Wednesday, February 25, 2009

Guppies and a rash at our house

The last two days have brought the unexpected at our house. It started yesterday afternoon. . . . Mandy had another CT scan as part of the "staging" process (determining the stage of the lymphoma). The goal was to see whether she has any enlarged lymph nodes in her abdomen or whether they are limited to the area above her diaphragm. This determines whether the stage is type II or type III, which is important for the chemotherapy dosage and is determinative of the areas that will be subject to radiation treatment. It is also predictive of cure rate. Preliminary results are that she is type II (95% cure rate). But this wasn't unexpected.

What was unexpected is that Mandy is apparently part of the 5% of people who experience an allergic reaction to the iodine used as a dye for CT scans. And boy is she allergic! A few hours after the scan she started feeling a flush and then a red, puffy rash spread over her entire body. She started feeling *very* cold and, long story short, I had to run over to Walgreens at 12:30 AM for Benadryl. Although the Benadryl didn't help the rash or fever (she couldn't get warm in fleece pajamas a down comforter and a quilt), it helped her get a little sleep.

This morning she went in to see the doctor who said it would pass and that she should keep taking Benadryl. After spending the day resting, thanks to friends and family who took care of the kids, she is starting to feel better now and the rash is fading.

The second unexpected arrival at our house: guppies. Yes, the little fish. We've had this 5-gallon aquarium on our kitchen counter that has been the aquatic equivalent of a vacant slum house for the past year after the unfortunate demise of our last fish (a guppy) who lived for the grand total of a single day. So on a whim, I stopped at PetSmart on the way home from work last night and bought two guppies--a male and a female--along with a bamboo plant to keep them company. I plopped them into the tank and hoped they were survivors.

The kids were excited to see their new fish this morning after having finally given up hope that Dad would actually make good on his promise to deliver the new pets. We explained to them that the dark one was the daddy fish and the light one was the mommy fish and that they might have babies at some point. Little did we know it would be TODAY ... or that there would be TWENTY (20) of them. Yes, I got a call at work from Mandy this evening saying mommy guppy had five babies and wasn't that a lot. By the time I got home there were 7, no 8, no 9, no 13 babies. By 8:30 there were 20. Twenty baby guppies in a 5 gallon tank. And how could a sub-inch long fish carry 20 babies, even if they were each only a quarter inch long? We told the kids that most of them won't make it but we didn't have the heart to them that we don't know who the father is (surely guppies can't reproduce in one day?).
Anyway, if anyone would like some baby guppies swing by our house. Apparently we breed them.

Daddy guppy (mommy was hiding along the filter pump to keep warm)


Baby guppy (1 of 20--maybe)

Iodine. . .

Yesterday Mandy had another CT scan to check her abdomen for more cancer. The good news is her abdomen is cancer free. So it looks like she has stage 2 cancer. The not so good news is she is one of the 5% of people who have an allergic reaction to the iodine used during the CT scan.
All last night she was going between chills and a fever. This morning the doctor put her on some medicine which should fix things in a few days. Until then, she could use a little help with her children. The medicine has made her spacey.

We were hoping some of you could see what fits in with your schedule and take the kids for a little while. (Meals have already been taken care of- thanks) Here is what is needed:
Thursday-
Miles to be watched from 11:45am- 5:30pm
Philip and Fiona to be watched from 9am- 5:30pm

Friday-
Miles to be watched from 12:45- 5:30pm
Fiona to be watched from 9am- 2pm-ish

Just let me know what part of the day you can help out. Then we can fill in the blanks.
Thanks-
Lindsay

Monday, February 23, 2009

A sigh of relief at our house!

