Doctor Appointment

At the follow-up examination, Ralph was informed that his white blood count had dropped and the others were rising, as expected. He can go to a restaurant with a mask, but if seated in a booth, he can remove the mask. All food must be well cooked....I doubt that he does this.

The doctor wants him to wait another 3 to 4 weeks to give the stem cells a chance to graph before addressing any should discomfort issues. After the ride to Pittsburgh and sitting in the waiting and examination rooms, he needed pain medication for his back. He sees a neurologist on July 17th about that. He will receive a bone strengthening treatment in 2 weeks, at UPMC in Meadowlands, and have the myeloma parameters determined. He goes back to Hillman on July 23rd.

Ralph has been enjoying our healing garden on sunny days. He has been putting alone and with friends on his green.

Home Sweet Home

Ralph got home today at 8:30 PM. He needs to stay around our house and yard for a few weeks. His diet remains the same until all counts are normal. He has a lot of follow-up appointments. There is nothing that he cannot do for himself. He must wear a mask for doctor appointments, keep shoes or slippers on his feet, wash hands frequently, and bathe daily. He is encouraged to walk and stay “off the couch” to build strength and stamina.

Again, thank you for all your cares, concerns, and prayers. Your cards, calls, and visits were inspirational and gave strength to each of us. We have learned the true meaning of, “If God brings you to it, He’ll carry you through it”. Our journey is not over, but, at least we know what we are up against. Bless you!

Cross all fingers...

Ralph’s counts were near 5000 this morning. The other counts are increasing, and the doctor wants to send him home tomorrow! Before Ralph can come home, he will receive more platelets and his port must be removed. Thus, he would not be discharged until late afternoon or early evening.

His back and shoulder are still bothersome, but I guess those will be addressed at a future time. His responsibilities include nothing but caring for his meals, his hygiene, and keeping a positive attitude. Tomorrow, the complete list of instructions will be reviewed and he will have a printed copy.

TUESDAY and WEDNESDAY

I went home for about 32 hours to do some gardening and trim the jungle in our front yard. Ralph wanted me to take pictures of the healing garden and putting green. It must inspire him to get well soon.

Ralph’s white blood count jumped from 900 to 2700 to 3600. Normal counts are between 5,000-12,000. He is eating better and walking faster. The other counts rise slower. He received two more units of blood to increase those. All vital signs are good.

On Tuesday, Mallory spent the afternoon, and Megan delivered a “Party-in-a-Box” that Ralph’s friend and appraisal typist, Cathy, got together for his birthday. She collected cards, well wishes, and a few presents from all the friends at credit unions, banks, and businesses that Ralph either works for or is associated. He’s already read the book, “Extreme Golf”, that was in the box.

On Wednesday, Mallory visited, and Michael spent the late afternoon with Ralph. Megan came after dinner.

HAPPY BIRTHDAY, RALPH!

Ralph celebrated his 55th birthday with visits from Mallory, Megan, Nathan, and Michael! We brought homemade cupcakes for the staff, and Megan brought a huge balloon! He received a lot of calls, as well. For lunch and dinner, the hospital added a small, one serving cake. His counts are going up but are still low. PT thought that he was walking pretty quickly and that the muscles in his shoulder make his arm shake, because they are in the habit of protecting Ralph from pain. He still has an IV for hydration and potassium.

HAPPY FATHER'S DAY!

Ralph had a rough night of vomiting. In the morning, Ralph showered and shaved. He was able to eat some of his breakfast, and then went for a little walk. He ate lunch and is consuming a little more than broth. While he watched the U.S. Open, he chose half of a peanut butter and jelly sandwich as an afternoon snack. He still hates to fill out his own menu and waits for one of us to arrive. Although, he has more interest to choose, and he has the menu pretty well memorized. Megan and Michael visited, and we all played Spades until his dinner arrived. It was encouraging that he would rather eat something than finish the game. Mallory was at work.

Ralph's address...

UPMC Shadyside
Room 750 West Wing
5230 Centre Avenue
Pittsburgh, PA 15232-1381


Some have requested Ralph's address. This is the Internet site address with his room number. We assume that he can receive mail, but if not, they will probably hold it for him until he can. Mallory has been bringing the mail, from home, weekly. We expect him to be in the hospital for the rest of this month.

