Ugh, been a while. Sorry, folks, I've taken about a month off from this blog and it's mostly just been to act like everything is back to normal. Just needed a break from it. Back at it today as this morning is Day One of radiation therapy. In total Kim will have 30 sessions spread out over the next 6 weeks. It's a bit of a long haul but it feels like the fourth quarter so the end is in sight. Time to finish strong.
Here's where we are now. Kim had surgery on December 15th and has been slowly recovering. She's been diligent about her physical therapy, her exercises, and taking overall good care of herself. She moves better and better each day but she is in constant pain. The doctors aren't sure if it's nerve related due to the fact that she's sleeping only on one side and over compensating for the one side or if it's residual neuropathy. No matter, her arm hurts a lot most of the day. Even the clothing on her skin by her wrist is painful. She complains very little but nearly five weeks of pain has taken a toll. I try to offer some comfort though massage isn't all that helpful. Mostly I just try to be a dork and distract her from it. I'm good at that, Dr Dork.
Acupuncture has provided some relief and I'll bet the slight change to warmer days will be well received, too. We could all use a break from the cold. Her arm pain has kept her off the bike and limited exercise overall though tomorrow we hope to get her onto an indoor bike trainer and work on some fitness. She says that walking and light exercise help her arm to feel slightly better so the hope is to move some blood through her system and get those exercise endorphins doing their thing. I only have to help now and then with sweaters on and off though carrying bags, lifting things, and reaching up into cabinets is still difficult if not impossible.
But I do feel as though a breakthrough is imminent. Therapy, exercise, warmer temperatures, and a return to normal life will converge into relief from this nagging arm pain. Now, speaking about normal life, her hair is growing back. Like, really fast. It was just about a week-and-a-half ago that she took off her pink wig and her scalp looked really dark. I investigated and discovered that it was hair poking through. A few days later and it was sprouting out. About a week after that she had the tiniest case of bed head you've ever seen. Today it's got a pretty even growth overall and is starting to lay down just a bit. It's still a buzz cut and very much in the Sigourney Weaver as Ripley in Alien 3 or Demi Moore in G. I. Jane though it damn sure looks like a hairstyle someone would choose. I think she could walk out of the house any time now and fit right in. Again, we'll miss the pink wig but Kim is ready to be done with it. It's still a little too cold out for her to go out without the wig or a hat but she looks really good. And so far the hair growing in seems to be the same color and type as before. There's been talk that it may come back curly so we'll keep everyone updated. Amazing how quickly it's coming back.
Kim has been taking Glutamine supplements since the start of her chemotherapy treatments to reduce the severity of mucositis and neuropathy. Mucositis is the painful inflammation of the mucous membranes in the digestive tract and radiation is a further cause of the condition. Oral mucositis is also a common side effect though Kim has only experienced the digestive tract side effects. She's been mixing in a scoop of powder with some cereal and almond milk three times daily but is now down to just one. Research has shown that this supplement provides relief from symptoms of chest radiation so she'll stay on glutamine through the end of the treatment. Further new research also shows that honey is a great natural therapy to precent side effects from chemotherapy and radiation induced mucositis. Some other side effects she's prepared for are skin irritation, fatigue, and further lymphedema. Her doctors are on top of everything and we'll keep an eye on things.
Kim's nutritionist mentioned that her pink wig served to inspire a new patient of hers. The woman is a young mom and didn't want to frighten her children with her hair loss or the sudden appearance of a new wig. Kim's success with the pink wig and how she let the kids be part of the selection process inspired this woman to do the same. It allowed for a calm transition for the family and now the wig is a fun part of the process. I'm gonna miss that pink wig and the light it shined amidst all this darkness though I am excited to see Kim's new curly, golden locks.
Kim's radiation schedule will be every morning at 7:30 AM. It's a really early start but we chose this time on the advice of several people in the process. First, it's great to get it out of the way and still have a full day ahead with no running around. Next, being first into the clinic means they are on time and ready to go. Kim has already been in for her set up so the visits will be quick in-and-outs allowing her to get to work even a bit early. Plus, there's no other patients jamming up the system in front of you. Kim and I made the choice for this early time together knowing that it would inspire us both to be on top of our days early. We'll get up, make a good breakfast, and begin our days even earlier than usual. By the time 6 weeks have passed we'll have a routine in place to make the most of those early spring days.
Thank you for allowing the long break, we're back on schedule. Hair we go...
Tuesday, January 31, 2017
Tuesday, December 20, 2016
Six Months
Kim learned of her cancer diagnosis around dinner time on June 19th. Six months later and she's passed through 4 months of chemotherapy, dozens of doctor's visits, and lumpectomy surgery just last week. Her chemotherapy port was also removed during that surgery. Today, December 19th, she's in good spirits and recovering quickly. She's been out for walks, joined us all to see Rogue One, and will return to work tomorrow. Her pain medicine pump came out Saturday evening (by yours truly) and the surgical drain will be removed Thursday morning (by a doctor, whew!). Thursday evening will be the first time in quite a long time that Kim is back to normal. There's some peach fuzz on her scalp. The daylight hours, thankfully, will also be growing longer every day beginning Thursday.
