Thursday, April 30, 2009

Emotions run strong today

Today was a day where it became certain that Kay is not going to be able to go to Portland for Jean's graduation party and ceremony. After seeing seven different physicians today, and lots of consultation the consensus is that in order for her to have adequate bile drainage, and to have her best chance to clear up this biliary infection (cholangitis) she needs not just several days of IV antibiotics, but a larger stent in the common bile duct. To do this the interventional radiologist and the gastroenterologist are going to work together tomorrow using the existing small stent to place a larger stent to adequately drain the bile, and allow the infection to clear and stay clear.

This will be done late tomorrow afternoon. Kay is disappointed, as we all are that she is going otot miss the graduation events, but we are going to do it virtually. I have some arrangments to make but the plan is that I'll stick in Puyallup tomorrow to keep Kay company and be here when they place this stent. It is really comforting for her to have me around for things like that. Brett and I will head for Portland after she is done with that, and get in later tomorrow evening. Jean is going to meet Bill and Horace Pullen at the airport and hang with them tomorrow. Fay and Keith Colmar are already in Portland, and had some fun with Jean today.

Saturday I intend to have local friends spend much of the day with Kay, and we plan to use Kay's Macbook and Jean's Macbook to video conference during her party, so everyone will get a chance to have some face-to-virtual-face time with Kay.

Kay may be able to come home Sunday, and if so I'll drive home Sunday evening about the time Horace (Dad) and Bill (brother) fly back to ME.

This is a lot to digest for all of us in one day. We had really hoped Kay could at least come to Jean's party Saturday, and that she would not need another biliary procedure. She is pretty discouraged tonight, but I know she and we will buck up and do what it takes for her to get well.

Your prayers are appreciated, and we feel the love. Pray for a successful stent, for joy and fun at Jean's graduation events, and for Kay to have endurance and strength through all these physical and emotional twists and turns.




The latest setback is that both of Kay's blood cultures from yesterday morning show that she has a bloodborne infection with a potentially serious gram negative rod shaped bacteria, with the usual "final ID and sensitivity" to follow. This means Kay will need several days of IV treatment. She is also going to get a blood transfusion today. Lots of specialists to see her. A more complete message to follow at bedtime tonight. I am racing to the office.


Wednesday, April 29, 2009

Positive spirits reign

By the time I went in to visit Kay about 5 PM, I was not in my best spirits. Up early, Kay in misery, the ER visit, lots of tests, hospitalization, missed the morning clinic, interviews and meetings all afternoon, a quick dinner, then in to visit.

I got to Good Sam and Kay's smile lit up the room. She is elated that she has an appetite today. She refuses to be down, and just remains totally positive. She says her survival depends on remaining positive, and she is 100% certain she is going to beat this "thing."

How can I not smile back and just hug her. Well it is tough to hug much, the port infusing, and the bile drainage tube a bit tender still, but a gentle hug worked. We had a really nice visit. Her walking the halls now is almost a "airborne shuffle" pace. She ate three full meals between noon and 7 PM. She told me about them in detail, an egg salad sandwich (both halves) for "lunch" then a grilled cheese sandwich, again "both halves" as a snack, and then an open faced turkey sandwich, mashed potatoes with gravy and string beans for dinner. These are really the first full meals she has eaten since her diagnosis. She says she ate so much she "stopped counting the calories."

We can all sleep well tonight knowing Kay is eating. Now to figure out how to get rid of whatever is causing her to be sick. We suspect an infection of the biliary tract, she is on IV antibiotics, and may need to take these for a while. I may be able to take her to Portland this weekend, and just give her the IV meds in the hotel room. All TBD.

Sleep tight.


Another eventful day

We had hoped for a quiet and relaxing day today. It was not to be. At 5 AM Kay started to have pain in the left lower anterior chest, worse with breathing. By 6 AM she was short of breath and had severe pain with deep breaths. It got so bad we called Dr. McCroskey who recommended she go to the ER to assure she did not have a pulmonary embolus, a blood clot to the lungs more common in certain cancer patients, ovarian cancer especially.

The good news is that all the tests at the ER were negative for a pulmonary embolus. Last night we had clamped off the external bile drainage tube, and it is possible that Kay developed an infection in the biliary tract. Tests today did show that her internal bile stent is draining perfectly, and that her bile ducts are decompressed just fine.

Kay is staying in the hospital at Good Samaritan at least tonight, to be on antibiotics while blood culture tests are done to see if she has serious infection. Our hope is that these tests all come back negative, she goes home tomorrow, and this was all much-to-do about little. Anyway, I just got off the phone and Kay is ecstatic, she just finished a whole sandwich and fixings, her first complete meal in recent memory, and she feels good.

My poor patients again today had to be rescheduled on short notice, but everyone at the office has been extremely supportive, and I suspect I'll have some patients left when I become more dependable. Anyway, I feel blessed that I could be with Kay this morning to help with decision making and for love and support.

Tomorrow evening I help Brett move home from Seattle. He is going to live at home for the rest of his quarter at school, and commute to classes, either by rail, or by car. Then Friday, all-goes-well we are off to Portland for Jean's graduation party Saturday and graduation Sunday.

So far really no problems we can directly relate to the chemotherapy. Maybe this pain was somehow related, but we just do not know what caused that with any degree of certainty.

I'll post again after I see Kay this evening. I had a series of meetings at the office this afternoon, and Kay is much more confident and comfortable in hospitals now, not necessarily a life-skill we all want to develop, but a good one for Kay to be accruing now. She is as always, a quick study.

Until later.


Tuesday, April 28, 2009

Day is done.

Wow, does our yard look great. When we got home from the Cancer Center today after Kay's first chemotherapy session, to find Terry Asplund on her knees weeding the flower bed in the front yard. She was followed by her husband Dave and Barb Aune. Before they left, Paul Freese brought a fabulous dinner. Wow, wow, wow. We are feeling far too blessed by all this pampering. I have to say it is incredibly nice and helpful though.

Kay has jut cruised so far. Not even a hint of nausea, no allergic reactions at all during the infusion, and no problems with the external bile drainage tube clamped off for 3 hours now. It is about 8 PM now, we are winding down for an early to bed night.

Tomorrow if all goes smoothly, Kay will get the external bile drainage tube removed, and will basically rest up.

Sleep tight.


Chemo session #1 almost done

Today we move on. After waiting several days for Kay's liver enzymes to come down to a level where she could qualify to participate in a clinical trial, we decided we just had to get on with treatment. This is the first time I have really seen the chemotherapy process first hand, and they are smooth. Having a modern and beautiful cancer center here in Puyallup is really sweet.

