Discharge day!

September 29h

(Mom took her "Big Girl Panties" off the wall to go home. These are her therapists that came by to say good bye)

This morning I had to perform a dressing change, flush the line and cap change on her central venous catheter which is semi-permanently in her arm. I passed with flying colors :)

Dad also took this class....and well, he almost failed. While in the class he was working with a practice syringe in order to practice our home duties with her catheter. Dad pulled back on the plunger and pulled it out completely spilling the liquid in the barrel all over his station. Oh Bobby Yates, we can always count on you for some comedic relief!

Our last day in the hospital did not go as quickly or as smoothly as we would have wished for. By now though we should have anticipated this sort of thing happening. They wanted us to check out by 11:00 but they shared with us that her platelets level was at 16,000 (normal 140,000 - 300,000) and they wanted her to do one more transfusion before leaving the hospital.

While waiting for the platelet delivery Dad and I packed up her room. Also, tons of doctors, nurses, therapists and friends came by the room to wish mom well and to say goodbye.

After the transfusion we also had a surprise visit from her lead oncologist, Dr. Puduvalli.

Our next appointment with Dr. Puduvalli to decide the next step in attacking the tumor is October 14th. Between now and then mom will most likely need platelet transfusions every four days. She will have doctor appointments with the Gastro guy and the blood guy. She will also be going to PT and OT sessions at a facility in Deer Park.

Physical status: She will be using a walker and a wheelchair, but will also need to be spotted by someone at all times while using the gait belt as her knees can give out on her at anytime. She can take her of daily needs with very minimal assistance.

Emotional/mental: From the very beginning Mom has had a very strong and hopeful spirit. This month in the hospital has truly challenged her spirit, especially when she learned that her brain tumor is still growing. She oscillates between angry, peace, sad, elated, grateful, scared - basically she goes through the rainbow of emotions on a daily basis. Spending time with friends and family always brightens her day and boosts her spirt. Keep those phone calls coming and please visit us at the house if and when you can.

Medical explanation of Mom's health status (if you are interested in reading about all of the detail here you go).

- The biggest challenge we are currently facing is her low platelet levels and mom's inability to naturally create these vital cells. Since her level is 16,000 they gave her a transfusion which typically jumps her level to 50-65,000. Over a few days her levels have typically dropped to 10-20,000. The dangers of having platelet levels lower than 10,000 include spontaneous bleeding (internal bleeding, blood in stools, bleeding nose etc.) and can become life threatening. She has to be careful not to cut herself and avoid major bruising. A medical treatment to stimulate platelet production does not exist so we must wait for nature to kick in and start producing those darn platelets.

- October 6th she goes in for another MRI and we will check in with Dr. Puduvalli on October 7th to learn the status of the tumor.

- We are still anxiously waiting to start the next tumor treatment called Avastin. Before she can begin with this bio-therapy treatment her diverticulitis has to be completely healed, therefore we are meeting with a gastro doctor in the next couple of weeks.

- Even if and when she is approved to begin the Avastin treatment mom will have to make the tough decision to treat or not treat as there are many side effects that could cause harm. No one can predict whether the side effects will or will not effect her so that is why it is a tough decision.

Rehabilitation Day 6

September 28th, 2009

Mom's last day of rehabilitation went smoothly. She worked very hard in PT, group exercise and OT. She took a shower on a similar shower bench to prove her readiness for home.

Medically everything is stable except for her low platelets which we might have to come to MD Anderson every couple of days for a transfusion.

The next appointment with her primary oncologist will be tomorrow to check her platelets. When we get back to Deer Park we will be going to a local PT for continued therapy and enjoying days away from the hospital.

We will miss the fellow patients, patient's families, nurses, doctors, therapists and administrative staff we have become close to over this month in the hospital. They feel like my only friends in the Houston area. Everyone at MD Anderson maintained a strong work ethic, demonstrated compassion, patience and love. They made our stay as pleasant as a stay in a hospital could be.

Rehabilitation Weekend

Mom had a great weekend. We are still looking forward to a discharge date of Tuesday, September 29th.

While good news is all around at the hospital, we have some bad news concerning our abode. After suffering a house filled stench for days, dad finally had time to investigate the ridiculous problem. This evening he found a dead possum in our attic. Mom is excited to go home, but we may be staying at my Uncle's condo in Houston until the vomit inducing smell of a dead animal has found its way out of our home.

