Thursday, July 30, 2009

Thurs, July 20

First day out of hospital after surgery 6 days ago. Woke up this morning feeling pretty stiff. Not a lot of sharp pain - more a dullness on most of my right side. Slept kinda so-so. Didn't take either an ambien or pain meds.

I woke up several times during the night. Each time I had to find a new sleeping position. One position that won't work is on my right (surgery) side. Since I'm a side-sleeper, I usually spend about half the night on each side. This eliminates a big option for me. So...I must often move - upstairs in bed, downstairs on Lazy-boy, back upstairs. The Lazy-boy is the only way I can sleep sitting up on my back. Three or four moves during the night. I was able to finally get back to sleep; but, it took a little work each time.

But, I guess I'll figure it out. I decided today to break down and get the pain meds. They gave me pain meds in the hospital. But, I have such an attitude and hate to take something that I don't think I really need. But, I took a couple pills tonight at dinner. Waiting for them to take effect. (While I've been writing, I feel a bit better).

Unfortunately, they recommend strongly against driving - I guess they don't want a drug impaired driver on the roads. Probably a good thing. Jill has offered to drive into work tomorrow; but, that seems like an imposition since I can handle almost everything by email. Jill says that nobody really expects me to get into the office - but, I feel more "recovered" when I can get in even for a few hours. It's not so much that I must go to the office. It is more that things feel a bit more normal. I guess that's another thing that I'll need to figure out.

So...I actually went out with Jill for a real meal outside the house or hospital - my first in a long time. I'm still not feeling like I have much of an appetite - but, at least I didn't feel turned off by the food. We went to Macaroni Grill and I had the Penne Rusticca - one of my fav's on their menu. It tasted great and I ate much of. Left just enough for a lunch tomorrow. It was good to be out into the real world.

Physically, I feel better than I have in a while. I can breathe but I can't take real deep breaths yet. Seems to be improving through the day. Most movements seem to pull on my right side which, of course, hurts. I occasionally get a cough and must support my side - but, it is becoming somewhat routine.

Still not quite accustomed to the fact that they knocked me out, operated for about 90 minutes on my lung, took out 1/2 gallon of fluid during the operation, put two tubes in my lung to drain another gallon or so of fluids during the next couple days, and perhaps most oddly, they sealed the incision with talc powder.

I am able to walk OK as long as I don't try to move too quickly and my discharge instructions say that I should take short walks 4X per day. Gotta figure that one out. I'm not generally a "let's take a short walk" person. But, I better figure out how to manage this.

They lowered my O2 from a setting of 3 to 4 down to 1.5. Hopefully, this will be the start to getting off the oxygen completely. That would be nice!

Other limitations include no lifting over 10 lbs, no soaking my incision site (might need to limit to sponge baths for another day or so), no driving while on the pain meds.

So...I guess I just relax for the night. I've already started the pain meds - so, hopefully, they will kick in soon. I'm hoping the pain meds will help me to get a good night's sleep tonight.



Wednesday, July 29, 2009

JimA & Jill

I realize that many of you who follow my blog for travel. But, you may not follow my lung cancer blog at http://jimallen-lungcancerhappens.blogspot.com/

So...you may not get the latest re my health. I will provide a simple update. You can read more detail at the blog site above.

Both Jill and I have had Dr appts right after we completed the cruise. I met with Dr Forkin - my primary care doc. She handles pretty much all non-cancer-related med stuff. All of my tests and blood work were OK.

On Tuesday & Wednesday, I had various scans, xrays, blood work and tests. My blog has more details of these tests. Basically, my brain is OK. The breathing issue is being caused by significant fluid in my right lung and the fluid must be removed by a surgery called a talc pleurodesis. Scheduled for Friday.

Thursday, Jill has an appt with Dr Abonour (her amyloidosis doc). Appt went well and he said she is doing fine. The next Monday, she had an appt with her kidney doc, Dr Kraus. He was not as happy about a couple things and he apparently told her he would have to do the dialysis prep surgery very soon if she keeps straying - I don't remember the exact details.

I went in for my surgery very early Friday. I spent Friday through Wednesday in the hospital. I had a few minor complications but got through them all and was released from the hospital today in the late afternoon.

That's the quick update. Jill is much better since the trip. I had surgery to help my breathing. We'll see what kind of pain or other issues tomorrow brings.

For more details, feel free to visit my blog noted above.


Hurray!

Just had a visit from Dr Birdas - the surgeon. He said that my morning xray looked good - from the surgery healing standpoint. He confirmed that they will do another xray in a couple hours. Unless something unexpected comes up, they will release me later today.

Took a short two loop walk with the RN. Handled it pretty well. Dr Birdas asked her to lower my oxygen setting down to 2 to see how I tolerate it. He still wants my O2 concentration to stay at least in the low 90s. I can always increase the level if I am active. Think I need to buy a pulse ox monitor so I can be sure to keep at the level needed based on activity.

The RN is now testing to figure out what setting I need. First, got a baseline with just sitting with oxygen on. (96) Then a few minutes sitting without O2. (86). Now, back on to baseline (97). Next, will be some kind of activity. Yippee - they want me to use just a 1 level vs the 3-4 that I've been using.

I'm out!!!

Maybe discharged today

A doc came in early to examine. She seems to think it is still likely that they remove the second chest tube today. If that happens, I could possibly go home today.

Had a rough night with severe pain from constipation & gas. My entire midsection really hurt big time. The RNs gave me meds, walked me around the floor and gave me an enema. Finally had a little relief and was able to sleep.

This morning, I am feeling pretty good. Good breakfast - I stuck to raisin bran and blueberry muffin.

They continued to pump me with potassium & magnesium. And, they are giving me a low dose of lovenox - an anti-coagulant or blood thinner. They are also giving me meds to help with my bowels.

10:25am - the second chest tube is out. She said they will do an xray in about four hours to be sure that everything seems to be OK. Will monitor any leakage into the bandage. If all goes OK, we are still on schedule for discharge later today.