Thank you for all thoughts, concerns, and prayers!

NO Resistance

Ralph has no resistance, now. Through the night, he had a slight fever, and his mouth became swollen. Both are common. His fever was monitored carefully until it went down on its own. Thus, he did not feel well. He describes it as flu-like without vomiting. He is also urinating a lot. He prefers no visitors, as a precaution, so we will stay in touch through phone conversations.

Hopefully, we were fortunate enough to weather only one storm.

Ralph’s appetite improved, today, and he has been able to keep everything down. He received platelets and walked his laps. Thank goodness the US Open is distracting him! Dr. Raptos predicted that Ralph’s counts will begin to rise on Monday (Ralph’s 55th birthday) and that Ralph would not feel as badly. Megan and Nathan visited. He answered all his calls, as well.

Another patient, named Paula, visited Ralph in the hopes that he could inform as well as comfort her. She has the same type of cancer, but it affected her kidneys. She was diagnosed in January. She described her symptoms as flu-like with nausea that lasted over a month. Paula received her transplant, today, and wanted to know what to expect. Ralph encouraged her.

Email worthy of sharing!

Recently I overheard a Father and daughter in their last moments together at the airport. They had announced the departure. Standing near the security gate, they hugged and the Father said, 'I love you, and I wish you enough.'

The daughter replied, 'Dad, our life together has been more than enough. Your love is all I ever needed. I wish you enough, too, Dad.' They kissed and the daughter left.

The Father walked over to the window where I was seated. Standing there I could see he wanted and needed to cry. I tried not to intrude on his privacy, but he welcomed me in by asking, 'Did you ever say good-bye to someone knowing it would be forever?' 'Yes, I have,' I replied. 'Forgive me for asking, but why is this a for ever good-bye?'. 'I am old, and she lives so far away. I have challenges ahead and the reality is - the next trip back will be for my funeral,' he said.

'When you were saying good-bye, I heard you say, 'I wish you enough.' May I ask what that means?'He began to smile. 'That's a wish that has been handed down from other generations. My parents used to say it to everyone.' He paused a moment and looked up as if trying to remember it in detail, and he smiled even more. 'When we said, 'I wish you enough,' we were wanting the other person to have a life filled with just enough good things to sustain them.' Then turning toward me, he shared the following as if he were reciting it from memory.

I wish you enough sun to keep your attitude bright no matter how gray the day may appear. I wish you enough rain to appreciate the sun even more. I wish you enough happiness to keep your spirit alive and everlasting. I wish you enough pain so that even the smallest of joys in life may appear bigger. I wish you enough gain to satisfy your wanting. I wish you enough loss to appreciate all that you possess. I wish you enough hellos to get you through the final good-bye.

After the first storm passed...

Ralph was given something, in his IV, to alleviate the nausea. Once that took effect, he walked in the hall, twice, ate a Popsicle, and enjoyed some macaroni and cheese. About 2:30pm, he received more potassium, liquids to hydrate, and 2 pints of blood to go with a nap...a sound nap from the Benadryl that was given for relaxation during IV transfusion, hydration, and potassium. By 4:30, he was awake and watching TV...disappointed that the US Open was postponed. He ate some dinner...tried lasagna but said that it was inedible. Megan visited, and they walked a few laps in the hall.

Darkest before the dawn...

Ralph' s period of not being sick was short lived. As expected, he was violently ill through last night and thus far, today. He is unable to keep anything, that is given, down. The medical staff is working on an answer for some ease. Every patient is different and reacts differently to the process of the transplant and medications. We are thinking that his counts have hit rock bottom and after these storms pass, he will begin to see clear skies ahead. Hopefully, we are not too naive.

DAY 9

Well, the shot must have worked! Ralph had no problems holding his food down! Of course, his appetite is minimal, but he slept better. After examining Ralph, the doctor felt he was doing well. As of 11AM, Ralph felt weak and slightly nauseated, but he made a business call! More food was consumed, at lunch and dinner, than any meal over the past few days. At 4pm, Ralph commented that he felt okay and that he had walked in the hall which has filtered air, twice. Michael and Megan visited.

