A Few Good Memes

Anna went to Chemotherapy for nearly 12 hours on Monday, 3 hours on Tuesday and 3 hours on Wednesday. Monday was longer because one drugs she’s on takes a long time to administer. Fortunately, she only has to have it once every 21 days. Now she has 18 days to rest up before the next round (cycle) of Chemo, which should start on May 2. Anna had some problems with nausea and the doctors are trying some different anti-nausea drugs. She is also trying C-bands, the anti-seasickness bands recommended by Liz Bowes-Spiegel.

In addition to the Chemo, Anna goes to radiation therapy each day. The actual procedure only takes about 6 minutes, but with getting to the right place and set up and everything, it’s usually an hour or an hour and a half. Radiation happens Monday-Friday and will continue for something like 25 days in this cycle. They are only radiating the tumor in Anna’s left lung. The one in her leg is being left alone. The idea is use it as a control so the doctors can determine whether the Chemo or the Radiation is working better.

Jason has been going to each radiation therapy with Anna. When the treatment is over, Jason goes to work, generally around 9:30 or 10 a.m. He’s trying to work as much as possible so he doesn’t burn up all his leave, FMLA leave, etc. That way, if he really needs time later, he’ll have it.

On Wednesday, Anna, Jason, Frieda, and friend Cricket went to see Dr. Einhorn, a specialist in tumors of unusual or unknown origin, at the UI Medical Center in Indy. They went in a little apprehensive that Einhorn would question the diagnosis or treatment, especially since it’s so unusual for a non-smoker Anna’s age to have lung cancer. He felt like the diagnosis and treatment are both on target. He offered to consult with them and their doctors at any time and made a follow up appointment for July. He also gave Anna the name of a patient who went through a similar, but not identical, situation a couple years ago. The other patient is now in remission and talked to Frieda for a while. The other patient was very generous with her time and has offered to answer any questions Anna has. All in all, they came away from the meeting with Einhorn feeling good that, given the facts, they are headed down the right path.

Alyssa (age 7) went to a support group this week for kids whose parents have cancer. She was pretty nervous before going. The other kids, all of whom are at least 11 years old, were really supportive. Alyssa came away feeling good. Hopefully this group will give her another way to understand and work through what’s going on.

On Saturday, Jason was able to take the kids to the Bug Bowl, an annual festival at Purdue University. Believe it or not, Bug Bowl is supposed to be a blast. So amidst everything, they are managing some normality.

Anna’s Mom, Frieda, is going to return to Tucson on April 26 and get some much needed rest and some time to catch up on her bills and friends. Several volunteers have been coming in to help with things in the morning and again at night. The volunteers will be covering for several days, until Anna’s sister Virginia arrives and helps out for about a week. Then the volunteers are covering things again before Frieda returns in May. The Fairchilds (my immediate family) will be there in late May / early June.

Anna, Jason and Frieda have all asked me to express their sincere thanks to everyone. They truly appreciate your concerns, your thoughts, your prayers, your cards, flowers, and the many, many other things all of you have been doing. God bless you all.

Thanks for the great updates. The port is actually near my right collar bone and thankfully getting less painful. Monday will be a gruelling day starting at 7:30am with a shoot to prep for radiation, radiation at 8:10 and then chemo starting at 9 ending between 4-5pm. The shot is something that is supposed to help protect my internal organs since they are radiating so close to all my major organs - the heart, liver, kidneys. I am scared to start chemo. It seems like if the cancer doesn’t kill you the treatment will. My coughing is supposed to get worse before get it gets better. At some point they have told me I will probably not be able to swallow so they will insert a ‘peg’ into my stomach for hydration and nutritional supplements. You don’t have to share all this gross stuff. I am not ready to embrace this yet.

This still seems like a journey I don’t want to walk down. But many of our truly challenging journeys are not ones any of us would choose.

Mom is taking more breaks as there as been a lot more volunteer support this week. She, Jase and I are much more comfortable with our new childcare provider for Emma which is a huge stress relief. Michon picks Emma up at 7:30am and drops her off at 3:30pm. Not much seems to phase her. Her 3 year old likes to help feed Emma. What a relief. Mom went to Ready Care and was treated for a sinus infection. She has been leaving early around 4pm and not staying to help get the kids ready for bed. Today she read to me for a while and then I napped. She was supposed to nap but chose to read her own book instead.

Ian seems to be getting used to the volunteers that are coming in the morning. He even asked Anne (one of my bosses at work) to take him to day care this morning. She has a 4 year old boy and is still in the swing of things when it comes to coaching little boys out the door.

We have found out about a local kids cancer support group that meets once a month at the YWCA. You have to be 6 years old to attend. Alyssa is interested in attending. The next meeting is this coming Tuesday. I reached out to Alyssa’s school counselor with low expectations of support and have been pleasantly surprised by her response and caring. She is now meeting with Alyssa once a week. I told Alyssa this past Wednesday night before I started radiation that I was scared to start radiation the next day. Alyssa said that it would be alright that she, Pappa and her school counselor would support me so I wouldn’t have to be scared. My sweet girl.

