July 27th

Tom just called.  Dr. Aziz called him this morning and Dad has to have some fluid drained from his lungs again.  Tom is going to get the blood work done today and the procedure is scheduled for Monday morning.  To put it in some perspective, Dad’s thoracic cavity was drained on 6/28 and then again just 12 days later.  Monday will be 20 days since the last tap.  Dr. Nyguen’s appt has been moved to Tuesday at 1:20 for a couple of reasons; so he can see Dad after the fluid removal, to get his thoughts on Dad’s ear pain if it is still present, and to give us a little more prep time for the chemo. 

July 25th

Just returned from the visit with Dr. Aziz.  Dad’s BP was 154/56 with an O2 level of 97.  Dr. Aziz was pleased with that and listened to Dad’s lungs and said he sounded good.  Dad complained of shortness of breath and Dr. Aziz ordered a chest xray.  He said if the lungs have too much fluid he will have to drain it again.  If not he will wait until after the second chemo treatment.  We went over to Kern Radiology and got the chest x-ray.  Dr. Aziz will only call if Dad NEEDS TO HAVE his fluid drained again.  Otherwise we set an appt. for three weeks. 

Dr. Aziz said the physical therapy would help Dad’s condition and said he would prescribe it, but would prefer to have Dr. Nichols prescribe it.  So, Tom, I don’t know how this works, but if you could ask Dr. Nichols office tomorrow that would be great.  I don’t know if it makes a difference but I would like to use Glinn & Giordano at 24 & and M.

Other observations:  Dad’s ear is bothering him.  He sees Dr. Rabinov tomorrow – just in time.  I would hate to have to take Dad out of county to see a specialist, but we might need a fresh pair of eyes on this problem.  Dad’s ankles seemed to be slightly swollen.  I think that happens in the afternoon though.  He had breakfast with Nedra and lunch before the doctor visit.  He seemed okay for most of the time I was with him.  It’s doctors – sit around and wait.

July 18th

Tom, Dad and I saw Dr. Nguyen this morning at 9am.

 The doctor said he had a little fluid on his right side, but not enough to warrant a drainage.  He said he believes the body will heal that problem on its own, however we should watch it.

He went through all the drugs he's on and removed the Furosemide and lowered the dose of the Allopurinol and Sodium Bicarb.  See the attached sheet for more details on his medications.

He said the prednisone is on a cycle, 1 week on, 2 weeks off, following each chemo treatment.  He said dad should have more energy when on the prednisone and may have difficulty sleeping.  2-3 days after his last dosage, which will be tonight, Dad should want to sleep more at night, like 10 to 12 hours.  This is normal and to be expected.  However, after 12 hours, it is best if he gets up and around.

Tom asked the doctor if someone should stay with dad now, or around the chemo treatments.  He turned to Dad and ask him if he knew how to use a phone, in an up-beat, non-sarcastic tone, and dad said yes.  The Dr. then turned to us and said, I see no reason why he can't continue to live alone if that is what he wants. Tom asked if he could drive while on these medications and he replied yes.  At Costco, while we were waiting for his perscription, I mentioned I would be happy to stay through the weekend and that both Cate and Billy said they would be more than happy to come back down as well. He smiled and said he would be fine, and got a little teared up.  He knows we love him.

Note: His next office visit is 8-1-12 @ 3:40pm, he will likely get his next chemo treatment the following day.  He will be back on the prednisone and should be fine for traveling down to San Diego.

We're headed to Dr. Nichols at 2:45pm today.

...Jim

Afternoon:

Trevor at Dr. Nichols was who we saw.  He came in prepared, had read all the previous notes and was well informed.

Key points:

1) He ordered the blood work and cc: all the doctors.  They took Dad's blood while we were there.

2) He doesn't feel they should have taken him off the Furosemide 40mg. This is for swelling, which Dad showed a little of in his legs.  As a compromise, Dad purchased some compression knee-high socks for $40 that he should wear when around the house. He should also use a pillow when in his chair to elevate his legs.  Therefore, I did not discard his Furosemide, just in case they decide to put him back on it. They're good until Feb 2013.

3) He made an appoint for dad to follow-up with Dr. Aziz, his Pulmonologists. Note the appointment is for 7/25/12 @ 1pm. That was the only time they had available.  The goal is for Dr. Aziz to monitor Dad's breathing and to establish a relationship with this Dr. on all issues related to his lungs.

4) Trevor said that Dr. Nguyen is the captain of the ship, with Dr. Aziz, Dr. Saiki & Rabinov as running backs.  He said he didn't see any reason to make Dad to continue follow-ups and asked to see him again in 3 months.  Note, Dad's next appt with Dr. Nichols is 10/17/12 @ 3:45pm.  He said if we need him, just call and they'll get dad right in.

5) Trevor said he thought Dad's lungs sounded great, just a small amount of fluid on his right side.  He checked his ear also and said it was looking great.

I think it's good we have a follow-up appt with Dr. Aziz.  As the Prednisone leaves his system over the next 2-3 days, if he has trouble breathing we have a follow-up with a lung doctor next Wednesday.

Dad's spirits are good.  He's tired, probably from beating me at 5-straight.  Becky called, she coming over tomorrow to get a few tips from the master before her 5-straight arrives from Amazon.

His medications are becoming a bit tricky. I'll restock his pill case after dinner, he'll need help restocking it before it runs out a week from tomorrow.

Let me know if I missed anything.  Whenever I wake-up tomorrow, I'll be heading back to Bend.

