My Tribute to Cathy

Early in the morning of December 7th, I woke with the need to write Cathy a letter. I believe it was Cathy giving me a last hug on her way by that woke me.

Here is the letter I wrote:

If you envision the world as a huge forest then, before I knew Cathy, I was stranded in it, with darkness all around me and the cries of nearby animals loud in my ears. Fear and desolation were my companions.

The innumerable trees in that forest represent Cathy's love. When she found me in the forest she lit a fire for us and fueled it with her love. This glorious fire kept me warm and safe from the forest's dangers. She always had an abundance of firewood, never admonishing me to huddle close to a small fire, but building a huge bonfire sending a glorious shower of sparks into the sky. Her love knew no limits and she had more than enough firewood to keep that fire blazing through all my nights. Her love kept me warm and safe from the forest's dangers.

Cathy always knew when my fire was burning low and she would appear out of the darkness, arms overflowing with more firewood.

Now I am overwhelmed with the knowledge that the firewood supply, which I foolishly thought was endless, is not. Our fire will never again blaze up to the heavens in all its glory. But I have realized if I tend my fire carefully she has left me enough firewood to stay warm and safe from the dangers of the night. I will stay vigilant and feed the glowing embers with all the memories we made together. And when those of us whom she so dearly loved gather together, we can nurture each others fires.

We weep for ourselves that we will no longer rejoice in that blazing fire sending beautiful sparks into the dark moonless sky. Our world is darker now and we are bereft.

Hi everyone... this is Sandy. It is with a heavy heart that I announce that Cathy passed away last night about 10:30 with John and the girls by her side. I am relieved to say she passed away peacefully with minimal pain. Due to the timing there will be a private service this week and there will be a memorial/celebration of Cathy's Life in January that you will be advised of later. The family has requested in Lieu of flowers donations be made to the Wings Of Providence, which is a womens shelter in Edmonton. Their address is Box 32141 Edmonton, Alberta T6K 4C2. The phone number is (780)426-4985 and their website is www.wingsofprovidence.ca and donations can be made on line. A big thank you for all the support we have received. Hope you all have a Very Merry Christmas and a Happy and Safe New Year and we all look forward to seeing you in January.

Hi everyone... just got back from Devon. Cathy is resting comfortably and is really at peace. We had a little birthday party for John in Cathys room tonight. Sang Happy Birthday and had cake with candles. Cathy has been taking small doses of morophine to help her sleep at night because she is starting to experience some pains from cramping in her abdomin but she even asked to have that delayed so she could join in with our little party when John got there. John is taking next week off so I am sure Cathy will really enjoy that. Talk to you soon Love Sandy

Hi this is Sandy. I am sorry we have not been keeping the blog up to date but I wanted to wait until I went up to Devon today so I knew what I was going to say. It is with a heavy heart that I inform you that Cathy has slipped into the final stages of her cancer. I was up to see her last Wednesday and we had a good visit. She sat up in her chair for 4 hours and visited with us and it was wonderful. Unfortunately Cathy took a turn on Thursday. It was like she didnt want to talk to anyone and she did not want to get out of bed. She was just too tired. At the time we were not sure if it was because she was worried about having the Cat Scan done on Thursday and the possibility of starting chemo again... if she had another small stroke... or if it was the cancer. As Cathy Brown has blogged the oncologist told the family on Monday that her liver is full of cancer and there will not be any more treatments. Since last Thursday Cathy has been sleeping most of the day and if you ask her a question she will answer it but she is not interested in carrying on a conversation. Mom and I went up today to see her and Wanda, Larry, Ashley & I are going up tomorrow as it is Johns birthday. I will try to keep you better posted as I will be up there all next week for the Roar to the Rings (curling) and I am hoping to see Cathy alot. For those of you who are asking what you can do to help unfortunately there is nothing any of us can do but pray. I again want to thank you all for your outpouring of support and love it is not going unnoticed even if we are not getting around to responding to you all. Love you all Sandy

From Cathy Brown:

Cathy saw the oncologist on Monday. The CT showed that her tumor has grown and is now filling her liver. While it hasn't spread beyond her liver, the chemo is not working. It was a very hard decision, but Cathy has decided not to continue with further chemotherapy. She remains at the Devon hospital and is not in any pain, just very tired.

