tag:blogger.com,1999:blog-47680087250820816062024-02-20T19:24:35.738-08:00Kay & Ed's Family BlogEd Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.comBlogger203125tag:blogger.com,1999:blog-4768008725082081606.post-47264717205900073462018-03-18T20:44:00.000-07:002018-03-18T20:44:25.178-07:00Thanks to Everyone The memorial service for Kay Saturday at Celebration Lutheran Church was a wonderful outpouring of love. Kay touched the lives of an incredible number of people and many of you gathered to share your prayers, your support and love for Kay to be there for each other. Pastor Paul led the service as not just our pastor of many years, but a close friend. Paul's words, along with the words of family and friends, the shared stories, the incredible music of the CLC choir with added voices of many musical friends and the beautiful table of cookies and goodies together made an event I'm sure Kay looked down upon with pride and her big smile.<br />
Through my tears I was able to feel the caring and love of so many people from so many different aspects of Kay's life. I want to send a sincere thank you to everyone who was able to come Saturday, to the many others who could not come but whose support and love was felt in other ways. Kay fought an extraordinary battle against her cancer, but her longevity, the energy to keep up the fight so well, and our wonderful years together after her diagnosis would not have been possible without a great team. The first rate medical care, the prayers and support of such a fabulous network of friends and family, and our love for each other carried us both through that time as though we had a tail wind. Even Kay's death came on her terms. She was able to pass peacefully and mercifully quickly. I am convinced that this was possible in no small part to her confidence in God's salvation and to knowing that we will all be there for each other now and going forward. You are all beautiful and appreciated. Thanks.<br />
<br />
EdEd Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com1tag:blogger.com,1999:blog-4768008725082081606.post-44824465452909328982018-03-13T15:26:00.001-07:002018-03-13T15:29:47.568-07:00Memorial ServiceWe have been getting a number or inquiries as to the time of the memorial service for Kay. Now that I've arranged for someone to keep a close eye on the condo, I feel I can publicly put this out for everyone. <br />
<br />
Kay's Memorial Service<br />
<a href="http://celebrationlutheranchurch.org/" target="_blank">Celebration Lutheran Church</a><br />
2500 Shaw Road SE<br />
Puyallup, WA 98374<br />
<br />
All continues to go appropriately well.<br />
<br />
Thanks.<br />
<br />
EdEd Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com0tag:blogger.com,1999:blog-4768008725082081606.post-85828156412834572332018-03-11T18:31:00.001-07:002018-03-11T18:31:10.392-07:00Coping OKJust a shout-out to everyone. Jean Louise, Brett and I are coping well overall with the loss of Kay. Alan has been here with Jean and is of great support to her. My brother Bill has been staying here too, and he and I have been having good "brother" time. Brett is sticking close and doing OK too it seems. Anyway thanks for all the prayers, notes, calls etc. <br /><br />EdEd Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com0tag:blogger.com,1999:blog-4768008725082081606.post-43601588477126114012018-03-08T14:08:00.000-08:002018-03-08T14:08:27.753-08:00Blessedly QuickKay passed peacefully about 9:45PM Wednesday night. Although she had felt like she was ready to go for at least a few days, I believe she needed to hold her daughter one more time, and to see her last artwork project, the remodel of our new condo, completed in order to let go. Jean came home Tuesday night, and spent the morning cuddled up with Kay and they had a nice morning together. The inspectors came for final electrical and plumbing inspections that morning also. As the afternoon approached Kay became more somnolent, and about 4 PM dropped to sleep for the last time. She passed quietly about 9:45.<br />
This has been an incredible last almost 9 years. Kay was diagnosed with stage 3C ovarian cancer about Easter time 2009. She was training for a half-marathon at the time, and it seemed to come out of nowhere. The prognosis was dismal, and to have had this long together since then has been an unexpected gift and we have taken full advantage of the time. <br />
Our 33 1/2 years of marriage have produced two wonderful children and more joy and memories than one man deserves. We were both blessed with families that made biological vs. in-law terms that have little meaning. Her family has become mine, and mine hers. Our friends have been a constant source of support and enjoyment throughout the years, but have especially stepped forward over the span of Kay's battle with cancer as rock-solid. The prayers, meals, phone calls, lunches, parties, and innumerable other acts of friendship have sustained Kay and my spirit.<br />
Kay wanted you to know that your love, prayers and help have been instrumental in her unexpectedly long survival and in the quality of those years. We both thank you with our whole hearts for everything. Kay will live on in my heart, and I'm sure in many of yours as a source of energy, inspiration, creativity, love and passion. <br />
Pray for each other and for Jean, Brett and me over the next days, weeks and months as we learn to live without Kay's physical presence. Pray that her passage into Heaven is as joyous as she knew it was going to be. You are invited to join us at Celebration Lutheran Church on Saturday March 17th for a memorial service. If you wish to commemorate Kay she would want contributions to ovarian cancer research at the U.W with Dr. Swisher at http://supportuwmedicine.org/kay-pullen or to the Tahoma Audubon Society at http://www.tahomaaudubon.org/honormemorygifts <br />
<br />
Thanks and love to all.<br />
<br />
EdEd Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com3tag:blogger.com,1999:blog-4768008725082081606.post-64457148854568402602018-03-01T21:35:00.000-08:002018-03-01T21:35:26.389-08:00Update
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<br />
<div class="MsoNormal">
<span style="font-size: 12pt;">The last year has been a struggle for Kay.</span><span style="font-size: 12pt;"> </span><span style="font-size: 12pt;">After it became clear that her ovarian cancer
had recurred Kay started to fight back with one treatment option after
another.</span><span style="font-size: 12pt;"> </span><span style="font-size: 12pt;">Initially there was some
promise, but every choice seemed to either not work at all, or work only very
transiently.</span><span style="font-size: 12pt;"> </span><span style="font-size: 12pt;">The only thing that seemed
to work was Taxol plus Avastin, but after a short time this led to a bowel
perforation complication.</span><span style="font-size: 12pt;"> </span></div>
<div class="MsoNormal">
<span style="font-size: 12pt;">Kay survived
this in September with two hospitalizations, a drainage procedure and prolonged
antibiotics. Kay was just starting to get a little better when she developed a
partial malignant small bowel obstruction at Thanksgiving.</span><span style="font-size: 12pt;"> </span><span style="font-size: 12pt;">With this anytime Kay tries to eat she gets
painful cramping and bloating.</span><span style="font-size: 12pt;"> </span><span style="font-size: 12pt;">This was
initially only when she tried to eat larger meals, but has progressed now to
where any food leads to hours of severe pain and eventually to vomiting up all
she ate and more.</span></div>
<div class="MsoNormal">
<o:p></o:p></div>
<div class="MsoNormal">
This bowel obstruction has been devastating, and has kept
Kay from eating enough to maintain her weight and strength.<span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
<div class="MsoNormal">
Since Thanksgiving she has tried two more types of
chemotherapy, neither of which seem to have even slowed the rapid progression
of her cancer.<span style="mso-spacerun: yes;"> </span>During that time she has
lost a great deal of weight, has become very weak, and has had progressive pain
when she tries to eat even minimal amounts of food. <br />
We have prayerfully and thoughtfully considered options like TPN (total
parenteral nutrition also called IV feedings) but Kay has chosen not to prolong
her dying by this means.<span style="mso-spacerun: yes;"> </span>Today we met
with the Hospice intake nurse and signed up for home Hospice services.<span style="mso-spacerun: yes;"> </span>Our hope is that the Hospice team will help
us navigate the coming days.<span style="mso-spacerun: yes;"> </span>Although
Kay is having pain, her pain medication regimen is working pretty well at this
point, and we are getting additional options set up with the help of the
Hospice team.<o:p></o:p></div>
<div class="MsoNormal">
Kay and I want to send our love, thanks and prayers back at
all of you who have given us so much of these types of support over the last 9
years of fighting cancer.<span style="mso-spacerun: yes;"> </span>Please focus
your prayers and hopes on peace as the end approaches, relief from pain and
other aspects of suffering, and comfort. Kay is being her usual self in wanting
