A Bittersweet Kind of Day

Today has turned into a bittersweet kind of day.  Today at 3pm, I finished my last regularly scheduled therapy appointment at the Duke Cancer Center.  What had once been weekly for the first 3 months, then bi-weekly for a couple of months and since late June, once every three weeks, came to an end today.  After discussion with Jennifer Harsh (my therapist), we decided that maybe this was a good time to stop the regularly scheduled visits and just go with an "as needed" approach.  It comes at a good time for her because as of today she is FULL TIME at the DCC.  However, full time means that approximately 75% of her time will be devoted to research and 25% to counseling/therapy sessions.  This means that if I'm having a particularly hard time or feel the need to reach out to her, her schedule of patients will be far less and thus her schedule much more flexible to see me or just talk on the phone.  While I'm glad that we both feel I've reached the point where this will work, it also means letting go of one more thing that bonded me to Joe, the Cancer Center itself.  After 2 1/2 years of almost weekly visits, it became part of a comfortable routine.  After his death and I began counseling, it remained part of my routine.  I felt comfortable going there.  I even have some good memories there:  when we got good news of no growth but tumor shrinkage; seeing Dr. Zafar & Leigh Howard (who I still adore and admire so much); the familiar and caring faces of the various nurses and staff.  They all became a little bit of an extended family.  One that I have missed, but with my counseling sessions, even though I didn't see them often at all, I knew they were there.  Today, although I can go back anytime I feel it necessary, I moved one step further away from them.  That is what is bittersweet and makes me a bit sad.

After saying goodbye to Jennifer, I got on the elevator and had a good cry on the way down to the 1st floor and on my walk to the parking garage.  I just felt like I was letting another tiny piece of what Joe and I shared slip away.  I know it probably sounds silly to others, but even though it is a very big positive step forward for me, I couldn't help but be sad.

The Duke Cancer Center (left)    Duke Medicine Pavilion (right)

I can't say enough about the care that Joe received and then I have received at the Duke Cancer Center.  It is a world class facility, but even if it was in shambles, if the same employees were there, you couldn't be in better hands.  I owe you 2 1/2 years that I got to spend with Joe that I probably would not have had otherwise.  I also owe you 7 months of helping me regain my footing when it seemed like the ground was crumbling beneath my feet.  If a small crack reappears, I know where to turn.  Thank you.

February 21, 2012

Today I made what I consider a giant step. I arrived at the Duke Cancer Center a little early for my counseling appointment so I had Leigh Howard paged. I had not seen either Leigh or Dr. Zafar since Joe's death although I had spoken to each of them. I had wanted to see them because of how important both of them were to Joe and still are to me. Although Joe fought really hard against the cancer, I attribute much of his ability to have survived for over two years to the care he received from our oncology team. They are both such wonderful people as well as incredibly gifted medical professionals. For more than two years they were part of our lives. We saw them weekly. A close relationship developed between us. I have missed them but knew it would be difficult to see them again and although I have been to the DCC weekly, have not had the courage to go up to the third floor to see them. Today I found that courage and I saw both of them. Although it was a tearful visit on my part, it felt good to visit with them, talk to them and express my gratitude. After that I went back downstairs for my counseling session.

Today when I got home I pulled all of mine and Joe's tax information together so that our taxes can be done. I also pulled out all the cards that I received following the news of Joe's death and the memorial service. So many people to thank for thinking of me and our families. The Hardy family, Virginia Joines, Julie Hilton Steele, Tim & Netta Ketterman, Erin Juliano, John Belch, Marcia Fleishman, Wes & Cathy Anderson, Ruth Heath, the Russell family, Hal & Deanna Bruen, Phil & Pat Hoffman, the Potratz family, the Duke CC GI Oncology Program, Barbara Johnson, Patty Kranich, Iris & Mike Colvin, Bill & Fredda Umphlett, Donna Clelland, the Minnick family, Angela Teachey, Desiree Davis-Omburo, the Simpson family, Marilyn Kennedy, Mary Nell Thomas, the Hume family, Bob & Mary Anderson, Amy Daws, Cheryl Crane & David Murray, Nancy Glascow, Jennifer & Rob Williams, Kent Parks & Randy Moore, Don & Doris Click, Michael & Missy Fox, Stella Honeycutt, Valerie & Leroy Hurd, Shawn Morgenlander, Lennie & Dianne Rosenbluth, Becka Huckabee, the Shade family, Ray & Judy Peede, Charlotte Margolis, Michele Burris, Laura Delauney, Stephen Melott, Jane Albright, Larry & Angela Tollen, Beverly & Talmadge Skinner, Mark Shelton & Michael Gosch, Katy Lupton, Jan Jackson, Donna Lloyd, Wayne Dedrick, John & Glynnis Cowell, Mary Kay Pendergraph, the Piscorik family, Bert Elliott, Mary Thomas, Durham Regional Assoc. of Realtors, the Clemo family, Bill Lupton & Sandy Okazaki, Ruth Patterson, Jenny & Bill Krieski, the entire Quest group at PGUMC.....and many have sent multiple cards & thoughtful gifts. Meals with the Minnicks, the Frys, the Clarks, the Levines, the Lawsons, Lucinda, Mike, Jeff, and Artie. Phone calls from Rob & Lola, Mark & Jill, Bill & Sandy, Scott & Ken and others. Many others have helped with a variety of tasks. These people along with other friends and family are a major force in what is helping me get through each day.