More later.

Tuesday, July 28, 2009

July 28 more

Report from Dr Henderson, "I received the comparison MRI of your brain from March. There are small differences between the two MRI studies (March and July), but I think these differences can be explained by differences in your head position and in the technique used to acquire the images. The number and size of brain metastases are stable from March to July. I do not see any new brain metastases or any metastases that seem to be progressing. As we had discussed at your visit last week, I recommend repeating an MRI only if you have new suspicious symptoms."

So...good news re the brain lesions.

Tuesday, July 28

So far today, I spent most of the AM being lazy in my hospital bed. I went to the bathroom twice - required quite a bit of wire & tube juggling. To be exact, 8 tubes & wires had to be unhooked and kept untangled. Then, I had to keep the chest tubes from tangling as I hauled the chest tube drainage tubs with me since I couldn't unhook from them.

After situating in the bathroom and doing my business, I had to repeat everything backward to rehook everything without things getting tangled. Basically, just going to the bathroom is quite a chore. Not painful - just a chore to keep things from becoming a tangled mess. Now, with one chest tube removed, I'll have one less thing to deal with.

I had my first real breakfast of something more than Cheerios today. I had a two-egg omelet with potatoes, peppers and mushrooms. Also, had hash browns and a blueberry muffin. I ate all but about half of the hash brown potatoes. Had two cartons of whole milk.

About 10:30am, a person came in to remove one of my chest tubes. Kinda like the catheter, removal wasn't painful. But is was a little bizarre feeling. "Hold your breath, breathe out, hold your breath again, breath out, take a deep breath and hold it" and let out let out a loud noise like a karate yell (OK, so I added that last one myself both times!!). Adding the final karate yell seemed to help me feel better about it.

He cleaned me up and re-bandaged the incision and remaining chest tube. He had me take a few test breaths and left. So much a procedure that I had fretted about.

So...now I'm sitting hear watching TV. Watched the last portion of Witness. Now watching something on the Travel Channel. It will have to go once I'm done writing. Some dude is in a jungle letting insects, slugs and slimy critters latch onto his skin. Apparently, the idea of the show is to show these little critters and how to get rid of them. Boom - I'll change the channel and they'll be gone.

More later since it is only 11:23am.

Monday, July 27, 2009

A few days after talc pleurodesis

The talc pleurodesis went very well. I've forgotten who I updated on what. So...I will do a recap. Sorry if this includes info you have already seen. The procedure is intended to remove fluid build up - in this case, in my lower right lung. This is the same side as my lung cancer.

The scans that found this new issue also confirmed that the blood clot in my left lung has fully dissolved. So...one thing cleared up with another new problem. At least this time I didn't need to get radiation or chemotherapy - just surgery.

This is my first major surgery. I have never had general anesthesia. I have never needed this level of pain meds. And, I have never had to deal with the type of nervousness and anxiety that go with major surgery. Certainly, I have had very significant medical procedures - 12+ hours of IV chemo every 3 weeks for months or ten rounds of full brain radiation therapy. Those were, obviously, pretty serious. But, there's something different about being awake vs being knocked out completely for surgery.

Don't get me wrong. I would not want to be awake for the surgery. It's just that it's the first time for me. So...they start prepping me and I heard the comment to start the anesthesia. That was it. The next thing I knew, they were waking me in recovery. After a few minutes, I was pretty much fully aware and it was a matter of waiting until they had a bed to put me in - took a couple hours.

The bed they had for me was in the IU Hospital. Typical hospital room - I have been in plenty for Jill's amyloidosis treatment, stem cell transplant and ongoing treatment.

Turns out that I was now in a wait and see process. Wait and see how much drainage comes from the chest tubes. Wait and see that everything heals properly. Wait and see if I can breathe better. Wait and see if the fluids have cancer cells. Wait and see - wait and see. In some ways this is not different from my process for the lung cancer or the brain cancer lesions or all the various side effects from cancer treatments.

I've now had Saturday, Sunday and Monday mostly sitting around in my hospital room. Watching TV. Blogging. Answering emails - both work and personal. I don't do much reading right now. I have had problems with maintaining concentration for a few months since my radiation treatments. But, I have adequately kept myself busy and occupied.

Happily, things are progressing well. The chest drainage is coming; but, it is reducing. So far, with the 1/2 gallon removed during surgery, I think there has been something like another gallon or more that has drained during the past few days.

Most importantly, I am finally starting to feel better. With the fluid almost all drained, I can breathe again. I do still have an occasionally cough that hurts quite severely. But it is what they call productive - meaning it is bringing up "gunk" and is helping to clear my chest.

Also, I have some appetite back. They gave me a couple meds to increase my appetite over the past couple days. Perhaps they have finally helped. Don't get me wrong. I have some appetite - but, it isn't a bigtime appetite. But I can finally have food in front of me without it making me feel bad.

Well...that pretty much catches everyone up to where I am right now. In-patient at IU Hospital. Recovering from a talc pleurodesis. Finally, able to eat again. Expect to be released later this week.


Saturday, July 25, 2009

Not a really good week

Well....Wednesday didn't bring very good news. Dr Henderson met me first after my MRI. The current MRI shows that I still have several significant lesions in my brain - all are still very small; but, they're still there and some appear active. He will need to compare this MRI to the one from Feb to determine if any are new. He will then determine if we have any treatment options.

Then, Dr Birdas (a thorasic surgeon) came in to see me about possible surgery. It seems that the docs think the fluid in my right lung is cancer-related rather than a cold. He explained a couple options and I indicated the one that I would prefer.

Einhorn has taken me off the Tarceva because he doesn't feel it is helping. I start an IV chemo - alimta - in 3 weeks.

They also took me off the lovenox (blood thinner) because I apparently have surgery tomorrow and because the clot in my lung has dissolved. So...no more daily shots in the belly.

