Monday, May 22, 2017

Ellis Health Update - 170522

Background

I am undergoing treatment for Stage 4 Mesothelomia Lung Cancer. The problem started with chest pains on 2 January 2017 after I returned from my workout at the gym. A trip to the emergency room resulted in a CT (computed tomography) scan that revealed a mass in my right lung. A later biopsy indicated it was mesothelioma; a sample was sent to the Mayo Clinic for a second opinion; Mayo concurred in that diagnosis and I was sent for a PET (positron emission tomography) scan at the Verde Valley Medical Center clinic in Sedona, the nearest facility with a PET machine. Following the PET scan I was referred to the Arizona Oncology Center Sedona facility in the same building. I saw Dr Anthony at the oncology center who discussed treatment options and recommended chemotherapy consisting of the following two drugs: Pemetrexed and Carboplatin, treatment I am now undergoing.

Two previous posts touch on this subject they are shown at:
and

Current Status
I underwent my fifth chemotherapy session on 17 May 2017. The doctor was happy with the associated lab results.

The laboratory results are meaningless to me. However, the most pertinent in my case (based on the doctor's emphasis) seems to be my Hemoglobin level, so I looked that up online at the Mayo Clinic website. Low hemoglobin results in anemia, a condition which is somewhat normal for me.

The specific parts of the test he seems most interested in are the HGB (Hemoglobin, the oxygen-carrying component within the red blood cells) and the HCT (volume of red blood cells in a specific volume of blood).
The lower HGB level for continuing the treatment I am undergoing is 7 g/dl.

On the 21 April test, my HGB reading was 9.9 g/dl, so I increased my intake of blackstrap molasses (for iron) and Potato chips (for sodium) and the 15 May test results showed an HGB level of 10.4 g/dl.

With the chemotherapy port in place (installed at the time of the last treatment), the treatment on 17 May went smoothly.

I have been having a problem with my eyes watering recently. The doctor called it “easy lacrimation” and suggested an antihistamine such as Benadryl. He said that should also help me to sleep during the three-day period surrounding chemotherapy treatments during which I take a steroid (Dexamethasone).

I normally have a couple of down days following chemo sessions, days on which I really don't have any pain, but just feel listless. These listless days are usually the second and third after treatment. This time was no exception. The first day after treatment, I went for a 2.5-mile walk and still felt good. The second day, still feeling good in the morning, I walked 4.7 miles and that may have been a bit too much: because by early afternoon I was really dragging. My listlessness continued through another day.


This morning, 22 May, the doctor's office called to tell me to start taking two iron tablets each day. Hopefully that will help with the anemia. Later in the morning, I got out and walked about a mile before spending most of the rest of the day watching pre-recorded TV shows with daughter Diana who is visiting for the week. I think that I am now ready for some more substantial activity and Diana and I have a 2.5-mile walk scheduled for tomorrow morning.

Friday, May 12, 2017

Ellis Health Update - 170512

At the Tuesday, 25 April visit with the oncologist we reviewed the results of the CAT scan taken last Monday along with the lab tests from the last blood draw (Friday, 21 April).  The blood tests all showed my white cell count to be OK but that I am still anemic as usual.  The doctor didn't seem worried about the anemia, but maybe I will increase my intake of salty potato chips and blackstrap molasses just in case.  The really good news is that the tumor is shrinking and in anticipation of that, based on results of the previous blood tests (the last previous to this Mondays tests), he had added something (he called it bone cement) to fill in the defects left in my rib as the cancer retreats .  Based on these results he recommended continuing the tri-weekly chemo for another nine weeks.  My next office visit and chemo is set for 17 May at 0930.

A  chemo session was originally scheduled to immediately follow the Tuesday, 25 April doctor visit; however, my blood vessels absolutely refused to cooperate.  The nurses successfully inserted needles in five different locations (pretty much without pain, I might add), but my body had apparently learned that they were trying to insert a foreign substance and just refused to accept it. That meant that the installation of a port to facilitate injections would be necessary.  The nurses said that if we could get a port installed the next day at the hospital in Cottonwood and still get to the Oncology Center in Sedona by 1400 they would do the chemo the same day.  That was important to me because I must take a steroid (dexamethasone) twice a day -- the day before, day of, and day following each chemo session.  I get little or no sleep on the days that I take the steroid and by delaying the chemo only one day, I could just continue the steroids for one more day rather than start a new three-day regimen of sleepless nights.

The surgeon at cottonwood saw me late in the day on the 25th (the day for which the chemo session was originally scheduled) and got us scheduled for surgery to install the port (Bard Power Port on right chest with a lead to an artery near the heart) early in the morning of 26 April. When he installed the port he left it ready for chemo and we were in Sedona early enough that the treatment was completed and we were home a little before 1400 on the 26th.

