73 yr old Mom with stage IV NSCLC

[thinkpink]

Hi, I'm new here. I found this forum about two weeks ago while searching for info on my mother's lung cancer diagnosis. All of you here are really wonderful, supportive, and provide excellent insight from your own personal experience as a patient or family member. I am an 8 year breast cancer survivor, and all of my checkups have been great since my surgery and treatment 8 years ago.

My 73 yr old mother was diagnosed with stage IV NSCLC about 3 weeks ago with mets to the bone. She is a 29 year breast cancer survivor. Had a radical mastectomy of the left breast, but no chemo or radiation. The doctors have advised that the lung cancer is not a recurrence of the breast cancer. She has also suffered with anxiety and depression over the past 20 years, and takes meds for hypertension, anxiety, depression, type 2 diabetes, thyroid, asthma, and for anti-Parkinson or slight tics of the hands and feet.

We have been through so much in a short period of time and it has emotionally and physically drained my 74 yr old father and I. It started with pain in her hip, and then in the other hip, and then in the lower back. A CAT scan and MRI was done, and doctor advised that she had some fluid at the base of her spine. Before she could have the biopsy of the fluid in her spine, she started having shortness of breath. I told her to make an appointment to see her asthma doctor. When she went to see her asthma doctor on the Tuesday morning after Easter, the doctor said it appeared as if she had fluid in her lung. The biopsy of the fluid in the spine was scheduled for Wednesday, but we left the asthma doctor's office and went straight to the ER.

She had a thorocenthesis (I don't remember how much they drained) done in the ER on the night of our arrival, and on Friday we found out that she had malignant pleural effusion. The first chest tube was inserted and after several days of drainage, a pleurodesis was done with the talc, but the lung still collapsed, so basically, the procedure didn't work. They did another chest tube, and after that chest tube was removed, the fluid accumulated again pretty rapidly. She had her first chemotherapy treatment of carboplatin and pemetrexed in the hospital. They then did a thorocenthesis through her back to remove some loculated fluid, and drained 750cc?s. After that, they were able to reduce her oxygen level to 2 liters, and after over three weeks in the hospital, she was able to come home.

Even though the statistics are stacked up against her, we are strong in our faith and staying positive. There are so many family members and friends lifting her up in prayer.

She was released from the hospital on Friday, May 8th. The home health nurse came on Saturday, and everything went well. We took her to the oncologist's office on Monday for lab work and checkup, and all went well. She had lost about 10 lbs, probably due to proper diet and eating habits while in the hospital. She has only thrown up two meals since the chemo, and seems to do well with the Zofran to combat the nausea. Her potassium levels were a little low so they put her on supplements for that.

I just have no idea what to expect. I hope that the chemo will prolong her life at a good quality level, at least. I pray that she's able to make a short trip to my daughter?s first performance as a college cheerleader at her university's opening football game in September. What a wonderful blessing that will be.

tp

_________________
73 yo mother - 29 year breast cancer survivor, radical mastectomy with no radiation and no chemo and no recurrence.

Presented to the ER on April 14, 2009 with pleural effusion and pericardial effusion. Diagnosed on April 17th with stage IV adenocarcinoma NSCLC with mets to the lumbar spine. Began chemotherapy on May 1st- Carboplatin and Alimta plus Zometa for bone mets.

To read a summary of our journey: http://cancerforums.net/about12486.html

[pbj11]

tp,

I'm sorry that your mom has been diagnosed with this crummy disease. You already know about various treatments, etc from both of your experiences with breast cancer. You both were very lucky and it's a shame to know that cancer is once again in your Mom's life.

Lung cancer is notorious for weight loss. Once the chemo begins to work and shrink the tumors, she should regain some of the weight. It's tough if she is also having nausea issues. Make sure they try different anti-nausea meds for her as some types will work better than others for certain patients.

I'm sorry to hear that she had an unsuccessful pleurodesis procedure. The dreaded chest tube! My husband hated that thing after his wedge-section biopsy, so said NO to any thought of pleurodesis. He kept having thoracentesis procedures done and was okay with that.

