Thursday, January 28, 2010

And The Winner Is . . .

Johnny would like to thank everyone for their submissions in

The Fighting Toad Asstastic Booty Tattoo Contest!

There were 18 entries and we have the Winner!

~~~ DRUM ROLL, PLEASE ~~~

Third Place goes to Johnny -- Toad himself. (I know he shouldn't get an entry, but he was just so tickled with himself when he thought of it that I didn't have the heart to tell him he couldn't enter his own contest.) His submission was the Bio Hazard Symbol.

Second Place goes to Alan (my brother-in-law). His idea was a Gerbil.
Um, yeah.

and . . . Winner! Winner! Chicken Dinner! goes to

DAVE SCHIELE!
The winning submission is of a Toad on a Stool (toilet!). Get it? Toadstool!!! Love it, Dave!!

Dave is the lucky winner of a Fighting Toad t-shirt! Congratulations, Dave!

All silliness aside, you may be wondering how the actual tattooing procedure went today. It was a very simple procedure and Johnny handled it without any issues at all. He was gone from his room for only approximately 20 minutes. The rest of the time he just slept off the sedation and then took me out for a fantastic breakfast. When we got home, we both took a long nap and have basically just stayed indoors the rest of the day.

We are anxious to get to Indy and accomplish the next phase. We had a nice long talk today at breakfast about our hopes and fears and all the emotions that come along with cancer, chemo, and the procedures required to fix you when you are broken. I am so lucky that Johnny is a talker. If I wonder what he is thinking, I ask and he tells. Same in reverse. (It may surprise you to know that I consider myself a "talker", too!)

I'd like to let you all in on a little secret. I do believe that one of the keys to the happiness of our relationship is our ability to talk about EVERYTHING. You should try it -- if you haven't already. You just might like it.


On a very sad note:

Today the Lord brought Jason Arnold home to be with Him. Jason was an original. He was kind, funny, goofy, a good husband/father/friend, and saying he will be missed terribly is an understatement to the Nth degree. So many of you knew Jason and his family and know what a presence he had, no matter where he was.

Jason was helping out at his church on Saturday and fell off a ladder. He took the impact of the fall with his head and suffered severe brain swelling as a result. His injuries were not recoverable.

Please, please, please pray for Jason's wife, Karen, and their two children, Dylan and Alexis. I also ask that you pray for the rest of their family and the close friends that will mourn his loss for a long time to come. This includes my brother-in-law, Alan. He and Jason are life-long friends and this loss is overwhelming.

Tuesday, January 26, 2010

All Set

It seems that all our ducks are in a row.

We have the colon tattoo scheduled for Thursday. Many, many suggestions have been entered in the Toad's Booty Tattoo Contest! Keep them coming . . . entries will be accepted until 7:30 am Thursday morning!

Our hotel reservations are made for the week in Indy. We will be staying at the University Place Hotel and Conference Center. It is directly across the street from the hospital and there is a covered walkway to and from the hotel. It wasn't our cheapest option, but it is the closest. I don't want to be more than a couple minutes away in case Johnny needs me for anything. The other (cheaper) option got terrible reviews (Thanks for your input, April!!!) and sounds scary and noisy. I figured that Ginger and I will eventually take shifts with Johnny, and I want both of us to feel comfortable coming and going no matter what time it is. When we have the opportunity to get good rest, the hotel needs to be close, safe, and comfortable.

Johnny's surgery is scheduled. I have have a very complete list of things I must take with us including a reclining lawn chair. (I've had a warning about the hard, straight-back chairs in the patient rooms -- thanks again, April!!!) I have a plethera of electronic devices to keep me entertained. I am such a HUGE fan of technology! My laptop, iPod, cell phone, Nintendo DS, and my brand new KINDLE should do the trick in passing the time. I am still taking suggestions on must haves for the hospital stay for all three of us (Johnny, Ginger, and me). Also, I really need some great reading suggestions to load onto my Kindle. So if you have read something awesome, please share!