Tonight after seeing Leigh & Yousuf; a counseling session; organizing the taxes; along with a day at work, I am tired! It's only 6:45 pm but I hear my bed calling. After I call Joe's mother, I think I will turn in early. I have a feeling of accomplishment and it feels good.

Thank you to EVERYONE who continues to pray for me and remember me in their thoughts. I am humbled and most grateful.

One of the Top 3 Worse Days We Have Had

For regular readers, remember the days when my posts would be clever, whimsical and humorous to read?....well this won't be one of them unfortunately. Before today, in the last 2 1/2 years we have had 2 really bad days. Bad day #1: November 8, 2010 - The day that we found out Joe had pancreatic cancer. Bad day #2: February 22, 2011 - The day of his surgery when we found out they could not remove the tumor. Bad day #3 - Today, January 3, 2013 - The day our oncologist advised us that due to the continued growth of the tumor in Joe's pancreas as well as the growth of the lesions on his liver, he felt it was time that we discontinued any further chemotherapy. Stop trying to treat the cancer and start working on increasing Joe's quality of life. This was not an easy conversation for Dr. Zafar. He took longer than normal to come in the exam room, he came in quieter than usual. But in typical Yousuf Zafar manner, he told us the truth, his professional opinion, and our options, all with a half smile and a sense of true caring. I wish everyone could experience being around him (not necessarily in the Cancer Center surroundings - I don't want that for anyone), but could know him and know how much he cares about Joe and me. How well he has always treated us. How hard he has tried to give Joe the absolute best care possible. When they were passing out "bedside manner", he got a double dose. He is a wonderful doctor and person.

But what are our options: 1- Discontinue chemotherapy and start with a home health care nurse coming to our home once a week to check on Joe, obtain vitals, examination, answer questions and be a "go between" for us and Dr. Zafar. We will still see him as often as we want too. That schedule can be worked out however best works for us. We would concentrate on getting Joe feeling better. Trying to increase his appetite, monitor any pain and manage as necessary and help Joe continue to do the things he loves most: continue with the choir and playing the organ/piano at PGUMC, teach his private piano students and be able to get out and see friends. Basically, return Joe's life to the normalcy that he had before the last few months of intense chemotherapy. The side effects have taken a big toll on him. 2- Dr. Zafar can refer Joe to another facility for a 2nd opinion. He can refer locally to UNC or wherever we would like to go including Johns Hopkins and other well known facilities. We just need to name it. 3- Try a different combination of some of the 6 different chemotherapies that Joe has already undergone.

We have an appointment with Dr. Zafar (he wants me to call him by his first name...but I find it really hard to do. After all, he's Dr. Zafar! ) next Thursday morning where we will have to give him our decision.

It's been a very emotional day for both of us. I cried at the appointment, Joe cried at the appointment. I cried at home, Joe cried at home. I cried at work, Joe didn't go to work so no crying there. This evening I have had conversations with my family and Joe's family. We wanted to talk to them before we published anything. We have gotten lots of texts, emails and phone calls. I have gone through the story today with 6 different people. I can't do it anymore. Besides starting to loose my voice, I am tired of telling it. It exhausts me. Joe is having some voice issues of his own. It sounds like he is getting laryngitis, but has no other symptoms of an oncoming cold. Therefore, he just isn't talking if he can help it.

To everyone who has called, texted or emailed, I apologize for not answering. It was very important to us that our family know about today before anyone else. This isn't something I can put in a text. Thank you for the love and prayers. Matt, Jeannette, Izzie & Jake: Thank you for the flowers to brighten our day. They could not have come at a better time.

Please say an extra little prayer for Joe the next time you talk with God. Say one for me too. I need the extra help to be stronger right now.

Goodbye 2012

I thought I might try something a little different for my end of the year post.