Lots of prayers and a good sense of humor will get you and yours far on this journey. Keep her hydrated and don't forget to include fluids that have electrolytes so these don't keep getting depleted.

Keep us posted on how she is doing.

God bless,
PBJ

[thinkpink]

Thanks, pbj for your words of encouragement – you are so wonderful! With the exception of why we're all here, this is a great place to be…

Mama has been doing well since her last visit for lab work and to see the nurse practitioner last Monday, May 11th. She had lost 10 lbs in the last 3-4 weeks. During that visit, they prescribed potassium supplements for her since her potassium level was low, and told me to start giving her stool softeners to help with her bowels. All else looked good. The home health nurse, Patti, came to the house last Tuesday and Thursday, and everything checked out well. The occupational therapist, Suzanne, came to the house last week as well.

Today, (Monday, May 18th) we took her again for lab work and follow up with Sandra, the nurse practitioner. Once again, everything went good. Potassium level was normal. Air is passing through her right lung – yep, the same one that collapsed twice while in the hospital! Her breathing is good. Gained 3 pounds. She was anemic, so they gave her a shot of Aranesp to stimulate her red blood cell production. Also, even though she doesn't feel constipated, her bowels are not moving, so they told me to give her some Mag Citrate to drink. I got one bottle of lemon lime flavor and one bottle of cherry flavor – she picked cherry. I will have to let you know how that works – she might lose those three pounds she gained since last week's office visit! Sorry, that was uncalled for…

It's strange, I haven't kept track of anyone else's bowels than my own since my 19 year old daughter was a baby/toddler! Now, since I'm back at work during the day, I have to ask Mama, Daddy, or whoever stayed with her during the day "Did Mama have a bowel movement today?" Life is funny….

I also found out some more details today. Mama has Adenocarcinoma with mets to the lumbar spine. I was never told what type of NSCLC she had, and exactly where it had metastasized to. Also, as far as her chemo drugs go - Pemetrexed is the same thing as Alimta, and Carboplatin is the same thing as Paraplatin. As if I don't have enough to remember! She will have her next chemo treatment on Tuesday, May 26th.

She has gotten stronger every day since her first chemo treatment, and I think we are going to take her out this weekend – to church and maybe out to eat. She dressed herself this morning and decided that she did not want to wear any protective underwear today! She had been wearing those since being admitted to the hospital on April 14th – so over a month! That's right, Mama put on her big girl drawers today! Go girl! Something else I hadn't talked about since my daughter was a baby!

One of the doctors had told us that Mama may only have a month to live, but our prayers have been answered and she has come a long way since April 14th when we took her to the ER. God has heard our prayers, and Mama is feeling better. I'm still praying that she will be well enough to attend that football game on September 5th.

God is good, and life is a blessing!

tp

[arasara]

I'm glad to hear that your mother is doing so well You're right, God is Good!!! I'm glad that your mother's spirit is so upbeat and y'all are so positive! I'm keeping my fingers crossed that things will continue to go well and she'll be able to make it not only to the cheerleading game, but of course Christmas as well

Good for you guys for being long-time breast cancer survivors! That's so great!

Take care!
Sara

[thinkpink]

Ah, Sara! That sounds so wonderful - not only her granddaughter's college cheerleading debut, but also Christmas! As a Christian, I celebrate the blessed day of Jesus' birth, but December 25th is twice as special because it's also my mother's birthday! Yep, Mama is a Christmas baby! So, if it's in God's plan, her 74th birthday will be a real big celebration!

The "think pink" is my breast cancer survivorship pride motto! I have a license plate that says "think pink".

Mama continues to feel well, and just to update everyone on the magnesium citrate, it works! There was "movement" – no impacted bowels over here! We'll have to keep that stuff in stock during her subsequent chemo treatments! So patients/family members/caregivers, any problems with regularity, if your doctor okays it, use the mag citrate!

