Gemzar... The Gold Standard of Pancreatic Cancer Treatment

Gemzar is the nickname given to a potent chemotherapy drug called Gemcitabine.  It was the baseline treatment for mom during her pancreatic cancer journey.

Mom chose a mostly traditional route of treatment for her cancer.  It was what she felt most comfortable with, although along the way we did give a nod to several holistic treatments and we'll share more about that in coming weeks... but Gemzar chemotherapy was the treatment most highly recommended by her oncology team, so that is where we spent the majority of our time.

I can remember a friend, sincere and well-meaning, asking mom how long she would have to be on the chemo.  Mom gently told her "for the rest of my life, as long as I have...it is the only thing holding the cancer at bay right now."

It sucks the air plum out of my lungs to remember the finality of that statement.  I wanted to cry at the obscene honesty, my heart grieving and torn over the obvious truth.

Mom accepted her terminal diagnosis long before any of the family could... We all, especially myself, just knew she could beat the odds.  And hearing her admit she would be on the gemzar until the cancer won out was incredibly painful, horrifying really...

Don't we all just assume the doctors and treatments will help us?  That at some point we'll be back to good health and the nightmare journey will fade into the past, complete with a "Well Done" certificate and a celebratory party when we walk out of the Chemo Lab for the last time?

That wasn't the way mom's story ended... We've journaled much of her experience with Gemzar on the website, so I won't rehash old news... but there are a few notes we could add in hind sight for those of you just beginning the journey.

First of all, Gemzar is still one of the most effective chemotherapies that we have in the arsenal to fight pancreatic cancer.  That may not be saying much, but it is true.  Gemzar did indeed work for mom in shrinking the tumor (for awhile) and actually kept the cancer from metasticizing to other parts of her body.

That is incredibly good.  Yes?  Definitely worth the host of side effects that accompany the use of such a potent chemotherapy drug.

But I also feel compelled to share the other side of the coin for those wanting an honest, transparent opinion...  Pay attention to the side effects. 

We knew (and mom experienced) the bouts of nausea/vomiting and flu-like symptoms.  We knew (and she definitely experienced) the low blood counts. 

What we didn't pay attention to was the small print... way down the list of side effects there was a caution about lung problems...

This drug can cause serious lung problems in some people. Tell your doctor right away if you start to notice cough, wheezing, trouble breathing during exercise, shortness of breath when lying down, or in other situations.

Many of you that have read our journey know that mom contracted aggressive double pneumonia the week before she passed away...

Pneumonia.  Not Pancreatic Cancer.

We never saw it coming.  As a matter of fact, her oncologist had just told us several weeks before she developed the pneumonia that the pancreatic cancer was still contained to the pancreas.  We had cheered that little victory.  No spread of the cancer yet.  All the while her lungs were being comprised to the point that the pneumonia got a foothold and never let go...

It was truly The Perfect Storm...

Do we blame the Gemzar?  No more than I could blame the donuts I ate for my increasing waistline.  The Gemzar did what it was made to do.  It kept the pancreatic cancer at bay for over a year.  It also destroyed most of mom's immune system in the process.

Do we wish perhaps that we had been more vigilant while her white blood count was so low?  A million times yes!  I would have buttoned her up and kept her at home instead of shopping for Thanksgiving turkeys together.  Even though I know in my heart of hearts there was no way we could have tied her down and kept her from the Thanksgiving festivities...

And that is the reason her story keeps on giving.  For in our hind sight, we can maybe, just maybe, give another cancer sojourner a chance to keep on fighting...

Pay Attention to the Side Effects... Listen to your Body...

Fight Hard... Love Harder...

Find Joy in every single Grace we are Given.  Always.

    

Good New/Bad News

Today has been a Good News/Bad News kind of day.

As a rule we're a pretty optimistic family. Doesn't take much for us to find a silver lining in any storm cloud. But sometimes life just takes the wind out of your sails, and you can't outrun the storm.

And today that storm dumped a boatload of rain on our barely afloat dinghy...

Mom's tumor marker took a huge leap up this week (we don't want it taking leaps, jumps or even little baby steps anywhere but down!). It's up to 509. And this while still on the chemo. We're not smiling.

