Heading Home?

It appears that we are going to be released to go home today.  The stem cell doctors said they actually extracted 10.2 million stem cells in that one collection.  Over twice what they had hoped to collect.  The Lord provides!  The cardiologist just came in to review the results of the echo-cardiogram.  She said everything looked good on the echo.  They are still  concerned with the high heart rate, but agree its probably a combination of things working against Sarah in this regard.  She is on a strong antibiotic, has had an enormous amount of stress on her mentally and physically in the last few months, her body condition has declined due to inactivity over the past months so she is not in as good of shape as she was, and maybe the biggest factor, her hemoglobin (oxygen carrying capacity) is still 3 points low at 9 rather than the bottom of the healthy range at 12, her electrolytes and hydration are also very much on the low end of where they should be.  Hopefully, when all returns to normal, so will her heart rate.  We are still waiting on the infusion therapy nurse to come in and remove the large pheresis catheter from under Sarah's collarbone.  Hopefully all will go well with that and we finally won't have to deal with any lines to flush and dressings to cover and all of that good stuff.  Pray as well that we don't have to turn around and come right back over Tuesday for restaging scans.  Pray we can get everything done to get them moved to Baton Rouge.  Pray as well that they are still clear, as we fully expect them to be, and we can move on with the radiation.  The Lord has watched over us so wonderfully.  We thank you for all your prayers, and may the Lord bless all of you as well.  Pray everything goes well and we can get home safely.  Praise God from whom ALL blessings flow!!!  He is more loving and merciful than we deserve.

Hospital/Stem Cell Update

We are now sitting in the apheresis unit at MD Anderson.  Sarah is currently hooked up to the apheresis machine for the stem cell harvest.  Everything is going well.  It is a painless procedure.  Sarah is just cold because as the blood is filtered it takes on the temperature of the machine/room.  I have her bundled up like an eskimo, though, so that problem has been alleviated.  The procedure will take between three and four hours, so we've a while to wait yet.  Although they will not know if they have enough stem cells until the morning, early indications based on the sheer volume collected indicate we might need to do it once more in the morning. Our biggest concern at the moment is that Sarah's fever has returned at a low grade level.  The doctor's don't seem particularly concerned with this though.  Her fever when last checked was at 99.3.  I realize this is mild but any fever in this state is a major concern.  She has been fever free for the better part of two days now.  Her only remaining issue has been an elevated heart rate (100-125).  So they have taken steps to test and eliminate things as to the cause.  Sarah has been on some high-powered antibiotics via her IV catheter.  They have gradually eliminated the drugs to the point where they only have her on one oral antibiotic.  I talked to the nurse practitioner just a while ago, and he informed me that all of the cultures and tests they ran for infection came back clear.  This is a good sign, but it is still bothersome to know the fever came back after eliminating some of the IV drugs.  I don't know what the protocol will be from this point forward, but they are just monitoring the fever for now.  Please pray for this major issue.  Namely that the fever and any infection/issue associated with it will be taken away, and also that her heart rate would go down to a safer level.  There could indeed be a correlation between the two.  Sarah and I both are very ready to go home.  Speaking for myself and most likely on her behalf as well, I am weak and tired.  Every little set back seems like home moves farther away.  Just keep us in your prayers.  Pray for a speedy recovery and that Sarah's body would recouperate, and we could return safely home as soon as possible.  Although its been 16 days since Sarah has been home, in reality the Lord has taken good care of us.  There are so many others that are in such more dire situations than we are. Admittedly though, its hard to stay focused and not have a sinful, worried, impatient attitude.  Pray for strength and peace, for patience and the grace to handle whatever situation arises, and ultimately for Sarah's safety and health.  Also, don't forget to give praise for all that God has done for us along the way.  He has been very merciful to us and has blessed us in  so many ways.  Not the least of these being blessed with such wonderful caring friends and family.  All your texts, messages, comments, and prayers lift us up on a daily basis.  There are many others dealing with tough situations in this broken down world as well.  Please be in prayer for the family of Mr. Larry Gayle.  For those of you that may have known him, he passed away yesterday afternoon after a year long battle with ALS ( Lou Gehrig's Disease).  He and his family are friends of ours that have helped us a lot over the years in our cattle business.  He recently lost his wife (about a month ago) to Huntington's disease coupled with cancer.  Their family has really been through a lot in the past few years.  Please keep them in your prayers.  I was fortunate enough to see Mr. Larry just this past Sunday when I was home.  As hard as it was, I am thankful the Lord granted me that opportunity.  I know there are a lot of prayer concerns out there that I am not mentioning.  This one just happens to be close to my heart at the moment.  Thank you again for your love, prayers and suppport.  Please continue to lift us up, we are doing the same for you. 

