Life goes on

Things are getting better, although very slowly. This is Karri talking again, and everything isn't always positive. I'm on medication round the clock, and trying to learn to eat again because I'm on intravenous nutrition all the time as well. I get very tired by just ordinary moving around, so I guess it sounds like I'm complaining an whining, but I really do feel like things are slowly turning around for the better. What really helps me feel better and brightens my day is when I get comments from all of you - my loved ones. I can't keep up with e-mailing everyone that I want to , so I'd love to hear from any and all of you either through blog comments - or you can still e-mail me as I check that every day. Thank you all for your wonderful support for me - keep it up!

Chemo is a mixed blessing

Karri here talking again about the chemo experience. It's really not all that it's cracked up to be. I felt good on Tuesday, the day of treatment, but it's kind of gone downhill since. I've had a lot of nausea and flu-like symptoms, so needless to say I haven't been doing much! Hopefully these symptoms will subside in the next few days and I should feel OK for the next 3 weeks until chemo resumes. Apparently, it is going to be a huge uphill battle, but then I knew that a long time ago. I want to thank everyone for your wonderful comments and care and concern for me. I love reading all your comments -so keep them coming!

Late Night “Food” Drama

Since Karri came home from the hospital last week, each night we have changed her liquid food sack, the 24 hour TPN (IV infused nutrition) that Karri is receiving. Since none of us have a bit of medical training, it has been a fairly intense process. We have saline syringes and needles and alcohol swabs and all kinds of exciting procedures we have to perform using them. We take the sack with the nutrition mix out of the refrigerator two hours before changing it so that it doesn’t chill her veins when it begins to pump through. We have a $5,000.00 pump that is all programmed to dispense the liquid at the rate that is right for Karri. Before hooking up to the pump and connecting the tubing to Karri’s IV port line, we add a small amount of insulin as well as various multivitamins and an antacid to the mix. We have to draw it up out of vials into the syringes – we are beginning to look pretty darn professional after just a few days! Nonetheless, the learning curve has been somewhat steep and we have had a few surprises, such as when we learned that we had accidentally added 10 times the right amount of insulin one evening. Happily we learned that before we hooked it up to Karri! That bag went out to the garbage and we prepared another.

Last night we had the sack of liquid all prepared, and we started to flush the line into her port with saline solution. They have us do that each time to be sure the line is clear. The saline didn’t inject as easily as we had remembered from previous evenings, but it did all infuse into the port line and so we hooked up the TPN from the pump to the port line and pushed “run” to start. A moment later Karri looked down to see that rather than having the milky liquid infuse into her port, she had blood from her port running down the line toward the TPN sack. PANIC! Everyone had the presence of mind to clamp off the tubing at each end of the line and then we looked at one another and at the blood caught in the tubing and wondered what on earth we were going to do. Of course we immediately called the 800 number help line, but it was already about 9:20 and Karri was already tired and feeling quite a bit of nausea and pain from chemo, which had arrived, just as promised, on the second day after.

To make a long story short, we finally had two nurses arrive at 11:25 to take care of the problem. It was a little surreal sitting around looking at all the paraphernalia and not having the slightest idea what had gone wrong, particularly as the hours ticked away. First they tried to talk us through ‘trouble-shooting’ on the phone, but we ran into a road block when we couldn’t detach the tubing from the port line as instructed. We all tried and it was stuck tight with some clotted blood. We felt rather sheepish that we couldn’t detach it as instructed, but when the nurses couldn’t do it either, we felt somewhat relieved that we hadn’t screwed it up through general incompetence. In the wee hours of the morning, they ended up changing the needle input on her port line before they were able to hook up the TPN – somehow it had become blocked. The nurses were wonderful, but we felt a little shell shocked. We couldn’t even remember anyone telling us that such a thing was a possibility we might run into. They change the needle routinely once a week and we assumed it would just run like clockwork in the interim. For some reason, this needle decided to quit working early, which is what we felt like doing ourselves. A bit bleary eyed and a bit giddy from the late hours and the drama of seeing Karri’s blood coming down the line, we all fell into bed about 1am. Although Karri still felt a lot of nausea, she and all of us slept deeply (the sleep of exhaustion, I suppose), leaving tomorrow to take care of itself, knowing only what we have so far learned in this cancer journey - we can't predict what it will bring.