On arrival back home, we were faced with a sprinkler leak where I had apparently damaged the system while planting flowers the day before. That took about 45 minutes and when finished I was feeling spry enough that I finished clipping the already-bloomed irises except for the few alongside the backyard steps/walkway that were still in bloom. The exercise did me good after being confined to hospital beds, wheelchairs, car seats and chemo-treatment chairs for almost eight hours.  The only good part of that confinement was that I knew nothing from the time they wheeled me into surgery until they were ready to take me out again and that I managed to get in a couple of quick naps while undergoing chemo. With the port in place, the chemo went very smoothly.

The few days following the port installation and chemo session, were pretty rough. I had diarrhea for two days and, a severe reaction to the anesthesia used during the surgery to install the port. I did not feel up to resuming my daily walks for several days. After that I recovered nicely and even went for a 3.2-mile walk to Tavasci Marsh with the Skyliners Wednesday walking group on 10 May. I blame most of the problem on an adverse reaction to anesthesia and expect the chemo session scheduled for next week to go smoothly.

Before completing and posting this report, I waited for the doctor's visit report. Arizona Oncology has a website that should make such information available. However the website provides nothing resembling office visit reports. They do complete the reports in a timely fashion and I thought that I had requested that they mail me a copy as soon as it was completed. However, I apparently failed to make clear what I wanted and, after waiting a week, I called to find that they had not understood what I wanted. To make matters even worse, they really did not understand what I was calling about and I had to call again the next week. Finally, after talking directly to the doctor's assistant, I received the report in the mail today, just five days before my next scheduled visit.


Wednesday, May 10, 2017

Hike to Tavasci Marsh


Lila Wright, leader of the Skyliners hiking group, recently added a separate weekly hike that she calls a “walk” to the regular October through May schedule of hikes. The regular hikes are still scheduled for Saturdays. The weekly walks, however, are scheduled for Wednesdays, thus allowing those who wish to participate in both activities to do so.

Today, 10 May 2017, the Wednesday “walk” was scheduled to be along the river starting at the old Jail in Cottonwood and ending at Tuzigoot Bridge. However, the day was a little chilly and that trail would be largely shaded by the trees growing along the river. Because of this, she switched hikes and we hiked from Tuzigoot National Monument to Tavasci Marsh instead, delaying the hike along the river until next Wednesday. Never having been to Tavasci Marsh before, I was pleased with the change.

We carpooled from the Safeway parking lot in Cottonwood through Old Town, turned onto Tuzigoot Road and were shortly at the Tuzigoot National Monument parking area. There is a $10.00 per person charge for entering the monument but, luckily no charge for parking. We were thus able to park there for free, skirt the monument entrance, and hike along a concrete walkway that leads about 0.35 miles from the north end of the visitors center down the spine of a ridge to an overlook on the west side of the marsh. We turned off the concrete walkway about 0.1 miles from the visitor center onto what was once a section of Tuzigoot Road and descended the ridge.

This overlook and the concrete walkway to it are described in an article posted at gjhikes.com1. That article notes that there is a $5.00 fee for persons over the age of 15. Our leader told the ranger at Tuzigoot what we were doing and we did not pay a fee, perhaps because we were not going all the way to the overlook on the west ridge. The same article also notes that the marsh is named after the Tavasci family who “ran a farm there from 1928 to 1991.”

Biologist and local resident Doug Von Gausig, is quoted in a 23 April 2001 article in the Verde Independent Newspaper as follows:

"It was a cattle pasture," He explains. "A dairy reclaimed it as pasture land and that destroyed Tavasci Marsh for 50 years." 

According to Von Gausig when Arizona Game and Fish along with the land's owner Phelps Dodge allowed the beaver dams to return, the marsh slowly, "recreated itself in a natural fashion. They created a new habitat that had to gather new species."2

The following photograph of the concrete walkway to the marsh overlook on the west ridge was taken looking back toward the Tuzigoot Visitors Center. The walkway is almost completely hidden from the parking lot.

Looking back toward visitors center and parking lot from concrete walkway
A number of plants growing along the walkway were identified by signs. Some of these are shown below along with identification and usage information.

Catclaw Acacia (right). This is a plant with claw-like thorns that you will never forget if you stumble into one while on a hike. The associated sign includes the following information: “On long journeys, ancient travelers relied on the fruits for food. The green seed pods can be eaten fresh or dried, or ground into flour to make mush, cakes or bread. The branches make good drumsticks and furniture. Bees that feed on the blossoms produce a delicate and distinctive honey.

