July 3 Baby update

P7030028a.jpgLittle Andrew is now 11 days old.  We’re enjoying each moment with him, and at the present moment, I’m learning how to type on my laptop while holding a sleeping infant:)
Squirmy (as we mostly call him these days) had his first doctor’s appointment on Tuesday last week.  He had already eclipsed his birth weight, and he weighed in at 7 pounds, 6 ounces.  A champion eater, he may be taking after his parents… We’re getting not quite enough sleep, but not too bad either.  Andy is a cooperative baby (so far!), and he’s just so fun to look at!  I put up some new photos from the past week in our gallery.  All the photos of him are in the Summer album.

Weekly update from BabyCenter.com
Week 1 –
How your baby’s growing:
This week your newborn continues to adjust to her new world, which she finds perhaps a bit too noisy and well-lit for her taste. But she’s coming along. You’ll notice her limbs move in a jerky, uncoordinated way. Soon, probably by the end of the month, her movements will become more fluid as her muscle control matures. Sucking and chewing on her hands are her main activities for the moment.

Is your newborn a noisy breather? Lots of air passing through very small airways clogged with lint from blankets, clothing, and dust is the culprit much of the time. For the most part, you don’t need to worry; she isn’t likely to have a cold at this young age. She’s just trying her best to breathe.

Welcome Baby Andrew!!

He’s Here!!  Andrew Gordon Dotzour was born on June 22 at 6:14 am.  He weighed 7 pounds, 3 ounces and is 19 inches tall.
Mom, Dad, and Baby all are doing well.  Delirious:)
P1010090.JPG
For some starter photos of our little guy, visit the photo gallery.

As we drove to the hospital the night before, there was a lovely full moon low in the sky.  It was also the longest day of the year.  An auspicious day!

I started having contractions on Monday night about 7 pm.  They weren’t regular or progressive but continued through the night.  On Tuesday morning, I stayed home from work…not knowing if the contractions would fade away or develop into active labor.  Bryan went to work in the morning and worked from home in the afternoon…by mid-afternoon it seemed like maybe we were on our way toward labor…contractions were about 5 minutes apart and lasting 45 seconds.  Around 8 pm, we called Laura, our birthing assistant, and asked her to come over.  The three of us headed in to the hospital at about 10 pm.  Active labor continued through the night, and after a bit over an hour of pushing, little Andrew was born at 6:14 am on Wednesday, June 22.  Well, Baby Dotzour was born at 6:14. We didn’t name him until the next day.
What a wonderful and life-altering experience.  Bryan and I both can’t believe he’s finally with us.

We stayed at St. Mary’s until Friday, and now that we’re home with him, we just can’t stop looking at him.  That and sleep is I think what will make up our hours for the next few days and weeks.  Thanks to the multitude of good wishes and loving thoughts and prayers that have been sent our way these past weeks and months.  We are so blessed to have this miraculous little guy in our life.

Love,
Althea

Baby Dotzour: Week 39 Update

9.jpgJune 20.  I cannot believe that Baby D’s due date is just seven days from now!
Bryan and I celebrated our 6th anniversary on Sunday, which was a lot of fun.  We went to a hot and sunny Mallards baseball game here in town.  I had a good time at my 10th high school reunion on Saturday night.  Anne came over and painted a sunflower on my enormous belly.  Baby has been growing ever bigger, and with hot weather in the forecast this week, I imagine I’ll be ready to deliver whenever he wants to join us.  Bryan is beside himself with anticipation about meeting him, and each day we’re getting closer to seeing his little feet instead of feeling them push out of my side:)  My next (and last scheduled) doctor’s appointment is on Wednesday.

Babycenter.com Update

How your baby’s growing: Your baby’s ready to greet the world!
He continues to build a layer of fat to help control his body temperature after birth, but it’s likely he already measures about 20 inches and weighs a bit over 7 pounds. (Boys tend to be slightly heavier than girls.) Your baby’s organs are fully developed and in place, and the outer layers of skin are sloughing off as new skin forms underneath.

How your life’s changing:
At each visit, your midwife or doctor will do an abdominal exam to check your baby’s growth and position. She might also do an internal exam to see whether you’ve started effacing (when the cervix thins out) or dilating (when the cervix opens). If the week passes and your baby stays put, don’t panic. Only 5 percent of babies are born on their scheduled due date. And your baby can’t make you wait indefinitely for his arrival. If you go past your due date, your provider will schedule you for fetal testing (usually a sonogram) after 40 weeks to ensure that it’s safe to continue the pregnancy. If you don’t go into labor on
your own, most practitioners will induce labor when you’re between one and two weeks overdue.