I feel fortunate beyond belief.  We met with the wonderful oncologist today, whose immediate words as she shook my hand were, "Hi Amanda, you're going to be fine."  She told me that my type of cancer, Nodular Sclerosing Hodgkin's Lymphoma, is cured in 95% of cases like mine and that I would live "happily ever after, I promise."   I figure you can't get much better than that.  I will have some more scans done to determine what phase the cancer is in, but judging by my current health and what they already know, she is pretty sure it is stage II.  Even if it is stage III it should be curable; it would just change the treatment a little bit.  It is interesting that after taking a very detailed health history she said that most of the odd things I've experienced since Fiona's birth (I guess I'll have to give more details about all that another time) are unrelated and have more to do with pregnancy and hormones.  The only symptom which is definitely a sign of Hodgkin's Disease is the erythema nodosum, which sounds like a Harry Potter chant but is actually the technical term for the odd rash I had on my leg starting in October which was accompanied by the burning, tingling sensation, the edema in the evenings (swollen ankles like I used to have when I was a few weeks from giving birth) and also strange knots and indentations in the leg.  Apparently this is a very common symptom and of course is what finally convinced me I needed to see a doctor.  

I will have 3-4 months of chemotherapy which will begin late next week or early the week after.  I will go in one day for 4-5 hours every two weeks and they will give me the drug cocktail intravenously.  After I have completed all the rounds of chemotherapy I will likely have four weeks of radiation treatment (everyday or every other day), and then I will be done.  So even if there end up being delays due to colds or a low white cell blood count or whatever, we should be wrapping this thing up by the time school starts in the fall.   

I was thrilled and amazed to find out that on this particular chemotherapy, nausea is rare.  Wow, what a pleasant surprise for a woman who has endured three horribly nauseating pregnancies!  Apparently I will take a really good new pill the day before each treatment and then they will also infuse Zofran into my blood stream along with the other drugs.  Zofran is the anti-nausea drug I took during my last two pregnancies.  The doctor said even queasy people like me really don't get sick on this particular chemo.  I am told I will feel somewhat tired the day of treatment and for a day or two afterwards, and that then I will basically feel normal until the treatment starts again.  All in all, this sounds a whole lot easier to me than being pregnant.

Best of all was the news that unlike the Hodgkin's treatments a decade or two ago, the current treatment rarely causes fertility problems in women under age 35.  This was a big concern to me, as we had hoped Fiona would not be our last child.   We were prepared for that to complicate things, but it looks like it won't.  Once I have been through treatment and had some time to recover and see that my health is good, I should be able to become pregnant again.  And I pledge to complain less about it the fourth time around (although really for all you pregos out there, it is such a hard thing so give yourself a pat on the back)!

So truly the most traumatic part will be losing my hair.  The doctor says it comes out like clockwork on day 15 of the treatment.  I will admit it:  I have tendencies toward vanity.  I hope my friends will accept this as a likable quirk.  It's not that I think I'm gorgeous or anything, but in recent years in an attempt to feel young despite being upwards of 30 and mother to more than one baby, I've taken more of an interest in my clothes, my makeup, and yes, my hair.  I really like my hair right now.  I have this fabulous hairstylist who half my friends go to and we all have such cute hair.  I am guilty of admiring my hair in the mirror multiple times throughout the day.  My husband fed this attitude by literally complimenting me on my hair ten times a day for like, three months the first time I got it cut this way about a year ago.  And on top of it, I have been leading the music at church for almost two years now and I am not making this up when I say that for every comment I get about the nice music, I get at least 3 comments on my appearance, be it clothing, accessories, or yes, hair.  I didn't believe it myself at first but this is totally consistent every Sunday and I would be lying if I said I didn't enjoy getting compliments.  I think it is just that there's not much to look at when you're sitting there in church, so you start critiquing the chorister's latest outfit.  So clearly part of the reason I need to go through all of this is to gain humility.  

But I do think the love of hair is partly genetic and can't be helped.  When I told my brother how put out I was about losing the hair he laughed at me and then I said, "You're a guy, and you wouldn't want to lose your hair," to which he responded, "Point taken.  You're right.  I would not want to lose my hair."  He spends plenty of time getting it to look just right, as did my father.  One famous story told at Dad's funeral was the fact that for five or six years he used that brush-in hair dye and my mom didn't even know it!  He said that at age 42 when my youngest brother was born following a very stressful pregnancy, he looked at this baby and said to himself, "This poor baby has an old man for a father."  With everything he'd been through in those last months before Scott's birth, he had grayed quite a bit, and he always had such a handsome full head of dark hair.  So he started brushing in that stuff every morning in a bathroom on the other side of the house and this all came out over a dinner conversation with friends years later.  They commented on how he had very little gray and accused him of dying his hair but Mom said, "Oh, Bill would never do that."  Then came the confession.  He said he figured if his own wife couldn't tell, it must have looked pretty natural.  