to hurry up and get on with dying, and we pray that all of you will respect and
support her in this choice.<span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
<div class="MsoNormal">
As we see how this goes I’ll try to keep this site
current.<span style="mso-spacerun: yes;"> </span>We love you all.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Kay & Ed<o:p></o:p></div>
<!--EndFragment--><br />Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com15tag:blogger.com,1999:blog-4768008725082081606.post-35784181463877211122018-01-04T20:27:00.000-08:002018-01-04T20:27:48.380-08:00New Year News on Kay's Status <div class="MsoNormal">
<span style="font-size: 16.0pt;">As we enter the new year Kay
and I look back on the last 8 2/3 years of living with cancer as time we had
not expected, but are grateful to have lived and loved together.<span style="mso-spacerun: yes;"> </span>Although there have been challenging periods,
most of Kay’s days/weeks/months/years since her diagnosis have been lived
comfortably and fully.<span style="mso-spacerun: yes;"> </span>We are especially
thankful for our family and friends.<span style="mso-spacerun: yes;">
</span>From the beginning when the prognosis was grim, through her three major
courses of chemotherapy and surgeries, in the 4+ years remission off treatment,
and in the last year of sometimes frustratingly minimally effective treatments
you have been there for us. <span style="mso-spacerun: yes;"> </span>Sometimes it
has been a phone call or letter, and sometimes a date for tea or lunch.<span style="mso-spacerun: yes;"> </span>Sometimes a visit, a trip just together or
with friends or family, and sometimes prayers we have palpably felt
supporting us. Everyone’s love has been there for us without fail.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 16.0pt;">Now things are looking like
we are nearing the end of effective treatment options for Kay’s ovarian
cancer.<span style="mso-spacerun: yes;"> </span>At a recent visit she told Rob
McCrosky, her oncologist, that she felt like the time was approaching when her
cancer was going to take over. <span style="mso-spacerun: yes;"> </span>Kay has
asked both Rob and Elizabeth Swisher this question many times, whether she was
near the end.<span style="mso-spacerun: yes;"> </span>Always the reply was
certainly not, and that there were effective treatments ahead. This time Rob
honestly told Kay that he agreed that the time of holding the cancer back may
be past. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 16.0pt;">In the last year Kay has gone
through numerous types of treatments. She has tried experimental studies with
immunotherapy, as well as new and established types of chemotherapy, and none
have proved effective for any prolonged period of time. <span style="mso-spacerun: yes;"> </span>For 8 years Kay was a chemotherapy superstar,
tolerating treatments well and avoiding complications.<span style="mso-spacerun: yes;"> </span>This year has been different.<span style="mso-spacerun: yes;"> </span>Kay had little response to treatments, then
she had the bowel perforation complication from Avastin.<span style="mso-spacerun: yes;"> </span>Since then the cancer has progressed despite
continued Taxol chemotherapy, and Kay is battling a partial bowel obstruction
which is <span style="mso-spacerun: yes;"> </span>causing unacceptable symptoms
when she tries to eat much at all.<span style="mso-spacerun: yes;">
</span>Although Kay is not ready to give up hope of some more time with
palliative chemotherapy, we understand the options are not promising. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 16.0pt;">We are going to take the next
few weeks to see how the cancer responds to a bit of additional
chemotherapy.<span style="mso-spacerun: yes;"> </span>Last week Kay received the
first dose of Topotecan, a new drug for her, that she will get as weekly
infusions.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Although we are hopeful that it will be
effective, the odds are not in her favor. <span style="mso-spacerun: yes;"> </span>If as is most likely these treatments are not
effective in stalling the progression of the cancer, Kay and I plan to work
together to figure out the best way to live her remaining time as enjoyably and
fully as is possible. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 16.0pt;">The good news today was that
despite having to get new insurance when Regence dropped everyone on their
individual plans, and having limited options available due to “market
uncertainty” our new carrier, Kaiser, agreed to let Kay keep seeing Dr.
McCrosky for 6 more months to allow transition to their system.<span style="mso-spacerun: yes;"> </span>We are going to not worry about things more
than 6 months ahead right now, and are grateful for that much of a reprieve. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 16.0pt;">We hope you all had a Merry
Christmas, wish you a Happy New Year.<span style="mso-spacerun: yes;"> </span>Keep
the prayers for Kay going and live 2018 with vigor and joy.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
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Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com7tag:blogger.com,1999:blog-4768008725082081606.post-81861733685953909482017-12-24T10:03:00.000-08:002017-12-25T13:15:11.565-08:00Merry Christmas.<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwtJDxc2P2zggz8H83z0hdrE8h3CCWcgLNuX97VjNQDpwI9m_HLYfRxxvkkJAJ788VQevGUWQvijXxZnbO8APW48Tybv2Q6y4bjjY2kdmHYVQt8Io3Qv1N5c1LiEGTBju7WnDQ0FQSZ9I/s1600/DSC_0104.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1067" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwtJDxc2P2zggz8H83z0hdrE8h3CCWcgLNuX97VjNQDpwI9m_HLYfRxxvkkJAJ788VQevGUWQvijXxZnbO8APW48Tybv2Q6y4bjjY2kdmHYVQt8Io3Qv1N5c1LiEGTBju7WnDQ0FQSZ9I/s320/DSC_0104.jpg" width="213" /></a></div>
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<span style="font-size: 12pt;"><br /></span></div>
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<span style="font-size: 12pt;">For the Pullen family of Washington 2017 has been a very
eventful year.</span><span style="font-size: 12pt;"> </span><span style="font-size: 12pt;">We continue to be blessed
with great friends and family, and many life changes.</span></div>
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<o:p></o:p></div>
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Among the biggest changes for us is that Kay and I moved
from our home of 30 years in Puyallup to a condominium in Old Town Tacoma.<span style="mso-spacerun: yes;"> </span>Most of our time here has been living in a
major renovation, and today we are sitting watching the water from a couch in
our living room for the first time in over a month. We look forward to living
here in the middle of most of what’s happening in Tacoma, easy walks to many
places including the Ruston Way waterfront parks. <span style="mso-spacerun: yes;"> </span>I saw my first of the year Sabine’s gull with
my spotting scope from the living room.<span style="mso-spacerun: yes;">
</span>A nice “yard” bird.<o:p></o:p></div>
<div class="MsoNormal">
Brett continues to work on his home in the McKinley District
of Tacoma, and I’ve been having fun working with him at times.<span style="mso-spacerun: yes;"> </span>Who’d have thought that we would learn how to
lay hardwood floors and tile floors and walls (mostly Brett on this). <span style="mso-spacerun: yes;"> </span>Brett has also progressed in his soccer
refereeing and is now one of the top high school refs in the area, doing lot’s
of high level playoff games, and this year got his college certification. He
did lots of local college games too and is enjoying the challenge and exercise.<o:p></o:p></div>
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Jean has moved to Costa Rica.<span style="mso-spacerun: yes;"> </span>She travelled extensively for much of 2016 and
the first half of this year, before coming home for a very nice 3-month visit
home in the summer.<span style="mso-spacerun: yes;"> </span>Her partner Allen
joined her for the last half of the visit.<span style="mso-spacerun: yes;">
</span>In September they left for Puerto Viejo de Talamanca, CR where they have been living
since, exploring options for developing a permaculture farm and lifestyle
there. <o:p></o:p></div>
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Kay and I have travelled to Florida for a trip to the Dry
Tortugas and to visit Bill and Carol in April.<span style="mso-spacerun: yes;">
</span>Kay got 12 ABA lifers and Ed 3 on the trip, and we really enjoyed the
visit at Bill and Carols, where Carol and Kay set up their studio in the
Florida Room while Bill and I biked, walked, the beach, and visited. In June of
us visited the SoCal Colmars. Scott arranged an Airbnb in Fullerton, Jean,
Brett, Kay and me, and Scott and Erin’s family stayed there while Ken and Keith
stayed nearby.<span style="mso-spacerun: yes;"> </span>We had three consecutive
celebrations.<span style="mso-spacerun: yes;"> </span>First was Fay’s fabulous
retrospective show at Fullerton College, where we all marveled at her body of
