Waiting on the results

Today I give thanks for...
Spending time with my daughter playing, and reading
Being a Dad
My strong back and the avoidance for pain
Apple computer for making my life so connected

Yes, we made the trek down to San Francisco on Monday for another Lulu cancer center appointment. I was going to wait until we received the results of the bone marrow test before writing here, but all the feelings that I have been experiencing just needed to be released. I haven't been in the office this week seeing patients, but I can feel the stress that comes with caring about the practice of treating kids. Lulu has been working on Thursday, yesterday, and today, and the effort/stress has been taking a toll on her. I was at the office for the management and team meeting yesterday, and I could tell from her tone of voice, actions, and the way she was moving that she wasn't having the best day. I did my best to console her, and I secretly wondered if the stress wasn't related to the office and dentistry, but the waiting on the results of Monday's test? I know that I have been very apprehensive about what the bone marrow biopsy number will say? Did the trial drug decrease the amount of cancer cells in the bone marrow during the shorten 3 months that Lulu was given the drug, or could the numbers have possibly increased? Both Lulu and I have been told by the oncologist that the pending results of this test must be taken "with a grain of salt" because the research that has been done so far on the concentration of cancer cells in the bone marrow, and the recurrence of the cancer has been shown. My understanding is that the hypothesis is: the higher numbers of cancer cells present in the bone marrow the higher probability of either a recurrence of the cancer or the increased possibility of the cancer showing up in other vital organs? The trail drug's purpose is to reduce the overall numbers of those cancer cells in the bone marrow, thus decrease the possibility of recurrent or new cancer locations. So, even as we are reassured that this is all "in theory", I can't help but think that these theories are weighing heavily on my beautiful wife's mind? (I know that I'm struggling with the information). The results (higher or lower) of the cancer cell count we're to be dropped upon us by the end of the week. I'm almost envious of my wife for getting the chance to be busy caring for the patients at the office, so she can be relieved from her anxiety. (if even for a short time). Heaven knows that I have had plenty of time to be thinking about what all this means.

Monday's visit was a little strange this time down to the cancer clinic. What I mean is the whole trip went by very quickly for me, and there was some flashbacks to all the trips down. Lulu and I fell quickly into the routine that we know so well; stopping at specific gas stations for snacks and gas, parking in the same floor UCSF cancer clinic parking garage, and eating dinner on the drive back at our favorite spot The Cheesecake Factory. I was seeing the trip down to SF as a downer, because this was the first trip down since the post operative surgical appointment in late November, I had begun to disassociate SF with my wife's cancer battle, and this trip was a reminder that there's still a long journey ahead. I guess that I should be seeing the positive side of this. It shows that Lulu has passed the stage of thinking about the daily battle of the cancer and she's thinking about the bigger picture. It's great to see that Lulu is thinking about a future that's less about cancer and it's effects and more on her other obligations like your career and family.

I know that there's more to this journey for Lulu and our family in the coming months? The next few months are going to be important in determining how the next number of years of being a "Breast Cancer Surviver" will effect our live's? I know that this dreadful disease won't be able to break the resolve of my strong life partner.

We are approaching the day of the big test

Today I'm grateful for...

Getting to a new year with new hope for our family
The great heath of the members of my family
Hot chocolate on a cold evening
spending time at home with the kids

It's new years eve, and our family is snuggling on the coach watching "The Sorcerer's Apprentice" movie and eating popcorn while drinking hot chocolate. I can't remember doing this as a family ever? As I look back at 2010 I can only think about the "Cancer" and how it's effected our family. Not all of it negatively though. I can see the positive in the way that Lulu and I interact and communicate. Also, the closeness that Lulu as forged with the kids (part of this is the extra time that she has been able to spend with the boys). Our whole immediate family and the extended family has pulled together due to the illness to support not only Lulu, but each other through the stress filled days. I have heard the saying that adversity brings out the best in people, and I would have to say that for us in 2010 that has been so true. I'm looking forward to this new year, and I think that God will be looking upon our family and extending his power to make our year really special? Lulu and I haven't spoken about the "Big Bone Marrow Test" that she is scheduled for on Monday.

