Michelle was admitted to the Pathways Hospice Care Center in McKee Medical Center in Loveland (about 25 minutes from our house) on Sunday night. She was essentially unconscious and had moved beyond our ability to care for her at home.
In the wee hours of Monday morning (6/28) she aspirated fluids from her stomach and her breathing became labored, quick, and shallow. Over the course of the day we were able to use medicatins to calm her breathing somewhat and make her as comfortable as possible. The hospice doctor examined her and confirmed that her body is showing all the signs of shutting down, but since she is still so young it is impossible to predict how much longer she will hold out. It could be hours or a day or two.
This morning (Tuesday 6/29) she is comfortable and her breathing is still rapid and shallow, but with little of the laboring and gurgling sounds that were present yesterday. She appears relaxed and comfortable.
This will be my last post until she passes. Thank you all for your prayers and kind thoughts. Your support has been a key source of strength throughout our ordeal.
Tuesday, June 29, 2010
Saturday, June 12, 2010
Prayer Service
Thursday night's prayer service was awesome, very spiritual and heartfelt. In addition to Michelle's family (mom, dad, and 2 sisters), my brother Tim and 12 of our close friends joined us. Many brought small tokens or readings to share, including religious icons, a photo of the sunrise taken on Easter morning from Horsetooth reservoir (just west of Fort Collins in the foothills), and several readings.
Here are some of those readings:
So do not fear, for I am with you,
Do not be dismayed, for I am your God.
I will strengthen you and help you:
I will uphold you with my righteous right hand.
Isiah 41:10
An Excerpt from Henri Nouwen by Robert A. Jonas
Robert A. Jonas is the editor of this collection of writings from the Christian writer Henri Nouwen. Here is an excerpt on faith.
"The Flying Rodleighs are trapeze artists who perform in the German circus Simoneit-Barum. When the circus came to Freiburg two years ago, my friends Franz and Reny invited me and my father to see the show. I will never forget how enraptured I became when I first saw the Rodleighs move through the air, flying and catching as elegant dancers. The next day, I returned to the circus to see them again and introduced myself to them as one of their great fans. They invited me to attend their practice sessions, gave me free tickets, asked me to dinner, and suggested I travel with them for a week in the near future. I did, and we became good friends.
"One day, I was sitting with Rodleigh, the leader of the troupe, in his caravan, talking about flying. He said, 'As a flyer, I must have complete trust in my catcher. The public might think that I am the great star of the trapeze, but the real star is Joe, my catcher. He has to be there for me with split-second precision and grab me out of the air as I come to him in the long jump.' 'How does it work?' I asked. 'The secret,' Rodleigh said, 'is that the flyer does nothing and the catcher does everything. When I fly to Joe, I have simply to stretch out my arms and hands and wait for him to catch me and pull me safely over the apron behind the catchbar.'
" 'You do nothing!' I said, surprised. 'Nothing,' Rodleigh repeated. 'The worst thing the flyer can do is to try to catch the catcher. I am not supposed to catch Joe. It's Joe's task to catch me. If I grabbed Joe's wrists, I might break them, or he might break mine, and that would be the end for both of us. A flyer must fly, and a catcher must catch, and the flyer must trust, with outstretched arms, that his catcher will be there for him.'
"When Rodleigh said this with so much conviction, the words of Jesus flashed through my mind: 'Father into your hands I commend my Spirit.' For us it means trusting in the catcher…'Don't be afraid. Remember that you are the beloved child of God. He will be there when you make your long jump. Don't try to grab him; he will grab you. Just stretch out your arms and hands and trust, trust, trust.' "
We also enjoyed and sang along with a moving rendition of one of Michelle's favorite hymns, "Lord of the Dance".
We closed with a Navajo prayer:
Navajo Blessing Way Prayer
In beauty may I walk.
All day long may I walk.
Through the returning seasons may I walk.
On the trail marked with pollen may I walk.
