelets are at 29 vs. 27 yesterday (normal is 140 to 440), her white count is 0.2 vs. 0.2 yesterday (normal is 4.0 to 11). (For those paying close attention, I had reported hemoglobin as 8.5 yesterday but it was actually 8.6). Any day the counts don't go down is good but of course I was hoping to see some significant increases. Her temperature remains normal; however, she does have some infection. The antibiotics should take care of that. At least that is what I assume until somebody tells me differently.

Cheryl just does not have the energy to be as active as would be ideal to go to the apartment Monday. She does not have much of an appetite because her mouth is hurting. She is drinking milk today instead of eating jello because it hurts so much. They are trying several different things to solve this problem. Mouth sores is very common with chemo, but that doesn't make it feel any better.

Cheryl is enjoying company for the first time in more than a week. Her mom June and husband Chuck and brother Daryl and his wife Joy arrived at the hospital about 11 this morning. I know Cheryl will get a big lift from them being here. They will be here through Sunday. We are all going to try and help Cheryl be motivated to do more physical activity so she can gain her strength back and get to leave the hospital. Our daughter Michelle and two granddaughters Jolene and Justine will arrive Monday for a visit.

This is the only post I'm planning for today. I hope all the detail I write about isn't too boring to you. It helps me to write it out like I was sitting down and talking to each of you. That's what it feels like to me, that I'm talking to my friends just like you were here. As I write I see your faces and feel your support. So, if you don't mind I'm going to keep doing it. But you don't have to read it all, it's enough if you just keep Cheryl in your prayers. Ron

Another day

Not much to report for this afternoon. After eating lunch and taking a couple of quick walks, Cheryl has slept for the past 6 hours. Tonight will be my eighth night staying with her in the hospital. She says she wants me to stay overnight because she hears my snoring when she wakes up and knows she is not alone. It is little enough I can do, besides the chair makes into a pretty comfortable bed. I know I get a lot better sleep than she does. Although she does not hear you snore at night (well maybe you don't snore, I don't know) but she does know that you are with her in spirit from all the comments, emails, cards and calls she receives. It means so much to her to know that she does not travel this road alone.

Whenever I think about being alone in hard times I think of the the two, then the one set of footprints in the sand (http://www.footprints-inthe-sand.com/index.php?page=Poem/Poem.php). I believe that sometimes He uses the arms and voices of our family and friends to be His arms and His voice and remind us that He is always there with us especially in the really tough times. Thank you for being there for us.

My specific prayer request is:

1. That Cheryl start feeling stronger so she can enjoy a few good days out of the hospital before starting this all over again.

Ron

The blood counts are in

Nurse practitioner Sue was just in. She said Cheryl's hemoglobin was at 8.5 vs. 7.5 yesterday (normal is 12 to 16), her platelets are at 27 vs. 8 yesterday (normal is 140 to 440), her white count is 0.2 vs. 0.1 (normal is 4.0 to 11). The counts aren't up as much as hoped but they are enough so no transfusions are necessary today, but more transfusions may be necessary over the next day or two. The increase in the white count is not much but Sue said it is a start and good news. Her temperature has been back to normal since yesterday afternoon. That could be partly because they gave her tylenol before her blood transfusions, but the fever had already started down before that so hopefully the antibiotics are doing their job. Cheryl has been sitting up for more than an hour and we hope she will be up to a walk after lunch. Ron

Day 13 is nearly done

Cheryl's thirteenth day in the hospital in nearly done. She has been awake most of the day and feeling much better than yesterday. She has received the blood platelets and is getting the first unit of red blood cells now with a second to follow later tonight. This should insure a marked improvement in two of the blood counts in the morning. Because she still had a fever today, Sue, the nurse practitioner, said Monday would probably be the earliest she could leave the hospital. I've learned not to expect the earliest. We just have to be patient. I am so thankful that Cheryl stayed in the hospital so she could get the antibiotics and blood transfusions right away without having to go through the emergency room. I think Dr. Ravi expected this all along so did not want to release her until she was definitely on her way to recovering from the chemo.

My specific prayer request is:

1. That Cheryl respond to the intervensions and fight off the fever and get her bone marrow back to creating the bood cells she needs.