An Answer to the Fluid Question

Some people had asked what caused the fluid build up in Joe's belly (a total of 4 liters was removed).  I emailed our oncologist at Duke, Dr. Zafar,  last night (he is undoubtedly the best...both doctor and caring human) and he emailed me back within 30 minutes and it was late when I sent the email.  His response: "The most common reason for the fluid is the cancer — it can cause fluid shifts in the body. It doesn't mean that the cancer is growing—it's just a common finding, especially with pancreatic cancer".  So we will just have to be vigilant for signs of more fluid.  Now that he has a history, it will be something they routinely check for.

Chemo Day.....Oops, No Chemo After All But Blood Instead

This past weekend was wonderful. Joes's choir at PGUMC put on a magnificent performance with their Christmas cantata. The combination of the 20 voices and 11 instruments was magnificent. I wish everyone could have heard it. Joe had worked so hard to pull it off and he did. Even when not feeling his best, he rose to the occasion and anyone that was at either the 8:30am or 11:00am services were treated to a beautiful program. We even got to see some of The Grove service regulars there to see and hear the cantata (Larry it was very good to see you).
Today however, reality was back as we had Joe's next doctor and chemo appointments. After dropping Joe off a little after 7am at the Duke Cancer Center for labs I went on to the office and Facetimed his appointment with Dr. Zafar. Joe's blood work was not optimal and thus Dr. Zafar wouldn't allow the chemo treatment. Instead, since his hemoglobin counts were low, Joe got a blood transfusion instead. This of course meant more blood work to verify blood type before he could get the transfusion. We had to wait 2 1/2 hours before he was called for labs and didn't get up to the infusion center until after noon. The wait before going back for the transfusion was 2 hours. But finally we got back into a room. It even is a room with a quasi view!

Still though, there was a wait in the room before the blood came.  Apparently they were experiencing difficulty with the tube delivery system and all drugs, blood, etc. were having to be hand delivered.  It was well past 3:00pm before it arrived and started flowing, but it did.  Joe's first comment is "it's like True Blood" (HBO vampire show).

Another observation (one i have complained about for two months) was that Joe's belly, where the hernia is, has gotten larger and larger and is now looking very distended and bloated.  Even Dr. Zafar's nurse noticed his belly as soon as she entered the exam room.  With that in mind, Joe is having an ultrasound tomorrow to see if there is any fluid build up or some other cause of the bloated appearance.  We will cross the bridge to treatment for that depending on what they find, if anything.  On January 2nd he will have a CT scan to give us a new "baseline" for where we stand as far as the tumors size and then he has a doctors appointment and chemo on the 3rd.  Also, his stomach issues don't appear to have been completely resolved, so he will be back on antibiotics for the next 10 days. 

So that has been today. We finally left the DCC a little past 6pm.  Not exactly what we planned on, but then it has become commonplace  for our plans to not go as planned.  Joe is handling it well.  He's tired of being tired and I'm tired of him being tired.  He however is much stronger than me.  He sits here calmly.  I sit here anxious with tears.  I was all smiles yesterday.  So proud of Joe.  So proud of the PGUMC choir.  I beamed.  Today I find it hard to manage a smile.  I need a good comedy...a good long, gut busting laugh.  Maybe I should just have Joe dance for me.  That's always good for a chuckle.

Thank you to everyone for the cards, emails and prayers.  We both greatly appreciate them.

"Worship fully, Spend less, Give more, Love all"

A Quick Trip to the Duke Cancer Center Today

The last few days have been miserable ones for Joe. His back pain has increased in intensity each day. The pain has caused constant nausea and bouts of vomiting. He finished the infused antibiotic on Tuesday and had the picc line removed the same day. He spent much, and by much I mean all except for maybe 2 hours, in bed Tuesday with a heating pad on his back and taking his pain meds. He hardly ate anything and what he did eat did not stay with him very long. In the wee hours of this morning he got up and took 2 more pain meds without eating and of course within an hour or so, he was throwing up again. (See post earlier this year about eating when he takes his pain meds....a must do!). Joe had called the oncology triage number on Tuesday and spoken to our oncology nurse. She told him which of his pain meds should be most effective and to call again today if he wasn't any better. Well obviously this morning he wasn't so he called back. At first they thought he should go see his primary physician but an appointment there would not be possible until Thursday. Daryl, our nurse, called back a little later and said that Dr. Zafar wanted him to come in for a CT scan and had scheduled an appointment for 1pm today. So I left work at noon, picked Joe up and off to the Duke Cancer Center we went. We won't have the results for days but Dr. Zafar should have seen the results by days end and should at least know if the pain is coming from something cancer related. That is the biggest fear. We already know that one of the common symptoms of pancreatic cancer is a specific type of back pain but thus far, the area where Joe's pain has been is not typical. But time will tell.