DAY 8

Ralph vomited for about 20 minutes about 10pm, last night, but was able to get some sleep after that. He awoke,this morning, not feeling very well. Around-the-clock medicine is being given for nausea and Ralph needed IV potassium. The Neupogen shots were started today. Those stimulate white blood cell production.

He made the effort to eat, but breakfast and lunch did not stay down. He made one outing into the hall but is significantly weaker today. At about 4pm, he was given a medicine that tells the brain to not be nauseas…it knocked him out until supper which he attempted to eat.

Small world, again…a friend of Megan’s from high school, who is in med school, recognized Ralph’s name and stopped in.

DAY 7

Ralph did not sleep well but was not vomiting. He was able to eat Cream of Wheat, orange slices, and a 6 oz. chocolate milk shake for breakfast, but that did not stay down. He showered and was given a medicine, before lunch, in an effort to keep his lunch down. He ate beef vegetable soup, mandarin oranges, and crackers after he took a shower. The medicine must have worked! He took it before dinner, as well, and as of 8pm, all is in his stomach! PT walked 11 laps with him…a new audience to hear all about baseball teams that he coached and on which he played. He refused therapy on his shoulder. An orthopedic surgeon is going to evaluate his shoulder.

He took phone calls.

His only expectations are to walk, fill out his own menu (which he hates to do…haha), wear his mask out of the room, shower, do his shoulder exercises, and try to eat.

As of now, everything is going as predicted. He has not hit rock bottom, yet. Once he does, his health will begin to improve! The nurse encouraged him by stating that he will be pleasantly surprised as to how fast he will feel better>>>KEEP ALL FINGERS CROSSED!

DAY 6

Ralph vomited through the night and needed potassium, so an IV was started. His appetite is basically nil. Medicine was given for nausea through the IV, too. Twice, he walked in the hall but mainly watched golf and baseball. He was pretty quiet and didn’t feel like talking on the phone. Small world…Sharon Difilippo’s and Fran Binder’s niece was Ralph’s nurse! She would also be Nathan Voytek’s cousin!

DAY 5

Ralph is only able to eat Popsicles, saltine crackers, and broth, at this time. He showered and walked around the restricted hall area. Staying awake was getting easier. He only napped for about an hour. Michael, Megan, Nathan, and Mallory visited, which always distracts Ralph from his discomfort. Looking at some of the other patients, Ralph realized how lucky he is. He seems inspired to get out of the hospital and realizes that eating and excercising is the key. He needs to push himself to do both.

DAY 4

Ralph started the day with no appetite and the smell of food making him nauseous. He also experienced diarrhea and was treated for both problems His energy level decreased by early morning, as well. The doctor explained that Ralph is experiencing some of the common effects of the Chemo he received. As of 1pm, he still had no motivation to leave his bed. He was able to answer phone calls.

For lunch, Ralph ate some broth and crackers. The PT had him walk and do one shoulder activity. The girls visited in the late afternoon, and Mallory decorated the room with family pictures. Random odors began to nauseate him such as the ink on the newspaper.

For dinner, Ralph ate broth and crackers again. Because his potassium went low, he was hooked back up to an IV.

The Rest of Day 3...

After Ralph settled himself, he dozed off and on for the rest of the day and through the night. He walked a little, but his esophagus burns, and he felt nauseous. For that reason, he only enjoyed Popsicles. He took a few phone calls and watched television.

TRANSPLANT COMPLETE

Ralph has had his new birth! The actual re-infusion lasted 4 minutes! The preparation was one day less than 5 months! His cheeks got red, he asked for peppermints to mask the taste, and mentioned that his ears felt hot. The doctor checked his vital signs and told him that the cells would begin to make their home in 10 to 14 days. That is when they will begin to grow. He has begun to lose his appetite from the Chemo taken this past Tuesday and Wednesday and is expected to feel tired from the Benadryl given prior to the re-infusion. All reactions to the Chemo will begin tomorrow or Saturday.

