Chemo next week and Jehovah-Shalom

I spoke with an oncology nurse about the interperitoneal chemo treatments which begin next week. These rounds are different from the IV chemo I have been receiving. They start in the hospital and involve getting the IV chemo over a 24 hour period and then the chemo in the abdominal cavity and then getting hydrated - followed by another round of the abdominal chemo 5 days later. I also will need to have 11 shots during the round to stimulate the bone marrow to produce white blood cells. I will be dangerously low and susceptible to infection 10-14 days following the chemo. I am praying about resting in the Lord but the anxiety keeps creeping in.
I am so thankful to the Lord that I am able to get this chemo - it is very effective in battling the cancer but I am worried about the unknown side effects - although God who inhabits eternity is there already! Another item for prayer is that everyone in the house is sick with a cold or virus - please pray that I am able to stay infection free so that I can continue with the chemo schedule.

So, this is the next step of the journey - thank you all for continuing to pray that the chemo will get all the microscopic cancer cells and that there will not be any secondary infection.

One of the names of God in the Bible is Jehovah Shalom or the Lord my peace. I am praying that I can enter into the reality of this name of God and be filled with peace. This name of God was revealed to Gideon. He was called by God to do battle against the Midianites, who were an oppressive and powerful people. Here are the verses (Judges 6:23-24a) which describe the Lord's appearing to him:
23 And Jehovah said to him, Peace be with you. Do not be afraid; you shall not die.
24 Then Gideon built an altar there to Jehovah, and he called it Jehovah-shalom.

My worries, like the Midianites, can only be defeated by Jehovah-Shalom. Oh Lord, help us all to enter into the reality of this name.

Much love,
Joanne

Post Operative Visit with a few edits

Hi Everyone,
I just want to correct a couple of items Stephen put into the blog yesterday - there was an opening in the incision but it was not infected. The opening was very small - about the size of a pea - so it will close and is closing up - there was no redness around the opening - so I am certain there was not infection. I cleaned it out once and then there was a scab over it so I am not sure how to proceed. I will ask the nurse on Tuesday.

I will be having chemotherapy on August 23-25 - as an in-patient at Brigham and Women's. They will be doing both types of chemo at that time - the interperitoneal - which goes into the abdominal cavity directly and also the IV - which I have been having. The IP chemo requires that I be in the hospital for its administration. Please pray for this chemo treatment that it will reach all the tiny tumors (1-2mm) that the doctors were unable to remove surgically - and for me that I am not overcome with anxiety about it.

I praise the Lord for so much answered prayer - thank you all for your faithful and diligent prayer for all the details of the surgery - the Lord surely did answer and so we believe that this is His will. I pray that through all this I gain Him more and more each day. Sometimes I worry that I am not gaining the Lord because I get so focused on my physical status.

Yesterday I was reminded of this verse from Psalms 34. 8 Taste and see that Jehovah is good; Blessed is the man who takes refuge in Him.

It is interesting that the tasting of Jehovah is coupled with taking refuge in Him. These days I have taken refuge in Him - I cannot find refuge elsewhere. I was encouraged to see that this is also a tasting of the Lord - so I can testify that He is good!

Much love to all of you -
Joanne

Post-Operative Visit

On Friday Mom visited Dr. Berkowitz at Dana Farber as a post-operative follow up. He was over two hours late so it was a challenging wait. He looked at Mom's wound and noted that a small area was open. He cleaned it out and commented that so much of the wound had closed so there was no way to pack it with either gauze or sponges. The woumd could be treated with a cue tip which Mom was to use 3-4 times a day on her own. Mom was terrified of this idea, but Dr. Berkowitz insisted that she could do it and even had her do it right in the exam room. She only stuck the cue tip in a short distance, however, so Dr. Berkowitz encouraged her to go deeper. Mom reluctantly complied, but successfully completed the process.

Back home Mom is still having trouble with her digestive tract. Dr. Berkowitz said her bowels look fine, but the analgesics she is taking tend to slow her bowels down making elimination difficult.

The next major step in treatment will be chemotherapy on the 23rd. This will be more extensive as she now will be getting an additional dose through the IP catheter into her abdomen.

Stephen Juraschek

Monday Update

This past week Mom has been home, moving around the house, recuperating from surgery. On Friday she had her staples out. There was a little concern that this was premature, but there is no infection and taking the staples out should help prevent this. On Monday Mom visited a palliative care clinic at Dana Farber. She was referred there by Dr. Berkowitz. They gave Mom a better pain regimen and pointed out that her perscription of Motrin for pain was a mistake - she was on enough blood thinner with the Lovenox and did not need more. Otherwise Mom is ok. Pain in her lower back, air in her abdomen, pain from the incision, and hot flashes from the hysterectomy are fatiguing and rob her of sleep. This Friday she will be seeing Dr. Berkowitz and will attempt to ask if she can be switched from Lovenox to Coumadin, an alternative, oral blood thinner.

