I am not Ready to Make Trips to the Emergency Room, Yet

One thing that (sort of) amuses me is the way our symptoms are referred to as being "flushing and diarrhea". Flushing, like my face just turns pink or red. Why doesn't anyone show a flushed face with sweat running down from the front hairline to the ear? How come they don't show the back of the head with wet hair on the neck? 

When I was suffering from diarrhea this week, I kept waking up at 4:00, 5:00, and 6:00 am bathed in sweat from my head to my waist. How I longed to take a shower, but I didn't want to wake up my husband. He takes care of buying the groceries, cooking meals and cleaning up when I am sick. He has been in pain from gout; so I wanted him to sleep. (I did bathe, but it was later in the day.) I seem to really overheat before dawn when cancer makes me sick.

Early on the third day of being sick, I got my body out of bed and pulled the pillowcase off the sweat-soaked pillow, as a reminder to wash the sheets. I managed to lift the shower chair out of the bathtub, and put it in place. I wasn't strong enough to take a complete shower, but I could sit down and get the water to run over my upper body and wash off the worst smells. So I succeeded in getting washed off before I started my day, but I was horribly weak.
  So, why not go to the Emergency Room and get an IV of electrolytes when I am so weak? I know that was probably what I needed because of the fluid loss from diarrhea and perspiration. 

OK, Update! 7-18-2013: I talked to my gastroenterologist about being dehydrated. He says I should be OK by just drinking water and Gatorade when I feel better. Unless I have very dark urine or no urine, my body should replenish its fluids in the next days after being ill.
So, what causes the weakness? Well, I am somewhat dehydrated, but it's the cancer making me feel weak. I have been having the D-word and feeling ill for nearly 2 weeks. My face is flushed. That's just carcinoid syndrome.

I am not ready to begin making visits to the ER, yet. I guess it's just an attitude. I am not ready to begin that pilgrimage that will go with me for the rest of my life. Other patients write of the strong pain that develops later in the progress of carcinoid cancer. They go in for shots of dilaudin or other painkillers to relieve chest and abdominal pain. Others have heart and lung problems, and, of course, our livers begin to fail. I don't want to go from France to an ER in 21 days. So for now, I am depending on Gatorade and fresh fruit to help adjust my electrolytes. I am getting stronger every day.

Tracking Variations in my Health

After posting just last week about our trip to France, I am going through a rough patch in my carcinoid symptoms. From the evening of July 6 through July 9, I had repeated diarrhea. Usually, I am only sick for a day or for the morning, and then I just collapse into bed. When  I get up after sleeping, the diarrhea is often gone. I take Welchol at the first sign of unusual bowel activity, and I keep up with my Octreotide shots.

I just want to track that this does happen. I was sick for 3 days and today I am noticeably weak. I took a loooong time to walk 30 feet  toward my car from the doctor's office today.  I had a regularly scheduled appointment with my oncologist today. 

One change we made was to start a standing order to have my Chromogranin A and Gastrin checked every two weeks. Whenever I get sick suddenly, I can go in and use that standing order to see if I have high levels of either compound in my blood. I would really like just one time to catch my cancer markers in the act of making me suddenly sick.

The last time I went through a period of being sick over several days was in March this year. I wrote about it on March 16, 2013. One thing I want to do is to keep track of the regularity of when I get sick. Here we have a four month time again when I gradually got better, then got worse. I would like to figure out why the tough times come around.

I realize that I have not written much lately about drawing strength from scripture or from music. One verse I have known was in the Bible, but I didn't know the location of was found by me while on the Seine!

Psalm 118:17 I shall not die, but will live, and proclaim what the LORD has done. The LORD has chastened me severely, but He has not given me over to death.

Doing Well in June 2013

Hi,

I hope things are well with you! In May and June I have been quite well, and even went on a trip I have been planning for a few years. All three of us were able to go via Air France to Paris and spend 12 days in France! We didn't spent much time in Paris, but saw Reims and Chantilly, and then headed to Normandy. About 8 days were spent in Normandy because it may be the home of my Lesueur ancestors. My ancestor, Joseph Lesueur or Lazzieur, was married in Maryland, in the American colonies in 1702. We are not sure specifically where his family was from as there were many Lesueur's in Normandy, Picardy, and Paris by the time Joseph came along. That story would make another blog.

However, I have wanted to go to France since I was 15 and saw pictures of Versailles. I spent time last year working out where I would want to go, and began praying about when to go. As I was looking up airline schedules and hotel locations, ads for group tours started to pop up on my computer's monitor. After studying several, I realized only one of them would go to the places I wanted to see and stay in one place the length of time I wanted to remain there. So we made the arrangements to go with a tour that would start from Paris and go overland to Chantilly, Reims, and Cabourg. Then we would board a riverboat that would go down the Seine and take us to Paris.

