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Hallelujah

Sherryl said she knew it was going to be a bad day when she stepped on the scale at her doctor's office and her weight had dropped to a number she hadn't seen since she was in her early teens.  Then her oncologist told her the current chemotherapy is not working and that her tumor marker is over 900.  He gently told her there are no more chemotherapies for her, and then he reminded her of a conversation they'd had a while back, one about a day when they would know there would be no more treatment. 

Sherryl's oncologist told her it's now time to focus on the quality of her life.  And he told her it's now time to contact Hospice.  Sherryl has contacted them and has an appointment next week; she learned that she does not need their services yet.  That news, coupled with the physical absence of medications, has given her spirits a boost.  The precious-sounding lilt in her voice is audible, and she's talking about a craft project she wants to begin at home as soon as she feels a little bit better.  

Sherryl has always wanted to "be at peace with cancer."  She has never intended to give up and still does not feel completely defeated by the disease.  But she understands the reality of her situation and will continue on this journey exhibiting a level of grace and dignity that is a lesson to us all.   

Interpreted as a prayer for mercy during devastating times, Justin Timberlake and Matt Morris sang it live last month on TV during the Hope for Haiti Now concert.  And k.d. lang sang it this past Friday night in Vancouver during opening ceremonies of the 2010 Olympic Winter Games.  Sherryl didn't see either of those performances, but she did see the song performed by the Canadian Tenors on the Oprah Winfrey Show last week.  She raved about this beautiful song and how moved the four tenors were when, as a surprise to them, Celine Dion joined them on stage mid-way through their performance.  Sherryl loved that a huge surprise was planned and carried out, and she loved the beauty of Celine's voice soaring with the voices of the Canadian Tenors.  But most of all, she loved the emotional reactions from each of the unsuspecting tenors as they discovered Celine had joined them on stage.  Even during difficult times, Sherryl is focused on making people happy, delighting them. 

This is a devastating time for our family, and we are being as brave as possible.  We are trying to emulate Sherryl's resilience -- for her, and for the younger members of our family.  But silently, we are each singing this prayer for mercy, too.  Hallelujah.   

~xoxo~

Happy Thanksgiving Weekend!

Sherryl's favorite holiday has arrived once again and she is happily spending the day with the entire family.  Sherryl has hosted our annual feast every year since Mom passed away and now, it is with great love and pleasure, that she is passing the proverbial baton to Jonathan and Rachael to carry on the tradition of Thanksgiving dinner.  Fun will certainly be had by all! 

Sherryl has been feeling pretty well the past couple of weeks and, in fact, her tumor marker has dropped a bit to 470.  Following a conversation with her oncologist, she believes that the dip in her spirits was due to the current chemotherapy as it is known to play havoc with emotions.  The doctor also prescribed Sherryl a medication to reduce water retention.  She says she doesn't mind pushing through fatigue, but there's nothing she can do in this case for a side effect that involves swelling. 

Sherryl also learned that the results of the brain scan were back.  Her doctor reported the brain and skull are fine.  Sherryl has identified a small spot on her chin that is numb, so the doctor took note and explained that, if there is metastasis in the jaw, that may be the cause.  He plans to watch it carefully. 

On this Thanksgiving weekend, we are so thankful for the people in Sherryl's life who love her so very much.  From longtime friends to nurses to daycare kids and parents to our aunts, uncles and cousins -- you all make such a difference to Sherryl's spirits.  We hope you are spending part of this holiday weekend with those you love, too.  From our family to yours, we wish you a very Happy Thanksgiving!

~xoxo~

Chemotherapy #6: Docetaxel

Sherryl saw her oncologist on Monday and began a new chemotherapy today.  Docetaxel will be administered intravenously once a week for three weeks, then there will be no chemo on the fourth week.  The other news Sherryl received is that her tumor marker is 553.  This high number does not come as a surprise because chemotherapy is suspended during radiation treatment, so Sherryl has had no chemotherapy since before she was in the hospital.  Once radiation was completed, Sherryl's oncologist needed to determine if Gemzar should be resumed or not; the decision was to try another therapy. 

Sherryl's oncologist explained that, although there is "a lot of disease in the bone," it is not overtaking her the body and it has not spread to any organs.  He explained some of the side effects of the new drug, many of which are similar to side effects Sherryl experienced on the first chemotherapy.

After her first dose today, Sherryl says she feels tired, but it's a good tired.  She has returned to day care and continues to slowly but surely push herself in order to optimize her strength.

Special thanks to those who continue to send to RaRa prayers, good thoughts, and hopes for good health.  We so appreciate every thought and every gesture you express for our sister.

~xoxo~

Chemotherapy #5: Gemzar

Following the "we're running out of options" appointment Sherryl had with her doctor and the subsequent case review by the tumor board, Sherryl placed a call to her doctor and he called her back on Saturday morning.  Here is a summary of what he told her:

Overall, the disease is looking better.  There is a "slight" spot on the humerus of both arms and a very small spot on the clavicle.  The new chemotherapy that will be administered is Gemcitabine, also known as Gemzar.  Sherryl will receive 1 infusion per week for 3 weeks and then will have 1 week of no chemotherapy.  There was discussion, too, of the original fracture to Sherryl's back and a procedure that will strengthen that area in her back is being considered.  The cancer is "not worrisome," and all areas where the disease is present will continue to be watched closely.  A new tumor marker will be ascertained within the next week or two.