My sisters and parents along with a great assortment of other family members and friends are helping us with the kids while we are gone. We have had many offers of helping during the time we are gone, and we greatly appreciate it. Some of you have asked if you can help with meals again. The answer is Yes, please. I would really appreciate the help for Carla and Robert and my mom and dad while they stay here with the boys in our absence. Just give us a call if you want to pick a day of the week to help out. We expect to be gone for a week. Thanks, friends. We have known since Day One that we could (and have!) count on you. Thanks for being part of our lives.

The last thing to do is pack and head to Indy. I just wish we were packing for a tropical vacation instead of a surgery for Johnny. I know that getting this taken care of means LOTS of tropical vacations in our future, so it will be worth it when we are all done. He is soooooo taking me on a tropical vacation when this is all done.

Stay tuned for the winning tattoo to be posted after Johnny's booty tattooing on Thursday. Remember the winner will receive a fantastic Fighting Toad t-shirt! Get your entries in! :O)

Thursday, January 21, 2010

The Date is Set!

Johnny's surgery is set for Monday, February 8th.

{{{ Collective Exhale }}}

We will arrive at the hospital at 5:30 am on that day and surgery is schedule for 7:30 am. I am relieved that it is the first surgery of the day. Being in the medical field, I know if you aren't first there is NO guarantee of what time your procedure will actually be performed. I also made sure that Dr. House IS NOT on call the night before. He should be well rested and fresh after the weekend and ready to perform his best work on my Johnny.

Dr. O'dea's office will be calling to schedule the sigmoid tattoo.

I have decided that until Johnny goes in for the tattoo, I am going to hold a contest!

What do you think should be tattooed inside Johnny's colon?

The winner will receive a Fighting Toad t-shirt!!! That's right, this isn't any fly-by-night operation. If I'm putting on a contest, I'm going to give out a prize!!

You can submit your entries by comments here on the blog, by message on Facebook, or by email (toad4mimi@aol.com). Enter as many times as you like!

Johnny will have final say on who wins, and of course, I will post it here on the blog.

Good luck!

Wednesday, January 20, 2010

Visit with Dr. Ansari

At 2:00 today we had a little sit-down with Dr. A. I am still working 0ut the details of my "I heart Rafat" tattoo.

Basically, he reviewed the details of the plan presented to us by Dr. House yesterday over the phone. He filled in the blanks on the chemotherapy regimen. He also told us that in the past he dealt with these HAI pumps a lot. Unfortunately, when the pumps came out there wasn't really a chemo agent available that made the pumps worth the effort. He was happy to report that now there are a few promising drugs on the market specifically for metastatic liver disease from the colon.

Because of these new drugs, he anticipates seeing a resurgence in the use of the HAI pumps. I'm glad it is available, because I have read a lot about them and they seem like just what the doctor ordered (pun intended).

The only thing that was a surprise was the amount of chemotherapy. We thought it would be once a month, but actually it is every two weeks. He will receive a pump fill and systemic chemo at each visit. I tried to get a duration of chemo out of Dr. Ansari, and all he would say was, "We will do scans and they will tell us." OK, well, that's clear as mud. What I have read from my online research is that chemo is usually 4-12 months. Most people have it for 8-12 months. I'm hopeful that we will be on the shorter end of that timeframe, but lets not kid ourselves . . . there is a mess in his liver that needs to be cleared up. I don't care how long it takes, I just want it gone!

We are waiting for a call from Dr. House's office (AGAIN!) but really don't expect to hear anything until Friday. We would like to get the surgery scheduled as soon as possible. Obviously. We do have to wait until at least after February 1st because of the previous chemo. The Avastin has to be out of his system for 6 weeks, otherwise the colon will have a hard time healing after the operation. We are also waiting for an appointment to be schedule with Dr. O'dea for the tattoo.

WHAT? I haven't mentioned Johnny's latest tattoo? Oh this is my favorite part of this whole stinkin' ordeal. When we saw Dr. House in Indy, he told us that Johnny would require a tattoo so that he will be able to identify the lesion from the outside of the colon. Since the ulcer is so small, he won't be able to feel it from the outside during surgery and it needs to be marked somehow. The tattoo will bleed through the mucosa of the colon and he will be able to see the ink on the outside.