Dr. Davis wasn't smiling either, BUT (here's the good news), he's not ready to throw in the towel yet. While the tumor marker jump is troubling, he reminded us that it is not a scientifically exact measuring stick. He wants to finish this round of chemo and then do a CT scan to get a more accurate pic of the situation before concluding (gulp) that the Gemzar has stopped working.

That leads me to the other bit of Good News. Mom's blood work was looking great this week (except for the rebellious tumor marker :-/), so the Gemzar was a go.

And one more little bit of Good News. The thrush is just about gone. Okay, that's a Big piece of Good News.
 
And here's the Best Good News - Tomorrow is Thanksgiving Day!

There will be feasting and family, laughter and hugging. And feasting some more!

Despite this setback with the tumor marker, and the black cloud of worry that nags at us, we are unbelievably grateful for another day to be together.

May your day be filled with only the Best Good News, the love of family and friends, and hearts overflowing with gratitude for the miracle of Grace.

My Love, Jane

Christmas Tree Time

It's Christmas Tree Time! At least here at the Polly household...

Dean and Ryan stopped by on Friday to help Mom get a jump start on the festivities. They pulled all the decorations out of the attic

and got the tree up. Now mom can decorate it at her leisure.

Which is a good thing, because she's been laid low by another tiresome round of thrush. She's been feeling pretty "ishy" all week. Most likely from the thrush. We think it's gone down the back of her throat and is messing with her stomach, hence the nausea and yuckies.

The good news is that she was able to continue with her chemo this week and began another round of Gemzar on Thursday.  Even feeling crummy from the thrush, her blood work was all close to normal and that deserves a thumbs up for sure.  The doctors have put her back on Diflucan for 10 more days for the thrush.  Hopefully this time she'll be able to beat it back for good.

In the meantime, the Christmas decorations can wait. After all, we still have Thanksgiving to enjoy! This Thursday, at the Schraceo farm, be here for Turkey and all the trimmings! Dinner served at noon straight up! Naps and football to follow...

Balancing Act

Well, it's Monday. And we haven't had to call the doctor...yet. Mom's abdominal pain isn't worse, and maybe it's just a tad better, but definitely still a problem. Mom thinks the increased dose of Nexium may be helping. We have our fingers and toes crossed :-)

She is still eating fairly well, but when the pain hits, she says it is like a burning spasm under her rib cage. Not fun. She's been having to take quite a bit of break-through pain medication just to stay comfortable. We covet your prayers for this nagging discomfort.

I think that is probably one of our biggest concerns as we face this terminal illness head-on. Balancing physical comfort with aggressive treatment. And it is a balancing act. We have the toxic Gemzar on board to go after the cancer, and then we also have the Nexium, the marinol, the steroids, the morphine and the vicodin on board to counteract the harrowing effects of the chemo. Balance.

It's all Balance. And when we get the balance right, it's a good day! Praying for wisdom and grace to walk that tightrope well.

Love you all, Jane

Just a word, Not a sentence...

It's a fact. What goes up, invariably comes down. Obviously mom's tumor marker didn't get the memo...

In the past week it has spiked up 80 points and is now at 362. It was not the news we wanted. Combined with her increasing upper rib cage pain, and we have a worry fest in the making.

However, the good news is that all her other blood work looked great. Platelets have rebounded well and chemo was a go today. So this will be round #1 of Gemzar in this cycle. Hopefully the increased tumor marker is an anomaly and will be dropping as we hit it hard with the chemo.

Mom talked with the nurse today about the increased pain and described it as intense acid-reflux. When it hits, nothing seems to help. For the last two nights she's been sleeping upright in the recliner (only way she can get relief from the burning pain). Bridget, the nurse, doubled her nexium, and said to give it a week, hoping that will help. We've decided that if mom's not better by Monday, we're calling. None of this "waiting and seeing" business anymore. We tried that with her gallbladder and then again when she had the septic strep infection. Both times we followed the oncologist's "let's wait and see" approach to mom's great detriment. It's time to be a little more assertive!

Thankfully none of this has affected her appetite. Dad took her to IHOP tonight and she made quick work of the Short Stack Sampler, (pancakes, eggs, bacon and hashbrowns)! Ummm... Just love breakfast for dinner!

