Yesterday was a big day. Tuesday, December 8th marked a year since I have been diagnosed with cancer. It has been a long year, but one filled with many blessings. I have found many new friends and rediscovered many others. There has also been the prayer circles which have been a blessing showing God's true grace around friendship. We experienced another wonderful prayer circle on Monday.
Yesterday was also my 4th treatment out of the 4 scheduled for this round of chemotherapy (it has been my 23rd treatment total). My blood counts have been good for each one. It has been amazing what prayer and visualization can do to help blood counts.
Yesterday, I also found out my cancer blood markers have gone up from 238 in October to 425. So that isn't good. That may mean a new kind of treatment. We meet with the oncologist on Thursday, December 17th to talk about what all of the numbers mean and what we are going to do next.
Remember the time for the true Christmas season and don't get too crazy with "holiday stuff".
Michelle
Wednesday, December 9, 2009
Sunday, November 29, 2009
Happy Thanksgiving
I hope everybody had a Happy Thanksgiving. We celebrated a quiet day at home with all of our favorite treats.
We had good news earlier in the week. My blood counts were high enough that I got chemotherapy on Tuesday. I also received the shot to help build white blood cells. So thank you for all of your prayers about my blood counts. Over the past few weeks, I have been having some pain that has been hard to get under control, so please pray that the pain can get under control with my pain pump.
Saturday, November 21, 2009
No More Stents
On Monday we had a very spiritual prayer circle. We did some visualization around lights and healing. It was a small, but powerful group. The next prayer circle is scheduled for Monday, December 7th at 6:30 at Karen Lowe's house. All are welcome. Let me know if you need the address.
Wednesday was another day of visualization. Bill and I met with Dr. Brandon, our psychologist. He did a visualization with Bill and me around lights and healing. It was another powerful experience for me.
On Thursday Bill and I went down to Denver to the University of Colorado Medical Center for another ERCP to replace my stents. Come to find out the strictures (or narrowing) of the hepatic ducts are basically gone and they don't need to put stents back in. The purpose of the stents is to allow bile and stones to flow through the hepatic ducts and common bile ducts into the duodenum. The strictures or narrowings were causing these ducts to become blocked so the stents were needed. It has been a year since they started putting the stents in and now they don't need them. That is good news.
The doctor has been watching my white blood counts. If they stay high enough, I will be able to receive my chemotherapy on Tuesday as planned. Please pray that the blood counts are high enough to receive chemo.
Have a great week.
Michelle
Wednesday was another day of visualization. Bill and I met with Dr. Brandon, our psychologist. He did a visualization with Bill and me around lights and healing. It was another powerful experience for me.
On Thursday Bill and I went down to Denver to the University of Colorado Medical Center for another ERCP to replace my stents. Come to find out the strictures (or narrowing) of the hepatic ducts are basically gone and they don't need to put stents back in. The purpose of the stents is to allow bile and stones to flow through the hepatic ducts and common bile ducts into the duodenum. The strictures or narrowings were causing these ducts to become blocked so the stents were needed. It has been a year since they started putting the stents in and now they don't need them. That is good news.
The doctor has been watching my white blood counts. If they stay high enough, I will be able to receive my chemotherapy on Tuesday as planned. Please pray that the blood counts are high enough to receive chemo.
Have a great week.
Michelle
Wednesday, November 11, 2009
Two Chemos in a Row - Yea
I received chemotherapy #22 on Tuesday. It was a victory of sorts. I got my 2nd chemotherapy treatment on schedule with my blood counts being at a good level. Before this my blood counts would be too low after the first treatment to get my 2nd treatment on time. Please pray that trend continues for the 3rd and 4th treatments in this cycle.
I had secret help getting my blood counts up. My Mom suggested that I visualize the platelets popping like popcorn. This worked.
Bill talked about there being a razor's edge in the last blog post. He talked about this razor's edge in terms of treatment and doing no harm. There is also a razor's edge about the mental health aspect of a chronic disease. One minute you are going to beat this horrible disease. The next minute you are having a little more pain and wondering how much time you have left. Keep me in your prayers that my mental outlook can remain positive.
Enjoy your weekend.
Michelle
I had secret help getting my blood counts up. My Mom suggested that I visualize the platelets popping like popcorn. This worked.
Bill talked about there being a razor's edge in the last blog post. He talked about this razor's edge in terms of treatment and doing no harm. There is also a razor's edge about the mental health aspect of a chronic disease. One minute you are going to beat this horrible disease. The next minute you are having a little more pain and wondering how much time you have left. Keep me in your prayers that my mental outlook can remain positive.
Enjoy your weekend.
Michelle
Saturday, October 24, 2009
The Razor's Edge
Howdy all, Bill here for a change.
We had our monthly visit with oncologist Dr. Marschke last Wednesday. The main focus of our conversation was coming up with a new strategy to attempt to get more chemotherapy medicine into Michelle in each 4 week cycle. The last cycle didn't work out too well, as you probably surmised if you've been keeping up with these blog posts.
For those of you who haven't been following closely, Michelle's last chemo treatment was almost 4 weeks ago. The day after treatment, she received her first dose of the white blood cell growth factor medicine, whose purpose was to stimulate Michelle's bone marrow to produce more nutrafils, the white blood cells that kept falling too low to treat. The medicine was a success at addressing the too-low white cell count, but unfortunately her platelet counts fell below the line and we had to cancel her scheduled treatment 2 weeks later.
Dr. Marschke said he's walking a razor's edge with Michelle's treatment. While he could give her a second growth factor to boost platelet production, that drug would effectively be working against the white cell growth factor because bone marrow blood cell production is something of a zero sum game. There's only so much work the bone marrow can do and when we stimulate it to produce more white cells, it can impact the production of red cells and platelets. The razor's edge comes in because our primary guiding principle is to first do no harm, and the Dr. is very concerned about pushing too aggressively with treatment and putting her back in the hospital.
Where does this leave us? After much discussion we decided to lower the treatment threshhold for the platelet count slightly and try again to get 2 treatments in over the next 4 weeks, one every other week starting Tuesday 10/27. The threshhold had been at 75,000 and Michelle was at 71,000. The absolute floor is 25,000, below which it will be very difficult to prevent her from breaking out with bleeding everywhere, since the primary job of platelets is clotting and controlling bleeding. We set the new floor at 50,000 and increased blood count monitoring to 2 times per week instead of 1.
In other news, Michelle's antigen level (tumor marker) is back above 200 again, at 248. It was up to 211 in September, then back to 134 at the beginning of October. This is, of course, a little scary. We'd like to see it go back below 55 and stay there, but at least it's not in the 1000's. The truth is, this is just a number, and it's part of the roller coaster of this disease. It doesn't mean anything to Michelle's day to day experience. It simply confirms what we already know: we need to find a way to get back to a consistent treatment plan where we can get at much of the drugs into her over a set period of time, while keeping her as strong as possible to continute to tolerate treatments.
It's important to celebrate the things that aren't happening as well. Michelle is NOT vomiting on a regular basis. She is NOT bleeding uncontrollably. Perhaps most importlanty, Michells is NOT experincing elevated bilirubin levels, jaundice, liver pain, stomach discomfort, difficulty with eating or digestion, etc. Yes, her energy levels continue to taper off, and she requires even more sleep now (up to 14 hours per day), but her waking hours are good. She has taken up rug hooking, and enjoys going for walks outside when the weather is nice (not too many more nice days left, unfortunatley.)
We had a great prayer meeting at Karen Lowe's house this last Monday evening. It's been over 2 months since the last get together, and we all had lots of catching up to do. Somehow the conversation inevitably turned to the local balloon hoax that captured the attention of the world in the last couple of weeks and put our hometown back in the national spotlight again. The next prayer meeting is scheduled for 4 weeks from now, on Monday November 16 at 6:30, again at Karen's.
Some of you may have heard that I spent the morning in the ER recently. I was having severe abdominal pain, but all the tests for bad stuff came back normal. The doctor thinks it could be an early precursor of diverticulitis, but at this point the only treatment is anti-inflammatories (ibuprofen) and rest.
My brother, laid off since early July, found a job and left this week for cross-country drive to his new home in Halifax, Nova Scotia, Canada, where he will be the project controls engineer for a major ship-builder.
We have also firmed up plans for Michelle's entire immediately family (parents, 2 sisters, and their husbands and kids) to get together here in Fort Collins just after Christmas. It should be a lot of fun, and gives us a bright spot to look forward to.
TTFN,
Bill
We had our monthly visit with oncologist Dr. Marschke last Wednesday. The main focus of our conversation was coming up with a new strategy to attempt to get more chemotherapy medicine into Michelle in each 4 week cycle. The last cycle didn't work out too well, as you probably surmised if you've been keeping up with these blog posts.
For those of you who haven't been following closely, Michelle's last chemo treatment was almost 4 weeks ago. The day after treatment, she received her first dose of the white blood cell growth factor medicine, whose purpose was to stimulate Michelle's bone marrow to produce more nutrafils, the white blood cells that kept falling too low to treat. The medicine was a success at addressing the too-low white cell count, but unfortunately her platelet counts fell below the line and we had to cancel her scheduled treatment 2 weeks later.
Dr. Marschke said he's walking a razor's edge with Michelle's treatment. While he could give her a second growth factor to boost platelet production, that drug would effectively be working against the white cell growth factor because bone marrow blood cell production is something of a zero sum game. There's only so much work the bone marrow can do and when we stimulate it to produce more white cells, it can impact the production of red cells and platelets. The razor's edge comes in because our primary guiding principle is to first do no harm, and the Dr. is very concerned about pushing too aggressively with treatment and putting her back in the hospital.
Where does this leave us? After much discussion we decided to lower the treatment threshhold for the platelet count slightly and try again to get 2 treatments in over the next 4 weeks, one every other week starting Tuesday 10/27. The threshhold had been at 75,000 and Michelle was at 71,000. The absolute floor is 25,000, below which it will be very difficult to prevent her from breaking out with bleeding everywhere, since the primary job of platelets is clotting and controlling bleeding. We set the new floor at 50,000 and increased blood count monitoring to 2 times per week instead of 1.
In other news, Michelle's antigen level (tumor marker) is back above 200 again, at 248. It was up to 211 in September, then back to 134 at the beginning of October. This is, of course, a little scary. We'd like to see it go back below 55 and stay there, but at least it's not in the 1000's. The truth is, this is just a number, and it's part of the roller coaster of this disease. It doesn't mean anything to Michelle's day to day experience. It simply confirms what we already know: we need to find a way to get back to a consistent treatment plan where we can get at much of the drugs into her over a set period of time, while keeping her as strong as possible to continute to tolerate treatments.
It's important to celebrate the things that aren't happening as well. Michelle is NOT vomiting on a regular basis. She is NOT bleeding uncontrollably. Perhaps most importlanty, Michells is NOT experincing elevated bilirubin levels, jaundice, liver pain, stomach discomfort, difficulty with eating or digestion, etc. Yes, her energy levels continue to taper off, and she requires even more sleep now (up to 14 hours per day), but her waking hours are good. She has taken up rug hooking, and enjoys going for walks outside when the weather is nice (not too many more nice days left, unfortunatley.)
We had a great prayer meeting at Karen Lowe's house this last Monday evening. It's been over 2 months since the last get together, and we all had lots of catching up to do. Somehow the conversation inevitably turned to the local balloon hoax that captured the attention of the world in the last couple of weeks and put our hometown back in the national spotlight again. The next prayer meeting is scheduled for 4 weeks from now, on Monday November 16 at 6:30, again at Karen's.
Some of you may have heard that I spent the morning in the ER recently. I was having severe abdominal pain, but all the tests for bad stuff came back normal. The doctor thinks it could be an early precursor of diverticulitis, but at this point the only treatment is anti-inflammatories (ibuprofen) and rest.
My brother, laid off since early July, found a job and left this week for cross-country drive to his new home in Halifax, Nova Scotia, Canada, where he will be the project controls engineer for a major ship-builder.
We have also firmed up plans for Michelle's entire immediately family (parents, 2 sisters, and their husbands and kids) to get together here in Fort Collins just after Christmas. It should be a lot of fun, and gives us a bright spot to look forward to.
TTFN,
Bill
Sunday, October 11, 2009
Brrrrrrrrrrr
What a cold birthday weekend. Saturday's high was 27 and Sunday it was 37 degrees. Brrrrr. We had the top of the sprinkler backflow pop off because it hasn't been blown out yet and the pipes want to freeze. We usually do it around now, but it is a little early for the snow and cold. There is still alot of leaves on the trees and many are still green. We had pumpkin pie and chili for my birthday. It was a good dinner and fabulous birthday.
Our house is under quarantine. Chris is getting over the flu. Since it is too early for seasonal flu. We are assuming swine flu. He has a nasty cough. Lots of hand washing going on as the rest of us are trying not to get it!
Our house is under quarantine. Chris is getting over the flu. Since it is too early for seasonal flu. We are assuming swine flu. He has a nasty cough. Lots of hand washing going on as the rest of us are trying not to get it!
My whole family has decided to come out for Christmas this year. It will be my parents 50th wedding anniversary in May. Christmas break seemed to be the only time everybody can get together. Given my situation, they decided to have it here. So that should be a fun time. There will be 13 of us. Looking forward to seeing everybody.
The next prayer circle will be Monday, October 19th at Karen's house at 6:45. Please call me if you need directions.
Michelle
Monday, September 28, 2009
Good News
Bill and I met with the oncologist today. We got some good news. My CA 19-9 blood test was 134, down from 197. He also talked about the ct scan. There wasn't any new stuff on the scan. The liver looks like it has healed from the radiation recall in June that damaged the liver and landed me in the hospital.
The last 2 rounds of chemotherapy we tried to do weekly chemo for 3 weeks with the 4th week off. Each time I was only able to do 2 weeks of chemo, because of low blood counts (white blood cells). Now we are going to do a higher dose of chemotherapy every other week. The day after chemo, I will get a shot that will help bring the white blood cells up, so low blood counts aren't a problem. The shot has some side effects like bone pain, fever, fatigue, etc. Hopefully, the side effects aren't too bad for me.
The deck is almost done. There are 2 railing pieces that need to be put in place and a set of stairs built.
That is it for now.
Michelle
The last 2 rounds of chemotherapy we tried to do weekly chemo for 3 weeks with the 4th week off. Each time I was only able to do 2 weeks of chemo, because of low blood counts (white blood cells). Now we are going to do a higher dose of chemotherapy every other week. The day after chemo, I will get a shot that will help bring the white blood cells up, so low blood counts aren't a problem. The shot has some side effects like bone pain, fever, fatigue, etc. Hopefully, the side effects aren't too bad for me.
The deck is almost done. There are 2 railing pieces that need to be put in place and a set of stairs built.
That is it for now.
Michelle
Tuesday, September 15, 2009
That smells good
I didn't get chemo today. My blood counts were too low. My blood counts are so low, the doctor put me on antibiotics as a precaution. Next week is my week off of chemo. I will be having a CT scan to monitor how things are going. My CA 19-9 tumor marker did come down to 192 from 211 after the 1st chemo in this round.
I did get my laptop back. Thank you Bill for putting it all back together and thank you Kelly for letting me us your laptop. A quick update on Kelly. She is back to work after her bouts with dizziness that has kept her off work since July 27th. She still gets some bad headaches, but things are better.
I have been doing some cooking the last couple of weeks. I don't know what has gotten into me. A couple of weeks ago I made Chicken and Potatoes. Then we went to the Farmer's market. I made a homemade peach cobbler with some delicious peaches we got there. I also canned 5 jars of refrigerator pickles. They were good. On Saturday when it was so cold, I made some Tomato Bisque Soup with a recipe from Coopersmith's restaurant here in town. We also went back to the farmer's market on Sunday. This time I made a peach crisp with an oatmeal and brown sugar crust. It was awesome with vanilla ice cream.
