No Radiation

Ma had an appointment this morning with Dr. Shank, the radiation oncologist. Dr. Shank feels that additional radiation will not help Ma at this stage. This is what I expected to hear.

Afterwards Ma had her port flushed. I keep forgetting to ask if Ma should have it removed, but maybe it's better to keep it just in case.

Crappy Insurance

I spent over an hour making phone calls to the online pharmacy and insurance company and the pharmaceutical company. It looks like the $366 copay is correct. That's $530 a month or $6350 a year. I thought Ma had good insurance but apparently not when it comes to her chemo pills.

Xeloda Arrived Today

Ma's pills arrived today, and she took her first dose of 3 pills tonight. She'll be taking them twice a day for the next two weeks, then she gets a week off. If she gets severe side effects, the oncologist can adjust the dosage.

Ma ordered her Xeloda online hoping that will save money, but the online pharmacy claims she has a copay of $366. That's too much! I hope it's just a billing error. According to the manufacturer (Roche), Xeloda is covered under Medicare Part B. I suspect the pharmacy is erroneously charging her meds under Medicare Part D (prescription drug coverage). Apparently a lot of pharmacies don't know how to bill oral cancer medications. Roche even provides the correct billing codes. I'm hoping we can clear this up in the next few days.

Skin Metastasis

Ma's cancer has spread to her skin. The symptoms: red, itchy skin on one breast only (the one that got a lumpectomy) along with tumor nodules. The treatment: An oral chemo called Xeloda. It's milder than IV chemo. The worst side effects are diarrhea and hand & foot syndrome. Hair loss and nausea, while possible, are less likely to happen.

Ma will take 3 pills (500 mg. each) in the morning and 3 pills at night every day for two weeks, take one week off, then start the cycle all over again. She'll be on it indefinitely.

Update on Pa (and a Mini Update on Ma)

Pa has improved dramatically in the last month. He no longer needs physical or occupational therapy. He'll go once a week for speech therapy, maybe around 4 sessions.

Today he went back to work. Fifteen patients showed up. Busy day. He plans to stick to his old schedule of 5 hours a day, 4 days a week. Ma & Tito Lum helped out at the office.

Leg

He can walk without a cane. His balance isn't quite there yet (he can't stand on one leg), but it's improving.
 
Arm

•  He can drive. Ma insists that he stay off the freeway for now.
• He can play the piano, kind of. Nothing like before. He can do octaves and can play only two notes at a time. But he practices daily and is steadily improving. The arthritis in his fingers is getting to be a problem though.
• He can write slowly. Uppercase printing is fine. Cursive writing isn't legible yet.
  

Face/Head

• His swallowing is back to normal. The feeding tube was taken out two weeks ago. It hadn't been used in a month.
• He still has facial droop. This is the most visible sign of his stroke and may never go away entirely. He will get speech therapy for this.
• Speech is still a little slurred due to the facial droop.

Update on Ma

Ma is on physical therapy for her legs. She walks so slowly and with a cane. We're hoping therapy will make a difference. She used to have numbness in her legs, but it went away after she started exercising.

Handrail

The handyman is here and just installed a second handrail along the stairs. Ma has already tried it. I also had Pa go up and down the stairs. He said it's much easier having two handrails.

We finally got an aide to come out and help Pa take a shower. We already had a shower chair from when Ma was sick, and the showerhead is attached to a hose, so that made things easier. Isa & I will try helping Pa take a shower this afternoon.

It looked like a combination of Trazadone and Benadryl helped Pa stay asleep, but it stopped working after just a couple of days. Last night we tried Trazadone and Ativan, and that seems to have worked.

We saw Pa's cardiologist on Thursday. He was very nice and very helpful. He didn't like Pa's EKG results and had cut Pa's heart medicine in half. He wants to do another EKG on Monday to see if cutting the medication makes a difference.

Safety Recommendations

The physical therapist made several recommendations. Among them:

• Add a second rail to the staircase.
• Remove the shower doors and replace them with a curtain.
• Get a bed rail for the bed.

I found a hand rail at Home Depot but have no idea how to install it. Use L brackets maybe?

I think the shower doors can be removed easily enough. The reason the therapist wants it removed is so that there will be a wider opening when entering the shower stall.

The bed rail makes it easier for the patient to get out of bed. I'll order one from Amazon. There are versions that can be installed without tools.

All these suggestions should have been done when Ma was sick, but she never got physical therapy, and no one ever checked the house for safety. When she goes upstairs, she goes up one step at a time and uses a cane. She said she doesn't have trouble getting out of bed and apparently can take a shower standing up. I did get her a shower chair, but she's used it only once. The shower stall actually has two seats, but they're full of shampoo bottles and shower gels.