Round One: Done.

Dad and Aaron: Matching Doctors at the Hospital

Vivi Getting a Blood Transfusion (EEK!)

Visiting Vivi

Butoh Taking a Nap with Vivi

Hi Everyone,

Here is the latest on Vivi:

While we were all feeling undeniably defeated at the onset of the news of Vivi's relapse, we also knew this was a process we had not only been through before, but one that Vivi had already braved so valiantly. While last year was an exceedingly challenging year, we also walked away with an incredible amount of memorably hilarious moments, unforgettable time together as a family, and 576 more names to add to the Vivi Fan Club. So, with this in mind, very quickly, there was a collective sense of "we can do this."

The feeling only continued upon our first visit back at the hospital. Vivi had barely stepped one foot into the waiting room before she was mobbed by a hoard of people who could not be more thrilled to see her. It was almost humorous to see the conflicted looks on each of their faces as they could barely contain their excitement at the mere sight of my mother, but were also aware of the circumstances under which she was back at the hospital. It was equally entertaining to watch the reactions of the other people in the waiting room who had likely not received the same pompous welcome, and were looking at my mother clearly thinking, "Who the fuck IS this woman?" Certainly a celebrity in these parts.

Vivi was even up to her old antics, behavior at which I have no choice but to shake my head and think - yup, that's my mother! First we went through the old routine of getting her a private room. A process that - although requires hours of waiting and finagling - I am convinced, my mother would be willing to undertake even during her final breaths.

Later that evening, I was fortunate enough to witness another one of my mother's favorite hospital activities: Let's Fuck with the Nurse! The basic rules of this game are an unassuming nurse comes into my mother's room to ask some standard questions and run some basic tests, and about 30 minutes later the nurse leaves bewildered and exhausted, not understanding how a) a 70-year-old woman who just received a hysterectomy could actually be pregnant, and b) how she ended up spilling the entire story of her recent break-up with her boyfriend to a patient when all she was trying to do was get my mother's vital signs. While my initial reaction to this kind of behavior is generally somewhere between humiliation and shame, it is all worth watching my mother amuse herself to the point of laughing until she cries (or pees...it's often a toss-up) - something that is rather contagious if you are around her for such an episode! In the end, I can only think - good for her. If she can find a way to have fun, keep her humor, and lift her own spirits (albeit at the expense of other people's sanity at times) - all the power to you, Mom!

Even sitting here now, in room #1702 - a room we have spent countless hours, days, and nights in over the last year and a half- watching the rain spit onto York Avenue as the rest of the world unknowingly zooms by, and listening to mother's heart monitor machine beep rhythmically in the background - it all feels almost comfortably familiar.

However, despite our acquaintance with this hospital, this disease, and this process, it is, in so many ways, different this time around. You reach out with a bit more hesitation when you already know the hot stove is going to burn you when you touch it. Bottom line: to a certain degree - we just know what we are in for - for better or for worse.

Additionally, this round of treatment seems to be offering a very different set of challenges than we faced last year. While chemo is never easy (to say the very least), Vivi seemed to tolerate her treatment last year better than most. While the physical side effects were certainly tough, and often hard to endure - the most significant of which was that Vivi lost her hair, which is scary and shocking, but not painful, by any means - they certainly did not take the physical toll on her that this treatment seems to be doing.

Vivi is on a new chemo called Gemzar. The side effects of which are as follows:

• Flu-like symptoms (muscle pain, fever, headache, chills, fatigue)
• Fever  (within 6-12 hours of first dose)
• Fatigue
• Nausea
• Vomiting
• Poor appetite
• Low blood counts.  Your white and red blood cells and platelets may temporarily decrease.  This can put you at increased risk for infection, anemia and/or bleeding.

Not only has Vivi been experiencing all of these side effects, but to make matters worse, her low blood counts made her more susceptible to getting sick or developing a infection - which is exactly what happened this last week. Starting last Thursday, Vivi started to develop the flu-like symptoms listed above - and was told by her doctor to head to the emergency room. However, after running some tests, receiving some hydration, as well as some platelets, Vivi was sent home. Unfortunately, Vivi's fever continued to spike, she continued to feel worse, and this routine repeated itself for four more days until she was finally admitted into the hospital Wednesday night.

Long story short - not only had Vivi developed some sort of infection, but her red blood cell count was so low she needed to receive three blood transfusions to get her counts back to a sustainable level. While these types of side effects, as listed above, are expected, due to Vivi's cardiac conditions, these symptoms can be not only dangerous, but actually life threatening. When Vivi's body is under such stress, her heart starts to overwork, and while she doesn't actually develop a heart attack, this type of stress to the heart can be quite damaging - which in turn makes Vivi feel extremely weak and tired (likely an understatement if you were to ask her).

The good news is, after three blood transfusions, some IV antibiotics, and a ton (literally) of IV hydration, Vivi is feeling MUCH better. She even got out of bed, put some make-up on, and joined me for a few laps around the17th floor! She was even back to her feisty self, insisting that I was not offering enough entertaining details on the latest and greatest in my life, as well complaining about how much nicer the rooms on the 18th floor of the hospital (where she had spent the prior night) were, compared to the 17th floor - where she is now staying.

So - what now? Vivi is going to stay in the hospital and be monitored until her blood counts go back up and her EKGs (heart monitoring tests) read normally - at which point they will continue with her next round of chemo (which was originally scheduled for today). Her counts seem to be back to normal, but she is still waiting for the results of her EKG. If that reads normal, she will receive chemo tomorrow and will likely be able to go home either tomorrow or Sunday.

The question that remains is whether this was all due to some fluke infection that Vivi picked up during regular cold and flu season, or whether this was a bad reaction to the Gemzar. According to her doctors, it is likely a combination of the two. So they are going to closely monitor her through this next treatment and if the same symptoms start to arise, they will have to consider cutting back on her dosage of chemotherapy - as the routine she went through this past week is simply unsustainable. To answer a common question that has come up - will the chemo still be as effective if they pull back the dose? The answer is yes. Vivi is getting the maximum dose possible of Gemzar right now, which her oncologist decided to give her considering she tolerated her chemo last year like a bull. So they can still pull the dosage back significantly without changing the effectiveness of the treatment. Which is great news.

So we will see how this next treatment goes and I will send an update after that. In the meantime, please know that, despite a very tough week (likely our toughest yet), Vivi is really feeling so much better and seems to truly be on the mend.

Per usual, I would like to thank everyone for the love, support, thoughts, and prayers that have already poured in (and a special thanks to whoever sent the box of dark chocolate treats - they're my favorite!) - even just a few weeks into this process. I can never truly express how much strength it offers both my mother and our family as we forge ahead back down this road.

Happy Friday and happy Fall to all of you.

Until next time...