Happy Birthday Brett

Today was a pretty great day. First, Kay got out of the hospital after an overnight stay because of a fever while her neutrophil count (the type of white blood cells that fight serious bacterial infections) was low. Shortly after Brett and I left for Yellowstone Kay developed a fever and after trying to make it at home her oncologist had her hospitalized for testing and starvation therapy. (just kidding about the starvation, she was just kept the dreaded NPO until after all the testing suggested that she did not have an infection around the bile duct stent, and so did not need the stent removed emergently.

This morning she got sprung just in time to pick up Fay from Seatac, and by all accounts has had a good day.

Brett and I had a huge marathon trek around Yellowstone National Park. There was a detour, requiring the long way around twice, so we saw nearly all the main roads, many of the side roads, and most of the prime sights in one day. We really liked Yellowstone Lake, the Grand Canyon of Yellowstone and Monmouth Hot Springs. We saw many bison, an elk, a large buck deer, Bald Eagle, Osprey, assorted birds, and were a couple of minutes late to see a Grizzly bear.

After all that off to the hopping nightlife of West Yellowstone for Pizza and bear to top off a pretty nice father and son day for Brett's 21st birthday.

Now off to zzzzz land.

Pray for Kay to stay well.

Ed

Positive news today

We met with Dr. McCroskey today. There are advantages and disadvantages to having a doctor as a husband. One of the disadvantages is that your physicians try to be really prompt in giving you results, and sometimes this can mean you get preliminary results, before you get final results. The PET CT scan done yesterday is a perfect example of this phenomenon. The radiologist looked at the PET CT, made a preliminary interpretation, called Dr. McCroskey, who called me and Kay as he know we were anxious to hear right away. This morning Dr. McCroskey met with a second radiologist, and then with the first radiologist who read Kay's scan yesterday, to review the scans, compare them to the CT scan she had before surgery. It appears that the area of activity seen on the PET scan is actually fairly faint and small, and is in an area of the liver above the stent, not very near where the cancer was noted prior to surgery. In addition there is no mass, or tumor seen on the CT part of the scan. This is the beauty of the PET CT process, where in the same scan both tests are done, so an area seen on one part of the test can be accurately compared to the other part. Their conclusion after this comparison is that there is a high likelihood that the area seen on the PET scan is an area of inflammation from the insertion of the stent through the liver, not residual cancer. He thinks Kay is in remission at this time, and recommends that she have the stent removed, and easy procedure, and that she have her CA 125 followed monthly, and the PET CT repeated in 2 months if the CA 125 remains low, or sooner if it increases.

We are really pleased with this news. It leaves the possibility of a cure at this time, and at least gives Kay a chance to recover from all of this therapy.

We are going to enjoy the rest of the week, Brett and I at Yellowstone; Kay, Jean and Fay at home visiting and playing.

I'll keep this brief as I have an afternoon of patients to attend.

Prayers of thanks for God's greatness and healing power, and for a time of rest, healing, and regaining strength for Kay are in order.

Thanks for all of your support.

Ed

Not the best of news

Today Kay had her PET CT scan done, and this showed an area near the stent that she has draining her biliary duct, with increased uptake of the glucose marker on the PET scan. This area is where she had the large mass of tumor at the time of her original surgery which made it impossible to surgically remove all of her cancer. There is a high probability that this area is residual cancer.

The good news is that there was no evidence of cancer in any rest of the body.

The plan is really TBD, to be determined, but we have an appointment tomorrow with Dr. McCroskey to discuss where to go from here. She probably needs an laparoscopic evaluation to see if this area really is a cancer, and if so we will need to decide what is the best direction to take from here to continue our quest for a cure.

Certainly this is not the best of news, we had been hoping, and praying along with all of you, for no detectable cancer at this test, but it is not the worst of news either. Most of the cancer, and there was a lot, has been killed off. There are additional therapy options left, that have the possibility of a cure. We will be looking at our options, getting expert advice, and making choices from here. Kay cannot have any surgery for at least another couple of weeks, as it was only 2 weeks ago tomorrow that she had her last course of the avastin. No non-emergent surgery should be done until the avastin is completely out of the system, so wound healing can happen.

Keep up the prayers, I'll post more when I know more.