We got her at 11 AM, and Kay was quickly brought to the infusion center, where they have Lazy-boy type recliners for the patients. "Chairs" as they call them. They put an infusion needle into the port-a-cath Kay had placed earlier, not a painful thing at all, and then give her lots of drugs. IV decadron (a corticosteroid) and IV benadryl to prevent allergic reactions, a long lasting IV antiemetic, and IV ativan (for nausea but also makes her very drowsy. She then essentially slept through 4 hours of IV infusions, no side effects at all except the drowsiness.

Now we go home. The big thing tonight is we clamp the external bile drainage and see if Kay tolerates that. If so she may be able to get the external drain removed tomorrow. That would make her unattached for the first time in a while, and able to shower. I plan to get mine first before she uses all the hot water.

I'll make this quick. We are going home.


Monday, April 27, 2009


Good news today is that Kay's alk phosphatase was down to 350. Bad news is that Kay's alk phosphatase was down to 350. It needs to be at 300 to qualify for the clinical trial she hopes to participate in, and although she is closer, still does not qualify. After Kay spoke with Dr. McCroskey it sounds like the plan is to draw this again early tomorrow AM, and start chemo tomorrow, or possibly Wed. If low enough on trial, if not to start with the best chemotherapy regimen and consider adding the Avastin off-label (non- FDA approved, not in a clinical trial) if we and Dr. McCroskey agree it is appropriate.

Anyway, Jean is home, I am about to leave work, and we had another session of hypnosis this AM. Kay is getting very good at induction, and I think this is going to help a lot.

Yesterday I planted all of the "shoe flowers" in pots on the back deck. I told Kay I gave it the "old 3rd grade try", with my gardening skills definitely not the "old college try. "

More as I know more.


Sunday, April 26, 2009

Nice to get back to church

Today seemed close to like a normal Sunday. I went to church early to warm up for choir, Kay usually sings too, but Brett and Kay came a bit late, in time for the main part of the service, and we left right after communion, but nice to be back. After that we went to the hospital for a blood draw, then a short rest, and off for a second breakfast for Kay at Denny's. Kay just loves breakfast at Denny's.

We are hoping this labs now are back into a range to qualify her for the clinical trial she wants to participate in, but either way we should be starting on the offensive again tomorrow or Tuesday. Kay and I have been working on hypnosis to have post hypnotic suggestion for minimal side effects from chemotherapy. I had a good teacher, Larry Fitzgerald, in residency, who taught us to do hypnosis, and I used it a fair bit early in my practice with OB patients. I recall one woman in such a deep trance that she rested comfortably during labor, and the L&D nurses at Madigan were so upset with me because she would not communicate with them, that they "reported" me to the chief of the OB service. He came by, looked the situation over, and as only a good Colonel can, tried not to smile, and told the nurses he could not find anything to worry about. The woman as per prior suggestion, when I told her it was time to push, came out of her trance and delivered her baby. A fond memory.

Anyway, there are some old studies I recall showing reduced nausea in chemotherapy with hypnosis. These all preceded the nice new drugs to combat chemotherapy induced nausea, and Kay will certainly use the meds, but maybe I can take partial credit.

Last night we watched the M's until they seemed to have all in hand, an 8-3 lead in the 6th inning, and then watched the season finale of our one TV show together we had on the DVR. Saturday Night Lights season is over, and we switched back just in time to see the last out of a 9-8 M's win. Oh Keith, tough to see those Angels 5 1/2 games behind so early in the season.

Anyway, we plan to enjoy the end of the weekend, and face the week well rested.


Saturday, April 25, 2009

Shoe Garden

Earlier this week my running buddies delivered a garden sculpture to my yard to cheer me on my new path. Old worn sneakers filled with flowers snaked across my lawn with a placard of me reaching the finish line and an inspirational quote from Isiah. Last year we were inspired by Coach White to compete in the Tacoma City Half Marathon. Some walked, some ran, some did both. We all finished whether it was the 10K portion or 13.1 miles, with big smiles. There are a lot of pairs: Karen, Leda, Monica, Christy, Wendy, Jessie, Heather, Cheryl, Patty, Mary Rose, Sue, Colleen, and Sue B.  Keep them all in your thoughts or cheer them on May 3 at this year's Tacoma half marathon.  Jean will be graduating that day in Portland.  

Satruday Rocks

We have all had a good day today. Started with pancake breakfast for Kay about 7:30 after a pretty good nights sleep. Then at 9:30 Kay's church running group finished their final 12 mile training run and got together for a celebration breakfast at Patty and Paul Freese's house. Some people will go to any extreme not to run that far, and still get invited to a celebration breakfast. Kay and I joined them and feasted on eggs, bacon, coffee cake, fruit, mimosas, and good company.

Home for a rest, then as Kay woke up just a few minutes after Synnove Turner brought us a roast chicken dinner, we had an early dinner about 2 PM. My plan for the weekend was to get three meals into Kay each day before she got tired late in the day, and generous friends made that easy today.

After another rest, suffering through NFL draft boredom, and a little yard work (I am learning that the spring spruce up of the garden that Kay usually does pretty much on her own is as much work as I thought it was, far more than she thought it was. Maybe it is true that doing what you love is not work. Kay loves gardening. I think it is work.) we went on a drive. The front seat of the minivan is comfortable for Kay, and we drove through Orting, stopping for a milkshake and snack for Kay (and Brett) at the Parkside Cafe, then off to enjoy a sunny drive through Kapowsin and back home.

With the Mariners to entertain us tonight, we look forward to a nice evening, and a better day yet tomorrow. I hope to rejoin the choir to sing at services tomorrow, and Kay hopes to come late and leave early to church, duck in for the sermon and communion. Let's see how the night goes, but it sounds like one more step towards normal.

A great weekend to all.


Friday, April 24, 2009


Today was a day with no procedures, no drama, and Kay enjoyed just relaxing. Her pain since the replacement of the biliary drainage tube is considerably less today, and seems even better since I took her staples out this afternoon. After all the really big procedures Kay has faced with grace and bravery, she has been dreading removal of her staples. I have tried to assure her it was no big deal at all, but she has a very large incision, 41 staples on the incision from the xyphoid to the pubic bone area, that she had just dreaded facing this. As promised it was easy, and she is soooo relieved. Also less tugging and pain with movement, etc.