Oncologist Appointment

Hi All, this is Cathy Brown.

Cathy, Joyce, Jen and I met up at the Cross for an appointment with Dr Sawyer. The ambulance ride in from Devon was uneventful and the ambulance crew was great (Cathy has had them before for a trip to the Alex). Cathy had blood drawn at the Cross which makes the visit so much longer since we had to wait for results to see the doctor. This time Cathy had a bed instead of a wheelchair so was much more comfortable.

The hallmarks of the type of cancer Cathy has (cholangiocarcinoma) are weightloss, marked fatigue, hypercalcemia (too high calcium) and hypercoaguability (thickend blood that clots too easily and too often). The concern with the paralysis in Cathy's leg is that it could be a side effect of the chemo, or a blood clot in her hip area or in her brain. It turned out to be a clot in the brain - which is a stroke in non-hospital jargon. The stroke was small and it is in an area of the brain (intenal capsule) through which the motor fibers pass - therefor the paralyzed leg. Cathy does have some movement in the leg but not enough to walk.

Dr Sawyer and Cathy discussed whether she should continue on the chemo or not. In the end they decided that Cathy will have a CT scan on Thursday and then decide based on what the scan shows. If the tumors are smaller - then continue the chemo, if they are larger then perhaps stop the chemo. Cathy has an appointment next Monday to talk with Dr Sawyer about the results.

For now then Cathy is back at Devon where they are taking good care of her. She tires easily and that is why her visitors have been limited. She is not in any pain and her paralyzed leg doesn't bother her, although it does cramp up and stick straight out every once in a while.

Cathy had her head shaved a week ago and Jenn had hers shaved as well. They look like two peas in a pod (a comparison I know all you cousins are all familiar with!). Last time I went to the Cross with Cathy they thought Becca and I were her daughters (which technically is possible since I am 13 years younger than she is). This time - the nurses/volunteers thought it was Mom - Joyce, Cathy and I were sisters (which they thought was weird since we both are named Cathy) and then Jenn was Cathy's daughter. I get a laugh out of my 'relationship' status every time I go there. It's nice to be a member of the family - even is it is only mistakenly.

Jenn says keep emailing her with the visiting requests.

Take care all - I will post when I have more news.

This is Cathy Brown. Mairin and I saw Cathy yesterday. She was sitting in a raised wheelchair when I got there and she looked like she was an 8 foot tall, bald goddess. Her spirits are pretty good and she is fine with staying at the Devon Hospital as opposed to moving to one of the palliative care units in the city. It means she might be able to go home sometime on a weekend pass and it is a lot closer for John to visit than any of the other hospitals. She says the staff are very good and she has a window that she can see out of (which is not really something that happens in a lot of hospital rooms). I was so pleased to hear that she is not having pain. As Sandy wrote in her last post she is very tired though. She was on antibiotics last week as her while count (a cell in the blood that deals with infection) was unexplainably high. They were making her sick so she is feeling better now that she if off them. Cathy says the food is good there - imagine that!

Hi This is Sandy. Cathy had a full case study done by the doctors on Monday and they have decided that they will not be giving her anymore treatments. The cancer is too aggressive and the chemo is not doing anything to it so they are looking at quality days now. The nurses have also talked to the family and have voiced their concern for the number of visitors Cathy is receiving and her lack of time to rest. The family and the medical staff have agreed at this point to run the following visiting schedule. There will be no visitors allowed on Tuesday and Thursdays. The other 5 days of the week there will be no visitors allowed from 1:00P.M. until 3:30P.M. Jennifer and Jeffrey are keeping a visiting calendar online so that we can control the number of visitors Cathy receives. If you want to visit Cathy could you please email Jen at spearchuckjen@hotmail.com or Jeffery at imunalia@gmail.com and they will confirm if you will be able to visit. We all apologize for having to do this but our concern is for Cathy. Thanks again for all your continued support and love through this trying time.

