Infections

Cancer patients usually are at greater risk for infection because some chemotherapy drugs, cancers in bone marrow and radiation treatments cause neutropinia - low white blood cell counts - that means fewer immune system fighters.  Luckily during Garrett's adria treatments his white cell count remained strong.  We try not to let infection risks keep us from spending time with friends and family, especially when  his counts are so strong, but instead we try to remember the common sense ways to reduce spreading bacteria and viruses - hand washing and sanitizers, covering coughs and not sharing food...  ways that everyone can behave to avoid the cold and flu season!  Amazingly, Garrett does not seem to catch much even when I have something, but when he does it is usually a doozy or multiple issues compounding his symptoms.

The last time we dealt with infection was December 2009 when Garrett was very low on red blood cells and had to be hospitalized for three days.  At the hospital his skin ulcer was cultured and it came back with two strains of bacteria, one of them (we found out much later) was methicillin resistant staphylococcus aureus (MRSA) which has been discussed in the media lately for spreading in hospitals.  Although it is a tough bacteria that is resistant to some antibiotics and disinfectants, it can live on our skin or in our nasal passage without causing any trouble for years even.  When someone is neutropinic and/or has an open wound the bacteria can get in and cause real trouble.  Luckily hand washing is one of the most effective ways to not share the bug.  In December Garrett got several days in a row of Vancomycin, a powerful antibiotic that is used when bacteria is found resistant to others.  This cleared up Garrett's symptoms, along with blood transfusions, got him back on his feet. 

During our inpatient transfusion last Friday we learned more about MRSA and how nurses are supposed to wear disposable gowns and gloves when in a patients room with a history of MRSA...  some nurses did, some didn't...  and in all the times we've been in the hospital for transfusions since December this was the first time they tried to address it.  On the 3rd floor where cancer patients check-in it should be a high priority since many are neutropenic, but the night shift wasn't so concerned this time.  I followed up with the infection control department and they gave us a lot of information about getting cultures, washing hands and giving feedback to hospital staff on how to better educate patients like us.

When we discussed Garrett's current symptoms with his doctor this Wednesday he took a new culture of his skin ulcer and saw signs of thrush (a fungus) in his throat.  With a prescription to treat the throat and waiting to hear results of the skin culture, Garrett should start feeling much better and be able to eat and drink without the discomfort he has had the last few weeks.  Hopefully that will get us back on track, gaining weight, feeling good. 

Also, we got a call with the echo results - his heart looks as good as ever!

Chemo #1 Gemcitabine + inpatient transfusion

Over the last few weeks Garrett’s energy was diminishing, his appetite along with it. A sore throat led him to believe it was a virus, but when he started feeling winded walking to the kitchen we figured his blood counts were down. We got in last Friday to see a doc and have blood drawn and sure enough his red blood cells and platelets were low enough to need a blood transfusion. Although we’d had good blood counts the previous week, it seemed like the cold just brought him down faster than we expected. After trying to get an outpatient transfusion appointment with no luck, Garrett agreed to check-in to the hospital that night and get it over with. We went straight over at 5pm and didn’t get done with the transfusion until 5am!  It was a very long night with several quirky night nurses and no sleep.

After being pumped up with new blood, Garrett still had a sore throat which kept him from enjoying drinks and food again this week, argh!  Today our oncologist selected a new chemotherapy that our insurance had already approved, so we went ahead with the first treatment of gemcitabine and a bag of fluid to combat dehydration. He will get a low dose once a week for two weeks, then have one week off. Most of the side effects listed for gemcitabine (aka gemzar) happen when you are getting a higher dose; Garrett should only feel some of them mildly, if any. It is supposed to be as easy or easier on his body compared to adria!

Echocardiogram results were not in, but that should be a good sign because any irregularities would have been immediately relayed to our doctor.

Chemo #13 + Echocardiogram

Last week Garrett had another great blood count result, gained weight (!), got a dose of adria and zometta (bone strengthener) and scheduled the echocardiogram. The echo is also called cardiac ultrasound. It will check on the strength of Garrett's heart to be sure he is healthy enough for another dose or two of adria. I am looking forward to the echo because I get to sit off to the side watching the images and hear the swoosh of Garrett's heart pumping blood, very cool stuff to me!

While Garrett was finishing up his chemo last week I took a little walk around the medical park and their super green retention pond. The weather here has been keeping up with summer and we deserve it after such a cold and rainy spring!

Homemade crab dip, yum

Delicious date at Hearthfire!

Last Friday we made it out to my favorite local fare, Anthony’s Hearthfire Grill. At the last peninsula, on the very southern point of the puget sound, between East Bay and West Bay in Olympia, Hearthfire has a nice twist on Anthony’s well known northwest cuisine and it’s a place Garrett and I can reliably enjoy! It is a bit fancy, but the view and food are worth it to me. We had great seafood and good company as you can see, Garrett didn't let one bite of crab dip go to waste :)

Chemo #12 and concluding hyperbaric for now

This past Wednesday Garrett had impressive blood counts, hemoglobin up at 9.0 and shockingly high white blood cells, which is a continued sign of chemo affecting the bone marrow cancer and a boost from his blood transfusion a few weeks ago. Since the numbers were so strong he went ahead with another chemo dose marking the third to last appointment where adriamycin will be used to fight his cancer. Our usual oncologist was out of the office this week, but we hope next time we will start talking about the next drug up. Garrett has been eating often the last week or so, but was only mildly rewarded for his efforts by maintaining weight this time. We hope for gain in upcoming weeks.

After two weeks of making the daily commute to Tacoma for hyperbaric oxygen therapy Garrett decided he was at his limit. We’ve put further sessions on hold until he feels mentally and physically ready to tolerate more. The daily routine was wearing him down day by day, but since deciding to suspend he has had much energy to work on eating multiple times a day and adding activity as he is comfortable to do like our recumbent bicycle with full back support. Putting more effort into these behaviors will no doubt help him feel well and tolerate continued chemotherapy!  He has already been feeling better making these changes to his routine.

We’re finally feeling summer time heat here in the pacific northwest, but Garrett is lucky to have air conditioning at home and in the new travel van! His body doesn’t regulate temperature well so having a/c available at all times makes the change in weather bearable. Olive on the other hand is basking in the sun, loving every minute! We drove the van down to Centralia on Thursday, taking all the pretty country back roads to get there, for the grand opening of the Centralia Deli & BBQ a new sister to the Chehalis Deli!!! We had a great dinner with Garrett’s parents and hope the Deli family and staff had a good practice run for their public opening night tomorrow!  Good luck!

Patriot

Just in time for the 4th, Olive's US jersey arrived in the mail! We don't usually dress her up, but Garrett said this custom jersey was just too perfect to pass up!

We had a great steak dinner grilled by Garrett's dad last night and watched Seattle's 4th show on tv while our neighborhood was booming late into the night despite a local ban on fireworks. After the first hour or so of darkness the dogs calmed down and tolerated the remainder of the explosions. Hope everyone out there had a great independence day!