Kay did have a blood draw today, and Mary Rose took her to this, and on the way home they stopped at a drive in for a BLT, fried, and a chocolate milk shake. Good to see Kay thinking about food at least.

We had a nice sit in the sun of the front yard this late afternoon, really enjoyed having Cheryl W. bring us dinner, and watching the M's dominate Keith Colmar's Los Angeles Angels of Anaheim. I know it's a long season, but it feels nice to look at the standings.

Probably the highlight of the day was an incredibly thoughtful, fun, and just delightful gift box from Betty Caton, a long-time friend of mine, and good friend of Kay's from Maine. Don Caton was one of my closest friends from Bowdoin, and I lived with Don my third year in Med school, and Betty has been a good friend since those days too. Betty sent a box with a large colorful carry bag/ purse with several individually wrapped gifts, including two pair of PJs, sunscreen for Kay's head after she loses her hair, individual gifts for Brett, Jean and me, and several other items. Each item had a humerus card explaining why it was included. We sat in the sun, Kay opened the gifts, and we just marvel at the love and caring that is reaching us from all directions.

Off to sleep, and looking forward to a weekend of healing, rest, and relaxation.


Thursday, April 23, 2009

Progress today

The dreaded NPO after midnight again last night, but all for progress today, as Kay had the short term biliary drainage tube replaced with a longer lasting and better drainage tube ("stent") placed again by Dr. Frood. This is a small plastic tube placed through the obstruction at the common bile duct to allow bile to drain into the duodenum. The drainage tube that had been placed both internally and externally, was replaced with an external tube, designed to stay in place to drain additional bile if needed for a few days, and then be removed after we are sure the new stent is working well.

Jean and Cheryl W. went to the hospital with Kay for the procedure, and I stopped in just before she has the procedure done, and returned as it was finishing. Kay went through this with flying colors. Kay is always funny, interesting, and outgoing. You should see her with versed on board. Versed is a short acting hypnotic and anti-anxiety medication, sort of a like a super powerful but short acting valium. She loved everyone as she came out of her conscious sedation. She toke Mike, the sedation nurse who took over for John part way through the procedure she was over her crush on John, he was the new nurse in her life. She asked Jean to give Dr. Frood a hug and a kiss for her, as she could not get up to do it herself, and she generally kept us all laughing and light as she woke up. Much of these funny lines were even more funny the second time she said them, having little memory of saying them the first time.

She woke up hungry and thirsty, new feelings for her recently. Both we think good signs. She came home and Jean made her one of her favorite meals, Top Food roast chicken, baked potato, and petite frozen peas. She gobbled them down and feels like she can eat more. Hooray.

Now we feed and rest her for a day or two and pray for better liver enzyme tests. If not we start chemo early next week anyway.

Staples come out tomorrow, the bile drainage tube to external drainage comes out mid week next week, and then the much anticipated shower. Kay plans to stand in the shower until the water runs cold.

Paul Freese, Peter Wiederspan and I plan to go out for a beer tonight, the Mariners beat the defending AL champion Tampa Bay Rays 1-0 today, no big medical issues to think about tomorrow, Kay seems to have an appetite, and life seems to hold promise and hope this evening. Pray for more good days.

Thanks to all who follow us here, we are enjoying the comments, feel the love from near and far, and give thanks to God for so much grace.

Look tomorrow for photos of the shoe garden.


Wednesday, April 22, 2009

A day without much drama

Today was sort of an off day for Kay and her battle. The only news today was on a blood test for inflammation of Kay's biliary tract, called Alkaline phosphatase. In order for Kay to qualify for the clinical trial she is hoping to enter, this needs to be below 300. Yesterday it continued downward, from a high of over 800 to about 500. We had hoped it would be dropping quickly, and maybe have her get started on chemotherapy Friday, or Monday. Unfortunately today it was up a bit, at a bit over 600, and tomorrow she gets this larger biliary stent placed. Hopefully that will allow better bile drainage, and this test will quickly go down to normal. If not by Monday, we are going to start on the standard best chemotherapy regimen of carboplatinin and taxol and decide about possibly adding the avastin (unproven experimental treatment, hoped to be helpful, but currently in clinical trials including the one she is hoping to enter) outside the trial, or not. We will do more research and decide on that later if she does not get into the trial. She would not use this until her second course of treatment anyway.

Mostly rest and trying to gain strength today. Jean home, Brett visited, both off to the M's game tonight with good friends Alison and Andrew Desmond. Alison and Andrew are brother and sister about the same age as Jean and Brett, and longtime family friends. Nice that they can get out tonight.

We plan to be early to bed.

Wish Kay well tomorrow, this stent procedure is a technically difficult but important step for her.


Tuesday, April 21, 2009

Photos from Jean's walk at Relay for Life, ACS last weekend in Portland.

A luminary bag made for Gramma Pullen, fought cancer much of 2008. In remission now.
Jean walking with friends at her Relay last weekend.

Jean with her team at Relay.
Hope is ours.

No fear, Kay is fighting, and we feel the support.

Indian dinner

Today was a rough day for Kay. She just did not sleep well last night, uncomfortable, fitful, and today had to force herself to eat and rest. I worked a few hours this morning, Jean helped out at home, and when I got home for lunch, Kay continued to struggle. It was funny to see Kay laying in the twin bed Jean set up in her office, sipping her drink and pushing her lunch around on a plate, while Shan Vipond, good friend and part time employee of Kay, took care of some left over work. Not what we planned on the bed for, but it worked well.

We saw Dr. McCroskey today, signed up for a clinical trial using the standard treatments for ovarian cancer chemotherapy as well as an experimental biologic medication vs. placebo. Good thing- she had the dressing removed from her port-a-cath site on her upper R chest, so one less dressing to keep clean and dry. IF we can get the internal common duct stent placed Thursday, and the external drainage tube out, she will be unattached. (except to me of course)

It was emotional for Kay to read through all the informed consent associated with the trial, with page after page of possible side effects. Anyway, after our appointment there, Kay seemed to perk up, and we sat on the deck, and really enjoyed a curry dish prepared by TJ Singh MD, the boyfriend of my office administrator, and longtime local internist. It was the first time in a couple of weeks I've seen Kay really enjoy eating. Nice to see.