Today my former work team was getting together for happy hour. I met them and got a chance to catch up. It was great.
I did get my laptop back. Thank you Bill for putting it all back together and thank you Kelly for letting me us your laptop. A quick update on Kelly. She is back to work after her bouts with dizziness that has kept her off work since July 27th. She still gets some bad headaches, but things are better.
I have been doing some cooking the last couple of weeks. I don't know what has gotten into me. A couple of weeks ago I made Chicken and Potatoes. Then we went to the Farmer's market. I made a homemade peach cobbler with some delicious peaches we got there. I also canned 5 jars of refrigerator pickles. They were good. On Saturday when it was so cold, I made some Tomato Bisque Soup with a recipe from Coopersmith's restaurant here in town. We also went back to the farmer's market on Sunday. This time I made a peach crisp with an oatmeal and brown sugar crust. It was awesome with vanilla ice cream.
Today my former work team was getting together for happy hour. I met them and got a chance to catch up. It was great.
Have a rowdy week.
Michelle
Sunday, September 6, 2009
Ups and Downs
Bill and I met with Dr. Marschke, our oncologist, last Tuesday. We decided to lower the blood count parameters that decides if I get chemotherapy or not. This way I have a better chance of getting all 3 chemos before my week off. I had chemotherapy after the doctor visit. The blood work is looking good for the most part. The CA19-9 which is the tumor marker for the bile duct cancer has gone up again. It was 97, 4 weeks ago. Now it is 211. So that needs to start coming back down again. Hopefully after this round of chemo if I can get all 3 doses, the numbers will start coming back down again.
I forgot to mention that I got a 2006 Saturn Vue last week. We needed another car since Chris and Kelly are going to different schools now and with both of them working there were too many logistics to manage. I like driving it.
Sad news. My laptop hard drive died last week. So I am writing this on Kelly's laptop, she has so kindly let me use. As you can imagine for someone that spends alot of time at home, I use the laptop alot. It should be another week before I get it back.
My next chemotherapy is 8:30 am the day after labor day. I will have to set the alarm clock. That is just too early.
Have a great week.
Michelle
I forgot to mention that I got a 2006 Saturn Vue last week. We needed another car since Chris and Kelly are going to different schools now and with both of them working there were too many logistics to manage. I like driving it.
Sad news. My laptop hard drive died last week. So I am writing this on Kelly's laptop, she has so kindly let me use. As you can imagine for someone that spends alot of time at home, I use the laptop alot. It should be another week before I get it back.
My next chemotherapy is 8:30 am the day after labor day. I will have to set the alarm clock. That is just too early.
Have a great week.
Michelle
Saturday, August 29, 2009
Friends are Gifts
This week was my week off of chemo. On Tuesday, September 1st, we go back and see Dr. Marschke, the oncologist. I don't anticipate any big changes to the routine. I am still doing well, but continue to be on oxygen, which can be frustrating sometimes.
I was blessed with 2 visits from friends these past 2 weeks. A week ago Friday, Brenda came over and we had a nice visit over some pink lemonade. Suzanne came over on Wednesday this week. We had little single serving hagen-daz ice cream cups. It was quite a treat. I enjoyed visiting with both Brenda and Suzanne. I also got to catch up with my friend Cindi yesterday as she gave me a massage. No ice cream, but it was still a treat. It is awe inspiring when friends take time out of their busy schedule to call up or e-mail and say when can I come over. Friends are also those to pick up the phone to catch up or send a newsy e-mail on what is happening at work. It can be lonely sometimes, so I am grateful to everybody that can take that extra couple of minutes.
God Bless all of our friends. Have a peace filled week.
Michelle
I was blessed with 2 visits from friends these past 2 weeks. A week ago Friday, Brenda came over and we had a nice visit over some pink lemonade. Suzanne came over on Wednesday this week. We had little single serving hagen-daz ice cream cups. It was quite a treat. I enjoyed visiting with both Brenda and Suzanne. I also got to catch up with my friend Cindi yesterday as she gave me a massage. No ice cream, but it was still a treat. It is awe inspiring when friends take time out of their busy schedule to call up or e-mail and say when can I come over. Friends are also those to pick up the phone to catch up or send a newsy e-mail on what is happening at work. It can be lonely sometimes, so I am grateful to everybody that can take that extra couple of minutes.
God Bless all of our friends. Have a peace filled week.
Michelle
Wednesday, August 19, 2009
No Chemo Last Week, Chemo This Week
So on August 11, my blood counts were too low to get chemotherapy. So they skipped it. This week they were better and I received chemotherapy yesterday. It is funny how not getting chemo can make you sad. I think I was worried about things growing if there was nothing in there to stop it. So I am glad I got chemo this week. I am still dragging around an oxygen tank. I am hoping to stop that soon. I got a massage today after not having one in a couple of months. It felt good. I am finding I am feeling a little low, though my mood is picking up. I know part of it is feeling bored and house-bound. The kids start school next week and then we will see how lonely it will be (or if we are all fighting over cars!).
Have a peaceful week.
Michelle
Have a peaceful week.
Michelle
Friday, August 7, 2009
Good News - Tumors Shrinking
Bill and I were down in Denver on Thursday at the University of Colorado Health Center. I had my 5th ERCP to replace the stents in my bile duct. The doctors said that one of the tumors has resolved and so I am taking that to mean one of the tumors is gone and the others are a little smaller from April and they didn't put stents as high in the hepatic ducts. So good news. Praise God.
I had chemotherapy on Tuesday. It was weird being back there after missing the last 7 weeks. There was a new set of regulars. The nurses all recognized me. They gave me the lower dose of chemotherapy. I am feeling good. I am still on oxygen full time, but that is getting better also.
We got a diagnosis for Kelly this week. She had been dizzy since July 26th, the Sunday we got off of the cruise. She has been unable to really be on her feet. She has had to call into work the past few weeks. Thursday she went and saw someone at the Ear Nose and Throat doctor's office. She was diagnosed with maldebarq syndrome. Her brain never reset to say she was back on land. There isn't any medication to fix it. There is some physical therapy she can do to help reset her brain. So she has physical therapy appointments the next 6 weeks along with some exercises to do at home. The concern is she starts school in 2 weeks and needs to be able to go to class.
Have a great week.
Michelle
I had chemotherapy on Tuesday. It was weird being back there after missing the last 7 weeks. There was a new set of regulars. The nurses all recognized me. They gave me the lower dose of chemotherapy. I am feeling good. I am still on oxygen full time, but that is getting better also.
We got a diagnosis for Kelly this week. She had been dizzy since July 26th, the Sunday we got off of the cruise. She has been unable to really be on her feet. She has had to call into work the past few weeks. Thursday she went and saw someone at the Ear Nose and Throat doctor's office. She was diagnosed with maldebarq syndrome. Her brain never reset to say she was back on land. There isn't any medication to fix it. There is some physical therapy she can do to help reset her brain. So she has physical therapy appointments the next 6 weeks along with some exercises to do at home. The concern is she starts school in 2 weeks and needs to be able to go to class.
Have a great week.
Michelle
Tuesday, August 4, 2009
CA19-9 went up
On Friday Bill and I met with Dr. Marschke, the medical oncologist. The new plan is to try to continue the chemotherapy with a lower dose of the gemzar. Gemzar is what I was getting before the side effects showed up in June. The dose is going to be started much lower we will be watching for any symptoms. So far I have been scheduled for chemotherapy on August 4, 11 and 18th.
We had a great prayer circle last night. We celebrated a great vacation with coconut rum cake and chocolate rum cake. We also sang Happy Birthday to Bill. Chris and Kelly's 20th birthday was on Friday.
I will also be having an ERCP on Thursday to replace my stents. It has been 15 weeks since the last ERCP. They like to wait no longer than 12 weeks.
I got my CA19-9 results today. It has gone up to 97 from 57. I am sure this is from not having chemo for 7 weeks. So it is a good thing we are starting back with treatment. Please pray that this comes back down.
Have a good week.
Michelle
We had a great prayer circle last night. We celebrated a great vacation with coconut rum cake and chocolate rum cake. We also sang Happy Birthday to Bill. Chris and Kelly's 20th birthday was on Friday.
I will also be having an ERCP on Thursday to replace my stents. It has been 15 weeks since the last ERCP. They like to wait no longer than 12 weeks.
I got my CA19-9 results today. It has gone up to 97 from 57. I am sure this is from not having chemo for 7 weeks. So it is a good thing we are starting back with treatment. Please pray that this comes back down.
Have a good week.
Michelle
Monday, July 27, 2009
So when is the next cruise?
We had an awesome cruise. We got back home Sunday night a little before midnight. I was overwhelmed because I felt happier and better than I have in over 6 months. I was surrounded by healthy, happy people and it was contagious. The week surpassed any expectations and definitely a blessing. Thank you for all of the prayers. They were all answered.
First, I have to give Bill kudos. He spent hours and hours on logistics with airlines, cruise company, medical supply company, wheel chair rental, travel agent and other people. Everything went smoothly. Thank you Bill.
In Colorado before the cruise, I was on oxygen full time. Once we got to Flordia, because we were at sea level, I only needed oxygen at night along with a couple of times during the day. We also rented a wheelchair for on board. We only needed to use it the first day. It was really liberating not being tied to the oxygen machine.
The kids went on some shore excursions and had a great time. They got to play with some dolphins. Theirs was named Newton. He was a prankster. When the trainer wanted him to go with the one group of people he went back to the other group. Kelly had fun petting the turtles. She liked to pick up the small ones and see their flippers flap vigorously. They also went to the Mayan ruins at Telum.
Bill and I went into town to do some shopping at Jamaica. We found some 25th anniversary rings. Bill also bought me a cancer survivor ring. It was very special. It was also very hot. It wore us out. We spent the next 2 port days on the ship in the air conditioning.
We found all kinds of stuff to occupy us while on the ship. Bill and I won a couple of hats playing trivia. We all won some document holders playing movie trivia. I won about $40 playing nickel slots. We won't mention what happened to other people at the casino. Kelly and I also played some Bingo. Kelly, Bill and I attended an art auction. I can't believe the kind of art they had on the ship. Original Rembrants that were 350 years old. No we didn't buy them. I won a bottle of champagne and a picture of the ship in the raffle. Kelly, Bill and I played cards. We had some good family time.
So again thank you for all of the prayers and send God a few thank you prayers as the cruise was truly blessed and God's presence was there.
-------------------- Prayer Request --------------------------
Please join my family in praying for the family of Stephanie Harvey. Stephanie was my brother-in-law's sister who was diagnosed with stage 4 esophageal cancer a year and a half ago. She passed away Sunday night. Please pray for comfort and strength for her husband Steve and 3 kids, Rachel, Christina and Steven. The oldest is 9 1/2 years old.
Have a peace filled week.
Michelle
First, I have to give Bill kudos. He spent hours and hours on logistics with airlines, cruise company, medical supply company, wheel chair rental, travel agent and other people. Everything went smoothly. Thank you Bill.
In Colorado before the cruise, I was on oxygen full time. Once we got to Flordia, because we were at sea level, I only needed oxygen at night along with a couple of times during the day. We also rented a wheelchair for on board. We only needed to use it the first day. It was really liberating not being tied to the oxygen machine.
The kids went on some shore excursions and had a great time. They got to play with some dolphins. Theirs was named Newton. He was a prankster. When the trainer wanted him to go with the one group of people he went back to the other group. Kelly had fun petting the turtles. She liked to pick up the small ones and see their flippers flap vigorously. They also went to the Mayan ruins at Telum.
Bill and I went into town to do some shopping at Jamaica. We found some 25th anniversary rings. Bill also bought me a cancer survivor ring. It was very special. It was also very hot. It wore us out. We spent the next 2 port days on the ship in the air conditioning.
We found all kinds of stuff to occupy us while on the ship. Bill and I won a couple of hats playing trivia. We all won some document holders playing movie trivia. I won about $40 playing nickel slots. We won't mention what happened to other people at the casino. Kelly and I also played some Bingo. Kelly, Bill and I attended an art auction. I can't believe the kind of art they had on the ship. Original Rembrants that were 350 years old. No we didn't buy them. I won a bottle of champagne and a picture of the ship in the raffle. Kelly, Bill and I played cards. We had some good family time.
So again thank you for all of the prayers and send God a few thank you prayers as the cruise was truly blessed and God's presence was there.
-------------------- Prayer Request --------------------------
Please join my family in praying for the family of Stephanie Harvey. Stephanie was my brother-in-law's sister who was diagnosed with stage 4 esophageal cancer a year and a half ago. She passed away Sunday night. Please pray for comfort and strength for her husband Steve and 3 kids, Rachel, Christina and Steven. The oldest is 9 1/2 years old.
Have a peace filled week.
Michelle
Friday, July 17, 2009
This post is brought to you by the number 57
Great news! My CA19-9 cancer tumor marker was 57 today. Normal is 55. I am 2 points from normal. I think that is reason to celebrate. I think I will take a cruise. Oh, wait, we already have a cruise scheduled to start tomorrow! YAY!
So we have lots of great news to celebrate. I am doing better after getting out of the hospital 2 weeks ago. I am still on oxygen, but my breathing has improved a lot, so I need less: 2-3 liters per minute instead of 5. A chest x-ray done yesterday showed my lungs are healing. My blood work also looked good. I am still working on getting my energy back.
We are taking a 7 day Western Caribbean Cruise. We fly out on Saturday to Florida and board the ship on Sunday. We disembark and fly home the following Sunday. Our itinerary includes Cozumel, Grand Cayman, and Jamaica. The kids are signed up for shore excursions at every port. They will be visiting the Mayan ruins at Tulum during our stop in Cozumel. They will swim with the dolphins and visit a turtle farm at Grand Cayman Island. In Jamaica, they will ride a gondola to the top of a mountain and then ride down on a wheeled bobsled all the way to the bottom.
Bill and I are going to take it easy and just enjoy the amenities on the ship. I am excited to have some time away from medical stuff, and looking forward to spending some quality time with my sweetie.
Love and God Bless,
Michelle
So we have lots of great news to celebrate. I am doing better after getting out of the hospital 2 weeks ago. I am still on oxygen, but my breathing has improved a lot, so I need less: 2-3 liters per minute instead of 5. A chest x-ray done yesterday showed my lungs are healing. My blood work also looked good. I am still working on getting my energy back.
We are taking a 7 day Western Caribbean Cruise. We fly out on Saturday to Florida and board the ship on Sunday. We disembark and fly home the following Sunday. Our itinerary includes Cozumel, Grand Cayman, and Jamaica. The kids are signed up for shore excursions at every port. They will be visiting the Mayan ruins at Tulum during our stop in Cozumel. They will swim with the dolphins and visit a turtle farm at Grand Cayman Island. In Jamaica, they will ride a gondola to the top of a mountain and then ride down on a wheeled bobsled all the way to the bottom.
Bill and I are going to take it easy and just enjoy the amenities on the ship. I am excited to have some time away from medical stuff, and looking forward to spending some quality time with my sweetie.
Love and God Bless,
Michelle
Saturday, July 4, 2009
Home Again Home Again Jiggety Jig
Michelle was released from the hospital Thursday morning and is very relieved to be home in her own bed once again. After struggling for over a week with only small improvements from day to day, Wednesday was a banner day as her pain management issues resolved and the medicine to get her digestive tract working again finally produced tangible results.
The radiation damage to her liver continues to be a major source of pain, and after all she went through in the last 2 weeks, her supplemental oxygen needs remain fairly high (5 liters). The pain pump that was installed last Friday is working well, and she is getting good (but not perfect) pain relief with much reduced side effects.
