Chemo Week Update

Mina is, as usual, feeling poorly during Adriamycin/doxorubicin week. She’s barely eating a little chicken when I hand feed her, but she did eat an entire jar of organic baby food this morning.

There was a small puking incident before the mobile groomer lady came, but it was just yellow foamy stuff. She still took all of her peanut-butter coated pills and supplements and drank some water.

Kristen had her all groomed and back home in less than an hour. Mina’s hair color is definitely darker than it used to be, more like an Airedale than a Wheatie. She’s very thin, too.

We’re going out for a bit, not sure where we’ll end up. Maybe the winery, mabye just a drive. Mina will feel better by Monday and then we can work on fattening her up.

s.

 

Looking Forward to Rest Week

Mina was pretty lethargic yesterday, which I blame on all the excitement from Saturday, our late night, and the overwhelming gloom of Sunday. She didn’t eat very much, as I expected, just a few jars of baby food and maybe a handful of beef and chicken. Normal bowel movements, no vomiting, just not feeling like herself, I guess.

This morning she was pretty sleepy so we walked only as far as she needed for a poop. When we came home, I offered her some beef and chickens and she ate a little from my hand and one jar of baby food. I’m finding that Mina is very sluggish now in the mornings and doesn’t really seem interested in food until later in the day. So, I left a note for her sitters to give her baby food if there’s still breakfast in her bowl. She cannot survive on damned baby food, it has the nutritional value of air, so I’m hoping she improves today. I did give her the Mirtazipine before bed and she went to sleep pretty quickly afterward.

Tomorrow is her rest week exam and CBC and I fully expect a weight loss. Not a huge one, but she may have dropped a half a pound this week. If all goes well during rest week she’ll gain it back.

s.

 

Another So-so Day for the Mina Bean

I wish Mina were sailing through this doxorubicin week like she sailed through the last one. But it’s always different with chemotherapy and I’m doing my best to roll with it.

Mina clearly wasn’t interested in eating much yesterday after breakfast. Auntie Sherrie fed her a jar of baby food, Uncle Robb said she was perky during her walk but there was still food in her dish from earlier in the day. When I got home after stopping at Whole Paycheck for more carcass and veggies, I tried to hand feed her but she wasn’t interested.

The weird thing is that she was very perky on our walks and very interested in meeting canines and humans. She met a little sort of chihuahua mix, named Puppy, on our way home from an afternoon walk and was genuinely engaged. I didn’t notice any drooling, but later in the evening I started to notice that she was changing her positions a lot. I just needed that one indication that she might be nauseated to whip out one of the two remaining Zofran tablets and dip it in peanut butter for her. About an hour later, while I was still dismembering chicken corpses, she came out the to kitchen asking for some fresh food.

I had toyed with the idea of adding some pureed organic squash to her beef mix, but nixed that idea because it’s also possible that the chemo drugs are messing with her taste perceptions again. So figured we’d better keep it simple for a while longer. I mixed two local farm eggs, some dried parsley, and garlic powder into the ground cows and baked it. She seemed to really like it.

This morning we took a short walk, just long enough for Mina to find a place to poop, then I put some shredded chickens into her dish. Not interested. I sat down beside her on the tile entryway and, at first, she turned her head away when I offered it to her. But after a few more tries she was eating it out of my hand, then she got up and moved to another spot in the living room. I sat next to her and kept feeding her until she’d eaten almost everything in the bowl. I doubt she’ll eat again until I come home this evening.

Tomorrow, I’m taking her out to the Sanctuary with me to meet up with everyone after they finish the chores. I’ll take along a treat, too, but I really want them to meet Mina because they are so kindly asking after her every week. It’ll be a stimulating outing for Mina on a day when the doxorubicin will peak in her body, so I’m hoping she’ll be able to enjoy herself without noticing any nausea or other bad feelings. I have one more Zofran that I’m saving for tomorrow if she needs it. I’m sure I can get another prescription for the last quarter of chemo that starts on August 11.

s.