Kay's blood tests keep improving, and we hope she may be ready for chemo to start Friday, possibly Monday though. In the meantime Jean keeps making these small but calorie packed milkshakes for Kay. The consist of whole milk yogurt, ice cream, half & half, banana, chocolate syrup, and topped with whipped cream. Kay had two of these today, plus a modest amount of food. They look like most of us could gain weight just smelling them. Kay needs to, she is down about 10 lbs since her diagnosis.

Anyway, Kay and Jean are watching TV, I'm listening to the M's and the day is near done.

Sleep well.


Monday, April 20, 2009

Home again

Kay came home from Good Sam just after noon today. It’s nice to be at home on such a beautiful afternoon, sunny and warm, but mostly just nice to be home.

Kay remains in excellent spirits, is eating better, walking much better, and has a busy week ahead. Tomorrow she goes to see Dr. McCrosky for more blood tests. Thursday Dr. Frood is going to place an internal stent, to better drain the bile into the gut. Now most seems to be draining externally into a small bag that Kay empties every couple of hours.

Of note last night Kay participated, albeit long distance, in a Lakota healing ceremony. A friend of Mel Hillman, Jean's boyfriends Mom, is a Lakota faith healer. He led a ceremony for Kay and others with Mel in East Cape, Baha MX last evening. It is amazing and wonderful how many people are praying for Kay.

Today Jean also got back from school for the week. Brett is staying in Seattle tonight at his apartment there, and things seem good overall.

We got a nice walk in the sunshine today, and Patty Freese made a short but nice visit late afternoon. As the day wore on, Kay seemed to fatigue, and I need to remember how much her body has been through in such a short time. Tomorrow we focus on rest and relaxation prior to the doctor appointment.

Kay is going to try to return some calls this week, but I am encouraging her to focus her energy on eating, walking, and healing. More after Kay's appointment tomorrow or if any news comes up.


What a delightful person

That is how Dr. McCroskey described Kay to me on the phone this morning. Kay is feeling much better today. I get in early, we took a walk outside the hospital for some fresh air, and had a nice early AM together. I'm about to start work but Dr. McCroskey just called me and is really pleased at how well Kay is doing. She will probably come home after lunch today if she eats well. He saw a version of Kay closer to normal today, he saw her not feeling well at all last week, and as a delightful person himself, is very able to recognize another when he sees them.

Hope from here is to give Kay's liver a couple of days to recover, and probably start chemotherapy later this week. Jean gets back home today. Fay and Mary fly out this AM, thanks to Cheryl W. for being our on call airport limo service.

Another sunny day in WA.

Exciting news too is that my brother Bill and my Dad are coming for a quick visit so Jean's graduation on the weekend of May 2-3. In a perverse sort of way it is nice how difficult times bring great families closer together.

Well, off to work.


Sunday, April 19, 2009

Feeling better

I think Kay is feeling better this afternoon. I have really seen her only a little today, as she has asked me to have some "girl time" with Fay and Mary. This morning seemed like it was 3 days long, as I sat outside the interventional radiology suite praying for a successful procedure, having no idea it would take over 3 hours, and reading RE Lee on my Kindle. Did you know that the Confederates lost the War between the States? Just kidding of course. I chose this biography for our Rotary book club, as this month was Kay and my turn to host the meeting. Per Time Magazines listing of the 100 greatest non-fiction books of the 20th century, this is high on the list, and considered by some to be the best biography ever written. Well reading it has been a grind, though interesting and mostly enjoyable. I have just a little bit left.

By late afternoon Kay finally had enough of her "conscious sedation" drugs out of her system to walk around and feel better. Brett says that after she got up for a walk, she seemed to snap out of her sedated state, and look a lot better. When I got to the hospital about 5 PM after a wonderful bike ride on the Orting trail with Peter, she was eating, having a lively discussion with Mary and Fay, and looking like the Kay we all know and love. Brett and I left the girls to themselves, I had a Bourbon Pepperjack burger and sweet potato fries at the Ram with a Washington Blonde to wash it down. I wonder if Kay may be a blond after her hair regrows post chemo. I hear that it can be very different.

Anyway, dinner was almost as good as the taco soup for lunch (brought by Synnove not Mary Rose, sorry Synnove) for lunch.

Pray for good rest tonight, and home from the hospital soon, possibly even tomorrow.

Never thought I'd have people reading about my gastronomic adventures.


Bile drainage went well

This morning Kay went to the interventional radiology suite at Good Sam, and John, the self described "candy man" who administers the drugs for conscious sedation, and Dr. Frood were able to safely drain Kay's obstructed biliary system. There was a very high grade obstruction of the common bile duct, allowing very little bile to drain into the intestine. One advantage of being thin is that he was able to access the bile ducts through the left lobe of the liver, through the abdominal wall beside her prior surgical incision. This avoids the need to go from the right side between the ribs, the usual approach, and avoids the pain of this tube moving with each breath causing a lot of pain. They drained a large amount of bile, and were able to pass a small drainage tube down through the bile ducts into the duodenum. The tube has small holes above the blockage, and in the tube into the duodenum, so bile can drain into the gut. What bile does not drain that direction, can drain out into a small bag through the tube allowing complete decompression of the biliary system. We anticipate that this will allow Kay's bilirubin to go down to normal, and her liver to function normally, so she can start chemotherapy later this week. Kay was as I knew she would be, a "patient" and tough patient, allowing them to work for nearly 3 hours to accomplish all of this work. Thanks to Dr. Frood, the supporting staff, and all concerned for giving Kay their Sunday morning to do this excellent work.

Brett is with Kay now, Fay and Mary plan to visit this afternoon, and I'm going to nap. After a nap I'm going on a bike ride with Peter Wiederspan, and maybe other church friends, on the Orting trail. This is a beautiful biking and walking trail along the Puyallup River, through the Orting Valley. It was 71 degrees F and bright sun on my ride back home from the hospital. We are getting so much help, that it is blurring in my mind, but much thanks for the taco soup I have for lunch today. I think Mary Rose brought it, but I am honestly so tired now I just cannot think straight. I am happily tired though, nothing a nap won't fix.

Thanks for all your support. I hope this blog is as good for all of you as it is for me. I feel so much love and support from everyone I just cannot express my gratitude.

Love to all.


Saturday, April 18, 2009

A little rest makes everything brighter

Well, after a little rest things seem a little less discouraging. The nicest thing is to see Kay eating the best part of a turkey and mashed potato dinner, after eating a grilled cheese sandwich for lunch, and seeing her smiling tonight. It seems like her chills and some of her nausea have resolved on these antibiotics.

Tomorrow we get this stent placed in a different way and go on from there.