We are very hopeful that with continued breathing therapy using the inspirometer supplied by the hospital, her oxygen needs will return to the pre-hospital level of 2 liters, if not go away completely.
Dr. Marschke said that as long as she feels up to it, we will still be able to take our trip (we are scheduled to depart 2 weeks from today). While we are still hopeful that will be the case, she definitely needs to show more improvement before that will be practical.
Chemotherapy is on hold for the moment. Michelle was scheduled for a treatment this past Tuesday which we skipped for obvious reasons, but since we are going on vacation the week after next, and since the Gemzar caused the radiation recall effect resulting in the damage to her liver, we want to regroup a bit and discuss all our options with Dr. Marschke before restarting treatments. He wants to meet with us next week to follow up on Michelle's progress and then again after our vacation to discuss chemo treatment options.
Michelle's mom and dad, Ron and Sharon Beyer, have been staying with us since their arrival from the Phoenix area last Thursday June 25. It's been great to have them here. Dad worked on the deck nearly every day while Bill and Mom spent every day at the hospital with Michelle. Yesterday Bill helped Dad finish the decking, so the project is almost complete! Only the steps and railing remain.
Thank you all for your continued prayers and the notes, emails, flowers, and other good wishes you sent our way during this latest ordeal.
Love,
Bill & Michelle
The radiation damage to her liver continues to be a major source of pain, and after all she went through in the last 2 weeks, her supplemental oxygen needs remain fairly high (5 liters). The pain pump that was installed last Friday is working well, and she is getting good (but not perfect) pain relief with much reduced side effects.
We are very hopeful that with continued breathing therapy using the inspirometer supplied by the hospital, her oxygen needs will return to the pre-hospital level of 2 liters, if not go away completely.
Dr. Marschke said that as long as she feels up to it, we will still be able to take our trip (we are scheduled to depart 2 weeks from today). While we are still hopeful that will be the case, she definitely needs to show more improvement before that will be practical.
Chemotherapy is on hold for the moment. Michelle was scheduled for a treatment this past Tuesday which we skipped for obvious reasons, but since we are going on vacation the week after next, and since the Gemzar caused the radiation recall effect resulting in the damage to her liver, we want to regroup a bit and discuss all our options with Dr. Marschke before restarting treatments. He wants to meet with us next week to follow up on Michelle's progress and then again after our vacation to discuss chemo treatment options.
Michelle's mom and dad, Ron and Sharon Beyer, have been staying with us since their arrival from the Phoenix area last Thursday June 25. It's been great to have them here. Dad worked on the deck nearly every day while Bill and Mom spent every day at the hospital with Michelle. Yesterday Bill helped Dad finish the decking, so the project is almost complete! Only the steps and railing remain.
Thank you all for your continued prayers and the notes, emails, flowers, and other good wishes you sent our way during this latest ordeal.
Love,
Bill & Michelle
Sunday, June 28, 2009
Still in the hospital
I'll try to keep this update brief, but a lot has happened since the last post.
The pain pump was installed on Friday morning. The surgery went smoothly and the pump is working. Unfortunately, the process of getting the dosage to the proper level has been a slow and agonizing process. Since every patient is different and since this is a new and relatively rarely used technology, finding the right dose is challenging. The process is to start with a low dosage and gradually increase it, being careful not to go to far too fast, out of concern of triggering side effects such as over sedation or respiratory impairment. This caused Michelle to have much higher pain than we would like Friday night (she didn't sleep a wink) and most of the day Saturday. Fortunately, the pain doctors increased the frequency of the bolus doses the pump was allowed to deliver and also added an order for oral pain medication for breakthrough pain. Last night she was able to sleep much better.
In the last post I didn't say much (if anything) about what has emerged as a key symptom that we are currently working to overcome. For reasons that have not yet become clear, Michelle's abdomen is distended and full of gas. Abdominal x-rays show gas in her colon suggesting reduced motility in her small intestines, even though the constipation remedies have been doing their job. Her belly is large and very firm to the touch, causing her organs to be pushed up tight against her diaphragm and preventing her from taking deep breaths. This in turn is significantly affecting her pulmonary function.
After the surgery on Friday, she needed 10 liters of oxygen just to keep her O2 saturation levels in the nominal range. This required not 1 but 2 oxygen masks, pulling 5L from each. On Saturday we were able to step her down to her current (but still quite high) level of 5L.
She is also retaining quite a bit of fluid, particularly in her legs which are visibly swollen. This makes walking painful and difficult. She's able to get back and forth to the bathroom, but that's about it. We'd like for her to be able to walk more because walking will help with the gastric issues and hopefully reduce the gas in her belly.
The plan for today:
1. Base line pain pump dosage doubled from yesterday, bolus schedule increased to once every 4 hours (up from 1 every 6 yesterday), oral pain meds still available for breakthrough pain.
2. CT scan to get a closer look at her lungs to determine why the pleural effusions
are increasing. We first saw small amounts of fluid in her pleural (lung) cavity but outside of her lungs back in December on the first PET scan. After decreasing for a while, they came back at about he same level, but have increased again just in the last couple of weeks. Dr. Marschke has asked for a pulmonologist to take a look at Michelle to help figure out the breathing issues.
3. An echocardiogram to check on her heart - a chest x-ray reported a mild enlargement which may be due to portions of the view being obscured by low lung volume.
Dr. Marschke doesn't expect Michelle to be ready to go home until at least Tuesday, and maybe a few days after that. There are still quite few issues that must be resolved first, but at least we have a plan and are making progress if only by inches.
One last piece of good news: there is every indication that the cancer treatments that Michelle has been receiving are still working and keeping the cancer at bay. There has been no indication that anything is growing or spreading. We need to keep focused on that fact and celebrate the good things that are happening in the midst of these challenging times.
Thank you all for your prayers.
Bill & Michelle (typed on the WebTV at Michelle's bedside)
The pain pump was installed on Friday morning. The surgery went smoothly and the pump is working. Unfortunately, the process of getting the dosage to the proper level has been a slow and agonizing process. Since every patient is different and since this is a new and relatively rarely used technology, finding the right dose is challenging. The process is to start with a low dosage and gradually increase it, being careful not to go to far too fast, out of concern of triggering side effects such as over sedation or respiratory impairment. This caused Michelle to have much higher pain than we would like Friday night (she didn't sleep a wink) and most of the day Saturday. Fortunately, the pain doctors increased the frequency of the bolus doses the pump was allowed to deliver and also added an order for oral pain medication for breakthrough pain. Last night she was able to sleep much better.
In the last post I didn't say much (if anything) about what has emerged as a key symptom that we are currently working to overcome. For reasons that have not yet become clear, Michelle's abdomen is distended and full of gas. Abdominal x-rays show gas in her colon suggesting reduced motility in her small intestines, even though the constipation remedies have been doing their job. Her belly is large and very firm to the touch, causing her organs to be pushed up tight against her diaphragm and preventing her from taking deep breaths. This in turn is significantly affecting her pulmonary function.
After the surgery on Friday, she needed 10 liters of oxygen just to keep her O2 saturation levels in the nominal range. This required not 1 but 2 oxygen masks, pulling 5L from each. On Saturday we were able to step her down to her current (but still quite high) level of 5L.
She is also retaining quite a bit of fluid, particularly in her legs which are visibly swollen. This makes walking painful and difficult. She's able to get back and forth to the bathroom, but that's about it. We'd like for her to be able to walk more because walking will help with the gastric issues and hopefully reduce the gas in her belly.
The plan for today:
1. Base line pain pump dosage doubled from yesterday, bolus schedule increased to once every 4 hours (up from 1 every 6 yesterday), oral pain meds still available for breakthrough pain.
2. CT scan to get a closer look at her lungs to determine why the pleural effusions
are increasing. We first saw small amounts of fluid in her pleural (lung) cavity but outside of her lungs back in December on the first PET scan. After decreasing for a while, they came back at about he same level, but have increased again just in the last couple of weeks. Dr. Marschke has asked for a pulmonologist to take a look at Michelle to help figure out the breathing issues.
3. An echocardiogram to check on her heart - a chest x-ray reported a mild enlargement which may be due to portions of the view being obscured by low lung volume.
Dr. Marschke doesn't expect Michelle to be ready to go home until at least Tuesday, and maybe a few days after that. There are still quite few issues that must be resolved first, but at least we have a plan and are making progress if only by inches.
One last piece of good news: there is every indication that the cancer treatments that Michelle has been receiving are still working and keeping the cancer at bay. There has been no indication that anything is growing or spreading. We need to keep focused on that fact and celebrate the good things that are happening in the midst of these challenging times.
Thank you all for your prayers.
Bill & Michelle (typed on the WebTV at Michelle's bedside)
Thursday, June 25, 2009
Adventures in Pain Management
Michelle was admitted to Poudre Valley Hospital (PVH) on Tuesday for pain management and tests to figure out what's behind the pain. I'll skip the gory details and tell you where we stand as of Thursday morning.
For pain management, the plan is to install an intrathecal pump, aka an epidural pump. This works much like the epidural that they give to delivering mommies to ease their pain, in that a catheter inserted into the intrathecal space in the spinal column delivers pain medicine directly into the spinal fluid and blocks the pain signals from reaching the brain. A hockey-puck sized pump will be installed under the layer of fat in her abdomen to deliver a constant, low-level flow of pain medicine. Michelle will have a remote control to deliver a bolus (larger dose) of medicine if she is having "break through" pain.
The primary advantage of this method is that a tiny fraction of the pain medicine dosage will have the same effect as the oral medication we had been using, resulting in almost negligible side effects like constipation, mental fogginess, and respiratory suppression.
A trial epidural catheter was installed Tuesday evening to experiment with different medications and doses to find the right combination to make Michelle comfortable. She's now on morphine, and it seems to be doing the job. We're also dealing with the consequences of being on pain medication for several days and working to alleviate those symptoms to clear the way for installation of the pump tomorrow.
Michelle will also have an MRI this afternoon to recheck the status of the tumor in her vertebra that was treated with radiation back in February.
Speaking of radiation therapy, it turns out that this whole episode of pain is related to that same treatment. The radiation beam that treated the tumor in her spine had to travel through her liver and her stomach on the way to its target. Normally this is no big deal, but there is always risk of organ damage from the radiation, which we were made well aware of at the time. When no damage showed up by 6 weeks after the end of treatment, we all believed Michelle was in the clear. We were wrong.
It turns out that Gemcitabine (aka Gemzar), the chemo drug that Michelle has been on since January, can act as a radiation sensitizer, even after the fact. Dr. Marschke has used Gemcitabine along with radiation therapy with good results in many other patients, but usually for pancreatic cancer. Since the pancreas is off to the side and well away from the liver, he's never seen an effect like Michelle's. Dr. Simpson the radiologist said he's never experienced a problem, either. Regardless of all that, it is fairly clear from the evidence we have that a portion of Michelle's liver is suffering from radiation damage.
Radiation lingers in the body for a long time after treatment, and continued gemcitabine treatments increased the sensitivity of her liver tissue to the radiation,
resulting in tissue damage over the last 3 or 4 weeks. A CT scan the last week of May showed the early beginning of the damage, but it looked more like a tumor at the time. Just 3 weeks later the damage had spread through both the left and right lobe of the liver, but following an absolutely straight line that fit the radiation beam and didn't match the expected growth pattern of either a tumor or damage due to loss of blood supply, the two other most likely diagnoses.
According to Michelle's gastroenterologist Dr. Dunphy, only 1/6 to 1/7 of her liver was affected. The best news is that the liver is really good at repairing itself, and should replace all the damaged tissue over time. The other great news is that all Michelle's liver function markers are at or near the normal range, indicating that the liver damage is not making her sick, other than causing massive amounts of pain.
In the process of ruling out other causes, they checked the blood supply to her liver and the CA19-9 tumor marker. No clots were found, and her CA19-9 dropped from 127 a month or so ago to 75! This is the same number that was 7998 back in January. Hallelujah! Thank ya Jesus! Amen!
In the mean time, Michelle's parents Ron and Sharon Beyer are driving up from the Phoenix area and are expected to arrive tonight. Dad is bringing his tool belt to help me with the deck - we're getting closer to finishing, and I'm hopeful everything will be done in a couple more weeks. (Ha! Michelle says, like that'll happen!) Oh ye of little faith.
Thanks all for your continued prayers. We're holding up well through this bump in the road and are still looking forward to our Caribbean Cruise in just 3 short weeks. We should know in a week or so if we'll still be able to go, so keep your fingers crossed and stay tuned for further developments.
Bill
For pain management, the plan is to install an intrathecal pump, aka an epidural pump. This works much like the epidural that they give to delivering mommies to ease their pain, in that a catheter inserted into the intrathecal space in the spinal column delivers pain medicine directly into the spinal fluid and blocks the pain signals from reaching the brain. A hockey-puck sized pump will be installed under the layer of fat in her abdomen to deliver a constant, low-level flow of pain medicine. Michelle will have a remote control to deliver a bolus (larger dose) of medicine if she is having "break through" pain.
The primary advantage of this method is that a tiny fraction of the pain medicine dosage will have the same effect as the oral medication we had been using, resulting in almost negligible side effects like constipation, mental fogginess, and respiratory suppression.
A trial epidural catheter was installed Tuesday evening to experiment with different medications and doses to find the right combination to make Michelle comfortable. She's now on morphine, and it seems to be doing the job. We're also dealing with the consequences of being on pain medication for several days and working to alleviate those symptoms to clear the way for installation of the pump tomorrow.
Michelle will also have an MRI this afternoon to recheck the status of the tumor in her vertebra that was treated with radiation back in February.
Speaking of radiation therapy, it turns out that this whole episode of pain is related to that same treatment. The radiation beam that treated the tumor in her spine had to travel through her liver and her stomach on the way to its target. Normally this is no big deal, but there is always risk of organ damage from the radiation, which we were made well aware of at the time. When no damage showed up by 6 weeks after the end of treatment, we all believed Michelle was in the clear. We were wrong.
It turns out that Gemcitabine (aka Gemzar), the chemo drug that Michelle has been on since January, can act as a radiation sensitizer, even after the fact. Dr. Marschke has used Gemcitabine along with radiation therapy with good results in many other patients, but usually for pancreatic cancer. Since the pancreas is off to the side and well away from the liver, he's never seen an effect like Michelle's. Dr. Simpson the radiologist said he's never experienced a problem, either. Regardless of all that, it is fairly clear from the evidence we have that a portion of Michelle's liver is suffering from radiation damage.
Radiation lingers in the body for a long time after treatment, and continued gemcitabine treatments increased the sensitivity of her liver tissue to the radiation,
resulting in tissue damage over the last 3 or 4 weeks. A CT scan the last week of May showed the early beginning of the damage, but it looked more like a tumor at the time. Just 3 weeks later the damage had spread through both the left and right lobe of the liver, but following an absolutely straight line that fit the radiation beam and didn't match the expected growth pattern of either a tumor or damage due to loss of blood supply, the two other most likely diagnoses.
According to Michelle's gastroenterologist Dr. Dunphy, only 1/6 to 1/7 of her liver was affected. The best news is that the liver is really good at repairing itself, and should replace all the damaged tissue over time. The other great news is that all Michelle's liver function markers are at or near the normal range, indicating that the liver damage is not making her sick, other than causing massive amounts of pain.
In the process of ruling out other causes, they checked the blood supply to her liver and the CA19-9 tumor marker. No clots were found, and her CA19-9 dropped from 127 a month or so ago to 75! This is the same number that was 7998 back in January. Hallelujah! Thank ya Jesus! Amen!