Thanks. Ron

Blood transfusions today

At 10 this morning the nurse came in to tell us that Cheryl will be getting one unit of blood platelets and two units of red blood cells. She told us her hemoglobin was at 7.5 (normal is 12 to 16), her platelets are at 8 (normal is 140 to 440), her white count is 0.1 (normal is 4.0 to 11). Cheryl is also getting a different antibiotic (vancomycin) today based on the blood tests done. The transfusions were an expected possibility the doctor told us about from the beginning. It just means the chemo drugs have been really tough on Cheryl's good cells that need to divide often. Hopefully they were just as tough on the cancer cells. Cheryl has been awake for 3 hours now so I hope she will have a much better day today. Ron

A little good news

When I returned to the hospital last night about 9:30, Cheryl was more awake than she had been all day. She had slept for about 5 hours and was feeling better. It turns out, when she told the doctor yesterday morning that she had slept well the night before, it was not exactly accurate. Anyway, late last night she was feeling better rested and much more alert. Last night her sleep was better although she was wide awake each time the nurses came in (2, 4, and 6) but she went back to sleep. She is awake now (8), has ordered her breakfast, and plans to sit up in a chair to eat. Last night her temperature was over 101 but this morning it is 100. I'm hoping this is a sign that she will continue to improve today. Haven't heard what her blood counts are yet. Maybe they will start to increase today as well. Ron

A VERY rough day

As I reported this morning Cheryl's white cell count was still low today. As it turns out, that was only the beginning of the bad news. Cheryl also has a fever. They have taken blood samples to identify the cause and started her on antibiotics. If a cause is identified, they will give her more specific antibiotics to fight it. Often there is no specific cause, just her general low blood counts and weak condition. Sue, the nurse practitioner, let us know that not only does her blood count need to increase but her fever has to be gone for 48 hours before she can leave the hospital. She estimated that this weekend would be the earliest that would happen. How disappointing.

Both the low blood counts and the fever are perfectly normal for the second week of the type of chemo Cheryl received. For many patients all of this, the chemo, the low blood counts, possible transfusions, fever and antibiotics are done as an outpatient. And someday, Cheryl may be able to do it as an outpatient as well. But for now, because of her weak condition at the start, she needs to be in the hospital.

My mind knows all this, but I am still disappointed. I thought she was getting better and now she seems almost as weak as when she was getting the chemo drugs. It’s all part of the cycle that Dr. Ravi and Sue have seen hundreds of times. But it is a new experience for me and the roller coaster ride of the three week cycle is just beginning to sink in. I can only hope that the third week is a good one like it should be.

Cheryl has been in the hospital here for nearly two weeks and for three days in KC before that. I can tell it is beginning to wear on me and I don't have to be here 24 hours a day like she does. I can't wait for us to have a normal day at home away from the hospital.

My specific prayer requests are:

1. That Cheryl's white blood count starts to come back. It normally takes 3-5 days so pray it starts tonight.
2. That Cheryl fights off this fever as quickly as possible. It normally takes 1-3 days so pray it happens right away.

Thanks for caring. Ron

Morning update

Cheryl's white cell count is still low this morning. Dr. Ravi was by early with the news. He is all set to release her just as soon as the counts start coming back. Cheryl is still sleeping but she did open her eyes and tell the doctor she had a good night and didn't even need to take her pain pills. I hope she will have the strength to walk more today and keep drinking those liquids. With all her body has been through this past week, she just needs a little more time. Ron

Still waiting, trying to stay patient

Cheryl is doing about the same today as yesterday. She's feeling pretty good, but doesn't have much of an appetite and has spent nearly three hours sleeping since being up in a chair for four hours this morning. Dr. Ravi and nurse practitioner Sue just stopped by. Cheryl asked them what she could do to get out of here. The doctor said he wanted the same thing but she couldn't go until her white cell counts started to increase. Apparently she doesn't have hardly any at this point. The nurse had told us it was .3 this morning. He said to drink lots of fluids and walk even more than she did yesterday (which was three laps around the nurse's station). So that's what we are going to do.

My specific prayer request for today is:

1. That Cheryl's white count starts to come back up better than the doctor thought possible.

We thank you for all your thoughts and prayers. And we thank you for all your comments and emails. Cheryl reads each one or I read them to her if she's not up to it. It means so much to us to know so many are sharing in this journey with her. So if you have a few minutes, please let us know you are pulling for Cheryl. If you don't know how to do a comment or want your message to be private just send us an email (rsmith2@everestkc.net). Thanks. Ron

Preparing for the apartment

No, the doctor has not said when Cheryl can leave the hospital, but her improvement is steady and I have faith it will be soon. I know the doctor wants to be sure she is well enough so she doesn't have to come right back into the hospital or ER. So, we need to be patient and not rush it but I know she is going to be so much more comfortable at the apartment (and so will I). I'm later in posting today because I had to be at the apartment this afternoon for the delivery of a wheel chair and commode. I wasn't that convinced they would be delivered in the time frame promised but they were.