Lulu and I are taking the drive down for a check up, but also a bone marrow biopsy. This is the test to follow up on the results of the trial drug treatment Sutent that Lulu was a part of for a shortened three and half months. (the full treatment time was to be 6 months, but they stopped the treatment short of the six months because Lulu was having so much trouble with the healing after the reconstruction surgery on her breasts. Even though Lulu didn't complete the treatment with the cancer fighting drug, we are hopeful that her cancer cell numbers in the bone marrow have been reduced, if not eliminated? Lulu future heath may very well be lying in this test. I can tell that she is very nervous about it too. I will be praying that the test results with give her a clean bill of health, and the best new years gift that one could ever hope for.

Where has the time gone???

Today I'm grateful for...
Routines
Feeling really good
An optimistic future
Family and friends supportive love

Wow, where has the last month gone? As I look back on the blog entries I see that it's been 3 weeks since my last posting. So, you're probably wondering "WHAT THE HECK HAS BEEN GOING ON?" Let me tell you a little about it.

First, the family took a short flight to the Washington DC area to visit Lulu's younger sister Ibis for Thanksgiving. What were we thinking flying with four kids under the age of ten? Lourdes is at that age where she isn't very happy about sitting in a seat for more than a few minutes let alone hours. The flight back from DC was long and I couldn't get the cutie girl to sleep. She wanted to, of course, get out of her seat and see her surrounding? I spent much of the flight turning on and off the overhead reading light above her seat (that seemed to be the best entertainment of the trip?) Unfortunately, the light wasn't working on the second leg of the flight (from Chicago to Reno) so I had to use the light above my seat. The following two or three nights I was waking up to various nightmares of lighting storm flashes, dark scary places that bright things would jump out at me, and dreams of driving through a tunnel (as the lights blinked above the car as I passed at 60 miles per hour). It got so bad, at one point I needed to start using my thumb to turn the light on and off, because my index finger so sore. When we had returned to Reno, I suggested to Lulu that we could change our Christmas plans and celebrate it here in Reno (we have tickets to visit Puerto Rico for Christmas week, and that's a 9 all day flight there and back)? We seriously debated it, but in the end we felt that changing the plans at this juncture would be harder on us then just getting through this? The visit with Lulu's family was nice, as we all haven't been together since last summer, and we won't be seeing Ibis' family this holiday season, because they will be spending it with her husband's family in Ohio.

Second, Lulu has been to UCSF a couple of times in the last three weeks (one of these without me). Yesterday Lulu was seen at the clinic for treatment plan addressing her over active ovaries and future breast surgery. Lulu ended up going down to San Francisco with a friend since I had patients scheduled at the office, and she didn't want me to reschedule him on her behalf. She told me that the doctors have said that if she wanted to she could have both the reconstruction and ovaries removal both during the same surgery and this could be done in May or June. This is good news, because we had both been thinking that Lulu would have to have a surgery in January for the ovaries and then an additional one in May or June for the breasts? The only drawback to wanting until Spring for the ovaries to be removed, is that Lulu will have to continue the estrogen suppression shots monthly to keep the estrogen in check. I asked if she might be able to get the shots here in Reno, so we would have to make monthly trips down to SF for these. The UCSF doctors think that this is very possible, and Lulu is to make a appointment with a Reno oncologist to administer the future shots. The other trip down about two weeks ago was to follow up on Lulu's healing after the last surgery, and the talk with the newest surgeon. This woman doctor we found out specializes in female reproductive surgery. She lead us through the need for Lulu to have out her ovaries and what the science says about the production of the estrogen and the recurrence of estrogen positive breast cancers like Lulu's. She seems very confident that the right choice for Lulu is to get the over active ovaries out, and subsequently reduce the chance of recurrence of Lulu's cancer. During this same trip to UCSF Lulu received her monthly estrogen shot, and blood test.