Tonight Fay and Mary are going to take the evening "sit" with Kay and Brett and I are going home to see the Portland Trailblazers first playoff game tonight. This new TV being put to good use.

We will likely channel surf the M's game at the same time.

Let's all pray for a good night's sleep tonight. OK and for another M's win and Trailblazers win too if we are really greedy.


Not to be

Dr. Hassig tried this morning to place a stent into Kay's common bile duct from the duodenum, but due to edema (swelling) and pressure from the cancer in the area he was not able to visualize the opening. Kay otherwise did well in the procedure, no complications, and so she was taken directly from the endoscopy suite to radiology where a CT scan shows that the bile ducts are dilated enough to make it likely that the radiologist can place a drainage tube into the biliary tree using a small needle and guidewire tomorrow AM. The hope is that he can then go through that tube to push a wire through the common bile duct into the duodenum, allowing the gastroenterologist to locate the opening of the common bile duct and be able then to place the stent that he was unable to do today. If this sounds complicated, don't fret. I understand, and so do Kay's physicians. This is definately not the way we had hoped things would go, but is really just a road-bump.

Kay is at the Good Samaritan Hospital now, Brett is visiting, Kay and Mary are going in soon, and I'm off to the YMCA to decompress. Marc Aversa, Kay's FP and my partner, visited me while Kay was having the procedure this morning, and it was nice to have his company.

The reason it is so important to get this stent placed is that decompressing the liver will allow full doses of chemotherapy to be used, and give Kay a better chance of getting the cancer to respond, allowing a better chance of a full remission and long term survival. Aren't words like remission, and survival terrible words to have to use when you are talking about someone you love? These are doctor words. Words like cure are what cancer patients, relatives, friends and loved ones want to hear, but cure is a term impossible to define. The only cure for life is death, so we fall back on this medical jargon.

We keep in mind that Jesus gave us the cure for death. Thanks be to God.

Thanks for your prayers. Kay is fighting hard, and we feel wrapped in your love.


Friday, April 17, 2009

The roller coaster ride continues

After such a nice day yesterday, today has had its good and tough parts. On the good side, Kay met Dr. Rob McCroskey today. I really like Rob, have known him for years, and asked him to be Kay's oncologist. Kay really enjoyed meeting him too. As an ironic aside, as we were sitting in the exam room, we saw a plaque on the wall with out name on it. It turns out that for our donation to the capital fund to build the cancer center, they named the very room Kay and I were using for her initial oncology evaluation as being possible through our gift. Amazing how life plays out.

Today Kay has been much more weak, fatigued, and nauseated than yesterday. Also when she first woke up I noted that she was jaundiced. Dr. McCroskey thinks that the cancer near the head of Kay's pancreas that had initially caused the elevated liver enzymes has not started to block the outflow of bile through the common bile duct. This is causing her to be nauseated, jaundiced, and to have chills. He asked her to go back in the hospital tonight to get some IV fluids and antibiotics, and to have a stent (small tube) placed in the common bile duct to allow free drainage of bile into the duodenum (first part of the small bowel, just beyond the outlet of the stomach. This will be place with a scope put down through her esophagus, stomach and duodenum and pushed in through the ampula of Vater, into the common bile duct. This is a pretty common procedure in these circumstances. Kay is excited to get this behind her, and get on with her chemotherapy. Having an explanation for her nausea and loss of appetite that can be fixed tomorrow is exciting, and we pray that this is extremely helpful.

What we had hoped to be a weekend of rest and nutrition, has become more eventful. We are looking at this as just a bump in the road. Keep us in your prayers. I'll keep you posted.

Fay and Mary are here, the Mariner's have rallied to a 5-0 lead, Patty brought a really nice dinner with apple pie, the sun came out this afternoon, Brett is home, Jean is walking at the Relay in Portland, and God is great.

Sleep well.


UP Beacon article by Jean.

Jean started participating in a University of Portland student team in the American Cancer Society Relay for Life last year. After Louise, my Mom and Jean's grand mother fought through throat cancer this past year the Relay developed a much more personal flavor. Now it is intensely personal. I am really proud of Jean for her courage and talent in sharing her experience in the student newspaper at UP this last issue of the 08-09 school year. You can read the article on-line at:

To see Jean's personal page at the Relay web site here is the link:

Keep Jean in your prayers tonight. She walks from 6-10 PM today. She is really anxious about her ability to "hold it together" in such a public environment with so many people likely to express their condolences and love. She is well known at UP, as previous year book publisher. She is going to do great, but could use all your prayers.


A quiet morning

We woke up this morning early, 4 AM, for a little repositioning, and to get comfortable, then dozed until 7AM. For you long distance followers, the glorious sunshine of yesterday, is back to the reality of rain today. A good day to just relax, fatten up, and be together.

Fay and Mary are being met at the airport this morning by Cheryl W. They should be here for lunch, and we are looking forward to their visit.

Kay and I watched nearly the whole M's game last night; too bad to see the winning streak end, but King Felix tonight.

Kay only had 3 pancakes for breakfast, but I didn't tell her I used no water, made them with whole milk yogurt and apple juice for liquid, so squeezing calories in at every opportunity. She liked them. Reminds me of shredding veges to hide in the spaghetti sauce when the kids were little.

Make it another great day, we plan to.


Thursday, April 16, 2009

Just a little bet better

Actually today was more than a little bit better, it was a whole lot better. Kay was hungry today. When Rob the milkman, aka as the best looking deliveryman in Pierce County a few years ago as published in the Tacoma News Tribune, came today to deliver our milk we were sitting in the sun in the yard after Kay had a snack of PB&J on crackers and milk. As he was leaving Kay asked him to leave two quarts of chocolate milk and more juice. A good sign that Kay is back to thinking about her next meal before she finishes the one she is eating. (This after a pretty good lunch, and before having spaghetti for dinner. ) Yes!

Earlier today, after the closest thing to nagging Kay has done since she got sick, I made the dreaded call for yet more help with the TV. 1-800-COMCAST to figure out why it suddenly stopped working. Like any red-blooded male, I figured I could do it myself, and hated to ask for directions. Finally after calling it took about 45 seconds of advice, and it was working fine again. Comcast really does have excellent over-the-phone help for most issues. (the TV was on channel 2, not channel 3, so had "no input")

Also today we took a drive after dinner. We went down to the Orting valley, and slowly drove one of our favorite local birding loops thought the fields across the Puyallup River. Not quite hiking 11 miles to find a Colima Warbler at 6500 feet elevation above the basin at Big Bend like we had planned to do today, but still a nice time together. We did see a Greater yellowlegs at a wet spot in one of the fields.

