Sunday, December 23, 2007

We Have a Plan

I spent the week at home with my Mom, Dad, and sister Em alternating days. Every day I feel a little bit better. Deb was back at work every day except for Wednesday. On Wednesday I had my first consultation with my melanoma specialist, Dr. Flaherty at Karmanos.

Karmanos is located just north of downtown Detroit, next to Wayne State University. Deb, my Mom, and I went downtown together for the appointment. Our friend Felicity, who works at Karmanos, visited with us before we saw the doctor, which made the appointment feel more comfortable.

Dr. Flaherty clearly explained what I was up against and his recommended treatment plan. Since I am diagnosed with Stage IV melanoma (in the body, not the brain), surgery isn't a viable option. Dr. Flaherty explained why surgery wasn't utilized for my condition through the following metaphor. If you found a dandelion (i.e. cancer) in your front yard, you could use a shovel (or even a backhoe) to remove the dandelion, but in the future other dandelions would sprout in the yard. The primary problem isn't the dandelion, it's what's in the yard. Dr. Flaherty discussed the treatment options that attack the cancer that is in my body (not necessarily limited to my liver). Unfortunately, the state of the art in body imaging (CT scans) can only detect tumors greater than 1 cm in size (about 3/8 of an inch)

The 2 primary treatment options that Dr. Flaherty discussed were chemotherapy and biological therapy. Chemotherapy was selected at this time because bio-therapy can cause fluid to collect in the chest cavity. Since I already had been admitted to the hospital with excessive fluid in my lung, there is a risk (at this time at least) that biological therapy would not be fully effective, as I would have to stop the treatment if I was re-admitted to the hospital.

I had another CT scan early Friday morning at Detroit Receiving Hospital (for which I drove myself downtown). In a small world moment, I chatted with a very friendly woman (also in for a CT scan) who happened to have Dr. Flaherty previously for melanoma and breast cancer (on separate occasions). She expressed a very positive experience with Dr. Flaherty.

On Saturday and Sunday, Deb's family arrived from Chicago and Grand Rapids for an early Christmas celebration. We fit 8 adults and 9 children (all under age 7) into our little bungalow. At times it was hectic, but we had great fun spending time together.

Sunday, December 16, 2007

1st week back home

Every day I am recovering more of my strength and stamina. I have my share of aches and pains, mainly due to being inactive for such a long period of time. I take these pains in stride; sometimes it is hard not to think that these are somehow related to my cancer.

The official diagnosis of my condition, for which I was admitted to the hospital, is pleural effusion due to pneumonia. The type of pneumonia was not determined (i.e. bacterial, viral, fungal, etc.). The fluid extracted from my chest tested negative for cancerous cells.

If this is truly the case, then I firmly believe that the pneumonia is a blessing, as who knows when/if the melanoma in my liver would have been discovered. I thank the Lord for having the shadow on my liver show up on the original CT scan when I was admitted to the hospital.

I will be meeting with the melanoma expert at Karmanos next week, which hopefully will help us lay out what to expect for my treatment.

Deb's mom returned home on Friday after spending a week with us taking the kids to a from daycare and running countless errands to keep our house in order. We thank you so much for all the time you have given us.

Mom and Steve arrived on Friday evening. Dad arrived on Saturday, together we spent a few hours working on the kitchen. Derrick and Mike installed the base cabinets on Tuesday, John put in a new sink on Wednesday, and our floor was installed by contractors on Friday.

Tuesday, December 11, 2007

Returning Home

The chest x-ray was finished early morning and the pulmonary doctor informed us that there was no indication that fluid had returned to my left lung, so I would be cleared to go home if everything came back fine on my bone scan.

My oncology doctor's assistant noted there was some "irregular activity" in my 7th and 8th ribs on my left side (location of my back pain when I was admitted to Oakwood). There weren't any specific conclusions that could be drawn, as the "irregular activity" could be due to a strained muscle. A set of rib x-rays were ordered (which turn out to be different than a chest x-ray for my lungs). Since I already had approximately 6 x-rays over the duration of my stay at Oakwood, the hospital tried to get the necessary rib images from previous shots. By 3 pm, it was finally decided to send me downstairs to get the set of x-ray images of my ribs.

At 4 pm, we were transferred to a different floor of the hospital, as the 10th floor was being cleared for renovations over the holiday. At 5 pm my primary doctor informed me that the rib x-rays showed no abnormalities in my ribs, so I was free to go home. By 6 pm I had my discharge papers, so after 195 hours in Oakwood hospital I walked out of the building with Deb.