With grasshoppers about my feet may I walk.
With dew about my feet may I walk.
With beauty before me, may I walk.
With beauty behind me, may I walk.
With beauty above me, may I walk.
With beauty below me, may I walk.
With beauty all around me, may I walk.
In old age wondering on a trail of beauty, lively, may I walk.
In old age wandering on a trail of beauty, living again, may I walk.
It is finished in beauty.
It is finished in beauty.
I want to take this opportunity to thank everyone for all the wonderful messages of support and prayer that continue to pour in. I apologize that I haven't the time to respond to each message individually, but please know that we appreciate every one.
Here are some of those readings:
So do not fear, for I am with you,
Do not be dismayed, for I am your God.
I will strengthen you and help you:
I will uphold you with my righteous right hand.
Isiah 41:10
An Excerpt from Henri Nouwen by Robert A. Jonas
Robert A. Jonas is the editor of this collection of writings from the Christian writer Henri Nouwen. Here is an excerpt on faith.
"The Flying Rodleighs are trapeze artists who perform in the German circus Simoneit-Barum. When the circus came to Freiburg two years ago, my friends Franz and Reny invited me and my father to see the show. I will never forget how enraptured I became when I first saw the Rodleighs move through the air, flying and catching as elegant dancers. The next day, I returned to the circus to see them again and introduced myself to them as one of their great fans. They invited me to attend their practice sessions, gave me free tickets, asked me to dinner, and suggested I travel with them for a week in the near future. I did, and we became good friends.
"One day, I was sitting with Rodleigh, the leader of the troupe, in his caravan, talking about flying. He said, 'As a flyer, I must have complete trust in my catcher. The public might think that I am the great star of the trapeze, but the real star is Joe, my catcher. He has to be there for me with split-second precision and grab me out of the air as I come to him in the long jump.' 'How does it work?' I asked. 'The secret,' Rodleigh said, 'is that the flyer does nothing and the catcher does everything. When I fly to Joe, I have simply to stretch out my arms and hands and wait for him to catch me and pull me safely over the apron behind the catchbar.'
" 'You do nothing!' I said, surprised. 'Nothing,' Rodleigh repeated. 'The worst thing the flyer can do is to try to catch the catcher. I am not supposed to catch Joe. It's Joe's task to catch me. If I grabbed Joe's wrists, I might break them, or he might break mine, and that would be the end for both of us. A flyer must fly, and a catcher must catch, and the flyer must trust, with outstretched arms, that his catcher will be there for him.'
"When Rodleigh said this with so much conviction, the words of Jesus flashed through my mind: 'Father into your hands I commend my Spirit.' For us it means trusting in the catcher…'Don't be afraid. Remember that you are the beloved child of God. He will be there when you make your long jump. Don't try to grab him; he will grab you. Just stretch out your arms and hands and trust, trust, trust.' "
We also enjoyed and sang along with a moving rendition of one of Michelle's favorite hymns, "Lord of the Dance".
We closed with a Navajo prayer:
Navajo Blessing Way Prayer
In beauty may I walk.
All day long may I walk.
Through the returning seasons may I walk.
On the trail marked with pollen may I walk.
With grasshoppers about my feet may I walk.
With dew about my feet may I walk.
With beauty before me, may I walk.
With beauty behind me, may I walk.
With beauty above me, may I walk.
With beauty below me, may I walk.
With beauty all around me, may I walk.
In old age wondering on a trail of beauty, lively, may I walk.
In old age wandering on a trail of beauty, living again, may I walk.
It is finished in beauty.
It is finished in beauty.
I want to take this opportunity to thank everyone for all the wonderful messages of support and prayer that continue to pour in. I apologize that I haven't the time to respond to each message individually, but please know that we appreciate every one.
Tuesday, June 8, 2010
Back Home!