It would be easy to let worry consume our moments. This journey is unpredictable and rocky. We have to constantly remind ourselves that "cancer is just a word, not a sentence." If we let it become a sentence, then it takes over our lives, snuffing out the joy in the everyday blessings all around us. Like:

Rain pouring from the sky this day to quench a parched patch of earth

The first crackling fire in the woodstove this season

Pancakes smothered in sweet syrup

Gentle hands from the chemo staff, thanks Lance :)

Platelets, Red Blood Cells and Hemoglobin all doing their jobs

The smell of homemade Banana Bread baking in the oven

Giggling Grandbabies

and Chocolate Truffles

Oh, the list could go on and on, I'm sure you can add to it the many blessings of your day. God is good. May I never forget, even when worry tries to derail our Hope.

Leaning into Him, Jane

Life's a Teeter-Totter

One's up. One's down. Welcome to life's precarious teeter-totter!

Mom is actually doing well. Chemo Day was uneventful. Blood work looked pretty close to fine.  Platelets were actually higher than they were last week! Weight is up. Again. Yea! And nausea is a distant memory. Well, okay, not that distant, but at least not currently plaguing her.

And so, Round #2 of this Gemzar cycle is in the bag.

Just in time to take Dad to the doctor. He has the beginnings of pneumonia. Has felt rotten all day and can barely make it out of bed. It's chicken soup for him plus lots of antibiotics and steroids.

Thank goodness mom is feeling better. Her turn to be the giver of meds and plumper of pillows. And maybe, one day soon, they will both feel good - at the same time!

Hugs and Prayers Tonight, Jane

Fannie Mae to the Rescue

Today was Round #2 in this Gemzar chemo cycle.
 
Mom started the day a little green around the gills and lost her breakfast before we even got to chemo. However, a little steroids, a little Kytril (anti-nausea wonder drug) and some Gemzar seems to have turned the tide.

This evening she polished off a delicous Italian Sausage Sub Sandwich prepared by Dad, what a chef! And then had a delectable Fannie Mae Truffle for Dessert, compliments of Ruth and Manny, thoughtfulness drenched in yumminess.

Now that's a way to turn the day around!

Happy Birthday Dad!

Happy Birthday Dad!

May the fishing always be good, and the birthdays even better! Love You Always!!

Unfortunately, even Birthday Celebrations can't stop doctor visits and chemo infusions. Today, mom was busy with both.

We started with a visit to her surgeon this morning, and plans are now in the works to surgically implant another medi-port  this coming Monday. Several weeks of standard iv lines up and down her arms have reinforced our hearty endorsement of this medical marvel!

Then we followed up with a visit to Dr. Davis, her oncologist. Bloodwork was drawn, weight checked, and blood pressure monitored. I would love to say all are in ideal ranges, but... RBC and Hemoglobin are still a little low and her weight has dropped to 106. Blood Pressure, however, was great! And so were the WBC and Platelets. Enough so that Dr. Davis was ready to continue the Gemzar chemo today. Off to the chemo lab. Round #1 Gemzar cycle has begun.

As before, they pre-dosed mom with Kytril and Decadron, our favorite anti-nausea, steroid duo, and gave her a bag of fluids. All very welcome, as mom's nausea has been increasing steadily for the last two days, along with 2 bouts of vomiting. Praying these meds help settle the stomach and make her more comfortable. We opted for a note of positive thinking on our way home and got Olive Garden To Go for Dad's Birthday Dinner (thanks Steve, the Gift Card was well appreciated!) And so far, so good. Chicken Marsala is a hit!

A busy, productive day makes for a tired mom, so now it's off to bed for much needed rest and some delightfully sweet dreams of Tuscan villas and sleepy vineyards at sunset. Wow... that Chicken Marsala was really good!!

Happy, Happy Birthday Dad! Consider yourself loved and hugged!

Always yours, Jane

Outsmarted!

Raccoon Report: Zero, Nada, Zip!

Nice to find the trap empty for a change. Although "someone" or "something" cleaned up the treat offering very neatly. They actually pulled the bowl out of the trap and feasted on salmon-flavored catfood without setting off the trap-door.

Whatever it was has the trap figured out. Now, that's a scary thought! They're getting smart....Uh oh!

Tonight I have the bowl tied to the trap floor. We'll just see who's smarter now! Can't wait til morning....

I know that mom is rooting for me. She actually said she was glad I knew how to use the shotgun, just in case...