 

A Quiet Day

Mina is rather quiet today, which is typical of the day after chemo. She’s been out on three walks, all quite perky, visited the leasing office twice for butt scratches and liver treats, but has mostly been napping in front of the couch or on the tile in front of the door. She’s eaten three meals and taken all her pills and supplements. I don’t think she feels bad, but it’s clear that she’s pooped.

She has a new habit, too. When we go downstairs now she turns to the back of the breezeway and sniffs at Max’s door. This afternoon she got lucky as Max and his mom were just coming out for a walk. Mina loves Max, even though she can’t keep up with him. It seems that she has a thing for younger boys.

s.

 

FIVE …

You're gonna miss these guys when this is all over in a few weeks ...

Mina’s home from her day stay at VIMP for the Adriamycin/doxorubicin chemo treatment. She did very well and they gave her a reduced dose to help prevent any side effects. Mina was pre-treated with a Pepcid IV and a Benadryl IV. Here are the highlights from her discharge papers:

• Physical exam: bright, alert, some alopecia (hair loss) on medial thighs and where legs were shaved for chemo, left popliteal lymph node palpable at < 1cm, all else within normal.
• Normal white blood cell count at 6,700, normal HCT 38 percent (not anemic), normal platelets.
• Urinalysis (free catch): specific gravity 1.025, trace protein, negative glucose, no overt infection.
• She gained a half pound for a weight of 49.7 pounds!

Today's bandage was pretty cute!

I got this note from Dr. B. about the left popliteal lymph node that changes from less than .5cm to less than 1cm from week to week: “Dr. Birnbaum wants to let you know that the notation of the change in size of the lymph node is actually not precise as it is estimated based on feel, not with calipers, and that either ‘less than 1 cm’ or ‘less than ½ cm’ are both meant to indicate ‘barely palpable.’ She also stated that if the lymph node does change in size by this miniscule amount, that it may not even be related to her cancer, but could be related to her resolved UTI or any other process that might trigger the immune system locally. She said that either way it is not an indicator of whether or not Mina is headed for remission. She said she is more interested in the appearance and size of the spleen, which today looked wonderful.”

I thanked Amy for that note because this node has been worrying me a little for weeks now. I’m no longer going to worry about it unless Dr. B. tells me she’s worried about it.

Did you notice in the urinalysis the part about “negative glucose”? That means that Mina’s mild glucosuria has resolved. Her kidneys are working fine, but they do show signs of aging. That said, I still plan to complete the Five Leaf kidney treatment once Mina is done with chemo and has built up her immune system a little. I think a kidney detox can only be beneficial for her.

Resting after lunch

We got home and Mina drank a lot of water and I gave her a big helping of the chickens I’d boiled for her this morning, as well as a jar of organic baby food. I’m boiling the carrots for the ground cows dish right now and I’m not adding rice this time. She’ll get organic carrots and organic tomato all pureed and cooked in the ground cows with some safflower oil and parsely (and a little garlic).

Next week is her last rest week in the protocol.

 

Forensic Pukologist

That’s me. Mina had a little pukey-puke last evening. It was her dinner and her supplements and Tramadol. I slapped on the latex and started sifting through the puke and found this black stuff in the middle. Turns out it was her Mushroom Defense pill starting to dissolve – it looked quite fungal. I picked up the Tramadol because it was in good enough shape for a return visit, cleaned up the puke and gave Mina the Tramadol and Meto. Later on I gave her some slippery elm and ginger.

I could hear her tummy gurgling from a few feet away. I did see something in a ball of grass in her puke, so that may be what made her sick. It could also be the excitement of the weekend and some anxiety related to it because the gurgling sounded like her IBS days.

At any rate, she’s fine today! Eating like a great, big dog and walking all perky and everyone reports that she’s in a good mood. Her Auntie Lolo noticed the spot on her behind where her hair is now missing. When does the hair loss end? Does anyone know?