The surgery tomorrow (Friday) is to remove fluid in my right lung. They will knock me out and go in my side between ribs to remove the fluid. Then, they will put talc in the area - yes, sterile talc. It helps the surgery incisions stick together and seal - I guess simple stitches perhaps don't work for the lungs. The procedure is called a talc pleurodesis.

After the surgery and recovery, I will be put in a room at IU Hospital for 3 to 4 days.

I saw another doc today while they were doing a couple hours of labs and tests. He indicated that they rate me as a high risk for surgery. However, this procedure is considered to be very low risk. So, I guess one balances the other.

So...ungodly early to the cancer center tomorrow - 5:30!!

Well...we made to the IUSCC right on time. Ugh!!

They took us back to registration for all the usual questions- name, birth date, what do you understand is being done, do you have questions?, etc.

Then, we waited for Dr Birdas - he was doing an emergency procedure at Wishard Hospital. About 9:00am, they got me into an operating room, started prepping me, explained the process to me and started the anesthesia. Other than the first IV, I was out for the entire procedure.

The next thing I remember is when they woke me up about 11:30. This was the first time I have ever been under general anesthesia and the first time I have had a breathing tube. Luckily, they removed the breathing tube almost immediately. Very uncomfortable. Once I am awake, they started working on me to be sure that I was OK. Then, I laid around in the recovery room waiting for a bed in the ICU. In the end, after a couple hours, it was clear that I wasn't going to ICU. Instead, I was moved to the PCU (progressive care unit) which was essentially a regular room with more significant staffing to check on me often and give me a similar type of intense care.

I had felt pretty good while in the recovery room. But, just about immediately at about 4:00, I started to feel very significant pain in my back between my shoulder blade and spine. It seems that this is basically the norm for this surgery. They started me on a PCA unit (push a button and I get a dose of pain meds -morphine). Even though Jill has always said this is the most effective pain med for her, it was very ineffective for me. Eventually, with dosage increases and additional doses, the morphine began to help to a partial extent. This afternoon, they added another pain med - don't remember the name. This one was much more effective. I am still in pain, but it is at least bearable.

Even with the pain meds, my back and right side are still very sore. I have two foot+ long chest tubes still draining fluid. Dr Birdas told me that they drained about 1/2 gallon of fluid during the surgery. And, the chest tubes have drained more than that this afternoon. As I understand it, the chest tubes will remain in my lung until they no longer drain fluid. At that time, they will pull the tubes and spray in more talc to finish sealing the surgery area.

So, I have survived the surgery!! And, it appears to have accomplished what it was supposed to. Jill spotted red in the tubes and the RN explained that it was blood and small blood clots. The RN explained that eliminating all of this fluid was the intent of the procedure. And, apparently, my recovery has gone very well. After several hours of outrageous pain, my condition has settled down and my pain is pretty much contained.

Finally, in the late AM, they released me to start drinking fluids and eating food - I ordered a lunch and plan to order dinner.

Also, this afternoon, several nurses helped me to get out of the big tangle of tubes and wires. I have had 2 chest tubes, a catheter, an IV in my right hand with 2 tubes of meds and 2 IV's in my left hand - each with 2-3 med connections. And, I have my oxygen tube. My legs have thigh-high compression socks and each leg has a device attached that massages my calf every minute or so. I am wired/tubed up like a Borg character from Star Trek. This enabled me to get out of bed so that I could sit in a chair for a few minutes. The nurses were able to change my bed linens - by this time I had been laying in this bed with these linens for something like 36 hours. It was a much needed change.

I saw the docs a couple times during the day. The procedure seems to have gone very well - just as hoped. They will now monitor me for perhaps another day or two. If all goes well, I would expect to be released Monday or Tuesday. It is possible that I might not need the portable O2 - or I should at least to dial it down to around 1 versus 3 or 4. It sure would be nice to be able to stop carrying the oxygen around.

Dr Einhorn came to see me today. He explained what we had accomplished and that we may start an IV chemo when I see him in 3 weeks. This chemo is called alimpta and, apparently, has had some success with situations like mine.

So...we continue to battle and to try different options.


Tuesday, July 21, 2009

Trouble recovering

Well...since returning home Saturday night, I have had difficulty with various tiresome health issues. Of course, this started with the entire trip home from Rome which had been a little difficult for me. Thankfully, PJ (from next door and the son of our limo service) was home to help carry our luggage into the family room. I'm not sure that I could have hauled all the bags in from the garage. I went to bed almost immediately.

On Sunday, I spent almost the entire day in bed - until 6:30. I was up about every hour with diarrhea - very draining. And, my congestion and cough increased throughout the day. No appetite seems to be the norm for now. I am down 13 lbs since June 10 and 23 since early May. I am down about 35 lbs since late Feb. This is not good - even though the average person might look at me and assume that I need to lose the weight.

Anyway, I was up for a few hours and back to bed early since I had a 7:45 appt with Dr Forkin for my physical - who the heck agreed to that time!! I am not in too bad a shape on other things besides my obvious big issues. My creatinine level is high - indicated a small problem with kidney function. 1.7 versus desired range of 0.9 to 1.6. My hemoglobin is quite low - 9.7 versus normal range of 13.3 to 17.0. Hematocrit measures 32.6 v 42.0 to 52.0. These indicate that I am anemic.

After my physical, I hauled the oxygen concentrator and all its batteries/accessories to the UPS store. I had to take it in pieces since total weight was about 42+ lbs and I couldn't have handled that pre-boxed. Happily, a woman from the UPS store helped me carry things in. She gave me the signed forms that I needed and handled all the repacking for me. Even with the helped, this chore really wore me out.

After some schedule confusion, it was determined that I was scheduled for a scan on Tuesday AM at 8:30. So, I was up and on my way down to IU early. When I checked in, the schedule confusion continued as they told me I had a morning appt with Dr Einhorn. Well...OK. I met him at 10:30ish.