White blood cells are still holding up very strongly!

After her platelet transfusion several days her level went from 10,000 to 65,000. They have since dropped down to 35,000 still showing signs that she is not producing her own platelets.

Mom and I would want to give a big shout out to all of the wonderful friends and family who visited this weekend! The swinging door kept mom entertained and her cup of love was filled.

Tomorrow she faces her last day of in-patient rehabilitation. Send her a text to remind her to kick some ass and work hard!

Rehabilitation Day 4

It was an early morning when they woke mom up at 5:00am to draw some blood and to tell her they would be picking her up at 7:15am for her IVC procedure. By 7:45 they had already started the drugs. The procedure went smoothly and in one hour she was waiting in the recovery room. By 10:00am she made it back to her room for a day full of rest.

She tried to tough it out with OT and PT although she could not give much effort because of the residual effects from the near sedation.

This weekend she gets a vacation from physical and occupational therapy and it looks like she will have tons of visitors!

We are still hoping for the discharge date of September 29th.

Rehabilitation Day 3

(This picture is from her last day of radiation on August 24th)

A great day to report! Nothing exceptionally bad or exceptionally good happened today.

Platelets have dropped to an all time low of 10,000 so she will get another platelet transfusion today (that just means they hook her back up to an IV).

Tomorrow she is scheduled for her ICV filter procedure at 9:00.

During PT she lapped the nurses station 4 times with only one break.

Nothing tastes good to her so she is still not eating very well but her blood work in regards to her nutrition is good. She is actually losing some weight which in the end might be good so she doesn't have to carry so much weight when she walks and stands up.

Group therapy was extremely boring as they played memory with a deck of cards.

During occupational therapy we came up with some strategies and home care products we need to purchase.

Brenda came to relieve me for the night.

All in all a great day.

Rehabilitation Day 2

(This photo was taken the weekend after she was diagnosed - June 26th)
The day of realization: Mom woke up this morning and just before attempting to eat breakfast she asked me, "Brook, is my tumor growing?" I stood quiet for a moment and somberly nodded my head. Even though Mom was told by the doctors one week prior that the tumor has grown, it was only in this moment she was ready to process the news. Naturally she broke down and this started a day full of tears and telling each person she came into contact with that her tumor is growing. Through the tears and anger she is working towards accepting her tumor.

News updates:

White blood cells - they are remaining at healthy levels

Platelets - They dropped back down to 16,000 (normal range 200,000 to 400,000)

Nutrition - Even though she has only been able to eat several bites of food at each meal the blood work shows her nutrition is exactly where it is supposed to be! Tonight they gave her medicinal marijuana to hopefully increase her appetite. I am still trying to figure out a way to sneak some for myself :)

Bone marrow biopsy report - The doctors reported that they have every reason to believe that the lack of platelet production is due to the residual response from the chemo and they are not suspecting any other secondary condition. This is good because it means we are not dealing with a secondary medical condition/cancer, but it is negative because she is no longer a candidate for chemotherapy

Diverticulitis - healed to 50%-75%

The rehabilitation team has given her a tentative discharge date for September 29th! The light is at the end of the tunnel.

She pushed hard during physical therapy and made three laps around the nurses station with no breaks!

After a rest between therapy sessions we made our way to group therapy. Wednesday's is music therapy which mom HATES! After social directing the group and once we got started with the actual music therapy which consisted of making notes with the letters of your name, mom gave me the predetermined signal for me to get her the hell out of there!

After we snuck out of group music therapy the white coats entered our room to tell us more news. Mom cannot go home with low platelet levels without a way to manage the potential risk of blood clots. To avoid blood clots she has been taking blood thinning shots each morning. She cannot take this blood thinning medicine however when her platelets drop below 20,000, therefore she has to have yet another operation. On Friday she will have an Inferior Venna Cava Filter installed via a catheter via a port on her chest. This will prevent blood clot in the lungs.

After some more crying we took a nap together in the hospital bed. It reminded me of the days when I was afraid to sleep by myself and mom would always let me sneak in bed with her.

She worked with the occupational therapist in the afternoon with bath rooming and grooming. She got another shower and this time managed not spray her shoes and her guests with the nozzle. She was a little out of control the other day in the shower.

Her friend Tater came for a bit to give me a break. Soon there after another friend Kathy came to give me big relief for the evening.