Four-Wing Saltbush (left). The associated sign provides the following information: “Named for the four-winged bracts on its fruit, this common high desert shrub provides food and medicine and is burned during ceremonies. The leaves, young shoots, seeds, and fruit are edible.” The sign goes on to say that the ashes from burned leaves make a baking soda that fortifies “baked goods with calcium and minerals.” Additionally, it says the leaves can relieve pain when chewed and applied to insect stings.

That use of saltbush leaves reminded me of an old folk remedy from my childhood. Grandmaw chewed tobacco leaves and applied them to bee stings when we children got too close to Grandpaw's bee hives. What made this use of tobacco leaves so memorable was that Grandmaw was adamantly opposed to the chewing of tobacco, declaring it to be the nastiest of habits, and would not allow the men in the family to do so in her house. She would have no nasty spittoons scattered about the premises and would not allow anyone to spit tobacco juice in the fireplace. Strangely enough, we later learned that she put aside a couple of hands of tobacco leaves each year and kept them hidden in the back room along with a small silver knife. She would then, on rare occasions, quietly sneak into the backroom, use the silver knife to cut a dainty plug and chew away to her heart's content. We never did find out where she expelled the chewed leaves and the juice except, of course, on those occasions when it was for medicinal purposes.

But enough of this trip down memory lane. One other plant that was identified along the walkway to Tavasci Overlook was Mormon Tea (right). The sign in this case was so far from the plant being identified that one could choose from several different plants. In other words had we not already known what Mormon tea looked like, we would not have learned to identify it from this sign. According to the sign, “Southwesterners add the dried stems of this shrub to hot water to brew a popular and tasty tea. Slightly bitter to the taste, it is a mild stimulant similar to coffee. Medicinally, Mormon tea is an antihistamine and relieves cough and allergy symptoms.” I have tasted Mormon tea and can attest to its slightly bitter taste. I did not find it unpleasant; however, I prefer green tea. As to the medicinal properties, I have never tried using it as an antihistamine.

As already noted we followed the concrete walkway for only about 0.1 mile and and turned down a dirt trail (an old road) to descend the ridge. This was the only part of the hike that was not essentially level. Even here the descent was only around 35 feet in about 150 yards.

We were traveling almost directly south as we descended the ridge. At the bottom we turned generally northeast and continued for about 0.3 miles to very near the southwest corner of the marsh. The trail then made a sharp turn to the south (actually ,at first, a bit to the southwest) and continued for 0.5 miles before turning back north to the southeast corner of the marsh where we found the below sign.

Sign posted at the edge of Tavasci marsh
In effect our track had formed the shape of a large jug about half-a-mile deep with an opening at the top that was about a tenth-of-mile wide. In looking at old maps, I determined that the top of the jug was once closed by a section of Old Tuzigoot Road, shown by the short straight yellow line in the map below map.

The trail takes the form of a large jug with a quarter-mile opening at the top
I am not sure whether it would still be possible to follow Old Tuzigoot Road directly across the neck of the bottle, The marsh may have reclaimed that section of road. In any case, the walk around the bottle was a pleasant stroll along a level section of trail, so there was really no great incentive to shorten the hike.

About 0.2 miles beyond the Tavasci Marsh welcome sign, we came to the east overlook, a sturdy, recently-built platform from which one could view the marsh and the wildlife it supports. Unfortunately, at the time of our visit wildlife was scarce. We saw only a couple of redwing blackbirds. However, I understand that the marsh is normally a great place for bird watching. We paused for a time at the outlook looking out over the marsh.

Across the way we could see the west over-look (telephoto view, left) at the end of the con-crete walkway. It was perched high on the ridge west of the marsh as opposed to being at the very edge of the marsh as was true of the one where we stood.

The photo-graph shown here (right) shows a bit of the marsh and a corner of the east overlook platform located at its very edge.

Before leaving the viewing platform, I took a series of photographs that I could stitch together into a panoramic view of the marsh.

Panoramic view of Tavasci Marsh
On the return trip just past the southernmost tip of the trail (that is just past the bottom of the jar), several of the hikers broke off and followed the Old Tuzigoot Road along the river to the river access point (boat ramp) near Tuzigoot Bridge. One member of the breakaway party carried my GPS so that we would have a recorded track for that route. They came out at the large parking area provided for the river access point. The trail ends at the posts shown in the photograph (left), taken from the parking lot.

The included map (below) shows the track from the visitor center to the east overlook (heavy red track), the route along the river to the river access point (light red track) and other points of interest mentioned in this report.


The hike from the visitor center to the east overlook and then on to the river access parking area was 3.5 miles. The highest elevation was 3380 feet and the total ascent was 218 feet.




1http://www.gjhikes.com/2013/03/tavasci-marsh-overlook.html

2 https://www.verdenews.com/news/2001/apr/23/the-bird-man-of-tavasci-marsh