Just in case what? I trap another snake. Or maybe a bear? Under no circumstances should you surprise me late at night or early in the morning. I am finding lately that unexpected noises make me jumpy...

Well, for heaven's sake, the heat is just making me crazy. Nothing to fear out here in our tiny corner of paradise ;-)

Sorry you had to wade through all my ramblings to get down here to the important stuff!
 
Mom Update: Doing fairly well. Card party last night sounded like a great time, although by the end of the evening, both legs had swollen up past her knees. You guessed it, she's been in the recliner all day today with her feet propped up. Another concern is her low blood pressure. It's making her a little wobbly at times, and we've been watching it closely. On the up side, she's eating well and is pretty much over the flu-like gemzar reaction from this round. It's so nice to have a break from the chemo tomorrow! It will be another day of rest for her, and then it's off to lunch and the IMAX theater on Friday.

Looking forward to a great day on Friday. In the meantime, if no one hears from me in the morning, please send a search party. Something is lurking in the woods...I'm pretty sure it's just our cat,

but you never know.

My love to each, Jane

Another Round in the Bag

Raccoon #21 sauntered into the trap sometime early this morning!! Even I am astounded at the number of coons in our tiny corner of the world!

She got the requisite red stripe and a free trip to Deep Creek. She was not appreciative. Go figure!

Mom on the other hand is very grateful. Grateful for another finished round of chemo!

Dad took her in this past Thursday for the third and final infusion of Gemzar in this cycle. She's had a few off days, the normal chemo crummies, but is doing fairly well. Glad to have a chemo-free week coming up to rest and recharge. Although, I just spoke with her, and it sounds like the week is filling up with lots of activities:

Card Parties

Lunches

 and Scrabble games.

Consider that the recharging part! Nothing like having something fun to look forward to. She can rest in between all the entertainment!

One note of concern, her hemoglobin counts continue to drop, and have been in the low range for the past 2 months. Not sure when the doctors will consider a blood transfusion, but it's not out of the question. I think it has been interferring with her energy level, common problem with the low counts. So, there will be lots of nap/quiet times scheduled into the week too!

I think that's what siesta's are for! Especially in this heat! I vote we join mom for afternoon siesta's all week!

Autumn's vote is in!!  Sleeping like a baby....Nothing more precious.  Love you punkin!

Saying a prayer of thankfulness that the Gemzar is doing it's job, filled with gratitude for the upcoming week of rest, and delighting in the joys of grandparenting!

Grace Overflowing, Jane

Wild Weekend

It's been one of those days - all weekend long!  Busy, exhilirating, fun, and scary all wrapped up together.  I'm needing Monday just to catch my breath...

Let's start with last Thursday.  Chemo day for mom.

Here we are with Lance, one of our favorite chemo nurses.  And we're all smiles because Lance just gave mom her tumor marker results from last week.  Are you ready?!

174!!!

So exciting!  At the end of June, mom's tumor marker was sitting at 630.  Now it's 174.  This is a huge nosedive!  We're thrilled and thankful that the Gemzar is hitting the cancer so hard.  Makes the side-effects a little easier to bear.  We still have a ways to go, normal for the Ca19-9 tumor marker is 0-35.  But we're headed in the right direction.  Nothing better than that!

After chemo, we grabbed a bite at the Corner Bakery, stopped for some groceries, then got mom home and tucked in on the recliner with her foot propped up.  The left ankle is still swollen, and looked particularly moody (puffy, red and peeling) by the end of the afternoon.  The doctors are not alarmed, seem to still think it's just part and parcel with the cancer and chemo, but we keep it propped up whenever possible.  Does seem to help.

Once mom was settled in, I headed over to my brother's and picked up my niece, Sami, for the weekend.  Dean and Lisa were headed out of town and Sami was staying with us.  She's 12 years old, full of mischief, and cute as can be.

She loves the farm and was such a big help:

Here she is helping with chores.  She's so sassy!  Choretime with attitude.

Making her own jewelry.  So classy!

Beautiful!!

Then it was off to the Ft. Worth Museum of Science and Natural History to catch the Wild Oceans IMAX show!  Great way to beat the afternoon heat!

Back home to make some pizza!

Top Chef look out!

Yum!