Now, anyone who knew my father will tell you he was among the kindest, gentlest, most grateful men on the face of the earth.  Super content--I honestly almost never ever heard him complain (including when his cancer treatment made him lose his hair).  Perhaps if someone like that cared so much about his appearance once upon a time, I can be forgiven. 

Tom, while very sympathetic to my angst regarding this issue, is excited about the opportunity to shave his head.  He has done this twice before, both times in college.  The first time was during our Freshman year and we were best friends but not yet dating.   All day long I saw mutual friends who would say, "Did you know Tom shaved his head?" and then carefully watched for my reaction.  These were the scads of people who clearly saw I was in love before I did.  I kept wondering why they all seemed to think it was so daring for him to do such a thing without my permission.  The second time was our last year in college, several months after we'd gotten married.  I went on a trip home to go to my brother's missionary farewell and came back to a bald husband.  So I guess this is Tom's once-in-a-lifetime chance to have his wife's full support in his head-shaving antics, as well as hopefully not getting too much slack at work.   

I explained to the boys that happily the treatment won't make me sick like I thought it would, but it will make me tired and oh by the way I'll be losing my hair.  Philip put on his mad glare face and said gruffly, "I don't WANT you to lose your hair!"  Join the club, buddy.  Tonight when Miles said his prayers he thanked Heavenly Father that I would have medicine to make me well and asked that "the medicine that will make her hair fall out won't make too much of it fall out."  Afterwards, we explained that actually I will be completely bald.  Phil reiterated that "You CANNOT BE BALD!!!"  Tom said he would be shaving his head and the boys could too!  Miles seemed pretty concerned about that.  "Maybe I could just get a haircut," he suggested.  He was reassured that he could cut however much hair he was comfortable with.

Looking at pictures  of my mom after her treatment made me realize that I had rewritten my memories.  In my mind she had her regular hairstyle when Miles was born, eight months after she finished chemotherapy.  Actually, it was still short and curly for over a year after her treatments ended.  So I am sadly seeing that I will not regain my current cute hairstyle until at least a year and a half after the hair falls out.  Well maybe styles will change by then anyway.  At least this gives me a good excuse to see how I look with really short hair, and I am also kind of enthused about the prospect of a few months of natural curls.

On a more serious note, I am overwhelmed with gratitude and at the same time the feeling of "Why me?"  I don't mean why did I get cancer, I mean why do I get to survive it?  Why am I so blessed with incredible friends and family who will get me through this thing knowing from the start that the ending will be a happy one?  Why is it that others I know, family and friends, have already been taken by disease, while still others are fighting what looks like a losing battle for their lives, super gracefully I might add, and I have the good fortune of having the best kind of cancer, where the only thing I can find to whine about is hair?  It is hard to see people I love suffer, and I have a feeling it is going to be a lot less hard to get through this little bump in the road.  

I don't know the answers to these questions but I am grateful to know that there is a God in heaven who does.  I know that through our trials we gain maturity and depth of character, and that many of these dear ones who are called upon to endure so much have those qualities in high doses.  I imagine people like my father and my mother-in-law, looking down on me from heaven, where they are free from pain and I am sure they were welcomed with much celebration back in 2003.  They and others who endure various hardships have been great examples to me, and I have thought so much about them and their goodness these last few weeks.  I really want to give more of myself to others in the future. 

