Skinny

At the hospital

• A pretty good day for Rachel. She was set on minimal ventilator support early in the morning, and managed it well all day long -- essentially breathing on her own. This is a big step toward getting off the ventilator and getting out of ICU. In addition she sat up (with some nursing help) on the edge of her bed for a few minutes. Tomorrrow she'll get out of bed and into a chair, for the first time in three weeks.
• Rachel's much more aware, but still can't talk due to the ventilator. Lots of written notes today, with almost indecipherable handwriting -- it's sort of a combination of codebreaking, Pictionary, and charades, but some questions and answers got across.
• One sensitive issue: We got last week's news about cancer spread while Rachel was out of it, so she doesn't know she has a lesion in her brain. I talked to her doctors today, and we're probably going to tell her tomorrow or Thursday. The combination of her awareness and communication issues make this tricky, but she needs to know.
• The tumor diagnosis is still a little murky, but doesn't appear to be germ cell carcinoma (per the U. of Chicago, and a consult to Indiana U.) The elevated tumor markers which pointed to germ cell are being attributed to "de-differentiation" of epithelial ovarian cancer. I never considered myself an expert, but cancer is certainly more complex than I thought, and more frustrating. We'll do the second round of chemo this Friday, with the epithelial ovarian regimen (taxol plus platinum).
• One thing everyone will notice once Rachel's home (or even out of ICU) is how skinny her arms, legs, and face have gotten. It's not a result of the cancer or chemo per se -- it's being bedridden for almost a month, including a couple of weeks with zero nutrition. I'm sure this loss of muscle tone is why her handwriting is so shaky.
• Aunt Kathy took the kids to the hospital in the evening, and had a very nice visit. It's a lot more fun for them when Rachel's awake and interactive -- still "Mom".

Pat