Mom made a friend during music therapy in room 22 who is also a quilter. Kathy took mom to see her and they had a nice long chat about quilting and cancer.

She went down early for another peaceful rest.

Day 1 of Rehabilitation Therapy

(This is a fun family photo taken - June 26th)

The day started with an attempt at breakfast but deterred by the overriding nausea.

Her first rehabilitation meeting was with Ellen for speech therapy to work on cognitive skills such as memory and concentration.

She reached another milestone when the nurse removed her catheter.

During physical therapy she walked using her walking two laps around the nurses station! This is the most she has walked in three weeks! It was so exciting. We even made it to the PT gym and she did 10 minutes on the cardio leg press machine.

We were done by 12:00 with all of the hard work and after a trip to the cyber center we spent rest of the afternoon watching movies and relaxing. She went down early in the evening as the morning wiped her out.

We are still waiting for the results from the bone marrow. The delay of the test results is no surprise to us as everything in hospital land is late.

9/21 - Turn around day!

(Mom and some of her closest friends in her quilt world)

I started the blog in 3rd person, but now I (Brook) am switching it to 1st person because it is easier. Sorry for any confusion.

Although the morning did not show potential signs of a "turn around day", as the hours passed during Mom reached more milestones and positive news spilled from the doctors mouths.

Mom's white blood cells have climbed their way to 2.4 (normal range 4-11) compared to the stationary 0.6 level she has had for nearly three weeks. This means we no longer have to wear masks when we are in the room!!!

She took a shower for the first time in 21 days :)

Perhaps the biggest highlight of the day came when one of her favorite physical therapists, Nahir, came for a PT session and assisted her with walking 20 feet using her walker. I am convinced I know the reason for this new found strength. Earlier in the day we hunted down Nahir who told Mom one week ago she was having trouble with a specific technical aspect of quilting. Mom had me bring from home the beginners quilting manual my mother made and a sample binding piece to show Nahir. During Nahir's lunch break Mom taught Nahir how to properly sew a binding of a quilt. This brought so much joy to my mom - she had a sense of purpose and passed along some wonderful knowledge to a young quilter who soaked up the advice like a sponge.

After three days of an uneasy and a testy stomach she finally put down some food that will aid her in regaining her strength.

Another milestone reached today occurred when Dr. Shin came into the room to announce that she had been transfered to rehabilitation services. This means that medically there is nothing else the doctors need to do at this time because she is stable. Even though her new in-patient primary doctor has changed luckily we get to stay in the same room. She will be with rehabilitation services until she can safely transfer out of bed to the walker to access the toilet and shower. A loose estimate of one week was given, although we have learned through this experience that time lines and schedules in the hospital mean NOTHING! Whenever mom is ready is when mom will be ready to go home.

We are still waiting for the bone marrow biopsy test results - hopefully we will have them tomorrow.

Request for electronic photos

If you have electronic photos of Vicki please email to brookyates@gmail.com. Thank you!

Details of hospital and visitation

It is likely that Vicki has weeks to months left in the hospital. She loves to have visitors and the family will be looking to have people to take "shifts" as Vicki cannot handle being at the hospital by herself. Vicki's daughter, Brook, is acting as one of the primary "care givers" spending most days and nights in the hospital. If you are interested in visiting or taking a shift please communicate with Brook (brookyates@gmail.com - 970-333-4035). Vicki is on so many drugs and her short term memory has been affected she cannot keep up with the schedule.

She is at MD Anderson in room P816. If you park in parking lot #2 (this is the best parking lot) walk across the street towards the MD Anderson building you will get on elevator E. Take the E elevator to the 8th floor. There are two units on the floor - walk to the unit on the left and just ask for room P816. If you walk to the unit on the right it is not a problem because it is only 30 feet away. When you arrive you will need to wash your hands and put on a face mask.

There are not set visitor hours, feel free to stop by anytime. You can call her room directly - 713-834-8724 or call my cell phone 970-333-4035 and I will let you know when would be a good time to see her.

Generally speaking during the day therapists and doctors are in and out of her room working with her so if you take a "shift" or visit during the day there will be lots of action. If you want to come in the evening there are typically not many interruptions.

Disclaimer - DO NOT SEND FLOWERS! At this point we have everything we need and I know people want to do something for Vicki and the family and when we think of things we need we will ask and appreciate the out-poor of support.