Pregnant women on television sitcoms always have their water break dramatically — in the middle of a crowded room, of course — just before going into labor.
Don’t worry about a similar scenario happening to you. Membranes rupture before the beginning of labor in less than 15 percent of pregnancies, and it’s not normally an enormous gush — usually a small gush or a slow leak. In any case, if your water does break (or you even suspect you might have a leak), call your doctor or midwife right away, but stay calm — it may be hours before your first contraction.

We’ve identified a treatment strategy

On Friday, June 17, we met with Mom’s oncologist, Dr. Diggs, to talk about treatment options for dealing with her cancer.  We came to the meeting having done a lot of research and full of questions about which treatment would be most appropriate for the stage and type of cancer Mom is facing.  Dr. Diggs spent quite a while talking with us, and by the end of the meeting, we decided to go with the clinical trial: Gemcitabine and Radiotherapy Versus Gemcitabine, Fluorouracil, and Cisplatin Followed By Radiotherapy and Fluorouracil in Patients With Locally Advanced, Potentially Resectable Adenocarcinoma of the Pancreas
Early the week of June 20, Mom will be placed in one of the two treatment arms.  She’ll get a chemo port placed in her upper chest, and may be starting her treatment by Friday.

The data manager for the clinical trial is Lisa Peronto.  She met with us after Dr. Diggs, and we liked her a lot.  I think she’ll help us navigate all the doctors and appointments and details of Mom’s treatment, and it’s good to know we’ll have someone looking out for her and helping us by serving as a clearinghouse for our treatment questions.

She’s planning to set up an appointment mid-week to have a catheter placed in Mom’s upper chest for chemo treatments and blood drawings.  It should be a day surgery.  For more info on this type of catheter, see this website.
Dr. Gibson (her surgeon) would normally be the one to do this procedure, but as he is out for the next couple weeks, Lisa was going to identify a different surgeon on his team to place the catheter.  While I know she’s not looking forward to the procedure, the catheter will keep the doctors from having to poke her for blood draws or chemo drugs during her treatment.

Sometime this week, they will also assign Mom to one of the two arms of the study.  There isn’t a clear “better” arm to be assigned to.
Here’s how the study looks:
Arm A (standard therapy arm)

  • Gemcitabine and radiation therapy once a week for six weeks
  • Four to six weeks of no therapy
  • CT scans to see if the tumor is resectable and if so, surgery (if it’s not operable, potentially go back to the Gemcitabine and radiation therapy again.)
  • After surgery, four to six weeks of recovery
  • Gemcitabine once a week for two weeks followed by one week of rest.  Repeat five times.

Arm B (the experimental arm)

  • Three weeks of no chemotherapy
  • Radiation therapy and 5-FU for six weeks
  • Four to six weeks of no therapy
  • CT scans to see if the tumor is resectable and if so, surgery (if it’s not operable, potentially go back to the chemotherapy followed by radiation).
  • After surgery, four to six weeks recovery
  • Gemcitabine once a week for two weeks followed by one week of rest.  Repeat three times.

Once we know which arm of the study Mom is assigned to, I’ll write up a calendar with her expected treatment schedule.  The radiation therapy takes about 30 minutes per day.  Chemo in Arm A takes about one hour per day and in Arm B takes about four hours per day.

Breastcancer.org
has some nice info on their website about what to expect from chemotherapy.  Lisa did give us a gentle warning that this treatment regime isn’t an easy one and that Mom is likely to experience nausea, hair loss, loss of appetite, and fatigue.  The chemotherapy also may cause low white blood cell count and low platelet counts (making her more susceptible to infection and bruising).

At this point, Mom’s Cancer Antigen (CA) 19-9
count is 450.  The average is 37, and the standard for resectable tumors in under 1000.  We’ll be tracking this number through her treatment and will be hoping that chemo and radiation help to drop it down.  It can serve as an indicator of how well the treatment is working.

During the meetings with Dr. Diggs, we talked about two alternative drugs, Avastin (bevacizamab) and Erbatix.  Both of these are currently being used to fight other kinds of cancers and may have applications for pancreatic cancer, but it isn’t clear that either drug benefits pancreatic cancer.  They work by cutting off the blood flow to the tumor.  For more info on Avastin, click here.  For a general article on these studies, click here.
I also have the results from a variety of clinical trials that used
these drugs and can give you links if you’re interested.

OK, enough info for today!  Take care,
Althea

Internal stents are placed

On Friday, June 9, Mom had an internal metal wire stent placed in her bile duct.  The tumor at the head of the pancreas had blocked the bile duct, and the stent should keep the duct open so her liver and pancreas can drain like normal into the small intestine.  Mom’s body didn’t react very well to this procedure, and they kept her in the hospital until Tuesday.  On the 14th, doctors tested the bile duct and ended up inserting two additional stents.  Mom went home later that day.  She’s not feeling well, however, and we’re hoping that in a couple days her body will adjust to the poking and jostling it’s been getting and she’ll feel better.