work, partied, and told stories.<span style="mso-spacerun: yes;"> </span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9x6Fj9moEJGSeRLGUtikAoCCAgnY8XVMgBsjwZuEo3c-UqqjWiVi9MB1Na6QdHn9xAUGtgVSRUjRjJ7JvVmdIdUBJ3Fq8XPaOsLmbPYAahzjvRcvgU0-nYVu0hdJkAeeJDCHHHuZ4bDU/s1600/IMG_7279.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1200" data-original-width="1600" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9x6Fj9moEJGSeRLGUtikAoCCAgnY8XVMgBsjwZuEo3c-UqqjWiVi9MB1Na6QdHn9xAUGtgVSRUjRjJ7JvVmdIdUBJ3Fq8XPaOsLmbPYAahzjvRcvgU0-nYVu0hdJkAeeJDCHHHuZ4bDU/s320/IMG_7279.jpg" width="320" /></a></div>
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<br /></div>
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Next
was a graduation party for Mic (from the University of California at Santa
Barbara) and Caroline from Fullerton High School.<span style="mso-spacerun: yes;"> </span>We celebrated their success and loved the
party at Mary and Jim’s house.<span style="mso-spacerun: yes;"> </span>Last was
Fay and Vince’s 40<sup>th</sup> wedding anniversary. They renewed their vows,
and we had a great celebration in their back yard. <span style="mso-spacerun: yes;"> </span>In October Kay and I attended the wedding of
Morgan in Unity, ME.<span style="mso-spacerun: yes;"> </span>It was a really
great wedding set in Morgan and Kendall’s back yard.<span style="mso-spacerun: yes;"> </span>The fall foliage was a great backdrop.<span style="mso-spacerun: yes;"> </span>We had a fun but whirlwind trip scheduled
between Kay’s treatments. <o:p></o:p></div>
<div class="MsoNormal">
The year has been somewhat of a struggle with Kay’s health,
and we are blessed that she has survived over 8 ½ years since her
diagnosis.<span style="mso-spacerun: yes;"> </span>I’ll post an update on that
soon, but this is a letter of joy and celebration so not here.<o:p></o:p></div>
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A highlight of the year was giving much of our art collection to a fund raiser event called Art Beat's Cancer. We put this on with the tremendous help of Kay's Celebration Lutheran friends at the Bird Cage in Kirkland. The event raised $15,000. to support Ovarian cancer research at U.W. by Kay's U.W. oncologist Dr. Elizabeth Swisher. It was also really fun, and since then we've had the joy of seeing some or our art being enjoyed in friends homes. The generosity and support from everyone in this event was overwhelming. </div>
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May your holiday season be joyous, your new year filled with
joy and wonder, and may our love for all of you be received and returned in
full. <o:p></o:p></div>
Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com1tag:blogger.com,1999:blog-4768008725082081606.post-66802600995958826422017-12-01T13:13:00.000-08:002017-12-01T13:13:06.653-08:00Homeward Bound <div class="MsoNormal">
<span style="font-size: 12pt;">Kay has been in the hospital at Good Sam in Puyallup since
Tuesday for fluid and nutritional support while we have waited for her bowel to
begin to function again.</span><span style="font-size: 12pt;"> </span><span style="font-size: 12pt;">The initial CT
scan was felt to show a bowel blockage, but when a tube was placed through her
nose to drain her stomach very little drainage happened.</span><span style="font-size: 12pt;"> </span><span style="font-size: 12pt;">This led to reevaluating whether there is a
mechanical blockage, or maybe just a dysfunction of the small bowel related to medications
including chemotherapy and the cancer in the abdominal cavity.</span><span style="font-size: 12pt;"> </span><span style="font-size: 12pt;">For the last 24 hours Kay has been able to
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liquid) and she is enjoying eating again.</span><span style="font-size: 12pt;">
</span><span style="font-size: 12pt;">No pain or problems so far, and the hope is that if she does well this
afternoon we might go home tonight or maybe in the morning.</span></div>
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<o:p></o:p></div>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Date"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 9"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/>
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The future from there is less clear, but the first step is
to go home and tolerate eating, regain some strength, and then figure out what
to do from there. Thanks to everyone for your prayers and help.<span style="mso-spacerun: yes;"> </span>Now to get in the Christmas spirit.<o:p></o:p></div>
Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com2tag:blogger.com,1999:blog-4768008725082081606.post-88724243196579320812017-11-28T16:49:00.004-08:002017-11-28T16:49:46.857-08:00Update on Kay's Situation<div class="MsoNormal">
<span style="font-size: 12pt;">Thanksgiving 2017 will be one to remember, or maybe better to forget if we
can. Our place is in major renovation mode, and we were blessed to stay at the
Asplund’s home while they visited family in Portland.</span><span style="font-size: 12pt;"> </span><span style="font-size: 12pt;">On the day before Thanksgiving, after a
really enjoyable day visiting with Stephanie Allgood and doing art projects, on
getting home Kay started to feel really poorly.</span><span style="font-size: 12pt;">
</span><span style="font-size: 12pt;">By early Thursday morning she started with diarrhea and then a strange
vomiting without nausea.</span><span style="font-size: 12pt;"> </span><span style="font-size: 12pt;">This was
severe enough that our move to the Asplund’s was put off until early
afternoon.</span><span style="font-size: 12pt;"> </span><span style="font-size: 12pt;">Her gastrointestinal troubles
continued all day, and Brett and I had a very quiet Thanksgiving meal while Kay
struggled on the couch.</span><span style="font-size: 12pt;"> </span></div>
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<o:p></o:p></div>
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By mid-evening Kay was getting very weak, and we went to the
ER for IV hydration and evaluation. Her labs looked OK, she managed not to
vomit there, and we got home by about 1 AM.<span style="mso-spacerun: yes;">
</span>We slept in Friday, but all weekend Kay couldn’t eat anything without
severe pain, and by Monday morning we contacted Dr. McCroskey and he saw Kay
yesterday.<span style="mso-spacerun: yes;"> </span>He ordered an abdominal CT
scan that explained the problem, showing a distal partial small bowel obstruction.<span style="mso-spacerun: yes;"> </span>(near the end of the small bowel before it
dumps into the large bowel was a place where the bowel narrows considerably
causing the bowel above there to dilate and fill up with air and fluid.)<span style="mso-spacerun: yes;"> </span>This explains the pain with eating, the
vomiting, and the severe bloating Kay has.<span style="mso-spacerun: yes;">
</span>It is not clear what is causing the partial obstruction, but it is a
fairly common problem in people who have had abdominal surgeries.<span style="mso-spacerun: yes;"> </span>It may be related to adhesions, or possibly
kinking where cancer causes a loop of bowel to bend too sharply.<span style="mso-spacerun: yes;"> </span>It is not considered a surgical emergency at
this time.<span style="mso-spacerun: yes;"> </span>The plan is for Kay rest in
the hospital, not eat or drink, get IV hydration and use a naso-gastric tube to
drain her stomach and decompress the small bowel above the point of obstruction.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>This
may or may not work, but often it does once the proximal swelling of the bowel
loops goes down. <o:p></o:p></div>
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This is likely to take a few days though and though we have
been trying to find reasons to get out of the condo-under-construction, this
was not high on our list of ways to get away. <o:p></o:p></div>
<div class="MsoNormal">
The other not-good issue found on the CT scan is that the
fairly small metastasis of the cancer to Kay’s liver and the area behind her
peritoneal cavity have grown quite a bit in the last 2 months, despite being on
the weekly Taxol chemotherapy.<span style="mso-spacerun: yes;"> </span>This is
an issue we will need to address after the bowel obstruction resolves and Kay
is well enough to resume her chemotherapy.<o:p></o:p></div>
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Kay is at Good Samaritan Hospital in Puyallup, and maybe in
a day or so a brief visit once or twice a day will be nice, but at least today
we need to just get settled in and appreciate everyone’s prayers and best
wishes. <o:p></o:p></div>
Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com2tag:blogger.com,1999:blog-4768008725082081606.post-8894455815570761992017-10-31T15:25:00.000-07:002017-10-31T15:25:00.118-07:00Initial Good Response to Taxol It's been a while, so as I wait at the Subaru dealer for my service to be done, and Kay is at Rainier Oncology getting the second infusion of her second 4-week cycle of Taxol for her ovarian cancer I am taking time to report on her status so far.<br />
As previously reported Kay got a nice response to the combination of Taxol plus Avastin, but developed a tiny bowel perforation likely from the Avastin so she had to stop that drug. After a break from treatment to allow the infection to resolve Kay has restarted treatment on weekly Taxol infusions a a single agent. She gets 3 weeks of Taxol infusions the a one week break to recover, which constitutes a 4-week cycle.<br />
