Radiation

     So Beth finished her final (25th) radiation treatment last Friday (and yes, that's her lined up in the machine in the picture). These daily sessions (Mon.-Fri.) have gone pretty smoothly. Most of the time they are between 8 and 9 o'clock in the morning and this timing has worked well, as it's nice to get it out of the way first thing and then get on with the day. Napping in the afternoon has been a pretty regular part of her routine as well, although it's difficult to decide what is causing the tiredness - at first she wondered if it was still recuperation from the surgery, or a cold bug, or a side effect from the radiation. Apparently fatigue is common as the radiation progresses. Her skin (in the areas she receives the radiation) has gotten pretty red, which is normal. We're hopeful that her skin doesn't blister or break open into sores, but that can also be quite common. We were told that effect on the skin will continue for up to 10 days after the treatments are complete (that is, her skin could continue to react for that long). Someone has also said the actual radiation continues to work in the body for up to 2 months after the treatments are finished. There isn't a lot that can be done for the skin - Beth has an anti-itch cream she has begun to use and if sores appear she is just supposed to use polysporin cream or some compresses on it.
     At the beginning of March Beth began attending the Well Fit program on Wednesdays and Fridays, which is run at the University of Waterloo. This is a free fitness program they offer for cancer patients and she finds the trainers to be very good. However her schedule has sometimes made it challenging to make it out on a regular basis.
     There have been a couple of follow-up appointments regarding Beth's (one remaining) parathyroid gland. We saw the surgeon in Toronto on the 11th and he was quite pleased with how the incision is healing, as well as with the calcium level which appears to be approaching normal levels, meaning that the parathyroid is beginning to work. The following week we saw the local endocrinologist who is also following these levels. While there have been some minor medication adjustments made it seems good progress is being made with this aspect of her bodily function.
     One other encouraging appointment this month was with the genetics counsellor at the Grand River Cancer Centre. She has been studying Beth's family history and gathered quite a bit of information from a number of her relatives who have had cancer. The good news is that the results indicate that there is no apparent genetic link. The counsellor seemed to confirm what Beth has been suspecting all along about her cancer history - that she received some form of radiation on her head as a baby, which likely led to the Hodgkin's in her 20's, and the radiation she received for that very probably caused her thyroid cancer in 2002, and may have even been involved in the occurrence of breast cancer now. In the end the lack of a genetic cause is good news for our family, especially our daughter Alison and granddaughter Lindsay.
     Just over a week ago we got a bit of a scare as Beth started to get sick (ie. vomiting) a couple times on Thursday night going into Friday morning. We assumed it was a flu bug and because of the way she was feeling she didn't go in for her regular 8:00 radiation treatment. Fortunately she felt better during the day and the hospital was able to fit her in for the treatment at 4:00. Beth felt fine most of the weekend but then on Sunday night she got sick again. So she laid awake a lot that night beginning to worry about why this could be happening and one thing that she thought was that she has never had a CT scan of her head. Beth couldn't keep her toast down at breakfast but felt well enough to go for the treatment and I tagged along at the last minute in hopes we'd be able to at least talk to the nurse for Beth's radiation doctor. She did meet with us and after listening to our story she was very reassuring - she felt pretty strongly that it was probably just a flu bug (her daughter had had very similar symptoms in the last week), and she said when the brain is affected any nausea or vomiting comes with severe headaches (which Beth wasn't experiencing) and curiously it usually occurs in the morning. She said she would talk to the doctor and was sure he'd gladly book a CT scan for us if we still wanted it.
     So Beth is booked for this scan of her head on Thursday and the doctor said he will meet with us on Friday to share the results. We are certainly hopeful that it will show nothing suspicious. If you're the praying kind we'd obviously appreciate your support in this way. We know from experience that worrying is not a helpful thing but sometimes it gets hard to not worry. Beth doesn't look forward to these kinds of appointments much, as she's had too many times when she went into a doctor's office expecting everything to be fine and then having a bombshell dropped on her. Praying that won't be true on Friday.