Tonight Kay agrees to let me watch part of the Mariner's game on the HDTV. I had to text Keith Colmar, Kay's older brother who is a big Los Angeles Angels fan, today to ask him how the Angels were doing. He reminded me it is a long season, but fun to be in this position now. Let's sweep tonight, go M's.

All for now.


The sun is out this morning.

We woke up this morning to sunshine. I WA that makes any day more special. So far off to a good day. Jean helped Kay get a shampoo, still no showers as we have to keep the dressing over her port dry. Morning tea, the newspaper, we are trying to make this seem like vacation. The difference is Kay is not devouring a big breakfast, just nibbling at bland stuff. Anyway we plan to make this a great day.

Kay plans to sit in a lawn chair and give me guidance as I plant the spring bulbs she had planned on doing about this time of year. We figure we may have more time at home than usual to enjoy looking at the garden, so want to make sure it gets planted.

Jean goes back to school today, has a class tonight, and I am encouraging her to stay for the weekend, have some normal life, and let me hold down the fort here for a few days. She has been like having the super combo daughter, housekeeper, hairdresser, cheerleader, and general all around cook and bottle washer.

Brett is back at school today and tomorrow. He also has been at Kay and my beck and whim this week. Although they have both been extremely helpful, and we love their company and support, it will be nice to have an evening alone tonight too. Just Kay and me, quiet, and on our own.

As I mentioned Fay and Mary (Kay's Mom and sister) are coming tomorrow, and we look forward to their visit.

Keep up the prayers, we feel all the support. I'm off to the YMCA before Jean leaves for Portland.


Wednesday, April 15, 2009

It Really Was a Girl Fart!

I was so glad to know that my condition of bowels didn't stir up remedies among ya'll except from my mother. I was wondering how that first bit of air might hit the world. Last night Ed and I took to the street of our cul-de-sac armed with a chair, plastic bag and my old green bathrobe in search of relief. After a few loops, Brett brought me out a pair of gloves, stocking cap and a blanket to toss over my shoulders. If you had set me out on Lexington Ave in NYC with a cup, I might have earned enough for a whopper. I was such a sight that my neighbor Rob came out to make sure we were alright. We left the chair on the sidewalk and continued our journey circling right and then left and then traversed the street of my neighborhood. Finally Ed got dizzy and I got fatigued and called it a day. In the Kathy McG family they only have flatulence as I heard that word from her son with a smile. But today is a new day and I woke up Ed at 6 am after a nice night of sleep to continue the quest for movement. After a couple of circles around the dining room table a sound escaped me. And it was so dainty not like the regular "girl fart". I asked Ed, "Did you hear it?" So now I am whole with the world. I am now eating and resting and continue to bask in the glory of all your blessings and love. Thanks for all your cards, flowers, messages, and extreme kindnesses. My love to all.


We've got gas

First night at home a big success. Kay and I both slept our best in a while, woke up early to get in a little walk, a civilized cup of tea at the dining room table, and the flood gates opened. Nice to put that concern behind us.

Comcast comes today at the usual, "Sometime between 8 AM and noon" time frame. We used our new TV to snuggle, Brett between me and Kay, and watch two sessions of Entourage, Kay and Brett's favorite TV show together. I had boycotted this previously, but actually it is not a bad show at all.

We (all but Kay) enjoyed Linda Sinden's steak dinner last night. Kay had a lot of nausea last night, we put her back on clear liquids. She thinks stopping opiates has been the big breakthrough. Just Tylenol since last night. Pain is not a big problem for Kay now, and if the gas all passes, and Kay can start eating better, all should be on the mend.

We are all home today, Brett is skipping school today, Jean is home, I'm home and we should have a great day.

I plan to slow down on the posts now, as things seem pretty calm.

Best to all.


Tuesday, April 14, 2009

Nothing like your own bed.

We got home about noon today, after Kay had her port placed about 8:30AM. Kay's first order of business at home, a walk in the fresh air, from the end of the driveway, to touch the basketball hoop pole on the opposite side of the cul-de-sac, and then into the house and into our bed, already make really inviting by Jean.

Oh! NPO is nil per os (latin for Nothing by mouth) Norm, I like the list you got, and like the comments.

This afternoon consisted of a nap in the same bed with Kay, nice to share a bed again, then off to the pharmacy for the Rx from Dr. Safarri. Back to give Kay her pain meds. Then a bit of lunch which led to nausea. Much of the afternoon spent trying to figure out a plan for how to try to get nutrition without nausea. The problem? Guess. Still no gas. My conclusion is Kay has been moving too fast with progressing her diet, and we are going to try reducing the pain med a bit, more walking, less food, more fluids, and see how the night goes.

Brett thinks there are lots of good omens. Easter Sunday dawns just as Kay starts to recover from surgery, and the Mariners off to a great start. I just think Kay is awesome, and is recovering in the way I expected her to. Either way, we'll take it.

Off for another walk.


No place like home!

We're out of here today. Kay is a day ahead of usual schedule, and though the prayed for flatus is yet to arrive, we are going home anyway. Kay got a good night's sleep and feels really good today. We've been up for our tour of the four oncology pods and Kay has declared to all that the A pod rocks. None-the-less it can rock on without us.

Jean is home this morning doing last minute preparations. We have been coveting a HDTV for a while, and yesterday I visited Costco and got a nice 40" flat screen, and blue-ray player. Kay is going to have a bedroom home theatre to enjoy.

Yesterday Cheryl bought Kay a really pretty floral pattern robe, and she looks really good. A shower and shampoo at home today will finish the look.

We expect to be home by early afternoon if Kay can get her port placed early on the schedule this morning. She sure hopes so as the dreaded 3 letters of being in the hospital apply now: NPO.

We're off now for the port. Got to go.


Monday, April 13, 2009

Pray for gas

As any of you who have had major abdominal surgery may recall, it is not uncommon for the bowel to be inefficient at moving its contents along. A prerequisite to progressing to a regular diet is to pass gas, and so far none to be had. We spend so much of our lives holding gas in, and now Kay is focusing on the opposite. Strange thing to talk about after the 7th grade.