1st Chemo down, 5 more to go!

This is Karri talking again, coming to you one day after my first chemo treatment. I have to say that it really wasn't that bad - I just made myself literally sick with worry the night before. It lasted about 4 hours of sitting in a big easy chair and having drugs pumped into me via an IV "port" that I have on my chest. It didn't hurt, and I passed the time by watching a movie on a portable DVD player (thanks to my niece Jenna) or by falling asleep. My darling husband Jerry stayed there with me the entire time to comfort me as he has so often done during this whole process. I did get a little bit nauseated during the chemo infusion and the nausea stayed with me all evening long. However, it is now the next day and I am feeling much better than before, so hopefully it will be a trend that I will continue to feel better and better all the time! One of the most immediate effects we've all noticed is the reduction of fluid in my legs, feet, and abdomen. We had been told this might happen and we are thrilled that it seems to have. We are crossing our fingers that it doesn't come back. One can only hope! One of the things about cancer is that you never know what you're going to get from one day to the next, so hope and prayers are about all we have.

A New Meaning of Enduring Through Faith

As I (Kim, Karri's sister) write this posting, Karri is undergoing her first chemotherapy treatment. Due to the nature of the drugs she is being treated with, it will be a long infusion time - at least four hours, and we'll post a blog entry later today to update you on how that went. But in the meantime I wanted to pay tribute to how Karri has endured and continues to endure a very challenging situation with dignity, grace, humor, and perseverance -- all based in an awe-inspiring faith commitment. Many of the so-called side effects of chemotherapy have already been making Karri's life miserable for well over a month. To see her handle this situation with unwavering faith and acceptance and stoicism is almost beyond our ability to comprehend. All of the qualities that I have always admired in Karri, including her incisive ability to size up the heart of the situation and respond with intelligence and compassion have been on exemplary display in this time period when she might just as easily have chosen to respond otherwise with self absorption and self pity. With gentle but witty irony she has met hellish developments head on, commenting wryly at each new turn, 'There is a new evil in my life,' and then tackling it. Enduring physical suffering in a way that defies our experience, always with a gritty determination not to let it get the best of her, she has been courageous and uncomplaining. Her caregivers, both family and professional have all been moved by her gratitude to them for their help and her cooperation as a patient, even in the hospital when separation from her family was an agony for her beyond all the physical suffering put together. During a family priesthood blessing last night Karri typically focused on the few silver linings that can be wrung from the hardest experience of her life, expressing gratitude for and to her family and for all the prayers from all of her many friends at church and school and in every area of her life. We love and appreciate all of you for your support, which continues to be very sustaining to her and to each of us as we struggle forward without knowing exactly what to expect at each new turning in the road.

Many, Many Thank-Yous

This is actually Karri talking now. I just wanted to say a million thanks to a lot of special people who have been so kind to my family and I. I won't name names because I'd probably leave someone out, but you all know who you are - who have made meals for our family,helped take care of my children, come to visit me or sent me cards or just called to see how I am. And what an amazing surprise it was to come home from the hospital and find such a beautiful quilt made just for me by some very special people. Thank you again, I know you all spent many hours of hard work and it turned out so lovely! I feel so special to have one of the famous quilts! Thanks again to everybody for helping us out in our time of need. I still appreciate all your good wishes, prayers and love as I begin Chemo this week. Love, Karri and The Robisons

Yippee, She's Home

This is the long awaited day. Karri is home with us again. We never dreamed she would spent 15 more days in the hospital. But we are so grateful to have her home with us. She also is happy to be here and content to sit in the recliner and just be with us.
We have all learned patience through this ordeal. We have also learned to be conscious of what is really important in our lives. This is by no means the end of the story. I still can't see the light at the end of the tunnel. but now I have faith that we will get there. The fasting and praying of Karri's congregation and our family on Monday June 16 was a real eye opener to me. I have never seen the power of the Lord in action as I did that day in Karri's behalf. It was not a good day for her but the next day was great and that's when Karri told me she thought she had "turned the corner." We have seen her improve a little each day. There are still ups and downs but she is moving forward.