By now I'd bet that all of you know the play-by-play from her surgery last week as so many of you acknowledged well wishes on Facebook as I posted throughout the day. So, for this post I'll just add some detail and let everyone get back to the holiday buzz.
Kim's surgery went as best as we could have hoped for with her doctors reporting successful procedures and her quick recovery from anesthesia.
The real take away from this procedure is that there's never really an easy step. Prior to surgery there's the cleaning of the house, the washing of all the linens and towels, showers for both of us with anti-bacterial soap, all the fasting Kim must do in advance. Next, at the hospital, it's loads of questions, tests, and pre-op procedures. The surgery, for Kim, lasts about 5 minutes. For me, those 4+ hours were spent hanging out with friends nearby because listening to the mainstream news on the TV in the waiting room is mind-numbing. The benefit of this hospital being in town is that there's so much to walk to nearby including snack and treats for both Kim and me.
Perhaps the hardest part of this surgery is that it's not "over" once leaving the hospital. Kim had a pain medicine pump fanny pack attached to her waist with a catheter inserted into her upper left chest. She has a surgical drain exiting her left underarm and a collection tube attached to a special bra. For three days she was bothered by both. Now, it's just the drain. It's unpleasant, uncomfortable, requires regular care, and, of course, requires another visit to finish off. Time, Kim is most eager to have her time back.
By now I'd bet that all of you know the play-by-play from her surgery last week as so many of you acknowledged well wishes on Facebook as I posted throughout the day. So, for this post I'll just add some detail and let everyone get back to the holiday buzz.
Kim's surgery went as best as we could have hoped for with her doctors reporting successful procedures and her quick recovery from anesthesia.
The real take away from this procedure is that there's never really an easy step. Prior to surgery there's the cleaning of the house, the washing of all the linens and towels, showers for both of us with anti-bacterial soap, all the fasting Kim must do in advance. Next, at the hospital, it's loads of questions, tests, and pre-op procedures. The surgery, for Kim, lasts about 5 minutes. For me, those 4+ hours were spent hanging out with friends nearby because listening to the mainstream news on the TV in the waiting room is mind-numbing. The benefit of this hospital being in town is that there's so much to walk to nearby including snack and treats for both Kim and me.
Perhaps the hardest part of this surgery is that it's not "over" once leaving the hospital. Kim had a pain medicine pump fanny pack attached to her waist with a catheter inserted into her upper left chest. She has a surgical drain exiting her left underarm and a collection tube attached to a special bra. For three days she was bothered by both. Now, it's just the drain. It's unpleasant, uncomfortable, requires regular care, and, of course, requires another visit to finish off. Time, Kim is most eager to have her time back.
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| Kim's check-in time was 7am for a 9am start. A heavy winter storm hit the city the evening prior so getting up and out early was important. Nothing was keeping Kim from her appointed surgery time. |
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| Please, no more waiting. More than anything, Kim wanted that chemotherapy port out. |
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| Back again in the same pre-op bay as her port surgery. Gotta love those inflatable warming blankets. |
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| Each doctor signs their initials at the location of their procedure. Dr Nathalie Johnson is the only doctor authorized to use a symbol, hearts, as her official signature. |
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| Off she goes. |
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| No one ever wants to see this view of their loved ones. |
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| Sunrise after our evening in the hospital. Surprisingly, a restful sleep for both of us. |
Friday, December 2, 2016
Ten Years Starts Today
Kim went in for her surgical consultation on Monday of this week. The great news is that the tumor has gone from 3.7 cm to just a bit of 2 cm. Her lymph nodes have also diminished in size though she we be having three of them removed. We went with high hopes that the plan for surgery would be a quick in and out and I'll say that maybe we were flying a bit to high off of the chemotherapy finish.
The surgery will likely be an outpatient procedure on Thursday December 15th though there is a chance Kim may spend the night. It really will depend on what Dr Johnson discovers during surgery and Kim's comfort level with the drain she'll have in place to manage the lymph node removal healing process. Man, what a bummer. Recovery from the lumpectomy and lymph node removal will have Kim toting a surgical drain for at least a week. There's also a risk of lymphedema, swelling and pain in the arm on the side of the removal. Kim is confident in the surgery process but very worried about long-term effects such as the arm pain. Dr Johnson is as good as it gets and we are confident that the procedure will go well. One benefit to the surgery on that day is the removal of the port in Kim's right chest. It'll be a big day.
Today was the first Thursday in four months that Kim did not return for chemotherapy on the alternating week. She's feeling better and better, her feet don't hurt as much. She also seems to mentally willing her hair and eyelashes to grow more quickly.
But today is a day to note because it's the first day she's taken a Tamoxifen Citrate tablet. Tamoxifen is used treat breast cancers that test positive for estrogen receptors. It blocks the effects that the hormone estrogen has on cancer cells and lowers the chance that breast cancer will grow. By starting today she'll give the drug a few weeks to work the tumor size down even further.
