Month: May 2023

30 May 2023

The good news just keeps on coming! I had an appointment with my ophthalmologist today. You know the routine. They have you stare into all these machines to take photographs of your retinas, then you go to the machine from hell that checks your peripheral vision, and then of course the dilations. I was waiting for the D.O. to come in when my newish (Nov 2022) Maui Jim glasses fell apart in my hands. That’s the second time that has happened. The first time it happened was a few weeks after I purchased them, and they are not inexpensive glasses. The clinician said they are really strong glasses and hole up better than most. The clinician thought the lens had broken but the D.O. said no. He repaired them on site so that was just a minor stress point.

The larger stress came when I informed him of my breast cancer diagnosis and mentioned I started chemo on June 5th. He then proceeded to tell me that chemo would probably speed up my cataract development. I’m well on my way to need cataract surgery anyway – a year or two in the future – now it seems like it may occur sooner than that.

When I mentioned I would be on tamoxifen for five years, he said that would very possibly lead to retinopathy. The what-if scenarios include loss of color vision and central vision. If severe, it could lead to blindness. Chemotherapy is targeted at dividing cells which include many cells of the body that need to replenish, like corneal epithelia. Maybe cornea transplants are in the future.

I realize this sounds like gloom and doom but the reality is that most of this will probably never happen.

What is with my credit union? Last week I received a check from my flood insurance company and I wanted to deposit it into my savings account. Since the check was a rather large sum, I didn’t want to rely on the U.S. Postal Service so I drove to the nearest branch of the credit union and stood in line – and stood in line – and stood in line. When I finally reached the teller, the first question was “What is this?” Although the check distinctly stated it was a check for flood damage, he looked at it for a long while and said he would be back.

He then walked into one of the managers’ offices and they conversed for a few minutes. He then returned, processed the check into my savings account and asked me to check the amount on the receipt. I did. It didn’t show the cents. I pointed that out and he said the paper was not adjusted correctly and it cut that part off.

Today I left the ophthalmologist and drove directly to the credit union to deposit a second check from the same company. Exactly the same thing happened. The line, the asking about the check, the consultation with the manager, and the processing of the check. It seems the credit union doesn’t bother with cents and did not include that on my receipt. It wasn’t the misaligned paper in their printer.

I could understand if it was a third party check or some such nonsense but why the problem with a check made out directly to me and going into my savings account? I don’t understand banking, I guess.

I asked my contractor when he would start contracting and he texted me that it would probably be tomorrow. I’ll reserve judgement on that text until tomorrow.

Anyone have any suggestions as to what to take to my first chemo session? It will last around six hours. I’ll take my iPad and charger, ear buds and maybe some crossword puzzles. I can take food and I was thinking sandwiches, bottled water, and cookies. Can anyone suggest anything else?

Stay tuned!

28 May 2023

I cheated by two hours. I was told I could remove the bandage over the port incision after 3 days. It also meant I could take a shower! I have to admit the bath wipes did an excellent job of making me feel clean but it’s hard to beat a shower. I can wash the area with soap and water but must pat dry the area around the incision.

I still have the steristrips attached and I have to leave them on until they fall off on their own accord. There are three or four internal stitches but they dissolve in a couple of weeks. The redness you see is the antiseptic they wipe you down with prior to surgery. Actually, they wiped me down twice. Once and then let it dry and then a second time and let that dry. It didn’t come off in the shower and I suspect it’ll take quite a few more showers to get rid of the stain. By then I”ll probably have been through my first infusion.

The site is still tender and sore but with the bandage off, there’s less pull and push on the area. They say to put another bandage on if it begins to seep but so far, it’s be OK.

Who knew that in short order I would have a breast biopsy and port implant. Things can certainly change quickly in life.

Today was the first day I’ve driven the jeep. I headed to Whole Foods for some weekly grocery shopping. I was not allowed to drive for the first 24 hours but I was still in a brain fog for a few days after and I really didn’t need to go anywhere, anyway, so I stayed home.

Tonight is hamburgers with John, Joel and Keith. I should be able to get them grilled in between rain storms. It’s pretty much rained every day this week and sometimes accompanied by pretty severe lightning.

As of now, I’ve received two checks from my flood insurance. Now all I need is the contractor to show up to do the work. Fingers crossed!

Stay tuned!

