Wednesday, September 30, 2009

Yosemite

The big question is whether it may be more beautiful by moonlight than by daylight. This evening, after a great hike midday, and exploring the Yosemite valley in the daylight, we went for a sunset dinner at Glacier Point. The colors of sunset off the granite cliffs was spectacular, but on the ride home we stopped to see the strange and wonderful white cliffs by moonlight. It is awesome, in the God created this, he is an awesome God.

Kay held up really well today on a hike listed under the "strenuous" category, though we both thought moderate was more appropriate we felt pretty good when we thought, "we did a strenuous hike!"

Overall Kay is feeling stronger than she usually does in her third week post chemo, and we are looking forward to finishing this vacation with a few more great days and then putting the last course of chemo behind us next week.

Keep Jean in your prayers tomorrow as she takes a section of her CPA exam.

Ed

Monday, September 28, 2009

You can't take the California out of the girl

Kay and I had a wonderful SoCal day today. Slept in and then went to the beach. At Huntington beach we took a great barefoot walk in the wet sand, then went swimming and body surfing in the 65 degree El ninyo water. Then met Kay's nephew Matt for sushi lunch. After a leisurely lunch and a nice visit we stopped by Mary and Jim's in Fullerton. We love Jim's art, and bought some pieces to bring home, saw the kids, the chicken, and left for Fay's.

Fay, Vince, Kay and I enjoyed a nice bottle of wine Ken had given us when we saw him earlier this trip, and went out for a nice dinner. Now we are relaxing, packing for an early departure to beat the LA traffic. Plan is for breakfast somewhere north of LA.

Tomorrow night we plan to stop just shy of Yosemite and get there early Wednesday. Tonight we are finishing the Burns documentary on National Parks, which fortuitously starts with the story of Yosemite.

Wish us safe voyage and adventure.

Ed

Sunday, September 27, 2009

Colmars aplenty

Today we arrived at Fay Colmar's at about noon. This is our turn around spot on our trip, and a chance to visit with Kay's family, do laundry, rest up, and get a little more beach time. Today we had lunch at Fay and Vince's, then went to see Caroline, Mary and Jim Dahl's youngest daughter play a soccer game, and then met at Keith Colmar's for dinner with Mary, Jim, Michael, Christopher, and Caroline Colmar-Dahl, Vince and Fay, and Keith & Matt Colmar. It was nice to be with Kay's family again, and to see everyone doing so well.

Vince is struggling with low back trouble, but remains mobile, and is still as sharp as ever. Fay is doing some new art with melting acrylic photo holders and then air brushing and adding mixed media. They are really cool. Vince and Fay are also in an acting class, and entertained us at dinner with monologues. Matt, Keith's son, is a blossoming photographer, and it was nice to see him again. All-in-all it was nice to see everyone again, and renew the family bond.

Kay continues to do great. On this trip we have really had no Cecil related problems, and Kay's energy has been really good. Not even a sniffle, and we have been having a really great trip.

Tuesday we'll get an early start and will head north again, taking two days to get to Yosemite, spend two days there, and then stop at Scott and Erin Colmar's place for an overnight visit, then a two day ride home.

Pray for no infections related to close family contact with children in school, for continued happiness and smooth travels, and for a safe arrival back home next week.

Ed


Saturday, September 26, 2009

San Simeon - Hearst Castle

No photos, Kay's camera battery dead, but what a great tour. Today we toured this amazing place this morning. W. R. Hearst was a pack rat of the finest type. Apparently he collected over 200,000 objects in over 500 categories, including antiquities like ceilings, fireplaces, and what he called the "headlines of history" all over the walls of his home were ancient fabulous tapestries. The vistas were incredible, and the scope of the estate beyond vast.

From there we went for another lunch with a view, sitting on the very front of the Moonstone Beach Bar and Grill. An understated name for a pretty incredible place. Good food, but the view from the outdoor patio was killer.

Then a longer drive than we have been doing lately, about 170 miles to a small town Oxnard, basically a bedroom town as a place to stay without paying Santa Barbara like prices, and just a short dash tomorrow to Orange County to visit Kay's family for a couple of days. We decided to spend one less day on the coast, in order to make a two day drive to Yosemite instead of a long one day drive when we start north.

Kay remains well, is growing new hair, though we can't figure out why, as she is back on chemo. We'll see if it "sticks" of if she starts over again. Anyway, sunshine makes us happy, and we are having a great trip.