Kay continues to be a strong, she has walked a great deal today, and is just exhausted. We hope this leads to a good night's sleep. I plan to go home tonight earlier, because if I can be well rested tomorrow it will make taking Kay home a better experience for all. I got out of the hospital from 12-5 today, and made good use of the time. I went to the office, got a patient care schedule set up starting next week. Very limited hours, but many patients were really concerned that I had stopped scheduling new appointments for a couple of days, leading to anxiety on some patient's part. Now at least they know I have not stopped working, just cut back for a while. Then I took care of a few administrative and patient care details, and got Kay her initial oncology appointment for Friday afternoon, checked some insurance details, and got to the YMCA for a good workout. Only planned thing that did not happen was a nap. We hope to start chemo early next week. As I mentioned earlier she will be getting an indwelling "port" to use to give chemotherapy placed in the morning tomorrow.

Kay had quite a few visitors today, too many to mention by name, but she enjoyed the company, though is pretty exhausted now. If she goes home tomorrow we will need to see how she is feeling re visits at home. I'll keep info re this "posted" here.

As usual Jean and Brett have been here a lot today. Keep Brett especially in your prayers as he is commuting to and from Seattle for visits each day (pray for safe drives) , living alone there, and with school, homework, visiting Kay, and the commute really burning his candle at both ends. Tonight he needs sleep, and I think he is committed to having rack time to get it. He is sitting with me in a very nice family room here at St. Joes Oncology floor, doing his math homework. Pray for restful sleep for him.

Overall a very positive day. I'll keep you informed when the the gas passes.

Love to all.


A new day dawns

Well today got off to a pretty good start. Kay is feeling tired today, she thinks the adrenaline of all these new challenges is wearing off. I think she is anemic, sleep deprived and sedated. We are probably both right. Anyway, Dr. Safarri's visit helped put a bright side on the morning. He is a kind and positive person. He declared Kay to be progressing in her post operative recovery faster than most patients, and we may go home tomorrow. Kay figures all this training she has been doing has her fit for a different type of marathon than she was training for. God works in mysterious ways.

One pretty cool think that happened yesterday is that Colleen Gray and Stan Shaw somehow got photos, letters, and all sorts of stuff and had a big poster printed for the hospital wall. For some reason an iPhone photo does not seem to work to post to this page, so you'll have to see it another time.

Tomorrow Kay gets a port to use for her chemotherapy, and the plan is to see Dr. McCrosky next week to start the chemo then. I think we will be able to do this at the Cancer Center in Puyallup.

Brett is back at school today at Seattle Central Community College, and Jean is going to be in soon to visit. On the agenda for today is lots of walking. The deal breaker for going home is to have adequate bowel function to "pass gas." Kay asked if she could have a bean and cheese buritto, but not to be.

I had a good talk with Becky Sullivan yesterday. Becky and I are long time friends, and she has always been someone I can talk with about important issues in my life. She was my residency director at Madigan another lifetime ago, and her support as a "physician friend" is something I appreciate.

I think Fay and Mary may be coming up to visit next weekend. That should be a good time as it will be after we get settled in at home, and before Kay starts chemo. I really don't have anything witty to say this morning, but appreciate all of your prayers and support. Oh, I did learn from Jean yesterday that you guys can comment back. It was fun to read the comments. I read many to Kay, and we enjoyed that. Learn something every day.


Sunday, April 12, 2009

Christ is Risen!

He is risen indeed. I made an early call to my brother Bill in ME this morning at 5 AM here, and forgot that they had already been to Easter sunrise service. I remember as a child going each year to sunrise service on a hillside looking east over never-ending fields and hills to see a glorious sunrise as we shivered in brilliant sunshine. (at least that is my memory 50 years later) Quite a difference from our sunrise services here where we know it is sunrise because it is no longer raining in the dark. Needless to say our family missed Easter services at Celebration Lutheran today, but Paul came this afternoon and we had an Easter prayer here in Kay's hospital room.

Kay has been an even more vocal witness than usual since her diagnosis of cancer. She has really felt the grace of God enveloping her in His strength.

Of note Jean for the second year is participating in a Relay for Life next weekend in Portland. She is raising funds for cancer research, and if anyone wants to contribute to her effort, you can use the link below. Feel no pressure at all, but if you feel able and moved to contribute, go for it.


First night behind us

Kay had a good first night post-operatively. Her pain is under pretty good control. She got about 4 hours of sleep and rested much of the rest of the night. Her naso-gastric tube came out a 4 AM, and she is now able to take clear liquids. Blessedly no nausea at all from anesthesia, and her spirits are good.

We have such good friends. Love has been showered upon us, via e-mail, phone calls (thanks to all for keeping these from being too overwhelmingly many and forgive me if I don't get to voice mails, i think the VM box may be full) Andrew Desmond and Marc Hillman have been the point support people for Brett and Jean, and Kay would definitely call them King Cobras. Paul Freese and Peter Weiderspan sat with me during surgery, and were great support. I appreciate Toot Reid and Scott Bailey, who came and sat patiently, quietly supportive, and not needing my attention, which was to say the least scattered widely. The news during surgery was such a roller-coaster. First promising, then discouraging, then news the surgeon would be out to talk to us sooner than expected, but not knowing why. It was very emotional.

I had a good talk with Kay when she woke up at 4 this AM. She wanted to know more details while she was more alert, i.e. not on so much pain medication. We discussed that more tumor was left behind than we had hoped would be the case, but that things are really not different. We are still relying on chemotherapy, Kay's own tough immune system, and God's grace and all of our prayers to help her heal.

She is especially focused on Jean's upcoming graduation now, and we will be facing the dilemma of trying not to postpone her first course of chemotherapy, yet letting her participate in some way to the graduation celebration. Peter W. is going to help us do this electronically if needed.

I'm going to close now. Thanks for all your support and prayers.


Saturday, April 11, 2009

Surgery done

Kay is now in recovery room and we just met with Dr. Safarri. He was able to remove a good deal of the cancer, but unfortunately had to leave more cancer in Kay's abdomen than he had hoped. This means that intraperitoneal chemotherapy will not be effective, and that she will be getting IV chemotherapy. This is likely to start in about 2 weeks.

This is difficult news, but we are going to hang tough, give Kay our full love and support. We know you are all going to do the same.

I don't plan to post again today.


News after 1 1/2 hours of surgery

The last message was cryptic. Dr. Safarri is finding more cancer and the surgery is going to take quite a while. Although this does not sound very encouraging, we are remaining hopeful, and praying for the best.


Kay's Favorite Gift Pre Surgery

FIrst news is not bad.