So Dr. O'dea will go in to Johnny's cute little booty and tattoo the INSIDE of his pooper. We are thinking about a heart with a ribbon through it that says, "MOM". That was my idea.

It really does feel good to have a plan in effect. I will be content when we have a date for the surgery. And as soon as we have that date, believe me, I will post it for all of you.

Johnny's blood pressure still isn't coming down . . . we have added an additional BP med to Johnny's regimen and hope to have that under control before he is bombarded with more chemo. Although, the Avastin was what caused the high BP, so with that no longer in the picture it just may be an issue of a little more time.

I do have another prayer request, if you all have the time:

Jake has been plagued with migraines for the past couple months. He was started on Inderal (a blood pressure medicine, commonly used for migraine treatment in children) two weeks ago. It still isn't working, and he is missing a significant amount of school because of these near-daily migraines. I feel so bad for him. I am a migraine sufferer myself, and I can't imagine having the number of them that he has had. I called his doctor today, and we are starting on another medication. Hopefully, this will start working for him.

To add insult to injury, his leopard gecko died today. Rest in Peace, Edmodius. We really loved that little bumpy gecko.

Quinn seems to be doing OK. Thank goodness for that.

Tuesday, January 19, 2010

*** UPDATE ***

*** UPDATE: ***

Dr. House called tonight. Yee Haw!

He and Dr. Ansari finally made contact today -- sometime after Dr. Ansari's office called and scheduled our appointment for tomorrow.

They put their heads together and determined the best plan of action for Johnny. Here is what they came up with:

  • We are definitely going with the Hepatic Artery Infusion (HAI) Pump (Option 1). It will be placed during the surgery when Dr. House removes the ulcer left in the colon (and the gallbladder).
  • The best news of all is that the pump will be managed by Dr. Ansari, himself!!!!! He has had experience with this pump in the past and feels confident that he will be able to manage it right here in South Bend! Yea!! Although a trip to New York sounds exciting at first, I knew that it would become a chore.
  • Johnny will receive chemo through the HAI pump and his existing port. This means that he will be receiving another full protocol of systemic chemotherapy as well. This isn't something we were counting on, but if it is what will take care of every little bit of the cancer in his liver, then we are more than willing to do it. I feel so bad for Johnny just knowing how difficult the last few sessions were for him. I'm already praying for this chemo protocol to go easy on him.
  • At set intervals, Johnny will get re-scanned to determine the response of his liver to the chemo. We expect him to be on the HAI pump for 4-8 months; however, it could go as long as 12 months.
  • We are looking for complete response by his liver, you know -- no more tumors. If tumors remain after the HAI pump has done all it can, then we will consider resection of the remaining tumors at that time. The expected response rate of the HAI pump is 60-70% on its own. Dr. House said that he is confident that we will be able to "clean up" the entire liver. I think that is his way of saying "complete remission".

We were looking for a plan and now feel like we have one again. That is a good feeling. The few questions that we have will be answered by Dr. Ansari tomorrow. Of course, I will update again once we have talked to him.

Wanted: A Plan

After leaving several very sternly worded messages yesterday on four different voice mail boxes, I finally talked to a human being today. A couple human beings, as a matter of fact.

I called Dr. Ansari's office today and told them our plight. I also added that I was not interested in leaving another message on another voicemail, so could she PLEASE NOT TRANSFER ME TO ANOTHER VOICEMAIL AND JUST GET A PERSON ON THE PHONE THAT CAN DIRECTLY ANSWER MY QUESTIONS THANK YOU VERY MUCH. And she did.

My question was simple: Have Dr. House and Dr. Ansari had an opportunity to discuss the surgical options presented to us last Tuesday?

The answer, also simple: No.

My response: Unacceptable.

Then I called Dr. House's office in Indianapolis where I spoke with a very delightful young lady named Jessica. She was very sweet and answered every single question. When I told her we had been waiting six days (!!! SIX DAYS !!!) for information, she asked if she could put me on hold and she would get some answers for us right then.