Everyone was relieved that I was home (myself included). Although the hospital has all of the needed care available on-site, there is nothing like the comfort of home.

Monday, December 10, 2007

First Positive News

Early morning, our Oncologist let us know that the MRI scan of my brain was clean. This really felt like a turning point, as this was the first positive news we had received regarding my cancer.

I had the bone scan done in the afternoon, with results anticipated tomorrow. An x-ray of my chest was scheduled for first thing in the morning to verify that my left lung was still clear of fluid. If the x-ray came back clear, I was told that there was a good chance for me to return home tomorrow.

Ben and I played chess in the evening while Deb and her Mom spent some time at home with the kids. Ben returned home in front of the oncoming storm.

Ben, Deb's mom

Sunday, December 9, 2007

Finally, Some Mobility

This was the first day where I felt more comfortable out of bed than in it. I spent a large chunk of the day down in the visitor's waiting room with family and friends. We passed the time playing card games and discussing everything we knew up to this point.

In the late afternoon, I went downstairs for the MRI of my brain. The procedure lasted about 1/2 hour and required me to stay absolutely still. We expect to hear results from the scan tomorrow.

We know that there are a lot of people praying for us, and I am already feeling the positive effects of the healing process. Thanks so much to everyone out there who is praying for our family, we firmly believe that this is what is going to get me through this.

Ben, Deb's mom
Mom and Dad, Steve
Marc, Drew and Caren

Saturday, December 8, 2007

Where Do We Go From Here?

Deb and I anxiously awaited for our anticipated 9 am consult with the Oncologist, but that time came and passed. We waited as patiently as possible, but by 11 am, our nurse noticed the emotion in our faces and paged the Oncologist. She returned with news that he would stop by between 3 and 4 pm.

It was great to have visitors during the afternoon to help keep our spirits up. Even though we didn't know exactly what I was facing, it was good to share what we knew with our friends and family.

At 4 pm, when our Oncologist arrived at our hospital room for the consult, Deb and I were in great spirits. We went over my medical history, including my previous experience with melanoma when I was an undergrad in Chicago. At that time, the surgically removed melanoma was diagnosed Stage 0, which typically means that cancer had not progressed deep enough in my skin to reach the bloodstream. The Oncologist answered all over our questions the best he could with the information he had. He was optimistic regarding my recovery, saying that my condition was "serious, but not hopeless." His next steps for me were to get additional scans of my brain and bones to determine if the cancer had metastasized elsewhere in my body. In addition, I would be seeing a melanoma specialist at the Karmanos Institute.

Although I was still exhibiting pain in my left side, the consult with the Oncologist was a real lift for Deb and I, as we finally had some sense of what the future looked like for us.

When I had become ill, our DIY kitchen remodel was at a point where half of our new cabinets had been installed, but the critical (i.e. sink and dishwasher) portion was completely gutted. John, Ben, Deb's dad (Cal), Deb's mom, and Jorge (John's contractor back home) worked all day Saturday to build cabinets, prep the sink, and mud the walls. Derrick offer to be a liaison for me with the crew at the house, which was great considering all of Derrick's experience in the field. I can't thank enough all of the help we received from our family and friends aiding the completion of this project.

Thanks to Derrick and Mike for bringing Pizza Papalis for dinner. The day was capped with a visit from Deb's family, which was special for all of us. John, Cal, and Jorge returned home after the visit.

John and Carol
Mike, Derrick
Deb's mom, John, Ben, Cal (Deb's dad)

Friday, December 7, 2007

The News Nobody Wants to Hear...

Since all of the diagnostic tests requiring sedation (and an empty stomach) were complete, I had full access to the hospital menu. At this point only a couple of items were appetizing to me, including bacon, banana bread, and apple juice.

We spent the bulk of the day hoping that we would get the biopsy results. It was hard to make the time pass despite all things (TV, paper, magazines, etc.) I had to pass the time. I found that the most enjoyable way to pass the time was to have visitors. It was nice to have friends and colleagues stop in to say hi in the early afternoon. Even through my diagnosis was still undetermined at that point, it was still good to explain everything that had happened up to that point.

My primary doctor in the hospital stopped by around 3:30pm to see how I was doing. I asked if the biopsy results had come back yet. He said he hadn't seen anything yet, but would check again.