And on to the Final Treatment Stage

     Last Monday's (Feb. 24th) parathyroid surgery in Toronto went very well. We drove down in the early morning (the best time to beat all of the traffic) and found our way to the pre-surgery area. We were encouraged by the IV nurse who came, as she shared she is a breast cancer survivor, being diagnosed just one year previous to Beth. Eventually they came to wheel her away and I headed to the beautiful waiting area they have at the hospital. Her surgery was scheduled for 8:00 and the surgeon came to talk to me by 10:30, sharing that everything had gone according to plan. He said that he was able to clearly see the vocal cord nerve so was easily able to avoid that. He told me that he removed the left superior (upper) parathyroid gland and saw that the anterior (lower) one was intact. However this lower gland was quite small, as the upper one with the (non-cancerous) tumour would have been inhibiting its functioning. The doctor said that it could take up to several months before her one remaining parathyroid gland completely takes over regulating her calcium level (that is the role of our parathyroid glands - to regulate the amount of calcium in our blood and bones). Regular practice for this type of surgery is to stay in the hospital for a couple of nights to have your calcium levels closely monitored, which is what happened with Beth.
     She made it up to the floor around 1:00 and was a bit groggy, but feeling okay. Within an hour or so she just seemed like herself, though she did have a headache. We did some walking and got her some yogurt from the Tim's in the hospital. We were kinda surprised that there wasn't pain medication ordered for her yet (according to the nurse anyway) and that they didn't have some of the other pills ready either even though it had seemed to us that all of this was supposed to have been setup when we visited the week before with the pharmacist as part of the preop preparations. It's a good thing Beth is a nurse and that she even did bring some of her meds because we ended up using a few pills from home initially. The previous week Beth had noticed that one of the incisions from her mastectomy had a spot of infection so she went to emergency (Sunday, Feb. 16) to get it looked at and they put her on an antibiotic. It seemed to take a while to get better so she didn't want to be missing any doses of that medicine (it seems to have pretty much cleared up by now).
     So the stay at the hospital was pretty quiet and relaxing. Beth had a nice and warm private room. I came home on Monday night but stayed with our friends Sheila & Bert's at their condo near Lakeshore Blvd. on the Tuesday. We hoped to get away early on Wednesday but they needed to do blood work around noon. The calcium levels were dropping, as expected, but they weren't too low, and she began taking calcium supplements 3 times a day (which has continued, along with regular blood tests back in Kitchener). We ended up leaving the hospital around 4:00, just in time to hit rush hour traffic on the way back home. Still, it was great to finally get back and we ended up having some quick visits with David, Rachel & Lindsay; Josh; and my mom & dad (Alison was working and Joel was still out in Halifax visiting his girlfriend Caora). Overall the whole parathyroid surgery part of this adventure went extremely well and it was pretty amazing to see how quickly Beth bounced back from this. We knew that the surgeon is highly respected in his field and this was confirmed by a doctor who came in to talk to Beth one day - he is a surgeon from Australia and has come to Toronto to work under, and learn from, Beth's doctor, as he has a world-wide reputation as one of the best head and neck surgeons.
     A highlight from this past weekend was that our grand-daughter Lindsay turned one year old on Sunday (March 2nd - yes Lindsay and I share a half-birthday if you know what that is). We ended up offering our house as the party place as both sides of the family adds up to 20 people and we can accommodate that number pretty easily. It was a wonderful get-together and it was so much fun to see Lindsay try to figure out what was going on - from the decorations, to the large crowd of people, all the presents, singing 'Happy Birthday', and of course her first taste of birthday cake! She had a great time (and a much needed nap afterwards).
     This morning (Monday) Beth began the last stage of her breast cancer treatment - radiation. She will be getting 25 treatments spread over the next five weeks. Each session only takes about 15 minutes and we're thankful that they're scheduled for earlier in the morning so that it doesn't break up the day and there's less danger of the technicians falling behind schedule. The first couple of weeks there are no expected side effects but as the treatments progress there may be some issues with the skin burning or blistering and fatigue.