She will be taking this drug every day for ten years.
I cannot get my head around that time period. Add to this the possible side effects of hot flashes, nausea, fatigue, headache, and hair thinning and it's a quick end to the sense of joy and optimism we had just a week ago. Sure, we knew four months ago that this drug would be prescribed but it really hit home today standing in the kitchen as she added the tablet to her pile of vitamins and supplements. It feels like another member of the household to me.
The bright side, right? Kim is strong and healthy and will only become even more so as we go on. To celebrate this fact the family is off to Seattle for the weekend. Art museums are good for each one of us.
The surgery will likely be an outpatient procedure on Thursday December 15th though there is a chance Kim may spend the night. It really will depend on what Dr Johnson discovers during surgery and Kim's comfort level with the drain she'll have in place to manage the lymph node removal healing process. Man, what a bummer. Recovery from the lumpectomy and lymph node removal will have Kim toting a surgical drain for at least a week. There's also a risk of lymphedema, swelling and pain in the arm on the side of the removal. Kim is confident in the surgery process but very worried about long-term effects such as the arm pain. Dr Johnson is as good as it gets and we are confident that the procedure will go well. One benefit to the surgery on that day is the removal of the port in Kim's right chest. It'll be a big day.
Today was the first Thursday in four months that Kim did not return for chemotherapy on the alternating week. She's feeling better and better, her feet don't hurt as much. She also seems to mentally willing her hair and eyelashes to grow more quickly.
But today is a day to note because it's the first day she's taken a Tamoxifen Citrate tablet. Tamoxifen is used treat breast cancers that test positive for estrogen receptors. It blocks the effects that the hormone estrogen has on cancer cells and lowers the chance that breast cancer will grow. By starting today she'll give the drug a few weeks to work the tumor size down even further.
She will be taking this drug every day for ten years.
I cannot get my head around that time period. Add to this the possible side effects of hot flashes, nausea, fatigue, headache, and hair thinning and it's a quick end to the sense of joy and optimism we had just a week ago. Sure, we knew four months ago that this drug would be prescribed but it really hit home today standing in the kitchen as she added the tablet to her pile of vitamins and supplements. It feels like another member of the household to me.
The bright side, right? Kim is strong and healthy and will only become even more so as we go on. To celebrate this fact the family is off to Seattle for the weekend. Art museums are good for each one of us.
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| Here's to 2026 |
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Wednesday, November 23, 2016
Chemotherapy #8
Done. Finished. Over with. No more chemotherapy. Kim's final session was last Thursday. Our friend Jessica Heenan joined in for this last session and really brought it home in style. Jessica works on an organ transplant team in her real life and at home she's her family's version of me so we get along great even though she's not really a dork like me. Jessica even had a pizza delivered to the infusion center for this last session. (Yes, it was gluten free). Thank you, Jessica for helping Kim wrap up this long four-month process.
Following the session we said good-bye to Jessica, who had to go to Vancouver for bizness, and then we headed over to see our friends at The Athletic. We checked out all the cool new stuff and then popped next door to The Commissary for a late lunch. Everyone's support through this process has been so helpful for us both. Again, thank you.
Kim and I got home in the late afternoon and spent some time with Andrew and Jason before deciding to walk over to one of our favorite local restaurants. We enjoyed a great meal together with plenty of laughs; Kim and I shared a glass of wine each. We took a nice walk home and I soon found my way to bed at 7:30 PM. Kim was in just a bit later and we were both zonked out by 8. The stress of these chemotherapy sessions along with keeping Kim from getting a cold or flu through the process was a long, four-month grind. It felt good to let that go. Kim doesn't feel very good right now, this final session really stacked up the fatigue on her, but she feels good overall. Every day from now on is back to feeling good. She's stoked.
Kim had a sonogram this week to look at the tumors and they are much smaller than at the start of chemotherapy so at least all the side effects were worth it. She'll go in for a visit with her surgeon to assess the upcoming lumpectomy scheduled for mid-December. Once she's in for that procedure her doctors will now how much radiation treatment she'll need so we do have a bit of uncharted waters before us. Still, it all feels manageable in comparison to chemotherapy.
Kim says she wants to write a post on this blog so I'll leave some things for her to say soon. But for now consider this, other than the 8 chemotherapy days Kim didn't miss a day of work. She didn't miss a moment of the things Andrew and Jason have been up to. She's been upbeat and kept us all on the move and going out to see and do fun stuff. She's so tired, I can see it, but she's resilient and resistant to being held down by it. She has not complained or called much attention to herself. She's embraced the pink hair and I wonder how she'll be someday soon without it. She makes a lot of new friends out in public with it. Yes, her feet still really hurt and her legs ache a lot. I know she's looking forward to the Neulasta (bone marrow stimulant) finally being purged from her system so the aching will subside. I am a little concerned that sometime next summer when she's back to feeling good that she'll smash us all on the bike.
