May I introduce.... Bruce

Bald is beautiful

Round 2, here we go!

My Dad’s week ‘off’ has come to an end. Being at home was an adjustment at first, but after a few days we were all able to sink into our new roles at the Albert/Moi homestead.

As my Dad cannot eat many fresh fruits or vegetables, Kelly has bought him a Panini maker- a George Foreman type grill. I came into the kitchen one day to find my Dad grilling up a storm:

Jer: “I’m quitting all my jobs, and going to work at Subway”

Me: “Oh yah? And become a sandwich artist?”

Jer: “Yah, I’m going to make sandwiches all day. Look at this one.”

Me: “They are called sandwich artists Dad. How are the lines on your sandwich, are they perfect?”

Jer: “They’re perfect. And yah, I’m going to be an artist.”

After a long pause…

Jer: “Or I’ll work at Starbucks…”

Me: “So you’ll be a barista? You should make me a coffee right now then”

Jer: “Yah, I’d work at Starbucks in the morning, then Subway at night.”

PERFECT plan Dad.

This was absolutely the funniest moment of my week.

Tonight we start round 2 of chemotherapy. Kelly, my Dad and I are going to need the Jer Diddy army to be in full force as we move forward through this next round.

Chemotherapy treatment for patients with AML is divided into 2 phases: induction and consolidation therapy. The goal of induction therapy was to achieve remission by reducing the number of leukemia cells to less the 5% and having normal blood counts. We reached that goal! Go us. The goal of this next round, consolidation therapy is to eliminate any residual undetectable disease and achieve a cure.

With leukemia, even after remission is achieved, leukemic cells are likely to remain in numbers that are too small to be detected. If consolidation therapy is not done, relapse is almost inevitable. Therefore, more chemotherapy is needed to eliminate all the leukemic cells that were undetectable and to prevent a relapse.

My Dad will be receiving a high dose of cytarabine twice a day, every second day for the next week. (Induction therapy was given as a 24 hr drip of cytarabine for 7 days, with the first 3 days getting an extra push of a different chemotherapeutic agent). We will be at the hospital every second day to receive theses treatments, and at home between dosages. Our goal is have papa Jer home as much as possible as it will help prevent infections, boost morale, and keep him active.

Decisions, decisions

As many of you now know, I am currently enrolled in dental hygiene school in Hamilton Ontario. As it turned out, my Dad’s first round of chemo happened to fall during my semester break; allowing me to be in Calgary and provide care and support for him during this time

With the end to my Dad’s first round was in sight, and my semester break coming to a close, I was now faced with a decision; do I go back to Ontario and continue with my last semester, therefore graduating at the end of July; or, do I defer my studies for 6 months and stay in Calgary to continue caring for and supporting my Dad.

The decision to continue with school or to defer has been one of the hardest decisions I've had to make in my adult life. The week leading up to my decision was one filled with family discussions and inner turmoil.

Whether our journey with this disease leads us to a bone marrow transplant, or through multiple rounds of chemo; it doesn’t change the fact that what is happening, is happening now. Yes, I am aware of the possibility that in 6 months when I must return to Ontario to finish my studies, something may be going on with my father. That is a 'what if'. But right now there IS something going on. I can't base my decision on a 'what if' in 6 months from now. I need to base it on the present. There are multiple directions this disease could take us, but 1 thing for sure; the next 6 months is when the majority of the treatments will be happening.

Right now, my Dad is sitting in the corner of the ring, waiting for the referee to signal the beginning of the next round. I want to be the coach in his corner. The coach that never leaves his corner; supporting him, cheering for him, and even picking him up after a hard blow. That is why I have decided to take a temporary leave of absence from my school, allowing me to be in Calgary and act as one of my Dad’s primary caregivers. I will be returning to school in Ontario to complete my last semester in August of this year. At that time, I truly believe my Dad will be in remission.

A message from the Captain

Hi Everyone,

Its been a month (as of yesterday) since I was diagnosed and admitted to the hospital. I have now officially completed my first round of chemo, known as the induction round. Aside from a few complications that are considered common side effects of chemo, and the shock of the diagnosis, I am now feeling much better . This first round went well and was successful in killing the cancer cells. We are moving in the right direction, but we know we still have to fight this battle one day at a time.

To help prevent the cancer from returning, my next round of chemo, known as the consolidation round, will start in 7 to 14 days. We are in discussions with the doctors regarding our future steps: a third round of chemo (another consolidation round) or potentially a stem cell transplant, depending on the availability of a donor match.

I would like to acknowledge and thank everyone who has sent cards, notes, emails and voicemails with messages of support. Through this experience I am learning alot, and that an important tool for recovery is a positive outlook.

All your support, words of encouragement and prayers are helping me maintain a positive attitude. I truly appreciate your messages and want you to know that it does make a difference.