Michelle was discharged from the hospital today and is back home. Hospice had a hospital bed and other equipment delivered, and the hospice consultant met us as we arrived with backup medications and orientation information for their services. Michelle's hospice nurse will visit tomorrow.
We've scheduled a prayer meeting for this THURSDAY at 6:30 PM MDT. Please join us in prayer at 7:00 if you can't make it in person.
We've scheduled a prayer meeting for this THURSDAY at 6:30 PM MDT. Please join us in prayer at 7:00 if you can't make it in person.
Monday, June 7, 2010
The Post I Don't Want to Write
Michelle had laproscopic surgery yesterday to identify exactly what is wrong with her digestive system. The news is about as bad is it gets. The cancer has spread through her abdomen, with thin sheets of tissue attaching to the inner wall of her abdomen, running through and coating the intestines, making it impossible for the muscular action of the intestines (paristalsis) to move the food through her system. For all intents and purposes, her digestive system is completely shut down. This explains why she can't keep any solid food down . The cancer is inoperable and impossible to treat with the current state of medicine.
We met today with a hospice consultant to start the process of setting up hospice care in our home. We will rent a hospital bed, wheelchair, and other equipment and focus all our efforts on keeping Michelle comfortable. She is not expected to survive more than a few weeks.
Once we have her home and settled, I'll post information about the prayer meeting we are planning.
Michelle's parents and sisters are converging on Fort Collins as we speak, and should all arrive sometime tomorrow. Chris has taken a few days off and came down from the mountains to be with us. He'll probably return there on Thursday or Friday. I have taken a leave of absence from work for as long as necessary. Kelly is continuing to work part time at Target (baking!) and still lives at home with us.
Thank you for all the prayers, cards, flowers, and loving messages you've sent. They really help to lift us up in these trying days.
We are so very thankful for God's Grace that has kept Michelle alive and fighting this terrible disease for longer than anyone ever expected. She fought successfully for more than 3 times the mean survival time, and that alone is a miracle. We are very grateful for the extra year we've had to spend together, knowing all the time that the end was approaching.
We met today with a hospice consultant to start the process of setting up hospice care in our home. We will rent a hospital bed, wheelchair, and other equipment and focus all our efforts on keeping Michelle comfortable. She is not expected to survive more than a few weeks.
Once we have her home and settled, I'll post information about the prayer meeting we are planning.
Michelle's parents and sisters are converging on Fort Collins as we speak, and should all arrive sometime tomorrow. Chris has taken a few days off and came down from the mountains to be with us. He'll probably return there on Thursday or Friday. I have taken a leave of absence from work for as long as necessary. Kelly is continuing to work part time at Target (baking!) and still lives at home with us.
Thank you for all the prayers, cards, flowers, and loving messages you've sent. They really help to lift us up in these trying days.
We are so very thankful for God's Grace that has kept Michelle alive and fighting this terrible disease for longer than anyone ever expected. She fought successfully for more than 3 times the mean survival time, and that alone is a miracle. We are very grateful for the extra year we've had to spend together, knowing all the time that the end was approaching.
Friday, June 4, 2010
No Biopsy Yet
The planned biopsy yesterday had to be canceled because the radiologist felt there was not enough tissue to sample and the risk of a bowel perforation was too high. Since Michelle's oncologist was unavailable yesterday, we had to wait until today to figure out a new plan.
When we got back to the room around noon, Michelle's nurse had her morning pills waiting for her. Unfortunately, as soon as the water hit her stomach it and the pills came right back up along with last night's dinner. Michelle rested and took it easy rest of the day and dined on Campbell's Chicken Noodle Soup.
Today she wasn't able to keep her breakfast down, and our concern and focus turned to her persistently queasy stomach. It's been several over a week since she's been able to keep solid food down and go for more than 36 hours without vomiting. We're growing concerned about her ability to get nutrition.