Ed


Wednesday, September 23, 2009

Pelagic Birding tomorrow

Tomorrow Kay and I leave early for a boat trip out of Monterey Bay on Shearwater Journey's, a pelagic bird watching tour led by Debra Shearwater, aptly named, who is one of if not the world's expert in pelagic birding. Pelagic birds are those who spend their lives at sea, come to shore only to nest. We hope to find several life birds each, and are hoping for calm seas and no motion sickness, but are going to be properly drugged to try to prevent this malady.

Today we toured the sights around Monterey, including the aquarium, "17-mile drive" seeing Pebble Beach, Spyglass, and other famous golf courses, as well as beautiful beaches and coastline. Lots of sea lions, birds, seals, and both sunshine and fog.

Wish us luck and lack of sickness tomorrow.

Ed

Monday, September 21, 2009

Bye Bye San Francisco

For the last 2 days we have really enjoyed visiting old friends. Today we got up late, after lots of good food and wine last night, and after a quick breakfast at the hotel went to Bodega Head, a high bluff overlooking the north side of Bodega Bay. Really nice surf and rocks.

Then we left Ann and John, and headed for San Francisco. We planned to go south on Hwy 1 to the Golden Gate bridge, but somehow missed a turn, ended up in Petaluma, and took a more direct route to the city. In doing this we missed Pt. Reyes, and a 30 mile or so segment of the coast, but did not feel badly as everything was pretty fogged in this AM.

We met up with Cecile Lozano, a longtime friend of Kay's from San Francisco and NYC, and of mine from NYC when Kay and I lived at West Point. We met Gary Clarion, Cecile's partner, and saw his art, had a nice visit, especially enjoyed looking at Cecile's old photos of our children as babies and young children, and then had a wonderful meal at a local favorite restaurant of theirs.

Then over the hills and on to Half Moon Bay, in the dark, so I'll tell you about this place after seeing it in the daylight.

The fun goes on. Kay is doing well, a bit tired as we are now on day 6 post chemo #7, but having fun, and on vacation.

Ed

Sunday, September 20, 2009

It's probably illegal in Sonoma

Drinking a nice French Cabernet in the hot tub with a view of Bodega Bay from a coffee mug. I broke our wine glasses a day or two ago packing the car, so until we get shopping, so be it. The wine is nice, the company terrific, and our trip is going even better than we could have hoped. Fabulous weather every day, vistas about every 1/4 mile, too much good food, and lot of rest too.

No Internet last night, so no post. Last night we stayed at Point Arena, in a nice old Inn overlooking the harbor. Fish tacos and a pitcher of local micro brew made for a great evening. The hot tub in the room, fireplace, and king size bed made for a nice night too.

The day was made extra special when in a brief interlude of cell connection I used the iPhone to see that the Huskies beat USC.

Today we drove only about 80 miles to Bodega Bay and had lunch with Ken, Kay's big brother. Now we are just resting by the hot tub and enjoying the wine and sunshine. Ann Heatley, Kay's lifelong friend, and her boyfriend are meeting us for dinner.

Overall just a beautiful day.

Ed


Friday, September 18, 2009

California or bust

At lunch today Kay said, "We are so lucky!" I asked why? She said, "That we met each other and have our lives together." I have to agree. Life has been pretty incredible for us. Certainly the last few months have been a challenge, but look at us now. We are together, and on a great adventure.

Today we got up and tried to track down some shorebirds at Coos Bay, OR. Not much luck, but found a pretty road along the river to check out. Then we drove south to Bandon, OR. a.k.a. Brandon by the Sea. We went there for two reasons, first to check out the Brandon Marsh NWR, a top shorebird spot. The tide was high, and the birds were so far away that even with good optics they were just shorebirds, without sharing their ID to us.

This left us with an hour or so before the other reason to visit Brandon. We found out on-line that the Brandon by the Sea Rotary Club met at at noon on Fridays, and the program was a wine tasting. Too good to pass up. Before the meeting we went to the Jetty at the entrance to the harbor, birded a bit, marveled at the beauty of the huge offshore rock formations, and enjoyed the sunshine. Then while looking for the meeting we saw vista after vista. This is truly a beautiful little town. The speaker at the meeting was the manager of the local pharmacy, and a wine aficionado. It turns out that his pharmacy is much better known for its wine selection than its medications. After the meeting we went there and chose two of the nice choices from the tasting.

Then off down the rest of the OR coast, into CA, and are staying the night at Arcata, CA. Tomorrow on south.

Another great day under our belts.