In the mean time, Michelle's parents Ron and Sharon Beyer are driving up from the Phoenix area and are expected to arrive tonight. Dad is bringing his tool belt to help me with the deck - we're getting closer to finishing, and I'm hopeful everything will be done in a couple more weeks. (Ha! Michelle says, like that'll happen!) Oh ye of little faith.
Thanks all for your continued prayers. We're holding up well through this bump in the road and are still looking forward to our Caribbean Cruise in just 3 short weeks. We should know in a week or so if we'll still be able to go, so keep your fingers crossed and stay tuned for further developments.
Bill
Friday, June 19, 2009
Attention Prayer Warriors!
Prayer Warriors, it is time to kick it back up a notch. We're worried and Michelle needs your renewed prayers.
Over the last few months, things settled into a smoother pattern we thought of as "the new normal". Michelle was mostly pain free, and seemed to be gradually gaining energy. She was able to walk around the block and even took a couple of short hikes at a nearby nature preserve. Although she could only handle about an hour or two of activity in any given day, it was very encouraging that she was able to leave the house and feel more normal.
That largely ended on Memorial Day.
Early in the morning, Michelle woke up with startlingly severe abdominal pain. The sharp, stabbing pain was centered just under her breastbone and was annoyingly constant. After some debate and trying Advil without success, we broke out the narcotic pain killers that she set aside back in March, and was able to get some relief. The pain seemed to gradually diminish over the next week, and we were hopeful that it was just a fluke.
Right around this time my knee pain was rapidly reaching a crescendo, culminating in my June 4 arthroscopic surgery to repair my torn medial meniscus cartilage. Michelle did a great job of helping me with my recovery, but her abdominal pain started coming back again. This time, we attributed it to a pulled muscle because unlike the Memorial Day pain, it only really hurt when she used her abdominal muscles.
Over the last 2 weeks, the pain has slowly ramped up again to the point where just shifting positions in bed or walking across the room is agony. She has been working with a Physician's Assistant, who agreed that the pain was probably muscular.
Yesterday, however, the PA was off duty when Michelle went to the cancer center for her scheduled IV hydration (she usually receives hydration 2 days after each chemo treatment) so Michelle's oncologist Dr. Marschke came by to see her. He took a closer look at the CT scan they ordered after Michelle first reported the problem, and is concerned that this pain may be related to one of 3 liver tumors shown on the scan. We were aware of one tumor that appeared on the December PET scan, but it was unclear to us whether the other 2 are new. No tumors showed up on the PET scan a couple of months ago, which means no metabolic activity was detected in that test, but it doesn't mean the tumors were gone.
Dr. Marschke ordered another CT scan for this Saturday, this time with contrast dye to help show more detail of the tumors, particulary the one in the vicinity of Michelle's current pain. We have an appointment with Dr. Marschke on Tuesday to hear the results.
This is where you come in, prayer warriors. Michelle needs your prayers for support and encouragement, and above all for healing. Thank you for all your prayers in the past. Michelle and I believe that they have worked wonders - we just need a little more of that wonder right now.
God Bless,
Bill
P.S. It's been two weeks, and I've healed quickly from my surgery. I overdid it a little last weekend, but this has been a good week and I'm well on my way to full recovery.
Over the last few months, things settled into a smoother pattern we thought of as "the new normal". Michelle was mostly pain free, and seemed to be gradually gaining energy. She was able to walk around the block and even took a couple of short hikes at a nearby nature preserve. Although she could only handle about an hour or two of activity in any given day, it was very encouraging that she was able to leave the house and feel more normal.
That largely ended on Memorial Day.
Early in the morning, Michelle woke up with startlingly severe abdominal pain. The sharp, stabbing pain was centered just under her breastbone and was annoyingly constant. After some debate and trying Advil without success, we broke out the narcotic pain killers that she set aside back in March, and was able to get some relief. The pain seemed to gradually diminish over the next week, and we were hopeful that it was just a fluke.
Right around this time my knee pain was rapidly reaching a crescendo, culminating in my June 4 arthroscopic surgery to repair my torn medial meniscus cartilage. Michelle did a great job of helping me with my recovery, but her abdominal pain started coming back again. This time, we attributed it to a pulled muscle because unlike the Memorial Day pain, it only really hurt when she used her abdominal muscles.
Over the last 2 weeks, the pain has slowly ramped up again to the point where just shifting positions in bed or walking across the room is agony. She has been working with a Physician's Assistant, who agreed that the pain was probably muscular.
Yesterday, however, the PA was off duty when Michelle went to the cancer center for her scheduled IV hydration (she usually receives hydration 2 days after each chemo treatment) so Michelle's oncologist Dr. Marschke came by to see her. He took a closer look at the CT scan they ordered after Michelle first reported the problem, and is concerned that this pain may be related to one of 3 liver tumors shown on the scan. We were aware of one tumor that appeared on the December PET scan, but it was unclear to us whether the other 2 are new. No tumors showed up on the PET scan a couple of months ago, which means no metabolic activity was detected in that test, but it doesn't mean the tumors were gone.
Dr. Marschke ordered another CT scan for this Saturday, this time with contrast dye to help show more detail of the tumors, particulary the one in the vicinity of Michelle's current pain. We have an appointment with Dr. Marschke on Tuesday to hear the results.
This is where you come in, prayer warriors. Michelle needs your prayers for support and encouragement, and above all for healing. Thank you for all your prayers in the past. Michelle and I believe that they have worked wonders - we just need a little more of that wonder right now.
God Bless,
Bill
P.S. It's been two weeks, and I've healed quickly from my surgery. I overdid it a little last weekend, but this has been a good week and I'm well on my way to full recovery.
Friday, June 12, 2009
Feeling Better
I had my sinus surgery yesterday. It went well. The cheek sinus was completely blocked with infection. So they cleaned that out and made the opening bigger so it will drain better.
My pulled muscle is feeling better too. It was really painful which scared me. My abdomen muscles are still weak from all of the time in bed.
Bill went to work on Wednesday and his knee is doing much better. He visited the therapist and has some additional exercises to do for his knee.
Have a great weekend.
Michelle
My pulled muscle is feeling better too. It was really painful which scared me. My abdomen muscles are still weak from all of the time in bed.
Bill went to work on Wednesday and his knee is doing much better. He visited the therapist and has some additional exercises to do for his knee.
Have a great weekend.
Michelle
Monday, June 8, 2009
Week of Surgeries
Bill's knee surgery last Thursday went well. He spent the weekend in his recliner with his knee elevated. The surgery center also sent us home with a contraption to ice and compress his knee to keep the swelling down. We had to make a couple of trips to the gas station to get ice. Scotty, our cat, also found out he likes to lick ice. He also liked to walk on the contraption which would push the buttons. Bill is up more today, but is experiencing some pain and is uncomfortable.
I think I pulled a muscle. I have a pain in my upper abdomen that doesn't hurt if I am sitting or laying, but if I get up or walk it is hurting. It is hard to deal with things like this. It may be a pulled muscle, but your mind always goes back to the cancer. So we shall see if it gets better the next couple of days.
I am having sinus surgery on Thursday, so keep me in your prayers. I have a sinus that is infected, but doesn't respond to antibiotics. It is a tricky balance. On one hand you don't want to due unnecessary surgery on someone with cancer, but you don't want to have a raging infection in someone whose immunity is lower.
Keep my friend Karen in your prayers. She is dealing with some serious health issues. Also keep my Mom, Sharon in your prayers. She still in the clinical trial. It seems like it is evaluated every month. So in her mind, this could be the month that her tumors haven't shrunk enough and they take her out of the trial. That is alot of pressure over something you have no control over.
Have a peace filled week.
Michelle
I think I pulled a muscle. I have a pain in my upper abdomen that doesn't hurt if I am sitting or laying, but if I get up or walk it is hurting. It is hard to deal with things like this. It may be a pulled muscle, but your mind always goes back to the cancer. So we shall see if it gets better the next couple of days.
I am having sinus surgery on Thursday, so keep me in your prayers. I have a sinus that is infected, but doesn't respond to antibiotics. It is a tricky balance. On one hand you don't want to due unnecessary surgery on someone with cancer, but you don't want to have a raging infection in someone whose immunity is lower.
Keep my friend Karen in your prayers. She is dealing with some serious health issues. Also keep my Mom, Sharon in your prayers. She still in the clinical trial. It seems like it is evaluated every month. So in her mind, this could be the month that her tumors haven't shrunk enough and they take her out of the trial. That is alot of pressure over something you have no control over.
Have a peace filled week.
Michelle
Monday, June 1, 2009
This last week was a tough one. I started having some pain on Monday and started taking some pain medicine. On Tuesday, they did a CT scan to see the stents were still in place. The stents were fine. It was what the rest of the CT scan said that was scary. It talked about 3 spots in my liver, my spleen was enlarged and there was fluid in my lung cavities. I was in bed all week because of the pain. I must say I was pretty down all week too. Could this be it? I really lost my faith. I started feeling better on Saturday, taking less pain medication. On Sunday I only had to take pain medication at bed time. I still have a little pain, but it is getting better. I learned a good lesson. Really a couple of lessons. First, God is with me always. Second, take One Day at a time.
Please keep Bill in your prayers. He will be having knee surgery in the next couple of weeks. Also please keep my friend Karen in your prayers. She is having some serious health concerns.
Have a peace filled week.
Michelle
Please keep Bill in your prayers. He will be having knee surgery in the next couple of weeks. Also please keep my friend Karen in your prayers. She is having some serious health concerns.
Have a peace filled week.
Michelle
Wednesday, May 27, 2009
Two Steps Forward, One Step Back
We had a great Memorial Day. We had a little party for our neighbors, work friends and prayer circle friends. I enjoyed being surrounded by such good friends. The rain held off until the end of the party.
I woke up Monday morning with a stabbing pain in my upper abdomen. I have started back on some narcotic pain killers. I went into the doctor office on Tuesday morning. They ran some tests and haven't found anything. I had a fever and so they think it might be a virus. Due to the narcotics I will be sleeping with oxygen. My oxygen gets low when I am on the painkillers.
Bill visited the orthopedic surgeon Wednesday morning. His knee has been hurting for several weeks and isn't getting better on its own. He had an MRI today and may need knee surgery in a couple of weeks for suspected torn cartilage.
Have a peace filled week.
Michelle
I woke up Monday morning with a stabbing pain in my upper abdomen. I have started back on some narcotic pain killers. I went into the doctor office on Tuesday morning. They ran some tests and haven't found anything. I had a fever and so they think it might be a virus. Due to the narcotics I will be sleeping with oxygen. My oxygen gets low when I am on the painkillers.
Bill visited the orthopedic surgeon Wednesday morning. His knee has been hurting for several weeks and isn't getting better on its own. He had an MRI today and may need knee surgery in a couple of weeks for suspected torn cartilage.
Have a peace filled week.
Michelle
Saturday, May 16, 2009
More Good News
I received my results from the latest CA19-9. The CA19-9 is a blood test that shows tumor activity for bile duct cancer. Less than 55 is normal. In January my CA19-9 was 7998 and in May it was 526. Now it is 127. So a celebration is in order. Things continue to move in the right direction. Yea.
This week was my week off of chemo, so my blood counts were at their lowest. So I was very tired. I did get to work a little in the yard this week. The weather has been beautiful. Bill and his brother Tim have been working on the deck. We really appreciate all of Tim's help. Bill wanted to build me a deck so I can sit outside this summer and look at the flower gardens. Three of our 10 ft by 10 ft garden boxes have been planted with perennials. Bill also planted raspberries and strawberries.
I have been a little sad this week. I think it is because I am no longer employed. I enjoyed my job and the people I worked with. I worked for the City for over 13 years. Logically I know my job right now is to battle the cancer, but emotionally I miss work. This is part of defining the new normal for me.
Bill left this morning for Maine. He is traveling there for work. He will be returning on Wednesday evening. We will miss him.
Have a peace filled week.
Michelle
This week was my week off of chemo, so my blood counts were at their lowest. So I was very tired. I did get to work a little in the yard this week. The weather has been beautiful. Bill and his brother Tim have been working on the deck. We really appreciate all of Tim's help. Bill wanted to build me a deck so I can sit outside this summer and look at the flower gardens. Three of our 10 ft by 10 ft garden boxes have been planted with perennials. Bill also planted raspberries and strawberries.
I have been a little sad this week. I think it is because I am no longer employed. I enjoyed my job and the people I worked with. I worked for the City for over 13 years. Logically I know my job right now is to battle the cancer, but emotionally I miss work. This is part of defining the new normal for me.
Bill left this morning for Maine. He is traveling there for work. He will be returning on Wednesday evening. We will miss him.
Have a peace filled week.
Michelle
Sunday, May 10, 2009
Good News about the Bone Scan
I had chemo number 11 last Tuesday. This week is my week off. That means my blood counts are low, which is why I am so tired. I had a bone scan on Friday. I got the report today and it talks about the spot on my spine that received radiation back in February/March. It also mentions my left sinus that has an infection. We will see the oncologist on Thursday this week, so we can ask him if more radiation is needed for the spine or if it is still healing from the last round of radiation. I see the ENT on Monday, May 18th about the sinus. The best news is that it says no other focus of osseous (bone) metastatic disease identified. Yea!
The deck is coming along. Friday night, Bill, Tim, Chris and Kelly were out pouring concrete in the dark for the post holes. On Saturday, we had the expert, Steve come over and show everybody how it is done. They got the ledger board on the house and some of the joists. My contribution was putting the saw table together. Bill got a combination miter saw on a slide for the project. He says it cuts like butter. Bill got the hard part out of the way, so we can get alot done on Sunday. Well we woke up on Sunday to rain, so Bill, Tim and Chris got a break.
I went over to the Enviromental Learning Center (ELC) to walk on the trail last week. It is only a mile from our house and the Poudre River runs around it. It reminds me of walking in the woods in Michigan, (except for the Pear Cactus). Chris came with me. The next day I asked Kelly if she would come with me. Chris piped up, "Yeah Kelly you won't break a sweat, in fact you could wear your high heels and still keep up with Mom." My response, "Chris, unload the dishwasher." Chris's response, "You were going to make me unload the dishwasher anyway." He was right.
Have a peace filled week.
Michelle
The deck is coming along. Friday night, Bill, Tim, Chris and Kelly were out pouring concrete in the dark for the post holes. On Saturday, we had the expert, Steve come over and show everybody how it is done. They got the ledger board on the house and some of the joists. My contribution was putting the saw table together. Bill got a combination miter saw on a slide for the project. He says it cuts like butter. Bill got the hard part out of the way, so we can get alot done on Sunday. Well we woke up on Sunday to rain, so Bill, Tim and Chris got a break.
I went over to the Enviromental Learning Center (ELC) to walk on the trail last week. It is only a mile from our house and the Poudre River runs around it. It reminds me of walking in the woods in Michigan, (except for the Pear Cactus). Chris came with me. The next day I asked Kelly if she would come with me. Chris piped up, "Yeah Kelly you won't break a sweat, in fact you could wear your high heels and still keep up with Mom." My response, "Chris, unload the dishwasher." Chris's response, "You were going to make me unload the dishwasher anyway." He was right.
Have a peace filled week.
Michelle
Friday, May 1, 2009
Happy May
Well after a wet Saturday we have a beautiful Sunday here in Colorado. It is sunny and about 65 degrees. Bill, Chris and Bill's brother Tim are working on the deck in the backyard. Bill wants to build me a deck so I can sit outside and look at the flower gardens this summer. Right now they are trying to dig the post holes with a 2-person auger. They have 15 holes to dig and I think they are done with 5. I hear some raised voices, so I will just stay up here in my room and out of the way. ;-) (Later in the day: they got the 13 holes done for the deck and everybody is stilll talking to each other. )
The ERCP must have taken more out of me than I thought. I was very tired this week. I spent alot of time in bed. I also received chemo number 10 this week. So that could have something to do with it too. In celebration of my 10th chemotherapy I brought in brownies for the oncology nurses. They truly have a gift of caring and compassion.