Hi this is Sandy. Cathy has a beautiful room in the Devon hospital and is actually resting comfortably. Not to mislead you Cathy is not in any pain I thought she would be upset with being in the hospital this early. We keep assuring her that this is a temporary set back and once they find out what is wrong with the leg and get her going she will be back home but who knows. Cathy is thinking it might be better to stay in Devon rather then go to the Royal Alex as there are less flu germs and is much quieter. The nursing staff is fantastic and it is a beautiful facility. They still do not know why she has lost use of her left leg but hopefully they will get an MRI ordered on Thursday now that the holiday is over. She went in on Monday for an MRI but her back gets so painful if she has to lay flat on her back that they could not finish it. They rescheduled her for Tuesday and gave her some heavy drugs, transported her into Edmonton and there was a miscommunication somewhere and she did not have an appointment. They took her back to Devon and so far there has been no word as to when another MRI is booked.

Wanda came down with a terrible flu (doctors think it is H1N1 but they did not swab her) last Thursday so she has not been up to see Cathy for awhile but she is slowly getting better and will get back up there soon. Jennifer has come down with something now too and is home in bed since yesterday. We just keep praying that Cathy does not get it.

Thats all my news hope everyone in your household is healthy... love you all Sandy

Hi everyone... this is Sandy. Just to bring you up to date on the progress of Cathy. She was asked to come to the Cross Cancer hospital last Wednesday to do an inhouse assessment. At this time she stayed in the hospital room and the many different doctors and nurses that needed to see her came to her to try and cut down on the amount of appoinments she was enduring. (To give you an idea Cathy goes to the Cross on Mondays for her pre chemo assessment and has an appointment with Dr. Sawyer. On Tuesdays she is back at the Cross hospital for Chemo on Wednesday she was at the Cross for the inhouse assessment. On Thursday Home Care was at her home and on Friday she was back at the Cross for an MRI) The trips to Edmotnon alone are wearing her out. Anyways on Wednesday during the inhouse they did a scan and found a very large bowels backup and ordered home care to start giving her enemas. Cathy was also losing the strength in her legs and her legs were starting to swell, so they ordered an MRI for Friday to see if there was something pressing on the nerves in her back to cause this as it is not normal for Cholangiocarcimona. Home care came to the house on Thursday morning, Thursday night, Friday morning and Saturday morning and administered enemas and Cathy was also drinking prune juice and stool softeners. There was not much progress. Fortunately through it all Cathy was not uncomfortable at all. Unfortunately on Sunday morning when Cathy woke up she could not stand on her own and could not get her left leg to move. Therefore she could not walk. Home Care came to the house and called for an ambulance to take her to the Stony Plain hospital. Then the games began.
She has been laying in the emergency in Stony Plain since Sunday morning. They got the results of the Friday MRI and it did not show anything that would cause the problem so they sent her to the Misacordia hospital Sunday night for an MRI of her head to see if maybe the calcium or the cancer had caused a pressure point in her head to cause the legs to not function. The MRI did not show anything. Cathy stayed in the emergency in Stony Plain Sunday night and then was transferred to the Cross Hospital today to see Dr Sawyer. They tried to do another MRI on her whole back and could not do it as Cathys back was in too much pain. They have transferred her back to Stony Plain hospital tonight and they are trying to get ahold of her family doctor so she can be admitted in Stony Plain Hospital. The family is going to contact Dr Baily (the doctor who diagnosed the cancer) tomorrow to try to get her admitted into the Royal Alex Hospital where she worked and then maybe the testing will get done faster and with less frustration for Cathy. I am going to Edmonton tomorrow to spend the day with Cathy just for moral support.

On a better note the first 2 1/2 days I had with Cathy were awesome. She was up all day, visiting and in good spirits. Cathy Brown,who quite often blogs for us to keep us up to date, has made Cathy the most awesome comforter. She took squares of fabric to the hospital and the nurses and doctors wrote their thoughts and prayers for Cathy and then she quilted them all together. It is quite something. It certainly says something for the way Cathy is admired by her co-workers.

John, Larry, Jeff (Bob's son) and Steve got busy on Saturday and built a ramp into the house to make it easier for Cathy to get it and out of the house with her legs playing out like they are. That took alot of stress off Cathy as we have dropped her a couple times in the last week when she would lose her footing. I will try to blog again tomorrow if I come back home, if not Wednesday night. Love you all! Sandy

Visit with Dr Sawyer

Cathy (Becca and I) had her prechemo appointment at the Cross today. She had blood work done and then met with her nurse and Dr Sawyer.