A Good Recovery

     It has definitely been too long since an update - I guess I'm taking this retirement thing pretty seriously;) These few weeks since Beth's surgery have been full of many good things. A real highlight was a week ago when we snuck away to Fort Lauderdale, Florida to soak up some warmth between appointments. Beth's niece Tina and her husband Brady have just acquired a condo down there so we flew down in the wee hours of Tues. Feb. 4th and stayed until Sunday the 9th. It was beautiful, peaceful and hot! Beth's two older sisters and husbands were also there for a good chunk of that time so it was great getting to hang out with them as well.
     Going back a bit to the surgery recovery, things went really well - Beth took pain pills for a couple of days but never was very uncomfortable, her range of motion on her right side continued to be excellent, and she was able to get 2 of the 3 drainage tubes out just 6 days later. The community care nurse came every second day or so to check the dressings, and I emptied the drains regularly. The last of the drainage tubes continued to produce significant fluid (it needed to drain 25 ml or less a day before it could be removed) for 3 weeks. This was a bit of a complication in trying to get away to Florida as we had to check if Beth could fly with it in and could we take it out while away. In the end, since it continued to drain above 25 ml until we returned, the doctor removed it when he saw Beth for the followup appointment.
     There also was a meeting with the parathyroid surgeon in Toronto the last week of January to try to determine the date for that operation. In the end it was kind of frustrating as we didn't get a confirmation and have had to make several phone calls to get things set up. Now we're glad to know that Beth will have that surgery on Monday, February 24th at Toronto General Hospital. They did blood work the day of the appointment (Tues. Jan. 28) and in talking to a nurse that Friday Beth asked about her calcium level and found out that it was quite high again - it was surprising to us that nobody had followed up on that and in fact that she had to ask! At any rate Beth herself did some following up with that so she could have the treatment to have the pamidronate (the drug that brings the calcium level down) when she went in to have her herceptin treatment on the following Monday.

   So that Monday (Feb. 3) was a bit of a whirlwind (along with being my first day of retirement!) - Beth had an echocardiogram, then the two drug treatments at the hospital, then a lot of calling around to determine if we could actually do this Florida trip. In the end we decided around 6:00 that we could make it work, and we were on the road by 10:00 to drive to Niagara Falls for a late night flight on Spirit Airlines. As I explained earlier, we had a wonderful time there - it's amazing how quickly you forget about the cold and snow back home. [By the way, as people have been asking about the shady character in the pool with the hat, it's actually Beth's brother-in-law Ted].
     We got home early the next Monday as Beth had 3 appointments: Monday with the mastectomy surgeon, Tuesday with the radiation oncologist, and Wednesday with the chemotherapy oncologist. All of them were extremely pleased with the pathology report from the tissue removed during the mastectomy as it showed that the chemotherapy was very effective - the tumour itself was non-existent (and it had been fairly significant in size: over 5 cm) though there were some traces of the cancer in the breast ducts, there was no evidence of cancer in the "margins" (the edges of the tissue which they check to see if there had been any spreading of the cancer cells), and of the 14 lymph nodes that were removed only 1 of them showed a small amount (7 mm) of cancer. And of course, all of that has been removed - the surgeon said that really Beth could at this point consider herself to be cancer-free. The radiation doctor mentioned how this kind of positive response to the chemo is also a good indicator for being cancer-free in the long run. As well, Beth was able to get things decided about the radiation - she goes next Tuesday, Feb. 18th to get everything set up and then begins the actual treatments on Monday, March 3rd.
     This past week also began a new adventure for us - I had said that when I retire that I'd be willing to help take care of our grand-daughter Lindsay a couple of days a week when Rachel went back to work. Well, Rachel just began a new job in downtown Kitchener at a very innovative company (called Thalmic Labs) and so we took care of Lindsay on Thursday and Friday - what a delight she is and what a privilege to get to spend extended time with her.
     So thanks once again for all of your support. The reports this past week were a real answer to prayer. There's still a bit of a way to go but we can see the end in sight (Beth made me mark April 4th on the calendar as her last day of radiation!).
   