Oh, and she's excited to have the port removed from her upper chest. (Ugh, even just typing about it makes me pee a little bit.) Nope, Kim never complained about the port either other than the time I tried to give her a shoulder massage and forgot it was there and during the final chemotherapy session when they assigned her a training nurse who fumbled with the port injection at first. Kim, sweetheart, you are so incredibly brave and strong. It's just so normal to me and the kids to see this strength that we sometimes forget what you're going through. Thank you for sharing that strength with us.
So, another Thursday with something to do this week although this Thursday will be nothing but good times. I have several cans of cranberry sauce, (none of that hand-crafted crap, this is the good, cheap stuff!) hidden away and we're gonna enjoy all of them along with a good bottle of wine. We all have a lot to be thankful for, as always. Thank you to all of the friends and loved ones reading this, I am so thankful for your support. Happy Thanksgiving, everyone.
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| Thank you, Jessica! |
Kim and I got home in the late afternoon and spent some time with Andrew and Jason before deciding to walk over to one of our favorite local restaurants. We enjoyed a great meal together with plenty of laughs; Kim and I shared a glass of wine each. We took a nice walk home and I soon found my way to bed at 7:30 PM. Kim was in just a bit later and we were both zonked out by 8. The stress of these chemotherapy sessions along with keeping Kim from getting a cold or flu through the process was a long, four-month grind. It felt good to let that go. Kim doesn't feel very good right now, this final session really stacked up the fatigue on her, but she feels good overall. Every day from now on is back to feeling good. She's stoked.
Kim had a sonogram this week to look at the tumors and they are much smaller than at the start of chemotherapy so at least all the side effects were worth it. She'll go in for a visit with her surgeon to assess the upcoming lumpectomy scheduled for mid-December. Once she's in for that procedure her doctors will now how much radiation treatment she'll need so we do have a bit of uncharted waters before us. Still, it all feels manageable in comparison to chemotherapy.
Kim says she wants to write a post on this blog so I'll leave some things for her to say soon. But for now consider this, other than the 8 chemotherapy days Kim didn't miss a day of work. She didn't miss a moment of the things Andrew and Jason have been up to. She's been upbeat and kept us all on the move and going out to see and do fun stuff. She's so tired, I can see it, but she's resilient and resistant to being held down by it. She has not complained or called much attention to herself. She's embraced the pink hair and I wonder how she'll be someday soon without it. She makes a lot of new friends out in public with it. Yes, her feet still really hurt and her legs ache a lot. I know she's looking forward to the Neulasta (bone marrow stimulant) finally being purged from her system so the aching will subside. I am a little concerned that sometime next summer when she's back to feeling good that she'll smash us all on the bike.
Oh, and she's excited to have the port removed from her upper chest. (Ugh, even just typing about it makes me pee a little bit.) Nope, Kim never complained about the port either other than the time I tried to give her a shoulder massage and forgot it was there and during the final chemotherapy session when they assigned her a training nurse who fumbled with the port injection at first. Kim, sweetheart, you are so incredibly brave and strong. It's just so normal to me and the kids to see this strength that we sometimes forget what you're going through. Thank you for sharing that strength with us.
So, another Thursday with something to do this week although this Thursday will be nothing but good times. I have several cans of cranberry sauce, (none of that hand-crafted crap, this is the good, cheap stuff!) hidden away and we're gonna enjoy all of them along with a good bottle of wine. We all have a lot to be thankful for, as always. Thank you to all of the friends and loved ones reading this, I am so thankful for your support. Happy Thanksgiving, everyone.
Kim, always baked.
The reason for the season...
Thursday, November 17, 2016
Chemotherapy #7
And so it is that I find myself on the eve of chemotherapy session #8 having realized I never posted about session #7. It's become so normal and uneventful in most cases that this one just sort of scooted by. The real highlight of the session was having my mother, Anita, attend with Kim but even they fell under the spell of just-another-average-day and didn't even get a photo. Session #7 came and went and we probably didn't pay all that much attention to it because our eyes are on #8. Thursday November 17. 4 months later. Kim, I know is very excited. To celebrate we are off to see Hypnotic Brass Ensemble this evening at the Arlene Schnitzer Hall downtown; it's a family affair and somehow we are all excited. Should be a fun night.
So, what to say here? I've been thinking about what information might serve best for instructional purposes here and it's a touchy subject, bills. Money, of course, is of no concern when compared to someone's life but it is a reality we face. So here goes.
So, what to say here? I've been thinking about what information might serve best for instructional purposes here and it's a touchy subject, bills. Money, of course, is of no concern when compared to someone's life but it is a reality we face. So here goes.