It worked out very well! If you have carcinoid, of course, you wonder, "What will I do on the days I get sick?" I got sick one day while we were at the Grand Hotel in Cabourg and on another day while we were travelling down the Seine. I was sick in the morning and went on the afternoon excursion at 2:00 pm. We never had to change any travel plans.I did miss going to see the famous tapestry at Bayeux, but I began to get better by 9:00 am, and had a lovely walk around Cabourg. I visited gardens, the shopping district, and a local creperie by 1:00 pm.

These photos show the Chateau Chantilly; Reims Cathedral; American Cemetery; Normandy Dancers; Eifel Tower; Notre Dame du Paris, and a garden in Cabourg in Normandy.

I have an Email Address for the Blog part 2

Hi!

The second part of the eddress is : urney@aol.com

Please don't send ads and unsavory things in the email, or I will remove it. I hope this is a way I can help someone.

God bless you,
Sharon

I Have Created an Email for This Blog part 1

Hello,

In the last 6 months I have had more readers asking if I could answer a question for them or commiserate with them that I had before. Therefor, I have made us an email address to keep us in touch.

I will write the first half of the address in this post and will follow with the second half in the next post. The first half is; A5YRjo

The case of the letters does matter.

Sharon

We Need an Update! Really Good news!

Well, looking back at last month's post I see I need to let you know I am fine. I had to adjust to being on a lower dose of medication, and then get back to "normal".  So I'm sick in the morning a few days a week, but I do very well during the week after my long-acting shot while the Octreotide is at a high level in my blood.

The good news comes from my meeting with Dr. Imagawa, my surgeon, regarding my MRI. The scan, as usual, didn't show any sign of my tumor. It is not any larger than 3 mm, so it still cannot be seen. I asked the doctor if there is any way to know if I still have just one tumor or if they are like tiny grains of salt across my liver. He said there is no way to know when the tumors remain tiny.

The good news is that the tumor has grown so slowly for the last 4 years that Dr. Imagawa doesn't think it will be the cause of my death! He said I will still be sick, but I won't die from the oncology of carcinoid cancer. He said I will live long enough to die of something else.

This caused me to chuckle because I have spent five years wondering if I have five more years or 10 more years. Now I don't have to think about that, and I'm glad I already have been following the advice of my cardiologist since my recent female ancestors have had heart disease.

I asked him about a case like Dennis Woods who was pretty well the first six years he had carcinoid cancer, but during the next 7 years his liver filled with tumors. His liver is failing and he has brain damage from  the ammonia produced by his liver. The doctor interrupted me and said that I won't do that. That was what I needed to hear!

If my tumor gets large enough to be seen, the good doctor will take it out.

Regarding the phrase saying I will not die of the oncology of carcinoid cancer: he means that I still have carcinoid syndrome. That means my tumors are busy pouring chemicals into my bloodstream: that's why I am sick. The serotonin overload affects the heart, and the leading cause of death of carcinoid patients is actually cardiac insufficiency. That is why I already have a cardiologist watching my heart valves with an echocardiogram

 I feel like I am in good hands. Now I no longer feel like there is a giant pan lid over my head ready to clamp down on my life and confine me until I die. I feel more like a normal person.

Thank you, Father for your grace!

Love,
Sharon

So,This is How it's Going to Be? Day by Day and with Each Passing Moment

Hi,

Well, I guess the big experiment was a bust. A couple weeks after having my medication reduced by 6 mg per month, I am all the way back to giving myself two 200mcg shots per day at home. I am also getting a 20mg long-acting, repeatable (LAR) injection at the medical center every two weeks. So I am back to total of 52mg per month.

Unfortunately, I have had a couple of rough weeks. Last week I was ill for a few days, then this week I was pretty well Sunday through Wednesday, but sick for three days so far. Even on days where I don't camp out in the bathroom, I am still weak. I use the support of  my cane and my walker when I need their help. It's becoming more common to be ill. I am developing the philosophy reflected in the title of this post: so this is the way it is going to be.

Disclaimer! See the change that occurred just a week after I wrote this post by reading below! 8/10/13.

God is good. This morning when I woke up He brought to mind an old hymn:"Day by Day and with each Passing Moment." The link above has several great scriptures before the singer begins the song. Just wait, she does sing and the lyrics are posted. It's a lovely hymn from 1865.

You probably Do NOT want to read the section below unless you are a patient with bowel issues.

I must express my appreciation for Welchol one more time. From all the posts on this blog the one about Welchol being effective on diarrhea is the most popular. It is read every day.  So, let me repeat some information about it one more time.

I use the packet of 3.75 grams of the powdered Welchol and mix it with water. It is made of resin beads called colesevelam hydrochloride that attract cholesterol to cling to them. I was having frequent diarrhea a couple years ago and mentioned my problem to my cardiologist. The Holy Spirit must have impressed it on me because it busted into my thoughts twice while I was talking to him. After I told him, the doctor instantly lit up, and told me how this cholesterol-lowering drug also causes constipation.

Welchol is the reason I was able to sleep last night. I took a dose about midnight and slept until 8:50 am. It is effective for me 60-90 minutes after taking it when I have been in the middle of hours of diarrhea. If I have already emptied my gut, Welchol can hold back the next bout for 3-48 hours. Typically, it gives me one night's sleep or rest for a few hours in the middle of the day.