Busy, fun weekend with Sami.  I think we were all exhausted by the time she headed home.  And she hadn't been gone long, when Leroy came running in the front door and hollered that the neighbor's field was on fire.

I don't think I can describe the sheer panic those words evoked.  As Leroy ran past me I could smell the acrid aroma of burnt grass and wood.  I raced outside and saw the billows of gray smoke rolling across our land and felt a blinding fear.  I could hear the sounds of fire engines and men's voices shouting, but could see little because of the smoke.

In minutes we grabbed what we could and packed the car, all the while just praying, "please, please..."

And God saw fit to answer that wordless prayer.  As we were preparing to drive out, the wind shifted and we could see that the fire fighters had contained the wildfire to just the other side of the road.  One spark, and our field would have been next.  As the sharp edge of panic lifted, I finally grabbed the camera and began shooting these pics:

Bless those firemen.  They worked fast and furiously.  Today we learned that the fire started at old Tom's place, just over the hill in the tree line.  Looks like his house is a total loss, but he made it out okay.  The fire got a good foothold in the dry tinder, and it took off with a vengeance.  All total, 10 structures (sheds, well houses, barns) were lost and probably between 30-40 acres.  Before it was all over, they had called in 20 fire departments from around the county, many of them volunteers.  We are so thankful for their dedication and quick response.  It could have been so much worse.  The winds were mild, but still we had ash and cinders floating down around our place for several hours.  

None of us slept too well last night....Kept checking the windows for smoke and flames.  I'm still jumpy today.  But all that remains is a blackened scar across the road and the faint smell of smoke when the wind shifts. 

What a weekend.  Think I need a vacation....

Too Hot in Texas!

Mom's been running like the Energizer Bunny this past week, and I think she finally hit the wall on Sunday! But before that, she enjoyed a great dinner out Saturday night at the Trail Dust Steakhouse with Steve.

Couldn't get her out on the dance floor, but watching the boot-scootin' sure was fun!

And unfortunately, she's been paying for all the fun now.  The first part of this week have been spent recuperating. Appetite's waned, fatigue has taken hold, and the chemo-crappies have set in. Thankfully, she can snuggle in on the couch with a good book, pillows for her feet and nap whenever the mood strikes. It's hard to imagine how people deal with cancer and these treatments, and still hold down a job or raise a family. And we know there are many brave and courageous cancer survivors who have done just that. Our hats are off in your honor. It takes a massive amount of energy to battle this disease. And to keep going when your body is so wrung out. True heroes. My paltry woes pale in comparison.

Praying that mom's strength returns in the very near future. Chemo #2 in this cycle is tomorrow. I think the heat wave may break by then - forecast predicts a high of only 100!  Yesterday, our outdoor thermometer hit 106.   A friend told us that it was so hot...How hot was it, we asked?  It was so hot that all the grasshoppers were sticking to the shady side of the fence post. We laughed and then we looked. She was right! Every fence post had dozens of grasshoppers clinging to the shady side!   I just had to get a picture of that!

Turns out that I'm not a very good grasshopper photographer!  Every time I got within 20 feet of the fenceposts, the grasshoppers' antenna swiveled in my direction, and they all went into panic mode, leaping to the four winds.  I must have sounded like the proverbial stampeding elephant to their sensitive ears.

But all's not lost.  Leroy, as it turns out, is a very good grasshopper stalker.  He captured these photos for me when he got home from work.

It may be hard to see the hoppers, but they're there on the shady side of the t-post!  Now, how strange is that?!  Tell me, does this only happen in Texas, or what?

As you can tell by the photos, the pasture and ground around here is parched.  And it's only July!  August is knocking on our door.  Texas is in the midst of an extremely severe drought.  While we may laugh at the oddities of grasshoppers, the truth is that farmers, livestock and neighbors are hurting.  Today marks the 26th consecutive day of triple digit heat in the north Texas area.  That's hot!  I don't care if it's dry heat or not, it's just hot!

Saying our prayers for mom, for rain and for healing.  To all in the heat wave zone: Stay cool, drink plenty of water and keep your mouth closed (flying grasshoppers are everywhere)!

 Love ya, Jane

Birthday Celebration!

Yesterday was Mom's 71st Birthday!  

