We just received word from Dr. Pait's office in Little Rock that Carla's scheduled spine surgery has been postponed due to the influx of trauma and critical myeloma patients who are currently in the hospital. We don't know when they will be able to schedule it now. Their schedule for surgeries for next week is full. They hope to give us at least a day's notice due to our four-hour travel time.
Pray that she can get scheduled soon and won't have to repeat the pre-op tests she had completed when we were down the first of October.
Stay tuned for further developments!
Tuesday, October 26, 2010
Monday, October 25, 2010
Upcoming Spine Surgery
We have enjoyed our time back in Springfield but is\t is about time to head back to Little Rock. We spent October 4-6 in Little Rock where Carla underwent a PET scan, MRI scan, blood tests and pre-op tests. Her PET scan showed no active lesions. The MRI showed that the 50+ lesions she had are getting smaller. The blood tests showed no myeloma components!!!
We will return to Little Rock this Thursday, October 28th, and Carla is scheduled to have the surgery on her back on Friday at the UAMS hospital with Dr. Pait as the surgeon. Dr. Pait thinks he will have to take the rod out that was implanted August 2009. This rod fuses the two vertebrae above T7 with the two below T7. T7 was the vertebrae that was practically devoured by the multiple myeloma and was pinching the nerve last summer. They probably will implant a longer rod and hopefully the screws will hold now that Carla's bones are stronger and denser.
The doctor anticipated Carla would be in the hospital about five days and he wanted us to stay in the Little Rock area for another week. As yet, we haven't been able to locate a reasonably priced furnished apartment we can rent for two weeks. We are on the waiting list for Home Away From Home but it looks like we will have to stay at a motel. Last summer, Carla found our recliner to be very comfortable as she was recovering from surgery. I hope to get it loaded in the Highlander so we will have it if she wants it.
The doctor has not claimed that the surgery will decrease her pain... only that he hopes it will. He is primarily concerned with the loose screw that is very near her spinal column. Please pray that the surgery will correct this problem and that she might be free from the pain and off her Oxycotin!
Carla had all the tests that needed to be done before she starts her maintenance phase. The Myeloma Clinic plans to see Carla just prior to our returning to Springfield. They will give her about a month to recover from surgery and will commence the Velcade and Revlimid about the first of December.
We will return to Little Rock this Thursday, October 28th, and Carla is scheduled to have the surgery on her back on Friday at the UAMS hospital with Dr. Pait as the surgeon. Dr. Pait thinks he will have to take the rod out that was implanted August 2009. This rod fuses the two vertebrae above T7 with the two below T7. T7 was the vertebrae that was practically devoured by the multiple myeloma and was pinching the nerve last summer. They probably will implant a longer rod and hopefully the screws will hold now that Carla's bones are stronger and denser.
The doctor anticipated Carla would be in the hospital about five days and he wanted us to stay in the Little Rock area for another week. As yet, we haven't been able to locate a reasonably priced furnished apartment we can rent for two weeks. We are on the waiting list for Home Away From Home but it looks like we will have to stay at a motel. Last summer, Carla found our recliner to be very comfortable as she was recovering from surgery. I hope to get it loaded in the Highlander so we will have it if she wants it.
The doctor has not claimed that the surgery will decrease her pain... only that he hopes it will. He is primarily concerned with the loose screw that is very near her spinal column. Please pray that the surgery will correct this problem and that she might be free from the pain and off her Oxycotin!
Carla had all the tests that needed to be done before she starts her maintenance phase. The Myeloma Clinic plans to see Carla just prior to our returning to Springfield. They will give her about a month to recover from surgery and will commence the Velcade and Revlimid about the first of December.
Friday, September 10, 2010
Carla's Back
We got back to Springfield on August 30 but returned on September 2 for a consultation with the UAMS neuro-surgeon, Dr. Pait. Basically the CAT scan revealed that the rod in Carla's back has shifted and the bottom loose screw is dangerously near her spinal column.
We returned to Springfield on September 3rd to wait for Carla's blood to recover from the consolidation #2 chemo. We expect that to take until the first of October. Dr. Pait said the surgery would probably require her to be hospitalized for five days and he wanted her to stay in Little Rock another week.
We haven't talked with Dr. Barlogie about her surgery and what she will need to do if she postpones the start of maintenance until December. That will need to be determined.