27 May 2023

The port implant finally allowed me to get some sleep on my right side last night. It wasn’t exactly a bed of roses but if I positioned myself exactly right, I didn’t feel any tugging or stretching on the area of the port. I still seem to getting plenty of sleep but that will probably start with the chemotherapy so I better get it while I can.

My friends keep checking on me. It’s a good feeling. John, Joel and Keith are coming over tomorrow night. John is buying the burgers, buns, etc. and Joel and Keith are bringing a salad. On Memorial Day, Nancy and Michel are having me over for dinner. Tom is taking me for my first chemotherapy. John will come over and spend the night the night of my first chemo. Everyone is pitching in and trying to help out.

I was warned about one thing. For anyone staying over or visiting, when I use the toilet, I’ll have to flush two times. It’s to prevent someone from coming into contact with the drugs from chemo. There’s a couple of things that stand out about that. First, how drastic are the drugs that they don’t won’t people to come in contact with them on a casual basis? I’ve been told I have to drink copious amounts of water to flush the drugs from my system and they say I’ll be spending a lot of time in the bathroom.

A second more concerning thing is considering the number of people in Broward County undergoing chemotherapy, how much of this stuff is being flushed down the sewer and then treated and either pumped back into the ground or discharged into the ocean? Remember, one way of tracing Covid-19 was testing sewer water of cities.

On a more cheerful note, I felt like doing a light cleaning of the house today and doing laundry. (Saturday is house cleaning day and laundry day). I still have to be careful not to put too much stress on the stitches, but I managed to put clean sheets on the bed and wash two loads of laundry as well as clean – a little bit.

I also finally finished identifying the majority of the plant photos I took on this trip. I took 504 photos and 31 videos while on the trip and, as usual, most of the photos are of plants. It’s not that I don’t like scenery, I just like finding plants better.

I identified 60 plant photos in three areas: Franklin Falls, Twin Falls, and Snoqualmie Falls. Of those 60, 20 were first time finds for me. I keep a spread sheet of all the plants I identify in all the different locations. Although there are numerous plants that are of the same species, I record them if they are in different locations of the country. I’ve recorded 1,924 species since my travels beginning in 2011 from 100 different locations. Add to that 672 species from Tishomingo State Park for my masters thesis and I’ve logged 2,596 species of plants for my lifetime list.

What has made life much easier for me, as I get older and forget most of my taxonomy has been my iPhone. The newer versions allow you to photograph a plant and click on the small “I” icon for information on the photo and it’ll list a plant option if it recognizes the plant. Click that option and it’ll “name” the plant for you. This past trip was the first time I used that option to any extent (thanks for letting me know, Jimmie!) and I found it to be amazingly accurate. There were only about 10 times the entire time that I doubted the name produced by Apple. I suspect that it is Artificial Intelligence in action.

Once I returned home, I broke out my Flora of North America, the online The Plant List, and the online Biota of North America Project to confirm the identifications. Also, don’t discount using the search engine Google and using their “images” option.

I intend, when time permits, to upload photos of the trip and plants of the trip on my website at http://fsearcy.com.

Stay tuned!

26 May 2023

A few days ago, my friend Barbara (Barbara I) texted and asked if I would like some take out from Jalisco’s, a local Mexican food place, the day of my port insertion, and if so, she would drop it off, or if I felt like it, join me for dinner. I texted back that was a great idea and would love to have her join me for dinner.

Between the procedure and the fentanyl, I didn’t remember after the procedure that she was coming over. She must have been psychic because she texted me again around 3 pm on the day of the procedure asking me what I wanted from the restaurant. Thank goodness she did. I looked up the menu online and I mentioned black beans and rice, plantains, and either chicken or pork as an entrée.

Jalisco’s has been in Fort Lauderdale forever. The outside is absolutely nondescript and I don’t think anything has been done to the building or interior prior to my arrival in 1985 nor since that date. The food was always good. It was standard practice to either eat at Jalisco’s first (so you could claim a space in the parking lot) and then go next door to a gay bar and have a beer, dance, etc. It was either that of risk being towed in the back alley and then going to Jalisco’s to rehydrate after all the beer and get a late night meal.

She showed up a little after 5:30 with two large bags of take out. Not only did she get the plantains and black beans and rice, but she got a huge container of chicken soup, their Pollo a la Plancha which is a grilled marinated chicken breast with onions but also their Bistec de Puerco a la Plancha which is their grilled marinated pork with onions. To top it off, she brought an individual serving of flan.