We went to Employee Assistance Program yesterday and got 10 play therapy sessions for Alyssa and Ian. Hopefully that will help.

I should try to get some sleep. Lying down is not always that comfortable. I have trouble breathing. Love to you guys. Share whatever of this note that you want,

Anna

Hi all,

A number of people have been added to the distribution list for updates on Anna since I sent out the first update on 4/4, just a few short days again. If you didn’t get the first email and want a copy (it provides lots of background information), please let me know. Please feel free to forward this message to family and friends who may be interested. If they want to be added to the distribution list, they should email me. If you want to be taken off the distribution list, please let me know.

Here’s the medical update…
1. On Wednesday Anna had a port put into her chest (near the bottom of her rib cage, I believe). The port allows the Chemotherapy doctors to give her a high volume of drugs without creating needle tracks in her veins. She also underwent some additional tests.
2. On Thursday Anna had her first radiation treatment. Radiation is applied locally (only in a specific area). Right now they are only radiating the tumor in her lung. They want to use the tumor in her right thigh almost like a control. That way they can tell if the radiation is or the chemo is what’s shrinking (hopefully) the tumors. Anna wears a custom brace that positions the radiation precisely so that it’s blasting the tumor and not the rest of her organs. Anna had some problems with the nausea after the radiation treatment.
3. Monday Anna starts chemo. The protocol for her treatment says she goes in for 3 days of chemo in a row and then has 18 days off. Then she starts the next cycle. Three plus 18 = 21 days. So every 3 weeks, she has another chemo cycle. Anna sat through a couple hours of discussion of what chemotherapy will be like. She heard that her hair might thin, but with the particular drugs she’s going to be taking, she might not lose her long, curly, red hair. (This is different that breast cancer where the prescribed drugs would
definitely make someone lose their hair.) Just in case, Anna has a wig.
4. Next Wednesday, Anna has an appointment with a specialist from IU Medical Center. He’s an expert in chemo for tumors of unknown origin and other unusual cases, such as Anna’s.

Support team information…
1. Frieda E. Worrall, Anna’s (and my) Mom, is in W. Lafayette helping out with Anna’s kids and doctor’s appointments. Frieda is staying with some friends. She is trying to pace herself so that she doesn’t get burned out. But that’s often easier said than done.
2. A church friend of Anna’s has been organizing local volunteers. Many of the volunteers have been truly wonderful. Sometimes there are frustrations when someone no-shows and doesn’t call to let them know they can’t make it.
3. Anna and Jason also have a number of childcare arrangements in place: school, pre-school and day care.
4. All of you. Anna and Jason truly appreciate all the support they’ve been getting from everyone. Prayers help. Cards or pictures of your kids or trips or garden or whatever help. And the many other things you’ve been doing help. Thanks! Anna and Jason are so busy with doctors they may not be able to say thanks properly right now. Please know they really appreciate it all.

Other information…
1. Some people have asked about Wills, Medical Directives, Living Wills, etc. Anna and Jason have worked with a lawyer to put all these documents in order. Hopefully, they won’t be needed them for a good long time, but just in chance they’ve got them.
2. You’ve asked about the kids. Anna and Jason have talked to their kids about Anna’s condition and treatment. They will be talking to them periodically. Anna and Jason have also secured professional help so the kids can work through the questions and concerns they have. So far the kids are as good as can be expected. Alyssa (7), Ian (2), and Emma (7 mos.) are wonderful. Feel free to send them a card now and then.

Ideas for ways to help…
1. Please ask me your questions to reduce the strain on Anna, Jason, Frieda and the kids. Anna, Jason and Frieda are trying to reduce the number of conversations that happen with their kids are around.
2. Liz Bowes-Spiegel, a breast cancer survivor and the wife of Anna’s cousin Mark Spiegel, has suggested that massages are very helpful for the achiness and fatigue that comes from chemotherapy. She has offered to organize a collection to help pay for massages. If you would like to contribute, please contact Liz. Her email address is bowesspiegel@comcast.net. Her U.S. Mail address is Liz Bowes-Spiegel, P.O. Box 420, Boulder, CO 80306. If we each give a little, then added together it might be of real benefit to Anna.

That’s all for now. Thanks again for caring for and loving Anna and her family. Best to all of you.

Hi all,

My sister Anna F. Dufair has been diagnosed with Stage 4 lung cancer.

In an effort to keep everyone as up-to-date on developments with Anna’s health, I’m going to start this email chain. I’ll try to send out new emails and new information becomes available. Please feel free to pass this message along to family and friends who would be interested. If they want to be added to the distribution list, please have them email me at RFairchild@aol.com. If you want to be taken off the distribution list, please send me an email.