The tumor has been screwing around with Cathy's calcium levels. When they are high she is constipated, has muscle aches and pains and feels really, really crappy. As well, high calcium levels cause dehydration. Cathy spent time at the Cross on three consecutive days getting IV fluids to rehydrate her. She was also given a medication that binds to calcium and gets it out of her body. Although the nurse thought the calcium would leave the body through her urine, she was wrong to Cathy's detriment. Cathy spend an awful night having explosive diarrhea that got all the calcium finally out of her body. Consequently she feels much better now that her calcium levels are back closer to normal.

Today we got Cathy set up for homecare nursing - and while the details have yet to be finalized, right now the plan is for the nurse to come in and help her shower/bath a couple of times a week. She also is going to get a handicapped placard for her car, and got a wheelchair, cane and (wahoo) raised toilet seat.

Cathy also managed to catch a cold this week and has been coughing so much she can't sleep, Dr Sawyer gave her cough medication and some other meds to help her sleep and relieve some of the anxiety she has been suffering from.

Cathy is starting her second cycle of chemo tomorrow and her Mom will be coming to spend the time with her at the Cross. While there Cathy is going to have some more blood drawn - she might need to have her synthroid levels adjusted. The home care nurse will come and talk to her about what they are putting in place and the dietician is supposed to see her as well. She has been prohibited from eating things with calcium in it so she needs some info from the dietician.

With all the love people I know are sending to Cathy through me, I could have spent 5 hours hugging her today. I would have liked that...I think she would have too.

Hi everyone this is Sandy. Sorry for the lag in the blog. All the Grozell female cousins went up to Stony Plain last weekend to have our weekend away and was able to include Cathy. When we got there on Friday night Cathy was having a really good day and came over to the hotel and spent the evening with us. When we talked to her about why she thought she had such a big turn around she had indicated she had stopped taking all her herbs. Her chemo on Tuesday was so early in the morning that she did not have time to do the whole regiment so she did not take them and she realized how good she felt on Tuesday night so she decided not to take them for awhile. But on Saturday she took them again and didnt have such a good day. So now her and her family have decided that maybe she was taking too many as they were upsetting her stomach, then she would take her nausea medication and then her liver was having trouble breaking them down and then she would be taking her pain medication, then she would be knocked out and sleep all day. They have decided to not take the herbs for awhile and then start back slowly starting with the herbs the pathologist has recommended. Uncle Glen and Aunt Barb were with her on Wednesday and Cathy had a really good visit with them. Thanks for your help Auntie Barb and Uncle Glen. Wanda went up on Thursday and I went up on Friday to try and give some relief to John and Jen who are doing the tag team thing right now. Jen works nights so she gets up with her mom in the morning and then she goes to work in the afternoon and John comes home at supper. Cathy seemed to have a really good week this week, she is still weak but it certainly doing more. She has had her second round of chemo this week and now has a week break and then 2 more rounds of chemo the following 2 Tuesdays. Wanda and I are going to try going up 1 day a week each to do some of the chores for John and Jen so they don't burn out. So until next week I want to thank all the family again for all your love and support. It means the world to all of us. Hugs & Kisses Sandy

Hello, everyone, it's Cathy. Sorry I blipped off of the radar for the last couple of days. It wasn't due to anything bad. So far, I'm doing fine. Because of my appointment being so early for chemo, John and I packed everything up and moved into Jenn's on Monday night. He left for work from there, and Jenn and I got ready and left for the Cross. It was much easier and quicker, taking only 15 minutes instead of the hour it would have taken us from home. My PICC line was plugged, so after fiddling with that, the treatment wasn't started until almost 9:30, which pushed us back to almost 1:00 by the time we left there. It didn't leave us enough time for Jenn to get me home with all of my stuff before she had to leave for work. So we made the decision that she would leave me at her place, and John could come get me there after work.
It worked very well. Jenn's roomates from upstairs checked on me, and fed me. I had no nausea, no pain, and I rested well. Rebecca came after classes, and she and John went out for supper when he arrived, the gathered up all my stuff and took me home. We stopped at Safeway and picked up a beautiful fruit bowl and flowers that Dorri sent. Thank you, Dorri.
The next day Jenn dragged me off to see her chiropractor, trying to find some relief from my back pain, with all of my limitations, like I can't lay on my back. He wants me to have xrays, which we haven't had time to get yet, but will. He thinks he can help me. Again, we ran out of time, and I spent my day at Jenn's, waiting for John. I had my first bout of nausea, but I took my drugs, and rode it out. It lasted about 1.5 hours, then was gone. I am eating better, become more adventurous. If something bothers me, I chase it with Milk of Magnesia, and can so far get it under control.
I am now on oxygen most of the time. I just don't have any energy it it's not on. With it on, I seem to be able to putz around the kitchen, clear off the kitchen table, maybe even do some dishes. I'm too nervous to try a shower by myself. That seems to take way too much of my energy, and I'm afraid I'll be stuck in there by myself until somebody comes home. Wouldn't that be fun to find when you got home?
Karen, I want to thank you so much for the beautiful quilt you sent me. I really love it. The girls are busy washing the crap out of it, trying to get rid of the perfumey smell that the lady put in it. It's getting better, so hope I can use it soon. It would be awesome to take with me to chemo days.
I want you all to know that even if I don't answer my phone or return my emails, it doesn't mean I don't hear and appreciate every message I recieve. I love you all, and appreciate eveything you do for me.
Cathy

