Here it is Tuesday July 17th, I have been in the hospital since Friday. After a lot of discussion, and tears, Heather aheather-tubing-at-malibu.jpgnd the boys left for Canada/Malibu/to visit the Goffs at their lodge yesterday. The picture on the left is Heather tubing at Malibu (I think we made the right decision!). Meanwhile I have had a very relaxing weekend at Northwest Hospital watching movies and talking with Dr Sam Tolman, the new Puget Sound Cancer Center oncologist who was on call for Dr. Doug Lee. He came from San Francisco with his wife and two children. We had a number of discussions over the weekend of alternative approaches to resolving the fluid in my lung and liver.

I had significant bleeding in my small intestine, up to a pint of blood each bowel movement. The transfusion of two units of blood helped get my hematocryt up from 25 to 32 (below 30 is not good, normal is 38-42). The reason for the bleeding is my blood thinner, Coumadin/Warfarin, which is necessary to prevent future pleural embolisms. I have also been taking Naproxen to control my nightly tumor fevers but that med also contributes to intestinal bleeding. I am now off Naproxen and taking extra strength Tylenol. I am sorry for all the detail, if you are not interested scroll on, I also use the blog to record important medical information and it has been very helpful to recall what was actually done on specific days.

To lighten up the blog a bit here are a couple of pictures from my birthday party last week. dob-blowing-candles-07.jpgThe group shot I really like and Idons-birthday-clan-07.jpg think my shirt, “Endurance”, is a visual reminder to me of the battle and of course the amazing story of William Shackleton. The other picture is me preparing to blow out the candles on the cake. When I look at the pictures I am amazed how healthy I look and appear without actual pain, when in fact I could hardly sit with the clan for more than about 30 minutes before having to rest. boys-with-grandpa-07.jpgOK it is hard to stop because I have so many great photos but here is one I love of the boys with Grandpa.

Yesterday, Monday, all the doctors (with the exception of Dr Lee) came and weighed in on my case. Dr. Sam Tolman recommended a tube into my lung to drain the fluid over 3 days along with one or more tubes in my liver so we could really dry up the abscess and healing could begin. He also felt since the IV medicines were working well I may need to go home with an IV pole.

Dr. Bill Enhi, the infectious disease specialist who has been with me for 9 months, had a different take. He felt the fluid levels had not changed, specifically not increased and that was good. While additional drainage would certainly be helpful, he felt the risk of infection and even lung collapse was too great because of the Coumadin/Warfarin I am on. He also said the last CT scan indicated the liver tumor had not grown even though I had been off Chemo for 7 weeks, which is wonderful news. So his recommendation was to leave my body alone and let it heal naturally. The only problem with this strategy is that it doesn’t seem to be able to keep me from returning to the hospital.

I asked him about getting on a float plane and heading to Canada to be with my family. He felt from an infection standpoint he saw no risk but the real concern was internal bleeding.

I then met with Dr Koch (pronounced Koke) who was meeting with me instead of Alex Reed who was in surgery. He is a great guy and was current on my chart (or should I say to me) when he walked in my room. His feeling was the bleeding was most likely occuring near the stoma (the small intestional opening I have through the skin). The reason for the bleeding is the Coumadin/Warfarin and the Naproxin which specifically cause irritation to the small intestine. His recomendation was to switch from Naproxin to Tylenol as I mentioned at the beginning of this blog. After concurring with Dr Alex Reed, my guardian angel gastroenterologist, the decision was to verify the location of the bleeding with an intestinal camera.

An hour later I was flat on my back ready to get my pain/amnesia medication before starting the procedure. I signed my release then asked if we could try the procedure without the medications since there were no nerves inside the intestine. They agreed and were set to administer the meds if I began to feel any pain. It was very cool to see the inside of my intestine and everything looked healthy with no sign of an ulceration. I felt no pain and we were able to talk about the exam as I watched on a color video monitor.