Anna and her husband, Jason, have 3 wonderful kids: Alyssa (7), Ian (2), and Emma (7 mos.). They live and work in West Lafayette, IN, where Purdue University is located.

The latest information:
In the last few weeks Anna found out that she has a tumor in her left lung and another in her right thigh. She has been through a battery of tests - PET scans, biopsies, MRIs, CAT scans, blood tests, and many more. The diagnosis is that she has non-small cell basaloid squamous carcinoma — which is very rare for someone like Anna. Generally, this disease strikes males 75 years old who are life-long smokers. Anna is none of those things.

By definition Anna’s at stage 4 because it has metastasized (spread from her lung to her leg). If you look on the Internet, the 5-year survivor rates for someone with this disease in stage 4 aren’t promising. But then again the odds aren’t great for otherwise healthy 75 year old male smokers. We are very hopeful that the odds don’t apply to Anna.

The proposed treatment plan Anna is supposed to undergo chemotherapy and radiation simultaneously and then have surgery to remove any remaining tumors. They hope that Anna can begin treatment this week.

What Is Chemotherapy And How Does It Work? (some sections below cribbed from the American Cancer Society web site — an excellent resource if you are seeking more information)

Chemotherapy is the use of medicines (or drugs) to treat cancer. Chemotherapy is systemic — it works throughout the body. Chemotherapy drugs can destroy cancer cells that have metastasized or spread to parts of the body far from the primary (original) tumor. More than 100 chemotherapy drugs are used in various combinations. Although a single chemotherapy drug can be used to treat cancer, generally they are more powerful when used with other drugs. Anna’s chemotherapy treatment probably will consist of more than one drug. This is called combination chemotherapy. A combination of drugs with different actions can work together to kill more cancer cells and reduce the chance that she may become resistant to a particular chemotherapy drug.

How Does Radiation Work to Treat Cancer? Radiation is energy that is carried by waves or a stream of particles that can alter the genetic code of a cell. This genetic code controls how a cell grows and divides in the body. Radiation therapy attacks reproducing cancer cells, but it can also affect reproducing cells of normal tissues. The damage to normal cells is what causes side effects. Each time radiation therapy is given it involves a balance between destroying the cancer cells and sparing the normal cells.

Surgery
Surgery is used to cut out tumors. Hopefully, the chemo and radiation will shrink the tumors by the time Anna has surgery. Right now, the tumor in her left lung is closing off her left bronchial tube and is close to her pulmonary artery. The pulmonary artery carries de-oxygenated blood from the heart to the lungs. The surgeon would make an incision under her left arm and cut away part of one rib in order to reach the lung tumor.

The tumor is Anna’s right thigh is the fatty tissue between the skin and muscle. Hopefully, the tendrils (thread-like extensions) coming out from the tumor will be eliminated with chemo and radiation.

How long will all this take?
Bottom line: at least 5-6 months. Chemo is applied in cycles, generally lasting 2 or 3 weeks. Each cycle is expected to be repeated 3 times. That’s 9 weeks. Then another round of tests, figure 3 weeks. Then recovery from surgery on her lung will take 6 to 8 weeks. Then recovery from surgery on her leg would take some number of weeks — we haven’t been given a time estimate yet.

What about Side Effects?

Nausea (vomiting) has traditionally been a major problem with chemo, but we’re told that they can give Anna anti-nausea drugs which should help significantly. General fatigue and achiness are a freaquent problem that doctors haven’t found a solution to yet. Anna will lose her long, red, curly hair. She loves her hair and seems very concerned about loosing it. She’s purchased a wig.

How can you help?
One of the biggest ways you can help, is to stay positive. Anna and Jason are determined to fight this disease. The more positive and hopeful energy we can send their way the better. You might consider sending a card or a picture (say of you or your kids) every couple weeks. Nothing, big, just a note to say we’re thinking of you. You might add Anna and her family to your prayers.

Another way to help is to direct your questions about Anna’s situation and the latest news to me or my wife, Judy. Reducing the time that Anna and Jason have to spend answering the same questions over and over from dozens of people will help reduce their workload and allow them to direct energy towards Anna’s recovery.

A couple other ideas:
Anna and Jason are looking at months and months of daily trips to doctors offices — that means lots of sitting in waiting rooms. having something to do during that time would be useful: 1) Anna likes People magazine, so a subscription would be nice (send me an email if you plan to do this so we avoid sending her 15 subscriptions from different people), 2) send old books on CD or tape that you’ve enjoyed.

Anna’s address is
Anna F. Dufair
813 Essex Street
W. Lafayette, IN 47906

Stories of Hope

People do recover from cancer. We’re looking forward to Anna’s recovery. You might find the stories at the following website helpful and inspiring: http://www.cancer.org/docroot/FPS/fps_0.asp

Thank you for you interest and concern.

Best wishes to all of you.