Today she is on week two of cycle 2 of the weekly Taxol infusions. She has been tolerating the Taxol quite well, each week having some fatigue and malaise on the Thursday - Saturday after the Tuesday infusion, but this is only moderate, and she is overall doing better. <br />
She lost a lot of weight when sick with the bowel perforation, but has started to gain some weight back, and is enjoying eating high calorie foods to accomplish the weight gain.<br />
Initial indicators are that the Taxol is helping. Her ascites (intra-peritoneal fluid accumulation) seems to have resolved and her CA-125 which had gone up a little when she was off treatment to treat the infection, has gone down by >50% after the first cycle of Taxol.<br />
Pray for continued benefit from the Taxol, minimal side effects, weight gain (for Kay not me ;.) and patience, endurance and tolerance for all involved. <br />
Thanks.<br />
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EdEd Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com0tag:blogger.com,1999:blog-4768008725082081606.post-26576851867599748042017-09-13T20:58:00.000-07:002017-09-13T21:21:54.054-07:00Update: Infection Seems to be ClearingAfter a 6 day stay at Good Sam to have a drainage tube placed in her intra-abdominal abscess and to get IV antibiotics and total parenteral nutrition (IV nutritional support) Kay came home Monday. She continues to seem like she is getting a little better each day, and today actually felt fairly comfortable. She is still getting daily IV antibiotics, and the drainage tube in uncomfortable and annoying, but her fever is gone, her abdominal pain much less, and her energy a slight bit better.<br />
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We are hopeful that the drainage tube will come out after we meet with her oncologist Friday, and maybe then or shortly after she can switch to oral antibiotics. I'm sure she is looking forward to a good shower unencumbered by areas she needs to keep dry, and to getting the somewhat painful drainage tube removed. </div>
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We are settling into our new place in Old Town, Tacoma and looking forward to being able to enjoy the walkability of the neighborhood, meet the local shop owners, explore the waterfront park, and generally become more active. </div>
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Kay also continues to look forward to our Art Beats Cancer event at the <a href="http://www.birdcagehome.com/" target="_blank">Bird Cage </a>in Kirkland from 1-4 PM on Sunday, Sept 24th. Hope to see some of you there. <br />
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Keep up the prayers for continued healing from the infection, and especially for the chemotherapy she will need to restart soon to be effective.</div>
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Thanks for all of your support and prayers.</div>
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Ed & Kay</div>
Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com1tag:blogger.com,1999:blog-4768008725082081606.post-67380970701073158622017-09-07T21:03:00.002-07:002017-09-07T21:03:48.276-07:00Update on a Tough Week or TwoFinally tonight I feel like I have enough time and energy to post an update on Kay's situation. She started her second cycle of chemotherapy with Avastin and Taxol about 16 days ago, after doing pretty well with the first cycle, and actually having a really good last 10 days of that cycle. On the third day after the first infusion of cycle 2 Kay started to have worsening abdominal pain which progressed daily until a on day 5, a week ago Sunday night, she developed fever, her chills worsened and her abdominal pain became so severe we went to the ER. <br />
She was admitted for IV antibiotics for presumed peritonitis, though the cause was uncertain. We suspected a small perforation of her bowel which is a know possible complication of the Avastin therapy. Kay responded very well to the IV antibiotic, and within hours felt a bit better, and within 2 days was dramatically improved. Her physicians, including the one she is married to, all felt good about her going home on oral antibiotics, but within a day she began to feel worse, with chills, worsening pain, and after just 3 days she was put back on an IV once daily antibiotic as an outpatient. Beginning the Friday of Labor Day weekend, and each day through Monday, she got the IV antibiotic, but really did not improve, and Tuesday her oncologist readmitted her to Good Sam. She had a repeat CT scan which this time showed free air outside her bowel, and and what looked like an abscess in her left lower abdomen where her pain has been the worst all along. Last night Dr. Frood, an interventional radiologist we know from when he put a biliary stent in for Kay 8 years ago, again performed a successful percutaneous drainage procedure with CT guidance to place a drain into the abscess. About 60 ml of pus was removed, and the drain has worked well since. <br />Today Kay has had a day the is better in some ways, namely no fever, no chills, and to me she looks better, but worse in that the pain from the drainage procedure has been pretty bad. Kay hates opioids, but today they have been necessary. <br />
On another note today Cheryl and Patty, two of Kay's great friends, worked in our new condo to unpack, organize, and generally make the place fit for Kay to return to after she leaves the hospital. We are both very grateful for their help, all the support, love and prayers of innumerable friends. Brett and Jean have helped spell me at the hospital, and tonight I felt comfortable enough to head home before dark and relax for a bit before bed. <br />Pray that this drainage procedure allows her infection to fully heal, that her bowel seals over and no further leakage and infection occur, and that she can resume chemo soon with good suppression of her cancer. Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com2tag:blogger.com,1999:blog-4768008725082081606.post-20459513993121827602017-08-28T16:25:00.000-07:002017-08-28T16:25:47.371-07:00One Step Ahead, Hopefully Just One Step Back. Kay started her second cycle of the Taxol/Avastin chemotherapy regimen last Tuesday, and it started much like first cycle. Kay felt really good, we suspect from the Decadron high, for about 2 days. Unfortunately from there it has been tougher. She started to have abdominal pain on the third day, much like with the first cycle, and to hurt all over. This time though the pain just kept getting worse for the next 3 days, until Saturday it was really hard for Kay to get out of bed. By Sunday it became even worse, and the chills she had been having for the past 2-3 days became worse also. By evening she had a 101.7 fever. This was enough to prompt an ER visit.<br />
As ER visits go this was accomplished in a timely fashion, we got there about 8:30 PM and by 10:30 PM she had blood test and abdominal CT scan results that did not show any life threatening abdominal catastrophe, but she was admitted to Good Samaritan Hospital oncology unit for monitoring and IV fluids.<br />
This morning she had two doppler ultrasound tests, one for arterial supply evaluation to her bowel, which looked OK, and then another for veinous flow evaluation looking for a blood clot or thrombosis that could block the drainage of the bowel. These were basically not conclusive and Dr. Aversa our family doctor, and Dr. McCrosky Kay's local oncologist, were concerned about an infection in Kay's abdominal cavity, possibly from a micro-perforation of her bowel that could be a complication of the Avastin. This led them to put her on IV antibiotics this morning, and so far, just a half day into the treatment Kay is not worse, maybe slightly better.<br />
Pain and sleep deprivation have Kay in a discouraged state, but the family has been able to sit with her today and we are working to keep her and our spirits up. I am forging ahead with our move to our new condo in the Old Town district of Tacoma and that should be accomplished by Thursday.<br />
We remain hopeful that this setback will pass and that better days are in Kay's immediate future.<br />
Keep us in your prayers and they will join with ours.Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com1tag:blogger.com,1999:blog-4768008725082081606.post-33928277578284660742017-08-04T14:05:00.001-07:002017-08-04T14:05:11.246-07:00Looking Up We Think<div class="separator" style="clear: both; text-align: center;">
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This week Kay had her second weekly infusion of Taxol, after getting the Taxol plus Avastin last week. Each 4 week cycle consists of Taxol + Avastin week 1. Taxol alone week 2, Taxol + Avastin week 3, then a week off to recover. Our hope is that the Avastin will allow the Taxol to work well enough to cause regression of Kay's cancer and relief of her discomfort and other cancer-related symptoms.<br />