Dr. Marschke was in today and laid out the new plan. He explained that he, the surgeon, and the infectious disease doctors concur that the main concern now is that Michelle may have a full or partial bowel obstruction keeping her from digesting any food. The next diagnostic step will be an exploratory laparascopy to get a close look inside her abdomen at the areas that look suspicious. The surgeon will also evaluate options for addressing whatever he finds and investigate the possibility of putting in a feeding tube below the blockage.
I'll post an update when I know more.
When we got back to the room around noon, Michelle's nurse had her morning pills waiting for her. Unfortunately, as soon as the water hit her stomach it and the pills came right back up along with last night's dinner. Michelle rested and took it easy rest of the day and dined on Campbell's Chicken Noodle Soup.
Today she wasn't able to keep her breakfast down, and our concern and focus turned to her persistently queasy stomach. It's been several over a week since she's been able to keep solid food down and go for more than 36 hours without vomiting. We're growing concerned about her ability to get nutrition.
Dr. Marschke was in today and laid out the new plan. He explained that he, the surgeon, and the infectious disease doctors concur that the main concern now is that Michelle may have a full or partial bowel obstruction keeping her from digesting any food. The next diagnostic step will be an exploratory laparascopy to get a close look inside her abdomen at the areas that look suspicious. The surgeon will also evaluate options for addressing whatever he finds and investigate the possibility of putting in a feeding tube below the blockage.
I'll post an update when I know more.
Wednesday, June 2, 2010
The Plot Thickens, Too
Michelle's condition hasn't changed much in the last few days. She's still in the hospital and still on the same dosage of pain medicine. This is contributing to the mixed picture of her situation and has the doctors scratching their heads a bit.
To recap:
Speaking of which, the fluid has been building rapidly in her abdomen and it will be time for another peracentesis tomorrow or Friday. We suspect that they may do both procedures at the same time.
Michelle's spirits are about as good as can be expected. She's heavily medicated for the pain, which is making her fairly groggy and sleepy. The antibiotics are taking their toll as well, so she doesn't have a lot of energy. In spite of all that, she's not complaining and has been very patient with the nurses and the sometimes nonsensical hospital rules.
I've been able to get some work done in the mornings and here in Michelle's hospital room on my laptop, and the kids have been visiting when schedules permit. Chris left yesterday for his summer job, he's a medical officer at the Boy Scout camp in the mountains about an hour from home.
To recap:
- Michelle had out of control pain and a fever at home on Saturday.
- We gave her Advil for the fever which brought her temperature down right away.
- We tried the oral pain meds we had on hand, but we couldn't get her pain under control and decided it was best to go to the ER.
- Initial blood tests revealed elevated white blood cells, which have been coming down steadily since then.
- The fever hasn't returned.
- Detailed review of the CT scans from Saturday show thickening of the tissue that enclosed the abdominal cavity and pelvis, the peritoneum, particularly around the part of her large intestine where it meets her small intestine, called the cecum.
- The cultures of her blood and peritoneal fluid have not returned any results.
- She's not getting better. By this time, most patients with bacterial peritonitis are bouncing back and showing reduced pain and increased energy. Rapid improvement is the rule, but Michelle's pain hasn't abated at all, and she's still pretty wiped out.
- Her bowels aren't moving, although most patients receiving the high amounts of antibiotics she has typically have diarrhea.
Speaking of which, the fluid has been building rapidly in her abdomen and it will be time for another peracentesis tomorrow or Friday. We suspect that they may do both procedures at the same time.
Michelle's spirits are about as good as can be expected. She's heavily medicated for the pain, which is making her fairly groggy and sleepy. The antibiotics are taking their toll as well, so she doesn't have a lot of energy. In spite of all that, she's not complaining and has been very patient with the nurses and the sometimes nonsensical hospital rules.
I've been able to get some work done in the mornings and here in Michelle's hospital room on my laptop, and the kids have been visiting when schedules permit. Chris left yesterday for his summer job, he's a medical officer at the Boy Scout camp in the mountains about an hour from home.
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