Every day our mailbox is filled with letters from the hospital or insurance company. There are letters to inform us of treatment services being considered for payment, letters confirming payment, and letters about the letters. Every letter has a privacy statement or some other insert, it's nuts how much paper they waste on telling us nothing. Some envelopes contain bills and, so far, they haven't been all that bad. We are fortunate to have insurance and we've been benefitting from the plan. The bills for all the early doctor's visits and procedures have been small though bills for CT scans and other big procedures stand out. The first chemotherapy bill arrived and the pre-insurance cost is $20k. That's for a single session out of 8 total. Insurance is picking up most of it though what's left is undetermined at present. I'll keep you posted but please know this is not an appeal for help, simply a heads-up on how much treatment costs. So much of this process is never spoken of and only discovered as it happens for those going through it. I'm hoping this blog helps demystify the process for anyone facing it in the future.
I suspect the health care system is flawed though I won't go tin-foil hat conspiracy here on everyone. That said, why are the prices of cancer drugs so high and why have they gone up in price so much so quickly over the past few years? Drug companies refuse to discuss how they set prices and, under our current laws, they can charge whatever they want. Back in a previous post I wrote about a 22-year-old women in for her first chemotherapy treatment. Will she be forced to choose between a personal bankruptcy she can never emerge from or the best possible treatment to extend her life to its fullest? Hospitals and doctors are pushing back against pharmaceutical company pricing though I think we'll need stronger legislation to protect the people of this country. You should pay a premium for luxury items bought voluntarily, not life-saving medicine. I found this quote while doing some research:
"They are making prices unreasonable, unsustainable, and, in my opinion, immoral," said Hagop Kantarjian, MD, chair of the Department of Leukemia at the M.D. Anderson Cancer Center in Houston, referring to pharmaceutical companies and their cancer drugs.
Kim and I are also fortunate to have some guidance through this process and our most recent education was a very instructive meeting about insurance and bill paying. Very simply, don’t pay anything until it’s all said and done. The billing process is long and not perfectly connected so wait until all the facts are on the board before acting. The best advice I was given on the subject, “This is going suck.” And by “this” I mean the coordinating and tracking of bills and costs. With so much information bouncing back and forth between hospitals, doctors, and insurance offices there’s a lot of unconnected dots and it's my job to connect them.
Match explanation of benefits to services and costs, if there’s no match between numbers for the same visit/treatment, don’t pay the bill just yet. Sometimes it takes time for benefits to post properly between all offices so tracking everything is paramount. The concern here is paying something prior to the full cycle and discovering you paid too much.
Again, money is a sensitive subject when it comes to someone's health, or life for that matter, but the expectation of a long life after treatment demands that attention be paid to ensuring our future best interests. The worst part of the money conversation is that the person under care often feels guilty for all the costs they are incurring. It's a normal reaction and one that shouldn't be dismissed without acknowledging that person's feelings. Kim will occasionally apologize for all this and I have to be gentle in reminding her there's nothing to apologize for. This is a fairly common relationship between the patient and the caregiver and especially, I believe, in the case where the patient is feeling good. So I am on the job of making certain it's all taken care of and that Kim does not feel any additional stress from the process. Still, there's a daily reminder in the mail for all of us that she has cancer and that there's $ associated with it.
Kim will finish up chemotherapy tomorrow and then surgery in December. She'll need time to recover from surgery and to allow for the holidays so her radiation treatments will begin in January. For the insurance company that means a new billing year so we'll have to meet our deductible for an additional year. The insurance company is allowing us to change our plan to buy up to a lower deductible so that's a positive result of meeting with them and coordinating payment for care. Yeah, just writing about this seems unsavory, I trust it comes across as helpful. I'm looking forward to writing about session #8.
-Chris
-Chris
The pink hair always attracts fans. We got to meet a few of the members of the band after the show at last night's Hypnotic Brass Ensemble show. Amazing, amazing performance. Such a great way to energize Kim for her final session.
Comet continues his antics. How about a nap in the dryer?
Wednesday, November 2, 2016
Thoughtfully Indulgent
Forty-eight hours from now Kim will have one remaining chemotherapy session to go. I can tell you that the anticipation for even that milestone is high right now. This therapy is a grind, I know I've said that a lot but it's the most apropos description I can think of. Finding even small victories throughout the process is what keeps everyone moving forward. Kim, well, she's incredible, right? She's really managed to find normalcy in all this and we've had a great off week since session number 6. She's upbeat, energetic, and bright; I cannot imagine how she does it. Still, every day she's up and at it and always with that crazy desire to do more than time allows.
Some things I've forgotten to mention and a few thoughts I've had over the past month:
Genetic Testing
Kim underwent genetic testing back in September to determine if she had inherited mutations of the genes that produce tumor suppressor proteins. Her report came back negative with no clinically significant variants detected in 24 genes. This puts her at lower risk, much like the general population, for other types of cancer. Further, it suggests that Andrew and Jason do not have as high a risk of inheriting a mutation. There's a lot going on with this and if you'd like to read further, here's a lot to look at.