It seemed that Dr. House and Dr. Ansari were playing phone tag on Wednesday and Thursday, and then Dr. Ansari left town on Friday. She assured me that they would be making contact today. She said that she was told by Dr. House to TENTATIVELY schedule Johnny for surgery on February 15th, but didn't have a description of the surgery, she was just "holding a spot" on the schedule. She also added that it was very out of character for Dr. House to not follow through with phone calls. Hmm. I don't know about that, but I hope it is the truth and this is just a fluky situation. I will not be happy if this is the set pattern for all of our interactions with him. From our initial meeting with him, he seemed like a decent, upstanding kinda guy -- not the kind that would say he was going to call and then just not do it.

This afternoon, Dr. Ansari's office called and asked that we come in tomorrow to speak directly with him. He had not yet spoken to Dr. House (at 1 p.m.) but would before our meeting tomorrow and we would come up with a plan at that time.

So, I guess the bottom line is we still don't know what we are doing for sure, but it looks like at least there is a tentative date set. Hopefully, tomorrow more questions will be answered than asked and we will leave Dr. Ansari's office with a plan.

That is exactly what we need . . . A plan.

Sunday, January 17, 2010

No News is . . . well, no news.

I thought I better log on and blog for everyone that is waiting to hear which option we are going with . . .

Well, we still don't know.

Dr. House was supposed to call on either Thursday or Friday, and that never happened. Obviously there are a million reasons why that call never came, but I have to tell you it doesn't make it any easier to handle.

Johnny's theory is that Dr. House and Dr. Ansari never made contact, which could definitely be the case. Who knows.

I called Dr. Ansari's office on Friday to see if they knew anything, and they couldn't say for sure whether or not both physician's spoke. Dr. Ansari was out of the office (and on a plane!) so the office staff didn't know what to tell me. I just hope that Dr. Ansari isn't gone for like 4 weeks or something crazy like that!

I can guarantee you that I will be in contact with Dr. House's office tomorrow and I will know something by the end of the day tomorrow. I WILL KNOW SOMETHING BY THE END OF THE DAY TOMORROW.

Fortunately, I work with Dr. Ansari's brother and will be on his tail tomorrow to find out how long Rafat will be out of town.



In other news . . .

Did anyone go to the Hunter Ice Festival in downtown Niles this weekend? I have to say that our little town really had an excellent turnout for the event. I haven't seen that many people walking around town in a very long time. It was so nice to see people enjoying themselves.

Even I enjoyed myself at the wine tasting tent for a little while on Saturday night. I was on call, so I couldn't taste all the great wines, but it was nice to be out socializing.

Wednesday, January 13, 2010

Filling in the Blanks

Scarlett O'hara said, "Tomorrow is another day." She was right.

As you may have guessed from last night's post, the news we received in Indianapolis yesterday wasn't exactly what we wanted to hear. I'll give you the longer version of that visit today, as promised.

Our trip to Indy was completely uneventful (thank you, God!) and we made it to the hospital without any issues (thank you, TomTom!). I guess I am now officially spoiled by my new hospital, because I was totally underwhelmed by the waiting room and exam rooms. The last update either one received was circa 1979; however, the rest of the hospital was very nice, I should add. Am I focusing on the wrong thing here?

Every single person we encountered was very kind and very professional. When the medical assistant was finished taking Johnny's history she told us that she just knew we would really like Dr. House. She was so right. He is a young, energetic, confident man who is a great communicator and looks you straight in the eye when he speaks to you. I like that in a person, even more so in the guy who is going to help my Toad.

He starts in by doing a physical evaluation of Johnny and tells us that he has studied the MRI that was performed here. He says, "The liver has significantly more involvement than what the PET scans demonstrate." There are multiple malignancies still growing in the liver and the process for ridding Johnny's liver of all the cancer will not be as easy as just cutting them out or ablating (burning) them. We were so upset when we thought there was a possibility of 6 lesions, so I asked Dr. House about the actual number that he saw. "More than 20?" I asked. "More like 12, maybe more," was his response. The problem, he explained, is that if there are 12 or 20, then why not 100? Microscopically, there is no way to tell what has yet to produce a lesion. There is no single section of Johnny's liver that isn't involved.