Carla's blood tests yesterday showed her white cell count had only climbed back to 2.1 which is still quite low. Her red blood count is somewhat low.
Carla doesn't feel up to much travelling so it looks like I will make a quick trip to Nebraska to retrieve our cat from my sister who has been caring for her since the first of January. Thanks Karan!
We returned to Springfield on September 3rd to wait for Carla's blood to recover from the consolidation #2 chemo. We expect that to take until the first of October. Dr. Pait said the surgery would probably require her to be hospitalized for five days and he wanted her to stay in Little Rock another week.
We haven't talked with Dr. Barlogie about her surgery and what she will need to do if she postpones the start of maintenance until December. That will need to be determined.
Carla's blood tests yesterday showed her white cell count had only climbed back to 2.1 which is still quite low. Her red blood count is somewhat low.
Carla doesn't feel up to much travelling so it looks like I will make a quick trip to Nebraska to retrieve our cat from my sister who has been caring for her since the first of January. Thanks Karan!
Monday, August 30, 2010
End of Consolidation #2
Carla is getting her line out and we will be heading home this afternoon. She has done extremely well during consolidation #2 with few side effects. She has an appointment this Thursday with the neurosurgeon, Dr. Pait. We plan to drive back early Thursday, meet with Dr. Pait, have her blood labs drawn here and spend the night at our Little Rock apartment before heading back to Springfield.
Carla meets with Dr. Pait to see what he recommends about her back including possible corrective surgery. Carla is scheduled to return to Little Rock in 4 to 6 weeks to have tests done before starting on her maintenance phase. Most of the maintenance therapy can be done in Springfield. Dr. Barlogie will help schedule the surgery if it is deemed necessary.
Carla's platelete count was coming up yesterday but at 32 it would not be above the minimum 50 required for line removal. Carla convinced the APN nurse to let us come back last evening for a bag of platelets rather than have to work them into today's schedule. Because of this foresight it looks like we will be ready to head out of here before 3:00 today!
Carla meets with Dr. Pait to see what he recommends about her back including possible corrective surgery. Carla is scheduled to return to Little Rock in 4 to 6 weeks to have tests done before starting on her maintenance phase. Most of the maintenance therapy can be done in Springfield. Dr. Barlogie will help schedule the surgery if it is deemed necessary.
Carla's platelete count was coming up yesterday but at 32 it would not be above the minimum 50 required for line removal. Carla convinced the APN nurse to let us come back last evening for a bag of platelets rather than have to work them into today's schedule. Because of this foresight it looks like we will be ready to head out of here before 3:00 today!
Saturday, August 21, 2010
Consolidation #2 Update
Carla has been progressing about as we expected. She had the black bag with the two IV pumps Saturday through Wednesday. At the new Cancer Institute infusion center they basically have not had us stay for the results of the lab tests but will phone us to come back later that day if there are problems that need to be addressed that day. Carla has the normal constipation and other digestive side effects but she has not had the mouth sores or loss of appetite yet.
She has been very careful to not get germs from the other patients. She puts on a glove and uses a disinfectant wipe to clean off the arm rests in the waiting room. She does the same thing when she gets in the infusion center. The chairs in the infusion center are supposed to be disinfected between patients but Carla isn't taking any chances.
Carla got the black bag off Wednesday and Thursday they started the growth factor shots. Today they stopped giving her the Lovenox blood clot preventer as her platelet count was dropping and the risk of blood clots was decreasing. Generally the white blood count bottoms out about day 10 with days 7 - 10 being the worst. Well today is day 8 and Carla's energy level has decreased. Due to the growth factor shots her white cell count rose to 13 yesterday. It will plunge soon.
I mentioned last time that Carla is being treated in the Winthrop P. Rockefeller Cancer Institue that opened August 1. This is a seven-story tower that houses most of the outpatient services for cancer patients.
This is the main entrace to the building with its valet service. We park in the parking garage instead.
The above picture was taken looking outward from the Cancer Institute. It shows the parking garage. The tall building down the street from the parking garage is the Spine Institue. This is the building that houses the Myeloma Institue Clinic (MIRT). This is where we go when we see the doctors.
I rotated on around and took this picture of the Biomedical Research Center. This is where most of the research concerning Multiple Myeloma is conducted. We have not been in this building.
This is Carla in front of the patient entrance from the parking garage. The parking attendants in the first picture were just to the left of this photo.