85/15
Back at the start of treatment we were reading every recovery and remission book and were gung-ho on a strict, life-saving diet. We both stayed true but as time goes on that dry toast with eggs for breakfast is a bummer. I mean, you can only prepare an avocado so many mornings until you run out or you just crave butter. We've found gluten-free pizza and pasta and we've all done our best to adhere to the plan. But some days Kim just needs a little something to pick up her spirits, a literal taste of the good stuff. And so we go by her instinct right now and every now and then she has real butter on toast or enjoys a piece of real pizza. Consider it 85% strict and 15% thoughtfully indulgent. We're not going too far off course but keeping the spirit alive is as important as the body. And, yes, I look the other way on some snack size Halloween candy bars this week.
Complacency
I'm not exactly sure that complacency is the word I want here but it's the one that came to mind. As you have just read, we've loosened the restrictions on diet to allow Kim some moments of joy. But successful progress and the long length of time this treatment requires allows bad habits to form or return or for drift from the goal to occur. Being satisfied with where we are and mastering the new normal does not mean we've reached our goal or that Kim is simply going to coast across the finish line for the win.
Prior to Kim's diagnosis the house always had a drawer full of sugarfree chewing gum. I've always looked past the phenylketonurics warning on the labels but with the new lifestyle I wanted it gone. Just last week I saw a new pack in the drawer and had a piece. The next day I did the same and then had that what-the-hell-are-you-doing moment with myself. Give an inch and you may give up a mile. I'd also been very diligent about using a water filter since Kim's diagnosis, (Kim and the boys have always used one), but in the past week I've just filled bottles at the tap and told myself, "next time" on the filtered water. Acceptance of the disease and treatment along with control of the process has us comfortable and we allow ourselves to drift back into convenience. Just yesterday, in fact, Kim forgot to go to her acupuncture appointment because she's been feeling so good. Or, she's just accustomed to feeling the way she now feels. There's also a little chemobrain at work, too.
In racing, you charge toward to line, not just cruise across and we've got to get back to the focus and discipline of our early ways. Many, many thanks to the meal train supporters for their amazingly delicious and healthy meals. We are back on track. (OK, a few more candy bars and then back on track!)
Thank you, as always, for reading and sending your thoughts to Kim. Yes, we can feel it here. Every day we feel it.
Some things I've forgotten to mention and a few thoughts I've had over the past month:
Genetic Testing
Kim underwent genetic testing back in September to determine if she had inherited mutations of the genes that produce tumor suppressor proteins. Her report came back negative with no clinically significant variants detected in 24 genes. This puts her at lower risk, much like the general population, for other types of cancer. Further, it suggests that Andrew and Jason do not have as high a risk of inheriting a mutation. There's a lot going on with this and if you'd like to read further, here's a lot to look at.
85/15
Back at the start of treatment we were reading every recovery and remission book and were gung-ho on a strict, life-saving diet. We both stayed true but as time goes on that dry toast with eggs for breakfast is a bummer. I mean, you can only prepare an avocado so many mornings until you run out or you just crave butter. We've found gluten-free pizza and pasta and we've all done our best to adhere to the plan. But some days Kim just needs a little something to pick up her spirits, a literal taste of the good stuff. And so we go by her instinct right now and every now and then she has real butter on toast or enjoys a piece of real pizza. Consider it 85% strict and 15% thoughtfully indulgent. We're not going too far off course but keeping the spirit alive is as important as the body. And, yes, I look the other way on some snack size Halloween candy bars this week.
Complacency
I'm not exactly sure that complacency is the word I want here but it's the one that came to mind. As you have just read, we've loosened the restrictions on diet to allow Kim some moments of joy. But successful progress and the long length of time this treatment requires allows bad habits to form or return or for drift from the goal to occur. Being satisfied with where we are and mastering the new normal does not mean we've reached our goal or that Kim is simply going to coast across the finish line for the win.
Prior to Kim's diagnosis the house always had a drawer full of sugarfree chewing gum. I've always looked past the phenylketonurics warning on the labels but with the new lifestyle I wanted it gone. Just last week I saw a new pack in the drawer and had a piece. The next day I did the same and then had that what-the-hell-are-you-doing moment with myself. Give an inch and you may give up a mile. I'd also been very diligent about using a water filter since Kim's diagnosis, (Kim and the boys have always used one), but in the past week I've just filled bottles at the tap and told myself, "next time" on the filtered water. Acceptance of the disease and treatment along with control of the process has us comfortable and we allow ourselves to drift back into convenience. Just yesterday, in fact, Kim forgot to go to her acupuncture appointment because she's been feeling so good. Or, she's just accustomed to feeling the way she now feels. There's also a little chemobrain at work, too.
In racing, you charge toward to line, not just cruise across and we've got to get back to the focus and discipline of our early ways. Many, many thanks to the meal train supporters for their amazingly delicious and healthy meals. We are back on track. (OK, a few more candy bars and then back on track!)
Thank you, as always, for reading and sending your thoughts to Kim. Yes, we can feel it here. Every day we feel it.