Who would ever think that we would be anxious to start chemotherapy. But we are all ready for it because it seems to be the thing that will help her to begin healing at this time. She actually begins her chemo on Tuesday, June 24. PLease join us in praying for her again and always. Tune in late for more details.....Myrth- Mom

"I Feel Like I've Turned a Corner"

Dear friends,
With extremely grateful hearts we thank all those of you whose fasted on Karri's behalf yesterday. It was a very hard day for her - possibly one of her worst days since re-entering the hospital and she had a great deal of pain and nausea. As a result she was on a lot of medication and seemed somewhat discouraged at being caught in this same cycle yet again. Late in the day, however, she had another procedure to tap the abdominal fluid, or "ascites," as we've learned it is called. As it builds up it puts pressure on her internal organs, causing difficulty in breathing, discomfort, nausea, and back pain. She was able to talk with Jerry and the kids for a few minutes after they removed another 3 liters of liquid, and she even made a joke or two. This morning she was still in great pain, but the nausea had subsided and she was steadily more alert and interactive as the day progressed. She worked for a bit on a crossword puzzle with Myrth, surprised one of her doctors with a joke, and ate a few small bites several times throughout the day. (Up 'til now she has only been able to eat minuscule amounts of liquid food at most once a day.) In the mid-afternoon she told Myrth she felt like perhaps she had turned a corner, and our observations confirm this. We will continue to hope that each day brings additional recovery, but we have learned that good days can be followed by bad days, and that the ascites will continue to overflow her vascular system and cause distension, swelling, and severe discomfort for some time to come.

However, the medical team has agreed that if her signs of infection continue to abate she can come home on Friday for the weekend and begin chemotherapy as an outpatient early next week. Who knew we'd be so thrilled with this possibility, but after all that she has been through, chemo sounds like a step up! She will come home with a couple of medical attachments for the continued healing of her incision wounds, and for the administration of her IV nutrition. Claude, Myrth, Kim and Jerry have all been trained in how to properly administer this and we will have home care nurses checking up on her. The medical team hope and believe that chemo will bring relief to her nausea through severely curtailing the ability of the cancer cells to produce the 'ascites' as well aiding her body to recover its ability to properly absorb some of the excess fluid. Our prayers at this point are that she will be able to begin chemo as currently scheduled and that it will bring the hoped for results.

Thoughts from Mom

Thoughts from Mom,
People are always asking me these days how I am doing. My first response is that I doing just fine, then I remember with a heavy heart that I am not doing fine, that my world has been turned upside down and that I am in a tunnel and I can’t see the light at the end of the tunnel. That is pretty much where Claude and I are.
Yesterday, Sunday, was a good day. At church I was able to renew my spirit, and try to put things in proper perspective. I know in my heart of hearts that in this life we will not be called upon to endure a burden that we cannot bear. So the problem for me is how to prepare myself to bear this burden in order to be be of help and service to Karri and her family. That is what I am working towards.
In our family we have “circled the wagons.” We all trying to make sense of this disaster that has struck us and trying to find a way to deal with it. At first when Karri was home it was pretty simple,: watch over her, love her, watch movies with her, do crossword puzzles with her and hope that she was healing. That didn’t work.
Currently we are taking turns being at the hospital with her during the day. Kim, Claude, Jerry and I take turns so she won’t be alone. This last weekend we took the family to Benihana’s to celebrate Kenny and Jordan’s High School graduation. Her oldest son Brandon took over for us since he is highly allergic to shellfish, even just the odor and steam from the cooking.
We wash her hair, sit with her, make smoothies for her, try to encourage her to eat , watch her sleep which she does a lot due to her heavy medications for pain and nausea, and do crossword puzzles which she requests. It is her way of staying alert which she wants so badly to do. Karri is a fighter and right now she is fighting to understand her condition and do what she can to help herself. She is sharp and lucid when she is awake and her memory is excellent. Even when she is sleeping and something happens around her she listens and remembers. She doesn’t miss a thing. We are all amazed by her.
At this point the only other thing we can do is pray for her. I have tried to put this in the Lord’s hands. This is hard for me because it means letting go, and it is personal agony for me. But it the only thing left for me to do. Only He knows.