After reviewing the fancy nuclear scan from the morning, he told me he wanted a chest xray. So, we did that next and I headed back to his office. Well...that still didn't do it for him. He next wanted a CT scan and we were able to get that scheduled for today. By this time, it was already 1:30 and I had been at IU for about 6 hours. I headed home.

I go in early tomorrow for a head MRI. Hopefully, there will finally be some info on status of the brain lesions from the radiation treatments. I see Dr Henderson in the morning after the test. Then, I go back to see Dr E once more. I'm hoping that all the extra testing today doesn't indicate that there is an issue. We'll see.

Sunday, July 19, 2009

Sicily & trip home

In Sicily, we docked at Messina. This seemed to be a nice port city; but, we didn't see a lot of it. We boarded a bus nice early at 7:45. Began the 90 minute drive to Mt Etna and the surrounding area. The drive included passing through something like 30 tunnels. It was very picturesque and our guide did a good job of pointing out sights. We stopped in a little town at the foot of Etna.

I waited in the bus and talked a little with the driver. We discussed the small town of Caliscibetta - which is where Jill's family originated. Her grandfather and great-grandparents came from Caliscibetta in 1904. The driver and I managed to communicate enough that he programmed the town into his GPS and showed me where it was - just 125 km or about 75 miles from where were sitting. He, and then the guide, were quite interested in knowing that someone was on their bus who was from the area.

Next, we drove to what was literally the foot of the volcano. We saw what was the end of the lava flow from the last eruption. We could see the top of the volcano where three vents were steaming. This is considered to be a live volcano.

Afterward, we visited a local jewelry store and production location. They served us a snack of various cookies, cakes, etc and, of course, wine. After about an hour of shopping, we headed back to the ship.

We didn't do much when we got back to the ship other than pack and relax. We were schedule to disembark at 7:15 the next morning.

Disembarkation was perhaps the smoothest and quickest we have ever had. There was a driver right at the exit door shortly after we got off the ship and he loaded up our luggage. Now the fun part of the story....

The driver was holding up a sign that said "Allen". I asked him if he needed our printed voucher - he said he didn't need it. Well...we had gone about 35 or 45 minutes when the driver got a phone call. He handed me his cell and the person asked "what hotel are you going to?". I told him we were supposed to be headed to the airport. Turns out we were not in the right limo! The driver tried to convince me that I would need to pay him for the ride - while I explained that I had already paid for the ride and had no intention of paying again. He tried to imply I had made a mistake and I told him that I had offered the voucher - he rejected seeing it and didn't deny that. He then tried to get me to split it - which would have been around €100 (about $140). I explained to him that I was prepared to give what I planned to give as a tip and no more. All this time we were sitting at an exit Y on the freeway. I guess he wanted to give the impression that he would drop us off right then. Eventually, he drove on another 30 minutes and dropped us at the airport.

Checking in at the airport was a little confusing due to issues between Delta and NWA - we actually checked in at KLM. And, as we figured this out, we had to haul all of our luggage with us. By the time we got checked in, I was wasted and they called for a wheelchair - which took almost 30 minutes to get there. Everyone else had gone on through security and the line for the shuttle bus to our gate.

When my wheelchair finally showed up, they whizzed me past security (without the long line) and put me in a van. Turns out that the others really only barely beat me to the gate. The next confusion was that they told us we were leaving from Gate 32 and our boarding passes said Gate 32. Luckily, just a few minutes from boarding, Arielle noticed on the video over the gates that Detroit was listed over Gate 31.
We boarded close to on-time an began our 9 1/2 hour flight. There is nothing you can do to make that kind of flight any shorter.

In Detroit, there wasn't a wheelchair when we got off the plane and the ordeal was very difficult for me. It was quite a walk to immigration and pretty long lines. Once we got through immigration, we had to locate and collect our luggage for customs. Then, we had to recheck our luggage. I'm not sure of the purpose of this step since I didn't see them do anything other than ask if the bags were ours and send us on. Then, even though we hadn't left the airport, we had to go through security all over again.

After security, I spotted a couple porters with wheelchairs. I stopped them and didn't even need to act re the pitiful shape I was in. One of them put me in the wheelchair and took me the rest of the way to our gate.

I was almost out of batteries for my oxygen concentrator - I ran out while we were on the plane to Indy. Luckily, there was a wheelchair waiting for me in Indy and she stayed with us the entire time while we got our luggage and she helped us take it outside for pickup by our limo.

All in all, this was a very good trip that would have been much better if both Jill and I hadn't had health problems. This is one of the few times we have completed a cruise without having the next one booked. But, I think we will need to be careful with what we book next. We really need more days a sea.



Thursday, July 16, 2009

At sea

Ah....this is my kind of day. We had breakfast on the verandah - as we have all cruise. Then...nothing particular to do. While Jill and Dee went to the casino in the morning, I relaxed in the Neptune Lounge while the cabin stewards made up our cabin.

We joined a Mariners Group for an early lunch. They gave out a few frequent cruiser awards. In general, this is the type of thing we would usually skip - and I think we'll skip it next time.

We went because we only had certif for two of us for lunch at the Pinnacle Grill and Dee could go with us to this lunch. Mistake. The steak was very good but wasn't as appreciated by Jill or me. We should have gone to the pinnacle and paid for Dee. Brett said the Pinnacle had great appetizers - and that probably would have been enough for us.

Relaxed and quietly wasted away most of the day. Jill and Dee went back the casino a couple more times. I watched Matrix. We had dinner at the Pinnacle courtesy of the cruise line to make up for the in-room dining issues early in the cruise. We all had a fantastic meal.

Brett felt that his filet mignon was the best steak he has ever had - I may have to agree with him. They allowed Brett two entrees and he had lobster in addition to land-&-sea. Desserts were fabulous - chocolate souffle, creme brulee, baked Alaska.