Dad came down to pick up the kids for the weekend around 4 pm. This was great for Deb and I, since we knew that I would be in the hospital for the remainder of the weekend. Knowing that Deb could stay with me in the hospital was a real comfort. Before Dad headed home, the kids came up to visit me in my room. There was a strange combination of joy and fear as I saw my 3 year olds sit on my hospital bed. Landon quickly figured out how to operate the switches on the adjustable bed. Morgan sat quietly next to me describing her new pink penguin stuffed animal.

At 4:30 I received a call from my primary doctor at the hospital informing me that the liver biopsy had come back positive for melanoma. I would be getting a consult from an Oncologist around 9 am tomorrow. As I was the one who took the call, I informed Deb and Dad. We all just sat in silence, all I could do is just hold Morgan close. Having the kids there was just too emotional for Deb and I, so Deb helped Dad take the kids back to the car. When Deb returned we cried together. When I was diagnosed with cancer (and no other information) it was natural to assume the worst. I was experiencing discomfort in my left chest, so after getting pain medication I drifted off to sleep.

Deb went to look for more information, getting a laptop from our friend Karen and asking her uncle (physician) questions regarding melanoma in the liver. Deb's mom arrived late evening to lend support. As hard as it was, we stayed as positive as we could.

Mike, Derrick, Joe
Wolfram, Tom
Deb's mom

Thursday, December 6, 2007

Some Relief

Early morning, the pulmonary doctor informed me that the fluid had stopped draining from my lung, so the drain could be removed. Although pulling the drain out was painful, there was immediate relief in being able to finally lay on my back without feeling like a rock was in the sheet.

Today I was able to walk out of my room and up and down the hall once. My room is located on the 10th floor of Oakwood. From my hospital bed I only have a 6 inch view of the Michigan sky. The walk to the panoramic windows at the end of the hall gave me a chance to see some part of the outside world that seems so distant at this point.

Since my admission to the hospital I have not been on a scale, but I suspect that I have lost at least 25 lbs from my 220lb frame. My appetite is slowly returning, but I am eating less than 1 full meal a day.


Wednesday, December 5, 2007


The first procedure of the day was a Bronchoscopy of my left lung. I don't recall any part of procedure itself, as I was heavily sedated. My pulmonary doctor informed us that there wasn't anything abnormal discovered during the procedure.

Mom came down to spend the day with me at the hospital. The value of having family here for support in such a time can not overstated.

In the early part of the afternoon I was transported back to the CT scanner room for the liver biopsy. This procedure was very similar to the fluid drain on Tuesday, except that the needle was smaller. Three small tissue samples were collected, the entry point was near the lower right side of my sternum. We were told that the lab results for the biopsy would take 1 to 4 business days to complete, which meant anytime between Thursday or Tuesday next week.

Deb and I were learning to adjust to the slow rate of information flow. We were asking as many questions as possible, but in most cases the doctors weren't able to give certain answers due to not having all of the diagnostic data. It was so frustrating being confined to a hospital bed, in pain, and not understanding why...

Tuesday, December 4, 2007

What a Drain

The pulmonary (lung) doctors at Oakwood explained the procedure to remove the fluid from the left lung. A CT scanner was used to find the precise location for the hollow tube to enter my back. The procedure itself wasn't painful as I was sedated. The doctor removed 1 liter of fluid from my chest during the procedure, allowing the remaining amount the drain slowly over time to reduce the risk of my lung collapsing.

I noticed an immediate reduction in the lower back pain on my left side, but I now had a drain (and protective plug) in my upper back that was very uncomfortable. Excess fluid from my left lung would slowly drain into a graduated container.

Deb and I were informed that there was a dark spot on my original chest CT scan that required an abdomen CT scan for verification. The scan was done in the afternoon and the doctors confirmed that a liver biopsy would be required.

Monday, December 3, 2007

Admitted to Oakwood Hospital

On 28-Nov-07 (Wed) I had seen my primary physician regarding an extended bout with a chest cold and new sharp lower back pain on my left side. A chest x-ray did not indicate pneumonia, so I went home to rest and take antibiotics and pain medication. Thursday and Friday were spent at home resting.

By 3-Dec-07 (Mon) my lower back pain condition had progressed to the point were I could no longer go up or down stairs. Moving from my back to the sitting position was extremely painful, particularly in my chest and left lower back. I found the sleeping had to be done in the sitting (well slouching) position. I took my primary physician's advice to go to the ER.

Dad (Nate) drove down from Port Huron to take me to the Oakwood ER, as Deb was in school teaching. We arrived at the ER around 3pm. A CT scan of my chest revealed that I had a significant amount of fluid between the chest cavity and left lung. I was admitted to the hospital around 11pm.