The chicken soup was outstanding. She even brought a special container or rice to add to it. We shared the Pollo a la Plancha (it was enough) along with the plantains. We each had our own serving of black beans and rice. It was delicious and a godsend. She repackaged the soup, rice, black beans and rice and the Bistec de Puerto a la Plancha and that’s my dinner tonight. I was still a little loopy from the anesthesia and I remember having a conversation with her after dinner, but don’t ask me about what.

As I kid, the first sleeping position I remember was on my belly with my head turned right on the pillow and my face to the wall. I shared the bedroom with my brother Archie and don’t believe a word he tells you about the stuffed blue French poodle named Pierre that I slept with. All lies.

When I moved to Fort Lauderdale in 1985, I learned afternoon naps in the summer after my teaching duties were over were a great way to recharge. Forget that my brother and I fought constantly with our mother who made us nap as kids. However, I found that I would drift off to sleep on my back and wake myself snoring. It was about that time I shifted to sleeping on my side.

My preferred position is to sleep on my right side – at least to first doze off. I shift back and forth from right to left and back again all during the night.

When bedtime came, the lidocaine was wearing off and I was worried I wouldn’t get any sleep. That wasn’t the problem. The problem was I couldn’t lie on my right side (the side of the port). I suspect that problem will go away once the port incisions heal but it was uncomfortable enough I had to sleep all night long on my left side.

The consequence was once I got up this morning, my entire life side: hips, ribs, shoulder, all ached. It’s still with me.

The ache from the port incisions abated a little today and I may try the right side tonight to give the left side some relief. Who knew major adjustments to the simplest things would have to be made from a little minor surgery?

Around noon my friend Barbra (Barbra II notice the spelling) texted and said she was bringing over some chicken soup (or as she calls it Jewish penicillin – she’s entitled, she’s Jewish, but then so is Barbara I who also called it Jewish penicillin). She had asked me via email several times if she could drop some off and today she was in Fort Lauderdale for a doctor’s appointment, and it was convenient for her. She brought over a huge container of frozen chicken soup with an additional frozen meal. I’m set for a while. I at least remembered most of the conversation with Barbra. I really do have great friends! Especially is their name is Barbara/Barbra!

Today is the first of three days I cannot bathe or shower or get my incisions wet. Fortunately, I have a solution. Over the years, I’ve learned that 90% of the national parks do not have showers for campers. I’ve learned to take “sponge” baths in the sinks of the men’s bathrooms. That gets old when it’s only cold water and the outside temperature is 20°F.

I eventually came across bath wipes sold by REI. I stocked up on them. I do, however, remember going into one particular REI store and asking for them and getting a blank look from the sales person. I did eventually find them on a shelf and went back to tell the person what they were and where to find them in his own store.

Since then, I order them from Amazon.

These things really work well. And since I haven’t camped in a national park in a while, I have a good stock of them in the house.

Amazon delivered two other things for me today. Ensure and Zensa’s Alert skin care cream with lidocaine. The lidocaine cream was a suggestion from a YouTube video of someone who had a port and was undergoing chemotherapy. Even though it is a port, it’s under the skin and you have to pierce the skin every time for infusions or blood draw and it has to be a very large needle. This one person recommended adding a lidocaine numbing cream to the surface of the skin where the port is located just before going in for your infusion and covering it with with Glad Press’nSeal to keep it from being rubbed off by clothing. When I got the port inserted and was in recovery, either Rosemary or Monique suggested the same thing so I’m going with it.

That process is remarkably like the bandage I have on now.

The RN for medical hematology told me during the chemotherapy consultation to try either Ensure or Boost or some such product. She didn’t specifically say I would lose my appetite after chemo but strongly suggested I lay in a store of the ones with the maximum amount of proteins. This makes since because the drugs attack the surface proteins of cells.

I did not realize there were so many varieties of this supplements. There are some that are for diabetics, some for those people who have gluten allergies, and this particular one was recommended for people undergoing cancer treatments. I could have gone with either Ensure, Boost or several other companies, but I liked the flavors offered with Ensure. I got creamy peach, French vanilla, strawberry, milk chocolate, mocha, and cherry cheesecake.

Part of the suggestion was that food would taste different after chemo and that I needed to eat and it was suggested to find what would taste good to me and stick with it and supplement it with an Ensure-like product. I think I’m ready for my first chemotherapy.

Stay tuned!