Tomorrow we dock on Sicily. Hopefully, our excursion won't be overly difficult.


Athens

Wednesday we docked in Athens - actually, Piraeus - the port for Athens.

We did a panoramic Athens tour. Typical bus tour around the city. Viewed the Parthenon and Temple of Athena - from the bottom of the Acropolis (hill). Our guide narrated as we drove.

Quite honestly, I wasn't very impressed with Athens this time around. When you get past the few significant sites, it seems like just a very large city (5 mil population) with lots of traffic, litter and utilitarian buildings. Our guide sometimes tried to be overly philosophical and dramatic. But, that didn't make much difference. After seeing some beautiful islands, this was a big disappointment.

Add to that the fact that, for the first time ever, I am ready for the trip to be over - with two full days left before disembarkation. I think perhaps this has been a trip that was too port and activity oriented. We have become accustomed to lots of days at sea to relax.

The anchor of the oxygen concentrator has been much more of a burden during the excursions than I had expected. The unit is something like 17 lbs and I need to take a couple extra batteries - and they weigh around 5 lbs each. Most other passengers have been very considerate and they have left the front bus seat for me; but, it is still necessary to carry the concentrator up and down the bus stairs at each stop. On some excursions, it really helped to have Brett there to help by carrying the batteries. On others, I just had to muddle through the best I could. Often, I just stayed in the bus to avoid the effort.

Also, both Jill and I have had health issues and didn't feel well much of the trip. Jill hasn't felt well for around a week. She is still quite congested and feels like she has had kidney pain in her back. Being at stage IV kidney failure for around 3 years, I think she is worried and suspects that her kidneys may finally be going. She will need to talk with her doctors as soon as we get home.

I haven't really felt "well" for the entire trip. Mainly, I just simply haven't had much of any appetite. My energy level is way down. And, using what energy I have to pull and carry around the concentrator has been a burden. A new problem with odors and tastes has effected any desire for food. Basically, any food with much odor or taste made me feel ill.

It has been really nice that I could eat the Italian Wedding soup and our waiter has had some for me the past few nights. And, I have ordered beef broth & crackers for lunch every day. Basically, I have been living on Cheerios, beef broth and soup. I really haven't been able to enjoy the food in the way I would normally.

So, between the port/activity intensity, the extra work of the concentrator and the various health issues, I am ready to be home. I can't believe I feel like that.

Next cruise must be loaded with sea days. And...I hope I am off the oxygen by then. And...I would be nice to enjoy food again. Is that really too much to ask??

Today is a day at sea and then we visit Sicily. Finally, on Saturday, we dock in Rome and begin the labor of disembarking and flying home.


Take care and be well. - JimA


Sent via Blackberry. Please excuse short answers and typos.

Tuesday, July 14, 2009

Kusadasi

Today we docked at Kusadasi, Turkey. Dee and the kids headed out very early to see Ephesus and Mary's house. Jill and I cancelled our tour because, have done it before, we were pretty certain that it would be a bit much for us.

Mary' house is the home where John brought her after the crucifixion. She lived the rest of her life in this area.

Ephesus is probably the largest and best preserved ruins in the Aegean Sea from ancient times. It is one of the favorite places we have visited - so we were disappointed to miss it this trip. Dee really enjoyed it. Haven't seen the kids; but, I'm sure they really enjoyed it. Apparently, they had an exceptional guide.

Jill and I relaxed and had a late breakfast in the Neptune Lounge (for those with suites). Afterward we relaxed on the verandah. It occurred to me that this would be a good morning for a massage. I checked with the concierge and she was able to get me in very quickly. As always, it was quite nice.

Dee got back about noon - shortly after, she and Jill headed to the Lido for lunch. I ordered to eat in the cabin.

Balance of the day - nothing particularly interesting.



Take care and be well. - JimA


Sent via Blackberry. Please excuse short answers and typos.

Monday, July 13, 2009

Santorini

Ugh - I hurt this morning. The walking yesterday was a little bit much for me. I'm not sure how far we walked; but, half of it was an uphill incline. The muscles in my legs, back and side hurt quite a bit this morning. Oh well.

Today we are anchored at Santorini, Greece. It is a very lovely place with buildings that look like they are made of sugar cubes.

OK, the tour Panoramic Santorini is NOT easy as the description indicated. Certainly, the first half of the tour was quite nice. We drove from the port up a winding, winding, winding road to get to the top. We stopped at the top of the highest point on the island. There is an old monastery at the top. We stopped to view the overall island. This was just a quick 10 minute stop.

We then drove to a winery for a tasting - along with bread, cheese, olives and local tomatoes. This was a 40 minute stop and we had plenty of time to view the very nice countryside.

Next, we drove around much of the island which is about 55 sq kilometers - I don't know the conversion. The downtown of the capitol is very busy.

After seeing a bit of the capitol, we drove north and visited a small city (we would call it a village) at the north tip of the island. This is where things went downhill - or I guess I should say UPHILL!!

Where the bus dropped us off was mostly gravel and when "paved", it was stones - very rough to get through with the concentrator which is on a couple roller blade wheels. Then...we made a left turn and it looked to me like the never-ending stairway up to h*#l. I decided to give a go. I made it about half way.

Jill and her mom made to the top of the n-e-s-t-h when they learned that wasn't the end - there was yet another stairway to climb. They decided not to continue.

I had stopped by a nice little restaurant called Blue Sky. The owner or a worker (I don't know) saw me and offered a seat under an umbrella in a little courtyard next to their kitchen. As I sat, he brought me a bottle of cold water and wouldn't take payment. One of the nicest gestures I've experienced in a long time.

When Jill and Dee got back to me, they told me about the continuing climb and that the guide was not bringing the group back the same way. So, since we were at a spot where we knew how to return to the bus, we headed out back to the bus - the walk wasn't too far. I got on the bus which too warm for them. They found a place to sit in a little shade.