Almost immediately after the first infusion Kay seemed like she could feel things getting marginally better. Now, only 9 days into therapy she is pretty sure she is a little bit improved. Her energy is noticeably better, her belly swelling (ascites) is slightly less, and overall she just is in less pain. These are subjective markers of improvement, but really the purpose of this treatment at this point is to feel better, improve day-to-day function, and have less pain, so we are pretty happy about her response so far.<br />
On the non-cancer front we have sold our house in Puyallup and are hoping to move to Tacoma by the end of August. We had tried to purchase a new construction home in Old Town but the legal issues over wetland permitting and mitigation simply made this untenable, and so we dropped that attempt and feel like God was smiling on us. Literally 30 minutes after deciding no longer to try to buy that house we looked at a condo a few blocks away. <br />
Both of us really like the place, the location, the floor plan and the view, and we have had an offer n that place accepted and pending our inspection plan to close on the sale before we have to leave our Puyallup home August 28th. <br />
Thanks for all the support, prayers and thoughts of all of our friends and family. Fay, Kay's Mom has sent daily cards with ideas for hats and scarves for Kay after she loses her hair. They have been a daily cause to smile and be grateful for Kay's whole family. Kay's Puyallup friends have been visiting regularly, bringing flowers, goodies, and love when Kay has really needed it. Pastor Paul has been helpful for all of us, and many other friends and relatives have reached out with help and support. I talk to my brother Bill regularly and it's nice to have his ear and virtual shoulder. <br />
Jean is home and her partner Alan is visiting from Mexico. He is a really nice fellow, and we are enjoying his company. Brett and Taylor have been a constant support and we are grateful for both of our children.<br />
Keep up the prayers, especially for confirmation that the chemo is helping fight the cancer and that Kay keeps on feeling better. Although she is feeling a little better, we are hoping for "more better" than it is now. <br />
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With all our love,<br />
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Ed & KayEd Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com4tag:blogger.com,1999:blog-4768008725082081606.post-65046145616756420852017-07-12T20:10:00.000-07:002017-07-12T20:10:26.434-07:00Latest on KayI'm back to posting on this family blog because once again we have news that we want to get out to friends about Kay's cancer that she and I just don't have the energy to pass on personally to all of our supporters, friends, and loved ones. You are all in our thoughts and prayers, and we very much need and want your continued prayers for comfort, peace and good response to therapy.<br />
After 8 years and 2+ months of fighting ovarian cancer, incredibly successfully much of the time, the cancer has seemed to enter an accelerated phase where after a 4 1/2 year remission at least 4 different treatment attempts have failed to stop its progression more than transiently.<br />
Kay, Jean and I met with Dr. Elizabeth Swisher today at U. W. and it was not difficult to read her emotions on her face. Dr. Swisher is usually a bundle of positive energy. Kay once asked Dr. Swisher if she was her favorite guinea pig, having responded to her expert treatment so successfully. Dr. Swisher responded from her heart, telling Kay that she was one of her favorite people. Today we could see a hint of sadness, of lack of good news to share, in her face and demeanor. <br />
We have known since the first recurrence of Kay's ovarian cancer that further treatments had the expectation of knocking the cancer back, keeping it from progressing, and buying time hoping for a big breakthrough. Even during her 4+ year remission following her third round of aggressive chemotherapy no one was bold enough to use the "cure" word. The bad news is that Kay's cancer growth has morphed into a phase where it seems to be relentlessly growing quickly. Kay is feeling more and more symptoms from the cancer, but overall most days remain good enough that she chooses to to accept further anticancer treatment. That said, realistically we are starting to accept that treatment needs to be focused on reducing her symptoms and giving her as many days as possible where her pain, fatigue and other suffering do not outweigh the joys and happiness of life. Her physicians don't have treatment options with a very high likelihood of shrinking or even halting its growth.<br />
That said Dr. Swisher had good suggestions. Kay is going to try another course of chemotherapy, using a lower dose of Taxol weekly, rather than a higher dose every 3 weeks. This may slow the growth of her tumor, or get it to regress for a while. with less side effects than a higher less frequent dosing regimen. In addition we are hopeful that it will get rid of the ascites (peritoneal fluid in her abdomen) and pleural effusion (fluid around her lungs) that is causing bloating, abdominal pain, and shortness of breath. We also have ideas on how to help with her nausea and fatigue, as well as her gastrointestinal difficulties under better control.<br />
What we ask most of all of you is your continued prayers, that you try to be supportive of each other when possible and that you remember that Kay is the same Kay as always, she just has this relentless disease that makes her sick. She will love phone calls, company and a good laugh, and maybe a good cry occasionally, but just cannot cry with each of you individually. Kay told me that "our bucket of tears keeps running dry," and it just takes too much energy to be sad with everyone she loves. Please prayerfully find a way to treat Kay normally while acknowledging that it is a hard time and that she is not well. <br />
Our love to all of you.<br />
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Kay & Ed<br />
<br />Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com6tag:blogger.com,1999:blog-4768008725082081606.post-167077956436028982014-09-13T16:37:00.004-07:002014-09-13T16:37:55.859-07:00RFE Visit TwoStay two of our RFE has been wonderful. We were passed off from the Yeovil Club to the Frome Selwood Rotary Club on Thursday Sept 11th at midday and were blessed to have fabulous hosts again. Patrick and Marie Cusworth are retired educators and have been extraordianrily kind and generous. Thursday we took a guided tour of the spectacular gardens of Stourhead before lunch, and then had lunch at cafe there. I quickly learned how to get a great pint of beer. Let Patrick order for me. He and I share a taste for good proper English Bitter. Thursday night we had a great meal at home with our hosts.<br />
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<span style="text-align: center;">Friday, after a nice breakfast at home, we visited Salisbury for a guided tour of town by Val Atkinson. She is a "Blue-Badge" guide and was a wealth of information. We had a very quick look at the cathedral which has a famously high spire before lunch at the Oxbow Inn..</span><br />
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<span style="text-align: center;">Then we were off to a surprise stop at a bird refuge.. We had close views of Great-crested grebe and watched a flock of about 35 Northern Lapwings circle the lakes looking for a place to land before flying away. From there we drove to get nice looks at Stonehenge from an overlook known to our local guides We were able to avoid lines and waits and still get really nice views. Last night we went to dinner at an upscale pub with our whole exchange group and hosts. After that we returned to finish off the great deserts from Marie's dinner the night prior. It was far better than the menu at the pub looked for "pudding."</span><br />
Today Patrick planned yet more personalized fun. We went to visit Lacock, an ancient town where the "inventor of modern photography" Fox Talbot lived and visited the museum, the abbey, and walked around the town.<br />
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From there we went to the surprise Patrick had been taunting us about for 2 days. We drove to the home of David Waters who has spent his last 20+ years trying to reintroduce the Great Bustard to England. The Great Bustard is the largest flying bird in the world, and the bird with the greatest sexual dimorphism. Males can be 5x the size as females. He keeps two birds with injured wings at his home, but has over many years tried to bring fertilized eggs back to their prior range in England and reestablish a viable breeding population.<br />
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They were hunted to exterpation in Great Britain by trophy hunters in the 1800's. It was quite wonderful to meet him, see his passion and pick his brain. Then after coming home for dinner we went to Bath to the theater <i>One Man Two Guvnors'. </i><br />
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This was the final Bath showing of a traditional British Comedy and was exceptional. Many thanks to our hosts for such a great stay in Frome. Tomorrow we are off to meet our next host family and visit the Crewkerne area. We just finished a nice facetime visit with Jean, and are off to sleep. Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com0tag:blogger.com,1999:blog-4768008725082081606.post-9665445732351979002014-09-11T10:41:00.001-07:002014-09-11T10:52:39.493-07:00Welcome from Somerset, England. Kay and I are now nearly 2 weeks into our European holiday and are resting before our sendoff barbecue outing with the Rotary Club of Yeovil, but first let's back up to the start of our adventure.<br />