Much to our surprise, we have discovered the hospital is a very busy place and there is little down time. Its a beehive of activity and I am constantly challenged with finding a few hours to sleep, but I have been keeping up with your messages. Fortunately, I have been able to slip away on day passes home over the past two weeks for some needed quiet and relaxation.

I would like to thank Samantha for doing this blog so everyone can be informed as much as possible. As my primary caregivers, Nurse Sam and Nurse Kelly have alot on their plate.

I look forward to talking to you all in the near future.

Jerry

Hi, I'm his daughter

On Thursday at 10:00am the doctors performed a bone marrow aspirate on my Dad. The procedure was actually done at his bedside, so I was able to be with him the entire time. The testing the lab will do on his bone marrow sample will be used to determine if he is in remission. Remission is defined as having a normal complete blood count; less then 5% of cells in the marrow can be blasts (leukemia cells); no signs or symptoms of leukemia in the brain, spinal cord or elsewhere in the body. The doctors received half of the results on Friday, and are awaiting the other half in order to make a definitive decision. I will keep the Jer Diddy army posted.

During the last couple weeks, my Dad has been experiencing pain around his ‘behind’. With no relief in sight, and blood counts now up, the doctors have decided to Sherlock Holmes this matter. On Friday my dad and I were off to an ultrasound appointment to hopefully figure this ‘pain in the ass’ out.

Side note: We’ve been here for a month now, and I still get, “and you are…..?” HIS DAUGHTER (not his gold digging 25 year old girlfriend, creeps). I get it; Hugh Hefner just got engaged to a 24 year old. But you don’t see my Dad rolling around Foothills with a smoking jacket, silk PJ’s and a cigar.

During the ultrasound the radiologist diagnosed a large abscess and brought an intervention specialist surgeon in to determine the course of treatment. The surgeon said he could drain it, and the procedure would be done right away. In the blink of an eye my Dad was wheeled in to a room where he would have a giant needle inserted, which would puncture the abscess and suck out the fluid that filled it. Currently, my Dad has a drain-like system attached to him, to allow the abscess to naturally finish draining out and hopefully, heal on its own.

Today we are at the hospital waiting for a colorectal surgeon to come take a peep at the ‘situation’ to see if this is the best course of treatment for this abscess, or if another form of intervention is necessary.

Bruce and his baggage

(Written Thursday morning... pre-bone marrow procedure)

On Wednesday we were sent home, and told not to return until 9am Thursday morning. At 10:00am on Thursday (today), the doctors will be performing a bone marrow aspirate (to “suck out” liquid bone marrow) on my Dad, which will allow them to determine if he has reached remission. The results from the bone marrow examination are expected within 1-4 days of the aspirate procedure.

Leaving the hospital with Bruce is no easy task. I strapped his IV med pump in its fashionable fanny pack across my chest (because wearing a fanny pack around your waist went out of style in the early 90’s… and even that’s pushing it), had a laundry bag full of supplies such as syringes, caps, alcohol swabs, heat packs and 2 large paper bags full of his IV and oral medications. I thought, “This is aggressive…all of this for 2 nights, 1 day?”

Prior to being released into the wild, Kelly and I were given a detailed lesson on how to purge my Dad’s PICC line with a saline filled syringe, attach his antibiotic medicine bag to the pump, hook it all up to him, and then purge the PICC line again. This must be done 3 times a day (now I think the docs are bumping him up to 4 times….eff). I suggested that I could go out, and just make sure I come home by 2am in order to hook him up to his antibiotics… my motions was denied!

Sitting in our dining room the first night home as a family, staring at our table covered with medical supplies and medications, I thought to myself, “Holy crap, how am I going to do this?” I felt overwhelmed and scared. With one diagnosis, our lives have changed forever. One day, I’m thinking about friends, boys, school, and gossip. Now I think, what are my dad’s vitals, when is his next dose of medicine, is he exercising, is he getting enough fluids... Yes, my life has changed.

After successfully administering the first round of IV meds, I went back down to my room, laid down in my bed and thought…”I CAN do this”.

The 1-day and 2 nights home was not only great for my Dad, but also for Kelly and I. We were able to do what we needed to do, but also act as caregivers to my father. Everyone wins! Kelly and I are looking forward to more home stays (especially the 'off' week), and I hope my Dad is too.

Last day of luscious locks

(photo: pre head shave photo-op...It was taken at 9pm, please hold your judgement on our beauty)

On Day 21, Jerry Albert became Bruce Willis.

Around day 17-18 my Dad began shedding like a dog. Every time he got up, the pillow would be covered with little Jer hairs. He turned to me on Day 20, and said, “so ham, what are we going to do about this?”

I thought to myself, “if B.Spears can shave a head, so can I!”

With the electric razor charged up, I put towels around his neck (like a real pro) to catch the hair, and began the head shave. First, I shaved steps into the sides of my Dad’s head. I always wanted to know how people like the Fresh Prince of Bel-Air did it…now I know. Next, I shaved his hair into a full Mohawk, Chuck Liddell styles. I voted to keep this style, but my Dad looked at my and said, “I’m not 15 Sam, shave it off.” (party pooper) Once the head shave was completed, my Dad got up to look in the mirror and yelled, “HAM, I’M BALD!”… Duh Dad, what did you think I was doing? Should have kept the Mohawk.