As Jerry says, Karri seems to have hit the 'reverse' lottery. Her drain from the abdominal cavity isn't working very well after the first evening it was placed and so she has fluid buildup with attendant nausea and pain again - thus more meds. This may mean she isn't stable enough to discharge early this week as we had hoped. Her oncologist and the hospital doctors continue to visit her daily to evaluate her condition. She is responding well to antibiotics and the infection seems close to being under control. A more comprehensive update will follow tomorrow after we meet with the discharge planning team.

Friday the 13th brings GOOD news!

As we are learning, things can change rapidly in Karri's world. Today the medical team agreed to try and work for her release early next week with the idea that she can continue to convalesce at home until her chemo start date. They appear to recognize that Karri will thrive emotionally in the home setting and they believe the infection is responding well enough to antibiotics that she can be successfully released with a portable home pump. Her nutritional profile is also improving with all that she has been receiving through IV lines at the hospital this past week and they think she can continue the TPN IV nutrition through an IV line from home as well. So far she is also responding well to the abdominal drain tube they placed yesterday. They have drained over 3 liters of fluid produced by the cancer cells since it was inserted yesterday and they hope that it won't build up so dramatically with this arrangement. If they can keep the fluid down, her nausea and pain should also decrease. Karri is very motivated to make this work if at all possible and so is the entire family. We will meet with the medical planning team at the hospital on Monday morning to learn the routine for her home cares needs beyond that which will be taken care of by home nurses. Keep your fingers crossed for her!

June 11 and 12: We meet the patient advocate

The best development of the past two days was the meeting with RN Pat Gild who will work within the system as Karri's nurse advocate. She will interface with the insurance company, with the hospital, with the doctors, and she will research questions we have about Karri's condition and share it with us. Her services are being paid for by Karri's insurance but she doesn't work for the insurance company. She interviewed Karri, Jerry, Claude and Myrth about Karri's history with her illness, gathering information. She seems to be a very caring person and listened to us patiently as she asked questions. She will have access to the hospital records and we hope she will help us to understand the medical aspects better as the doctors are often too busy to explain things to our satisfaction.

Karri's overall condition is unchanged, and it isn't great. In addition to around the clock medication for unexplained back pain, she has now begun to throw up blood. The doctors are working to figure these things out but there don't appear to be clear cut answers. They suspect that the blood is actually the easier thing to fix and don't appear to be alarmed by it even though it is vile looking. They call it "coffee grounds," if that gives you the idea. The blood is due to the fact that her gastro tract has been so abused and stressed by all she has been through that it is now exhibiting signs of tearing. She is taking strong doses of antacids to combat this and today she had less of it come up than yesterday so we hope that trend will continue. This isn't something you want to happen to you - her teeth and gums and tongue are black as a result. She is brushing vigorously several times a day to try to keep it under control. The doctors have also come up with a temporary solution to the problem of the abdominal fluid production and they hope it will relieve some of her nausea and pain - they have inserted a tube that will allow the nurses to drain off the fluid as it is produced. The tube was inserted this evening and immediately drained off close to a half gallon of fluid. They continue to culture it and have ruled out liver or gall bladder issues as well as bowel damage. They continue to believe it is caused by the production of the cancer cells. Dr. Edraki also finally opened up Karri's wound packing and drained an abscess that has been contributing to the infection. We are relieved this has been done but wish he had done so much earlier, and we hope there are no more pockets of infected fluid in the wound areas. He indicated that no further surgery is anticipated, for which we are all grateful.

We hope that Karri's condition will continue to improve over the next few days and that they can begin chemo as scheduled within the next 10 days. We'll try to document her daily routine in the next post. She remains plucky and determined despite the fact that she is quite exhausted and weakened by all of these medical complications and from taking the regime of medications needed to treat them all.