An Amazing Day!

     Well the short answer is that today went amazingly well! If you want more details feel free to continue reading (I promise not to get too medical or graphic).
     Beth woke up at 5:00 because she was told to drink a couple of cups of apple juice at that time and then we walked up to the hospital just before 6:00. Beth wanted to drop in on the 5th floor to pick up some information a coworker had photocopied for her and then we headed down to the day surgery unit to get registered. Our son David joined us about 6:45 (he took the day off work). Our friend and former pastor Olu Peters and his wife Tracey dropped by shortly thereafter and offered up a beautiful prayer before Beth went into the surgery.
     Then the waiting began. David and I went home and I ended up taking a nap as I hadn't slept well the night before. We went back up to the hospital around 9:30 since we wanted to make sure we were there if the doctor came out to talk to us after the operation. We were hopeful that would happen but in the end he didn't come and we could tell that he had several other surgeries he was performing in quick succession so it wasn't a big surprise. A former neighbour of ours is a long-time volunteer at the hospital in the day surgery unit so he was able to keep us informed a bit - that is, he told us that he had seen Beth in recovery but he didn't talk to her as it seemed she was sleeping a lot. At noon I felt we had sat there long enough so I went back to ask where things were at, and as it turned out Beth had just arrived back in that area. She was looking pretty pale and was still a bit groggy but was able to communicate fine (with regular doses of ice chips for her mouth). Alison came up from the house about that time as well so she and David were able to come in right away too (we saw signs up saying only 1 visitor per patient but nobody hassled us about the 3 of us being there, although we tried to rotate a bit as well so usually only 2 were there at a time).
     Around 1:00 David and I headed out to get some food (my 5:30 muffin had worn off a long time before!) and pick up a couple of items from the drug store (pain prescription and an anti-itch cream as Beth has found lately that her skin has become way more itchy and she wonders if it has something to do with her liver). While we were away she was able to get some sleep and gradually wear off some of the effects of the anesthetic/surgery - this mainly involved taking deep breathes regularly and keeping her legs moving. She did get some pain medicine as well but her pain never got over a 4 or 5 on the 10 point scale. She was surprised to find that she has pretty good range of motion on the right side where they took lymph nodes from under her arm. However she is restricted in lifting to nothing over 5 pounds.
     Beth got up to go to the washroom, needing a bit of support as she felt a little unsteady at first, but she really did quite well with that and then the nurse showed us how to empty the 3 drains that she has, one for each incision. She got a special camisole from the Hope Springs support centre that she can wear which includes pockets for the drains so we put that on and then got dressed for being discharged. Alison brought the car up and I bought Beth a bowl of soup from Tim Horton's on the way out. So we were home by 3:45 and Beth was pretty comfortably sitting at our kitchen table eating some soup (see photo).
     It was really wonderful being at St. Mary's Hospital where there are so many familiar and caring people. Beth connected with a couple of long-time friends and co-workers through Facebook on the weekend who work in the operating and recovery rooms. They each asked if she would like for them to be with her in those areas and she was thrilled to have Rosemary present as she got prepped in the surgery suite and then Kathy be her nurse caring for her during the first stage of her recovery. In fact, Beth and Kathy trained in the RN program together (oh so many years ago now) and even lived together for almost 2 years as they began their careers at St. Mary's. Amazing, right? And the whole day was filled with lots of other great connections as we crossed paths with many of Beth's co-workers. (it took a while to wheel her out at the end of the day as she needed to stop to talk to people along the way). While her primary care nurse in the day surgery unit was not someone Beth knew, Vicky was so supportive and helpful. She has known though of the situation through hospital channels and said that when she found out this morning she'd be taking care of Beth that she knew it was definitely a "God-thing."
     Josh dropped by later in the afternoon and then David went to get Rachel and Lindsay so we had supper together. [We had leftovers from a great retirement party that Beth and the kids hosted for me on Sunday at our house. 28 of my coworkers from Queen Elizabeth School came, where I worked for 19 years before transferring to my present school a few years ago. It was a wonderful time and Beth said it made for a great distraction from thinking about the surgery.]
     The rest of the evening continued to go well, with Beth taking pain medication at 5:00 and not taking anymore until 10:00. Lindsay therapy (which includes lots of smiles and giggles) is always very effective. Joel got home from work at 9:00, after a 12 hour day. I emptied Beth's drains and we've been pleased that the fluid draining now is more clear. I feel like I'm just starting to ramble random information now and for some reason I'm feeling kinda tired. But it really has been a very good day all things considered. I think we're all amazed at how well Beth is feeling and so we are obviously grateful for the many positive thoughts and prayers that have been offered up at this time. From the bottom of our hearts we say thank you once again for your love and support.