I asked Mama yesterday what she wants to do this weekend (Memorial Day holiday on Monday!!!) and she wants to go to church and to eat her favorite seafood restaurant. So be it! Say it and it will be done! I'm also going to see if she wants to go to a movie as well. We could do something Saturday, Sunday, AND Monday! Woo hoo! I went and picked up a wheelchair from the local Cancer Services office, so we are ready to roll, literally. They are a true Godsend! The weather forecast for this weekend is rain, rain, and more rain. But, it's not going to stop us! I will drop Mama off under the covered area, wheel her inside (the church, the restaurant, the theatre), go and park the car, and we will be good to go!

Thanks be to God, from whom all blessings flow!

tp

[pbj11]

tp,

Your mom is very blessed to have such a wonderful daughter. I imagine the apple didn't fall far from the tree.

Have a wonderful time this weekend and I'm glad things are "moving" along.

Hugs,
PBJ

[dano]

Think pink;
Mostly all I can say is wow. After all your mom has gone through I would expect her to want to hang it up, I am amazed. But your faith is the powerful difference and the prayers are working. I'm so glad she is handling the chemo so well. I've been on Alimta for over a year now and I'm still dealing with the constipation for one to two weeks after treatment, I'm trying fresh blueberries right now, seems to work. I hope all goes well with the fight.
God Bless
Dan

[Trudy]

It's been a LONG time since I have been here and I can say that all continues to go well with my Mom...in fact she has been the best these last few weeks than before she started Chemo in June 08.

I do have a question regarding her daily Lovenox injections...
I think Dano may know the answer..and it is this

I give mom her injections in her belly area, alternating sides, she has begun to have some black and blue marks and she is worried that I am doing something wrong....am I???

I tried to tell her that this does happen and I try to space them as taught...but now I am getting paranoid and was wondering what others thought

[EFP]

Hi Trudy.

My belly is Technicolor -- black, blue, yellow, green, you name it. If I had eyes behind my head, I'd do it sometimes on the butt to give my belly a rest. Maybe you can ask her doctor about that? At least you would be able to see what you were doing...

I've been doing two shots/day for nearly 18 months. It could be worse -- I could be paying for it!

Good luck.

Ellen

[dano]

It's been a LONG time since I have been here and I can say that all continues to go well with my Mom...in fact she has been the best these last few weeks than before she started Chemo in June 08.

I do have a question regarding her daily Lovenox injections...
I think Dano may know the answer..and it is this

I give mom her injections in her belly area, alternating sides, she has begun to have some black and blue marks and she is worried that I am doing something wrong....am I???

I tried to tell her that this does happen and I try to space them as taught...but now I am getting paranoid and was wondering what others thought

Trudy;
My belly was the same and I talked to a nurse who said to make the injections as vertical as possible and that did seem to help. I have found that areas above my belly button are more sensitive to needles than below it. Also, some time I hit a vein and it bleeds, other times I hit places that the fluid will not come out off the syringe. Some times the needle goes down very easy then hurts like H to inject, other time no problem. My skin seems like it is tougher now, I'll press the needle against my skin and the skin will sink in with out the needle penetrating, I clean a large area because if I hit a nerve when I start to poke I move it a bit and try again, and keep doing it until I don't feel it. I hate taking the shots still, I have at times stopped taking the shots to give my belly a rest, like a week. I'm down from two 100mg shots a day to one. My left leg where the large blood clot was does not bother me much any more. I just had a molar cut out and on my own I stopped taking the shots ahead of time to help with the recovery time and any extra bleeding, It has been over two weeks sense my last shot and my leg feels fine.
hope this helps
Dan

[dano]

TP;
How are things going? Hope you are finding a way to enjoy Memorial day!
Dan

[Trudy]

Thanks so much for the reply about the Lovenox injections...it sure has made me feel better...My Mom gets paranoid and thinks I may be doing something wrong...and I am a nurse! I have given plenty of shots in my time, but not Lovenox...so it was good to hear from the two fo you as to what your personal expereinces are with it...
again thanks so much!