Sherryl told her doctor her energy is good now, that she was planning to take a week of vacation, and that she'd like to feel good while on vacation.  Her doctor agreed that the new chemotherapy treatment can begin after her vacation. 

So, Sherryl is currently enjoying a week of good energy and free time.  She's spending most of her time at home since nesting is one of her favorite things to do.  She has not forgotten the phrase "we're running out of options" and intends to have a very direct conversation with her doctor the next time she sees him.  Two words: Go RaRa!!!

Special thanks to all of you for your continued support and concern for Sherryl's health and well-being.  Her spirits are buoyed by your thoughts, prayers, intentions, and actions.  Whether you see her often or hardly at all, please do not underestimate the power of your love for Sherryl. 

And we hope you're enjoying your summer!  

Tumor Marker is Up

Disappointing news, Sherryl's tumor marker increased from 107 on May 14 to 160 as of this past week.  Another PET scan, which is due about now anyway, will be scheduled for this week.  Sherryl will receive Nupogen shots next week and the next appointment with her oncologist is the first week in July. 

Although Sherryl has been tolerating CMF chemotherapy treatment relatively well, she has felt much fatigue the past several days.  As usual, she is paying close attention to her energy level and resting whenever necessary.

When Sherryl does have some energy during her free time, she spends a bit of time on the computer reading email or playing one of her favorite word games.  We know she loves Scrabble, and she also loves an AOL game called Word Zen. 

And when her energy is higher than expected, as it has been today, she talks a mile a minute, sounds as perky as ever, and takes on projects the likes of which would exhaust most of us.  Today, since her laundry room painting project is finished, she is cleaning out the very huge craft closet at home.

A very Happy Father's Day to all of the fathers who are RaRa fans!

~xoxo~   

Good News ~ Tumor Marker is Down

Sherryl met with her oncologist today and learned that her tumor marker has dropped from 168 in February to 107 today.  This is great news!  Sherryl's oncologist also told her that she is anemic again, so a course of shots were prescribed to boost her red blood cell count.    

The timeframe for the next bone scan was also discussed today; the next one will probably be scheduled for 8 weeks or two chemotherapy cycles from now.  

Except for some fatigue, Sherryl is doing well.  Her appetite is good and she feels OK.  She experiences no nausea and, in general, is thrilled to be able to function fully under the current treatment plan. 

Sherryl needed to stop into the clinic yesterday and one of the nurses approached her to tell her she had a "message from a friend."  Nancy, who has moved on to her new job, had asked the nurse to tell Sherryl hello for her.  Sherryl was truly touched that Nancy had thought to send her that message.

Sherryl continues to work at Day Care every day and this weekend will entail attending Austin's last Little League game, a massage, and spending time with family.  

All things considered, life is pretty good right now and we're all grateful for it.       

~ xoxo ~

PET Scan Results & New Chemotherapy

Sherryl saw Nancy on Friday and learned the results of Thursday's PET scan.  The overall outcome is best stated in Sherryl's words.  "I do not, do not, do not have any cancer in the liver or any other major organs.  There's only a slight, and Richard and I are focused on that word slight, increase of cancer in the spine and both hips."  Nancy explained that the bit of pain Sherryl sometimes feels in her lower back is probably muscle.  Nancy gave to Sherryl a copy of the PET scan report, which she poured over to absorb every last detail.  The test was summarized in impressions; numbered below are the highlights. 

Note: Just double click on any word to see its definition.

1. Mixed response to most recent therapy w/decreasing activity seen throughout a large portion of the thoracic spine with multifocal regions of increasing activity, most notably at T2, T11, L2, and right anterior superior iliac spine.  Remaining bony activity is relatively stable.  Stable L compression deformity.
2. Ill defined right upper lobe parenchymal opacity mildly increased in extent since prior exam suggests possible inflammatory disease although neoplasm cannot be excluded.  
3. No other evidence of new visceral metastasis.

Nancy next explained that she and Sherryl's oncologist discussed two chemotherapy options and decided that, given Sherryl's preference to stay active, a cocktail combining oral and intravenous medications is the best treatment at this time.  The new chemotherapy treatment is called CMF.

The C in CMF stands for cyclophosphamide, the M stands for methotrexate, and the F stands for fluorouracil, which is also known as 5FU.  Sherryl will take 1 pill per day for 14 days.  And during those 14 days, she will go to the lab twice a week to have her blood drawn.  On the day after she has her blood drawn, she will go into the the Marin Cancer Institute (where she receives most of her care), for the IV portion of the chemotherapy.  

After those two weeks are completed, no oral or IV medication will be administered.  So, the CMF cycle for Sherryl will be 2 weeks on and 2 weeks off.  Side effects may include fatigue and nausea, but another oral medication will be prescribed to offset nausea.  And there will probably be no hair loss as a result of this treatment.  