One positive is that this afternoon the pain has eased off some. He was even willing to walk back to the parking deck after we left the DCC instead of waiting for me to drive around and pick him up. After stopping to get him some lunch, I dropped him off at home and went back to the office. Apparently he felt well enough after he had his lunch to make a quick trip to the grocery store for a few items. He even had dinner ready when I got home. Although his back is still bothering him, it is obvious that he is better. Hopefully this isn't temporary and he will continue to improve. The last time his back was hurting really bad it only lasted a couple of days. We are now on day 4 so I am very hopeful it has run it's course.

While I have your attention I have one pet peeve I have to get off my chest. Parking decks and the way people drive in them. I spend a lot of time in parking decks. Weekly at the one at the cancer center and then in the last few months, the visitor deck at Duke Hospital. What is it about a parking deck that frightens people so? I'm assuming it is fright that causes them to drive at a maximum speed of 2 mph while in the deck. And what is worse, why am I always behind them? Do they see me coming? For goodness sake people, the empty spaces are easy to see without crawling along. Some of us would like to just park and go inside. There are only a limited supply of spaces right by the elevator. I know we all want one, but you can see from 50 feet away if there is one. You don't have to approach them so slow. I am not saying that I think you should speed through the deck, but a solid 15 mph, still slow, but moving would help out those of us with someone sick or who have somewhere to be because, yes, even when leaving, I still get behind the car that is deathly afraid someone will back out and they won't see them in time to stop. Believe me however, at 2 mph, you will have plenty of time to stop. So if your reflexes are so slow as to make you afraid to drive in the deck any faster than a snail, consider calling a taxi. For the love of all that is gracious and holy, if you don't, you will be the reason that I end up in hell.
There, I feel better.

Radiology waiting room (actually just a small part of it) at the Duke Cancer Center

This Weeks Draws to an End

It's Saturday night and this week is drawing to an end. And for the first time in many, many weeks, it has been a good one. Joe has not had a single fever, has felt good every day, has not had any real issues with his antibiotic infusions or tablets, had a good choir practice, good doctors appointment and NO hospital visits! All in all, I'd take duplicate versions of this week each and every week.

At this week's oncology appointment, Joe and Leigh decided that when he resumes his chemo, he will be doing the 1 large dose every three weeks. Since we are going away the week of Thanksgiving, he will start on the Monday after we return. The reason for the delay rather than starting the week of Thanksgiving: he will have to go to the infusion center the day after he gets his chemotherapy treatment to get a shot to boost his white cell count. Since we will be in mountains, that would be hard to do, so we will just wait another week.

Joe has been on oral antibiotics three times a day since he was released from the hospital and will be on them until next Saturday, November 17th. Also since his release he has been infusing a liquid antibiotic once a day for an hour through his picc line. That will end this coming Wednesday, November 14th. After his infusion that day, he will have the picc line removed. Dr. Zafar doesn't want anything foreign in him for any longer than necessary. The home health nurse will remove it after the infusion. Joe is really looking forward to that coming out. Wrapping his arm in plastic wrap and press-n-seal to take a shower is getting really old.

