update from Bob Shalowitz

HELLO to all of our friends and relatives. Sorry for no updates but the last 1-2 weeks have been stressful with many Dr appointments and very slow progress.
Next time anyone tells you that you will be fine 2-3 days after a surgery, let me tell you, based on 30 years as a doc myself: it may not be true! The surgery may be done perfectly, but every patient reacts differently, and doing surgery on a person is not the same as changing your car's spark plugs!
With Maureen's emergency surgery in June, we were all told to expect her to be home in 3 days-instead she was on a respirator for 6 days, in the ICU for 10 days, and in the hospital and rehab for a total of 6 weeks.
With her current surgery(left femur rod placement), she has been very sore, is walking short distances with a walker, and requires a lot of medicine. She has a hematoma near the upper of her 2 incisions but it appears to no be growing. Her blood thinners have been stopped and she is scheduled to start radiation treatment of the left femur this coming monday for a total of 13 treatments.
We both are very happy with the surgeon, Dr Durbhakula and the surgery was done perfectly. But everyone recovers differently and recovery is unpredictable, even with more minor procedures.
This is why when a women tells me to just take her uterus out, she doesn't need it anymore, I refuse unless she really needs it--because I know that complications can occur no matter how simple the operation, and certainly more with complicated ones.
It is probably going to take a total of 6-8 weeks for her to walk without a walker, but I have to say she is doing a little better each day.
GOOD NEWS(we certainly need some): Her CA27-29 tumor marker has dropped from 448 to 202, more than a 50% reduction, probably secondary to the medicine she is on(aromatast inhibitor) and the fact than some tumor was scraped out of the bone when before the rod was put it. This is a significant postive.
She has a lot of trouble getting in a comfortable position and thank god Eileen is here-I could not do this without her. She manages to work her sister into some type of position she can stand, using hot packs, cold packs, pillows, towels. The Ipod also really helps her sleep(thanks Susan Shalowitz).
In any case, the summer of 2009 has been a nightmare that we keep hoping we will wake up from, but since that doesn't look like it is going to happen, I have to say, that in view of the initial emergency in mid June, things COULD have been much, much worse by now. Her leg is stable, and hopefully the recurrent breast cancer will continue to respond to the medication as it appears to be doing.
Will try to update more often-
Thanks to everyone-
Bob S.

Quick update :-)

Mom is doing well...getting stronger by the day. She still has pain and has to walk with a walker, but she is working hard to get her strength back up. She is still staying in Bethesda and my Aunt Eileen is still doing a fantastic job helping care for her and helping her get better. I'm not sure when the radiation treatments will begin, but it should be in the next few weeks. She is still in good spirits and cannot wait until this chapter is over! There have been some requests on where to send cards/letters/anything else. You can send them to my house and I'll make sure she gets them within a few days. My address is 2270 Cathedral Ave NW, Washington, DC 20008. She is also staying at The Grand on Nicholson Lane in North Bethesda, MD. Some people have asked if/where they could send flowers -- the best place for them to go is probably to my grandmother's apartment in the grand. Send them c/o Florence Guggenheimer, 4801 Nicholson Lane, Apt 1105, North Bethesda, MD.

On another note, Snickers got to come visit Mom the other day -- she loved the visit and they had a great time!

Update from Bob Shalowitz

Maureen's surgery went perfectly. There is a rod running the length of the shaft of her left femur and it is in perfect position. There is one screw running diagonally through the upper end of the femur to spread the weight distribution. Often a second screw near the knee is needed, but the placement was so solid that the second screw was not needed, so there are only 2 small incisions. She should be able to go home either fri or sat. She is on a blood thinner which is routine for this surgery and will be on it for a few weeks to prevent blood clots. She also received antibiotics to prevent infection. She will be allowed to weight bear almost immediately. By the way I had gotten a consult from our long time friend Dr Mark Leeson in Akron--he is an orthopedic cancer specialist--and he completely agreed with the procedure and that it would have been a big mistake not to do it. She will get physical therapy at home for 2-3 weeks post op and hopefully can start radiation treatment in about 2 weeks. We also snuck in her first zometa treatment on tuesday at Dr. Priego's office-this IV drug prevents osteoporosis, helps new bone grow, and also has an effect against further spread of cancer to bone. This will be given once a month.
Thanks for everybody's support.
Bob Shalowitz cell 330-473-8083

She's out of surgery!