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| Some days our Big View is just walking down to the Willamette River |
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| This goofball keeps us in good spirits |
Monday, October 24, 2016
Chemotherapy #6
Our plan from the beginning was that I would join Kim for chemotherapy sessions #1 and #8 while allowing Kim to welcome friends and family for all the ones in between. I've joined Kim for her oncologist visits and then given her a smooch at the infusion bay for visits #2 through #5 but for #6 I stayed for the entire session. I swapped with our friend Jessica who will take over #8 for me. She's an organ transplant nurse and was on call for this session so I didn't sweat the change. I mean, that's a hell of a job compared to talking about bikes on the internet and stuff. So, back to #6 last Thursday.
The visit with Kim's oncologist, Dr Anderson, was routine. All her numbers look about as good as they can for someone soaking up all that chemotherapy. He once again confirmed the reduction in size of the tumors and is pleased with her progress. Our visits with him remain positive and brief, I'll take that as a good sign that there's little to be concerned about. He's a funny guy and always has on colorful socks. He fits well within our circle of friends. To say that the visits with him are quick isn't to say that he's in a rush or isn't thorough. He's very present in his conversation with us but wants to get things going for Kim as he knows better than anyone that the sooner we start the sooner we finish.
These final four sessions are longer and, quite frankly, not all that interesting. They get Kim started with a big bag of Benadryl to offset any potential allergic reactions and for the next 30 minutes she's kind of dazed. Last session they pushed it pretty quickly so for this week she asked to have the drip go more slowly. The result was that she felt better and more alert.
Once the Taxol bag gets hung and the drip starts it takes about 3.5 hours for it to complete. We bring books, magazines, snacks, coloring books, and all sorts of stuff to do but don't really end up getting much done. Kim dozed off a few times and I managed to read some magazines and look at everything on social media. Kim has been scheduling the sessions for 9:30 AM so that we can get out prior to the 3:00 PM rush hour. It's worked out well for us given that Portland now has real traffic to contend with.
It dawned on me last week that I'd let the Big Views Diet drop off so plans were made to take advantage of a break in the rain on Saturday to get outside. Now, all plans hinge on Kim feeling well on the weekend. For the most part, she's fine on Friday and then starts to feel symptoms creep in on Saturday afternoon. But the sun was out and she really wanted to be outside so we headed out for an easy hike with Jason joining along.
I choose Smith & Bybee Wetlands, a 2000 acre public park and nature preserve between the Columbia Slough and Columbia River north of Portland. It is one of the largest urban freshwater wetlands in the United States and home to thousands of birds. While we didn't get close enough to see the big populations of birds we sure could hear them. We did get to see a few hawks up close as well as garter snakes.
The main reason I chose this hike was that it is pancake flat. Kim had daydreams of a mountain hike but she's lost a few gears and I didn't want to put too much stress on her with climbing. We'd also never been out here so it was fun for all of us to try something new. Always fun to see a different view of the city as well.
So, six down and two to go. It sounds close to the finish but that still means 6-8 weeks of chemotherapy in her system. She never complains. Never. The closest I've heard was earlier this evening when I asked her the name of the drug she's on now and she said, "Poison". She's still skinny and pretty tired most of the time but hasn't missed out on much. So many side effects wreaking havoc and the best Dr Anderson can say is "hang on". He's doing all he can to keep her comfortable but his job is to kill cancer so there's gonna be side effects.
She still can't taste very much and deals with GI issues every day. Her eyebrows and eyelashes are starting to thin now, as well. Strangely, her thumb print is disappearing and she cannot use her iPhone ID with much success these days. And, boy, do her feet hurt a lot. On the good side, the pink wig really suits her and she makes friends wherever she goes. It helps, too, now that it's cooler outside and she doesn't overheat wearing the wig for long periods of time.
Session #6 marked three months for us in chemotherapy and that makes us veterans now. Kim has been called on to advise new patients about what to expect and I see new couples in the center for their first time now. It feels like a lifetime ago that it was us. They have that same enthusiasm to fight like hell but they don't know the grind that is ahead of them. I do the best I can to smile and show my solidarity. The infusion center is an interesting place to spend four or five hours because you learn a lot of intimate details about people. This week I saw a number of patients in the clinic on their own and I wonder why that is. Did they choose to spend the time alone or are there reasons no one can join them? I know I can't do much for Kim there other than help with blankets and getting water but I feel like someone needs to be there with her. I want someone there for everyone.
Every time a nurse brings medicine they ask for the patient's name and birthday to confirm the proper recipient of the medicine. Next to Kim for this session was a 22-year-old woman who was by herself. She looked even younger and I felt so angry that she had to be here with this disease. Her IV hurt and she was in a lot of discomfort. It's hard not to involve yourself in someone's life when they are that close to you. Two chairs from her was an elderly woman on her own as well though she was on her phone with a relative for much of here visit. She didn't seem phased by a bit of it all and I got a sense that she'd seen enough in her time to take this treatment in stride. Kim, too, I'd say. She dozed off once or twice and also seemed to manage the day unfazed. She drinks a lot of water during sessions and she pees a lot. Like, a lot. Up and down and up an down. I think I put blankets on her a dozen times.