Thursday was my last day at the City of Fort Collins. Really my last day at work was Friday October 31st. I ran out of leave at the end of March. I needed to either return to work part time (going full time in 6 months) or terminate. My doctor recommended that I not return to work at this time. After this week, I agree I can't work at this time. I really enjoyed the people I worked with at the City. I will miss them.
Next week will be chemotherapy and a bone scan. The bone scan is to look for any additional bone metastisis. I did have a tumor on my spine that was treated with radiation. It was found because it was causing pain. So they want to look for any other bone issues.
We will have prayer circle on Monday. I am always so lifted up after that experience. I really appreciate all of the prayers that I am receiving. I know they are working.
Have a peace filled week.
Michelle
The ERCP must have taken more out of me than I thought. I was very tired this week. I spent alot of time in bed. I also received chemo number 10 this week. So that could have something to do with it too. In celebration of my 10th chemotherapy I brought in brownies for the oncology nurses. They truly have a gift of caring and compassion.
Thursday was my last day at the City of Fort Collins. Really my last day at work was Friday October 31st. I ran out of leave at the end of March. I needed to either return to work part time (going full time in 6 months) or terminate. My doctor recommended that I not return to work at this time. After this week, I agree I can't work at this time. I really enjoyed the people I worked with at the City. I will miss them.
Next week will be chemotherapy and a bone scan. The bone scan is to look for any additional bone metastisis. I did have a tumor on my spine that was treated with radiation. It was found because it was causing pain. So they want to look for any other bone issues.
We will have prayer circle on Monday. I am always so lifted up after that experience. I really appreciate all of the prayers that I am receiving. I know they are working.
Have a peace filled week.
Michelle
Friday, April 24, 2009
Gorgeous Day in Colorado
What a gorgeous day yesterday in Colorado. It was 80 degrees. I spent the day down at the University of Colorado Health Sciences Center getting my stents replaced. The stents allow the bile to drain so I don't turn yellow and have pain. They said the tumor appeared improved from February. My next stent replacement is in 10 weeks. I feel okay today, but my throat hurts from the tubes. I found ice cream helps it feel better, so I think I am going to need to have ice cream for breakfast, lunch and dinner.
This is my week off of chemo. I did have bloodwork done. It showed my blood counts were low. They should be back up for next Tuesday when my next chemo is scheduled. The low counts make me feel very tired. So I have been spending alot of time in bed with my laptop.
We had a great prayer circle on Monday. I felt uplifted. I feel truly blessed by their prayers and presence. I would also like to thank all of the prayer warriors out there praying for me across the world.
Today I had a visit from my friend Maria and her almost 3 year old daughter Melina. It was fun playing Aunt Michelle. Kelly has a little doll bed and buggy that originally belonged to Bill's Mom. I had made a little mattress, pillow and blanket for the bed and the buggy when Kelly was little. Melina loved them. She put the stuffed animals to bed and then put them in the buggy. She would put the mattress, pillow and blanket on top of them and wheel the buggy around. Then take them out and put them back to bed. We also played with some blocks building a building a tower and then knocking them down. It has been a long time since I got to play like that. It made me feel young. I don't know how Maria keeps up with her.
Have a peaceful week.
Michelle
This is my week off of chemo. I did have bloodwork done. It showed my blood counts were low. They should be back up for next Tuesday when my next chemo is scheduled. The low counts make me feel very tired. So I have been spending alot of time in bed with my laptop.
We had a great prayer circle on Monday. I felt uplifted. I feel truly blessed by their prayers and presence. I would also like to thank all of the prayer warriors out there praying for me across the world.
Today I had a visit from my friend Maria and her almost 3 year old daughter Melina. It was fun playing Aunt Michelle. Kelly has a little doll bed and buggy that originally belonged to Bill's Mom. I had made a little mattress, pillow and blanket for the bed and the buggy when Kelly was little. Melina loved them. She put the stuffed animals to bed and then put them in the buggy. She would put the mattress, pillow and blanket on top of them and wheel the buggy around. Then take them out and put them back to bed. We also played with some blocks building a building a tower and then knocking them down. It has been a long time since I got to play like that. It made me feel young. I don't know how Maria keeps up with her.
Have a peaceful week.
Michelle
Sunday, April 19, 2009
Sunny Day
Well after a week of cold, rain and snow, it is sunny here in Colorado today. Our neighborhood fox is stretched out sleeping under one of our trees. For some reason all of the birds are gone. 8^)
On Tuesday I had my 9th round of chemotherapy. Everything went well. I am feeling good, just very tired. Last night I fell asleep with my glasses on and the TV blaring. I think I am going to take it easy today. Next week is a busy week. I have an appointment with the Ear, Nose and Throat doctor about one of my sinuses that showed a complete blockage on the last PET scan. I also have an appointment to go down to the University of Colorado Health Sciences Center to have my stents replaced. It is a 2 hour procedure they do under general anethesia. The stents are tubes they have put in my bile duct and hepatic ducts in my liver to keep everything draining so I don't turn yellow again. They have to be replaced periodically so they don't get blocked. The doctors will also access the tumors in my bile duct and hepatic duct.
Please keep Bill's Mom, Nancy in your prayers. She was diagnosed with Parkinson's Disease last week. She apparently has had it for a number of years, but the symptoms were masked by a medication she was taking for muscle weakness in her right arm and hand. It turns out this medication is also used to treat Parkinson's. When she tried to wean herself off the drug, she was assaulted by full-blown classic symptoms of PD. This is pretty scary for her and Bill's family as her brother died from complications associated with his 12-year battle with Parkinsons when he was 10 years younger than she is now.
We're looking forward to our prayer group meeting tomorrow evening. We had to skip the last one, so it's been 4 weeks between meetings. Please join us in prayer at 7:00 PM Mountiain time if your are so inclined.
On Tuesday I had my 9th round of chemotherapy. Everything went well. I am feeling good, just very tired. Last night I fell asleep with my glasses on and the TV blaring. I think I am going to take it easy today. Next week is a busy week. I have an appointment with the Ear, Nose and Throat doctor about one of my sinuses that showed a complete blockage on the last PET scan. I also have an appointment to go down to the University of Colorado Health Sciences Center to have my stents replaced. It is a 2 hour procedure they do under general anethesia. The stents are tubes they have put in my bile duct and hepatic ducts in my liver to keep everything draining so I don't turn yellow again. They have to be replaced periodically so they don't get blocked. The doctors will also access the tumors in my bile duct and hepatic duct.
Please keep Bill's Mom, Nancy in your prayers. She was diagnosed with Parkinson's Disease last week. She apparently has had it for a number of years, but the symptoms were masked by a medication she was taking for muscle weakness in her right arm and hand. It turns out this medication is also used to treat Parkinson's. When she tried to wean herself off the drug, she was assaulted by full-blown classic symptoms of PD. This is pretty scary for her and Bill's family as her brother died from complications associated with his 12-year battle with Parkinsons when he was 10 years younger than she is now.
We're looking forward to our prayer group meeting tomorrow evening. We had to skip the last one, so it's been 4 weeks between meetings. Please join us in prayer at 7:00 PM Mountiain time if your are so inclined.
Wednesday, April 8, 2009
Bill and I met with my oncologist on Monday. Things are going well. I am tolerating the 2 weeks of chemotherapy with the third week off. The doctor discussed different tests to check for cancer spread. None of the tests are perfect. The PET scan never showed my original tumors in the bile and hepatic ducts. So there can be other tumors that don't show because they don't metabolize sugar quickly. We talked about doing a bone scan in 6 weeks. I had the tumor on my spine that was found because I was having pain, but it would be good to do a full bone scan to see if there is any more metastsis to other bones.
I drove myself to my 8th round of chemotherapy yesterday. I'm feeling OK, but still tire easily. I've been able to walk around the block, but then I'm pretty much done for the day.
My Mom was accepted into the clinical trial and started a new chemotherapy drug today. It is in pill form, so she will take 2 pills every day. Wednesday she was at the cancer center for 10 hours as they tracked her blood tests and how well she is tolerating the drug. She will have to go back on Thursday, Friday and Saturday this week to have more blood tests.
(I talked to her on Thursday and she is feeling well. They said side effects will take about 2 weeks to show up. )
Thank you for the continued prayers.
Michelle
I drove myself to my 8th round of chemotherapy yesterday. I'm feeling OK, but still tire easily. I've been able to walk around the block, but then I'm pretty much done for the day.
My Mom was accepted into the clinical trial and started a new chemotherapy drug today. It is in pill form, so she will take 2 pills every day. Wednesday she was at the cancer center for 10 hours as they tracked her blood tests and how well she is tolerating the drug. She will have to go back on Thursday, Friday and Saturday this week to have more blood tests.
(I talked to her on Thursday and she is feeling well. They said side effects will take about 2 weeks to show up. )
Thank you for the continued prayers.
Michelle
Sunday, March 29, 2009
New Hope for Sharon
It's so good to be feeling better! On Sunday Bill and I went to Lowe's to get a quote for the materials to build a deck on the back of our house. Later in the day we took Kelly to a movie with us and went out to dinner. Iwas really exhausted by the time we got home, but it was a good day.
There is a poem in the sidebar that was written for me by Jim Hume. I have worked with Jim at the City of Fort Collins for the last 13 years. It makes me feel so special. Jim also dropped by a book of his poetry. Thanks Jim.
New Hope
My Mom (Sharon) and Dad (Ron) met with an oncologist at the Virginia Piper Cancer Center today. The doctor discussed some clinical trails that may be a possibility with one trial in particular she recommended. She also mentioned it would be good to get a biopsy of one of the tumors in her liver to see if it had mutated and see what drugs the tumors would be sensitive to. My Mom is scheduled for a liver biopsy on Thursday. So after last week with no options, there is renewed hope that there are multiple options to choose from. The doctor was excited to see what good shape my Mom is in for being 70 years old! Please pray that the liver biopsy goes well and she is accepted into the clinical trial.
Thank you for all of the prayers and have a great week.
Michelle
There is a poem in the sidebar that was written for me by Jim Hume. I have worked with Jim at the City of Fort Collins for the last 13 years. It makes me feel so special. Jim also dropped by a book of his poetry. Thanks Jim.
New Hope
My Mom (Sharon) and Dad (Ron) met with an oncologist at the Virginia Piper Cancer Center today. The doctor discussed some clinical trails that may be a possibility with one trial in particular she recommended. She also mentioned it would be good to get a biopsy of one of the tumors in her liver to see if it had mutated and see what drugs the tumors would be sensitive to. My Mom is scheduled for a liver biopsy on Thursday. So after last week with no options, there is renewed hope that there are multiple options to choose from. The doctor was excited to see what good shape my Mom is in for being 70 years old! Please pray that the liver biopsy goes well and she is accepted into the clinical trial.
Thank you for all of the prayers and have a great week.
Michelle
Tuesday, March 24, 2009
More Good News
I have been off all pain medication for almost a week and a half. What a difference. I have more energy and am feeling better. I still get tired going up and down the stairs, but it is getting better. We had a beautiful weekend here. It was in the seventies. I sat out in the yard for a little bit on Sunday. It was so peaceful sitting there listening to the birds and having a nice warm breeze blowing. Then Monday we had a high of 40 degrees with strong winds and snow predicted. What a change.
Another sign of healing. I am wearing jeans. I have spent the last 4 1/2 months in sweat pants.
We had an awesome prayer circle on Monday night. The parents of our friend Jill are visiting from Ohio. Her dad is a 15 year cholangiocarcinoma survivor, which is the same cancer I have. He came to the prayer circle last night and described the healing and peace he experienced through Jesus Christ.
Jill playing the keyboard and Bob on his guitar rocked the living room with song. It was wonderful. I love singing. Cindi led the Polarity Circle. I laid on a massage table with different prayer group members laying hands on me sharing their energy while praying my intentions to God. My prayers were for continued healing and thanksgiving for all of the healing I have experienced. The experience is energizing.
Please keep my Mother in your prayers. She was diagnosed with ovarian cancer 1999. After being cancer free for 6 years, in 2005 she had a recurrence. She has been doing chemotherapy on and off the last 4 years. For the last 5 months she has been doing the same chemotherapy drug that I am on. She had a CT scan last week and saw the doctor today. Her tumors are growing and this chemotherapy drug isn't working. The doctor recommended checking on a clinical trial, but didn't have good news about trying another drug. Her name is Sharon Beyer.
Have a blessed and peace-filled week.
Michelle & Bill
Another sign of healing. I am wearing jeans. I have spent the last 4 1/2 months in sweat pants.
We had an awesome prayer circle on Monday night. The parents of our friend Jill are visiting from Ohio. Her dad is a 15 year cholangiocarcinoma survivor, which is the same cancer I have. He came to the prayer circle last night and described the healing and peace he experienced through Jesus Christ.
Jill playing the keyboard and Bob on his guitar rocked the living room with song. It was wonderful. I love singing. Cindi led the Polarity Circle. I laid on a massage table with different prayer group members laying hands on me sharing their energy while praying my intentions to God. My prayers were for continued healing and thanksgiving for all of the healing I have experienced. The experience is energizing.
Please keep my Mother in your prayers. She was diagnosed with ovarian cancer 1999. After being cancer free for 6 years, in 2005 she had a recurrence. She has been doing chemotherapy on and off the last 4 years. For the last 5 months she has been doing the same chemotherapy drug that I am on. She had a CT scan last week and saw the doctor today. Her tumors are growing and this chemotherapy drug isn't working. The doctor recommended checking on a clinical trial, but didn't have good news about trying another drug. Her name is Sharon Beyer.
Have a blessed and peace-filled week.
Michelle & Bill
Sunday, March 15, 2009
I didn't study for the test....
...but I received a good grade anyway. On Friday I had a PET Scan. (PET = Positron Emission Tomography: after being injected with radioactive sugar they create a 3D image of my entire body with CT scans. The sugar metabolizes faster in areas where cancer cells are, so that is how they can see if the cancer has spread to other parts of the body.)
On the scan in December they saw fluid in my lung cavity and in my pelvis, a spot on my liver and on my spine. I received 14 radiation sessions for the cancer on my spine for pain management, and so far 5 treatments of systemic chemotherapy to treat all the other tumors.
The scan on Friday showed no fluid anywhere, the spot on the liver gone and scarring on the spine consistent with radiation treatments. So very good news. The sweetest words on the report were "no metabolically active malignancy in the abdomen or pelvis is evident." Can I hear an AMEN!
Neither this scan nor the one in December picked up the tumors in my bile duct and hepatic ducts. The doctors said this is because they are long and thin. We already got great news on those tumors from the doctors down in Denver when I had my last stent procedure on February 13th and they found there was significant improvement. We'll hear more about that progress in 4 weeks when I return to Denver for my next ERCP/stent check.
I also had some bloodwork done this week. The tumor marker CA19-9 was better. It was 5100 in January and 1093 just 3 weeks ago. Last week it was 603. Less than 60 is normal. So it is headed in the right direction. Our understanding from previous discussions with the medical oncologist is we will continue the chemotherapy until the tumor marker is back in the normal range. We meet with the medical oncology team this week Tuesday (St. Paddy's Day!) to review my progress and update my treatment plan. Immediately after meeting with the doctor, I'm scheduled for my next chemo treatment. As you may recall, they have me on a 2 week on/1 week off schedule for the next several rounds.
