Wrestling!

In January, we begin the 7th year of our cancer fight. I know some folks don't like to call it a fight, but for me that's exactly what it is... more like a wrestling match for an old grappler like me. Into a contest, my strategy was to control my opponent, get some points built up and work for the pin which would end the match.

That's how I feel today... I am trying to control this opponent (those nasty light chains in Sabine's blood) and I think we are doing a pretty good job (yes, "we" is Drs. Sheehan and Chan and their medical teams).

If you read the first blogs I posted it all sounded pretty grim -- like maybe there wouldn't be time to control the match.

So this Christmastide I am greatly thankful for these years I never thought I would have with Sabine. That's what blessing is -- something never expected yet something that needs to simply be accepted with a God-directed, thank you!

We have gone through a number of cancer treatment cycles this year with Velcade (bortezomid) being the primary drug in combination with the steroid drug, dexamethasone, and, occasionally, Revilmid (lenalidomide).

Eventually, the efficacy of Velcade will diminish (we may be starting that possibility now), but there is a new type of drug in the same class coming down the pike that may be of help. However, using this new drug will result in going back to intervenous infusions twice a week, two days in a row.

The last few cycles of Velcade have been much easier on Sabine because the drug could be used subcutaneously (just under the skin).

In the meantime, we have both lived our life together in its fullest -- daily exercise, trips, family reunions, church activities, and time with friends.

Yep, that's what it's all about.

Ding, Ding. Round two coming up!

Forward!

This chemo cycle report on the "cancer numbers" looked good. Last cycle when Sabine severely fractured her wrist and had to have an external splint (her erector set), the numbers went up and not down. This caused a lot of worry. The chemo cycle she just completed thankfully told another story -- the numbers went down. This would indicate she is still responsive to the chemo -- bortezimib (Velcade). The strategy now is to do two more cycles and then perhaps a rest.


So far, this chemotherapy has been effective as Sabine's blood cancer is responsive to the drug. Regardless, the future is still bright. Other approved drugs are available. And, as I have said in the past, we have a number of "arrows in the quiver!"

Life is good. Sabine's wrist continues to heal and she continues an active life (dialysis aside!).

That's it. Today's report from the trenches.

Continuing...

This guy was too cute
not to take his picture.

With the broken (shattered) wrist Sabine got two weeks off without chemo. The thinking here is that the steroid in the chemo treatment might impact healing of the wrist. But... the numbers went UP indicating that the current chemo cocktail may not be working.

So, it's back on the old cocktail for a three-week chemo cycle. If it fails to repress the cancer then we will go to another "arrow" in the quiver (and the good news here is that there are a number of arrows left).

As to the wrist, the orthopedic doc thought the bones were healing but would like Sabine to stay in the external apparatus (erector set) for a couple more weeks.

Sabine continues here daily activity and was even seen bicycling on the Military Ridge trail near Blue Mounds Park on Saturday.

And the leaves are coloring and the temperature dropping... sounds like winter is not far behind!

We live the life.

Recovering...

We got released from UW Hospital early yesterday afternoon and went home and did dialysis. All went relatively well (although I had to use a "sharp" needle on one of the buttonholes).

Sabine is still experiencing some arm pain (using Tylenol as the pain reliever but does have a more powerful painkiller standing by -- oxycodone). She is tough.

This morning's dialysis went well (no need for the sharp needles) but then I made a mistake (we have to tend to the four pin wounds in her arm and hand) and she got an extra dose of saline solution in the dialysis process before we corrected the error. But all ended well.

Now we are tracing down the surgeon (or anyone?) who can give us some info that should have been in her discharge papers. Like how much wound drainage is normal? They give us the hospitalist's phone number but when calling the hospital tells us that number is only available during an inpatient stay. (So why give us the number on the discharge papers?).

I also could not find the name of the orthopedic surgeon in the discharge papers. It seems foolish to say this" "Call your doctor or go to the ER if you have drainage or redness around pin sites..." That seems like an expensive way to answer an patient's question.