Sunday, February 22, 2009

The superhero at our house

I have had a lot of requests for pictures of Philip in Superhero attire. So now I am finally posting pictures on our blog, thus becoming a true blogger I suppose. Just about everyone who ever baby-sits the kids or has Phil over for a play date asks me afterward, "Do you just laugh all day long?" And the answer is that on some days yes, yes I do. Philip truly has an advanced sense of humor for a three-year-old. In fact, since he was very small, even in his infancy, he was cracking jokes. Funny jokes. The kid was born to make people smile. Apparently, this is exactly how Tom's brother Phil, who he is named after, was.

His incredible imagination is even more impressive than his humor. We are not sure what prompted his infatuation with Superman, but it began back in late November. He stopped answering to the name Philip and insisted that everyone call him Superman. He kept this up for literally close to 3 months, with very few lapses back into the Philip persona. We would be on elevators at the doctor's office or at the park or wherever and anyone who asked him his name (and some who didn't) were told, "I'm Superman." Usually if pressed he would admit that his parents gave him a different name, but he was pretty much Superman. And he has often told me, "Mom, you're Superman's mom." This does help give me a sense that I can conquer just about anything.

Then five days before Christmas we got a card from some friends that included a photo of their son in his Halloween costume: Superman. Phil's eyes grew wide as he stared at the picture of his friend and said, "I don't have that. I need that." Tom quickly did some internet research and ordered a costume which we thought would have to wait until Philip's New Year's Day birthday, but it arrived on our doorstep Christmas Eve. So I gave it to him for Christmas, and it was his favorite gift, along with his light sabers. This is where Superman morphed into a unique superhero/Jedi. Below we see Superman taking it easy, wearing his shades, pondering the myseteries of the universe.

Usually, though, Superman not only has the costume but also two light sabers attached to his belt--one on either side, thus alerting enemies that he is a Jedi Knight. Superman must be ready to use the Force at all times. Sometimes he has to leave his light sabers in the car but he still has the Force to protect him. For example, one day at the dermatalogist's she was taking a chunk out of my leg to biopsy to see what the rash was all about. (This was one symptom that eventually alerted us to a more serious health problem.) The doctor's assistant was trying to keep the kids busy and Philip, rather than noticing the intriguing procedure going on atop the table, quoted straight out of an Early Reader that Miles has: "We must be careful for Jaba the Hutt. He is a bad guy, but he loves his son, Ratta."

Of course, while the full costume is preferable and is frequently worn to stores, parks and other public venues, there are some days when it is too hot or too cumbersome or Mom just won't let him, so he improvises by attaching his cape, belt, light sabers and his Crocs rain boots which he calls his "Super boots" to whatever clothing he is wearing....or not wearing.

Well, it looked as though very little could break the magical Superman spell until this weekend when a friend took the kids one evening. Upon our return, we found Philip dressed in a Batman suit. We about fell over laughing. We were told that his friend had outgrown it and that is was his to keep. As Tom put him in the car he said, "Get your straps on, Phil," to which Philip replied, "No, I'm Superman. I mean Batman." It seems he is now in a bit of an identity crisis. We got home and he argued over whether he could sleep in the Batman suit, but finally consented to remove it and place it on his bedpost, where the Superman cape normally hangs. A few minutes later he decided that he would actually hang the entire Superman outfit on the other bed post, thus having both costumes ready and waiting for him when awakening in the morning. Today he was disappointed to find that it was Sunday and he couldn't wear either costume to church, but when we got home he changed to his Batman costume and then proudly wore it to Grandma's house for dinner (see picture below). Superman's voice is deep and resounding, while Batman's is raspy, so that helps us know which one he is when he isn't dressed for it. He has offered to guard not only our house but the bishop's across the street, so we are all feeling pretty well protected.

Thursday, February 19, 2009

Preliminary good news at our house!

I just spoke with the surgeon who removed the lymph node from my neck on Tuesday. Early testing shows that I have Hodgkins Lymphoma, which is what we were hoping for. It is more common among relatively young people and is definitely "treatable." More testing will need to be done to see whether that means totally curable or whether we are talking about a condition that I will have to live with for a longer time period. However, it does mean that it is not the kind that would have ended my life within a few years.