Sherryl was so disappointed when she learned the tumor marker had spiked that she was bracing herself for some bad news in hearing the results of the PET scan.  She didn't have a good feeling about it, so she was more than relieved to learn there is no cancer present in any organs and that it has spread only slightly in the spine and hips.  Resilience returned immediately and, after her appointment with Nancy on Friday morning, Sherryl returned to Day Care to finish the day.  She had dinner with a friend on Friday night, and spent most of Saturday out and about.  By Saturday evening, she was home and ready to nest for the evening and all day Sunday. 

But there is that small matter of the transition to Daylight Savings Time. . .

The day we turn our clocks ahead one hour is and always has been RaRa's least favorite day of the year.  Because she just hates losing that hour.  Whether she is at work, out and about, or at home, RaRa is highly productive.  And while she has added required sleep as a new measure of productivity, she really hates to lose any time at all.  With all that RaRa can accomplish in 60 minutes, an hour is a terrible thing to waste.  We'll just have to watch to see how she makes up for that lost time, because we know she always does.      

One Step Forward, Two Steps Back

Since it has happened in the past, we were all hoping the lab had made a mistake in processing Sherryl's blood and that the tumor marker of 168 was wrong.  Nancy had the lab re-check their processing, and it was confirmed the tumor marker is correct.

Sherryl had responded well to the current treatment plan, so there was no reason to schedule a PET scan since the previous one was done last October.  Given the spike in the tumor marker, Sherryl will have another PET scan on Thursday, March 5, and she will probably learn the results the following day.  Then Sherryl's medical team will determine the next course of treatment, which will include a change in chemotherapy medication since she has stopped responding to the one currently administered. 

The spike in the tumor marker feels like a major setback.  The only pain Sherryl feels is very low in her back, but the pain is not constant.  And she is so good about getting as much sleep as her body tells her she needs.  The new tumor marker comes as a blow and Sherryl has not felt this disappointed in a long time.  She said, "This is the best I've felt.  It's so disappointing to find out this chemo isn't working any more."  

She went on to say that it feels like a roller coaster, driven by the tumor marker highs and lows.  Each time the tumor marker spikes, a new plan is needed.  Her body response well, the tumor marker drops and all is well, then her body stops responding and another change is needed.  One step forward, two steps back.  Nancy has reassured Sherryl that there are many, many options available relative to chemotherapy medications and treatment plans.

Through this entire journey, there is one thing that Sherryl says she's learned to do that brings her great pride.  She has a new way of crying, and she's really excited about it.  She's able to cry without her face contorting.  What Oprah calls "the ugly cry," Sherryl calls "contorted face cry."  In the two years she's had cancer, Sherryl has learned to relax the muscles in her face and now just lets the tears roll down her cheeks.  No facial contortion.  At all.  She doesn't cry often, but when there are setbacks like this one and tears well in her eyes, this new way of crying is great progress. 

The "new way of crying" story doesn't translate well without Sherryl's voice.  She explains it in a way that has her audience in hysterics.  And ultimately, she's once again found the proverbial silver lining in the looming cloud.  Even with a spiked tumor marker, pending PET scan results, and a to-be-determined treatment plan, RaRa is laughing.  But we've seen this attitude surface in the past.  Lesson: Never underestimate RaRa's resilience.

Tumor Marker Is Up

Sherryl learned today that thetumor marker is 168, up from 78 on January 23.  Sherryl is disappointed, but for some reason she had a feeling the number would be higher this time. 

Sherryl did not see Nancy today, but will see her on Thursday.  Discussions will involve whether or not Neupogen injections are influencing the tumor marker. 

Aside from this disappointing news today, Sherryl's spirits are good.  She is tired this week, so she is going to bed early every night. 

We will let you know more information as soon as it becomes available.

Excellent News: Tumor Marker Is Down!

Sherryl was scheduled for a round of chemotherapy today, and popped in to see Nancy prior to receiving her "cocktail."  Blood tests indicated that her white blood cell count was marginally low, so a slightly lower dose of the chemotherapy was administered.

As Nancy was studying the other numbers that came back from the lab, she said, "Hmm.  78."  When Sherryl asked what the 78 meant, Nancy told her that was the tumor marker.  Sherryl couldn't believe her ears: the tumor marker has dropped from 127 mid-December to 78 today! 

Sherryl told Nancy that, although she's getting far more sleep than she used to get, she's feeling better now than she did before she was diagnosed nearly 2 years ago.  For those who have not talked to RaRa, you should all hear the lilt in her voice tonight.  One of the sweetest sounds in the world. . .

Our cousin Marie is doing better these days, too, so we're happy for that reason as well!

In honor of Sherryl's birthday, the new year, and other changes underway, we've freshened up the design here with help from the talented Jo-Lynne over at DCR Design.  The hands in the banner at top are littler than they used to be in order to make room for more hands and more white space, and we picked a different font for the title.  We also made a few minor changes to the purple background, but not very many.  Those little hands finger-painted that background, after all, and, well, art is art.     

There will never be too many thank yous from us to you for all you have done to support Sherryl.  We are so very appreciative of every thought, prayer, and gesture of kindness you send her way.