Ed

Thursday, September 17, 2009

Day 1 of our Adventure

Today we woke up at Cheryl and Peter's place at Cannon Beach, and started our first day of vacation. Our favorite breakfast place at Cannon Beach is Lazy Susan's so we had a nice breakfast there. Then a peek at the beach, and we were off. The day was beautiful, except for intermittent low fog on the beach, at times obscuring views. We stopped at too many beaches to mention, but as you can see, Kay stayed busy documenting each of them.

We got to Coos Bay, OR about 5:30 PM and I had a place all planned for us to go shorebirding. Unfortunately the road to the mudflats was chained closed, and so we settled for checking out a city park, having a nice dinner at a "Texas comfort food" place, and are pretty beat. Going to bed early, to be set for another great day tomorrow.

Pray for no problems from Kay's recent chemo and for a great trip. Enjoy this and every day.

Ed

Tuesday, September 15, 2009

Chemo #7

Kay had her 7th course of chemo today, and as is usual it seems everything went just fine. With the alternative to Taxol she received this time the infusion went much faster, and she was "only" there for 3 1/2 hours.

Tonight we are tying up loose ends, and getting ready for our great adventure. We leave after work tomorrow for a 17 day car trip from Puyallup down the Oregon and California coasts, then back up the highway with a 2 day stop at Yosemite. Neither of us have seen this whole route, and we are pretty excited. It was planned long ago as a 25th anniversary trip, and now doubles as an almost-done-chemo celebratory trip.

I'll plan to give frequent photo rich updates on this site.

Pray for no chemo difficulty on the road, and enjoy our trip vicariously with us.

Ed

Friday, September 11, 2009

Long Day - Change in Plans

Today was a very long and eventful day for Kay. We started by leaving early enough to miss some traffic and to be at the Seattle Cancer Alliance for an 8AM appointment. Actually we had 4 consecutive appointments. It is a very efficient, patient focused method. The flip side is that the way it works is Kay and I entered a doctors type exam room at 7:45 AM, and essentially stayed in that room until noon. (potty breaks allowed)

The first appointment was with a team of 2 genetic counsellors. They reviewed Kay's family history of cancer, the results of the BRCA genetic testing, and we talked about how to go about assessing Kay's family members for this genetic defect. I will pass on trying to explain this here, as Kay needs to discuss this with several family members personally.

Next we met with a medical oncologist who specializes in breast cancer treatment. We reviewed Kay's options for trying to avoid or detect early breast cancer. Unfortunately with this gene, Kay has a lifetime risk of breast cancer that is extremely high, maybe as high as 80%. Our plan is to screen aggressively with breast MRI and mammogram annually until we see if there is any recurrence of the ovarian cancer, and if none in a couple of years, consider a prophylactic bilateral mastectomy.

Next we met with a gynecologic oncologist. She reviewed all of Kay's test results, and we had a long discussion of the options from this point on. The good news is that there is no convincing evidence that Kay has any cancer detectable at this time, i.e. remission. The rest of the story though is that there is a better than even chance that the cancer will recur at some point. This leads to a discussion of whether careful watching and waiting, or some additional treatment is the best approach. After looking at several options, given that there is not any proof that any one of the options is best, and reviewing the advice from Dr. Safarri that Kay receive an additional 15 courses of the new drug Avastin, we decided that an alternative may be best. The logic for this change in plans is that:

First - there is no proof at all that the course of Avastin leads to a better chance of cure. All we know is that in some women with ovarian cancer that recurs, Avastin can give fairly long term help at stopping further progression of the cancer. The primary attraction of the Avastin is the hope that it may work combined with the relative lack of side effects. None-the-less life threatening side effects can happen, and it is not risk free.

Second - at the time of surgery Kay had a lot of cancer that could not be surgically removed. This cancer responded really well to the combination of Carboplatinin and Taxol that Kay got, even before we started the Avastin.

Third - the CA-125 level did not get down to the goal very low levels until after Kay's 5th course of chemotherapy, and this leaves concern that there is a high chance of tiny areas of residual cancer, too small to detect, but still present, that could possibly be eliminated by additional courses of the same chemotherapy.

Fourth - Women with the BRCA gene seem to respond especially well to platinum based chemotherapy, as their cancer cells which lack the gene for repairing the type of damage done by this type of drug are especially susceptible to this treatment. It seems that women with this BRCA defect who get a good response to chemotherapy may have a somewhat better chance of long term remission or cure than women with similar stages of ovarian cancer who do not have the BRCA defect.