Still, there is a pretty big difference between a few months of chemotherapy with an end result of "cancer-free" and a process that could continue indefinitely. We will be meeting with the oncologist sometime next week to go over in more detail the results of the biopsy and to discuss treatment. At that point they will have more information. In the meantime, I am authorized to live a normal life (ha ha ha). I have been taking Vicadin for the last couple of days to keep me from feeling much pain as well as to limit any anxiety I would have been feeling--my body reacts pretty strongly to such drugs. Right now I am completely loopy! Tom will be home soon, and then I am going to go to sleep.

Tuesday, February 17, 2009

Surgery Update

Today's surgery went very well even though the lymph node the doctor removed was lying right on Mandy's jugular.  There were no complications and it was completed in around 30 minutes.  We should hear about the test results in 24-48 hours.  Mandy is feeling fine.  We have both been amazed at the outpouring of love, support, prayers and fasting on her/our behalf.  Thanks to this, we have both felt relatively calm (only a few moments of panic) starting from this past weekend.  We're grateful for all of our wonderful friends and family who have already done some much for us.  Mandy, being the social butterfly that she is, has seen this whole thing as an opportunity to keep in touch and re-establish contact with friends and family.  She enjoys the calls (starting again tomorrow afternoon) and emails she has been receiving.  Please feel free to drop her a line.  Mandy also joined facebook in the last couple of days--look for her there.  Thanks everyone!  --Tom

Finally blogging at our house

Well, here we are.  I have been surprised at how many people over the years have asked in emails or Christmas card letters, "When are you going to start a blog?"  I guess I thought it was one of those things that people just a few years younger than us were into.  I figured when we finally became hip enough to embrace the idea, it would be to chronicle another move, or another baby, or another such happy adventure.  I am beyond bummed that I was finally convinced to begin a blog so that everyone could read about my apparently poor health!

We are playing the waiting game here at our house.    This is exceedingly difficult for me; I am a planner.  I remember when we were finishing up at BYU and Tom was applying to law schools and I couldn't apply for teaching jobs yet because I didn't know what schools would accept him.  Not knowing whether we'd be staying in UT, coming home to CA, or moving all the way out to NY was a huge challenge for me.  I like the security of knowing what is coming so I can map it all out.  A relative in Salt Lake City said that when she heard the news about me last week, her thoughts were, "This is really  going to annoy Mandy; now she can't take her trip to UT."  She knows me all too well.  I was so excited about taking the kids to visit family and snow over the Feb. break and I am quite put out to be having surgery instead.  I've been lining up a year full of magnificent vacations and fun activities, and now I don't know which ones, if any, I'll be able to participate in.  Most of all, pregnancy was not in the plan, therefore nausea was not in the plan!  At least from what I understand chemotherapy is not going to make me feel sick for five to eight months straight, so perhaps in that way it won't be as bad as my pregnancies have been. 

This lack of a complete diagnosis coupled with an intense outpouring of love from family and friends causes so many varied emotions.   I have only cried once, for a good twenty minutes all the way home from the doctor's office the day they told me they thought the X-ray showed a peach-sized mass in my chest cavity.  I was crying at the idea of my husband and children losing me.  I know enough about death that the actual event doesn't scare me (although the process is another story).  I am not a perfect person but I am relatively good and I honestly am not afraid to go, but I am afraid of what that would do to my family.  What a blessing to have a husband who loves me so completely that I am certain I am everything to him.  What a fortunate dilemma to have three beautiful children who give me every reason to want to be here to help their father raise them to the best of our ability.