Kay and I caught a non-stop flight from Seatac to Heathrow, London arriving at 6:30 AM on Friday August 29th. We figured out train and underground to our hotel and dropped our luggage off before roaming around Kensington Gardens and Hyde Park while awaiting our room at 2 PM. We birded the park, had lunch at the garden cafe and generally tried to stay awake and enjoy ourselves before getting back to our room for a nap. That evening we just went to dinner and crashed for a wonderful 12 hour sleep.<br />
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Saturday was an art day visiting the Saatchi Gallery in the morning and enjoying an incredible outdoor food market in the square near there and then off to the Tate Modern in the afternoon. At the Saatchi we found spectacular modern art shows and a wonderful space. At the Tate we saw two shows and the permanent collection there; the Mattise Cutout show was good but Malevich show was more impressive. In room were hundreds of sculptures of ants made of two casts of human skulls and wooden twigs. <br />
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Sunday we relaxed before catching an EasyJet (misnamed not really easy at all) to Nice, France and were met at the airport by Martyn Hammond, an English friend from Boston, England we met on our last Rotary Friendship Exchange (RFE). Martyn and Lesley have a vacation place in Biot just a few miles from Cannes and Nice on the Cote d'Azur. Our stay there was spectacular.<br />
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Rather than explain day by day I'll outline a typical day. Up late between 9-11 AM. A relaxed breakfast at home then off to explore a nearby spot (Nice, Cannes, etc.) where we usually had a walk around, lunch with wine and great food, then a bit more exploration. Returning home by 4-5 PM we had a swim in the pool, laid out on pool-side lounges with a gin & tonic, and read or napped for a couple of hours. Next was a long relaxed dinner at home. This was often a "light" dinner by our hosts description, but included "nibbles" (homemade croutons with olive spread, hummus and vegetables) and the local wine specialty (pronounced spe-see-al-i-tee) Rose. Then we would have salad with yummy local ingredients and a spread of meats. Later we'd have cheese and bread followed by "pudding" (any type of desert) then espresso. Wine was consumed throughout the courses. Dinner usually finished sometime after 10:30-11PM and we got off to bed about midnight. Repeat day after day. Exceptions were a wonderful evening meal out at an upscale restaurant for my birthday dinner and a larger fish meal made from a locally caught fish donated by the motorcycle driver who crashed into our car the day prior. Overall it would be hard to have a more enjoyable or more relaxing stay on the French riviera.<br />
EasyJet back to England early Saturday and we went to a comedy <i><u>Jeeves and Wooster</u></i> Sat night, the National Gallery on Sunday, and drinks and snacks with Ashley and Aaron Sunday evening before meeting our RFE group Sunday night. We enjoyed the Saturday excitement at both Picadilly and Trafalgar squares Sunday afternoon.<br />
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Monday we caught a train to Yeovil Station and have been on our RFE for 3 days now. On a RFE five Rotary Clubs from one district host several couples from different clubs in another district for 3 days each then later the exchange reverses. Our exchange is with Rotary District 1200 in Somerset County England. Their contingency visited District 5020 on Vancouver Island and South Puget Sound area in June. We are visiting them now. <br />
Monday the Yeovil Club host families met us with US and Canadian flags of welcome at the train station and we went to Lanes for a drink on the garden lawn and a traditional English fish & chips lunch. We went home with Mike and Sue Philips to rest at their stone village farmhouse before joining hour host club at The Lord Nelson Pub at Norton-sub-Hamdon for a skittles match and dinner.<br />
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Skittles in Somerset County is a local favorite pub game a sort of bowling with three imperfectly round wooden bowling balls, 9 heavy wooden pins aligned in a diamond shape so that it is very possible to roll the ball in slots between the pins without hitting any at all. We made two teams of about 13 members each and each turn consisted of three balls bowled at the pins. Although theoretically possible to get a score of 27 with 9 each ball a score of >5 was good. A score of 0 was more common than a score of 9. Spouses were put on opposite teams and Kay's team did not win. :.)<br />
Tuesday we traveled to Lyme Regis on the Dorset Coast. This is a popular summer beach spot where we walked on the "Cobb" and I got to do a bit of birding. We enjoyed the beach-side town, the shops, and lunch at the Pilot House. Tuesday night we attended a weekly Rotary Club of Yeovil meeting with spouses and gave our first power-point presentation about ourselves and our clubs to our hosts. It went pretty well and it was nice to meet many of our host club members. <br />
Wednesday we visited a small village Ilminser after leaving a bit early for an extra visit with our host family to Ham Hill. Ham Hill is where the quarry that supplies all the "hamstone" for local building is mined. The mine is owned by a Royal family member and leased by a mining company. The ocre colored limestone from this mine is the default stone for building in Somerset, and is considered both especially attractive and easy to work with for building. We met for lunch at Montacute House and did a house tour of this large country Elizabethan era (1500's) home and gardens. After a short rest we met the club for dinner at the farm of Patrick Palmer to visit his family farm, Bower Hinton Farm, for a hayride and barbecue. This was a great last night with the Yeovil club and a last chance to see some of the members. The deserts were especially spectacular.<br />
Tomorrow we are off to meet our next host family from the Frome Selwood Rotary Club at Stourhead Inn where we will have lunch and tour the inn in the afternoon.<br />
Hope all is well back home. We are having a great trip so far. Expect it to continue to be terrific.<br />
<br />Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com0tag:blogger.com,1999:blog-4768008725082081606.post-37964891087830722652014-05-04T11:03:00.000-07:002014-05-04T11:03:11.583-07:00Birdathon 2014<div class="MsoNormal">
Thanks to any and all Tahoma Audubon Society supporters who
have are plan to contribute in support of my 2014 birdathon effort to raise
funds for the educational and conservation efforts of TAS. From 3:48 PM on Friday May 2 until missing
our last chance at Chestnut-backed chickadee while sharing a Bud light at my
kitchen table to stay out of the afternoon rain at 3:48 Saturday afternoon Ryan
Weise and I chased species from Ocean Shores to Thurston and Pierce counties
while getting our highest ever total of 127 species. </div>
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Weather mostly cooperated until the last hour or so
Saturday, and tides at the coast were helpful.
We started at the Oyhut Game Range at Ocean shores with <a href="http://www.allaboutbirds.org/guide/rufous_hummingbird/id">Rufous
hummingbird</a> (hyperlinks are to Cornell Lab Bird Photos) our first species as we walked into the tideflats. The best bird there was a single <a href="http://www.allaboutbirds.org/guide/Long-billed_Curlew/id">Long-billed
curlew</a>. As the 9+ foot high tide
receded we found the rock-loving shorebirds, <a href="http://www.allaboutbirds.org/guide/Ruddy_Turnstone/id">Ruddy</a> and <a href="http://www.allaboutbirds.org/guide/Black_Turnstone/id">Black turnstones</a>
and <a href="http://www.allaboutbirds.org/guide/surfbird/id">Surfbird</a> at
the back end of the jetty along with two early <a href="http://www.allaboutbirds.org/guide/Heermanns_Gull/id">Heermann’s gulls</a>.
We were surprised at the numbers of <a href="http://www.allaboutbirds.org/guide/Rhinoceros_Auklet/id">Rhinoceros auclkets</a>
(120) and <a href="http://www.allaboutbirds.org/guide/Common_Murre/id">Common
murres</a> (20) off the jetty, and found the expected salt water birds. Driving
the open beach for a couple of miles explained where the numbers of shorebirds
were, as we found thousands, including huge numbers, maybe 1000+ <a href="http://www.allaboutbirds.org/guide/Semipalmated_Plover/id">Semipalmated
plovers</a>. At Bowerman basin in
Hoquiam we found the Great <a href="http://www.allaboutbirds.org/guide/great_horned_owl/id">Horned Owlets</a>
still on the nest platform where they had made the local newspaper for the Gray’s
Harbor Shorebird Festival the weekend prior. The <a href="http://www.allaboutbirds.org/guide/barn_owl/id">Barn owl</a> was at it’s
expected silo on Wenzel Slough Rd as the Wilson’s snipe winnowed all around us.