So we are winding up dialysis now and then going back down to UW Hospital to resume the chemo therapy cycle.

And, if I don't get a call back, we will ask the chemotherapy nurses what they think or go to the ER!

Nevertheless, dear friends, life is still good! And your prayers and God's presence, abundantly felt!

Breaking News

It's been a while since we have had a medical crisis -- and that's why there haven't been any posts on this site for quite some time. Up until yesterday evening both chemo and our life has been relatively easygoing.

After a wonderful mini-vacation including cycling, disc golf, stock car races, and a stay at a good old traditional Wisconsin lake resort, we returned only to have Sabine fall and shatter her wrist when a chair she was standing on collapsed while she was removing a window hanging.

The 9-1-1 call. The ambulance to our farm at about 7 p.m., seven hours in the E.R. and then an admission at 2 a.m. I went home to sleep for a couple of hours and then back to the hospital and the prospect of surgery.

Now up to this point, for most of us it's just a broken bone, and a cast for 6 weeks. But for a kidney dialysis and blood cancer patient, it's only just begun.

Here's what we may have to struggle with:

1. The broken wrist (both heads of the radius and ulna were snapped and one of the bones penetrated the skin compounded the fracture and presented an infection problem). Unfortunately, the injury was on Sabine's fistula arm (the access points for her hemodialysis) and that "buttonhole" site needs to be preserved (initially, it took three separate surgeries to establish the fistula).

2. If we cannot use her fistula, a tunnel catheter will have to be inserted into Sabine's chest (before the fistula was developed we dialyzed through one for over a year. It, too, could present an infection potential.

3. Sabine's cancer-caused compromised immune system makes the possibility of infection a dangerous situation.

4. Sabine's blood cancer (multiple myeloma) makes her bones less strong and both repair and healing can be compromised.

5. She is currently in a cycle of chemotherapy which we hope will not have to be ceased during her orthopedic recovery.

6. The surgeon may not be able to cast the arm and will have to put pins and a connecting rod in her arm as an "exo" support (see picture). This also could lead to the possibility of an infection.

Sometimes things get complicated. But Sabine is a valiant and joyful fighter. And we do teamwork well together for these past 30+ years!

If you are a believer, pray.
If not, project healing thoughts for her.

Stay tuned. And for all of you who have already sent emails and FB messages, we both are deeply moved and thankful.

p.s. as I was writing this, her surgeon came down and informed me that the surgery went well -- they did have to put in the "exo" structure -- pins and rod system (but not traditional plaster cast.) Sabine will be in the hospital for another night and will most likely be discharged tomorrow (Tuesday).

NEWS FLASH: Now for the dialysis problem: can her arm be used for dialysis given the surgery? Yes! The orthopedic surgeon says he has no problem with it and that will preclude having to look for a new dialysis site (tunnel catheter!). The doc says Sabine can be discharged tomorrow. Tomorrow will have to be a dialysis day. Next hurdle is Sabine getting her chemo shot tomorrow and keeping that cycle going. Whew!

The Life We Live...

My friend, Jeff, just alerted me to this powerful 4-minute video that seemed to capture for me our life in the medical system.

Currently, Sabine is back on the higher chemo dose for two more 3-week cycles. The last cycle of the increased dosage decreased the "numbers," but, at the same time, starts impacting her blood platelets. She continues to be positive and active. Thanks be to God!

As we make our twice weekly visits to the cancer center at U.W. Hospital, our monthly consult with her oncologist, Dr Sheehan, and our monthly group meetings with fellow cancer and kidney dialysis patients, this short video seemed to capture my feelings...

The Chemical Life

With Sabine at the Mallard's game -- 38 of us!

Some of the cyclists assemble before their ride --
the weekend theme: "Life's a Sweet Ride!"