But this post isn't about complaining (which I know seems to be all I do sometime). Since the first of November, many Facebook friends have been posting something that they are thankful for each day. So with that in mind, I thought I might list some things I am thankful for as well.
1- I am most thankful for Joe. For the last 15 years he has given me love and strength. He has taught me how to be a better person and brought so much joy into my life that I couldn't possibly ever repay him.
2- I am most thankful for my family. My sister Phyllis, her husband Woodie, my nieces Aimee & Sara and my nephew Wayne. My brother and sister-in-law, Bill Lupton & Sandy Okasaki. They are a constant source of love and support. I know that I have sometimes taken them for granted but I truly appreciate how much they have done for me and for Joe. They love us unconditionally and show that love all the time.
3- I am most thankful for Pleasant Grove United Methodist Church. Everyone from our pastors to the staff to the choir to the general membership have been caring, supportive and loving in every way. I never thought such a large group of people could find a place in my heart in such a big way.
4- I am most thankful for my friends. Joe and I have wonderful friends who reach out to us all the time. I work with an incredible group of people who are always there to lift my spirits when I am down and to help me smile when I didn't think I could.
5- I am most thankful for Dr. Yousef Zafar & Leigh Howard. Our oncology team has been with us on this journey for 2 years and they have always made us feel that we are priority number one. They inspire us with their optimism and positivity. We have had 3 different nurses during the last two years: Minoka, Mark & Darryl - All three of you are treasured and both of us appreciate everything you have done for us.
6- I am most thankful for our radiologist, Dr. Czito; our surgeon, Dr. Tyler; and all the nurses and staff who helped us during those trying times.
7- I am most thankful for the nurses and staff of the 9th floor of Duke Hospital. We have made 6 trips to the 9300 wing. Every time the care that Joe and I received was incredible. Every nurse was caring in such ways that one would not think possible. They looked after Joe day in and day out, helped me day in and day out, comforted me on those bad nights, made me smile or laugh on those really bad nights and always treated us and our relationship with the utmost respect.
8- I am most thankful for my health. Even though I have always been the "sickly" one with all my allergies and aches & pains, I know what real sickness is.
9- I am most thankful for the readers of this blog. You take the time to read my ramblings because you care about Joe and about me. You take the time to comment and send words of support. You say prayers. You offer help. I write this blog as a way to help myself deal with things. I write to help my sanity. I write it with no expectations of it being read, but you do read it. I thank you.
10 - This one will seem strange. I am most thankful for the cancer. Don't get me wrong, I wish I could snap my fingers and it was gone. I wish this terrible disease had never reached out and touched Joe. I wish cancer of all types could be eradicated. But it is here and it is a part of mine and Joe's life. But even though physically it has done it's damage, it has not defeated us in anyway. What it has done is bring me and Joe closer. It has changed our relationship for sure, but for the better. It's hard to argue over the petty stuff (although Joe will probably disagree that I still argue over petty stuff). We have found a better level of understanding of one another, a better understanding of what we mean to each other. Simply, we are better together now than before. Three years ago we were plodding right along, taking many things for granted, maybe even taking each other for granted. We don't do that any more. Now we treasure every day and every experience. Cancer gave us that rather than taking something away. For that I am thankful.

Thank you for your prayers and words of support. I thank you and appreciate you taking this time out of your busy day to read this post.

P.S. I have received some very nice comments to this post from some highly cherished friends. Here is but a sampling:

"YAY!!! You know it's a good week when there are no fevers and no hospital visits!!! Enjoyed your blog post. Hope you get to savor the delight of a fever-free/hospital-free week. See you tomorrow." Allana

"What a beautiful post you wrote tonight. WOW! That is awesome to be able to be thankful in the midst of all you two are in the midst of! Very impressive! What beautiful people you are! God bless you both! Fondly," Fredda

"I am thankful that Joe has been fever free and hospital visit free this week.
I am thankful that Rob and Joe met on that first day at uncg in 1974.
I am thankful that you and Joe call us friends.
I am SO thankful that you came to Connecticut to get married and to renew/cement our friendships.
I am thankful I have met all the wonderful PGMC folks AND got bread!
I am thankful that you both get tender loving (and skilled care) at Duke.
I am thankful for technology like skype, imovie, iphoto, etc that helps bring us closer in funny Cheeto kinds of ways...AND in ways like seeing Joe's wonderful piano concert!
I am thankful for the blog that keeps us up to date.
I am thankful that we had such a WONDERFUL visit with you this summer. We still talk about it.
I am thankful that we have things to look forward to sharing together.
Hugs!" Lola

"Jeff, You are an amazing and gifted writer. When I read your words, I can just hear you talking – like we are sitting and chatting in person. That is a wonderful talent. So I am thankful for your blog. I love you both so much and I want to stay informed on how things are going. I want to know how you are feeling and how Joe is feeling. Through your blog you keep me in the loop. Dave or one of the girls will ask me once or twice a week if I have any news on Joe – has Jeff updated his blog, particularly when Joe is in the hospital. So I’m not only in the loop, I have become part of the loop of information and love and prayers. Love," Cindy H


"What a beautiful post! Indeed, dire illness often brings so many issues into their true perspective. It's the fire that can either destroy or burn out the dross from a relationship; I'm glad you two have come through thus far with a stronger bond." Jean

Day 3 at Duke: Halloween 2012 Version

Joe started off the day with a low grade fever but was quickly given Tylenol and the fever subsided. Lab results from this morning showed his bilirubin down from the 3.5 of Monday to 1.3 this morning. Hopefully that number will continue to decrease to the .5 to .8 norm for him. Should have that answer after tomorrow's labs. Otherwise Joe has had a good day although a little tiring. Visitors most of the day and evening. Our nieces, Aimee and Sara came up from Hope Mills and spent the morning and early afternoon with him (Joe had a huge grin from getting to spend the day with Sara) and then this evening Mark and Jill came up and we all 4 had dinner together followed by Halloween candy and lots and lots of laughs. We always get together on Halloween so we saw no reason why a pesky hospital stay should interrupt the tradition. It made for a great evening.