Minimally we are looking at an extensive operation with additional chemotherapy directed straight in to the hepatic artery. Potentially we could be looking at two very extensive operations with removal of the entire right lobe of Johnny's liver (the biggest part). All of this is conditional on the response of the lesions in the left pole of the liver; we need the left side cleared for anything to really work. The good news, he tells us, is that he has been involved with several patients with whom this process has been successful. Additionally, Johnny is young and otherwise healthy. His liver function tests are STILL normal -- Crazy, isn't it?

Fortunately, Dr. House has two options available to us. Two options going in makes us much more comfortable with trying either one of them. Both hold anywhere from 70-80% response rates. According to Johnny's math, that gives us a 140-160% chance! I love his math skills!

Let me break down the options for you:

OPTION 1:

  • Surgery to remove the remaining ulcer in the colon.
  • Clear the left side of the liver of as many lesions as possible (resection).
  • Remove the gallbladder (This will die from the chemo, so best to remove it up front.)
  • Insert a hockey puck-sized reservoir directly into the hepatic artery for infusion of the liver with intensive chemotherapy. Four months worth of additional chemo to the liver with additional systemic (through his existing port) chemo.

Pros and Cons of OPTION 1:

  • Less involved option from the surgical standpoint.
  • Least amount of native liver removed.
  • New procedure that may require travel to New York once a month to have the reservoir filled.

OPTION 2:

  • Removal of the remaining ulcer in the colon.
  • Removal of the gallbladder.
  • Removal of the left-sided tumors in preparation of the "future liver". This is the term Dr. House gave the left side because should the right lobe be removed, the left side will eventually regrow (Yes, the liver regenerates itself or this procedure would not be possible.) into the functioning liver.
  • Embolization (cutting off the blood supply) to the portal vein to the right side of the liver.
  • Second surgery, approximately 8 weeks later, to completely resect the right lobe.
  • Additional chemotherapy.

Pros and Cons of OPTION 2:

  • Very extensive and involved 2-phase surgical process.
  • Loss of 2/3 of the native liver.
  • Chemotherapy is not infused directly into the liver.

Option 1 is our first choice. But, as I mentioned above it is a new procedure and very few oncologists are actually trained in the management of the implanted infusion pump. Dr. House is calling Dr. Ansari to discuss the possibility of having it managed here. If this isn't something that Dr. Ansari feels comfortable with, then we will look at other options which may include having the pump placed at the time of surgery, and going to New York once a month for 4-12 months to have the reservoir filled.

We could tell that this was the option that Dr. House was the most interested in, but of course there are roadblocks -- like getting to New York once a month. We told him that we have the most incredible support system at home and that nothing was impossible for us to do. Once we said that we are completely capable of getting there, his excitement in this option increased. I will drive Johnny to the end of the Earth once a month if it means I get to keep him. It is an outpatient procedure, so it would be a quick turnaround trip. Drive in, fill the tank, drive home. We could manage that in a weekend, easily.

Dr. House did an intensive fellowship at Sloan-Kettering involving this procedure and worked with the "father" of the technique. He said that getting in wouldn't be a problem, as a matter of fact he said he could get us in same day if need be. Seriously, he oozed confidence on this procedure. Very reassuring.

Starting with Option 1 leaves us with Option 2 open should the pump not take care of all of the lesions throughout the rest of the liver. Remember the two "BIG" lesions we were so worried about? Those are the "easy" ones according to Dr. House. "Cherry picking" is what he called it. Dang, I spent a lot of energy worrying about those two things, I could have spent my worry much more efficiently had I known!

It was just so much to absorb last night. Both Johnny and I had our brief meltdowns, but pulled it back together with the reassurance of Ginger in the backseat. (Have I ever mentioned how much I love my MIL?) This is not going to be easy. We know that. We also know that we have a HUGE support system who pray for us daily. You seriously don't know how comforting that is for our whole family.

So, the fight continues. We will never, ever give up. Please continue to pray for all of us, our entire families, and of course our medical professionals. We need you all now, more than ever.