24 May 2023

The chemotherapy consultation was interesting in a few ways. The RN pretty much read me the information sheets. I could tell she was exhausted and several times she lost her train of through even though the printed information was in front of her.

The long and short of the consultation is the chemotherapy consent form has two outcomes: “Become free of my cancer with the hope that it will not return.” and “Slow the progression of my cancer, relieve my symptoms and help prevent future problems.” Fortunately for me, the first one was prechecked.

As I mentioned in a previous blog, I’ll be infused with four drugs, called the TCHP cocktail: Taxotere, Carboplatin, Transtuzunab (trade name Herceptin – that’s from where the “H”comes, and Perjeta.

The first two, Taxotere and Carboplatin are the heavy hitters and will have a great physical effect on me. Also, Transtuzunab does have a history of causing heart problems, including heart failure, hence the echocardiogram today.

After the first six sessions with the four drugs, I’ll do eight more with only Trastuzunab and Perjeta, both of which are monoclonal antibodies. The idea is monoclonal antibodies are produced in a lab from a specific type of white blood cell and are used to interact with surface antigens of other cells, viruses, etc. In essence, you make a factory out of white blood cell to manufacture monoclonals. I used to deal with them when in graduate school at the University of Mississippi Medical Center when I would attach fluorescein dye to the surface of catfish white blood cells.

More often than not, the four drugs cause similar side effects from fluid retention with weight gain, swelling of the ankles or abdominal areas, peripheral neuropathy, nausea, diarrhea, mouth sores, hair loss, fatigue and weakness, infection, muscle aches, vomiting, anemia and changes in nails and many others. The lists simply go on and on about the side effects.

All four cause diarrhea but in one case, a side effect on one of the drugs is also constipation. What the left hand gives away, the right hand takes.

Side effects are reported in terms of (1) common in 30% or more of the population and (2) common in less that 30% of the population. Additionally, the side effects are broken down into categories of (1) you should expect these side effects (2) you should notify your doctor when you have time with these side effects and (3) you should go immediately to the emergency room if you experience this.

Taxotere, in particular, has greater than 30% lowering of white blood cells (increases my risk of infection) and low red blood cells (anemia). According to the info sheet, I should have this effect 5-9 days after infusion and should recover in 21 days (just in time for another infusion).

Several of the drugs can cause allergic reactions and all allergenic reactions should send me to the emergency room.

The “falls into to notify your doctor” category for Taxotere is fever of 100.4°F or higher and/or chills, vomiting more than 4-5 times in a 24 hour period, or diarrhea of 4-6 episodes in a 24 hour period. There are a lot more but you get the gist. Oh yeah, I should definitely not try to get pregnant but that’s not gonna happen because I’ll be impotent during treatments.

Several of these drugs affect the liver and kidneys and they will do a blood test before each infusion to see if I’m OK to do the infusion. They’ll also monitor my blood for levels of K⁺and Mg⁺⁺.

For absolutely anything that goes wrong: mouth sores, diarrhea, infections, etc., they have a pill for it. Before each infusion they will give me anti-nausea medications and then after the infusion I’m to take the two prescribed anti-nausea medications every four hours on a rotating basis.

After the consultation I was waiting around for my 1:45 pm appointment for the echocardiogram. I kept getting phone calls during the consultation (I had my phone on vibrate) and when I checked who called, it was Holy Cross. The echocardiogram specialist had a cancellation and wanted to know if I was nearby. Yes, I was sitting outside the main entrance of the hospital. I was called in a little after 1 pm and was finished by my appointment time of 1:45. She kept asking me if I had an echocardiogram before and I kept saying no but when she started the procedure I realized I did have one in 1985.

While teaching at Itawamba Junior College (now Itawamba Community College), I was diagnosed with a prolapsing mitral valve. The main consequence was I had to take penicillin when I had my teeth cleaned. The reason was any bacteria in the mouth could invade the gums when the gums. bled during cleaning.

When I moved to Florida in 1985, I told my physician the diagnosis and he said the only way to confirm a prolapsing mitral valve was to do an echocardiogram. They did and I didn’t – have a prolapsing mitral valve. It was when she started the procedure that I remembered. I guess two echocardiograms in 38 years is not too bad. She mentioned that back in the 80’s that was over-diagnosed (she had been at Holy Cross since the 80’s).

Tomorrow, I go in for the insertion of the port. I asked the Breast Health Navigator if they would put me under with a general anesthetic and she said no, it would be a local. It should take, at most, an hour.

Stay tuned!