After that exam they said it was fortunate I had not taken the pain medication because they needed me to sign another release to look in my stomach and more of the 30 feet of small intestine. I signed the form and asked them to bring on the pain meds since this time the entry point for the camera was my mouth. When I woke up the nurse gave me a color picture of my small ulcerations near and in the stomach. This evidently was a strong confirmation that Naproxin was the culprit. Since we had already agreed to stop the Naproxin, Dr Koch indicated that the ulcerations would heal quickly.

I then asked Dr Koch about flying on a float plane and he was OK with it as long as I could fly home and be at the hospital within 3 hours. By the way, my bleeding stopped about 18 hours prior to our conversation so this was why he was willing to consider my plans.

This morning I met with Dr. Doug Lee, my oncologist, and we reviewed all the specialists’ input. He agreed strongly with Dr Ehni’s input and felt I was ready to go home. I asked him about a flight on a float plane and he said “I am willing to have you go today but I would prefer we watch you a little longer and it would be a good idea to get another transfusion of two units to top off your tank.” As always, his decisions are hard to debate since he is so darn logical. We agreed I would stay one more night, get the transfusion, and I could be on my way to Canada by float plane in the morning.

Meanwhile in Canada, Bob Goff, the friends the family is staying with, was ready to take action and get all the flight logistics in order. He also reaffirmed he had a float plane and pilot on call to fly me back to Seattle early in the event I started bleeding again. So many times things seem not to work out the way I planned, including this trip, but it looks like God is giving us the green light to reunite as a family at Malibu with the Goff family.

We decided not to tell Heather and the boys I am coming since there are always last minute things that could change. But the plan is for Bob to round up the family with some crazy story and I will fly in and dock at their lodge. I am so excited and know it will be a shockingly joyful reunion.

Sorry for the length of this blog.

God is good, all the time, God is good!

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Comments

6 Comments so far

  1. tarman on July 17, 2007 6:40 pm

    I am so glad you are getting to go the Canada! Can’t wait to hear how it goes!

    I am also going to send a long some quotes in the days ahead which may or may not connect for you- but I have been reading and pondering in a bood entitled, “Everything Belongs” by a Franciscan Monk named Richard Rohr. I has really touched me…. as I have read and re-read it trying to plumb its simple depths.

    Here is a quote from the first chapter:

    “We are a circumderence peole, with little access to the center. We live on the boundaries of our own lives…. confusing edges with essence…..

    “The path of prayer and love and the path of suffering seem to be the two great paths of transformation. Suffering seems to get our attention; love and prayer seem to get our heart and our passion.”

    Love,

    Bart

  2. tarman on July 17, 2007 6:42 pm

    Opps… I meant “book” not “bood!” Also “circumference people” not circumderence peole!” Yikes I need to proof better when millions of people are reading it! 🙂

    Bart

  3. jim crowell on July 17, 2007 8:38 pm

    Don,
    Your blogs are never too long. It keeps us with you on your journey to recovery. Keep up the good fight. Give a hug to Heather and the kids for us.

    Jim and Terri

  4. stan on July 17, 2007 9:27 pm

    Don, thanks for your sharing and the excitement of seeing the progress (in our human term) as well as the setting for your float plane ride !!! What a joy !!! Praise God…and all the trials you went through with HIM. We have just returned to Seattle from a good trip and stay tune for more of the GOOD NEWS from you….
    We are with you all the way….to Malibu…..blockbuster movie material…..and lastly, from Psalm 40…..wait patiently !!!
    in Him,
    Stan

  5. gregu on July 18, 2007 12:21 pm

    Don – so glad to hear this is working out for you to be in Canada! I was just getting ready to call you to see if I could swing by for a visit today or tomorrow, and I checked the blog. Awesome news!! We’ll be praying for continuing progress and the wisdom and insight of your great team of doctors. I miss talking w you and look forward to getting together soon.
    All the best,

    Greg U

  6. hollythompson on July 18, 2007 4:37 pm

    Yay! I’m so glad you get to go. What a great surprise for the family!

    Have fun!
    Holly Thompson

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