Happy Thanksgivings everyone. We were all able to go up to Edmonton on Sunday and have Thanksgiving dinner with Cathy, John, Jen, Bec, Johns nephew Chris and his wife Linda and Our cousin Bob's son, Jeff and his partner Steve. We rented a private room at a restaurant and had a wonderful supper. We wish we had better news to report but we found Cathy to be failing fast. Cathy is definately struggling with her fight. She is tiring out very easily and is again having trouble with her breathing. Cathy is back on oxygen. Her chemo will start tomorrow and we pray she has the strength to endure it. Cathy is very emotional and we find it shows the most when thoughts of the family (including aunts, uncles, cousins etc) come to light or the overwhelming support she is receiving.

The female cousins from the Grozell side have started a weekend get together a year ago (sorry all the male cousins) and that will be next weekend. Aunt Myrel will be coming with Karen and will spend the week end with mom, which will be really good for mom too. Cathy is really looking forward to seeing everyone as we are excited to spend the week end with Cathy as well. It looks like we will be moving the weekend to Stony Plain as Cathy is just not strong enough to make the trip to Pine Lake. This way she can sleep at home if she is more comfortable or spend the week end in the hotel if able.

We all want to thank you all for the support you have sent our way it just increases our strength, knowing we have such a loving and supportive family behind us.

Love you all Wanda & Sandy

Wanda Buckley says;
Cathy you are in my thoughts 24 hours a day. Whenever you feel afraid close your eyes and you will feel arms around you, that will be me giving you a great big hug and absorbing some of your pain, hopefully helping you to stay strong.
I will continue to pray because I love you and want you to be well more than anything. I am looking so forward to spending time with you on Sunday as well as next weekend. Sisters forever. Wanda

Chemo

Our girl went to the oncologist yesterday, and the news is not good.

Her tumors have grown in size and increased in number. There is also lymph node involvement and a spot in her abdomen. This means she is starting on the cholangiocarcinoma specific chemotherapy Tuesday morning at 7:30am.

The oncologist said there is a 100% certainty she will lose her hair. Constipation is almost certain with the drug she will be on. Nausea and vomiting are probable.

It will be Day 1 on Tuesday, then she will have another chemo treatment on day 8. Then she will have two weeks off before starting over. I don't know how many rounds of this she will have.

Cathy came into our department at the Alex today and we put in a special IV line for the chemo. This type of line, called a PICC, stops the chemo from destroying her veins.

So, now she has a new 'friend' on the inside of her left arm. It will restrict the amount of weight she can lift with her left arm but otherwise lets her continue on with her regular life.

Cathy is quite short of breath and is planning to start on home oxygen on Tuesday. She doesn't need it all the time but feels much better if she has a bit on when she needs it.

Update Oct 7/09

Hi All, this is CB (Cathy Brown) again. Spent some time talking with Cathy this afternoon and thought I'd catch you all up on what's been going on.

Cathy had her follow up CT scan at the Cross last week on Tuesday. Although Cathy knew it would be hard to drink all of the fluid they required for the test, she did so and the test went well. Cathy and I had a bit of a laugh over the number of times over the years we've told people to do the best they can with the amount of CT prep fluid they have to drink - "just keep sipping and get as much in as you can without barfing". Cathy has a new appreciation for how tough this really is.