After Friday’s stent placement, Mom ran a high fever for a couple of days, had a moderate amount of pain, and felt nausea and gastrointestinal discomfort (which makes sense since the stent is pretty much in her intestine).  They had expected to release her on Friday night, but it wasn’t until Monday that she was feeling better.

They had a test scheduled for Tuesday, June 14, so on Monday, they decided to keep her in the hospital for another day.  On Tuesday, a radiologist tested the stent by injecting contrast dye into the bile duct and using an x-ray to see how well the dye was able to travel throughout the system.  Apparently
they felt like the single stent wasn’t working well enough because they added two more.  Although she was in quite a bit of pain after this procedure, Mom felt well enough to go home on Tuesday night.
As of Wednesday morning, however, she’s still experiencing pain and continues to struggle with gastrointestinal discomfort and nausea.  Hopefully her body will adjust in the next day or so.

We have an appointment with her oncologist, Dr. Diggs, on Friday, June 17.  At this point, we’ll be discussing treatment options.  We’ve been doing a lot of reading and research, but if anyone has suggestions or input, please contact me by the 17th so we can take your input into consideration as we look at treatment options.

That’s the update for now.  Take care,
Althea

Baby Dotzour: Week 38 Update

9.jpg

Two weeks until Baby D is due!  At my weekly appointment yesterday, the doctor said that he was still head down, heart rate was lower…around 130, he seems to be growing well, but my weight has been stable the last three weeks.  I’m not as comfortable as I’ve been up until this point, but that’s to be expected. Mostly feel like I have a bolder attached to my belly!  We can’t wait to meet him soon.  He’s due on the 27th.


How your baby’s growing:
Your baby has really fattened up. She likely weighs between 6 and 7 1/2 pounds now (boys tend to be slightly heavier than girls), and she’s probably between 19 and 20 inches long. She has a firm grasp, which you’ll soon be able to test with your pinky! Her organs are fully developed and in place, but her lungs and brain — though developed enough for her to function now — will continue to mature right through childhood.

Wondering what color your baby’s eyes will be? You may not be able to tell right away. If your baby is born with brown eyes, they’ll likely stay brown. If she’s born with steel gray or dark blue eyes, they may stay gray or blue or turn green, hazel, or brown by the time she’s 9 months old. That’s because a child’s irises (the colored part of the eye) may gain more pigment in the months after she’s born, but they won’t get “lighter” or more blue. (Green, hazel, and brown eyes have more pigment than gray or blue eyes.)

How your life’s changing: It may be harder than ever to get comfortable enough to sleep well at night. Take it easy through the day — this may be your last opportunity to do so for quite a while.  [I continue to sleep just fine through the night…thank heavens!!!…but rolling from side to side results in a
fair amount of grunting and groaning.  I know what my horse felt like when she was really pregnant.  And I understand the grunts!]

Keep monitoring your baby’s movements, too. Though she’s crowded, she should still be active.

Swelling of your feet is normal in these last weeks – [I’ve started to notice this especially when it’s hot and humid.  hmmm, it’s been hot and humid a lot!]

Encourage your partner to relax and enjoy some activities he won’t have time for after the baby arrives.

Mom’s laparoscopy has good results – no new tumors

On Thursday, June 9, Mom had a endoscopic surgery called laparoscopy.  The purpose was to look to see if the tumor at the head of the pancreas has spread to other portions of the abdomen.  And we got good news!  Dr. Gibson found no new tumors, and that means that Mom can start a combination of radiation and chemo soon.

Dr. Gibson reiterated that Mom’s cancer, is a mucin andocarcanoma. He warned us that there’s a high probability that the tumor has shed some microscopic cancer cells to other parts of the body.  But the good news is that none have grown to the point that they were visible from today’s procedure.  Our hope is that chemotherapy will destroy any metastic cells before they grow.

On Friday, Mom had surgery to have a permanent stent placed in the bile duct (which was being blocked by the tumor).  Dr. Gibson compared the metal stent to a chineese finger trap (see a photo). They’re keeping the external drain in until Monday (to make sure that the internal stent is working correctly), and then they’ll take it out on Monday the 13th.  This will mean she’ll have to give up her external bile bag, which I’m sure she’s become attached to over the last week (just kidding!).

She’s also supposed to be meeting with Lisa, the data manager for the ECOG study that we’re looking at right now for her chemo/radiation treatment.  That appointment is scheduled for Tuesday the 14th.  We should be able to get questions answered about her participation in that study during this meeting.