I just got the initial news from the OR. Dr. Safarri sent a messenger out to let us know that as expected the frozen section pathology confirms that Kay has ovarian cancer. The positive thing is that he is going to be able to go ahead with extensive surgery to try to remove as much of this cancer as possible.

Keep on praying.

Love to all.


Off to the OR

We woke up this morning to find Kay putting the finishing touches onto love letters to the children. Pastor Paul was helpful in assisting Kay in putting her thoughts into print yesterday. She got some rest after the "Cherry flavored" magnesium citrate finally did its job, and after waiting at the hospital pre-op area for a few hours, she was off to the operating room at 12:45. I expect surgery to actually start in a half hour or so, and to have an initial status update sometime after 2:30 PM PST.

On a light note our God-son Ethan Wiederspan and his older brother Peyton, sent a video over to the house this AM, delivered by Kay's running group. It is really funny, and Brett will post it for all to enjoy, as it is above my IT pay grade.

We have a great support team in place here. Marc Hillman, Jean's boyfriend, is up to be with her. Andrew Desmond, a longtime friend of the family, Brett's closest friend, and one of Kay's favorite people, is here to keep Brett company. Paul Freese, our pastor and good friend, is here to be with me. Dr. Safarri and his team are working to get rid of this cancer. We have all decided that as of this moment this cancer has had its time to thrive, but now we are on the offensive. First surgery, love and prayers. Follow this with whatever additional weapons we need to beat this alien disease.

More news when I have some.


Off to St. Joes

Well, we're off to St. Joeseph's Hospital in a few minutes. Kay feels ready, the night passed pretty well. Simon at Jean and Ernie's house, Marc coming to support Jean, Andrew as a friend for Brett, Paul will be there for me. We hope the waiting room is big enough for all that love. We feel your love. More to follow this afternoon.


Friday, April 10, 2009

Just about ready

Today has been a good day. Kay continues to be her usual great Mom and wife. She woke up at about 4 AM, and I think this is like the nesting prior to both children were born. She had energy not seen in a few days. By the time I got out of bed at 6:30 she had already called and arranged for a friend to shop for dinner for all of us (except her, limited to clear fluids and currently trotting as part of her bowel prep). We were blessed with an early Easter service, Pastor Paul thought we were having our own Good Friday, and we got to pray together with him.

Jean has a surprise photo gallery to put up in her hospital room all together, and we feel we are ready for surgery tomorrow.

Kay says she can feel the prayers surrounding her, and feels the grace of God on her and with her today as never before.

All our love.


Family Photos

One of Kay's usual great ideas. We had her friend, and freelance copywriter, photographer, director, etc. take some family photos in his backyard Wednesday. Enjoy.

Thursday, April 9, 2009

A better day.

Today was a long and exhausting day, but one that left us more hopeful. We met Dr. Safarri today, and he seems strong, confident and competent. He feels after examining Kay, and reviewing her tests so far, that there is a good chance he can remove most of her tumor surgically. Surgery is set for noon Saturday at St. Josephs in Tacoma. Kay will be in the hospital from 4-8 days depending on the extent of surgery needed. The plan is to do a hysterectomy bilateral oophorectomy (remove the uterus and both ovaries for those non-medical readers) and to remove any tumor possible to be excised to include the omentum (fatty apron in front of the bowel), the gall bladder, spleen, and bowel deeply involved if possible, and any other areas of tumor found that can be safely removed. He explained that he is just doggedly persistent, working as long as it takes to do this, sometime 5+ hours.

Tomorrow will be a tough day as Kay needs a bowel prep, i.e. take medications similar to the preparation for a colonoscopy. Lots of time near the toilet. No solid food after breakfast tomorrow, clear liquids until surgery after that. We'll show up at the hospital at 10 AM, and settle in for what we hope is a long and positive surgery.

We had some of Kay's close girlfriends over tonight for a love-fest. Kay has been really tired, she only was able to last about 90 minutes with company and we kept the group small as Kay's endurance has gone from running 9 miles just 12 days ago, to being so tired she needs to lie down every couple of hours now.

Jean and Brett are home for the weekend, and we plan to spend tomorrow together. We are looking at this as a time for use to live together, and enjoy each other as we did when the children were small. A perverse way to have this time together, but we are making lemonade here.

I'll keep this from dragging on, and expect future posts to be more terse.

Keep us in your prayers. Our love to all of you, and we feel your love coming this way.


Wednesday, April 8, 2009

Rough news from the Pullen's

I am going to use this blog to keep those of you we love and know updated regarding our circumstances without sending out too many e-mails. Kay has been diagnosed with ovarian cancer, and she is meeting with a top oncologic gynecologic surgeon tomorrow, Dr. Safarri, at 10 AM. We will know more after that meeting, but we are expecting a surgery on Saturday. At this point what we know is that the ultrasound and CT scans show that the tumor likely has spread beyond the ovary, into the pelvis and abdomen. The CT scan shows no evidence of the tumor in her lungs, or her liver. The surgery will give us a lot more information, and a formal "stage." We expect chemotherapy to follow shortly after the surgery.

Kay had been training for a half-marathon she was not going to run. We had planned to leave Saturday for a 10 day birding trip to central and west Texas. Ken Brown, one of our good birding friends, Vera Cragin and her husband Jack, were going to join Kay and me, and meet another friend living in Texas, to go enjoy some sun, birding, and wilderness. The marathon Kay and her church women friends were training for, the one Kay ran last summer, was while we were going to be away. After a 9 mile training run a week ago Saturday, Kay noted pain in her flanks. She thought it was a bit odd, but that she must have strained something. On subsequent runs over the next few days, she had abdominal pain, started to feel like her belly was swollen, and within a week, it was apparent that something was wrong. We got some blood tests done Sunday at the Same Day Clinic, and Kay saw Dr. Aversa Monday. The blood tests showed her liver enzymes were very elevated, and an ultrasound Tuesday (yesterday) showed a large mass on the right ovary, and what looked like tumors in the pelvis and abdomen. We arranged a CT scan of the liver and chest today, that look like there is no spread to the liver, lungs, or upper abdominal lymph nodes.

Kay is feeling weaker by the day, having some nausea, but keeping her spirits up pretty well. Jean and Brett came home today, we had a friend of Kay's, Paul Blanchard, take some family photos, as we have put this off too long.

Please keep us in your prayers, but we are really busy, and exhausted right now, so leaving us some space, and not calling or visiting for a few days would be best. Keep Kay and all of us in your prayers.

Ed Pullen