The next trip down to the clinic will be for a bone marrow biopsy. Since Lulu was part of the trial study for this new anti-cancer drug, even though she didn't finish the trial, the doctors would like to get a final count of cancer cells in her bones. Lulu has this biopsy scheduled for the Monday after New Years. I can tell that she isn't very excited about this procedure (who would be when you're getting a large, long needle thrust into your hip and the mushy insides of your bone sucked out)? I know that we're both apprehensive about whether or not the trial drug treatment and all the side effects were worth it? Will the bone marrow test show a reduction in the cancer cells, or would the 4 months of drug treatment not produce any noticeable results?

I've been busy working on my Christmas gifts for Lulu and the other immediate family. Last year for Christmas I put together a hard cover picture book of Lourdes first 6 months of life. With pictures of her first being born, the day she could come home from the hospital, and the family sharing their home life with her. I put it together with the thought that I was going to give Lulu, grandparents, and aunts a cherished memory book of "The little miracle angel girl", but I found out that I got more out of the project then I could even have imagined. Putting together the photos and seeing the growth of Lourdes in those first 180 days meant so much to me. We are so very lucky, and blessed to have her with us, and everyday I'm thankful that I get a opportunity to be part of her life. This year I decided that I was going to improve on last years theme, so I've been working on a hard cover picture book that chronicles all our kids from 2000 (when Carter was born) to 2010. I have been finding some really great pictures to add to the book, and with the exception of a coupe of family portraits, only picture of the kids are in the project. I love these kids, and just as last year picture book did, this one is bringing me great job. I'm not sure that I have enjoyed working so hard on a project as I have with this one? I can't wait to see the joy that this treasured memory will bring Lulu on Christmas morning. I'm think of doing this kind of project every Christmas, and bring joy to not only all the receive the book, but also to myself while I put it together. I will have an extra book made for viewing at the office, so anyone who might be a patient of Dentistry for Kids (or just wants to stop by to see the picture books) can see the labor of my love?

Were looking forward to the holidays (to forget about the medical issues)

Today I'm grateful for...
Computers
The up coming holidays with family
Thinking clearly through all the adversity
My kids

I've had good intentions about updating everything that's been happening in our lives, but my computer been having some issues and wouldn't hold a charge. Hopefully, that little problem is behind us? Where do I begin? Lulu and I have another trip down to see the doctors at the cancer clinic this Wednesday. I believe the agenda has her seeing the oncologist, the plastic surgeon, the gynecologist, getting her monthly shot to reduce her estrogen levels, and having a ultrasound done on her ovaries. Wow, now that's a complete day?

We are hoping the answers that we hear are positive for Lulu's health. On our last visit with the oncologist just a week ago, Lulu was told that she "might want to have her ovaries out"? I could see that she wasn't real excited about the suggestion, but I think that both of us knew that the prospect with there. Later we would discuss why her ovaries were taken out during one of her other 3 or 4 surgeries? Now she's looking at another surgery possibility coming up? Just maybe will we get some news during our appointments on Wednesday, and that she might not need to have this surgery? I think though we both know that having this procedure would help improve her health.

A Busy Halloween

Today I'm thinking about...
The balance between being busy and having enough time
Filling my days with sharing time with my kids
Seeing the great in all those around me
Having so many people that care so much

What busy week. After returning from San Francisco on Saturday afternoon with Lulu, the week has been filled with many family pack togetherness and work. Of course we have been keeping an eye on Lulu's healing after Friday's surgery. I think that the first two or three days was difficult for her to recover her energy? By Tuesday she seemed to have some of the Molina spunk back? I've always heard about patients that are dealing with cancer treatments starting out strong, but after a while the accumulative effects of all the emotional ups and downs just really begin to wear them down. I think this is exactly what has been happening to Lulu (and me)? I have noticed that our attitudes about the care she's getting, and the treatments that are needed we just aren't as optimistic as we once were.