Last week was my week off from chemotherapy. I have been able to reduce my pain medication to almost 1/4 of my January dosage, which is great news. I have, however, still been battling both extreme nausea and extreme fatigue. I'm still taking about the same dosage of nausea medications as I have been since starting chemo, and while my energy seems to be a little better on some days, the smallest activity just wipes me out. I frequently have to stop at the landing half the way up the stairs, and while I've been able to venture out of the house more often, even small trips send me back to bed for several hours and sometimes the next day, too.
Words seem inadequate to express my gratitude for all the prayers from all of the people who care about me. It's very clear to Bill and me that it is those prayers more than anything else that account for my astounding progress. It was almost impossible for us to see arriving at this point in my treatment so quickly, and while we know we're not out of the woods yet, we find ourselves filled with gratitude and renewed hope. Thank you, thank you, thank you, and please keep those prayers coming!
I would like to thank my ride coordinator Karen for driving me to my PET Scan appointment on Friday. I would also like to thank my personal chefs, Brenda who brought me over a wonderful lunch and stayed with me through the afternoon and Suzanne who brought me up to speed on all the City of Fort Collins IT Department gossip and cooked us a delicious chicken dinner, also on Friday. Turns out they haven't boxed up my cube just yet. Chris and Kelly both were working on Friday and Bill felt more comfortable having someone here to baby sit me.
Have a peaceful week.
Michelle (Bill helped a little bit this week, too)
P.S. I heard the coolest thing on a TV commercial this week:
On the scan in December they saw fluid in my lung cavity and in my pelvis, a spot on my liver and on my spine. I received 14 radiation sessions for the cancer on my spine for pain management, and so far 5 treatments of systemic chemotherapy to treat all the other tumors.
The scan on Friday showed no fluid anywhere, the spot on the liver gone and scarring on the spine consistent with radiation treatments. So very good news. The sweetest words on the report were "no metabolically active malignancy in the abdomen or pelvis is evident." Can I hear an AMEN!
Neither this scan nor the one in December picked up the tumors in my bile duct and hepatic ducts. The doctors said this is because they are long and thin. We already got great news on those tumors from the doctors down in Denver when I had my last stent procedure on February 13th and they found there was significant improvement. We'll hear more about that progress in 4 weeks when I return to Denver for my next ERCP/stent check.
I also had some bloodwork done this week. The tumor marker CA19-9 was better. It was 5100 in January and 1093 just 3 weeks ago. Last week it was 603. Less than 60 is normal. So it is headed in the right direction. Our understanding from previous discussions with the medical oncologist is we will continue the chemotherapy until the tumor marker is back in the normal range. We meet with the medical oncology team this week Tuesday (St. Paddy's Day!) to review my progress and update my treatment plan. Immediately after meeting with the doctor, I'm scheduled for my next chemo treatment. As you may recall, they have me on a 2 week on/1 week off schedule for the next several rounds.
Last week was my week off from chemotherapy. I have been able to reduce my pain medication to almost 1/4 of my January dosage, which is great news. I have, however, still been battling both extreme nausea and extreme fatigue. I'm still taking about the same dosage of nausea medications as I have been since starting chemo, and while my energy seems to be a little better on some days, the smallest activity just wipes me out. I frequently have to stop at the landing half the way up the stairs, and while I've been able to venture out of the house more often, even small trips send me back to bed for several hours and sometimes the next day, too.
Words seem inadequate to express my gratitude for all the prayers from all of the people who care about me. It's very clear to Bill and me that it is those prayers more than anything else that account for my astounding progress. It was almost impossible for us to see arriving at this point in my treatment so quickly, and while we know we're not out of the woods yet, we find ourselves filled with gratitude and renewed hope. Thank you, thank you, thank you, and please keep those prayers coming!
I would like to thank my ride coordinator Karen for driving me to my PET Scan appointment on Friday. I would also like to thank my personal chefs, Brenda who brought me over a wonderful lunch and stayed with me through the afternoon and Suzanne who brought me up to speed on all the City of Fort Collins IT Department gossip and cooked us a delicious chicken dinner, also on Friday. Turns out they haven't boxed up my cube just yet. Chris and Kelly both were working on Friday and Bill felt more comfortable having someone here to baby sit me.
Have a peaceful week.
Michelle (Bill helped a little bit this week, too)
P.S. I heard the coolest thing on a TV commercial this week:
I don't have an Expiration Date!
Wednesday, March 4, 2009
Painkillers and Reality TV
Bill is going to regret showing me how to do my own blogs. He forgets that I am home all day on strong painkillers. I need the strong painkillers so I can stand all of the the reality TV. I watch alot of Home and Garden TV, so Bill's "to do" list is getting longer and longer. So did anyone TIVO Flip that House? Where did they say the got the South Pacific Marble?
On to business, I had chemotherapy on Tuesday. The next few days were spent in bed with plenty of nausea medicine. This week I don't have chemotherapy. I have blood work I need to get done on Tuesday, an appointment with my Radiology Oncologist on Wednesday, and a PET Scan on Friday. We are praying the PET Scan shows significant improvement in the areas the cancer had spread.
May you have a peaceful week.
Michelle
On to business, I had chemotherapy on Tuesday. The next few days were spent in bed with plenty of nausea medicine. This week I don't have chemotherapy. I have blood work I need to get done on Tuesday, an appointment with my Radiology Oncologist on Wednesday, and a PET Scan on Friday. We are praying the PET Scan shows significant improvement in the areas the cancer had spread.
May you have a peaceful week.
Michelle
Sunday, March 1, 2009
Fatigue and Nausea
My radiation treatments for the cancer on my spine ended on Tuesday. Yea! The radiologists gave me a cake with a candle for my final day. All together I had 14 treatments. Talking with the doctor, the peak of the pain relief should come in 2 weeks. The nausea should peak in 2 weeks also. They said the fatigue should last 4 – 6 weeks. I have been having a lot of nausea and fatigue this week. I will have a follow-up MRI in 6 weeks to take a look at that area of the spine. In the meantime, I need to avoid falling as that is a weakened area of my spine. Luckily we haven’t had much snow and ice this winter.
I had chemotherapy on Tuesday with a reduced dose, so my blood counts shouldn’t go too low. They will check them this Tuesday when I get chemo again. I should have the week of March 10th off from chemo. The doctor wants to do 2 weeks of chemotherapy with a week off at the reduced dosage and see how things go for a couple of cycles. I should have a PET scan the week of March 10th or early the following week to see how the spot in my liver and fluid in my lungs and pelvis are doing. Dr. Marschke said he expects everything to have improved like my bile duct tumors have. He said that with this treatment either everything gets better or everything gets worse. It’s unlikely that some things would be better and others worse.
On Friday, I had a wonderful experience. A friend of mine has been certified in massage therapy, so Kelly and I had massages on Friday. It was relaxing and restful.
Kelly is signing up to take the Certified Nurses Aid classes starting March 16th. She will be doing the class for 3 weeks from 8:00am – 5:00pm. This will help move her toward her dream of going to medical school to become a neurologist. I am going to need some rides to chemo or hydration, so don’t ignore me when you see my name pop up on the caller id. ☺
We will be doing prayer circle again on Monday, March 2nd at 6:30 at my house. We will be having a celebration of healing. We will do communion and prayer along with some little treats.
The picture is of me and my 2 cats. Kira is the Siamese and is 5 years old. Scotty is the striped kitten and is 7 months old. Oh, and that’s my new La-Z-Boy chair we’re sitting in. It’s SOOO comfy!
I had chemotherapy on Tuesday with a reduced dose, so my blood counts shouldn’t go too low. They will check them this Tuesday when I get chemo again. I should have the week of March 10th off from chemo. The doctor wants to do 2 weeks of chemotherapy with a week off at the reduced dosage and see how things go for a couple of cycles. I should have a PET scan the week of March 10th or early the following week to see how the spot in my liver and fluid in my lungs and pelvis are doing. Dr. Marschke said he expects everything to have improved like my bile duct tumors have. He said that with this treatment either everything gets better or everything gets worse. It’s unlikely that some things would be better and others worse.
On Friday, I had a wonderful experience. A friend of mine has been certified in massage therapy, so Kelly and I had massages on Friday. It was relaxing and restful.
Kelly is signing up to take the Certified Nurses Aid classes starting March 16th. She will be doing the class for 3 weeks from 8:00am – 5:00pm. This will help move her toward her dream of going to medical school to become a neurologist. I am going to need some rides to chemo or hydration, so don’t ignore me when you see my name pop up on the caller id. ☺
We will be doing prayer circle again on Monday, March 2nd at 6:30 at my house. We will be having a celebration of healing. We will do communion and prayer along with some little treats.
The picture is of me and my 2 cats. Kira is the Siamese and is 5 years old. Scotty is the striped kitten and is 7 months old. Oh, and that’s my new La-Z-Boy chair we’re sitting in. It’s SOOO comfy!
Monday, February 23, 2009
No Break Yet
Blog readers beware. I am writing this entry and I am not as eloquent or coherent (thanks to the morphine) as Bill. He has done an excellent job describing the situation without using too much medical speak or supplying too much information.
The week of February 16th was a week of recovery for me. I was exhausted after the week before when I had surgery to put a port in, chemotherapy, surgery to replace my stents and 4 radiation treatments. My blood counts were too low to get chemotherapy last week. I did get 5 radiation treatments last week, but otherwise spent a lot of time in bed. This last weekend I had more energy, but I overdid it going up and down the stairs. On Saturday I had to sleep with oxygen.
Late last week, I received the written notes from the stent procedure on Friday, February 13th. The doctor described the strictures (tumors) in my bile ducts as significantly improved. So the PacMen and PacWomen and all of the people that have been praying for me have made a big impact. Wocka, Wocka, Wocka.
This week will see the end of my radiation treatments on my spine on Tuesday. I also thought it would be the last chemotherapy treatment before a 2 week break, however Bill and I met with my medical oncologist this afternoon. The doctor will be adjusting the dosage and I will be having chemotherapy treatment tomorrow, Tuesday February 24th and Tuesday March 3rd. I will then have a break the next week. The schedule that we are going to try is 2 weeks of chemotherapy treatments and a 1 week break. The doctor was happy to see my blood work was looking good. The CA 19-9 tumor marker dropped from 5,000 to 1,000 over the last 6 weeks. This was exciting news. Thank you for all of the prayers. They are definitely working.
So how did I do?
Michelle
The week of February 16th was a week of recovery for me. I was exhausted after the week before when I had surgery to put a port in, chemotherapy, surgery to replace my stents and 4 radiation treatments. My blood counts were too low to get chemotherapy last week. I did get 5 radiation treatments last week, but otherwise spent a lot of time in bed. This last weekend I had more energy, but I overdid it going up and down the stairs. On Saturday I had to sleep with oxygen.
Late last week, I received the written notes from the stent procedure on Friday, February 13th. The doctor described the strictures (tumors) in my bile ducts as significantly improved. So the PacMen and PacWomen and all of the people that have been praying for me have made a big impact. Wocka, Wocka, Wocka.
This week will see the end of my radiation treatments on my spine on Tuesday. I also thought it would be the last chemotherapy treatment before a 2 week break, however Bill and I met with my medical oncologist this afternoon. The doctor will be adjusting the dosage and I will be having chemotherapy treatment tomorrow, Tuesday February 24th and Tuesday March 3rd. I will then have a break the next week. The schedule that we are going to try is 2 weeks of chemotherapy treatments and a 1 week break. The doctor was happy to see my blood work was looking good. The CA 19-9 tumor marker dropped from 5,000 to 1,000 over the last 6 weeks. This was exciting news. Thank you for all of the prayers. They are definitely working.
So how did I do?
Michelle
Saturday, February 14, 2009
Signs of Improvement
Prayer works. Yesterday Michelle had her 5th ERCP since the beginning of this journey, and the plan was to replace the plastic stents installed on January 5 with larger metal stents to reduce the chance of blockage. However, when they removed the old stents and took a look at the condition of her bile ducts, they were surprised to find the blockages much improved. So much improved, in fact, that they decided to place new plastic stents and hold off on the permanent metal ones for now. They want to see her again in 8 weeks to refresh these stents and re-evaluate her condition. This is really good news because it seems to indicate that the chemo is working. And, we believe, it also means all the prayers are working.
At the same time, Michelle's day-to-day physical condition has been not so hot. Due to the chemo, her blood counts (both red and white cells) are low and getting lower. Her hemoglobin, which is a measurement of the oxygen carrying capacity of her blood, has started dropping again after being relatively stable since early December. On Thursday she completed her 7th of 14 radiation treatments, and the impact on her energy levels is significant. She is close to exhaustion all the time, and we have to be diligent with pain and nausea medications to keep those side effects under control. We're really glad we have the pulse oximeter on hand to check her oxygen saturation level, because it has a tendency to drop when she gets too fatigued. She slept with the O2 turned on three times this week.
The port installed on Monday is working as advertised. She was very dehydrated on Thursday morning (blood pressure 80/60) so we took her in for hydration and they left the port "tapped" (needle in place) for Friday's procedures. They were able to use the port for all her IV needs yesterday. No more pokes!
At the same time, Michelle's day-to-day physical condition has been not so hot. Due to the chemo, her blood counts (both red and white cells) are low and getting lower. Her hemoglobin, which is a measurement of the oxygen carrying capacity of her blood, has started dropping again after being relatively stable since early December. On Thursday she completed her 7th of 14 radiation treatments, and the impact on her energy levels is significant. She is close to exhaustion all the time, and we have to be diligent with pain and nausea medications to keep those side effects under control. We're really glad we have the pulse oximeter on hand to check her oxygen saturation level, because it has a tendency to drop when she gets too fatigued. She slept with the O2 turned on three times this week.
The port installed on Monday is working as advertised. She was very dehydrated on Thursday morning (blood pressure 80/60) so we took her in for hydration and they left the port "tapped" (needle in place) for Friday's procedures. They were able to use the port for all her IV needs yesterday. No more pokes!
Monday, February 9, 2009
Flash Update: All's Well
The port installation went smoothly today and Michelle was home in her own bed resting comfortably by 11:00 AM. Thank you all for your prayers.
Sunday, February 8, 2009
Surgery Scheduled Monday 2/9 8:00 AM
Michelle will have an IV port installed in her chest tomorrow morning at 8:00. This is a quick procedure but it requires a surgeon and general anesthesia. We met with the surgeon Friday and he showed us his port. He was treated for colon cancer 5 years ago and his port is still in place. It lies just under the skin, and the tube from the port empties into the jugular vein.
Michelle continues to do well in the wake of last week's treatments. Her nausea and pain are both under control with medication, but she is very fatigued. Most nights she has been sleeping well, but occasionally (like last night) she has trouble falling asleep and ends up awake most of the night.
Michelle continues to do well in the wake of last week's treatments. Her nausea and pain are both under control with medication, but she is very fatigued. Most nights she has been sleeping well, but occasionally (like last night) she has trouble falling asleep and ends up awake most of the night.
Thursday, February 5, 2009
We have engaged the enemy on all fronts
Since last week's post, Michelle has experienced more than a few ups and downs. When I wrote the post last Wednesday, she seemed to be doing much better but almost immediately after the post went up her condition went down. The last half of last week found Michelle becoming more and more nauseous, and more fatigued. Her pain seemed to be spiking more, and she was using the breakthrough pain medication more and more often.
On Friday we went to the radiation oncologist for Michelle's simulation appointment. They placed several tatoos on Michelle's abdomen and sides for use in targeting the radiation machines. Michelle was bummed, because she's lost the moral high ground and can no longer tell the kids not follow her example and avoid tattoos. (They also HURT!)
The nausea cleared somewhat by Sunday night, and the pain seemed to lessen a bit as well.