I enjoyed my time with her this session. I ran out for coffee in a terrible rain storm and we enjoyed some breakfast sandwiches with that coffee while trying to sort out the deal with our two kids. Teenagers are insane, (of course), and chemotherapy does nothing to help fix them. But it was as good a day as one can have for this and there's only two to go.
Thank you to everyone for meals, offers of meals, cookies, funny stories, thoughts, advice, all of it. We feel every positive thought here. Thank you.
The visit with Kim's oncologist, Dr Anderson, was routine. All her numbers look about as good as they can for someone soaking up all that chemotherapy. He once again confirmed the reduction in size of the tumors and is pleased with her progress. Our visits with him remain positive and brief, I'll take that as a good sign that there's little to be concerned about. He's a funny guy and always has on colorful socks. He fits well within our circle of friends. To say that the visits with him are quick isn't to say that he's in a rush or isn't thorough. He's very present in his conversation with us but wants to get things going for Kim as he knows better than anyone that the sooner we start the sooner we finish.
These final four sessions are longer and, quite frankly, not all that interesting. They get Kim started with a big bag of Benadryl to offset any potential allergic reactions and for the next 30 minutes she's kind of dazed. Last session they pushed it pretty quickly so for this week she asked to have the drip go more slowly. The result was that she felt better and more alert.
| Did I say more alert? |
Once the Taxol bag gets hung and the drip starts it takes about 3.5 hours for it to complete. We bring books, magazines, snacks, coloring books, and all sorts of stuff to do but don't really end up getting much done. Kim dozed off a few times and I managed to read some magazines and look at everything on social media. Kim has been scheduling the sessions for 9:30 AM so that we can get out prior to the 3:00 PM rush hour. It's worked out well for us given that Portland now has real traffic to contend with.
It dawned on me last week that I'd let the Big Views Diet drop off so plans were made to take advantage of a break in the rain on Saturday to get outside. Now, all plans hinge on Kim feeling well on the weekend. For the most part, she's fine on Friday and then starts to feel symptoms creep in on Saturday afternoon. But the sun was out and she really wanted to be outside so we headed out for an easy hike with Jason joining along.
I choose Smith & Bybee Wetlands, a 2000 acre public park and nature preserve between the Columbia Slough and Columbia River north of Portland. It is one of the largest urban freshwater wetlands in the United States and home to thousands of birds. While we didn't get close enough to see the big populations of birds we sure could hear them. We did get to see a few hawks up close as well as garter snakes.
The main reason I chose this hike was that it is pancake flat. Kim had daydreams of a mountain hike but she's lost a few gears and I didn't want to put too much stress on her with climbing. We'd also never been out here so it was fun for all of us to try something new. Always fun to see a different view of the city as well.
| Smith & Bybee Wetlands |
She still can't taste very much and deals with GI issues every day. Her eyebrows and eyelashes are starting to thin now, as well. Strangely, her thumb print is disappearing and she cannot use her iPhone ID with much success these days. And, boy, do her feet hurt a lot. On the good side, the pink wig really suits her and she makes friends wherever she goes. It helps, too, now that it's cooler outside and she doesn't overheat wearing the wig for long periods of time.
Session #6 marked three months for us in chemotherapy and that makes us veterans now. Kim has been called on to advise new patients about what to expect and I see new couples in the center for their first time now. It feels like a lifetime ago that it was us. They have that same enthusiasm to fight like hell but they don't know the grind that is ahead of them. I do the best I can to smile and show my solidarity. The infusion center is an interesting place to spend four or five hours because you learn a lot of intimate details about people. This week I saw a number of patients in the clinic on their own and I wonder why that is. Did they choose to spend the time alone or are there reasons no one can join them? I know I can't do much for Kim there other than help with blankets and getting water but I feel like someone needs to be there with her. I want someone there for everyone.
Every time a nurse brings medicine they ask for the patient's name and birthday to confirm the proper recipient of the medicine. Next to Kim for this session was a 22-year-old woman who was by herself. She looked even younger and I felt so angry that she had to be here with this disease. Her IV hurt and she was in a lot of discomfort. It's hard not to involve yourself in someone's life when they are that close to you. Two chairs from her was an elderly woman on her own as well though she was on her phone with a relative for much of here visit. She didn't seem phased by a bit of it all and I got a sense that she'd seen enough in her time to take this treatment in stride. Kim, too, I'd say. She dozed off once or twice and also seemed to manage the day unfazed. She drinks a lot of water during sessions and she pees a lot. Like, a lot. Up and down and up an down. I think I put blankets on her a dozen times.
I enjoyed my time with her this session. I ran out for coffee in a terrible rain storm and we enjoyed some breakfast sandwiches with that coffee while trying to sort out the deal with our two kids. Teenagers are insane, (of course), and chemotherapy does nothing to help fix them. But it was as good a day as one can have for this and there's only two to go.
Thank you to everyone for meals, offers of meals, cookies, funny stories, thoughts, advice, all of it. We feel every positive thought here. Thank you.
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| Jason made a friend |
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| Soaking up the last rays of sunshine |
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