The repairs on Lulu's breast seem to be healing well now that the implant has been taken out, and some new tissue has been placed on the site? Though we're both skeptical about the doctors assurance that this surgery will allow the area to heal properly. So far it's looking good, besides the blistering of the tissues around the lateral border of the surgical site. What's this from; who knows, but it quite sore for Lulu. She also complaining that the drain they placed into the breast is very uncomfortable, and when we return in a week that she wishing that the doctors will be able to remove it? I'm so proud of her dealing with this latest set back. Besides being a little skeptical of the treatment, she hasn't really complained much about the whole thing. I know if I was just cut on a fourth time, had blisters on my breasts, and had to put up with walking around with a tube and bottle sticking out of my chest, I would a huge pain in the butt to be around. I just pay that she will heal quickly and that she can get the drains removed next week, and be on her way to recovery. I think that she deal with enough adversity these last 15 months?

I'm not sure if I had mentioned the fact that the oncologist and the surgeons have elected to take Lulu off all three of the cancer treatments that she was on. They seem to think that there's a possibility that these medications may be contributing to Lulu's inability to heal? This is a great concern to us. These medication are the standard protocol for Stage III breast cancer patients and have been used for years for the prevention of recurrence of the cancer. Without these drugs the chances of either a return of the cancer in the breast or a metastasis of the cancer in other part of her body increase. They say that after Lulu heals they will get her back onto the regiment of the drugs, but so she can heal they think that the risk is warranted? There's times that you just have to have faith that the doctors know best and the treatments they recommend are the ones that are going to work? However, knowing what the consequences of not taking the chemotherapy drugs are, we pray daily that she will heal quickly so that she can return to these drugs?

On Sunday night our family met up with friends for a Halloween trick or treating escapade and we had a lot of fun. The boys love the Marios brothers and they each picked an outfit from the game. Carter was Yoshi, Hamilton was Mario, and Lourdes baby peach. Thomas didn't want to be part of the group, so he picked Captain Jack Sparrow form the Pirates of the Caribbean. Thomas likes to do his own thing. After hours of running from house to house (I didn't need to work out today) we returned home to organize the candy. Being dentist, our rule is the kids can pick out their favorite 10 pieces of candy and the rest gets recycled. (I think the kids have more fun figuring out what candy to keep then even eating it?). I have posted a couple of pictures from our Halloween evening I think you'll enjoy? I hope that it was a fun filled holiday for you too?

Surgery number three on Lulu's breast

Today I'm thankful for...
seeing the great qualities in everyone
being there for my family
good, caring, and responsible kids
my health

The third surgery on the Lulu's right breast happened on the afternoon of Friday Oct. 29th. After spending the week in the hospital on the IV antibiotics the surgeon made time in his schedule to operate on Lulu Friday at 11 AM. There was a lot of discussion about what needed to be done during this surgery. The implant was to be removed and the tissue cleaned and re-sutured together so it can heal properly. The tension on the tissue was thought to be too much for the radiated tissue to stay sutured together, and the best treatment for Lulu was to just remove the implant and start again with either a new tissue expander or nothing at this point? After waiting for Lulu to finish in the operating room, I was told that she had preformed beautifully during the 2 hour surgery, and she was our of the recovery area at 2:15 PM. I walked her to the same room that she had been in for the week, so she could continue her recovery.

Lulu is so tired of the routine of trips to SF, hospital stays, feeling sick, not being able to hold her little girl, and the time away from her kids (not to mention the time out of the office and not being able to care for the patients). I even caught her in a "feeling sorry for herself" moment the morning of her surgery (these moments are becoming more frequent with the continued struggles with the poor heal that she's enduring). It's hard to second guess someone who's about to go through their third surgery in the last 60 days. Not only that fact, but also Lulu will need at least one more surgery (and probably two) in 4 to 6 months to replace the implant that is causing her so much grief? I can see that with each complication, surgery, and recovery that Lulu is wearing down both physically and emotionally. I have been thinking of how to build up her strength emotionally, because this lady only has a sliver of the strength that she once possessed. I feel as if I have let her down? I have been saying with each surgery (or other medical event) that she's beat this and everything from now on will be better, but it seems that there's always more that creeps into our life's? I truly know that one day soon everything will past us by and the days will be filled with positive feeling and a new revitalized wife; however, until then we just have to have faith in God that he will give us the strength to make it through.