(FYI- Ham is not a spelling error. That’s what he calls me… and only him!)

When Kelly arrived back at the hospital, she said, “Wow, he looks like Bruce Willis.” My Dad then said, “Now I need to find me my Demi Moore”….

Indiana Jones'ing this hospital

(Written Feb. 8, 2011)

In the last week, I have not only been my Dad’s nurse, but also his travel companion. Our adventures included a CT scan, ultrasound and echocardiogram. A chest x-ray was also done, but he flew solo on that mission.

Unfortunately, my Dad was continuing to have random fevers earlier on in the week. As the blood cultures kept coming back negative, the doctors were trying to find another possible site or cause of infection.

The CT results showed a clot in my Dad’s lung- a pulmonary embolism. The clot is small therefore the doctors are not treating it yet (with anti-coagulants), just monitoring.

My Dad must focus on deep breathing (some would say ‘yoga breathing’), because his shallow breathing and regular supine position, are not allowing the bottom of his lungs to be used which is causing them to not receive enough oxygen; therefore the little branches in at the bottom of his lungs are collapsing. The physiotherapist has worked with him and taught him breathing techniques he must practice. She has also shown him exercises he must to do to prevent clots from forming and keep the oxygenated blood moving around his body, which will also provide energy.

Chest x-ray= clear

Ultrasound (extremities)= no clots

As my Dad’s blood counts (especially his WBC) weren’t coming up as quick as we or the medical team would have liked, the doctors decided to inject Filgrastim (or GCFS) into my Dad’s abdomen every morning to stimulate the proliferation of white blood cells. This, along with a couple days of transfusions have given my Dad the boost he needed before his marrow was able to produce blood cells on its own. On day 23, his counts finally came up! Not quite within normal limits yet, but getting there! Hasta la vista, transfusions.

Today, we journeyed through the underground workings of the foothills hospital, to get to our echocardiogram appointment. The CT results from earlier this week showed a possible genetic defect with his heart. When you are growing inside a tummy, you use oxygen obtained from your mother's blood through the placenta. As you can’t breathe real air, only a small amount of blood needs to go through the lungs, so the path by which blood circulates through the heart and lungs is different in a fetus. The mixing of the venous and arterial blood occurs through the foramen ovale, which is a temporary hole between the right and left atria. This hole is supposed to close within a couple of days or weeks of birth, but the CT suspected otherwise. After 30 minutes of watching my human anatomy text books come to life on the ECHO computer, the doctors found no such defect! His heart is a normal as can be. FYI- seeing my Dad’s heart, watching his valves open and shut and hearing the blood getting squished through the arteries and veins….was my HON

No one ever said it was going to be easy

Referring to this journey as a fight, couldn’t be more accurate.

You hear that it’s going to be a battle, but you never really know what to expect as you get tossed into the ring to face your opponent… cancer.

My Dad managed to get through round 1 of the chemo drugs with minimal setbacks and forward momentum. As a group we thought, “ok, we can do this”. Then, out of nowhere, cancer bit our ear off (Not literally people! Jer still has ears)... now I know how Evander Holyfield felt.

Chemotherapy not only kills the abnormal cancer cells in the body, it attacks every rapidly dividing cell (cells in the bone marrow, digestive tract and hair follicles). The cytarabine has managed wipe out my Dad’s blood counts, which has left him struggling to main adequate functioning blood levels. To further understand what I mean when I say “blood counts”, I’ll fill you in on the normal limits:

WBC: 4.0-11.0

Hemoglobin: 137-180 -> transfusion necessary when below 80

Platelets: 150-400 -> transfusion necessary when below 20

As a result of his low numbers, a few platelets and blood transfusions were necessary this week. Being immunocompromised and anemic has definitely brought us our fair share of challenges. The doctors expect his counts to begin to go up by day 20, and by day 23-28, they should be high enough for his bone marrow to be tested again, which will determine if he is in remission.

We live one day at a time, and sometimes, one hour at a time. I am looking forward to tomorrow, where I hope to see gains in his hemoglobin and platelet count. As a group, we all need a ‘gain’ day.

Personal Note

Adding to my list of accomplishments, I am proud to report that on Day 18, I finally memorized the 7 digit Username and 8 digit Password to the Foothills hospital unit 57 wireless internet. Go Sam

Also, I have decided to stop being a fattie and take the stairs instead of the elevator. My Dad is located on floor 5. You may be thinking, "Sam, 5 flights of stairs is nothing, go up when you arrive, down when you leave". BUT, the washrooms are down on the Main floor. So every time I have to use the facilities, go to my car, or meet a friend for 'coffee and creeping', I must get my hike on. My fluid consumption will probably go down now.