Joe continues to be on two IV antibiotics: one every 8 hours for 30 minutes and one every 24 hours for 15 minutes. We haven't heard back from last nights cultures yet but it has only been 24 hours. We had been told he would have blood drawn for cultures daily, but thus far today, no blood letting. But since it happened twice yesterday maybe they have cut him some slack for today. His spirits are good as well as his appetite and general feeling of health. The jaundice has abated some so no pumpkin look today.

I went back to work today. Although I was worrying about him all day, even with the 9 or 10 phone calls and one FaceTime session, it was nice to be out of the hospital and back to doing normal, productive things. Mind you, I am not complaining. I am reminded of our first oncology appointment with Dr. Zafar almost two years ago when he said we would both adapt to a new normal. Our normal has changed repeatedly over the last two years, but even with the pain and anxiety, these two years have brought me and Joe even closer than we were before and have been filled with some incredibly wonderful and joyous moments. Those times are what makes these times easier. Those times and these remind me of just how much I love Joseph Lupton and what a gift and joy he is to me. Granted, I still am not amused by his sense of humor, once a nerd, always a nerd. But nerds are quite lovable. At least mine is.

He is sleeping soundly. I am wrapped in my cocoon in the chair. It may seem odd to some, but I think i could sit here watching and listening to him sleep forever. But of course the serenity will be shattered by a nurse any moment now with antibiotics. Oh well. That's what dreams are for.

Thank you to everyone. Our friends, our family: Bill, Phyllis, Sandy, Aimee, and Sara; all of PGUMC - Jay, Allana, Lucinda, Cleta, Fredda, Cindy H.,Chelsea, Challie, Donna, Julie, Ivy, Deborah - basically all of the choir; the nurses and staff of 93 at Duke Hospital (simply the most caring, sympathetic, compassionate people I've ever met - Lucie, Brittany, Jacquelyn, Heather, Britany, Lila, Jon, Sam, Joann, Stephanie, Katherine, Donna, Kim, and the list could go on and on); and my office for being so understanding about my absences (Kim, Dianne, Susan, Barbara P., Sandra and MA)....especially MA who was about ready to just leave the office to come be with me during Joe's surgery yesterday when he was not doing so well in recovery and I was quickly becoming a basket case. So many people that care. I hope all of you know how special you are. If I ever seem to take you for granted, call me out on it because I don't mean too. You have been my salvation. Thank you.

Port Removal in Progress

They (the powers that be at Duke) have decided to remove the port that Joe had put in back in August.  This removal however is just a precaution since no bacteria or infection has yet to be traced to the port.  Whether he will have another port put in on the other side of his chest has yet to be determined.  The chemotherapy that he is on can be done via IV.  That isn't optimal, but it can be done.  They came for him for the surgery around 8:00am.  It is supposed to take around 1 1/2 hours but he will be quite sleepy and loopy afterwards (just like when they put it in).

He didn't have any fevers last night.  They started him on fluids around 6:30pm and then antibiotics around 8pm.  The antibiotics run for 30 minutes every 6 hours.  He ate well for dinner last night but was restricted to no food or drink after midnight for this morning's surgery.  They drew blood for cultures around 8:30pm and also needed a urine sample for culturing.  He slept well except for the usual interruptions.  More antibiotics around 1:30am, vitals around 3am, more blood drawn at 5am and then the final wake up at 6:15am when his nurse (Sarah) was in for her last check-up before the shift change at 7am.

They have identified the type of bacteria, but thus far I have not encountered a native English speaking doctor to tell me the name so I could look it up.  The doctor on the floor that was in for about 30 minutes last night was of Asian origin and although she said the name several times, I couldn't quite understand.  I didn't want to ask her to spell it for me, although I should.  I'm sure I can get the name from either Leigh, Dr. Zafar or Jason at some point today.   Speaking of Jason (Joe's former middle school student who is now a nurse in the Duke Cancer Center), he surprised Joe with a visit yesterday evening.  He had found out from another patient of his that reads our blog that Joe was in the hospital.  So he looked up the room (on the blog) and walked over to visit.  Just goes to show that once Joe has taught you, he has made an impact on you.  It also goes to the character of Jason.  He's very caring and dedicated to his profession and goes above and beyond the call of duty.  Thank you very much Jason.  It really lifted Joe's spirits to have you come by, as well as mine.