--Josh

Back in the Hospital :(

Some of you may already know this, but Sarah had to go to the emergency room last night and is now in a hospital room.  Her fever had gotten up near 100.5 and her heart rate was running around 150.  When she got to the ER they checked her blood pressure which had fallen pretty low.  They hooked her up on fluids and later on oxygen.  When they checked her blood, her hemoglobin had fallen to a level which required 2 units of blood.  She was finally admitted to the hospital this morning around 3 a.m.  She finally got through with the blood transfusion around 5.  The doctors are worried about the possibility of infection especially since she literally has no white blood cells.  They have taken all sorts of tests and cultures to check for the presence of an infection.  We won't know the results of these for at least another day, but she is getting 3 different broad-spectrum antibiotics intravenously.  If they do find an infection they will put her on an antibiotic specific to the infection.  We hope this is not the case, and rather the fever is due to a side effect of the high doseage of neupogen she is getting to facilitate the stem cell harvest process.  I made my way back to Houston this morning.  I had gone home to try to get some work done and did get caught up on some things while home.  Things have immproved somewhat since I have been here.  Her fever had gone down to 98.4 when last checked.  She's off the oxygen and her oxygen percentage is still 100%.  I think the blood has helped out a lot.  Her blood pressure which had fallen to 83/42, was up to 107/59.  Her heart rate has been staying under 130 and is 105 at the moment.  Thank you for the prayers and please continue to pray.  Obviously, an infection at this point with no immunity is very dangerous.  We know the Lord is in control of it, and even though its been a rough 24-48 hours, He continues to show us mercy and exceptional care.  Sarah is very tired and homesick.  Nerves play a big part in all of this when you are worried about infections, fever and the like and you are trying to keep your heart rate down, it does not work well.  Pray for her spirits and strength as well as healing and care.  Its hard when you are through with the chemo and want to be home, to be stuck back in here.  It's all in due time though.  The doctors say this should not have an adverse effect on the stem cell harvest so at least this may not all be for naught.  Just continue to be in prayer for us, particularly Sarah.  Thank you as always.

-Josh

What a Day

We have had quite a day today.  Unfortunately/fortunately it ended with me getting one unit of blood.

I had labs this morning and had my vital signs taken.  Even with all the Neupogen I'm getting, I still have no white cells.  This is only day 9 (first day of chemo is "day 1"), and this is the "crash" window.  Still, I was hoping the white count would come up a little quicker with all this Neupogen.  Fortunately, I don't have any bone pain from the Neupogen yet.  Maybe it will kick in when the white cell production kicks in.  My hemoglobin was all the way down to 7.2, and I was feeling it.  I thought that would mean two units of blood, but they said only one was ordered.  That made me feel a little better.  My temperature was still elevated at 99.4 (so I still have this unexplained fever), and when they first checked my heart rate it was 150.  They waited about 10 minutes and checked it again, and it came to around 130.  I think it got up to 150 because I had just walked from the wheelchair to the chair in the vitals room.  My mom has been carting me back and forth in a wheelchair since I've been so weak.  My heart rate has since been running around 120-130.  It's normally around 80-85.  This could be because I needed blood, or it could be a side effect of the Neupogen.

I finished getting my blood transfusion around six, and I do feel much better.  I guess one unit of blood after 4 rounds of chemo isn't much to complain about.  Some people need multiple blood transfusions.  I hope I'm not one of them.  The effects of chemo are somewhat cumulative, so it's to be expected that my counts would drop lower this time around than they have before.  Now I'm just hoping and praying I won't need to get any more blood.  I'm not really worried about the safety of the blood, but it is unsettling to watch it going into your body.

It turns out, I'm not O negative.  I'm actually O positive.  Either the blood mobile told me wrong several years ago, or I remembered wrong.  My dad is O+ and my mom is A+, so we thought it odd to begin with that I was negative.  It's definitely possible because my brother is A-, but to have two children without the Rh factor would be unlikely.  We just thought we were weird for all these years.  Turns out, we're not weird at all.  I was awfully nervous when the nurse showed up with O+, but she said she looked through my files and I'd been typed and screened several times throughout my lab work here.  So it's official, I'm O positive.  For all you O negative folks that offered to donate for me, thank you very much.  Sorry I led you astray.  My dad, mother-in-law, and possibly hubby are O+.  I must now relinquish my title as the universal donor.

Hope everyone is having a great Saturday.  Have a blessed Lord's Day tomorrow.

Fever Update

As of midnight, my temp was 98.6.  It has been around 99.0 all day today.  I talked to the nurse practitioner at the stem cell clinic, and she wasn't concerned.  If I have any symptoms or if the temperature gets up to 100.5 it's off to the doctor or the ER.

I'm scheduled to have labs drawn at 9:45 tomorrow and then will get the results from a nurse around 10.  The results of that will determine whether or not I get a blood transfusion.  If I must, I must, but we are sure praying that I won't need it.  If I don't get blood, we may go home for the weekend and come back Sunday evening.  That would be really nice.

Things are going okay otherwise.  I'm very tired, and my appetite isn't great.  That is all to be expected at this point in the post chemo cycle.  Mom and I took a trip to Target today for some supplies, and I just waited in the car and read.  It was nice to get out of the hotel room for a while and sit in the sun.

Thanks to all of you for praying :)

Got a Fever

I'm running a low grade fever now, 99.6.  If it gets to 100.5 or higher, I have to go to the ER.  I'm not having any symptoms of being sick.  I read online that one of the side effects of high doses of Neupogen is increased body temperature, so I'm hoping that's all it is.  Please pray I'm not getting sick 1) because I don't have much in the way of white cells to fight infection right now, 2) so there will be no delays with this stem cell process.  Thanks to everyone for checking the blog and being so faithful to pray.

Labs Today

I had my routine lab work today.  My red count is low, but not critical.  But, with the stem cell harvesting, they will give me a blood transfusion if my hemoglobin gets below 8 in order to keep me from going into the "harvesting" low.  It was 8 today.  They are going to check again on Saturday.  If it's lower than 8, I will get one unit of blood.  If it's 7.5 or lower, I'll get 2.  Normally, they would not transfuse until I was 7.5 or lower as long as I felt okay.  I'm really hoping and praying that I won't need it, but if it must be done, so be it.  Prayers would be appreciated!!