May 30, 2008 - June 10, 2008

June 10 - Continued pain, increased nausea, no answers yet

Today the infectious disease doctor told Karri he had reviewed the CAT scan they took last Thursday night when she was admitted and that he found quite a bit of inflammation all along the deep tissue in the open draining areas, particularly those that go quite deep. He confirmed his previous opinion that she didn’t get a long enough course of antibiotics last time in the hospital. After another 10 days of IV antibiotics, he says that her surgeon will need to re-culture these deep openings for infection and decide if oral pills are a necessary follow up. In general he is satisfied with the way the infection is responding – fever continues to be down and white blood cell count is back to normal. Incision area does not look inflamed along the surface.

The internal medicine doctor from the hospital next visited Karri. He does not recommend that she go home while she is taking the IV antibiotics for the next 10 days. Perhaps the doctor who will be making rounds for the next five days will evaluate it differently but he thinks she is not well enough to go home at this point. He is concerned that there may be too much variability of care with the home nurses for her condition at this point.

The two most critical things that have to happen for her to begin chemo as scheduled are:

1) Wound healing (clearing up infection) and 2) Good nutrition – and she isn’t getting enough. She is only getting about 1000 calories and she needs at least 2000 to be able to tolerate chemo. They will reluctantly begin supplementing with IV nutrients (TPN) because she needs to get stronger before going home. She is doing a great job at trying to eat and she should continue to get as much food nutrition as she can – this is just a boost until she is strong enough to get all she needs on her own.

The doctors have explained that the cancer cells remaining in Karri's body continue to put the fluid that is collecting in her abdomen. They have twice drained it off since she came into the hospital. The first time they collected a ½ gallon, and the second time half that much. The good news is that it isn't infected. However, the massive quantities of fluid she has been retaining are probably contributing both to the choking reflex she often has when eating or taking her meds orally as well as to her nausea because all of her internal organs (stomach, intestines etc.) are being squeezed out. The cancer cells will continue to produce fluid until chemo is started. She will begin to receive the TPN IV nutrition around the clock beginning at 8pm this evening.

Karri DOES NOT WANT TO STAY 10 MORE DAYS. She wants to come home! She is hoping that she can talk Dr. Sherman into supporting her in going home sooner. In the afternoon while waiting for him to come she was alert enough to eat some cottage cheese and fruit and work on a crossword puzzle with Myrth. Around 5:30 pm, however, she lost some of her lunch, as she tends to do at least once a day.

After that, her oncologist Dr. Sherman visited and asked Karri what are her major concerns. She said that she was most concerned with the increasing back pain and the possibility of having to stay in the hospital 10 more days.

His responses:

1) The pain we will handle with increasing medication and dosage. We don’t want to see you in pain. And we want to handle it as it rises, we don’t want it to get out of control. I’ll cut the necessary orders.

2) You have skilled nursing needs. You can’t get that at home right now. Home is not the goal. The goal is making you better – well enough that you don’t have to come back to the hospital. What does that look like? Nutritionally it means you have to be eating, drinking and having bowel movements like a normal person in order to tolerate chemo. We need to address the nausea and vomiting. We are going to try to do this with supplemental nutrition. In terms of antibiotics and your infection, you would need to have your order changed to accommodate a once a day home IV nurse in order to be able to come home, and I’m not sure if that is possible. Right now you are on a three times a day IV drip and that can’t be done at home.

He then went off to a consult with the other doctors to see if it was feasible to get Karri home sooner or not. Shortly after he left, Karri’s pain began to rise alarmingly as a result, she thought of the fluid drainage procedure the day before. It was much worse than it had been all day when she has been saying it was at a 4/5 level. Now it was an 8/9 but the doctor hadn’t cut the orders for more pain med before he headed down to the meeting. Karri endured excruciating pain for 30 minutes (sitting/pacing/trying to focus and meditate/deep breathing) while Kim, Kim and Jerry watched helplessly and the nurses paged all the doctors. Finally Dr. Sherman responded with a four fold increase in her pain med and 40 minutes after it began, she got some relief and conked out. The newest development is that Karri’s blood sugar is up and it needs to be regulated with insulin in order to start the supplemental nutrition. It will be checked every six hours for the next few days and she will receive regular insulin shots in the arm. Before Dr. Sherman left he ordered a CAT scan to see why the pain is so bad. It shouldn’t be that bad simply as a result of the fluid draining procedure. Jerry went down with her and then saw her safely off to sleep before heading home for the night. We hope tomorrow for results that shed some light and provide Karri with the opportunity for some relief.