Daughter Sarah, Sabine, Niece Teak, and Daughter Catherine
at the Ridgeway Station,

The families assemble!As I was expecting (with the rise in the "numbers" last month), Dr Sheehan has Sabine back on a heavier dose of chemo (Velcade + Dexamethasone) for the next month. In the past, Sabine has been very responsive to this drug combination and we will see how it goes.

We had a wonderful joint birthday celebration on July 6 which brought family and friends together from near and far. It was a joyful time for both of us as our birthdays fall on the same day. You are probably thinking, "At least with the same day you should never forget your spouse's birthday." Well, not quite, but that's another story.

We have had to cancel some summer vacation plans but we intend to do shorter day trips so that we are in the general area during the chemotherapy. In the past, we have worked together as a team, adjusted our schedules, and grieved together when it didn't work out the way we wished. We will continue to do so.

Enjoy the summer. Life is still good!

Moving Along

Peace flags at New Journey Farm

Another round of chemotherapy as we begin to try and control this disease.
Dr Sheehan was pleased about the "numbers" and it looks like to prescription is to continue this level of chemical intervention.... watch out for neuropathy... and decreasing platelets in her blood.

In the meantime... both Couper and Lobitz families will be assembling next week at our farm in the unglaciated hills west of Madison.

I will be leading (hanging on) a cycling group to celebrate my 75th year and Sabine will be biking in celebration of her 60th! (And entering her 6th year of the cancer fight.)

We have a beautiful (if somewhat damp) summer here in Wisconsin.

Life is good. And I continue to be reminded that it is not where you are going in life -- it's who we are becoming that counts!

A Check-In

Here we are enjoying beautiful summertime in Wisconsin. We just received a report on Sabine's latest cancer"numbers." The "normal" range of lambda light chains is from 6-26. Dr Sheehan started chemotherapy when Sabine's numbers got up to 142 and the last three three-week cycles of sub-cute Velcade (1/2 of her usual dose) with oral dexamethasome has respectively reduced those numbers to 127, 102, and now 85.

We meet with Dr Sheehan this Wednesday and expect he may continue to try and get those numbers down.

In the meantime, Sabine remains active -- cycling, kayaking, hiking -- and expects hike up to Granite Park in Glacier Park this summer after hosting a big family get-together in July to celebrate her 60th birthday!

Granite Park Chalet -- no vehicles -- you must HIKE there!

Recovery and More Chemo

We saw Dr Sheehan on Wednesday. Sabine's lungs remain clear. The calcium level within normal range. And with some progress in suppressing those nasty lambda light chains, another round of chemotherapy (Velcade [subcutaneous] combined with oral dexamethasone) was again prescribed.

The fight continues...

Other than that little setback a couple of weeks ago, the Energizer Bunny is looking forward to our combined birthday party (60/75th) on July 6 with lots of friends and family present for a barbeque, live band, dancing and appropriate amounts of beer.

And, oh yes, a 75 mile/60km bike ride at the Blue Mounds bike trail at 7 a.m. on that day.

E.R. -- Again!

Just when I thought it was safe to go back into the water...

High temp... congestion... lethargy and the oncology doc on call asked me to take Sabine to the ER suspecting I imagine pneumonia. Many tests and five hours later she was admitted. Lots of antibiotics and now things have stabilized to the point that she is expected to be released today.

So what's my problem? First of all, this seems to be the way multiple myeloma patients go. Pneumonia and we have seen it take many from our support group.


So this isn't about a common ER run that many of us have undertaken over the years. No, this might be IT. And I still am not ready for IT!

This was one scary night.

Yes, God was certainly there, mightily present but I was still afraid, not wanting to lose her... yet.

Fear is a not a stranger to me. I can literally taste it. I know his character, who he is. After years as a cop and fighting this cancer, I think I've got him under control.

I was wrong.

p.s. Sabine spent the night in the hospital. Dr. Sheehan was on call and released her with a healthy dose of antibiotics late that morning. Pneumonia seemed to be the culprit and now, a week later, she is on the "mend." A little tired but recovering. Thanks for all your healing thoughts and prayers.