The Infusion Center for myeloma patients is on the fourth floor. I hear there is another Infusion Center on the first floor but we have not been there. When we get there, Carla has to sign-in at the desk at the back of this picture. The patients usually take the chairs with the tall backs and the caregivers sit beside them. Carla is in the center of this picture with her mask on.
I took these pics on a Friday and it was a slow day. The waiting room is generally about 90% full.
The actual Infusion Center first has an area where patients are weighed and temperature is taken as they enter the Infusion Center. Patients are assigned to one of three areas depending upon their condition, the results of prior tests and what they need today. When Carla got her black bag and had it serviced she was it what are pods. Each nurse is responsible for a specific number of pods.
Each of the pods had a TV monitor, a comfortable chair and a blood pressure/temperature instrument. The assistant that calls the patient in the waiting room takes all measurements before the nurse comes to collect the blood samples and administer any IV's that may be necessary. If there are problems, an APN nurse is summoned. Each patient is assigned to a specific APN nurse.
In walking to a pod we discovered that one side has private rooms for patients who can't sit in chairs and need to be in bed.
Since Carla got the black bag off, we discovered there were a limited number of areas referred to as "Rapid Injection" areas. These do not have as comfortable chairs and most patients are there for drawing blood samples. I imagine that when Carla's WBC drops below 2, she will again go to a pod in case she needs IV's of sodium or potassium or she needs blood or platelets.
Hopefully this give you an view of the new Cancer Institute at the University of Arkansas for Medical Sciences.
We learned this week that a church has purchased the Senior Apartments where we are staying this trip. They plan to turn it into a transition facility for criminals. The none UAMS patient residents now have to find a new place to live. Myeloma patients starting their treatment had planned to stay here during all of their treatment. Those of you following Carla's treatment know this usually lasts for 10 to 12 months.
I also saw the auto body guy from Hope, Arkansas who wife got the upper lung infection and was in ICU. She is now out of her coma, out of the ICU but still in the hospital. He said today that things were looking up. Her hospitalization is approaching a month.
She has been very careful to not get germs from the other patients. She puts on a glove and uses a disinfectant wipe to clean off the arm rests in the waiting room. She does the same thing when she gets in the infusion center. The chairs in the infusion center are supposed to be disinfected between patients but Carla isn't taking any chances.
Carla got the black bag off Wednesday and Thursday they started the growth factor shots. Today they stopped giving her the Lovenox blood clot preventer as her platelet count was dropping and the risk of blood clots was decreasing. Generally the white blood count bottoms out about day 10 with days 7 - 10 being the worst. Well today is day 8 and Carla's energy level has decreased. Due to the growth factor shots her white cell count rose to 13 yesterday. It will plunge soon.
I mentioned last time that Carla is being treated in the Winthrop P. Rockefeller Cancer Institue that opened August 1. This is a seven-story tower that houses most of the outpatient services for cancer patients.
 |
| Cancer Institue Main Entrance |
 |
| Parking Garage and MIRT Building |
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| Biomedical Research Center |
 |
| Entrance From Parking Garage |
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| Carla In The Waiting Room |
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| Part Of Infusion Center Waiting Room |
a |
| Eating Area and TV Area of the Waiting Room |
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| Pods With a View |
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| Other Pods Showing Patients, Caregivers and Nurses |
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| Private Rooms for Critically Ill Outpatients |
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| Carla Having Blood Drawn in "Rapid Injection" Area |
We learned this week that a church has purchased the Senior Apartments where we are staying this trip. They plan to turn it into a transition facility for criminals. The none UAMS patient residents now have to find a new place to live. Myeloma patients starting their treatment had planned to stay here during all of their treatment. Those of you following Carla's treatment know this usually lasts for 10 to 12 months.
I also saw the auto body guy from Hope, Arkansas who wife got the upper lung infection and was in ICU. She is now out of her coma, out of the ICU but still in the hospital. He said today that things were looking up. Her hospitalization is approaching a month.
Friday, August 13, 2010
Consolidation #2
We returned to Little Rock on Monday. We were hesitant as we weren't able to get another apartment with Home Away From Home. We did get an apartment at Hidden Creek Retirement Home. This is a small furnished apartment at a former nursing home. The apartment is smaller but so is the rent. We don't have Internet access there so I have to use the Internet while at UAMS.