Before Friday's surgery I returned to Reno to spend a overnight with the kids. Lulu and I felt it best for me to return and spend a evening with the kids and take them to school in the morning. Both of their parents being away for this length of time can really emotionally effect the kids? (not to stay the effect that it has on us too). I found the drive home by myself was very lonely, and it seemed to take forever? I did manage to make it in time to pick up the older kids from school, and then pick up Lourdes and Hamilton for a evening of piano lessons, fast food dinner, and then an evening at home playing together.

The night flew by and before I knew it the kids were in bed, fast asleep, and I was trying to catch up a past due tasks before heading off to bed so I could turn around and drive back to be with my wife. After taking the boys to school and finishing some errands, I found myself making the 4 hour drive back. During the whole drive I had the old familiar feelings of losing my wife to this terrible disease return to my mind. My mind was racing with the what ifs. What if the cancer returned? What if Lulu couldn't came back to the office and work? What if she could never again live without the pain? What if I was left to raise four little kids alone? As I passed through Sacramento and on to Davis I soaked the steering wheel of the Prius with my salty tears. I felt guilty for crying, but could hold back the emotions that I was feeling. I just all seems so unreal. Like I'm caught in someone else's nightmare? I had no choice but to pull it all together and continue my drive ever closer the hospital. With only hours before another surgery for my battling wife, I pulled into the parking garage at the clinic, and said a little prayer as I got out of the car to face another seemingly insurmountable challenge with my wife. Walking in the the hospital I found myself thinking of only impending demise for all of us on this planet. That the most precious thing that all of us have is time (and following close behind is our health). I renewed a promise to myself to spend as much time with my love ones as humanly possible?

I walked into room 421 (her room for the week) with a mission on my mind; be strong, love all those around you, and take the time to be there for your family. No day is more important then today, and don't take tomorrow for granted. I saw Lulu in the bed with IVs hanging next to her bed and I knew that I needed to live those commandments from this day forward. I gave her the biggest hug and kiss that I could muster, while the whole time thinking of how my life has been changed forever!

Back to UCSF, what would the doctors want to do?

Today I'm grateful for...
Being able to express my emotions
Great medical care for my wife
Antibiotics
The love of the people surrounding my family

What a long week it has been. I have made the drive from Reno to San Francisco three times this last week and I'm not done yet. After saying goodbye the the kids on Tuesday AM, Lulu and made the journey down to the UCSF clinic so her breast swelling and wound healing could be assessed. We talked about a variety of things as we drove the scenic highway 80 down the mountain, but we were just avoiding the real issues of "what's next"? I know that the reality of the situation is that Lulu will be at the very least admitted to the hospital for IV antibiotics, and more likely a hospital stay and a surgery to repair the infected breast. The drive seemed to be taking much longer then normal this trip?

The Prius knows this trip well, and the familiar scenery passed by while we spoke about what we were going to do if the scenario means Lulu will be sending the week in SF? We both agreed as the car pulled into the 6th floor of the parking garage that she was going to be here for the next four to five days.

During the appointment with the plastic surgeon and the nurse was a tense 30 minutes. As he arrived to see Lulu I could tell the surgeon was felling horrible that Lulu was having the issues that she was with her breasts. He was extremely caring in his presentation of options to Lulu's new infection. We were soon all in agreement that the only options is just we had expected, four days of aggressive IV antibiotics, and then breast surgery to remove the infected implant and to leave the area without expansion to heal for 6 months. Once the tissues have healed appropriately then Lulu could have a new implant placed during another surgery. If all goes well that she might be done with the process in May of 2011? Both my wife and had been prepared for this as the answer to her recurrent infection issues. After the orders were written up, Lulu was admitted to the 4th floor of the Mt. Zions UCSF clinic.

Lulu was in remarkably good spirits for having to spend the next four days hooked to a IV pole, and mostly restricted to a hospital bed. The nurses have been close to fantastic every time we have been here, and the trends continue when we were assigned to Roshone. She was so caring, helpful, and skillful. I was happy ghat she would be the first nurse of many so Lulu would have the best experience (at least to start off with). Before we knew it she was hooked up and started on the vancomycin, and we both just hoped the rest of the week would be a success?