</div>
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After a brief sleep in our own beds we met and started the
day at Niszually NWR where ducks, warblers, tanagers, and a calling American
Bittern posed for digiscoped iPhone photos,</div>
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bringing our list to 102 for the
trip by 8AM. We forged ahead to get a <a href="http://www.allaboutbirds.org/guide/house_wren/id">House Wren</a> at the
Mountain View Cemetery marsh in Lakewood, added a few species at Ft. Steilacom Park,
and headed for Titlow Beach. The
highlight there was 7 <a href="http://www.allaboutbirds.org/guide/Marbled_Murrelet/id">Marbled Murrelets</a>
in their brown “marbled” brown plumage swimming not too far off the beach. <a href="http://www.allaboutbirds.org/guide/bushtit/id">Bushtit</a>s and a
drumming <a href="http://www.allaboutbirds.org/guide/Downy_Woodpecker/id">Downy
Woodpecker</a> brought our list to near 120 and we knew we’d get one at a time
from there on. The rest of the day we
chased “stake-out” birds, adding the <a href="http://www.allaboutbirds.org/guide/American_Dipper/id">American Dipper</a>
at the Carbon River bridge in Orting, <a href="http://www.allaboutbirds.org/guide/American_Kestrel/id">American Kestrel</a>
on its usual wire on Hwy 162, and <a href="http://www.allaboutbirds.org/guide/Huttons_Vireo/id">Hutton’s vireo</a>
at the Spanaway Marsh. </div>
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We knew we had near 125 species but trying to e-bird, keep a
list, drive and bird had our record keeping a bit iffy. After a good night sleep this morning I
audited our e-bird lists, and we say 127 species for the trip.
As it seems always the trip was as notable for the birds we missed as
the ones we got. No Brewer’s blackbird,
Chestnut-backed chickadee, Turkey vulture, Evening grosbeak or Pine
Siskin. This makes us excited about
future trips and ways to find even more.
Still a great trip. You can contribute at <a href="http://www.firstgiving.com/fundraiser/edpullen/birdathon">http://www.firstgiving.com/fundraiser/edpullen/birdathon</a>
if you want to support TAS. Good birding.</div>
<br />
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Ed Pullen </div>
Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com0tag:blogger.com,1999:blog-4768008725082081606.post-29774460497582183422013-08-21T19:23:00.000-07:002013-08-21T19:23:06.931-07:00The Good Times Keep Rolling<div class="separator" style="clear: both; text-align: center;">
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Kay had her quarterly follow up visit with Dr. McCrosky
today, and got really great results on her CA-125 tumor marker testing, a
really great 25. This was even better
than we had hoped. Kay is now just over
a year after her last course of radiation therapy, and has been taking the
curcumin for the last 4 months. At her
last visit we were really pleased that her CA-125 was down from 70 to the low
50’s, and were hoping for not much of an increase this time. The 50%+ drop in the number was great
news. We don’t really know what to think
of this. Is it because the rising CA-125
after finishing her radiation was really
a result of post-radiation inflammation rather than returning cancer? Is the curcumin a strong anti- cancer drug in
Kay’s case? Whatever the reason, we are
joyful and grateful for the results.</div>
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We’ve been having a great summer, the vacation to France, a
visit to the Maine Pullen clan following a visit from Morgan, our cousin/niece,
and then last week a trip with Ron and Linda Bahr to Glacier National
Park. This doctor’s visit result puts a
cherry on top of what has been a wonderful summer so far. </div>
<div class="MsoNormal">
Jean is settling in at her new job at Nordstrom’s as a
financial analyst, Kay continues to enjoy her retirement, and I am still
enjoying work along with lots of vacation.
Our love goes out to all who rejoice in these great results with
us. Enjoy the rest of the summer.</div>
<br />
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Ed & Kay</div>
Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com0tag:blogger.com,1999:blog-4768008725082081606.post-86188971572158235262013-05-08T07:20:00.001-07:002013-05-08T07:20:35.195-07:00Best News in a Long Time<div class="separator" style="clear: both; text-align: center;">
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Kay has been in the hopeful waiting mode for a few months with her ovarian cancer. She finished the three-stage surgery --> chemotherapy --> radiation therapy regimen we had hoped could possibly cure her cancer about a year ago, but discouragingly her CA-125 tumor marker started to rise steadily within a few months. After several consultation and a lot of thought we decided in agreement with both her local oncologist and the Seattle Cancer Care Alliance consulting oncologist to delay further treatment until Kay either started to feel ill-effects of the cancer or until there was demonstrable cancer progression on CT scans or other imaging modalities. Her CA-125 steadily climbed from about 10 to 27 and 3 months ago to about 70. (upper normal is 30) Her doubling time was about 45 days for this marker. On this projectile we were hoping for slowed growth in the number, maybe something less than 150-200 would have been on the good side of expectations. Kay kept a positive outlook, feeling greatful for the year off therapy, but the expectation of starting treatment and its potential side effects was hanging over her head.<br />
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<div>
Some of you may have seen a crowd-sourcing post on my medical blog <a href="http://drpullen.com/turmericcurcuminovariancancer">Crowd Source Help Requested: Curcumin - Turmeric for Ovarian Cancer</a>. Kay started the supplement Curcumin C3 about 3 weeks ago in hopes that it might slow the progression of her cancer. Today when she saw Dr. McCrosky to hear the results of the CA-125 drawn yeasterday she was flabbergasted to hear that it has DECREASED from 70 to 50. They rechecked this to see if it was a lab error, but the repeat was 55. So for some reason, ? curcumin response? Kay's ovarian cancer tumor marker that has been so discouragingly accurate and predictable in the past has dropped instead of increasing as expected. </div>
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<br /></div>
<div>
Kay continues to feel really good She is working hard in her garden, and it looks great. We are all grateful that she feels strong and is enjoying this hard work. Her energy is near normal, and we both are really excited about not needing to recheck the CA-125 for another 3 months. Having the summer off treatment and feeling strong and well is a blessing we had hoped for but not really dared to expect. </div>
<div>
<br /></div>
<div>
We do have lots of fun planned. We are vacationing in France for the first half of June. We have a vacation to visit the Pullens in Maine in July and hope to soak up the predictably wonderful sunshine here in WA for the rest of the summer. Three months of fun, sun and no chemo is really exciting. </div>
<div>
<br /></div>
<div>
Join us in prayers of thanks for the gift of this respite from therapy, for continued regression or at least lack of progression of Kay's cancer, and for joy and fun in this coming summer. </div>
Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com0tag:blogger.com,1999:blog-4768008725082081606.post-85332988980377497692013-04-25T20:13:00.001-07:002013-04-25T20:13:23.516-07:003-Month Update As many of you know we found out that Kay's ovarian cancer seemed to be recurring at her follow up visits after finishing her surgery-chemo-radiation therapy regimen last year, and she had her 3-month follow up visit with Dr. McCroskey last Thursday. The news is decidedly mixed. The good news is that Kay continues to feel well and life is good. Some of her local friends threw her a party for her 59th birthday and they went to a ceramics painting place and painted a set of marine-theme plates. We also had a family party in Seattle and she had a sleep-over with Jean and Brett at Jean's place. The medical news is just OK. Her tumor marker, the CA-125 continues to rise, from 30 about 3 months ago, to 72 now. This unfortunately confirms that her cancer is growing, but not terribly rapidly. She is going to get a CT scan soon to look for any measurable bulk of tumor, but the plan for now is to carry on, live our lives and recheck the tests in 3 months again. This will give her another period of time without chemo and the attendent side-effects.<br />
At that time there is a good chance she will need to go on treatment to keep the cancer from spreading, and there are some not-too-intolerably-difficult options. Most likely is seeing if an oral PARP inhibitor prevents works. Other options may include a tumor-immunization trial being done at the University of Pennsylvania. We will learn more about the options as the time for treatment approaches. For now it's time to live as normally as possible and cherish time off treatment.<br />
This is all pretty much in the mid-range of our expectations, not great news, but not a big setback either. We are committed to living fully and normallyEd Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com0tag:blogger.com,1999:blog-4768008725082081606.post-89884660372732757182013-04-25T20:13:00.000-07:002013-04-25T20:13:06.533-07:00Happy Valentines DayHappy Valentine's Day!<br />
<br />
Kay and I want to shout out to all Happy Valentine's Day. We love each other and want to sent some love out to all of our friends and family too.<br />
<br />
This year is off to a pretty good start for the the Washington Pullen family, and if this sounds like a Christmas letter that's because we didn't get a Christmas letter done. For details on Kay's cancer see the post immediately prior to this. That's the last I'll mention of cancer in this post.<br />
<br />