Stephen

Back at Home

At about 4 this afternoon, Mom returned home. She just finished eating some leftovers from meals friends had brought to our house over the past week and really enjoyed them. Mom is grateful for all your prayers, meals, and support. She still is in some pain from the incision and had some low blood pressure this morning. She is scheduled to have her staples removed on Friday. On August 10th she will have her post-operative visit. In terms of her mobility, she is able to get up out of bed and go to the restroom on her own. Stairs are challenging, but doable "one step at a time." Her next round of chemo will take place in coming weeks. With the IP catheter chemo treatments can have more complications so each treatment involves a three day stay at the hospital.

Please pray that there would be no wound infection, the next round of chemo would go smoothly, and that she would have a swift recovery.

Stephen Juraschek

Sunday Morning Doctor's Visit

Three doctors visited Mom this morning around 8:40. They asked her about her pain. They said she may use Tylenol or Motrin to help. They mentioned that Lovenox will be lifelong. They also fielded a number of her questions. She won’t need a bandage at home as long as the would stays together. She may put a pad over the wound to make sure the staples don’t catch on clothing. She needs to keep moving around to prevent blood clots. She should be out of bed as much as possible even just sitting up (lying down you waste away a little). She can go up and down stairs, but should wait 6-8 weeks before heavy exercise. She needs to build up stamina and going outside is a good wait to accomplish this. Mom had a good meal this morning - sausage with a egg & cheese bagel sandwich and a fruit cup. She is currently enjoying some honeybush tea from Trade Joe's that dad brought her.

Stephen

Saturday early evening, July 28th

A lot had transpired by the time I returned to the hospital at 5:30. Mom no longer had any tubes in her. They took her off the PCA and are now giving her oxycontin and oxycodone and ativan for pain. This has made Mom’s pain a little less bearable, but it is encouraging seeing her walk around with nothing but her walker – it makes a Sunday return home seem like more of a reality. She also started eating solid foods for dinner. Visitors have been consistent, which has been encouraging.

Stephen

Saturday Morning Doctors Visit

Mom was visited by a teamd of 3 doctors this morning, including Dr. Fleming from several months ago. They looked at Mom's wound, which still looks ok, but they are watching it closely to make sure it keeps draining out. They also gave Mom some tips for identifying an infection when she goes home. The doctor encouraged her to keep walking.

She is still in a considerable amount of pain and the nurse last night was a little demanding, but overall she is doing quite well. Everyone that remembers her from the last time, agree that she looks much better.

Stephen Juraschek

Friday Morning - Berkowitz Post-Surgery Visit

Dr. Berkowitz visited Mom at 6:50 am. He said that everything went very well. The cancer responded dramatically to the chemo. He removed everything bigger than a tenth of an inch, and there really wasn’t that much to remove. During surgery Dr. Berkowitz discussed with Dr. Berlin (Mom's oncologist) about putting in an abdominal catheter and they decided to put it in. Now chemo will be administered intravenously and through the IP catheter. They did take the appendix out, that was the only bowel work. The goals for today are getting out of bed with the help of the nurses and deep breathing. He said Mom has every reason to be encouraged by her current condition. The incision looked good – the dressing is nice and dry. They excised the old wound, so new tissue is being used to heal the incision. He emphasized that it is dramatic what the chemotherapy did. We have every reason to be hopeful that the chemotherapy will resolve the rest. The average is to be in the hospital 3 days. Hopefully she will be ready to go home Sunday or Monday. She can do the stairs in our house. The only restriction is from the perspective of her comfort. She shouldn't do stairs on her own, but she can do them.

In terms of her morale, Mom is quite peaceful. She is very lucid, much better than the last time. She was quite encouraged by the news from Dr. Berkowitz and is currently resting.

Stephen Juraschek

In the recovery room

We visited Mom at 3 and then again at 5. Currently she is still in the recovery room. We will remain here until she moves to the Connor's Center. When we saw her she seemed at peace though understandably in much pain--though she commented that she felt a lot less pain than last time. She has a lot fewer apparatuses attached to her, which increases her comfort level. She was happy to know that the colon remained intact, that they did the hysterectomy, and that she qualified for the intraperitoneal. Hopefully she will be moved out of the ICU soon. Andrew is doing well too, he was able to handle mom's condition much better than after her last surgery . Dad is also at peace.

Stephen Juraschek