Tag: cancer

Living overseas, Mexico, Retirement

The is the final post

This is the end for our blog and it will probably be the worst post you have seen, because I’ve lost my editor. Leslie, my long-time traveling partner and my beautiful wife of 31 years, died Wednesday, March 20, of metastatic endometrial cancer at Vanderbilt University Hospital in Nashville. The cancer came back, and it came back in a big and awful way.

Since returning to our home in Mexico in early January she had been growing stronger, hitting the gym four days a week to walk on a treadmill for 30 minutes. Then around February 20, she developed diarrhea. It got better, then came back. Then she started wheezing and had shortness of breath, as well as pain in the upper right quadrant of her abdomen, mostly after eating.

She was scheduled for her first three-month checkup at Cleveland Clinic in Weston, Florida, during the first week in March, and had several other appointments set up during that week, including with a primary care physician. But that doctor was ill and cancelled Leslie’s Monday appointment, so we went to the emergency room for the symptoms mentioned above as well as a distended belly. Doctors did a CT scan and diagnosed her with pneumonia and a large hematoma on her liver. They were stunningly wrong. And they did absolutely nothing to treat her.

Rather than go home at the end of the week we flew to Nashville, where Leslie planned to have all her future checkups. She saw a nurse practitioner in gynecology/oncology at Vanderbilt-Ingram Cancer Center, part of Vanderbilt University Medical Center. The NP sent Leslie to the ER, where she got another CT scan. This one showed lesions in her abdomen, and the Vanderbilt doctors feared there was a mass on her liver instead of a hematoma. A day later, a PET scan confirmed a large, fast-growing tumor on her liver that was pushing upward on her lung, which caused the wheezing. There was also a buildup of fluid filled with “innumerable” malignant ascites. The doctor said this was like someone had thrown rice into Leslie’s abdomen and each grain was expanding.

Doctors were encouraged by a mutation in the tumor. They hoped immunotherapy might help shrink the tumor and buy Leslie some time. But she never made it to the first infusion. Early that Wednesday morning she slipped away peacefully in her sleep. Stephanie and I were by her side. We are heartbroken. Everything happened so quickly. In just three months, she went from being “in remission” to being a victim of a highly aggressive cancer.

We are grateful for the care Leslie received from the team at Vanderbilt. If you would like to honor Leslie, please feel free to click on this link: https://give.vanderbilthealth.org/give/246900/#!/donation/checkout Under the question “What would you like your donation to support?” please select “Greatest needs at Vanderbilt-Ingram Cancer Center.”

The family held a party for Leslie on Tuesday, March 26, at Stephanie’s home in Nashville. Many of Steph’s friends and co-workers came. We ate food and drank wine. When I told some of Leslie’s friends we were doing that, three of them said, “Yep, that’s Leslie. She would love it.”

According to her wishes, we will be holding a slightly more formal Celebration of Life for Leslie in early May at our home in Ajijic. Our dear friend and retired United Methodist pastor Michelle will officiate.

It’s going to take me a long time to learn how to travel without Leslie by my side — if I’m able to do that. So I am closing out this travel blog. I will leave everything up for the rest of 2024, and if anything exciting happens I will post again. But I believe this is the end. Thank you for following us over the past eight years. Adios!

Leslie’s friends had so many amazing things to say about her. One said, “She lives on in the lives of those she extended herself to in love, ever changed because we knew her.” But everybody said she had the greatest smile! You can see that here.
health, Living overseas, Mexico, Uncategorized

We’re going home!

Leslie and I are in Nashville. We came here from Florida to spend Christmas with Stephanie, and also to get a second opinion on radiation therapy from the doctors at Vanderbilt Medical Center’s esteemed cancer program.

We met with a medical oncologist. She reviewed all the reports from Cleveland Clinic and said Leslie did not need radiation therapy. Then we talked with a radiation oncologist who said she did need it. Both, however, thought it was appropriate to take Leslie’s case before Vanderbilt’s tumor board, an interdisciplinary group that looks at cancer cases from many perspectives and makes recommendations.

They met Wednesday, January 3, and unanimously recommended no radiation. That’s what we wanted to hear.

Now we can go home and do what’s called “surveillance.” That means regular follow-ups to make sure Leslie remains cancer-free. Every three months for the first two years, then every six months for the next three years. After five years, she is considered a cancer survivor. The first follow-ups are scheduled at Cleveland Clinic in Weston, Florida, for the first week in March.

We have booked flights to Guadalajara for the coming week. Next post from Ajijic, México!

Hasta luego!

health

UPDATE: Remission!

Leslie is done with chemotherapy and her oncologist says she is “in remission.” That’s great news and we’re thrilled, but she still must do regular follow-ups with her surgeon and her oncologist at Cleveland Clinic in Florida for at least five years.

It’s exciting, but it seems there’s always a hitch. Leslie was scheduled for six doses of chemotherapy. At the end of the fourth dose, her oncologist suspended further treatment because her white blood cell count was too low, and was not recovering as quickly as expected. She will have more tests done soon to figure how why.