Monday night's prayer meeting was small, as several of the regulars stayed away to avoid sharing their sniffles with Michlle. It was still a very moving, intimate time with the 8 of us in attendance. Pastor Karen led us in guided imagery, taking us to one of Michelle's favorite healing spots - a clearing deep in the pine forests of northern Michigan. Eric brought his famous home-made pretzels and we all shared them. Next week we are planning to share communion with Michelle.
Even though there were fewer in attendance this Monday (we've had up to 18 at past gatherings), we keep hearing of more and more people who are praying with us at 7:00 every week. It's very humbling to us when we hear of all the churches, groups, friends of friends, close friends and family who are praying for Michelle every week. Michelle can feel those prayers working and our appreciation goes far beyond words. Thank You Thank You THANK YOU!
We heard from the Gastroenterology specialists at University of Colorado Hospital (UCH) in Denver on Tuesday. They scheduled an appointment for Michelle on Friday, February 13 at 9:30 AM to refresh her stents. As you may recall, the current stents (placed January 5) are plastic and expected to last 6-8 weeks. They will be replaced with "permanent" metal stents which should last at least 9 months up to several years. The metal stents have a larger bore and are much less prone to blockage.
The best news is that there is no evidence that the current stents are blocked. In fact, Michelle's bilirubin this week is only 0.1 points above the normal range: 1.3 vs 1.2! Hallelujah and Amen! (It's still important to go ahead with the replacement, because the plastic stents will eventually start to break down.)
Also on Tuesday, we heard back from the radiation center. They wanted to start Michelle's radiation treatments right away. She is scheduled for 14 daily treatments every weekday at 9:30. The first treatment was scheduled for Wednesday.
Tuesday's chemo treatment went smoothly (they even placed the IV on the second try this time!) and she didn't feel too terribly bad Tuesday night and slept well.
Wednesday's radiation treatment was quick and painless. She receives a dose both front and back, targeting the tumor in her T11 vertebra. They gave us some moisturizing cream to rub gently on her skin twice per day: the skin will become very tender, similar to a first-degree burn.
Michelle felt surprisingly well on Wednesday, and even reduced her pain medication to 2 doses per day instead of 3, with no breakthrough pain at all. Having learned how the nausea medications work for her, we carefully dosed her and managed to avoid most of it.
Thursday was pretty much a repeat. Radiation at 9:30, followed by a restful day, but without the severe out-of-control nausea experienced last time. As I write this, Michelle's getting ready for bed after a reasonably (and surprisingly) good day. She even ate a good dinner!
Tomorrow we meet with the surgeon to plan for installation of a port. This device will reside just under the skin of her upper chest, and provide easy access for blood draws and IV medication, without getting poked 2 or 3 times several times per week. We don't have a schedule for the installation, but we're hoping it will happen before the next chemo on Tuesday.
And that's all the news I'm fit to print this week. As Tigger says, TTFN!
On Friday we went to the radiation oncologist for Michelle's simulation appointment. They placed several tatoos on Michelle's abdomen and sides for use in targeting the radiation machines. Michelle was bummed, because she's lost the moral high ground and can no longer tell the kids not follow her example and avoid tattoos. (They also HURT!)
The nausea cleared somewhat by Sunday night, and the pain seemed to lessen a bit as well.
Monday night's prayer meeting was small, as several of the regulars stayed away to avoid sharing their sniffles with Michlle. It was still a very moving, intimate time with the 8 of us in attendance. Pastor Karen led us in guided imagery, taking us to one of Michelle's favorite healing spots - a clearing deep in the pine forests of northern Michigan. Eric brought his famous home-made pretzels and we all shared them. Next week we are planning to share communion with Michelle.
Even though there were fewer in attendance this Monday (we've had up to 18 at past gatherings), we keep hearing of more and more people who are praying with us at 7:00 every week. It's very humbling to us when we hear of all the churches, groups, friends of friends, close friends and family who are praying for Michelle every week. Michelle can feel those prayers working and our appreciation goes far beyond words. Thank You Thank You THANK YOU!
We heard from the Gastroenterology specialists at University of Colorado Hospital (UCH) in Denver on Tuesday. They scheduled an appointment for Michelle on Friday, February 13 at 9:30 AM to refresh her stents. As you may recall, the current stents (placed January 5) are plastic and expected to last 6-8 weeks. They will be replaced with "permanent" metal stents which should last at least 9 months up to several years. The metal stents have a larger bore and are much less prone to blockage.
The best news is that there is no evidence that the current stents are blocked. In fact, Michelle's bilirubin this week is only 0.1 points above the normal range: 1.3 vs 1.2! Hallelujah and Amen! (It's still important to go ahead with the replacement, because the plastic stents will eventually start to break down.)
Also on Tuesday, we heard back from the radiation center. They wanted to start Michelle's radiation treatments right away. She is scheduled for 14 daily treatments every weekday at 9:30. The first treatment was scheduled for Wednesday.
Tuesday's chemo treatment went smoothly (they even placed the IV on the second try this time!) and she didn't feel too terribly bad Tuesday night and slept well.
Wednesday's radiation treatment was quick and painless. She receives a dose both front and back, targeting the tumor in her T11 vertebra. They gave us some moisturizing cream to rub gently on her skin twice per day: the skin will become very tender, similar to a first-degree burn.
Michelle felt surprisingly well on Wednesday, and even reduced her pain medication to 2 doses per day instead of 3, with no breakthrough pain at all. Having learned how the nausea medications work for her, we carefully dosed her and managed to avoid most of it.
Thursday was pretty much a repeat. Radiation at 9:30, followed by a restful day, but without the severe out-of-control nausea experienced last time. As I write this, Michelle's getting ready for bed after a reasonably (and surprisingly) good day. She even ate a good dinner!
Tomorrow we meet with the surgeon to plan for installation of a port. This device will reside just under the skin of her upper chest, and provide easy access for blood draws and IV medication, without getting poked 2 or 3 times several times per week. We don't have a schedule for the installation, but we're hoping it will happen before the next chemo on Tuesday.
And that's all the news I'm fit to print this week. As Tigger says, TTFN!
Wednesday, January 28, 2009
No Chemo this week: Chemo next week
This is just a quick note to let you all know Michelle had to skip yesterday's scheduled Chemo treatment because her blood counts were too low. We're going to give her body a week to recover and check her counts again next Monday in advance of the scheduled Tuesday treatment. We are experiencing an odd mixture of disappointment and relief over this news. Disappointment because we want to keep the treatment moving, but relief because she doesn't have to endure the aftermath. In the end, though, it's all in God's hands, so we do our best to take it in stride.
Michelle has been feeling remarkably well the last several days: more energy, less pain, less nausea. She still gets fatigued easily, but her current state is a big improvement over how she felt before the first chemo treatment.
The cancer center decided it's time to give Michelle a port, a surgically implanted device that will reside just below the skin of her chest and provide easy, reliable access for IV medications and blood draws. (No more pokes!) The implantation is performed by a surgeon under general anesthesia. We have a consultation appointment scheduled for Friday, February 6.
The prayer meeting on Monday was full of praise songs, uplifting scripture readings, and positive energy. This week we placed Michelle on a portable massage table in the center of the room, laid on hands and prayed over her. We really appreciate everyone who was able to be present and all of you who prayed with us from afar. We've been hearing from more and more people who confirm that they have been praying with us every Monday evening 7:00 PM mountain time, and we dearly appreciate it. The healing wall of hope continues to grow.
Michelle has been feeling remarkably well the last several days: more energy, less pain, less nausea. She still gets fatigued easily, but her current state is a big improvement over how she felt before the first chemo treatment.
The cancer center decided it's time to give Michelle a port, a surgically implanted device that will reside just below the skin of her chest and provide easy, reliable access for IV medications and blood draws. (No more pokes!) The implantation is performed by a surgeon under general anesthesia. We have a consultation appointment scheduled for Friday, February 6.
The prayer meeting on Monday was full of praise songs, uplifting scripture readings, and positive energy. This week we placed Michelle on a portable massage table in the center of the room, laid on hands and prayed over her. We really appreciate everyone who was able to be present and all of you who prayed with us from afar. We've been hearing from more and more people who confirm that they have been praying with us every Monday evening 7:00 PM mountain time, and we dearly appreciate it. The healing wall of hope continues to grow.
Saturday, January 24, 2009
"Wocka Wocka Wocka Wocka"
Visualize an army of Pacman, Ms. Pacman, and all their tiny little Pacfriends gobbling up the cancer. That's Michelle's vision of how chemo works. (The sound effects in the blog title are mine.)Michelle came through her first round of chemotherapy with flying colors, although it was quite a ride. After an uplifting prayer meeting on Monday night, we arrived at the treatment center at 2:15 Tuesday afternoon. The treatment itself went well, with no complications, and we left about 3 hours later. Michelle said she felt bloated and "weird".
They prescribed Compazine and Ativan for nausea, on top of the Zofran we have already been using, and advised Michelle to take both when she got home. Although she experienced little or no nausea, the Ativan apparently caused muscle spasms that lasted all night long and kept her from sleeping. She was finally able to fall asleep around 6:00 AM, just as I was leaving for work. She slept pretty well until around 2:00 PM and then came downstairs to make a fruit smoothy.
When she went back upstairs to our bedroom, she felt completely wiped out and was breathing heavily. I had come home from work early because both kids had to work in the afternoon, and I grew concerned about her breathing. We checked her oxygen saturaion with a fingertip pulse oximeter I bought over the internet. The reading was 74%, and it dropped to 64% as I watched. (For perspective, they sent Michelle home from the hospital in December with oxygen because her reading kept falling to the low 80's - normal readings fluxuation between about 91 and 99.) We immediately put her on oxygen and her levels quickly returned to normal. What a scare!
The rest of Wednesday was pretty uneventful. Michelle was very, very tired but so far not really nauseous and her pain was under control. She slept well Wednesday night.
Thursday was a different story. While she did sleep OK, she was still quite fatigued. In the mid-morning she felt well enough to take a shower, but her O2 saturation fell to 80 and we put her back on oxygen for a while. The nausea struck with a vengeance in the early afternoon. I guess you could say that the medications did their job because she never actually vomited, but her misery was palpable. I took the day off work as planned and did all I could to comfort her, but in the end there was precious little I could do.
Fortunately, at around 5:30 PM the nausea passed and she suddenly felt better. It was like a veil of fog suddenly lifting, very much like the way a fever will suddenly lift. Michelle was able to eat some dinner and just lay back and relax. We spent the evening watching some TV and she slept like a baby all night.
Friday (yesterday) we met Dr. Gwen H. Lisella, MD. She is a radiation oncologist and will be performing palliative radiation treatments to address the cancer that has apparently spread into the bone of Michelle's T11 vertebra. We saw the image from last week's MRI. The good news is that the cancer is well away from the spinal cord. There is a black area on roughly half of the front side of the bone that the radiologists identified as cancer. Dr. Lisella said this area is fairly east to treat without huge impacts on the abdominal organs, but there will still be some nausea and increased gastric reflux as a result of the treatment. She is going to consult with both Dr. Marschke to coordinate radiation therapy with chemotherapy and with Dr. James Derrisaw, the pain management specialist who administered the celiac nerve bundle block back in December*. We should hear back from her by next week Thursday to set a treatment schedule.
The radiation treatments will take place over a 2 week period, Monday through Friday. We may want to try to schedule them to take place during the 2 week chemo hiatus in early March. Dr. Lisella said that such a delay should not make much difference in the outcome of the treatment. Given this week's experience with chemo, I support the idea of not adding daily radiation to the mix at this time.
* - The celiac bundle block was a treatment to provide longer-term pain management for Michelle's intense abdominal pain. The treatment was administered during her hospital stay the week of December 15 and consisted of a 4-point injection of a powerful alcohol solution which dissolved the nerve sheaths, effectiving deadening the pain transmission of the major abdominal nerves. The injection sites were near the T10 and T11 vertebra (in the middle of the back near the bottom of the rib cage and the top of the stomach). There is no indication or expectation that this injection had anything to do with the dark spot on the MRI. Dr. Lisella want to consult with Dr. Derrisaw to make sure all bases are covered, and to further rule out any relationship with his treatment and what we now see with T11.
We continued to add to the healing wall this week. We added pictures of everyone who attended this week's prayer meeting, plus hand written signs "God has a Plan for Me" and "One Day at a Time". These additions, plus a prayer from our dear friend Brenda and pictures friends and family members who have fought bravely and unselfishly cared for others, were a great source of strength and inspiration for Michelle during her lowest moments this week. She feels overwhelmed by all the love and support she is receiveing and tears up when she speaks with amazement at all the people who love and care for her. God bless you all, and please keep up your prayers.
Saturday, January 17, 2009
Next Prayer Meeting Monday Jan 19, 6:30 PM MST
Since Michelle will commence her chemotherapy treatments next Tuesday afternoon, we wanted to hold our next prayer meeting on Monday evening. We will gather in our home at 6:30 PM: if you would like to synchronize your prayers with us from a distant location, 6:45 or 7:00 would be a good time to start.
As I noted in my last posting, Michelle has been experiencing pain related to an apparent tumor in her T11 vertebra. In the last few days this pain has increased, so an MRI scan was performed yesterday (Friday Jan 16). The scan revealed cancer both in the bone and in the marrow, but there was no nerve impingement present. In order to reduce related pain by reducing the size of these tumors, Michelle is scheduled for targeted radiation on Friday, January 23. If an earlier appointment opens up, we intend to move up her appointment.
In the mean time, Dr. Marschke told us to double Michelle's pain medication. So far the new level seems to be helping, but it is definitely affecting Michelle's alertness.
As I noted in my last posting, Michelle has been experiencing pain related to an apparent tumor in her T11 vertebra. In the last few days this pain has increased, so an MRI scan was performed yesterday (Friday Jan 16). The scan revealed cancer both in the bone and in the marrow, but there was no nerve impingement present. In order to reduce related pain by reducing the size of these tumors, Michelle is scheduled for targeted radiation on Friday, January 23. If an earlier appointment opens up, we intend to move up her appointment.
In the mean time, Dr. Marschke told us to double Michelle's pain medication. So far the new level seems to be helping, but it is definitely affecting Michelle's alertness.
Thursday, January 15, 2009
Houston, we have a plan! (and a schedule)
Greetings all!
The prayer service at our house Monday night was (to use a much-overemployed-but-very-apt superlative) AWESOME! Fifteen members of Michelle's prayer circle (if you pray for Michelle, you're in the circle - even if you just send positive thoughts her way, you're in the circle too) met in our home Monday night for spiritual readings, community prayer, laying on hands, and above all: Healing! It was a tremendously supporting, energizing, uplifting, inspiring event and we can't thank all of you enough - those present in person and those praying with us from distant locales. We are going to try to hold these prayer meetings every week, depending on Michelle's status. Watch the blog for announcements.
On Tuesday morning, Michelle and Bill went down to Denver for an appointment with Dr. Weekes. The blood tests showed that her bilirubin level, while much lower, is not low enough for the parameters of the clinical trial. Even if her levels were to get down that low, it is very unlikely they would stay there for long. The clinical trial is therefore off the table, and it's time to move forward with the FDA-approved "standard of care" chemotherapy for this particular cancer.
At the risk of getting too technical, here are a few words about bilirubin. One of the important jobs of the liver is to destroy red blood cells. The waste products from the destroyed cells are excreted in the form of bile, which enters the small intestine through the common bile duct. Cholangiocarcinoma, bile duct cancer, forms tumors in the bile duct itself which tends to create blockages, impeding or halting the flow of bile. The bile backs up into the liver and eventually enters the bloodstream, where it is called "bilirubin". All of us have some levels of bilirubin in our blood; the normal level is 1.2 (not sure of the units, but probably something like parts per million.) In Michelle's case, her bilirubin peaked around 7.5 immediately following the last ERCP (Jan 5) and was down to 2.8 on Tuesday. The study parameters require levels of 2.0 or below. Michelle's gastroenterologist said that level is probably unrealistic in her case.