So today, I'm at work awaiting word once the surgery is done.  I'll keep pestering Joe on his cell phone, room phone and iPad until I get a response.  Or I can break down and call Duke for information.  I know this is not a major procedure but I still worry and won't take a deep breath or sigh of relief until I know he is out, conscious and talking to me.

Thank you for the prayers and words of support and concern.  We need a little extra right now and everyone is coming through.

9:31a.m. Update:  Joe is out of the surgery and eagerly awaiting his breakfast in his room.  It was painless and he is doing fine.

9:57a.m. Update:  Joe called again after his breakfast.  The oncologist on the floor came in (Dr. Riedel) and told Joe that the plan as it stands right now is to keep him on the antibiotics.  Apparently, the bacteria that has been identified has only been indentified by the family of bacteria, not the specific bacteria.  Until that is done, the general antibiotics will continue.  Once they zoom in more specifically, he will change antibiotics.  When released (earliest would be Friday), he will be on antibiotics at home for 2 weeks (no chemo).  They are doing another round of blood cultures this morning.  When they removed the port there was no sign of infection in the port site but they did flush it really well as a precaution. 

The Weekend That Was and Then Today's Chemo

This past week as earlier written about, Joe’s brother Bill and his wife Sandy, came for a visit from Las Vegas. The best thing about Bill & Sandy visiting is that you don’t feel you have to entertain them. The purpose of the visit was just that: a visit. Time for them to spend with us and us with them. Whether it was laying around watching football on Saturday and arguing with Bill about the scheduling differences between Vegas and here (when he gets up and ready to watch College Gameday in Vegas which comes on ESPNU at 9am EST and ESPN at 10am EST, he gets to start watching it at 6am or 7am there). Of course he was up early on Saturday and fussing and moaning about the lack of the show until 9a.m. We had some good bickering over that. Then when the games start, I’m watching 2 in the family room (PIP) and he is watching one in the kitchen and has his computer up and running. Not sure if there was one on it or not. But then we argued about which was a better game to watch and so on and so on. It was a lot of fun. Joe has no football interest so it made my Saturday to get to bitch and moan with someone. Sandy meanwhile just kept commenting that this was what she had to deal with every Saturday. Apparently control of their DVR in Vegas is a big issue. Joe and I don’t have that issue. I get what I want, plain and simple. But we had a great visit.

The day before, Friday, Joe and Bill had driven to Wilson to meet their mother and sister at Bill’s Bar-B-Que for lunch. The lunch lasted around 2 hours, they had nice conversation, no confrontation and both left with a bit of a sigh of relief I think. It was the first time Bill had seen them since the “blow-up” in March and except for their Aunt Sue’s funeral, it was the first time that Joe had seen them as well. Truly the first time for each of them to see each other and have a conversation face to face. No issues were addressed, mostly in an effort to not cause any more conflict and keep Joe calm. He was a bit tired after the return trip so we ordered Randy’s Pizza and picked it up for dinner. I think all 4 of us enjoyed that and were able to just relax around the house.

Besides Saturday’s afternoon football, there were naps by everyone. Me and Joe on the couch in the family room (it’s and L shaped sectional) and eventually Bill & Sandy upstairs. Later in the afternoon we all cleaned up and went out for dinner to our favorite sushi restaurant, Shiki Shushi at Homestead Market on Hwy 54. Once again we all enjoyed it and were home around 7:30 and then proceeded to watch the DUKE- UNC game on TV. Yes, I actually watched a Duke game. Football doesn’t have the same effect on me as basketball, mostly due to my complete lack of interest in ACC football (which I have historically considered a joke as far as being competitive with the rest of the conferences mainly the SEC and BIG10 – Let’s face it, the ACC sucks in football). But I digress. We watched the game downstairs up until UNC went ahead at the 3+ minute mark. At that point, I saw no need to stay downstairs and watch since Joe and I had to be up at 6am to get to church by 7:30am the next morning. Joe had already gone upstairs to prep for bed so I followed. However, I did turn the TV on upstairs, paused the picture and prepped myself for bed. By the time I was ready to climb in the bed, I popped on the iPad and checked the score on ESPN. The game was over, I knew Duke had won so I unpaused the TV and finished the game while remaining calm. I didn’t even wake Joe. Of course had it been basketball I probably would have been loud enough to wake the neighborhood. But it was just football. Fun night just the same.

