I'm On The Pump Now

Wednesday October 21, 1992

We are back at Kaiser Sunset at 10 a.m. I slept well. Dr. Semrad shows us the pump and how it works. It's much larger than I thought, about the size of a hardbound book, but thicker. It's heavy, 3-4 pounds. We talk. Yes, I will probably lose my hair, at least 50%, soon. I'd better shop for a wig soon. I hate them. They are hot and uncomfortable. Will probably only wear it out. I'm sad. I thought there were no side effects. Dr. Semrad says they're having much success with the pump.

More confusion. The nurse that is to instruct us on the catheter and bandage care is not available until 12:30-1 p.m. So we wait. She comes. It's so complicated and confusing. I'm glad Frank is there to help me remember. She also gives us instructions. I don't feel well. We go right home. I have some soup. I'm on the pump now.

For the most part up until now, I sense that Mom is blissfully in denial about the severity of her cancer. She has not had to curtail many activities and had few side effects. Having to now carry around a 3-4 pound pump everywhere she goes and cleaning out the catheter everyday will be a chore. Mom took alot of pride in her appearance and spent an hour fixing her hair and makeup every morning, so I am quite sure the thought of losing at least half her hair was quite disturbing. Her hair was fine, like mine, and also thin, so she didn't have much to lose. I completely understand her feelings of sadness.

A Fatal Decision

Wednesday September 9, 1992

I feel better today but it's still noon when I'm ready. We slept in. I'm anxious to hear from Dr. Schwartz. He finally calls about 12:30. NCI reports there are many studies going on with combination of drugs. Nothing conclusive. He has talked to Dr. Semrad. Out of 8 Dr. Senrad has treated for ovarian cancer, 3 are still in complete remission, 2 had partial results, and 3 did not respond. Dr. Schwartz feels comfortable with that choice. I tell him I will miss him. He wants me to keep in touch.

I call Dr. Senrad. He thinks it will be fine to wait til we return from our trip to start my treatment from him. He'll put the catheter in on October 20. I'm comfortable with that.

We go to Gary's at 4:30 to stay with the boys. Maria has doctor appointment at 4. When they get home we all go out to dinner to celebrate Frank's birthday (late).

I remember this day well. I was so angry with Mom. Her CT scan from August 17 shows her abdomen is riddled with cancer and she has not had chemotherapy for months. Now she's going to wait another 2 months to start chemotherapy again. I read ahead in her journal and she finally started chemo with the pump shown above on November 10. That's another 2 months to wait! What's more important, a Mediterranean cruise or her life? I am angry just thinking about it again now. Was Mom back in denial?

CT Scan Results

Wednesday September 2, 1992

Today we went to see Dr. Schwartz and the last CAT scan. Dr. Schwartz was very sweet when he touched my hand to tell me the news was bad. The tumors had grown larger in 3 months, but not to feel discouraged, there were other treatments to try. We talked about Taxol kemo. I'd have to go to UCLA once a week for a 2-day stay to have it injected and the cost would be thousands for us to pay, another drug he didn't have much faith in and Dr. Semrad's pump system. I said I wanted him to call NCI for latest data. He wants to talk to Dr. Semrad.

I saw the tumors on the CAT and the blanket of cancer on the wall of my abdomen. Not a pretty sight! Quite disturbing. We went out to eat dinner after shopping Costco.

I searched the internet for CT images looking for one I imagined was similar to Mom's image. Just looking at those images was very disturbing to me, so I can just imagine how hard it was for Mom to see her own cancer in black and white. Even more disturbing though was to see the photographic images of the actual cancer on the female reproductive organs. Cancer is so ugly!

Surviving Cancer

Wednesday June 4, 1992

We're on our way to Kaiser on Sunset in Hollywood by 9:30 for a 10:45 a.m. appointment. I'm hoping to see the oncologist I saw in November 1991 about using the pump/drip on me. I strike it rich and all 3 oncologists confer in the exam room with Frank and I. Two examine my pelvis area and concur there is a 3x3 mass on the right and a smaller mass on the left. Dr. Simrad says he could put me on the pump now because I do have measurable cancer. He's had some success with it. He says ovarian cancer keeps coming back and the goal is to keep me alive 1-5 years. I'm OK with that but of course hope there will be a new cure before it's too late for me. This is a devil cancer. It keeps dividing and resists treatment.

We see Dr. Schwartz in the afternoon and tell him where we've been. We have all decided to try the pills he offers first. If that fails then the pump.

As shown on the American Cancer Society's chart above, in 2009 ovarian cancer represents 3% of cancers in women, but 5% of deaths from cancer. It is a deadly cancer because it's symptoms are vague and there is no diagnostic testing to catch it in it's early stages. On the other hand breast cancer respresents 27% of cancers in women and only 15% of cancer deaths. I had my annual mammogram last week and then received a phone call yesterday that they needed another image of my left breast. What does that mean? Did they see something suspicious on the mammogram? My appointment is tomorrow morning, 25 days before my 59th birthday. Mom died 25 days before her 59th birthday.

Discussion of the Portable Pump

Wednesday December 11, 1991

Up at 7 a.m. to get ready to go to Kaiser Sunset Hollywood Clinic to meet with a team of doctors to discuss the pump. Dr. Senarad doesn't think I'm a good candidate because he has nothing to measure how well it is doing. My cancer does not show up in a CT scan. He suggests I have another CT and if there are visible tumors now he will reconsider.

We stop for lunch and then go to Woodland Hills Kaiser where I make an appointment for a CT for Christmas Eve and I have a mammogram.

I have a talk with the head of Oncology. I state my case against Dr. Bix and request Dr. Schultz. She will look into it and call me tomorrow. It's been 8 days since Dr. Bix said I'll call you tomorrow through Dr. Russack.

We go to the movies to see "Hook" and eat out--tacos.

The use of a portable pump and port-a-cath allows medication to be given over several days in the home rather than as a patient in the hospital. The port-a-cath is placed under the skin on the chest as shown in the above illustration. The catheter is then inserted into the superior vena cava vessel at the entrance to the right atrium of the heart.

It's been 20 years since Mom had her CT scans. Imaging techniques have improved and lower doses of radiation are needed for the images. It's a shame that her tumors did not show up on the CT scans in 1991 even though they saw them when she had surgery.