     









Can I just start by saying how absolutely wonderful you all are?! Truly, mom was honored and her day brightened immensely by your many words of love and sweet well-wishes. If you could have only watched her read your notes while sitting in the chemo chair!

It was like you were right there with her. And it was quite a party!! I only wish you could have enjoyed the Birthday Kolaches.

They were particularly scrumptious! I felt kind of like a room mother; you know, when the birthday rolls around you bring cupcakes for all the kids in class? Well, we brought Kolaches (a yummy czeck pastry) for all the nurses and chemo patients.  Give us a reason, and we can make a party out of it!! And I think celebrating this birthday was reason enough!

All in all, mom had a wonderful day. If you put doctor visits, chemotherapy and urn shopping on your birthday wish list.  Yes, mom and dad had another memorial park they wanted to visit after chemo was finished!  On your Birthday I ask?!  Yes, she replies, what's wrong with that?!  Mental head shake me...  Anyway, this time we visited Rolling Oaks Memorial Park and received a tour of their funeral home and columbarium.

Beautiful facility...

Inside and Out....

And they had the most unique columbarium niches made entirely of glass....

These niches truly were memorials to the loved one.  A beautiful tribute filled with personal mementos, pictures and notes.  Mom and Dad both were intrigued with the possibilities.  And to some, this might seem very counter-intuitive; to be planning a funeral while fighting the cancer.  It reeks of just giving up.  And that's so not the case.  Mom is fighting this battle with every weapon available, but she's also a practical soul and desires to have her affairs in order should the unthinkable come to pass.  I'm starting to be okay with talking about funerals and cremation and things, but when the funeral director asked if we wanted to see the cremation witness room I admit to hyperventilating just a bit.  So, I'm not as okay with things as I thought...  Still working on it.

And all on Mom's 71st Birthday.  So glad we had a nice dinner planned for the evening with a few close friends and family.  Now, that's more like it.

Great food...

Great Gifts...

And Great Company...

A time to rejoice in a special day with a very special woman!

 
To celebrating many more special days with you mom! You're not done party-planning yet!

Love you bunches, Jane

Ruffled Feathers

Fox Update: As of this morning we have captured 16 raccoons and 1 duck. Not 1 fox.  Something's wrong with this picture!  This is what greeted me this morning.

Duck-Duck. Our less than happy muscovey duck. And boy were his feathers ruffled. Duck-Duck is older-than-time and equally as grumpy. He can't quack, but always tries. Sounds like a squeaky tea kettle hissing or a gas pipe leak, neither of which is pleasant. He waddles around the farmyard keeping everyone in line by either pecking them if they are in reach or taking a flying jump and flogging them with his wings (ask Kelli, she's had experience with this offensive tactic...).

Perhaps you can't tell from the picture, but Duck-Duck is giving me the evil eye. I debated taking him on a drive to Deep Creek, but then came to my senses.  He is a fixture on the farm. For all we know, he may the reason the fox keeps to the boundary line! It's not wise to cross Duck-Duck!

Update on Mom: Trip to Wendover last week was a wonderful mini-vacation. Yes, she got tired, and yes, her feet ballooned up like melons, but the diversion, the fun, the sightseeing, and the meals more than made up for those minor inconveniences.

They got home last Thursday and we made a run to the chemo lab on Friday. It was her week off from the Gemzar, but Dr. Davis had her slated for fluids, steriods and anti-nausea meds in the off week. While we were there the chemo nurse and the P.A. took another look at her swollen feet and ankles, and advised her to make a follow-up appointment with her family doctor. He was the one who saw her first for the swelling 2 weeks ago and put her on antibiotics. So, yesterday she went back to Dr. Maxwell and they x-rayed the foot, suspecting perhaps a stress fracture. Negative on that count, so now we've ruled out cellulitis, blood clots and broken bones. Hmm...Begininng to suspect that the Gemzar treatment is the culprit.

We'll be talking with Dr. Davis this Thursday when she goes in for her weekly appointment.

Until then, she's reclining like a queen with her feet up on pillows. I think maybe Dad is feeding her grapes and keeping her cool by fanning her. Oh, wait...that would be Dad with a glass of wine turning up the a/c because it's running all the time! Well, at least I know mom has her feet up.

Here's to finding our ankle bones, cool summer breezes and out-foxing foxes,

Love to each, Jane