Love,

...Jim

July 3rd

Just got off the phone with Tom and he reported that Dad’s appetite is almost non-existent and he is somewhat lethargic.  This started, I believe Tom said, last night at dinner and this morning at breakfast.  The lethargy isn’t so unusual but from my time with Dad and watching him eat, it always amazed me how good his appetite was, so this does concern us a bit.  Dad has an appt with Dr. Nichols this afternoon. 

We think there could be one of two causes for the loss of appetite.  One, it could be the new med.  Jim, you read through the lit on that, any thoughts? 

The other could be a fluid buildup in his abdomen similar to what occurred in his lungs.  The fluid could be putting pressure on his stomach making him feel full all the time.

We’ll let you know what the doctor says.  My advice to Tom was to ask Dr. Nichols what would happen if we stopped the new med, but I think Dr. Nichols will go deeper than that.

Tom, I have a meeting from 5:30 until 10 tonight and will not be available.  If you need to contact me before or after that, I will have my cell phone handy.

Doctors report:

Dr. Nichols said Dad was looking better.  His lungs were in good shape.  He did take him off of one medicine and put him on another, Megestrol (Megace 40 mg) for his appetite.  His demeanor was better and once Tom and Dad started working on a project, Dad seemed okay.  He did pack his bag and plans on staying at his house tonight.  The Life Alert came late today and we are going to install it in the morning.  Dr. Nichol said Dad has about 5 liters of fluid in his abdomen and he advised against removing it.  He said it would likely just fill back up and Dad runs the risk of having some of the cells in his abdomen die (I guess as a byproduct of the fluid removal).  I think I got most of the important points.  Tom and Dad are headed to the Olive Garden where I’m sure they’ll eat like family.

June 27th

Dad's mental state is excellent.  He got caught up on his bills and cleaning his desk. He wanted to build a spreadsheet, so I helped him do that.

In addition to John's great email update yesterday while we went to Costco, I want to add that Dr. Rose also said the culture she took last week came back negative and his ear was now completely clear. Non of last week's puss returned.

He is having some intermittent breathing issues.  It reminds me of an asthma attack.  He could be sitting in his chair and out of know where, he starts breathing heavy.

I working with Debbie's cousin Dean who is an MD and used to work at the Heart Hospital to see if we get in to see a pulmonologists or other specialist.  Dad feels strongly that if I take him to see Dr.

Nickols that he's going to treat everything BUT the breathing. So I'm working this other angle. If I come up empty, Dad has agreed to go to Dr. Nickols Thursday or Friday for a check up. We agreed on that this afternoon, so that is the latest update.

...Jim

June 25th

We just got back from seeing Dr. Rose.  She is good with him stopping the antibiotics.  As she said, we are going to have to see what happens sooner or later, the ear looks good, let’s give it a try.  Dad can go to the House clinic tomorrow and finally get his hearing aids properly adjusted.

As for the breathing problem and seeing Dr. Nichols, Dad has decided to take a wait-and-see approach.  He knows Dr. Nichols will want to perform a lot of tests and Dad does not want that.  Dad did agree that if he has another breathing episode, he will schedule an appointment with Dr. Nichols.  Dad also agreed to leave the picc line in for another week while he sees what his body does without antibiotics.

Dad seemed in good spirits and a little relieved to have the doctor’s approval.  He did appreciate everyone’s concern the last couple of days and is looking forward to getting back to normal.  Let’s hope that happens.

I wanted to wait until Dad went to bed before I wrote an update. I hope my delay hasn't caused any needless worry.

Dad has had a tough day, but he's trying to stay up beat. He's very tired of being tired. 

Today he has been fighting diarrhea all day. He is also having intermittent  Shortness of breath. He has no energy.  The good news is, he says he has not been dizzy. Feels more like asthma, my words, not his.

He's also just having a bad day and is feeling depressed. He's thankful we're here, but wishes we didn't need to be. Does that make sense?

 

I'm going to call Dr. Nichols and Dr. Rose tomorrow and see if I can get him in. He's convinced he's been on these meds to long and wants off. In his mind, he was going to be able to stop in a few days anyway, so there is little risk to go off the meds and see if he feels better. As much as he wanted to go on a walk today, between his diarrhea and shortness of breath, he decided against it.

The shortness of breath is new, and he wonders what is causing it. I noticed it last night on the walk as well. I would worry if he was by himself.

Let me know if you have any questions. You can call my cell if you want more info or have specific suggestions.

..Jim

Sent from my iPad

On Jun 24, 2012, at 12:42 PM, "Bill Harrer"  wrote:

So this is very weird, he has been on those meds for 5 or 6 weeks now, and to suspect that the meds are the cause of his queasiness is probably not the case.  Please keep us updated on how he is feeling. 

So this makes me think that we need to have a schedule for dad for a few more weeks, what are your thoughts and availability if you agree.  Deb and I are going away for a few days at the end of this week to celebrate our anniversary, but I can be available after that if needed.  I am suppose to start a job, but I can bale on that too if needed, please let me know.

Bill

From: cate praggastis

Sent: Sunday, June 24, 2012 9:51 AM

Subject: Dad update

Hey there... So, yesterday Dad said he didn't feel great and slept a lot of the day... today, he woke up queasy and simply said he didn't want to take the IV meds anymore, they made him feel weird...   so Jim flushed the IV with Heperin.. and we will call Dr. Rose in the morning.. call if you have any questions... Love you all.. Sis

Catie