Tomorrow is Adriamycin/doxorubicin again and she’ll stay all day at VIMP. I’ll be here working and cooking chicken and waiting for the call to pick up my baby.

s.

 

Mina Had Company This Weekend

Mina and I had a guest with us this weekend, my 16-year-old niece, Erin. She lives about an hour away – in good traffic – and Mina and I drove to pick her up on Friday afternoon.

I parked in front of Erin’s townhouse and let Mina out for a little bit. She went crazy! I’ll bet it’s been six years since Mina’s been in that neighborhood and she seemed to recognize it. She kept climbing the stairs to the front door, wanting to go inside. She also seemed pretty excited when Erin got in the car. It’s been four years since Mina saw Erin, who’s changed considerably but not to Mina, I guess.

All weekend long, Mina put on some aggressive begging around Erin. I told Erin that Mina must remember what an easy mark she was as a toddler for food snacks. While driving Erin home today, Mina attempted to take a bite of Erin’s peanut butter cookie – in a moving car!

We had a good time and Mina was in great spirits. I stopped giving her the Metoclopramide yesterday because she just doesn’t need it on the reduced dose of Vincristine. She’s eating very well, feeling pretty perky, and Erin commented that she looks good and seems very well for a cancer patient.

I’m hoping at some point to get a more balanced diet for Mina, but I think that’ll have to wait until after the the chemotherapy. We have the day-stay for Adriamycin/doxorubicin on Tuesday, then a rest week, then four more treatments and we’re done. I’m hoping at some point in the next five weeks that Dr. B. will announce that Mina’s in remission.

s.

 

If the Cancer Don’t Kill Ya, the Chemo Will

Mina’s cancer seems to be in a retreat, but physically she’s not doing well. Down to 47.7 pounds as of Tuesday and she hasn’t eaten since then, either. Nothing seems to tempt her but bison bites and she can’t live on those. I’ve been heating her Chow Now in the microwave because she seemed to prefer it warm, but that’s not even working since Tuesday evening.

Then there was the debacle over the e-mail I sent demanding better estimates for Mina’s chemo expenses. I apologized, ’nuff said, moving on now.

We’re also having problems with pilling Mina. Last night I gave her some peanut butter with her pills and one of the smaller tablets got stuck on the roof of her mouth. I was able to remove it, but now she looks at the spoon very suspiciously. This morning it appears one of the capsules, either milkthistle or Keflex, melted in her mouth or throat and that was a couple of minutes watching her make faces and rub her tongue around and smack her lips. I gave her some more peanut butter and that seemed to help get the bitter taste out of her mouth. She’s on to every trick now and really doesn’t like being pilled manually. Yesterday, she bit down on my thumb with her back molars and that really hurt.

Mina is taking too many drugs and not eating enough. Period. I have to give her the medicine but it makes her nauseated so she doesn’t eat and that makes her feel worse. So today I’m calling VIMP, at Dr. Smith’s suggestion, so they can prescribe a stronger anti-nausea drug. The Metoclopramide just isn’t cutting it for Mina.

It’s been a hard couple of weeks, lemme tell ya. Still no word from the bank on my loan application.

s.

 

Doxorubicin Day Update

Mina is finally home after seven hours at VIMP. I’m so glad to have her here ’cause it’s just Weird when she’s away.

Chatting VIMP budgies

Thanks to Auntie Sue, I sent an e-mail to VIMP explaining what I need in the way of detailed estimates for the rest of Mina’s modified Wisconsin protocol. When I got there at 3 p.m. I told the receptionists about it and she promised to print it and put it on top of Mina’s file and get one of the LVTs to work up the estimates. That should help me plan because right now I feel like Mina’s chemo is a runaway train.

