The last Spinal-Plus-Doxyrubicin etc. happened on December 23rd! Nadine is also nearing the end of her "Consolidation" phase of chemo and will soon be in the next phase, "maintenance" -- still substantial, but with no more doxorubicin or asparaginase. After this big-big-chemo, only two more doses of doxorubicin were left, and about 6 more asparaginase. Also in the new phase she'll still get intrathecal spinal injections, but every 18 weeks instead of every 9.
THE CYCLE WENT WITHOUT DELAYS!! For this monumental final Big-Big-Chemo her counts went up on time!!!! The APC was even up at 1300, over the required amount of 1000! We found that out Wednesday morning.
Clinic was at 9:30 AM, early as usual since Nadine couldn't eat in the morning. Margaret emailed that Nadine's ANC was 1300, 300 over the required amount. Another freezy, icy morning.
Nadine went off into the procedure room, and there was Dr. Andrea Hinkle, the stately yet cheery doctor who had orchestrated the treatment for Nadine's medical crisis of sepsis in the ICU -- apaprently she takes a stint in the procedure room perioidcally.
DOCTOR SAID NADINE WORKED TO HEAL
I told Dr. Hinkle how much it had meant to me how she'd handled Nadine's crisis, and she replied that Nadine had done most of the work.
The spinal fluid aspiration and injection went as always -- this time Nadine did little oohing and ahhing as she'd done during the last procedure. She lay still, curled up on her side (as positioned by the nurse). Curled up under the cover with her fuzzy bald head, she sometims reminded me of a sweet baby, as I watched her underneath the cover.
Margaret, appropriately garbed, did the usual, oozing competence. She painted Nadine's back with something that looked like Betadine, inserted a scarily long needle or catheter, and attached a tube into which Nadine's crystalline spinal fluid dripped out, slow-slow-slowly, tiny drops in slow succession. This wasn't true of everyone, but Nadine's went slow. Then Margaret injected the straw-yellow methatrexate (which looked like dilute urine to me), the hydrocortisone, and the cytarabine into the spinal fluid, removed the apparatur, and placed a piece of gauze over the point of insertion.
All left except Dr. Hinkle, whom I asked if I could have a photo for our hospital album -- she looked so festive with her smooth dark hair and bright winter-patterned cardigan. We chatted some -- She turned out to enjoy music as well, and had just fallen in love with the sound of an oboe at an RPO concert.
After the procedure, we were escorted to Treatment Room 7, with its comfortable chairs, the super-duper one for Nadine and the "Parent Chair". Nadine got her IV chemo-meds through her port -- dex, dox and vincristine.
While we were there, we watched Mary Poppins together -- it had been my pick this time, hilarious and sweet with plenty of barbs about stuffy, unappreciative parents and greedy bankers. I saw Nadine grinning during some of it.
Another sign that I'm aging -- when I used to watch Julie Andrews on film, she seemed so old to me -- this time she looked awfully young.
Nadine started to feel shaky in the treatment room, and I was concerned even though it was normal.
An era over.
NADINE'S WEIGHT AGAIN
I was really worrying that Nadine's weight had to do with the cancer -- she seemed to be eating more than her weight would indicate. There were suggestions of mashed potatoes, gravy, cream, rich food, evaporated milk, etc. And no more neutropenic diet for the most psrt -- maple syrup, nuts, all of it were okay again.
MED DOSES -- I asked if Nadine's medicine doeses should be raised again, as her chemo was being done on time; I was told, however, that the doses would still stay the same, adjusted for weight as always.
AFTERWARDS, A FINAL UNPACKING
We were thinking of going to 414 to visit Amber, from TLC, who was in the hospital, but Nadine wasn't up to it after the Big Big Chemo and also Nadine was worried about any chance of giving Amber a cold (although I didn't think she had one), and we left.
We stopped at the Kanack School, where I thought we'd left a few things after we'd moved out. I was shocked when I looked into the dresser Nadine had used -- it was stuffed with Nadine's clothing tha tI didn't even realize was there, and when I looked in the closet of the room I'd used, it was stuffed with my clothing that I hadn't remebered was there either. Nadine triumphantly exclaimed that she'd found her missing journal. I decided to clean out all our things, which took about an hour of going up and down stairs, but finally it's all cleaned out. One more chore finished, this particular chore being one I hadn't even known existed.
The tedious emotion of moving from place to place flooded me again, and I was disgusted, disgruntled and dismayed. There were no boxes, but Nadine thought of stuffing clothing into pillowcases. We ended up with about 10 fully stuffed pillowcases in addition to a bunch of papers and a Therm-A-Rest mattress pad.
MORE STUFF TO DO
After we arrived home I was stuck helping Nadine write an answer to the Michigan composition teacher's email to Nadine after receiving her composition portfolio.
He had emailed and said he had liked listening to the portfolio -- he wrote that he'd liked listening to it, and that it was the only applkcation he'd ever received that had traditional Irish tunes in it.
However, he wanted to know what degree she was applying for, and he was wondering why the rest of Nadine's application wasn't in (he didn't realize the dean had told her to get the composition portfolio in first). Nadine was on the couch and not up to drafting a letter, and it had to go in. I didn't want to draft the letter for her, and wanted to relax before we went to the sughi party with the Klassens and the Waymans that night. Nadine kept finding fault with parts of my draft, whihc was her right, but I felt hurried to just get the thing over with. It all took about an hour and there was no time left to rest up. of course, wehn it was finally out, I got an automated reply that Prof. Evans was away from his email until January 4th anyway. By then, I was cranky and angry at myself for not having gotten this over with earlier and for not having simply let the prof. know that I was writing the letter because Nadine wasn't feeling up to wriing it. Nadine was on the couch in tears, and I felt paralyzed.
SUSHI PARTY
I realized it was time for the sushi party at the Klassen household, somethining Nadine had looked forward to a huge amount. However, she said she wasn't looking forward to it, although she didn't know why. If elt "torn" about styaing home with her or insisting she go -- finally I told her it was imortant to go to it, and she went. I felt like a fool an an ass for doing it.
It turned out Betty had had a cold, and she ended up not going to the party, and one reason I'd insisted on going was to have an evening with all the families together. And now I was stuck at a party I didn't think we should have gone to.
Hwoever, Nadine perked up and had a wonderfl time with Sylvia and Claire and the rest of them; preparing the sushi was fun as alwyas; Claire, Sylvia and Nadine did the usual compliment of hugging.
HOME AND MORE FOOD< MORE CAREGIVING
After we came home, I expected to finally get some rest, but Nadine was hungry again when we got back, so I cooked fried sweet potato for her and prepared some Spira-Teen in powdered soymilk (she couldn't have dairy because she couldn't take mercaptopurine with dairy). I felt annoyed that after we'd had "dinner" I still had to cook late in the evening. although I was gratified I could create something nurtrious and high-calorie with the veyr limited food inventory I had.
I was feeling so darn blue and band about myself. Objectively, I know I've done plenty of decent caregiving and I've had a lot to do under pressure. People have beenwonderful assuring me of that. Yet, when I make a mistake, or think I might have made one, I take it hard, especially if it concerns Nadine. This sadly can make me cranky enough to feel I've made even more mistakes. I was still worried that I'd overdone it by urging her to go to that evening party and possibly tiring her out.
Nadine, meanwhile, seemed okay, And in fact she turned out okay -- no ill effects at all. SO -- we ended up with an okay Nadine and an cranky and disgruntled me. Oh well, I guess it happens.
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