So, I contemplate this excursion and wonder why on earth they have it rated as "easy". Not even close. This was almost as difficult as yesterday.

The kids went on a short sail to another side of the island. They did a 45 minute hike to a volcano rim. They saw steam holes from the volcano which is apparently still considered to be active. They also sailed within a short swim to some hot springs. When they got back, the headed back up the hill/cliffs on a trolley and took a bus to a black sand beach on another side of the island.

We all met up for dinner. Tonight was "turkey & dressing" - so I ordered my first entree of the trip. Our waiter had also saved me wedding soup from last night. I think I ate more food at one meal than I have in about 3 weeks. Jill and Arielle both got the turkey. Dee got a steak that she said was very good. Brett, of course, to seafood - tonight was sauteed scallops and another seafood that had an unusual name but Brett said it was lobster as far as he was concerned.

The island is volcanic - created and changed by a volcano and related earthquakes. I wouldn't call particularly "pretty". It is quite interesting. Dee and I were just looking at the cliffs with the bright setting sun and it has many layers of different colors - gray, red, black, white. Also, the buildings are the quaint and most interesting feature. They grow grapes, cherry tomatoes, grains and a few other lesser crops. Obviously, they have a significant wine industry. I found the island interesting but inconsistent. I might have enjoyed myself even more if we hadn't gotten so tired from the excursion.

No real entertainment tonight since large numbers of passengers are still on shore. We sail at 8:45.


Take care and be well. - JimA


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Katakolon

Today we docked at Katakolon, Greece. This port is most associated with Olympia - the place where the original Olympics began. The original Olympics began in 776 BC as a festival to honor the god Zeus. The games were halted in 426 AD by emperor Theodosius because he considered them pagan. Most of the temples were destroyed.

Our first stop was at the ruins of Olympia. A few pics of the ruins are attached. Most statues and many other original elements of the building were lost when the area was occupied by the Roman and, later, Christians.

I was only able to complete about 1/4 of the ruins. Lots of up/down and it was very difficult to roll the oxygen concentrator because it was mostly gravel or uneven stones. By the time we got back on the bus, I was completely wasted. Luckily, Jill cancelled and stayed on the ship today.

After a couple hours at the ruins, we headed to Hotel Europa. They had set up tables with snacks that included feta, meat balls, Greek pastry with cheese, octopus, olives and other items. They set out pitchers/bottles of Greek wine, oozo, and a lemonade/orange non-alcoholic drink.

After giving us a few minutes to snack, live Greek music started and Greek "Zorba" dancers began performing. It was quite entertaining. And, when they started pulling ship passengers to the stage, it was clear who had consumed plenty of oozo - or who was just too young for their own good!

I don't have interesting tidbits about this port. Our guide was very interesting - but he heavily focused on the Greek gods and myths. I did learn that this area is filled with white marble - so much that the marble is actually cheaper than wood.

We have a short stay at this port. Scheduled to sail early today at 2:45. So...we relaxed a bit in the afternoon.

I haven't had much appetite this trip. But...tonight they had "Famous Italian Wedding Soup" on the menu. It was delicious. Happily the taste, seasoning and smell did not bother me. I ended up having two bowls.

Tomorrow we anchor at Santorini. The kids are doing a separate excursion that includes a 45 hike to a volcano rim - definitely not something we would attempt. The three of us are doing a simple Panoramic Santorini. I'm hoping it is a simple 4 hour bus ride with stops at scenic sites. That would be good since today was pretty tough for me.
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Saturday, July 11, 2009

Korfu, Greece

Today we docked in Korfu, Greece. Korfutown has a population of 25,000 and the island has a total population of around 100,000. The island is in the NW portion of Greece and is very close to Albania.

Korfu has been occupied by several countries/empires and, therefore, has monuments, ruins and foods from many cultures. The attached photo is the ruins of a church from the third century. Across the street, they are excavating Roman baths.

Industries are fishing, tourism, construction and olives. There are something like 4 million olive trees. Very close to where we docked is a fresh produce and fish market that opens every day. Our guide says that have very little crime on Korfu.

The island is very lush and green. December is their coldest month - perhaps down to 50 sometimes. In "winter" they often have 2 to 3 day long thunderstorms when it "rains like cats and dogs" - they get annual rainfall of 57 inches.

Summers can be very, very hot - as high as 104 or more. These temps would be during "heat waves". Otherwise, temps during most of the year would be in the 80s and 90s. It is supposed to be 88 today.

They appear to be religious people with 98% of the population being Orthodox Christian. They have "communities" of Catholics and Jews - which would obviously be small at less than 2% combined.

All in all, Korfu was an excellent port. Beautiful place. Very interesting old town area that looks like Venice. The palaces we visited were wonderful. I only wish Jill and I could have handled seeing more. For anyone interested in the Greek islands, this one is a must.

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Friday, July 10, 2009

Dubrovnyk, Croatia

Today, we anchored in the bay at Dubrovnyk, Croatia. I must admit that this one of the last places I would have guessed as a vacation spot. However, there were about six cruise ships (small and large) here today. And, I understand that this is a big vacation destination for Europeans.

The city population is just around 50,000. And is limited by mountains. So, everything is between the shore and the mountains which isn't a large area. Most of the buildings aren't old since much of the country was bombed and destroyed during war in the 90s. Dubrovnyk has an interesting Old Town - we didn't see much of it except at a distance since it wasn't included in our tour. But, what we could see looked like it would be worth a visit.

Brett and Arielle went kayaking and snorkeling. We haven't seen them - so I'm not sure how that went. But, I'm sure they probably had fun. It was pretty hot - so I'm sure a dip in the water was nice.

Our tour was more of a "riding" tour with a guide giving narrative since that works best for me right now. We saw the area south of the city up to the south tip of Croatia. Very nice views of the shore and bays.