Cathy and John are going to see Dr Sawyer (Cathy's oncologist) at the Cross tomorrow at 130pm to get the results of the CT and find out what the plan is for chemo. The type of chemo and its timing depends on whether Cathy's tumors have grown since her first CT on Sept 1.

Last Friday Jennifer and Jefferey took Zero to the vet to be put down. He has been unwell for some time and was getting worse. When he became reluctant to eat the family had to make their tough decision.

John's uncle Milton passed away this past weekend. His funeral is this Friday in Camrose.

Physically, Cathy is still trying to manage nausea, pain, constipation and diarrhea - obviously not all at the same time - otherwise the constipation and diarrhea would cancel each other out. At times Cathy is finding it hard to eat - anything that is high in fat content increases her pain and makes her very nauseous. It also tends to give her bad diarrhea. She has learned the hard way to watch the amount of fat in her food.

You've heard of night sweats that often come with menopause? Well, Cathy has developed flexible sweats - they come upon her whenever and soak whatever she happens to be wearing. (I told her to walk around naked with a towel under each armpit - she didn't think this was a great idea.)

Cathy's tired. I think this goes without saying (okay, I'm going to say it anyway) what with the nausea, diarrhea/constipation and pain, its hard to sleep. If anyone calls and there is no answer, fingers crossed that Cathy is having a nap and getting some rest.

That's it for now - I will add a further update when I find out what happens at the oncologist.

Unauthorized update on Cathy

Cathy Brown again - I separated this post from the last one since this one is serious. First of all - its the middle of the night and I can't sleep. I wanted to update you all and suggest something we could try, but of course, can't ask Cathy's permission to post this.

Cathy is in a low spot right now. She is having abdominal pain and not sleeping. I'd like to go into a bit more detail here, but I will await her permission to do so first.

Suffice to say I have two issues to address here.

First - I know we are praying and keeping Cathy in our thoughts. I am suggesting anyone who'd like to also try directing our prayers and thoughts in a more specific manner - aiming them specifically at lessening Cathy's pain so she can sleep better.

For those interested, here is something to try. In a quiet place where you will be free from distractions, get comfortable. Lying down or sitting in a really supportive chair is a good idea. Close your eyes and take a few really deep and relaxing breaths, trying to let your body calm itself down and free your mind from any distracting thoughts or what I like to think of as the 'committee' - the part of our brain that is telling us we should clean the house or do some yard work or yada, yada, yada.

When you feel relaxed and centered, picture Cathy lying comfortably in her bed The more realistic and the more details you can supply, the easier this will be. For example, I picture Stitch curled up next to her. Envision her fully relaxed and emotionally at peace. Think of a healing light - try to picture it in whatever colour you find pleasing that reminds you of health - mine is a light royal blue that is luminescent with sparkles. Imagine it originating in her liver and see it slowly growing until it envelops her entire body. In your body - feel how it is pervading her body with warmth and relaxation. See this light washing away the pain she is having - perhaps like waves eradicating lines on the sand - with each pulsation of the light more and more pain is erased. When you have fully removed her pain, see her relaxing so deeply she melts into her bed, as if she no longer has bones and is basically a pile of warm goo. Now concentrate on seeing her sleep deeply and restoratively through the night. Awakening full of peace and energy, ready to face her day.

Secondly and on a personal note - I find myself awake often during the night - my mind occupied with thoughts of Cathy. I struggle with my own emotions which are up and down like a roller coaster. I am having a lot of pain in my heart (not just emotionally but also physically in my chest area where my heart is) - which I know is my nervous system trying to deal with my emotional energy. During the day I often find myself at work, operating in a fog, still feeling like I've been hit by a truck. I find myself standing in the exact place I was when Cathy told me and am again struck with such a deep guttural pain I am surprised to find I can still stand up and don't just crumple in a pile of goo (which, to be honest is what I'd truly like to do).I am wondering if any of you are experiencing this as well or is it just me going crazy?

Friends of Cathy

Hi all, this is Cathy Brown. Thank you all for the kind words about my last post. I am very proud to be a part of such a wonderful group that cares so deeply for Cathy. She is a special person and while she is blessed to have us, we are truly blessed to have her in our lives.