Cheryl's blood counts went down a lot today, a side effect the doctor has been expecting. But in spite of that Cheryl has been up in a chair for about 8 hours today. Her appetite was not as good today, but she has eaten some at each meal. She is just so much more alert and active compared to a few days ago. She is feeling good and talked to several people on the phone for quite a while.

By now, you've no doubt figured out that my writing style is on the boring side. You would no doubt prefer to hear from Cheryl in her own words, but she has not been up to it to this point. I'm trying to pass on the things of interest but I'm so close to the situation my judgment might not be so good. If you have questions or want other information, please don't hesitate to add comments to the blog or send us an email (rsmith2@everestkc.net) or call me (785-851-7394).

I've been thinking about the power of prayer and would like to repeat the story about the apartment that Michelle wrote about last week. Looking back on it, I can see I didn't have enough faith in the church apartment being available, so I tried to do it on my own. How typical it is that God gave me another chance. After deciding to take a more expensive apartment, I got a phone call before actually signing a contract. My first instinct was to let the caller leave a message and get back to them after the contract was done. Even though it was a local Houston number I didn't recognize, for some reason I decided to go ahead and answer the call. When I hung up, I told Michelle, you can't tell me that was just a coincidence. But there was more. I told the salesperson working with us that I had a problem. I had told her I would take the apartment and now I had learned a church apartment was available at a much lower rate. I felt I had made a verbal commitment that I should keep in spite of this new information. You would not believe how understanding she was. She said she understood and encourage me to check out the church apartment before making a decision. I know I had made no legally binding commitment to her, but she went out of her way to make me feel Ok about changing my mind. Was it just luck that we were working with such a nice person, or is there a much more likely reason.

Just the day before, one of my daughter's friends had asked her what specifically she should pray for. One of the things she listed was that we find an apartment. Who knows if it was that one person's prayer or all the prayers collectively but one thing I know, it was not just a coincidence.

Witnessing the power of specific prayer, I plan to include a few specific prayer requests at the end of each post in hopes that you will join me in praying for them. Today, I lift up two:

1. That Cheryl get well enough that she can safely leave the hospital and go to the apartment.
2. That Cheryl have a safe and enjoyable time in the apartment before she has to return for chemo round 2.

Thanks for all your love and care and prayer. Ron

Steady improvement

I am so glad to report that Cheryl has continued to do well and make steady improvement since my update yesterday. Last night she sat up in a chair for about 5 hours while she ate supper and watched the Women's World Series. This morning she was able to sit up for around 5 hours again. She ordered her breakfast and ate it by herself. She went to the bathroom and had another good bowel movement. She even went for a short walk and got weighed. She was really happy she had lost the extra pounds she had gained during the chemo. Her oxygen has been turned down really low and she even takes it off some. She ordered her lunch and ate it on her own, though she didn't like it because she couldn't have the dressing she wanted (she's on a low carb diet). She also couldn't have one of the drinks she wanted (fruit juice) without giving up something else she wanted. It was really great to hear her complaining to the nurse. It seems like she is getting back to normal. Her argument must have been effective because the nurse talked to the doctor and he took her off her diet and said she could have whatever she wanted.

Speaking of the doctor, we had a good talk with him. He is pleased with the progress she is making. It wasn't surprising to him that her heart rate problem had such a turn-around yesterday. He said it is just the nature of what we are dealing with. We tried to find out if she was going to get to leave the hospital Monday, but he wouldn't make any definite commitment. At first he said she would get to leave sometime this week but later he said if she continues to improve maybe Monday or Tuesday. Cheryl asked him about plans for future chemo rounds. He reminded us that all the rough parts of this round are not behind us yet. The blood count drops, fever, and other things unspecified are still likely in the next week. That's his job to be prepared for what may happen but I'm going to hope for the best. He said we would talk about the next round when this round is over. Dr. Ravi did give us some hope that she would be able to get chemo treatments in KC at some point.

Another milestone for going home was met today. A family member who is going to take care of her CVC (Central Venous Catheter) has to pass a test to show they know how to do several procedures correctly. They take the CVC care seriously here because an infection can cause big problems. I was a little nervous. I haven't had to take a test for quite some time. However, I did fine. The nurse said my dressing looked better than the old one I replaced. Cheryl was a big help. She laid so still she went to sleep. In fact she's been sleeping for the last hour. But she deserves her rest since she sat up so long this morning.

Thanks to all of you who care enough about Cheryl to share in her journey and continue to pray for her. Ron