So she completed just four of the six doses. What does that mean? The doctor wasn’t very forthcoming on that question, simply noting that studies were done on the efficacy of three doses versus six, and six was found to be better. They needed studies to figure that out?

Anyway, now we can go to Nashville to enjoy Christmas with our daughter Stephanie and other family. But there’s still the question of whether or not to undergo radiation therapy as recommended by the Cleveland Clinic medical oncologist. While we’re in Nashville, Leslie will get a second opinion from oncologists at Vanderbilt Medical Center. If she decides to have the radiation it will be done at Vanderbilt and we will stay with Stephanie. If Leslie decides not to do the radiation we will head home to Ajijic as soon as we can book flights, probably the first week in January.

So our time in Florida is coming to a close and we’re hopeful that we’ll be back home soon. Florida is not our favorite place — weather (too humid), politics and insane drivers! It seems quite normal to weave in and out of traffic at high speeds on the freeways, sometimes with only inches to spare! And on city streets, the yellow light just means speed up — and if the light turns red, keep going or you might get rear-ended.

And we have lots of iguanas, but they’re harmless and fun to watch. This big guy hangs out in our yard sometimes, but I’ve also seen him at nearby houses.

On the plus side, we’ve been attending Christ Church United Methodist, just a five-minute drive from our temporary home. It’s a progressive church and we’ve enjoyed the services and meeting new friends. They’ve even asked us to light the Advent candle next Sunday. We also attended two concerts by the South Florida Symphony Orchestra, and may be able to do a third in early March because we’ll be here for the first of many follow-ups. Finally, there are lots of outstanding restaurants in greater Fort Lauderdale!

This is a few minutes prior to the South Florida Symphony’s performance of Handel’s Messiah — the Christmas portion plus the Hallelujah Chorus. The audience was invited to sing along, and I did since I remember most of the bass part. The venue is The Parker, a beautiful concert hall that is part of the Broward Center for the Performing Arts.

More information will be coming when decisions are made. Leslie and I hope everybody has a Merry Christmas and a Happy New Year!
Sometimes the iguanas get on the roof!
health

UPDATE: Better times

Leslie receiving a chemotherapy infusion. Our daughter Stephanie gave her the neat blanket. Notice that she’s smiling!

For once I can say things are going to plan — the revised plan, that is. Leslie’s first infusion of chemotherapy back in July hit her hard (see last post). So her medical oncologist changed the protocol. She’s now getting a full dose of chemo, but in thirds over a three-week period: one-third this Thursday, one-third next Thursday and the final third in the third week. Then a week off and do it again.

There are some issues with side effects but she’s not debilitated like back in July. We were able to go to church on Sunday, then out for dinner Sunday evening. And she helped me do grocery shopping yesterday. Her hemoglobin (red blood cells) is much better.

Each infusion begins on a Thursday about 7:30 a.m. with a blood test and a visit with Dr. Schwartz, the oncologist. The infusion is generally finished between 12:30 and 1 p.m., and we go to one of our favorite Weston-area restaurants for lunch.

Last Thursday was an off week because Leslie completed Dose Three on September 14. This week she begins Dose Four with 4.1 on Thursday. If all goes according to the new plan, the final infusion will be on December 7. Then we head to Nashville to spend Christmas with Stephanie and her two cats.

The next big decision is whether to have radiation therapy after the chemotherapy is done. Leslie is still gathering information on that option, but right now we both believe radiation could do more harm than good. The decision on that will come later. There’s no rush.

Meanwhile, I was able to go home early this month for a little over two weeks to get the house ready for our next set of house/cat sitters. Many, many thanks to Catya and Dany, now good friends, for their efforts. Long-time friends Susan and Rex are living in our house now and being a great help. Gracias!

Leslie’s sisters Laura and Cathy took turns taking care of Leslie while I was gone, and Stephanie made another long-weekend visit. For a few days, all four of them were together, and I think they had way too much fun!

More later!

Physical therapy is important. Leslie does her exercises in the pool when possible because the resistance of the water helps. And because she really likes the pool!

Mexico, Retirement, Travel

It’s not going according to plan

The Braathen Center in Weston, Florida, home of Cleveland Clinic’s Maroone Cancer Center. Leslie’s infusions take place on the third floor.

I promised to keep everybody informed as Leslie and I begin this journey of chemotherapy. I just thought I would be writing something different.

At this point we expected Leslie would have breezed through the first two infusions of chemotherapy. However, the side effects from the first infusion hit like a speeding train. We anticipated nausea and vomiting, but it was minor. We anticipated exhaustion and loss of feeling in the fingertips, and those came as expected. We anticipated hair loss, and that is continuing.

What we didn’t expect was diarrhea so bad it caused extreme dehydration. Just a few days after the infusion, Leslie was taken to the Cleveland Clinic Emergency Department with dehydration and extremely low blood pressure. Doctors admitted her to the hospital where she stayed six days and came home weak and unable to walk more than a few steps — about what you would expect after being in a hospital bed for almost a week.