Tears soon gave way to more of a nervous energy for me and a general sense of exhaustion for Tom.  We both have felt we are in a constant state of anxiety.  It is frequently a feeling of knots in the stomach and a constrictive heaviness in the chest, like when one has been under the water too long and is desperately trying to get to the surface to gasp for breath.  After the CT scan showed that it was actually not a mass but a cluster of many swollen lymph nodes, and that was highly likely to mean lymphoma, I found it nearly impossible to sleep for a couple of nights.  My uncle died of lymphoma, so I'm not fond of the word.  However, a lot of people I've talked to have personal friends who had the curable kind, were treated, and have gone on their merry way to live normal lives.  I like hearing about these people and have great hope that I will be one of them.  Then of course there is always a third alternative somewhere in the middle, and I have heard that my acquaintances know of these people as well--those who have a condition that may never go away, who live with this cancer every day and will be treated for it indefinitely.  Life that continues but is never the same as it was before.  This option frightens me and makes me feel very tired and somewhat gipped.  Everyone knows that if there is a party I want to be there.  In college I couldn't even be in my bedroom if I heard a conversation taking place in the apartment.  I am an extrovert and I thrive on the company of family and friends.  I don't like to be left out of anything!

The most surprising emotion I have felt throughout the last week is pure and absolute joy.  It comes over me in waves and I catch myself dancing and singing out loud.  Whatever the prognosis may be, I have been changed a little bit from the inside out.  I feel amazing love for almost everyone I see, but especially my dear friends and family.  In these moments I feel a renewed zest for life and a passion for everything that makes it worth living.  In many ways I have rediscovered myself; I feel as though I was getting a bit bogged down in the day-to-day tasks that a mother of three can't avoid.  I am realizing that ten years past my carefree college days, I am still an interesting person.   I appreciate my current life more than I did a week ago, and when I am not too overwhelmed with this anxiety, I am taking more time to stop and listen to my children as they explain in great detail about a Lego creation or an encounter with Jabba the  Hutt during imaginary play.  Sometimes I am Jabba the Hutt.  I am becoming fun again. 

I am grateful for longstanding daily routines that are in place at our house--mealtime, song time, scripture reading, family prayer.  These provide us with a warmth and a sense of normalcy and peace that cannot be overestimated.  And I am grateful for our friends!  In the neighborhood, at church, at school, at play group, and all across the nation they give support.  The constant stream of phone calls, emails, hugs and offers to bring ice cream are just what I need, and they know it because they know me.  I could not have better friends.

I am a queasy person, so today's surgery has me feeling nervous.  I am glad they will put me under.  Still, the idea of a gash across my neck makes me feel self-conscious and more than a little ill.  I have passed out on numerous occasions in my life--into the lap of the new boy in school during 6th grade sex ed; over my desk during health class in junior high; straight to the floor from a standing position at church during early-morning seminary in high school; at the theater during a war scene of a movie I should have known not to see; and most recently at my first blood draw when I was expecting Fiona.   I smiled when an uncle told me that compassionate people are prone to queasiness, as they can't stand the thought of anyone being in pain.

I passed out more during the first three years of life, however, than all the others combined.  I had a strong will and tried the patience of my angelic parents.  I would cry and cry until I ran out of breath and fainted, leaving them to pace the floor hoping that I would come to  quickly.  This began well before my first birthday and continued into toddlerhood.  I am hoping that I have not outgrown my strong will.  I won't be screaming until I pass out, but I will have a fiery determination to beat this thing, whatever it may be.   Along with that I will have a determination to figure out what I can learn from it.  Otherwise, what is the point?  I am thankful to know that God watches over us and won't give us trials we can't handle.  

This blog will not always be a serious reflection either.  I am joining the blogging world so I can share and remember through photos and words the cute and funny moments at our house, such as Philip, dressed in his Superman suit for two and a half months running, stalking through the hallway in search of Ventress, the evil villain from Star Wars the Clone Wars, whose presence he senses on a regular basis despite not having seen the movie until last night.   Yes, the Force is strong with that one.

How comforting and fulfilling that I am the mother of a brave and heroic Superman-Jedi, along with a thoughtful budding artist/builder and a sweet baby girl whose only word is "Hi."  It is used very liberally as an all-inclusive greeting, farewell, or even notification of migration between rooms.  I adore my children.

Monday, February 16, 2009

Email Lindsay at ledesma.lindsay@gmail.com to help with any of the following:

The Carmacks will know more about Mandy's diagnosis later this week. Please check back to see what they might need Thursday or Friday.