Ready for Part 2 (of 3)

     The last few weeks have been a nice respite from intensive medical treatment, although it hasn't been completely devoid of hospital visits. The Friday of Christmas week Beth was delighted to get out her port-a-cath tube that had been inserted into a larger vein by her heart for the chemotherapy. This had allowed the drugs to be given without irritating the veins in her arm. However she did find the port-a-cath itself to be kind of irritating too, though just skin discomfort.
     This past Monday Beth had to go the the Grand River Cancer Centre to receive her infusion of herceptin. She will continue to get it every three weeks until September. This is a drug that is used because the breast cancer was determined to be HER2+ (that stands for Human Epidermal growth factor Receptor 2-positive, for those that just need to know). Actually how this treatment works is fairly complicated so I'll just use a couple of internet quotes to say that it is "a targeted therapy that is designed to work on a specific area of the cancer cell to reduce it's ability to spread". It also "alerts the immune system to destroy cancer cells to which it is attached." At any rate they recommend continuing this treatment for a full year. The side effects of herceptin are much less than the other chemotherapy drugs, although it can result in heart problems, so Beth is having regular echocardiograms (every 3 months).
     On the weekend Beth went up to emerg early Sunday morning as she was concerned about a possible infection in a fingernail. The doctor there prescribed an antibiotic but she went to our family doctor on Tuesday as an abscess needed to be drained and since then it's been healing up fine. Beth was wanting to be extra careful not to have any complications that might delay next Monday's surgery.
     Beth has also been calling around trying to arrange to have her parathyroid surgery before the radiation begins. This would hopefully stabilize her calcium level so that she would not need to receive any more of the drug used to bring it down. We meet with the surgeon in Toronto at Princess Margaret Hospital the last week of January to determine a suitable date for that surgery.
     Tuesday was the presurgery appointment at St. Mary's, which involved some tests and a meeting with the anesthetist. So Monday (January 20th) is the big day - Beth is scheduled for a double mastectomy at 8:00 and apparently the surgery takes about 2 and 1/2 hours. Most people are shocked when they find out that this procedure is considered day surgery (that is, she won't stay in overnight) but apparently that's been the common practice for the last year or two. She will come home with 3 drains - one for where each breast has been removed, plus one along her right side as they will be removing lymph nodes under her arm. These stay in for 7 to 10 days and a community nurse will come in regularly to change the dressings, etc.
     Beth says that although it has taken her some time, she now feels that she is ready to face this next stage in the journey. We realize that there will be an adjustment period getting used to this new reality. At this point she has not made any decisions about reconstructive surgery.
     We certainly are grateful for everyone's thoughts and prayers at this time. We are thankful for skillful doctors and nurses and continue to trust in God to guide them. Your ongoing support has been so important and appreciated.