Ed

Kay without carbohydrates

Not a pretty sight. In preparation for her PET CT scan tomorrow Kay has been on a zero sugar diet today, to include starchy veges, fruit, milk products, and really anything but eggs, meat, and some green vegetables. By afternoon she was on her knees pawing through the freezer scolding Brett and me for the disarray of everything there. What she really meant I think was nothing there that sounded good to her to eat that she was allowed. It turns out that a part of her PET scan is the injection of a radioactive labeled glucose IV, which needs to be selectively taken up to metabolically active cells. Avoiding dietary sugar makes any possible cancer cells more active in the uptake of this injected glucose, as she has not eaten any for a day before. Anyway, those of you who know Kay know that she is usually thinking of her next meal part way through the one she is eating. We will both be happy after this test is done, not just to hear hopefully good results, but to get Kay back to eating her favorite foods again.

This should be a fun week for all of us. Brett and I head to Yellowstone after work Tuesday evening. Fay, Kay's mom, arrives on Thursday, and Jean is coming home Wednesday to spend some time with Kay and Fay.

Pray for great news tomorrow. I plan to post tomorrow evening with news after we get test results.

Ed

Seattle University

Brett got great news today, he is accepted to Seattle University for the fall quarter. We have been hoping and praying for this to come through. He finished his 2 year community college courses in a week, and we have been waiting to hear from Seattle University, the college Brett has really been hoping to go to, for a while. He got the "thick envelope" in the mail today, and I was excited to pass it to him to open when I got the mail after work today.

Now Brett can move on with his studies, and he is really excited. Actually we are all excited and happy for him.

Kay had a really busy day at work today, putting more progress on the Sound Family Medicine website upgrade behind her, and Jean went back to Portland. She and Marc are going camping, to Crater Lake and Bend, OR for a 5 day weekend trip.

Overall a great day for the Pullens, and one more step toward one of our goals, Brett at a 4 year university.

We have no doubt about Brett's ability and now that his focus is centered on academics, he is going to thrive there.

Enjoy the rest of the summer, and give prayers of thanks.

Ed

A Great Saturday

We had a great day today. Kay seems to be over this course of post chemo fatigue, and today we had fun until anyone would have fatigue. For Kay and Jean the day started with not such a tiring task, the got their toes "done" at a pedicure shop. They got home just in time for us to leave for the Rotary Flotilla. We joined Roger and Gloria Hunt on their yaught near Brown's Point in Tacoma and cruised from there to Gig Harbor. There we met up with several other Rotary members and boats and had Pizza at the Tides tavern. Several beers on the boat, more at the tavern, lots of sun, good conversation, great views of the Puget Sound, and then we raced home to go to the still 50 party of Colleen Wise, a church friend. Apparently she had not celebrated her 50th birthday, and turns 51 tomorrow (or soon?) and so she had a party tonight. More good food, and we expect to sleep well t0night.

The house seems quiet without Maeby, Brett's dog, who went back to Arizona with one of her other owners today. It will be interesting to see how our dog Simon reacts to being the ruler of the roost here again.

Tomorrow is supposed to be sunny too, so more fun is expected. It's nice to have Kay back feeling good again. Hope everyone has as good a weekend as we are.

Ed

9

The good news again this course is that Kay's CA-125 after her 5th and next to the last course of chemotherapy was 9. This is down from 11 last time, and is into the goal range of less than 10. This is excellent. Now we wait for the PET CT scan on Monday August 21st. We are really hopeful that this will not show any sign of Cecil.

On another note last night was a nice evening for the Pullens. Jean and Kay went to a movie neither Brett nor I had any interest in seeing, something about a summer with 500 days. They enjoyed themselves. In the meantime Brett and I decided at 6 PM to go to the Mariners vs. Chicago White Sox game at Safeco. We drove up, bought cheap tickets, sat in nice seats as the game was only about half sold out, and watched a classic pitchers duel between two all-star pitchers, Felix Hernandez of the M's and Mark Buehrle of the CWS who has a recent perfect game on his resume. The game was tied at 0-0 with two outs in the bottom of the 14th inning, runners on 2nd and 3rd bases, and Ken Griffey Jr. came up to pinch hit for the M's catcher. He hit a 2 strike pitch deep into the right field corner to win the game, and set off the M's ritual "beating" where the hitter of a walk off winning hit gets chased down and pummelled in good nature. It was a great game to watch.

Jean is home for the weekend, planning to take her second part of the CPA test Monday, and Brett is visiting his old UA roommate to whom he has to give Maeby (his time-share dog) back to Saturday. We'll miss Maeby's energy, loving, and constant fun, but we'll miss the dueling barking at everyone who even drives or walks near the house less.

So far no problems after Chemo session #6, and we all pray for any remaining cancer cells to be destroyed.

Have a great weekend.

Ed