Here’s the report from today’s doxorubicin/Adriamycin infusion:

Physical exam: bright, alert and responsive; no palpable splenomegaly; prescapular lymph nodes are small but palpable at about 1/2 cm; two left submandibular lymph nodes are palpable at 1/2 cm.
CBC: stable mild anemia at 35% with a normal white blood cell count.
Urinalysis: Specific Gravity 1.025, pH 9.0, trace protein, trace blood, sediment revealed many white blood cells (15-20/hpf) but no red blood cells. Questionable cocci bacteria/coccoid debris. Appears infected.

Adriamycin infusion (21 mg) was administered IV in the left cephalic vein today; administration went very well.

Ultrasound findings: Spleen is normal size and texture had improved as well. Internal lymph nodes are small in size. The urinary bladder wall is thickened and slightly irregular in appearance, consistent with a urinary tract infection. Cardiac ultrasound before her Adriamycin treatment was within normal.

If after 10 days of Keflex treatment Mina still has a UTI then Dr. Birnbaum will order a urine culture. So, if that becomes necessary it’ll likely happen next Tuesday when she goes in for her rest week CBC.

I asked the LVT about the palpable lymph nodes and she explained that “palpable” does not mean “enlarged.” All of Mina’s lymph nodes are normal size (about the size of a pea) and Dr. Birnbaum believes that she’s making good progress.

Mina lost another pound, so she’s down to 47.7. The LVT assured me that if she’s not eating better in a couple of days there are other anti-emetic drugs we can try to keep Mina from being nauseated. This chemo drug really makes her feel crappy, but I’d like to keep her from dropping below 47 pounds!

I saw Dr. Smith as he was leaving, having worked all night at PWEVC and then all day at VIMP, and he’s very pleased with Mina’s progress.

They ate all the homemade vegan doughnuts.

 

It’s Doxorubicin Day

**UPDATE** Mina will stay at VIMP until 3 p.m. Dr. Smith explained that Dr. Birnbaum is in a procedure and hasn’t been able to write Mina’s discharge orders and give her a final once-over. I called back to find out how much my bill will be and it’s not completed but it’s already more than I expected. More than I have in my checking account and I can’t make a transfer until July 1. I’ve used up all my transfers this month. So, I applied online for another loan to help cover the rest of Mina’s chemotherapy. I just hope it’s enough and that I can afford the payments. To say I’m despairing today is true.

Mina is at VIMP where she’ll be until around 11:30 a.m. Right about now, the LVTs are taking her blood and urine to make sure she’s fit for today’s 90-minute infusion of chemotherapy’s nastiest, and most effective, drug.

She didn’t want to stay and even burped up some puke while we waited for her paperwork. The tech came out with some Litmus paper to test the puke and then cleaned it up for us. Mina was shaking when the tech took her to the lab. I feel bad for her because she’s nervous but I know they take very good care of her.

They’ll do a CBC and if her numbers are good they’ll give her the infusion. If not, they’ll call me to come and get her and reschedule it. I put her on the scale in the waiting room and she’s lost nearly another pound this week. I simply can’t get her to eat much of anything, despite the mirtazipine. I told them this in the form I fill out every week to let them know how she managed the last chemo.

If she does get the doxo today, it’s going to be a rough week for her. That shit make her feel nauseated all the time, and she eats even less. But next Tuesday starts her rest week so I’m hoping to shovel as much food down her as possible before we start the third quarter.

As for me, I’m running out of money and it’s causing me enormous anxiety. I talked to Dr. Cliver last night, one of Mina’s regular vets, and I told her that if we both survive the chemo it’ll be a miracle. I honestly had no idea – NONE – how difficult this was going to be for Mina and myself. Mina’s a champ, she’s doing the very best she can, but I’m the worst cancer caregiver on the planet. I don’t sleep much, I’m cranky, and I can’t concentrate for very long. Last week was supposed to be a vacation, but I swear that Mina was depressed when I didn’t go to work yesterday. I think she needs a break from the constant insanity of my anxiety.

More later when they call me.

s.