   

Annual Family Update

     While Beth’s medical challenges over the past 4 months have been pretty much all-consuming, we look back over 2013 remembering the many good times we have experienced as well.

  We started the year preparing for the arrival of our first grandchild. The excitement mounted as we redid one of our spare rooms over into a baby room and shopped to furnish it. Then Lindsay arrived on March 2nd and everyone rushed to the hospital to welcome her. Lindsay has been a great joy in the life of our family. David and Rachel are awesome parents and Lindsay has been such a happy little girl at every stage of her development over the past 10 months.

  When they’re not busy parenting David & Rachel continue to work, Rachel even doing some freelance graphic design during her maternity leave. David still works out at the airport and volunteers with the Jet Aircraft Museum in London. A highlight for him was organizing, and participating in, a trip out to Nova Scotia this fall to help bring back an aircraft from there.  

Josh started a new company with some associates last year that has really taken off, to the point that he leased office space in Kitchener. Their internet presence is at blockless.com and it gives wider access to Netflix movies and such. We spent a fair bit of time this summer going around to look at houses in the area as he was seriously wanting to buy. While none of his offers went through now he’s now looking at condos.

  Alison graduated from teacher’s college, at the University of Western Ontario, in June, and did a fair bit of volunteering at dad’s school in the fall. While she waits to get on the supply teacher list she continues to work the desk at the local pool and moved home in September. Most of her fall was spent helping her friend (and former roommate) Julie prepare for her December wedding, as Alison was her maid of honour.

  Joel received a promotion (from cook to Chef de Parti) at Beertown in May and then moved to London in July to help open one of their restaurants there. He enjoyed the many challenges with this but has found some of the politics in the hospitality world to be draining. At the end of the year he was offered a position back at the Waterloo store so now has returned home as well. Joel also did a lot of writing this fall as he made applications to teacher’s college for 2014, hoping to become a culinary teacher in high school in the future.

  Most people are probably aware of Beth’s ongoing battle with breast cancer that began at the end of the summer. I’ve written a pretty detailed account on my blog (tkreutzkamp.blogspot.ca). We’re very grateful for how quickly things have been dealt with and have been so impressed with the care at the Grand River Cancer Centre. Chemotherapy finished on December 23rd and Beth is scheduled for a double mastectomy on January 20 (at St. Mary’s hospital). Radiation will follow several weeks after that.

  Terry had been looking forward to retirement after March break but now has pushed that forward so that he will be finished at the end of January. He got out golfing with his Dad a bit more this summer and enjoyed helping redo David & Rachel’s backyard. Terry leads the music at church at least once a month and we sing with the children there regularly as well.

  Our house got some much needed attention this year too. A young friend, James, who’s starting his own business, did some great work on our family room, steps and kitchen this fall (you can see pictures at facebook.com/starkeycontracting). Currently another longtime friend, Steve, is redoing the kids’ bathroom.

Holiday trips this year included:

• 2 full weeks (instead of our traditional one) at Harp Lake cottage near Huntsville. It was really nice having the extra time as we had friends and family visit over our time there.
• we stayed for a full week at our church Camp Kahquah this year and enjoyed it so much we booked for 2014 as well
• numerous visits with family and friends, including a quick trip up to North Bay and hosting a Hugill gathering at our house, including Beth’s niece Kim’s family from Edmonton
• a getaway to a Bed & Breakfast in Port Stanley with our friends Dan & Ellen in August
• attending the Gentleman of the Road music festival in Simcoe (along with 25,000 other people - all who seemed to be standing in front of me!)
• a few days during March break at Blue Mountain where Josh, Alison & Joel went snowboarding. We had a great room looking right out onto the hill.
• a trip to a concert in Cleveland, Ohio in March and a visit to the Rock & Roll Museum there

  Overall, this has been a year of drawing closer together as a family and leaning on the support of so many faithful friends. Tough times have a way of doing that, and we’re especially thankful for the blessings of caring relationships.