Oh, one more thing: I have started a list for when we pack for the surgery. I am looking for suggestions of things I just have to take with us, for either Johnny, me, or Ginger. You know, things like our own tissues, chapstick, lotion, decks of cards. If you have a suggestion, please let me know. I want to be prepared!

Love, love, love to you all.

Tuesday, January 12, 2010

In a Nutshell

I know so many of you are waiting for this post, but I have to make it short tonight. I will fill in all of the details tomorrow when I have had more time to process everything we talked over with the surgeon.

So, in a nutshell:

We LOVED Dr. House.

Biopsies from the colonoscopy showed that the malignancy is entirely gone (from the colon).

Johnny's liver is significantly more involved than we thought, throughout the entire liver.

We are going to be very, very aggressive with both surgery and additional chemotherapy.

We have two options on our plates.

He will NOT need a colostomy.

I may get to finally see New York, after all.

Please pray -- a lot.

I promise that I'll fill in the blanks tomorrow. Please know that we are OK. We will still beat this. It just is going to be a much longer and involved process than we originally thought. In the ups and downs department, today was a down -- with options.

Wednesday, January 6, 2010

Can I Get a WOOT WOOT!

I love Rafat Ansari.


I am seriously contemplating having that prominently tattooed on my body.


Talking with him makes me feel like things are going to be just fine. I love that about him. Obviously things went very well with Johnny's doctor appointment today, or I wouldn't even consider an "I heart Rafat" tattoo.

Our first concern was the PET scan. Dr. Ansari explained that having three different radiologist reading each scan was the problem. Imagine three people standing in front of a Picasso painting. Each will see something and explain the painting completely different than the other. Same deal here. He feels that the lesions were all on the last scan, but that they appear to be more like scars from healed lesions so they weren't mentioned last time. This time the radiologist felt like it was comment-worthy, thus six lesions versus two lesions.

The MRI report was more accurate with lesion measurements and locations and goes along with what was reported on the previous MRIs. Dr. Ansari felt that this was a much more accurate description of what is actually going on in Johnny's liver.


Dr. Ansari was really pleased with the results from the colonoscopy as well. Even though there is only a small ulcer left, he said that without a doubt it has to come out. We figured as much and it actually makes us feel better to know that it is going to be removed. We still don't know what this means in relation to a temporary/permanent colostomy. I think it drastically improves our chances for avoiding a colostomy altogether.


As far as the lesions in the liver and how they will be handled is up to the surgeon in Indianapolis. Dr. Ansari believes that he will remove the biggest two lesions and possibly some of the other ones that appear to be scars. At the very least he will take tissue samples from the small lesions that will be checked by a pathologist while Johnny is still in surgery. Minimally, they will do radiofrequency ablation (basically burn them) on the small scar-like lesions just to make sure they don't decide to grow up to be big lesions.


Now we move on to the next step which is our visit to Indy next Tuesday. Hopefully, Dr. House will be as great as Dr. Ansari and when we leave his office we will be completely confident with the plan. I already feel pretty good about it, to tell you the truth.


Johnny and I talked a lot about the surgery. He just wants to hear Dr. House say that it is an operation that he can perform. He still feels like it is up in the air whether or not Dr. House will accept the challenge. I'm relatively confident that he is going to rub his hands together while salivating over the opportunity to get at Johnny's liver. I am also concerned about the operation itself and all the things that can go on during a surgery (this is another one of those situation where a little knowledge goes a long way). Johnny is more concerned about the recovery. Dr. Ansari said that it will be about 2-3 months before Johnny will be up and around on his own. I know that open abdominal surgeries are a tough recovery, but I think Johnny being young and in relatively good shape is to his advantage. Again, this is where that butt-smokin' hot thing with healing comes in to play.


Until next Tuesday I will be praying my socks off that Dr. House not only feels like this surgery is do-able, but is anxious to accept the challenge and can get the surgery scheduled as soon as possible. We are hoping within a week of the office visit that we will be able to get on the surgery schedule. I will definitely make sure that it is his first surgery of the day, on a day when Dr. House hasn't been on call the night before, that he hasn't had a recent fight with his wife, and that he has a nutritionally complete hot breakfast. I'll even provide the breakfast.

