Insane in the Membrane

Sadly our big secret is not as exciting as The Count of Monte Cristo

Last night we hosted the 11th Annual Festival of Pies and had a great time. The house was stuffed with people who in turn were stuffed with 18 pies and 1 cake. I pinballed around all night socializing and being all host-y, more than a little bit punchy from not starting to bake until, oh, around 9 PM the night before. Miranda conked out around 2:30 AM but I plugged away until 4AM and then cranked out 4 more pies in the morning. This is not a schedule I particularly enjoyed and it is definitely not the one I had planned but these days our plans have a tendency to be rewritten on the fly. And the entity that tends to do all the rewriting is Karen's illness. That's what rewrote my baking itinerary and it's what gave our little soiree some undercover subtext because us Coffeys were all harboring a Count of Monte Cristo caliber secret through the whole thing.

So bright and far too early Monday morning we had our chemo consult at the oncologist's office.Karen had a headache after so she took some Tylenol or something and it went away. Then it came back. So she smoked some weed and it went away. Then it came back. She took more Tylenol and it was dulled but not gone. More weed, a few naps, and a few days later and the headache was there all day from the moment she got up and not responding to meds. She took some Vicodin and by the time our call to the oncologist was answered it was gone again. That was good, said our doctor, but if it got worse or persisted we were to go to the ER.

Friday at noon, Miranda and I began prepping to bake. Karen was in bed. The night before she was complaining about blurry vision and the headache. Her energy at this point was extremely low and her persistent nausea was not responding to the usual medical marijuana. Karen took another long nap, we got two pies finished, and when she woke up we shut off the oven, loaded her into the car and zipped her around the corner to the hospital. There was a CT scan and Karen was admitted to the hospital for observation and more tests. Later that evening Karen was full of painkillers that had nicely axe-murdered her headache. She was drifting off to sleep so I went home and strapped on my apron to bake. Sometime late that night she had an MRI.

The next morning I spoke with her doctor and our fears were confirmed. Karen now had three masses in her brain, the largest about 2cm cubed (maybe about the size of a ping pong or golf ball I'm guessing). The next largest measured about 1.5 and the third just wasn't putting in the effort to keep up with the others. So there's your headache. And there's your nausea, debilitating fatigue, and blurry vision.

Sid & Nancy approve of this new drug delivery method.

And there's your major spanner in the works. Short term, it was uncertain if Karen would be home for the party. Longer term, her treatment just got a whole lot more complicated. The short term hurdle was cleared relatively easily. After talking to her doctor with a head full of luxuriously lathered shampoo (I now carry the phone into the bathroom when I shower in case a doctor calls), she and the rest of the hospital staff became committed to finding a way for Karen to make her triumphant return to the Festival of Pies. A year ago, it seemed unlikely. With a host of new meds including better painkillers and a new blood-thinning prescription that requires me to give her a shot in her stomach twice a day, she was cleared for release. She was home by 5PM and when guests began arriving at 7 she was ready and raring to go, glowing with dilaudid.

Ideally, the metastases in her brain will be as easy to deal with as getting her out of the hospital. But that seems kind of unlikely. We will meet with our docs tomorrow to discuss treatment. Radiation seems most likely and she's already taking steroids four times a day to reduce the swelling in her brain caused by the tumors. The problem here is it's all but certain that she can only tackle one problem at a time (I'm saying "all but certain" because if I've learned anything over the last year it is that what you think will happen is not always what actually happens). Your body can't handle Bruce Banner caliber radiation loads and chemotherapy simultaneously, not without dissolving into a puddle of goo like that one bad guy in Robocop. That means that while we focus on one problem, the other is left to its own insidious devices. So while it seems most likely that we will be dealing with the brain because A) it's the freaking brain and B) it's causing the most problems for her, the growths that have sprouted up in her chest and neck are free to run amok until we can get around to chemo.

It is all just so much fun.

We will keep you posted. Unfortunately, it seems like my laggy ass posting schedule has the potential to become more frequent in the days ahead.

STATUS UPDATE

• An MRI has revealed three significant metastases in Karen's brain. These are responsible for her blinding headache. They are also probably the culprits behind her diminishing energy and persistent nausea.
• The largest of these is about 2 cm across in all three dimensions. It is smaller than a breadbox but bigger than you'd like a cancerous growth in your brain to be.
• New medications are better controlling Karen's pain and clotting issues.
• We will be consulting with our cancer team to determine the best course of action.
• Radiation seems the most likely treatment in the short term to deal with the masses in her brain.