Now for the plan.
On Wednesday we met with Dr. Robert F. Marschke from Front Ranger Cancer Specialists here in Fort Collins. We have been meeting with Dr. Marschke since December, using him as a sounding board and second opinion to balance the information we have been getting from the specialists at UCH. After reviewing our options with him, we decided to shift gears and asked Dr. Marschke to take the lead as Michelle's primary oncologist. There are several advantages to this.
First, we won't have to drive back and forth to Denver for treatments: FRCS is just 5 minutes from our house. this is a big deal since the primary side effect from chemo will be fatigue.
Anything we can do to minimize fatigue would be good.
Second, coordinating treatment between Denver and Fort Collins has been challenging, and the challenges would only get worse. Of course we would be more than happy to do whatever it takes to get Michelle the best treatment possible, but it looks like we can accomplish that right here in our home town.
Third, we really like Dr. Marschke. He is very caring and compassionate, and willing to listen to us and answer all our questions. When we pointed out a discrepancy between what we heard in Denver and what he told us, he immediately went to his computer, researched the question to make sure he had the absolutely latest information, and discussed the findings (which validated his position.)
The plan is to start chemotherapy with a drug called gemcitabine (aka Gemzar) next week. Treatments are scheduled every Tuesday afternoon (time varies) for the next 6 weeks. The next 2 weeks would be spent getting a PET scan, resting, and reviewing and updating the treatment plan. Assuming the therapy is working and Michelle is tolerating it well, we would start a new cycle of 3 weeks of treatment followed by one week of rest.
There is one other piece of news that we hadn't planned to share, but it may be more important than we thought. Late last week Dr. Marschke ordered a CT scan of Michelle's lungs to check for pulmonary embolisms (blood clots in the lungs) based on a new pain in her side. While no clots were found, and in fact a small clot noticed back in December had vanished, they did spot a probable new tumor on her T11 vertebra. We took this as simply more evidence of metastasis (spread of the cancer) which isn't news and doesn't change the treatment options. As it happens, this tumor bears watching because as it grows it can cause nerve problems with varied and unpredictable symptoms. If this tumor becomes a problem, the treatment will be palliative radiation to shrink it and alleviate symptoms. We'll keep you posted.
Thank you again for reading this blog and keeping us in your thoughts and prayers. They really do make a difference.
The prayer service at our house Monday night was (to use a much-overemployed-but-very-apt superlative) AWESOME! Fifteen members of Michelle's prayer circle (if you pray for Michelle, you're in the circle - even if you just send positive thoughts her way, you're in the circle too) met in our home Monday night for spiritual readings, community prayer, laying on hands, and above all: Healing! It was a tremendously supporting, energizing, uplifting, inspiring event and we can't thank all of you enough - those present in person and those praying with us from distant locales. We are going to try to hold these prayer meetings every week, depending on Michelle's status. Watch the blog for announcements.
On Tuesday morning, Michelle and Bill went down to Denver for an appointment with Dr. Weekes. The blood tests showed that her bilirubin level, while much lower, is not low enough for the parameters of the clinical trial. Even if her levels were to get down that low, it is very unlikely they would stay there for long. The clinical trial is therefore off the table, and it's time to move forward with the FDA-approved "standard of care" chemotherapy for this particular cancer.
At the risk of getting too technical, here are a few words about bilirubin. One of the important jobs of the liver is to destroy red blood cells. The waste products from the destroyed cells are excreted in the form of bile, which enters the small intestine through the common bile duct. Cholangiocarcinoma, bile duct cancer, forms tumors in the bile duct itself which tends to create blockages, impeding or halting the flow of bile. The bile backs up into the liver and eventually enters the bloodstream, where it is called "bilirubin". All of us have some levels of bilirubin in our blood; the normal level is 1.2 (not sure of the units, but probably something like parts per million.) In Michelle's case, her bilirubin peaked around 7.5 immediately following the last ERCP (Jan 5) and was down to 2.8 on Tuesday. The study parameters require levels of 2.0 or below. Michelle's gastroenterologist said that level is probably unrealistic in her case.
Now for the plan.
On Wednesday we met with Dr. Robert F. Marschke from Front Ranger Cancer Specialists here in Fort Collins. We have been meeting with Dr. Marschke since December, using him as a sounding board and second opinion to balance the information we have been getting from the specialists at UCH. After reviewing our options with him, we decided to shift gears and asked Dr. Marschke to take the lead as Michelle's primary oncologist. There are several advantages to this.
First, we won't have to drive back and forth to Denver for treatments: FRCS is just 5 minutes from our house. this is a big deal since the primary side effect from chemo will be fatigue.
Anything we can do to minimize fatigue would be good.
Second, coordinating treatment between Denver and Fort Collins has been challenging, and the challenges would only get worse. Of course we would be more than happy to do whatever it takes to get Michelle the best treatment possible, but it looks like we can accomplish that right here in our home town.
Third, we really like Dr. Marschke. He is very caring and compassionate, and willing to listen to us and answer all our questions. When we pointed out a discrepancy between what we heard in Denver and what he told us, he immediately went to his computer, researched the question to make sure he had the absolutely latest information, and discussed the findings (which validated his position.)
The plan is to start chemotherapy with a drug called gemcitabine (aka Gemzar) next week. Treatments are scheduled every Tuesday afternoon (time varies) for the next 6 weeks. The next 2 weeks would be spent getting a PET scan, resting, and reviewing and updating the treatment plan. Assuming the therapy is working and Michelle is tolerating it well, we would start a new cycle of 3 weeks of treatment followed by one week of rest.
There is one other piece of news that we hadn't planned to share, but it may be more important than we thought. Late last week Dr. Marschke ordered a CT scan of Michelle's lungs to check for pulmonary embolisms (blood clots in the lungs) based on a new pain in her side. While no clots were found, and in fact a small clot noticed back in December had vanished, they did spot a probable new tumor on her T11 vertebra. We took this as simply more evidence of metastasis (spread of the cancer) which isn't news and doesn't change the treatment options. As it happens, this tumor bears watching because as it grows it can cause nerve problems with varied and unpredictable symptoms. If this tumor becomes a problem, the treatment will be palliative radiation to shrink it and alleviate symptoms. We'll keep you posted.
Thank you again for reading this blog and keeping us in your thoughts and prayers. They really do make a difference.
Sunday, January 11, 2009
Please join us in Prayer Monday Evening, 1/12
It's been almost a week since the procedure to refresh Michelle's bile duct stents, and all indications are the procedure was successful. Her color is better, and she seems to be much more comfortable. The pain and nausea have let up a bit, and we've been able to cut her breakthrough pain medication in half. Her color is improving (much less yellow today) and the itchiness is reduced, so hopefully we'll get the green light to start chemo treatments when we meet with oncologist Dr. Weekes in Denver on Tuesday morning.
I know this is late notice, but we have organized a healing prayer meeting in our home tomorrow evening, Monday January 12. Karen Lowe, our close friend and former pastor of Christ United Methodist Church will be leading the meeting, with the help of Bob Simpson, another close friend who was also a pastor at CUMC. We will be praying over Michelle and participating in several healing rituals. Our focus will be on asking God for miraculous healing.
For those of you who wish to be prayer warriors for Michelle but are unable to attend on Monday, please join us in prayer from wherever you happen to be at 7:00 PM Mountain Time on Monday. If you are in the area and would like to participate in person, please call for specifics. We made several direct invitations, but welcome anyone who would like to pray with us.
I know this is late notice, but we have organized a healing prayer meeting in our home tomorrow evening, Monday January 12. Karen Lowe, our close friend and former pastor of Christ United Methodist Church will be leading the meeting, with the help of Bob Simpson, another close friend who was also a pastor at CUMC. We will be praying over Michelle and participating in several healing rituals. Our focus will be on asking God for miraculous healing.
For those of you who wish to be prayer warriors for Michelle but are unable to attend on Monday, please join us in prayer from wherever you happen to be at 7:00 PM Mountain Time on Monday. If you are in the area and would like to participate in person, please call for specifics. We made several direct invitations, but welcome anyone who would like to pray with us.
Tuesday, January 6, 2009
All's Well, Time to Wait (again)
Michelle's procedure yesterday went better than expected. Unlike the ERCP on the day after Christmas, the new stent slid right into place in her left hepatic duct. The doctors also placed a stent into the right hepatic duct. The two stents run next to each other through her common bile duct and both terminate at the opening into her small intestine (imagine a large Y made of 2 equal length tubes). Hopefully these two stents will provide adequate drainage so her bilirubin levels come down, allowing the chemo treatments to start. We'll know the outcome in about a week, as it will take that long for the excess bile to drain.
Our next appointment is Tuesday 1/13 with Dr. Weekes at the UCH Cancer Center in Denver.
We discussed additional therapies with the Gastroenterology team (Drs. Shah and Yen this time) and they have several more tricks up their sleeve in the event additional drainage is necessary.
Assuming yesterday's procedure is successful, and assuming the oncology team agrees, they will replace the temporary plastic stents with "permanent" metal stents in about 6 weeks. They used the plastic stents again because it is more difficult to work around metal stents if additional procedures to add drainage are required.
Dr. Shah also told us that there is a gastroenterology conference scheduled for mid-February, with specialists from across the country to hear him and Dr. Chen speak. The timing may work out such that Michelle could be the subject of a demonstration for placing metal stents (Shah and Chen would perform the procedure). Her face and identity would be obscured, but her innards could be famous! Michelle likes the idea of being able to contribute to the body of knowledge surrounding her condition and enthusiastically agreed to participate. Of course, Michelle's needs come first, and they will not attempt to delay necessary treatment for the sake of this demonstration.
Our next appointment is Tuesday 1/13 with Dr. Weekes at the UCH Cancer Center in Denver.
We discussed additional therapies with the Gastroenterology team (Drs. Shah and Yen this time) and they have several more tricks up their sleeve in the event additional drainage is necessary.
Assuming yesterday's procedure is successful, and assuming the oncology team agrees, they will replace the temporary plastic stents with "permanent" metal stents in about 6 weeks. They used the plastic stents again because it is more difficult to work around metal stents if additional procedures to add drainage are required.
Dr. Shah also told us that there is a gastroenterology conference scheduled for mid-February, with specialists from across the country to hear him and Dr. Chen speak. The timing may work out such that Michelle could be the subject of a demonstration for placing metal stents (Shah and Chen would perform the procedure). Her face and identity would be obscured, but her innards could be famous! Michelle likes the idea of being able to contribute to the body of knowledge surrounding her condition and enthusiastically agreed to participate. Of course, Michelle's needs come first, and they will not attempt to delay necessary treatment for the sake of this demonstration.
Saturday, January 3, 2009
Here we go again - ERCP on Monday
Friday's blood tests showed Michelle's bilirubin remains high, so another ERCP is scheduled for Monday January 5 at 1:30 PM. They'll check out the current stent and probably replace it with a new one.
In the December 26 procecure, the replacement stent was only placed across the blockage in the main bile duct, where the cancer was found. Upon further examination, the doctor concluded the site of the upper blockage (the left hepatic duct) which was stented in early December was probably not cancerous and he believed the blockage was cleared and no longer needed to be stented. Given that Michelle's bilirubin levels have increased beyond where they were on 12/23, it seems likely the left hepatic duct is blocked again.
In any event, Dr. Chen also told us that he wants to place a permanent metal stent instead the temporary plastic stents they have been using, since surgery has been ruled out. He had planned to see Michelle again in mid-February and place the stent then. It seems likely that since he's performing another ERCP now that he'll place the metal stent, but we haven't been told one way or the other. The advantage of the metal stent is that it is somewhat larger and less prone to blockages. Plastic stents can last up to 3 months; metal stents can stay in place for 9-12 months or even longer. We're hoping this will mean fewer ERCP procedures so we can focus on fighting the cancer instead of remediating the symptoms.
Michelle's sister Kim left on Friday to return home to California. We found out before she left that her husband Lindsey has painful shingles! He's in quite a bit of pain, but should make a full recovery. It was great to have Kim with us for a week, she was a big help and enabled Bill to work a full week for the first time since November.
In the December 26 procecure, the replacement stent was only placed across the blockage in the main bile duct, where the cancer was found. Upon further examination, the doctor concluded the site of the upper blockage (the left hepatic duct) which was stented in early December was probably not cancerous and he believed the blockage was cleared and no longer needed to be stented. Given that Michelle's bilirubin levels have increased beyond where they were on 12/23, it seems likely the left hepatic duct is blocked again.
In any event, Dr. Chen also told us that he wants to place a permanent metal stent instead the temporary plastic stents they have been using, since surgery has been ruled out. He had planned to see Michelle again in mid-February and place the stent then. It seems likely that since he's performing another ERCP now that he'll place the metal stent, but we haven't been told one way or the other. The advantage of the metal stent is that it is somewhat larger and less prone to blockages. Plastic stents can last up to 3 months; metal stents can stay in place for 9-12 months or even longer. We're hoping this will mean fewer ERCP procedures so we can focus on fighting the cancer instead of remediating the symptoms.
Michelle's sister Kim left on Friday to return home to California. We found out before she left that her husband Lindsey has painful shingles! He's in quite a bit of pain, but should make a full recovery. It was great to have Kim with us for a week, she was a big help and enabled Bill to work a full week for the first time since November.
Friday, January 2, 2009
Happy 2009!
Happy New Year! 2009 will be a year of hope and healing at the McDonough home.
Time to catch up on what's happened in the last week.
We had a great Christmas with Michelle's parents and Bill's brother Tim visiting. Michelle's folks arrived by car from Arizona the Sunday before Christmas and stayed with us for a week. It was great to have them with us and we really appreciated all their help and support.
Michelle's sister arrived from California Sunday night and has been a big help all week, and even enabled Bill go back to work. She's heading back home tonight (Friday Jan 2).
On the health front, we went down to Denver on Friday, December 26 for an early morning procedure to replace Michelle's bile duct stent, which had become blocked causing her bilirubin levels to rise. It's important to keep those levels down to satisfy the treatment protocol for the chemotherapy drugs.
For the first few days after the procedure, Michelle seemed to get better. We managed to keep her pain under control and she was relatively comfortable through the weekend and Monday. Unfortunately, on Tuesday we noticed she was getting yellow and itchy again, a sign of jaundice and an indicator that the bilirubin was on the rise again. Blood work on Wednesday confirmed levels higher than before the 12/26 procedure. Another blood draw is scheduled for today, and it looks like another procedure may be in the cards early next week.
We'll keep you posted.
Time to catch up on what's happened in the last week.
We had a great Christmas with Michelle's parents and Bill's brother Tim visiting. Michelle's folks arrived by car from Arizona the Sunday before Christmas and stayed with us for a week. It was great to have them with us and we really appreciated all their help and support.
Michelle's sister arrived from California Sunday night and has been a big help all week, and even enabled Bill go back to work. She's heading back home tonight (Friday Jan 2).
On the health front, we went down to Denver on Friday, December 26 for an early morning procedure to replace Michelle's bile duct stent, which had become blocked causing her bilirubin levels to rise. It's important to keep those levels down to satisfy the treatment protocol for the chemotherapy drugs.
For the first few days after the procedure, Michelle seemed to get better. We managed to keep her pain under control and she was relatively comfortable through the weekend and Monday. Unfortunately, on Tuesday we noticed she was getting yellow and itchy again, a sign of jaundice and an indicator that the bilirubin was on the rise again. Blood work on Wednesday confirmed levels higher than before the 12/26 procedure. Another blood draw is scheduled for today, and it looks like another procedure may be in the cards early next week.
We'll keep you posted.
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