While Karri was waiting for the CAT scan, Dr. Edraki, her surgeon paid her and Jerry a visit and expressed concern at Karri’s condition, particularly at her swollen and distended abdomen. He hopes that the CAT scan will not reveal anything that requires additional surgery but he fears that it may. We hope that will not prove to be the case as we cannot imagine how Karri can put up with that at this point.

June 9

The potential discharge plan didn’t work. Karri had a very tough night without the meds and threw up this morning. They recognize that she can’t be taken off the meds yet – and they aren’t comfortable releasing her from the hospital until they figure out how to best control the pain, which is essential to fighting the infection and to the continued healing of the wound. On the bright side, the wound care nurses today said the wounds were looking great – no redness or visible signs of infection. Also, Karri is feeling less nausea and seems able to eat more. And the doctors all seem to be working together to help address the entire complex range of issues she must get past in order to get healthy enough to begin her course of chemo, hopefully within the next couple of weeks. Her oncologist says he thinks that she’ll be in good enough shape to look ahead to chemo in another 10 days or so. Meanwhile they drained more fluid from her abdomen today with another LARGE needle. Ouch! Although we are all very sad that Karri couldn’t be released to be at Jordan’s graduation, she clearly needed to remain in the hospital and get stabilized. Kim and Kim stayed with her at the hospital during graduation and watched it with her live on Concord TV. She showed great determination to stay alert and enjoy the graduation as best she could, giving a running commentary about the kids who spoke and performed. We are all raised a huge cheer for Jordan as he crossed the stage, as well as for his cousin Kenny. After being up in a chair for the two hour program, Karri was exhausted and happily took her meds and went off to sleep.

June 8 - An old/new infection

Today the doctors told Karri they had isolated the infection. The fluid they collected from her abdomen is not growing bacteria however it is causing discomfort and a distended abdomen. The cultures they took from the wound sites do show infection, particularly the two deep ones that are continuing to drain a great deal. They are changing antibiotics now that they know exactly what the infection is, although the antibiotics they are giving her at least controlling the fever. They want to give her a longer course of treatment as this infection is related to the previous one, which they believe was never cured. Given her very compromised health condition in the past few weeks, we don’t dispute that at all. They want to knock it out this time for sure. It will be at least two weeks of IV antibiotics, although they hope not to keep Karri in the hospital the entire time. They hope to send her home with a portable IV. Karri says the nausea is under better control now so they are going to try and cut back on meds tonight to see if she has better energy and can go to Jordan’s graduation tomorrow.

June 6 - A mostly miserable month

Today it has been one month since her surgery and Karri is very unhappy about being in the hospital and very uncomfortable. The CAT scan did not reveal any pus pocket of infection in the abdomen but it did reveal a large collection of fluid that is not being drained by the wound vac. The white blood cell count from the blood tests DID reveal a probable infection, although no one was sure yet where it was. In a phone consult at 2am with Dr. Sherman, they decided to admit Karri and begin IV antibiotics. By 5am she was in a very nice room in the oncology ward and Jerry was, once again, on his way home for a few hours sleep before tackling a busy Friday.

She is also on IV for pain and nausea, as well as receiving potassium and various other fluids. The doctors have told her they will need 48 hours to culture the various samples to see where the infection is. She doesn’t want to stay in the hospital and she is particularly anxious to be discharged in time for Jordan’s high school graduation on Monday June 9^th. The doctors assure her they will try to make it happen if possible. She was visited daily throughout the weekend by Dr. Sherman, by the oncology ward doctor at the hospital and by the hospital infectious disease specialist. This is a good deal more attention than she received while in the Walnut Creek campus two weeks earlier and we are cautiously optimistic that this medical team will help her gain some ground. They have drained half a gallon of fluid from her abdomen! The problem is that they inserted a HUGE needle to do so and so that causes Karri additional pain. She is very groggy from all the meds and doses on and off both day and night. She isn’t awake long enough to eat much but when she does eat, she wants the fruit/protein smoothies that Claude and Kim concoct at home and bring to her in the hospital. A good choice given the alternative of hospital food! She is too weak from fighting the infection and from the other complications (suppressed appetite from wound recovery, production of cancer cells etc.) to care much – she just wants to feel better – she has tried so hard for so long to get on top of the nausea and pain and lethargy.