After trying to digest all of this, we decided to go ahead with 2 additional courses of the traditional chemotherapy plus the Avastin, rather than the 15 courses of Avastin. The only change will be Kay will get a slightly different type of Taxol-like drug to try to avoid the nerve injury, peripheral neuropathy, she has developed. Kay will get her 7th course Monday. We will leave on our trip as planned Wednesday, and will be back 3 weeks later for an 8th course if the 7th goes well. The big concern will be whether the neuropathy gets a lot worse, and of course avoiding chemotherapy related complications like infection, bleeding, etc.

After all of this, we met briefly with a nutritionist, who had really good advice, but we were so overloaded with information by then we asked her to keep it really brief. Kay asked for a "lightening discussion". Basically she told Kay to eat more, and gain some weight, but once at ideal weight to not get fat.

From here we raced back to Puyallup, rested a half hour, then went to the GI office to get Kay's stent removed. This went very nicely, and after a brief scare in recovery where Kay "did not feel good" and had everyone concerned, she responded well to some juice, IV fluids, and lying down for an extra hour or so, and we came home.

Off to a quick dinner at Olive Garden, now home for rest and to give thanks for a full day done.

Pray for no complications of the additional two courses of chemo, for continued endurance and strength, and give thanks for great success so far. We thank you all for your prayers and support.

Ed

Sunday, September 6, 2009

A nice Lab or Day weekend

So far we have had a very nice 3-day weekend despite spring-like weather, with rain/hail/thunder etc rolling through each hour. We met with Dr. Safari, Kay's surgical GYN oncologist Friday afternoon. He is our back to earth guy, Kay almost always has tears at his visits, and though he is a really nice man, and seems very knowledgeable, he is not one to have us leave with undue optimism. He agrees that it appears the Kay has no sign of cancer at this time, but is very much the realist that this is not a stamp of long term success, rather a step in the process. He strongly agrees with Dr. McCroskey that we should go ahead with a fairly long course of Avastin, the tumor blood vessel antagonist, for 15 more courses, i.e. nearly a year of every 3 month infusions. Though this is considerably easier and less risky that the chemotherapy Kay has already completed, there are potential major complications of this therapy, and it makes us feel that if everyone wants Kay to get this course of treatment, that no one is very confident that the cancer is completely vanquished. It is a reality check, but we are really trying to flatten the highs and lows of this roller coaster of emotions. It is a challenge we are rising to: be in this for the marathon it is likely to be, while enjoying every step of the way to the fullest extent that we can.

This week we will mostly be trying to wrap up as many work and home loose ends as possible, in preparation for our big 25th anniversary trip. In addition we have a big day Friday. In the morning we go to Seattle Cancer Alliance for genetic counselling about this CA-125 gene and how to manage this for ourselves and our family, then back to Puyallup in the afternoon to get the biliary stent removed endoscopically. IN this procedure Dr. Moussan, a gastroenterolgist, will use a fiber optic endoscope to go through Kay's mouth, esophagus and stomach into the small bowel and pull out the plastic tube (aka stent) that was used to keep the bile flowing when the tumor was obstructing its flow. This should be a minor procedure, but all procedures have their issues, and we want all your prayers that this goes well too.

May you all enjoy this weekend, and enter the fall/ school season with joy and enthusiasm.

Ed

Thursday, September 3, 2009

Dr. McCroskey says remission

Today at her visit with Dr. McCroskey she asked what she should tell her friends when they ask her how the fight against cancer is going. He told her that he believes she is in remission, with no evidence of cancer at this time. Those were nice words to hear. Of course he was quick to say there is a possibility of recurrence, but still, nice to hear very positive news.

Kay is doing OK at this point, but is struggling with what Dr. McCroskey thinks is the cumulative fatigue of her courses of chemotherapy. He does think though that this should be the low point of her energy, and that she should start to feel better from here. For about the first 4-5 courses Kay really seemed to get stronger and feel better each cycle, but for the last few weeks she has been more short of breath, tired, and just worn down. We are hoping that just a break from toxic chemicals (a.k.a. chemotherapy) will be just what the doctor calls for, and she will regain energy and strength.

We are really starting to look forward to our 25th anniversary road trip, from here to Orange county via the coastal route, and back with a stop at Yosemite. About 17 days in total, so not a rushed trip at all, and lots of time together.

Pray for healing, strength, peace and continued remission.

Love to all of you, and immeasurable thanks for all of the support and prayers.

Ed