Tuesday she had blood tests and that dreaded bone marrow biopsy procedure. Wednesday it was an MRI and then wait for the results. Yesterday was our appointment with Dr. Barlogie. Our appointment was at 1:30 but it was after 6:30 when we got out. They had failed to order Carla's Thalidomide. At our July discharge, We had warned the doctor that we only had enough for two days and she needs four days of Thalidomide for the Consolidation.
Basically they faxed the prescription to CareMark and I periodically called them. Today I got notification that it will be shipped overnight and I will have to stay at the apartment from 8 - noon tomorrow to sign for it.
As a result of the delay at the doctor's office yesterday, Carla couldn't get her line implanted in her chest yesterday. She is getting the line put in now but won't be able to get the black bag with the two IV pumps until tomorrow. This means were are getting a day later start to her chemo but her meds should be here as she needs them.
I did note that they failed to get us the prescription for the dexamethsone that she takes with the thalidomide. I am attempting to get that phoned in to Walgreens so she will have it in the morning. We have found you have to really check on what is done to make certain that nothing has been omitted or that the wrong meds/IV's have been given.
The treatment is in the newly opened Winthrop Rockefeller Cancer Institute. Both the Infusion Center and 7C are now combined into one location. The Blood Draw and MRI are also in the new tower. I will try to post some pictures in a later blog.
One lady from Hope, AR that we shared an infusion room with several times is in ICU with a lung infection. She has been in a comma for at least 12 days but appears to be improving. Please remember to pray for her. We are taking special care to prevent infections as Carla's immunity goes down hopefully for the last time.
Tuesday she had blood tests and that dreaded bone marrow biopsy procedure. Wednesday it was an MRI and then wait for the results. Yesterday was our appointment with Dr. Barlogie. Our appointment was at 1:30 but it was after 6:30 when we got out. They had failed to order Carla's Thalidomide. At our July discharge, We had warned the doctor that we only had enough for two days and she needs four days of Thalidomide for the Consolidation.
Basically they faxed the prescription to CareMark and I periodically called them. Today I got notification that it will be shipped overnight and I will have to stay at the apartment from 8 - noon tomorrow to sign for it.
As a result of the delay at the doctor's office yesterday, Carla couldn't get her line implanted in her chest yesterday. She is getting the line put in now but won't be able to get the black bag with the two IV pumps until tomorrow. This means were are getting a day later start to her chemo but her meds should be here as she needs them.
I did note that they failed to get us the prescription for the dexamethsone that she takes with the thalidomide. I am attempting to get that phoned in to Walgreens so she will have it in the morning. We have found you have to really check on what is done to make certain that nothing has been omitted or that the wrong meds/IV's have been given.
The treatment is in the newly opened Winthrop Rockefeller Cancer Institute. Both the Infusion Center and 7C are now combined into one location. The Blood Draw and MRI are also in the new tower. I will try to post some pictures in a later blog.
One lady from Hope, AR that we shared an infusion room with several times is in ICU with a lung infection. She has been in a comma for at least 12 days but appears to be improving. Please remember to pray for her. We are taking special care to prevent infections as Carla's immunity goes down hopefully for the last time.
Friday, July 16, 2010
Home July 6th
Sorry for not updating this blog when we got home on July 6th. When we are home my schedule changes and I forget about giving you an update.
Carla's white cell count kept dropping when we got home. It was 1.99 when we left Little rock and then dropped to 1.68 on Thursday and 1.51 on Monday. We were concerned and kept contacting the Myeloma Institute. They told us to wait before getting any growth hormone shot. Thankfully it was up above 2 yesterday.
Carla has been feeling stronger and has decided she had had enough of my 10 months of attempts at cooking so she has started fixing some of our meals. She still is tired some and attempts to work in a two-hour afternoon nap.
We are scheduled to start Consolidation #2 on August 10. This should be the last therapy before the three-year maintenance.
Carla's white cell count kept dropping when we got home. It was 1.99 when we left Little rock and then dropped to 1.68 on Thursday and 1.51 on Monday. We were concerned and kept contacting the Myeloma Institute. They told us to wait before getting any growth hormone shot. Thankfully it was up above 2 yesterday.
Carla has been feeling stronger and has decided she had had enough of my 10 months of attempts at cooking so she has started fixing some of our meals. She still is tired some and attempts to work in a two-hour afternoon nap.
We are scheduled to start Consolidation #2 on August 10. This should be the last therapy before the three-year maintenance.
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