[thinkpink]

Hi Dano,

Yes, our Memorial Day was wonderful! I find a way to enjoy every day!!!

We spent the day at home, and my mom's oldest sister (age 78, two time breast cancer survivor, both breasts removed at different times) and her daughter came to visit. We had a great time, reminiscing, laughing and talking.

Mama's second chemo treatment was rescheduled from today to tomorrow. Based on her first treatment, I expect her to be weak and disoriented for 7-10 days. But I assume that the second treatment may have a totally different effect on her than the first treatment.

Can anyone tell me if every chemo treatment affects the patient differently or does the patient feel basically the same way after each treatment

The glory and the honor goes to my Heavenly Father! I will keep you all posted!

tp

[pbj11]

Hi,

She'll be feeling pretty much the same, but as time goes by, the chemo has a cumulative effect and it will effect her blood counts more. This means shots to boost her red/white cells so they don't get dangerously low. It also means she may be more tired. Doesn't affect everyone the same, so you'll have to wing it and see.

Wish I could be more specific, but that's what I know.

Glad to hear she is doing well.

Hugs,
PBJ

[thinkpink]

Hello friends,

Thanks pbj! I will definitely wing it and see....

Mama went for her second chemo treatment yesterday. This was her first outpatient treatment since her first round of chemo was done while she was inpatient in the hospital. Her "pre-chemo" appointment went well and lab results looked good. Her red blood cell count had increased since the Aranesp injection on the 18th. She'd gained a couple of pounds since her last follow-up – thus far, her appetite has really been unaffected by this whole ordeal. Air was passing thru that right lung (yay!) and we were told that she could now use the oxygen as needed (wow!) .

When I took her to the bathroom while waiting to be called for chemotherapy, we took off the nasal cannula and didn't put it back on. She kept it off until she and Daddy got home around 5:15 that afternoon. She has been on oxygen therapy 24/7 since being admitted to the ER on April 14th, and at various liter levels. She started with the nasal cannula, was switched to a simple face mask, then back to the nasal cannula, and eventually down to 2 liters before being discharged on May 8th. Her breathing is much improved and she did well without the oxygen for those 5 hours.

She didn't get settled in for chemo until after 12 noon – Carboplatin, Alimta, Zometa. She also got a B-12 injection. The first nurse couldn't find the spot in her medi-port to insert the Huber needle, so another nurse came and inserted it with no problem.

Before leaving to go back to work, I asked "ma and pa" if they wanted something to eat. He said no, she said yes. She hadn't had anything to eat since breakfast at 8:00 am, so it seemed reasonable that she was hungry. So off I went to Subway. Since the footlong was $5.00, I decided to get it so that Daddy would have something to eat when he got hungry later on. Also bought two drinks and then back to the chemo room. Turns out that they were there until 5:15, and since Daddy never did eat his half of the footlong, Mama ended up devouring it before they pulled into the driveway at home!

The evening was pleasant and uneventful – no sickness, no pain, no drama, all was well. Mama ate again and she and I sat around watching TV until around 9:00 pm. We tried to watch "Wipeout", but after awhile changed the channel to "So You Think You Can Dance?". Daddy crashed early and got some much-needed sleep.

This morning, Mama woke up confused and disoriented. She was getting up, without assistance, going to the bathroom, and another time she showed up at my bedroom door asking if I'd "rang the bell". No Ma, the bell is for YOU to ring when YOU need us. Ringing in the ears is a side effect of the Carboplatin, so I wasn't surprised. We prefer to accompany her when she gets up in case she starts to fall, but she was "on a roll, solo-style" with that walker this morning. She was also complaining about a tightness in her chest, like indigestion, she said. I called the doctor's office, and they are going to check her out when she goes in to get her Neulasta injection later this afternoon.

Truly, my friends, the joy of the Lord is my strength!

tp