We had a short stop at a grain mill that operates by water power to drive the stone wheels that grind the grain - they were milling corn today. The mill is several hundred years old and is the only remaining one of its kind still operating in Croatia. They served us a snack. Could have tasted several locally made wines. We had fresh baked bread with cheese and proscuitto (sp?) and some rather unique "Croatian" pickles. These were not like any that I have tasted before and they were quite good. Dee and I tried to figure out how to label the pickles but we couldn't. The guide simply said they were Croatian pickles.

A lot of the area is mostly stone. But, there are enough trees to make it quite green. Not a lot of grass, though. Their only industries are tourism and farming. Most of the "farms" are pretty small compared to what you might think of. They mainly seem to grow olives, grapes and other fruits. Didn't see livestock of any kind.

So...I guess I would say that this was a bit of a surprising port for me. Much more interesting than I had expected - but, I didn't have much in the way of expectations.

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Thursday, July 9, 2009

Day at Sea

Today we are happy to have nothing scheduled. We will spend the day at sea on our way to Croatia.

Jill & I had breakfast at our cabin on the verandah. Dee preferred to go to the lido cafe (somewhat of a buffet).

The seas are incredibly calm. When Dee got up, she had to open the curtains because she thought we had stopped - it was so calm. Temp during breakfast was 79 and it will get into the 80s during the day.
After breakfast we sat on the verandah for quite a while. Dee was very happy using the binoculars to get a closer look at Sicily. She was fascinated by the island. We will visit Sicily on our return to Rome in 9 days.

Jill & Dee went to the casino for a while. Yes...Jill is winning! Apparently, she taught Dee how to play one of the machines and Dee said it was fun. I always wonder about the slots and how it can matter since all you really do is push a button. But, they seem to enjoy it.

I stayed back at the cabin and enjoyed just sitting on the verandah. I am pretty sure that I napped a couple times. Very peaceful.

They came back to get me for lunch in the lido. But, I didn't last long. It only took a couple minutes for all the odors to bother me. I left them and returned to the cabin and I ordered broth/crackers and tuna salad. This was much better for me. I hadn't realized that the food odors would bother me so extremely.

The rest of the day was uneventful. Watched TV, had dinner and went to the show.

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Onboard

Sorry if this is a duplicate for anyone. Email problems.

Wednesday we boarded the Holland America Noordam. This is a sister ship of several we have sailed. So, finding our way around won't be difficult. We will onboard for 10 days.

We are in a Concierge Suite with Dee. This is the typical suite that we book on HAL. It is the size of two normal cabins. It has a nice separate dressing area, a big verandah, both tub & shower and lots of closet & drawer space.

We were able to get the kids an upgrade. They had a regular, non-verandah cabin. At the last minute HAL offered a very inexpensive upgrade to a verandah cabin at the rear of the ship. It actually has a verandah about 2X normal due to its position on the ship.

So...we are all settled into our cabins. Jill and Dee wandered the ship a little while I rested in the cabin. The morning and check-in wore me out.

Dinner was uneventful. We have an excellent table. We are at a window at the rear of the ship. Since we have early seating at 5:45, I expect that we will have a very good view as we sail out of some of the ports.

Good menu - prime rib and salmon. Unfortunately, my appetite continues to be almost non-existent. I had soup.

I went back to the cabin to sleep - which I did until about 3:45. After that, I napped off and on until 6AM. Jill and Dee both just woke up at 6:30. Apparently, they were out until 10:20 - a record.

I feel OK right now. Jill is doing well. Mom said "I slept so well." So...all is well in our world.

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Onboard

Wednesday we boarded the Holland America Noordam. This is a sister ship of several we have sailed. So, finding our way around won't be difficult. We will onboard for 10 days.

We are in a Concierge Suite with Dee. This is the typical suite that we book on HAL. It is the size of two normal cabins. It has a nice separate dressing area, a big verandah, both tub & shower and lots of closet & drawer space.

We were able to get the kids an upgrade. They had a regular, non-verandah cabin. At the last minute HAL offered a very inexpensive upgrade to a verandah cabin at the rear of the ship. It actually has a verandah about 2X normal due to its position on the ship.

So...we are all settled into our cabins. Jill and Dee wandered the ship a little while I rested in the cabin. The morning and check-in wore me out.

Dinner was uneventful. We have an excellent table. We are at a window at the rear of the ship. Since we have early seating at 5:45, I expect that we will have a very good view as we sail out of some of the ports.

Good menu - prime rib and salmon. Unfortunately, my appetite continues to be almost non-existent. I had soup.

I went back to the cabin to sleep - which I did until about 3:45. After that, I napped off and on until 6AM. Jill and Dee both just woke up at 6:30. Apparently, they were out until 10:20 - a record.

I feel OK right now. Jill is doing well. Mom said "I slept so well." So...all is well in our world.

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Tuesday, July 7, 2009

Tuesday

Well...today started seemingly normal. Another nice breakfast up at the rooftop cafe. Comfortable temp, light breeze, sunny but not blazing. We lingered a bit since our pick up was 9:30.

However, once we got back to our room, Jill started to feel sick. Don't know if it was something she ate - but it's not in her stomach any longer.

Obviously, Dee and I were not going out, leaving Jill in the hotel room alone. So, I met Luigi and apologized that we wouldn't be touring with him today.

Jill has spent most of the AM sleeping. I also slept quite a bit. We finally got up around 3 and walked to a bakery/deli/convenience store. We picked up just a few things.

I got a small loaf of sandwich bread - I'm not sure what they call it. But, the plain bread is something I can eat without being bothered. And, since I have no appetite right now, it is something I can make myself eat a small piece.

We came back to the hotel. The walk of just a few blocks really wore me out. Again, we all laid down - watched TV and slept.

Finally, about 7PM, Jill is feeling much better. I am also feeling OK - though I can never really tell unless I try to move around.

We're hoping to fall into a better routine once we board the ship tomorrow.

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Monday, July 6, 2009

Vatican

Today, was a rough day for me. Thankfully, Brett was there to carry the weight of the extra batteries.