I hope this helps someone.

Post Script on August 10, 2013:
A week or so after writing the paragraphs above, I was doing better.  I had good health from late in March until July 7. For the second time in two years I had particularly good health for 3.5 months: in 2012 it was from about the middle of February through the end of May. I do not know why this happens, but I am certainly grateful for it, Father! This year we went on my "bucket trip" to France, and I only missed a couple of events.

As I was writing the original post in March, I came across this version of "Day by Day and With Each Passing Moment," but I uploaded the other one because the verses with it are encouraging. However, I do prefer this rendition by Russ Taff from his album Faroe Islands.

The Results of the Experiment!

Hi!

After one month on less Octreotide, the doctor and I have reached a conclusion. I will gradually resume using two shots per day of Octreotide at home until I can reach a happy balance that removes the dyspepsia and the weakness from too much Octreotide, but avoids the diarrhea and sweaty heat from the tumor!

Now, how will we achieve this perfect balance, you ask? For one month I have been taking just one 200 mcg shot per day about 10 am. I will begin to add in another 200 mcg about 10 pm on Mondays and Thursdays, and then do 3 shots per week. Maybe 4 nighttime shots per week will do the trick.

It is important to note that when my tumor is putting the chemicals into my bloodstream that make me sick, it is probably growing more capillaries, also. Octreotide works by decreasing the capillaries that supply carcinoid tumors. Therefore, when the level of the medicine gets too low in my body, my tumor might be growing.

In general, when I first decreased my shots at home, I felt stronger! I was going up and down the incline at the Grove Theatre where we have church without my cane. I even had my friend Raquel take my arm to walk down the aisle to her seat. Also, my upset stomach  went away after a week. (It was just dyspepsia. My stomach felt unsettled and some days I lost my appetite until after 12 noon.)

However, after 3 weeks of less medication, the cancer symptoms came back. I have had diarrhea on several days and the weakness that continues after it.  Plus, I can't go many places. And I get covered in sweat typically after 9 pm, when the medication in my bloodstream decreases. So the amount of medication needs to go back up, gradually.

Welchol still works for me! Thank God! See my other posts for what it does.

For patients who want to know the number of milligrams of Octreotide we are talking about, here goes: (200 micrograms is 0.2 milligrams)

0.2 mg aqueous shot at home every day
20 mg LAR February 14
0.2mg aqueous shot at home every day
20 mg LAR February 28

That is a total of 46 mg per month. I had been taking 52 mg per month by taking 2 shots at home per day. Now I have to figure out if 48 mg, 49 mg, etc., is the best amount for me.

This is something where prayer can be very effective so that God guides me to select the best amount of medication. Thank you for your prayers!

Love,
Sharon

Abdominal MRI 2013

For the last year I have been seeing my surgeon (Dr. Imagawa) at the University of California Irvine Medical Center every six months. I seem pretty stable, and my scans of all types don't show any tumors, so the doctor has decided to just see me periodically. Just because the scans don't show tumors doesn't mean there are no tumors. I have the microtumors of carcinoid.

When I went to see Dr. I in January, he noticed that I had not had an MRI since 2010, so one was scheduled. I went in on February 27 and had the scan done. I was supported in prayer by friends, and felt peaceful about going in. For the previous scan I had been afraid of claustrophobia causing me to panic during the MRI, so I had prayed, had asked 10 friends to pray, and took my regularly prescribed Effexor and muscle relaxant. That had worked very well, so I did that again. One other detail that really helped--I can see daylight if I look past the top of my head while I am in the MRI tube. It turns out there is open space only 9 inches away from my scalp!

So this time I was calm and the MRI even went faster! I brought in a CD by Mercy Me, and listed to the first two songs while the IV was put in and instructions were given. We were done with the scan before the last two songs were sung! I estimate I was in the tube about 30 minutes while last time it was 45 minutes.

It was good to lie in the MRI and hear "Where can I go from Your spirit? Where can I flee from Your presence? If I make my bed in the depths, If I go up to the heavens, You are there!" Those are lines from Psalm 139 (You are There) by Bart Millard and Kendall Combes from the cd MercyMe The Worship Sessions.

There is a beautiful version of the hymn Come Thou Fount on the same cd. The last verse is so exciting! "O that day when freed from sinning, I shall see thy lovely face! Clothed then in blood washed linen, now I'll sing Thy sovereign grace! Oh, I'll sing my song of grace, I will sing my song of grace! Come Thou Lord, O, do not tarry, Take my ransomed soul away! Come my Lord do not tarry, Take my ransomed soul away! (quietly) Send Thine angels now to carry me to realms of endless day." 

I found out the results of my MRI at a regularly scheduled visit with my oncologist. There is nothing new in the MRI. The same things are still in my liver. Now, I haven't seem the surgeon, Dr. Imagawa, yet. He might decide to do more exploring, and if anything changes, I will let you know.

God bless you!

Sharon