Dr. Zinda, an oncological radiologist will be meeting with Mom sometime next week to schedule a surgery to install the ports through which they will deliver the chemotherapy drugs.  These are called venous access device (VAD) and are surgically implanted devices that provides long-term access to a major vein.  Not a pleasant thing to look toward, but it will allow her to start her chemo treatments soon.  It’ll also mean she won’t get poked with needes every time she goes in for treatment, which in general will be a very good thing. Here’s more information and another good definition.

The following Friday, June 17, we’re meeting with her oncologist, Dr. Diggs, to talk about treatment options.  I’m hoping that her treatment will begin the following week.

For those of you would would like more information on pancreatic cancer, I’ve found the National Cancer Institute to be a good source: http://www.cancer.gov/cancertopics/types/pancreatic

I’ve found that breastcancer.org is a good website in terms of providing lots of good, readable content on cancer treatment (esp. what to expect from chemotherapy).

Here’s a list of clinical trials that Mom may be eligible for:
http://www.cancer.gov/search/ResultsClinicalTrials.aspx?protocolsearchid=1657219

Here’s info on the treatment that her oncologist, Dr. Diggs, recommended.
http://www.cancer.gov/search/ViewClinicalTrials.aspx?cdrid=258056&version=patient&protocolsearchid=1657219

Also, here’s a brief bio on Dr. Charles Diggs. and one for her surgeon who has been leading up her diagnosis and treatment, Dr. Scott Gibson.

Baby Dotzour: Week 37 Update

9.jpgJune 6: We’ve reached full term!  Baby Dotzour is now big enough to be born, but we’re planning on keeping him in for at least another couple weeks.  All continues to be well with our pregnancy, and the nursery is nearly ready.  We can’t wait to meet him!!

How your baby’s growing: Congratulations! Your pregnancy is now considered full term — meaning your baby is developmentally ready to handle life outside the womb. (Babies born before 37 weeks are pre-term and those born after 42 weeks are post-term.) Your baby probably weighs a little over 6 pounds at this point and measures between 19 and 20 inches, head to heel.

Many babies have a full head of hair at birth, with locks from 1/2 inch to 1 1/2 inches long. But don’t be surprised if your baby’s hair isn’t the same color as yours. Dark-haired couples are sometimes thrown for a loop when their children are born blonds or redheads, and fair-haired couples have been surprised by Elvis look-alikes. And then, of course, some babies sport only peach fuzz.

How your life’s changing: The next couple of weeks are a waiting game. Use this time to prepare your baby’s nursery or to take care of tasks you may not get around to for a while after your baby’s born. Take naps and catch up on your reading while you can.

You may be getting a lot more Braxton Hicks contractions now, and they may last longer and be more uncomfortable. Sometimes — when they start to come frequently — you may even think you’re in labor.

No surgery for Mom now…a week until the next test

On Friday morning (June 3), Mom met with Dr. Sharon Weber, a doctor of surgical oncology at the University of Wisconsin Hospital.  After looking at the CT scans that were sent from St. Mary’s, Dr. Weber told us that it’s her opinion that the tumor is currently inoperable. So our next step is to do a laparoscopy next Thursday to check for other tumors before beginning chemo and radiation.

The tumor (which I am considering naming Poco in order to encourage a tiny tumor with a slow growth habit) is in a part of the pancreas called the uncinate process.  When it’s in this location, it can be there for a while without exhibiting symptoms, which may be why it could get to be 4×3.7 cm in size before causing problems.  It doesn’t seem to have masticated (spread to other parts of the abdomen), which is a good thing.  However, the tumor (Poco) is classified as advanced as it involves about three centimeters of the superior mesinteric vein (SMV), and Dr. Weber thinks it is unlikely that any doctor would be willing to operate at this point.
“So what do we do next?” you ask?  We need to do a laparoscopy to look for tumors that may have spread but didn’t show up on the CT scan.  We want to know this before we head into a chemo/radiation regime because radiation won’t be effective if it has metastasized. Mom called and made an appointment for Thursday, June 9 to have this operation done (it will be an out-patient surgery).

We would also like to get a wire stent implanted so Mom’s bile goes back to the GI track instead of draining externally. This would be another relatively minor surgery, and we still have to look into scheduling it.

Mom should be able to start chemo and/or radiation in the next few weeks.  Depending on which course of action we take, the chemo/radiation regimes take around six weeks and then you wait another four weeks or so before doing a CT scan to see how much the tumor has shrunk.  The goal of these treatments is to shrink Poco to the point that he can be removed (probably by Dr. Weber).

So that’s our news right now.  I won’t have any further updates until after the laparoscopy results are back which won’t be until next Friday at the earliest.  Besides reeling from the magnitude of this news, Mom feels all right, and we’re all pulling together to find our way through this maze.  I know that we have a lot of people out there thinking of us and sending us their wishes and prayers.  It is very much appreciated.