Back in the (Chemo) Saddle Again...

At our appointment with Dr Sheehan today we decided to go back on a chemotherapy regimen. It will be a weekly dose of Velcade (sub-q) at the hospital with a dexamethasone chaser. We will check the progress with monthly appointments until the "numbers" reduce -- then, hopefully, a maintenance dose.

It is a rainy day, but we both remain grateful for each other, our family, and what world we inhabit. (And lunch at the Sushi Box made it all better.)

Blessings...

Lambda Light Chains Chart

These are the "numbers" we anxiously await before our time with Dr Sheehan. On the left is November, 2011 and the far right is the result of last week's test (142). We meet with Dr Sheehan tomorrow and are expecting to be back on chemotherapy. In the meantime, life is good...

Twelve Weeks!

A stop-over in the Poconos!

We have been off chemo for 12 weeks now. We took blood this week for the cancer test (lambda light chains) and this coming Wednesday we will be seeing Dr Sheehan again. Tension time. The numbers! We will see what direction we will take on Wednesday. Time for lots of prayer this past weeks. But to counterbalance the prospect of Sabine going back on chemotherapy again has been a GREAT birthday celebration with a visit to granddaughter, Taylor, and her mom and dad and uncle Mike!

Sabine is doing well, exercising daily, getting me and the dog out for snowshoeing, and maintaining her always-positive outlook on life as she enters her 60th year. I thank God daily for having her in my life!

Celebrating Our Birthday!

Not everyone knows this, but Sabine and I have the same date of birth -- April 5th. So, this week we celebrate her 60th and my 75th birthday. (Wow! 75 seems old!). To celebrate, we are going to visit our daughter, Sumi, granddaughter Taylor, and son-in-law Scott in West Orange, New Jersey, a short distance from Broadway! Son Michael will also be in the neighborhood (a biking partner me?). We are scheduled to see "Book of Mormon" and a modern dance program.

We bought a joint present -- a chess set -- to keep us tactically sharp.

But the "big birthday bash" will be this summer over the 4th of July weekend at our farm where I will attempt to cap my 75th year with a 75 mile cycling event. Some friends have already signed on! Others wisely did not!

Sabine has been off chemo now for a couple of months. When we return we will, take a blood test to check on the cancer growth, see Dr Sheehan, and plot an attack on those nasty blood light chains that has been slowly growing but were not quite at the intervention (chemotherapy) stage two months ago when we last checked.

By the time we get back we will expect Spring to have settled into Wisconsin.

Have dialysis machine, will travel!

Six More Weeks

As many of you know, Sabine has been off chemotherapy for the past six weeks. Sabine recently remembered the "five year" statement by Dr Sheehan early in our cancer fight. January 16, 2013 was the five-year anniversary and her "expiration date," which, thanks be to God, has now been exceeded!

Yesterday, we saw Dr Sheehan and reviewed her "numbers." They had risen somewhat during the past six weeks, but not, we were told, "significantly." Thus -- SIX MORE WEEKS OFF!

For my sake, Sabine pressed Dr Sheehan for another "expiration date" (more for my sake than hers!) and with the advent of a couple of new drugs like Velcade (bortezomib) that has worked well against Sabine's blood cancer. "At least two more years," he said.

So, my goal is to beat that date: February 20, 2015!

And we are so thankful for our family, friends, and church friends who have so diligently kept Sabine in both thought and prayer!

The Expiration Date

FIVE YEARS AGO on this day Sabine received her cancer diagnosis. Though I admit I didn't hear what else the doc said (because I was hearing 18 MONTHS on the Internet), the doc said that Sabine would have (at least) five years.

For Sabine, that was her "expiration date" like on a food label! So now we have exceeded the five years.

And tomorrow, when we wake up, every day will truly be a great and abundant blessing.

In anticipation, we give the Almighty a great THANK YOU! and to all of you who have kept Sabine in their prayers all these years!