This brings up a thought. We need a name to call ourselves - perhaps we could even get T shirts made. I like "Cathy's Coven" because it sounds cool. I don't like the witch connotation though - however many days I am a word that sounds like witch but starts with a 'b'. I find in light of all that is going on and the awakening to what is truly important in life, I am so much less tolerant of all the petty, trivial matters that seem to pop up in life. Especially at work where I want to flick some people upside the head and tell them to grow up and get a grip on what's really important. They just don't realize that such little matters are so unimportant - I guess they are lucky they aren't dealing with what Cathy and the rest of us are- only they don't realize how lucky they are.

Anyway - any suggestions for a name for all of us wonderful (and I love the fact that, judging by the comments) crazily humorous type people?

Barfing in a Bucket

Good morning from Cathy Brown. Health care workers often resort to gallows humor - it is one coping mechanism that lets us continue to function when faced with so much pain and suffering on a daily basis. It is what I have to resort to right now, because if I can't laugh about some of this I will be in a puddle of tears.

When I told a co-worker Cathy and I were going to Chemotherapy school she asked if they were going to teach us how to 'barf in a wastebasket'. Even though I have been a nurse for a measly eighteen years compared to Cathy's 35, I readily admit I don't know anything about chemo. Like most of the population all I 'know' is that you vomit a lot and you'll lose your hair. Guess what? These aren't always true.

So here's a crash course on Chemo 101, the blogger's version.

Chemo affects rapidly growing cells in the body, so besides the cancer it also affects bone marrow, the lining of the mouth and digestive system, hair, skin and the reproductive organs.

From the top then:
There are three types of cells made by the bone marrow affected by chemo:

White Blood cells (WBCs)
- these cells fight infections in the body
- they will be at their lowest levels (and least effective) from day 7 to day 14 after the chemo treatment
- Cathy has to be vigilant checking her temperature and watching for signs of infection. An out of control infection can kill her
- For the rest of us this means we have to be very careful when we visit. Frequent, thorough hand washing is the most important thing we can do to keep her safe. We have to monitor our own health and postpone our visits if we are sick. We especially have to be vigilant during the seven to fourteen day period after a treatment

Red Blood Cells (RBCs)
- these cells carry oxygen
- since the chemo will destroy some of these cells, Cathy will have less oxygen circulating in her blood and she may be short of breath and tired.
- some people have well defined, short periods of fatigue, while others suffer from it for the entire cycle
- there is no way to predict how it will affect Cathy

Platelets
- these cells are responsible for blood clotting
- low platelet levels mean Cathy might bruise easily
- she might bleed a lot, even from a minor cut
- nose bleeds can be very serious

Lining of the mouth and digestive system

Nausea and Vomitting (N&V)
While my stereotypical picture of barfing in the bucket won't necessarily come true, it still might happen to Cathy as the drugs she will be on do tend to cause N&V
- N&V can be immediate or delayed
- the doctor will give her a prescription for drugs to control this
- she will need to take these medications regularly for the first three days and then as needed after that

Mouth Problems
- many people on chemo get sores in their mouth and throat as well as bleeding gums
- the Cross (Cancer Institute - where Cathy will get her chemo) recommends rinsing with baking soda in water or club soda. Cathy might need to do this after eating and every two to four hours
- many people on chemo find their sense of taste is affected, so besides their mouth hurting when they eat, stuff may taste funny (only if this happens to Cathy will I send some of my cooking over!)

Constipation or Diarrhea
- constipation is more common with the drugs Cathy will be on, but diarrhea is still possible

Hair Loss
- not everyone loses their hair, some have no change, some thin a little, and some lose everything
- If it is going to happen, the most common time is about 15 days after the first treatment
- hair often grows back and may be a different colour or texture
- the doctor told Cathy she will probably lose her hair
- I'm hoping Cathy becomes a curly headed blonde when her hair grows back

Skin
- may be sensitive to the sun for one year after chemo
- this means Cathy will need to be vigilant about covering up and wearing sunscreen next summer

Reproductive organs
- not really an issue for Cathy

Others
- muscle weakness, numbness in the toes and finers and ringing in the ears are all possibilities
- Cathy has already been trying this one out at work - whenever our boss starts talking Cathy tries the "I can't hear you - my ears are ringing" thing

Here's a quick recap of all the above:
Cathy may or may not be tired, barfing, bald, sore mouthed with sun burned bruises, unable to hear while she flips up her middle finger to 'get rid of the numbness'. Irritability isn't on the list - I can't imagine why not.