Kay and I have been busy having fun for the last few months. We had a great 2+ week vacation in Cabos prior to Christmas, half with friends the half with Jean, Brett and Keith Colmar, Kay's brother. This was a really nice trip, and as usual the sun, water and Mexican environment were much enjoyed. Both kids were home for Christmas and that was low key and enjoyable. <br />
<br />
For the first half of 2013 we have fun planned with a fair amount of birding adventures coming up soon and a possible big trip if we figure out the details. Maybe Paris. Kay is getting more active in her painting getting together with an old friend Stephanie regularly for inspiration and creative exchange. She has wound Pullen Advertising down to functional retirement, and that is great too.<br />
<br />
I am embarking on a new stage of my career at Sound Family Medicine. I've recruited two very good young physician assistants to work closely with me to care for our patients. The expectation is that this will allow me to stay in practice longer, take more time for travel and enjoyment, and still have my patients get strong continuity care. I'm excited about this and so far, in the very early stages, it seems to be going well.<br />
Jean continues at Blue Nile, the online diamond and jewelry retailer based in Seattle as a senior accountant, and if finding the company a good place to work and balance work-home life. Life in Seattle has been great for her and she gets home regularly as well as our frequent trips to the city where we often meet up with her and Ryan, her boyfriend.<br />
<br />
Brett continues his career in internet business development and management. He is working really hard, making progress and we are proud and supportive parents of our entropreneur son. It is amazing how many young adults we know now whose careers are focused on internet marketing, managmenet and related fields. Brett is going to do great in this field as he is focused and determined.<br />
<br />Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com0tag:blogger.com,1999:blog-4768008725082081606.post-88842758214143866412012-12-24T07:32:00.001-08:002012-12-24T07:34:25.393-08:00Looking Back at 2012Kay and I were reminiscing about 2012 yesterday and we were surprised that we both remember mostly the good parts of the year. 2012 has been an incredibly eventful year for our family that roughly speaking involved two parts. The first part involved Kay’s no-holds-barred attack on her ovarian cancer recurrence. From Jan through July she went through first surgery to try to remove the known remaining tumor, then an aggressive and very difficult combined intra-peritoneal and intravenous regime of chemotherapy, and finally a course of whole-pelvis radiation to shoot for a long-term remission or even what Dr. Swisher hinted at, a cure. The emotional highs and lows involved in this undertaking were tough at times. First the surgery where no cancer was seen in the abdominal cavity<span style="font-family: Wingdings;">à</span> great news, followed by news that the surgical margins where the cervix was removed not being cancer free <span style="font-family: Wingdings;">à</span> bad news. This shift in prognosis came in just a few days. On the tail of that came the realization that the intraperitoneal chemo was going to be much tougher than any chemo Kay had faced yet, while the whole time dreading the unknown of radiation to follow. The discomfort of the chemo and the fatigue of the radiation seemed to drag on forever. Kay really hates feeling like she has to just rest and not be able to do much more than just make it from day to day on these treatments.<br />
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In late July Kay finally started to get some energy back and we started planning more fun, travel and higher energy activities. We even took a hike at Sunrise on Mt. Rainier, getting close up looks at mountain goats and spectacular scenery. We took our summer trip to Maine and made plans for a fall trip to the mid-Atlantic area and our December trip to Cabo San Lucas. Then just 2 months after her last radiation therapy, and before our east coast trip, we learned that her tumor marker, the CA-125 level, was starting to climb, and hopes of a long remission or cure were dashed. All of this led to yet more doctor appointments, consultations with Kay’s Seattle Cancer Care Alliance surgeon, and looking at options from here. <o:p></o:p></div>
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The consensus is that Kay should not hurry to more treatment and that the primary goals of treatments in the near future need to be to prevent progression of the cancer to an advanced stage while trying to minimize side effects of treatment. The goals of long term remission from an aggressive course of combinations of chemotherapy have not been very effective and Kay needs to instead focus on living with cancer and managing this with the least toxic regimens available. There is always the hope of a breakthrough in treatment that could give better results at some time, but currently available treatments have not done more than less toxic options may provide. We have tentative plans for relatively easy treatment when the cancer starts to progress to a stage where Kay feels less well, or there is evidence of cancer progression other than just the CA-125 marker. <o:p></o:p></div>
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Despite all of this Kay feels strong, healthy and really good right now. Her spirits are high, and physically she is near 100%. We just got back from a great 2 ½ week Mexican vacation, half with friends then half with family. We are home for the holidays and life is good. We don’t anticipate further treatment for some undetermined number of months and are enjoying life. Looking back at the year we both are amazed that we feel like it was a pretty good year, mostly fond memories, some great times, and the difficult times seem like a hazy distant memory. We joke that this is the remarkable ability of the human mind to block out the bad memories and focus on the good ones. <o:p></o:p></div>
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Both of our children continue to thrive, Jean working at Blue Nile diamond in the accounting department and Brett running his own company of web assets while both live in nearby Seattle. <o:p></o:p></div>
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We are grateful for the continued love and support of all of our friends and family, for the joy and peace of Christmas, and for these months of feeling strong and good. Thanks for all of your love and prayers.<o:p></o:p></div>
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Kay & Ed <o:p></o:p></div>
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Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com0tag:blogger.com,1999:blog-4768008725082081606.post-83677876201573073832012-09-16T16:29:00.001-07:002012-09-16T16:29:42.182-07:00Kay Rocks the Orting Trail<div class="separator" style="clear: both; text-align: center;">
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Kay is having a great end of summer. Today we went for an hour bike ride on the Orting Trail, a converted rails to trails bike and multipurpose trail, and she even impressed herself. She rode hard the whole hour, felt great doing it, and has continued to be an energizer bunny while Brett and I played couch potato and watched the whole Seahawk's domination of the Cowboys today.<br />
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For at least a couple of weeks Kay has been really about back to normal with her energy levels. She had been really concerned that this last course of surgery --> Intraperitoneal + IV chemotherapy --> Whole pelvis radiation therapy that lasted from Jan through the end of July of this year was going to be something she survived but was never really the same. Her energy levels and strength were just so beaten down that she questioned her ability to fully recover. She and we can put those doubts to rest. Kay is herself again.<br />
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That is super good news and we plan to take full advantage with lots of fun planned for the rest of 2012, starting with a 2+ week east coast vacation in late Sept --> Oct birding at Cape May, NJ and then touring dead presidents estates and the Shenandoah Valley and other regional attractions. <br />
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Thanks to all for all of the support we have received, and I'll keep posts coming once in a while for updates. For now, hooray, and hopes that I can keep up with Kay in her real self mode. <br />
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<br />Ed Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com0tag:blogger.com,1999:blog-4768008725082081606.post-80002750552830338542012-08-08T07:45:00.001-07:002012-08-08T07:45:44.830-07:00Summer is Great, So is KayNow in the second post-radiation therapy week at the Puyallup Pullen household life is going great. Kay seems to have regained a lot of her energy and a little of her hair, and we have been taking advantage of the situation. Last weekend I took Friday off and we had a "staycation." Friday Kay and I took a 6 mile hike out of Sunrise on Mt. Rainier, and though appropriately tired Kay did great. Saturday we joined church friends on the White's sailboat for a beautiful afternoon and evening sail out of Commencement Bay. Sunday we visited the kids in Seattle for a late lunch, then Jean and Kay's girl friends put on a surprise "congratulations- treatment is finally done" party at Jeans condo in Seattle that they all loved.<br />
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This week Mary, Kay's sister and our niece Caroline are visiting from So. Cal. arriving this afternoon. We're looking forward to a great week and more fun yet. A week later we leave for a week visiting family in Maine. I'm trying to fit a little work in between the fun, and so far so good.<br />
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Hope all of you are having a great summer.<br />
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EdEd Pullenhttp://www.blogger.com/profile/10684234991269328261noreply@blogger.com0