The experience is quite emotional. No doubt, a plethora of feelings and thoughts are going through Ralph's head. He is anxious and doesn't know what to do with himself. Ralph, Megan, and I received communion. He put on his mask, and then walked a few laps, with Megan, in the area where the air is filtered.

LET THE HEALING BEGIN!!! Again, thank you, family and friends, for your constant support, thoughts, and prayers!

Day Two

Through the very early morning, blood work was drawn. Another doctor introduced Ralph to the “virtual handshake” to prevent the passing of germs. There will be no more skin to skin contact. He ordered, “Walk and eat”. A physical therapist evaluated Ralph and began easy exercises to improve his shoulder’s range of motion. Around noon, Ralph complained of nausea and asked for medication. He was able to eat some soup, a couple crackers, and a little bit of the rice and vegetables. Michael stopped by during his lunch hour. As of 1pm, television still kept Ralph’s attention, and he played along with Family Fued. At 3:15, Ralph was inspired to take a short, quick paced walk, even though he asked for nausea medicine, again. As before, his cheeks and face are very red from Chemo.

Thus far, Megan, Nathan, Michael, and I like Ralph with really short hair. We have not convinced him to keep it, though! Michael likes it well enough to message us later in an effort to impress upon Ralph that he should keep it.

Again, at 5:30pm, Ralph received his second dose of Chemo. He was able to feed himself ice chips, continuously, for the hour. Mallory came in the evening.

Ralph is to get his new stem cells tomorrow between 10am and noon!

No matter what scenario we hear or live, there is always a sadder or one more devastating. We continue to count our blessings and have added new acquaintances to our prayer list.

Day One

Ralph was called into Shadyside at 8:30am. We arrived around 10:30 and were quickly escorted to his room, #750, in the West wing. His vital signs were taken; height and weight were measured; an EKG and a chest XRAY were prearranged; blood was drawn; a tour was given of his area; he did not complain about lunch or dinner; head was shaved; Chemo started at 5:30 and lasted about an hour. As instructed, Ralph chewed his ice chips during Chemo to help prevent too many sores inside his mouth. He also met one doctor who will be working along with the transplant team. Hopefully, everything goes as well as the pretty picture that he painted.

It appears that Ralph will need to build resistance to bacteria, so HE is the only one who will wear a mask when he leaves his room. Of course, no one is to be in his room if they have any sign of an illness or have been around anyone who is sick. His room is private, clean, and comfortable.

In the evening, Megan and Nathan brought Chinese food, and we watched the Penguins in the family room of the hospital!

Last week...

Ralph had anticipated feeling more energy last week. Each day, he felt weaker, short of breath, and even lost his balance a few times. On Thursday, he had a blood transfusion because his hemoglobin count was low. http://www.mayoclinic.com/health/low-hemoglobin/AN01295 http://en.wikipedia.org/wiki/Hemoglobin At Hillman, he received 2 pints. After that, he did find more energy and felt better, in general. We were able to go to Megan's and Nathan's for dinner with Michael and Erin, as well.

Meanwhile, on Wednesday, Ralph had an MRI of his back for the neurologist that he saw on Friday. Since Ralph admitted that he could tolerate his back pain until after the transplant, it was decided that the procedure to heal or ease his pain in his back would wait. We tried Angelo's, again, on Friday night, but Ralph got anxious, and we left after 30 minutes. Jim and he made their Saturday "ride around" and Shorty's lunch! On Sunday, Ralph accompanied me on a few errands. Michael came for "Take-out" dinner and watched golf and a movie. Sam and his son, Steve, visited.

The girls joined me at the pool which was a nice opportunity to relax, see a few friends, and gain some strength before the trek ahead.

FREEDOM....

Ralph is no longer restricted and can do anything he chooses between now and being admitted into the hospital. To have 2 transplants, one must harvest 5 million good stem cells. After the blood work results, the machine predicted that it could collect 43+million from Ralph! The nurse seemed very pleased, so we are taking this as a sign that Chemo did it's job! He is at Shadyside, today, for approximately 8 hours to collect those 5 million!