I hope my primer has given you a bit of information on chemo. If any of my attempts at humor have offended you, please forgive me. As most of us are finding, I struggle daily just to understand how all this could be happening to Cathy. Some days I am grown up and functioning and other days I am crying like a little child who doesn't understand what is going on and just wishes someone could promise me everything will be all right.

Hi, everybody, this is Cathy. Oh, my God, I never intended for anyone to feel like they couldn't contact me. I just might not answer the phone. Leave a message, and although it may take me a while, I will contact you back. Feel free to email me anytime. I don't look at me email every day anymore, but I will respond eventually. It is just sometimes hard to talk to lots of people all on the same day.

Hello, all. This is Cathy. I can't tell you how overwhelmed I am by all of the love sent my way. Many days I am unable to talk to anyone on the phone. In the early days, I was spending upwards of 6 hour per day on phone calls, and receiving messages on voice mail at the same time. It was really hard for me to dwell for so long on me and my problems. My family finally took over, and I no longer answer the phone. They monitor phone calls, take messages, or let voice mail answer if they can't handle it anymore. I hop nobody is offended by this, but it is so emotionally draining, we just can't deal somedays.
While in hospital, Dr Bailey gave me morphine every night to make sure I got a pain-free full night's sleep. Although I appreciated this, I also knew I would not be taking pain medication when I got home. I've learned what causes my pain and what I can do about it. Occasionally, I've been forced to take Tylenol extra strength, but I try to avoid it.
Yesterday, I returned to the Cross Cancer to meet with the doctor who will be in charge of my care. His name is Dr Sayer, and he's a very odd duck, but very smart, so I can deal with everything else. He believes I have choangiocarcinoma, which is cancer of the bile ducts of the liver, meaning we can stop looking for the primary outside of the liver. Apparently I have classic symptoms if you know what they are. They cause problems with clots, and they cause higher calcium and Parathyroid hormone levels, all of which I have. He says that I have been accidentally diagnosed very early, so now he's uncertain how to treat me. The outcome is still the same. It is not curable. Usually by the time a person has been diagnosed, they have football sized tumors. At the moment I have golf balls. If he treats me too early, he could actually do more harm by depriving me of life-lengthening treatment later on. He's going to wait and do a CT Scan on Sept 29, then I'll see him again on Oct 8th. He may start me on PRUNK chemo then, and wait to treat me with cholangiocarcinoma chemo later. I go next Tuesday for chemotherapy classes. I have been told I will lose my hair with the first round.
Dr Sayer has encouraged me to get active, and encouraged me to go back to work, even if I can't do a whole day. He told me that I can set up my Wii Fit that I bought just before all of the chaos. So this weekend, I intend to get my husband to set it up for me.
In the meantime, positive thoughts, everybody!! It ain't over until it's over, and I'm not giving up yet!!

Hi this is Sandy. I am just giving you all an update on our visit with Cathy on Saturday Sept 12/09. Wanda & I drove up to Edmonton to visit and met up with our cousin Lori and stayed probably too long at Cathys but had a great visit. We shared some laughs, we shared some tears, but through it all Cathy is holding up very well. Cathy is going to try to return to work on Monday Sept 14/09 and see how it goes. She probably wont work whole days but will see how it goes. She so far has been able to keep herself off all pain medication. Although she is taking shots to help disolve the blood clots in her lungs, which is a symptom of the cancer. She explained to us that the tumors in her liver thickened her blood and therefore has caused blood clots in her lungs. This has been the reason she has had shortness of breath. When we were there on Saturday Cathy is no longer using the oxygen but still has some labored breathing. This will get better as she gets the blood clots dissolved. They did a full body scan called a pets scan on Friday but still did not find the primary source of the cancer. Cathy is going to see the doctor on Monday and get the full results but at this point her chemo will be administered as a PRUNKS (primary unknown) patient. I would like to thank all the family who has sent thoughts and prayers to us and Cathy it helps alot. I knew we had a great family but it is times like this you all really shine. Between all of us we will keep you posted the best we can I sure hope you enjoy the blog. Love you all Sandy... ps we did not know how to set the blog so it doesnt say posted by Cathy so we will just say who is writing. It was the blind leading the blind setting it up.

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