Massimo picked us up again at 9:30 and we visited a few sights we had not seen yesterday. Visiting St Peter in Chains Church and got different/better views of the Coliseum, the Forum, Palatine Hill, and other parts of old Rome.

Massimo dropped us off to join Lorenzo - our Vatican guide. Luckily, our guide and my portable concentrator got us by many of the lines.

I won't even try to name the paintings, sculptures and other artwork that we saw in the museums. If you've there, you already know. If you haven't been there, I simply can't describe it. Master artists whose names even I recognize.

I eventually lost track of Lorenzo's info when I became so tired that the best I could do was to simply keep up and look at what I was struggling to pass. Of course, we finally got to the Sistine Chapel. Gorgeous, serene and over-powering. We were able to find seats - so we sat for a while.

Next, we headed to St Peters - a part that I chose skip - just too pooped. Instead, I sat by the entrance and watched security stop people who didn't meet dress code - no bare shoulders or bellies, no shorts above the knee, no short skirts. It was humorous watching some people try to get around the dress rules which are published all over the place.

After the Vatican, Massimo picked us up for the return to the hotel. First, he stopped for Jill's Mom at a small shop to buy a rosary.

Once we were back in the room, I once again passed out. I slept for several hours. I think Jill and Mom also napped some. But, they headed out a couple times - once to find cheaper bottled water and another time to get a light dinner. They found a deli and brought salads back to the room.

I think I have recovered but I haven't decided what to do about food - if anything.

Tomorrow we will be picked up by Luigi - our guide for 3 of us since the kids are going to Pompei. Quite honestly, I'm not sure what we are doing tomorrow. On Sunday/Monday we have done all of the things I thought we were doing totally. So, whatever we do tomorrow will be a bonus.

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Sunday, July 5, 2009

Ancient Rome

Sunday morning started with a very nice buffet breakfast. Then, our guide, Massimo, picked up promptly at 9:30. He proceeded to drive us through Rome - pointing out key buildings, fountains, etc. He stopped often for us to take photos and offered a couple times to give us time to walk the area.

Massimo timed things to put us at The Church of Santa Susanna for mass at 10:30. It was a very nice little church that offered this mass in English.

After mass, we headed back on our review of elements of ancient Rome. He also stopped several times for key photo ops. Throughout, Massimo told the important info/history of each area/building. Since there were only the five of us in a small minivan, everyone could easily hear the info from Massimo.

As before, we continue to be amazed by this city. The architecture, the people, and the history are exceptional.

Tonight, we ate at a restaurant recommended by the hotel. They were actually open when we wanted to eat just after 6 and they were only a few blocks from the hotel. Everyone had a pasta of some kind - ravioli, spaghetti, linguine, tortellini. And, the cost was very reasonable - ave $15 per person.

The kids went out to explore. But, I'm sure the rest of us will hunker down, shower and prepare for our day tomorrow.

Healthwise, I obviously made it through the day. We did have to say "no thanks" to Massimo's offer to go longer. The oxygen concentrator has worked well. Being on batteries, I have used a lower setting than normal in order to extend the battery life. This has been fine except when we walk a distance.

My appetite has been almost non-existent. It's been hard since I know I must eat something. Finally, the restaurant tonight had tortellinis in beef broth and I was able to finish it.

Tomorrow we visit St Peters, the Sistine Chapel and the Vatican area.

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Saturday, July 4, 2009

I hate overnight flights!

Once we finished packing last night (night before last - strange), we did our usual wait - and remember things we needed. Our pickup was noon - we wanted to be sure we had enough time for security with my oxygen equipment. It actually went pretty quickly.

Connection in Detroit was uneventful. We were able to use my Delta Club membership so we could be a little more comfortable.

I won't spend a lot of time re the overnight flight - I hate overnight flights. We arrived in Rome a little early. Luckily, we had arranged a wheelchair for me. It would have been very rough without it. Obviously, he knew where he was going and could get us through the passport checkpoint and customs quickly.

Once we got to baggage claim, our bags came quickly and together. Mom and Brett & Arielle were not as lucky. Their bags arrived - just a little bit of a wait. Once again, the wheelchair porter was a big help. He got a couple carts for the luggage and stayed with us the entire time while we found our driver and he took us to the minivan.

We checked into the Marcella Royal Hotel about noon. I am just a little disappointed in the rooms - but everyone else seems to think they are nice. In any case, we all hit the mattresses and went to sleep. I didn't keep track - but I think was probably slept around three hours.

Once we woke up, I worked on hooking up my oxygen to recharge the batteries. I had just enough battery power to make the entire trip. I plugged in the DC cord before we slept since I had just one electric plug adapter. Later, I was able to get another adapter from the hotel so that I can use the AC recharger and the DC adapter at the same time.

About 5:30, we went to the rooftop garden cafe for food. Every night they serve a light dinner - salads, pasta, antipasta platters. The cafe view was gorgeous and was filled with potted plants and flowers. We can see St Peters Cathedral from the cafe. Our waiter told us that it is even nicer after dark.

We have a 9:30 pickup tomorrow. We hope to go to mass and we have a driver/guide to take us to see the sights of ancient Rome.
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Thursday, July 2, 2009

Almost ready

Hard to believe we got everything packed. But here we are. Jill's bags are packed except for some last minute adds for meds and nightgowns. My main bag is packed - if I counted right. I need to really juggle around my carryon to make room for all the oxygen concentrator accessories. Need to leave my good camera home - I don't have the energy to carry it with all the other stuff. Better to breathe oxygen that worry about pictures.

Happily, we don't leave too early - 12 Noon pickup. Shouldn't be bad. Then, a very long travel day - something like 12 or 13 hours total travel time - house to hotel. Detroit to Rome flight is 9 hours.

So...I think I'll leave the last minute stuff until tomorrow. Gonna go get some sleep for now.

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