We just spoke with Dr. Durbahkula, her orthopedic surgeon, who told us that the surgery went great. She is still in the recovery room and we haven't seen her yet, but that shouldn't be too long. My dad will write a longer and more detailed update later, but so far things are looking up!

IMPORTANT UPDATE FROM BOB-PLEASE READ ENTIRE MESSAGE

Maureen is going to have a procedure which is scheduled for wed (tomorrow morning) at 10 AM. The area of cancer in the upper left femur creates a weak spot that has a risk of fracture-If that happens it would literally be a disaster. We have seen a orthopedic surgeon who is the partner of our radiation oncologist's brother. His name is Dr Durbahkula, and he did a fellowship at Harvard. We are very impressed with him. Both he and the radiation oncologist, Dr. Susan Stinson feel that this area of the femur should be fixed. She is going to have a rod inserted the length of the femur to support it and prevent fracture. There will be either 2 or 3 very small incisions, the operation will take an hour, and be done under spinal anesthesia. She will only have to be in the hospital about 2 days. She should be able to walk with a cane afterwards and radiotherapy to the femur can begin 1-2 weeks after the procedure. It will be perfomed at Shady Grove Hospital in Maryland. The 2 oncologists, Dr Priego and Dr. Stinson, still remain optomistic that this is all very treatable. Obviously setbacks are always emotionally challenging, but we plan to focus on the positives that at least there are things we can do about this. Eilleen is doing a great job as our executive assistant and we could not possibly get through this without her. Mom has also been extremely helpful throughout this ordeal. She is sick now too, with a persistant cough and we are taking her to Maureen's pulmonologist, Dr Jay Weiner, today. Dr. Weiner has gotton a lot of patients out of all this!! (Maureen, me, Sara,and now mom). I would like to emphasize that we totally appreciate all the support from our friends and family, even though I don't mention every name. Thanks also to Sara for setting up this web site which allows us to keep everyone posted--20 years ago this kind of thing would have been impossible.
Will update again tomorrow after the surgery as soon as I can get to a computer.

Bob S.

IMPORTANT UPDATE FROM BOB-PLEASE READ ENTIRE MESSAGE

We have a small to medium stumbling block now. An MRI today confirms that there is an area of cancer in Marti's upper left femur(thigh bone). We were went from there to Dr Priego (oncologist) who immediately got us in with Dr. Susan Stinson(radiation oncologist). She was very optimistic that this tumor can be completely dissolved with local radiation with very minimal if any side effects. However, the bone is weak in the area where this tumor is, so until it is fully treated, there is a risk of fracture of the bone, which would be a disaster. Therefore we have to see an othopedic specialist to see if anything should be done first to reineforce the bone and prevent it from breaking. We will be getting a couple of opinions on this, one from the doctor here on monday morning, and probably one from an orhtopedic cancer specialist back in Ohio that I have been friends with for 25 years-I have a call in to him now.
On a good note, Marti is getting stronger rapidly, I am really impressed with her progress the last 5 days. Her sister Eilleen watches what the Physical therapist does and helps Marti repeat those exercises each day. We have an excellent pool and workout facility available at my Mom's apartment building. Walking back and forth in the pool really helps.

NOW HERE IS SOMETHING ELSE REALLY IMPORTANT: To all of our highly valued friends and relatives: When you call Marti, PLEASE talk about anything OTHER than her disease. Talk about politics, the weather, trips you went on or will go on soon, kids, grandchildren, the economy, movies, TV shows,, ANYTHING but Marti's medical treatments, medical condition or stuff like that. It is highly valuable for her to spend time talking about fun things and highly depressing to be questioned about her medical condition, medical plans, etc. Most people realize this, but some VERY WELL MEANING people are just trying to show concern, but PLEASE do so in non-medical ways. MARTI AND I WOULD SINCERELY APPRECIATE THIS.

PLEASE get the medical updates from the blog. No news means she is improving and there is no bad stuff. For anyone with a medical question after reading this, please call ME(Bob 330-473-8083) and do not call Marti. DO call Marti ANYTIME with fun or interesting stuff that is NON medical.

Thanks for everyone for all the support.

Bob Shalowitz