I'll just need you guys to continue providing the prayers.

Monday, January 4, 2010

Happy New Year

This is my first post of 2010! And with it comes good news and well, maybe a little not so good news, too.

Since the last time I wrote, Johnny has had a PET/CT scan, an MRI, and a colonoscopy. Seriously, this dude knows how to party!

OK, so lets get the "not-so-good" news out of the way. The MRI results showed worsening of the liver. On the last scan there were two lesions. This scan showed a total of six lesions. What does this mean? We really don't know yet. It could just be that the lesions were "immature" and didn't enhance on the previous scans. I look at it like when you plant seeds -- they are in the ground and have to eventually bloom. Perhaps the cancer cells were there on the previous scan and just hadn't "bloomed" yet. I plan on asking Dr. Ansari about this theory on Wednesday.

Also, the lymph nodes continued to be clear. This tells me that there wasn't any more traveling to regions unknown. This also increases my confidence that the liver issues will be handled with surgery.

Now the really good news. Johnny's colonoscopy showed DRAMATIC improvement. On the previous study (at diagnosis) the tumor had almost completely obstructed the colon, and the tumor itself was approximately 6 inches long. On today's study, Dr. O'dea was jubilant when he came in to give me the results. When you compare the previous pictures with the current pictures it is amazing! The remaining lesion is only about 1/3 of an inch wide and one inch long. Dr. O'dea said that now it basically appears to be an ulcer that looks benign. However, since we know that is where the center of the primary cancer was located, it would make sense to have it removed regardless of the results from the tissue samples (biopsy).

So, where do we stand with things now? Well, we see Dr. Ansari on Wednesday and he will (hopefully) answer the millions of questions that I have come up with since the re-staging process began. We will meet Dr. House in Indianapolis on Tuesday, January 12th and finalize our plan for surgery. Again, I have a million questions that I will be asking in Indianapolis, too.

As you might just imagine, after the news about the liver I had a moment of temporary implosion. I am still terribly worried about it, but Johnny has a very unique way of talking through things with me that can get me refocused and calmed down. How pitiful that he has to do that when he is the one going through so much -- but we are a good team like that. I am so thankful that his attitude and outlook have been positive since he was diagnosed. He is an amazing guy.

~~~~

This past weekend we went to Boyne Highlands in Petoskey, Michigan for a little getaway. Jim and Molly, Dan and Aida, all our kids and a two other Niles families (Hi, McKeel's and Stephensons!) went to snowboard and tube. How FUN! It was just the weekend we were looking for. Fun in the snow, hot tub and sauna and big beautiful rooms with fireplaces! It was wonderful but entirely too short.

Unfortunately on the way home from Petoskey, we came upon an accident that had just happened and I got out to see if I could help. Without getting graphic, let me just say that it was the worst trauma scene I have ever experienced. The dad (Brad - 37 years old) died at the scene and I stayed with the wife until help arrived and they could be extracted from the SUV. Their two small children (18 months and approximately 3) had to be removed through the rear window. The children and wife were basically uninjured, but the husband probably died from severe head trauma. As we waited for help, the wife (Julie) spoke very calmly and told me that she was a medical professional (physical therapist, as was her husband) and she knew that his injuries weren't recoverable. My heart broke as I watched her say goodbye to him. I was struck with how fleeting life really is. There are no guarantees, are there? She had no idea when she woke up on Sunday that it would be his last day. I prayed for them the entire rest of the way home and through most of the night.

I also thanked God for the many blessings I have received in my life. When you lay awake at night and just start thinking through what you have been given, it is surprising what you can come up with! I ran the gamut from my daisy flowered dress in Kindergarten, to my first puppy, to my friend Ruthy who used to play Squad 51 with me, along with about a million other random thoughts. Of course all of the important stuff made my list, too.

I just feel overwhelmingly thankful right now.

This is going to be my New Year's Resolution -- to be thankful every single day for the important AND random. The big and the small. The obvious and the obscure.

It is going to be a great year.