June 5 -- Back in the hospital again

Late this evening, Karri was admitted to hospital again. On the advice of the womb care nurse, we had begun to track Karri’s temperature. In the evening her temperature began to rise. At about 6:00 pm, it was 101.4 and we called Dr. Sherman’s office. He advised us to go the hospital ER at the Concord campus to ask for a CAT scan of her abdomen, which had been causing her considerable discomfort all week. Since the last hospital visit had been such a bust, Karri did not want to go back again. However, Dr. Sherman told us that he thought her infection was not resolved and that the CAT scan would help locate the infection if it was inside the abdomen. Since we had a good deal of confidence in Dr. Sherman, we encouraged Karri to take his advice. When her temperature rose to 102.4, she groaned and agreed to be admitted. Her temperature when we arrived at the hospital at 7:30 pm was 102.5. They quickly gave her 975 grams of Tylenol to begin to bring it down and gave her priority admittance. Within 30 minutes we had a bed in ER and a doctor taking her history shortly thereafter. Although we were discouraged to be looking at another hospital stay, we got a much better response time in the Concord ER, which was something to be cheerful about, unless you were Karri, who was very restless and feeling very uncomfortable. Fortunately, they were also able to use the port for some of the IV lines they put into Karri; however, for the CAT scan, they had to use veins in her arm or hand and there were a couple of false starts until they got a line in. She has been poked so much lately there just aren’t good places to poke.

June 4

Dr. Edraki opened up all four of the drainage holes and said they all looked good. He trimmed dead cells from a couple of them and cleaned the newer ones, saying the drainage looked pretty good and he didn’t think there was any infection. He told us that the most important danger to Karri’s health was not the chance of infection but any delay in the beginning of chemotherapy and advised an immediate start. He wasn’t yet ready to close any of the wounds, and in fact, opened up a fourth site that was collecting fluid under the skin. He told Karri to come in again in a week and he would see then if any of the sites were ready to close. That afternoon the case manager of the home care nurses came and dressed the wounds. She felt that the wounds needed to be cultured for infection and encouraged us to track Karri’s food intake and other vital signs daily.

June 3 - Permanent IV (Port) Placed

Despite the fact that Karri was not feeling at all well – in addition to the ongoing nausea, she had begun to suffer discomfort in the entire region of her abdomen and had trouble walking, showering, eating, sitting up for long periods -- Dr. Edraki felt that the permanent IV device (Port) should be placed on schedule. It was an exhausting day with blood work in the morning and a long wait beyond her scheduled 3:30 surgery time. We had left messages for Dr. Edraki about the fact that Karri wasn’t feeling well, but he was in surgery and apparently didn’t get them. When he finally came out to see us about 5:30, he promised to check on Karri’s condition before deciding whether or not to place the port. He came out at 7:00 pm and said the procedure had gone well and he would evaluate Karri’s overall condition in his office the next day. Sometime after 8:30 Karri was finally allowed to come out of recovery, drink some juice, and go home. We have already begun using the port and it has worked like a charm. It has been so helpful to Karri during this most recent hospitalization. We are happy that Dr. Edraki did place it on schedule.

May 30
Karri met with Dr. Sherman, the medical oncologist who would be in charge of her chemotherapy. He was extremely warm and personable and told Karri that he would be available to her around the clock (24/7). Tentative plans were made for a pre-chemo consult with his Physician’s Assistant the following week to outline the course of the chemo, which he did not want to begin until Karri was more recovered from the complications from her surgery. He told Karri that although she would lose her hair and be very exhausted as a result of chemo, she should not suffer nausea because they had some greatly improved drugs to treat it these days. Karri would be receiving chemotherapy in three week increments, but he assured her that it could be scheduled around our planned summer vacation to Hermosa Beach and the family plans to take Jordan up to BYU-Idaho at the end of the summer.