Back in our temporary quarters, she seemed to be improving. But after just two days at home, she checked her temperature one night and had a fever of 101.6F. We followed the post-infusion protocols which stipulated going to the ED for a temperature that high, thinking they would give her antibiotics and send her home. Unfortunately, the doctors couldn’t find a source of infection so she was admitted once again and stayed three more days, getting a platelet transfer to help her get through the second infusion.

The third day in the hospital was because Leslie tested positive for COVID-19. Of course, so did I. Neither of us had any of the traditional symptoms, except a bad cough. And this is when we were moving into more long-term quarters.

Because of the side effects from the first infusion, we were afraid of being too far from the hospital. So we opted against going to a friend’s condo in western Florida because it’s a 90-minute drive from the Cleveland Clinic campus in Weston. Instead, we got an AirBnB just 30 minutes from the hospital in a quiet neighborhood north of Fort Lauderdale.

Our temporary home in Fort Lauderdale’s Imperial Point neighborhood.

The second infusion was scheduled for July 27. Based on what happened after the first, her oncologist has revised the plan. Starting today (August 3), she will get one-third of a normal dose once a week for three weeks. Only one hour in the chair as opposed to three. So the schedule now is three weeks of treatment on Thursdays followed by one week off to let her body recover. Then three more weeks for Dose #3 and so on. Her doctor believes that will help prevent a recurrence of the side effects. The downside is we will most likely be here in Florida through Christmas.

Despite all that, Leslie is feeling positive and is focused on finishing the course of treatment to prevent cancer from coming back. She believes God has her in the palm of His hand. She’s getting stronger every day and is delighted to have a nice pool in the back yard of our temporary home to do some water exercises. She’s also getting regular visits from home health nurses and a physical therapist.

We’re looking forward to getting back home to México as soon as possible.

Leslie is doing physical therapy exercises in our pool.

Living overseas, Mexico

Traveling again, but this time it’s not for fun

Leslie and I are in Florida. Our plan was to take a cruise from Los Angeles through the Panama Canal, ending in Fort Lauderdale, to celebrate our 30th wedding anniversary this year. The cruise didn’t happen, but here we are.

A little backstory first. In January, Leslie had surgery at a hospital in Guadalajara. It was supposed to be a complete hysterectomy but the doctor only removed her uterus and fallopian tubes. The pathology report showed a very small Stage 1 endometrial cancer, which we did not anticipate. Normally, Stage 1 means no further treatment, just what the doctors call “watchful waiting.” But because of the way in which the uterus was removed and the fact that other organs remained in place, the consulting oncologists recommended aggressive radiation therapy.

Leslie wasn’t happy with that. She wanted the job finished and done right. After a few months of trying to resolve the situation, she had surgery May 15 at the Cleveland Clinic in Weston, Florida, to finish what the Mexican doctor failed to complete. Her second surgery went very well. However, pathology reported another very small tumor (less than 100 cancer cells) in the right ovary. Leslie was referred to a medical oncologist who considers this a Stage 3 cancer because it appears to be metastatic. That means chemotherapy. Six treatments, three weeks apart to wipe out any stray cancer cells that may still be wandering around that can’t be detected through regular scans. We see this not as a cancer treatment — because all the cancer has been removed — but as a way of preventing it (hopefully) from causing problems in the future

Neither of us was happy with that recommendation, but after much prayer and consideration, Leslie decided it was the right approach, and I agreed. Chemo starts July 6, but first we’re headed back to Ajijic. We really need to see our home and our cats again, and we had only arranged house-sitters/cat-sitters through the middle of June. We’ll come back to Florida in early July and stay until the round of chemo is done — possibly four or five months. That’s better for Leslie than going back and forth every three weeks. And one of Stephanie’s long-time friends has offered us the use of her condo in the Naples area, which is about a 90-minute drive to Weston. Thank you, Lexi!

We cannot say enough about Cleveland Clinic and the outstanding doctors, nurses and technicians at the Weston location. Many thanks to our dear friend Carol who helped us become affiliated with this outstanding facility.

Also, this is not an indictment of health care in México, just of that one doctor. In the States we would sue for malpractice, but that’s problematic in México — it takes a long time and a lot of money and usually is not successful. In Ajijic, Leslie and I share a super cardiologist and an outstanding ophthalmologist. Leslie really likes her endocrinologist, too. But both of us now have primary care docs at Cleveland Clinic.

When I recently blogged that we wanted to do more traveling now that the pandemic is essentially over, this is not what I had in mind. We’ll be spending a good part of the rest of this year in Florida, and we’ll be making regular visits back for the next five years or so. Other travel, such as the Panama Canal cruise we were forced to cancel because of the surgery, will have to wait. That’s fine, we’re still young!

The good news is that we’ll be piling up airline miles and points with certain hotel chains and rental car companies. And we might be able to work in some touristy activities, like a visit to Key West or the Kennedy Space Center, if Leslie feels well enough. Hopefully, we’ll be back in México for Christmas — maybe even for Thanksgiving!

More to come!