Sunday brought our early morning trek to church for the 8:30am and 11am services. I got a lot of religion on Sunday by attending both services. Usually I am just recording the 8:30am service and have my headphones on up in the recording loft listening to music or some show on Netflix streaming but since I was assisting with communion at the 8:30 service, I actually sat in the pews. It did however give me a chance to sit with Dave & Kelsey and catch up a bit with them. I rarely get the opportunity so it was nice for a change and I always enjoy their company. The 11am service is the one the bulk of my closer friends at PGUMC attend so I felt I needed to attend that one as well so I could see those special people that have been so supportive of me and Joe. Besides, the choir was singing and I wanted to hear them.

After church we came home and the four of us went out to eat for lunch at Rick’s Diner (can’t go
wrong there) and then over to A Southern Season since that is one of Sandy’s favorite stores when
she visits. We were having a good time, Joe buying chocolate by the pound and eating it
(diabetic?????) while Sandy shopped for her favorite items that she has purchased on previous trips. She really likes that store, but then who doesn’t? During this time, Joe excused himself to go to the car saying he was tired. I should have just followed him on out but didn’t. When we did finish and I went to the car he was complaining of being cold but said otherwise he was fine. After stopping at Fresh Market for Pimento Cheese & Chicken Salad, he returned to the car having severe chills. I was not happy. We went straight home and I ordered, yes ordered, him to bed. He was still several hours out from being able to take Tylenol so he had to cuddle under the covers. When I took his temperature after making him some hot tea (which he never drank) it was at 103. So we waited the 2+ hours until he could have Tylenol. Why the wait, because unbeknownst to me, when we got home from church he took his temp and it was high and took some then. Had he just mentioned that he was running a fever, we would have done the afternoon different. Maybe lunch at Rick’s and then dropped him off at home. I could have taken Bill & Sandy to A Southern Season while Joe rested. But as he put it, “I didn’t want to ruin the afternoon”. So instead, he runs a massive fever getting everyone all worked up and upset. Not his smartest move. I was extremely angry at him for not telling me the truth about what was going on. He has promised over and over to tell me the truth about how he is feeling, but once again, he kept it from me. This has got to stop! Maybe my less than happy demeanor will have gotten through to him this time. Only time will tell. Anyway, we took Bill & Sandy over to the Marriott on Sunday night so that they can use the hotel shuttle to get to the airport today since we will be at chemo. It was a wonderful visit and I am so grateful to both of them for coming to visit. Even with the bumps, it lifted Joe’s spirits so much to see the 2 of them and get to spend the time with them. Sandy even spent quality time spoiling Dolly. Of course as we drove off from the hotel, Joe became very emotional. He loves and respects his brother so much and is so thankful and appreciative of the support that the two of them have shown us. The tears flowed as we went back home but mixed in with the sorrow for leaving, was a happy vibe that he had gotten to spend 4 days with them. We both just wish we could see them more often. But since our travel plans are somewhat limited by Joe’s treatments, it pretty much is put on them to travel here, so that obviously isn’t fair to them. But as long as we get a fix every year or so, we can manage.

The fall foliage outside A Southern Season

Joe is at the Duke Cancer Center as I type.  I have just finished Facetime with him during his doctor’s appointment.  Since his temp did get so high yesterday, Leigh has ordered some more blood work drawn for cultures.  103.1 is high.  So Joe is now heading back down to level 0 for lab work before heading up to the 4th floor for chemo.  Me, I’m just waiting for staff or someone to arrive here at the office, so I can leave to go meet him.  I had almost nothing to do here this morning except dodge leftover pumpkins from our office Pumpkin Patch this weekend.  We have lots of orange in the lobby (at least it is a color).

I made it to Duke around 9:30am, got my coffee and joined Joe in the chemo waiting room.  It wasn't a long wait before we went back to an infusion room.  Then we got a surprise visit from Dr. Zafar.  He came for two reasons: to ask if Joe would participate in a study (non-medical) and to inquire about the weekend fevers.  He was not pleased to hear about the teeth rattling chills and 103+ fever.  To say he was concerned is putting it mildly.  The have drawn blood for cultures already and we will wait the 48 hrs for those results but it is highly likely that they will remove Joe's port and put a new one in the other side of his chest.  This would have to be done 2 weeks apart, keeping Joe off treatment during that time.  Dr. Zafar was emphatic that the chills and such high fevers are not chemo related.  So time will tell on that front.  Today however, up in chemo, he is running a 100 degree fever again so they have let him take some Tylenol.  They'll be checking it again I'm sure.   

Unlike last week, Joe is awake and very talkative.  Not sure which I prefer; sleeping Joe or talking Joe. Talking Joe is keeping me from watching Netflix though, so sleeping Joe might win.

Construction on the Duke Expansion is moving right along.

I hope everyone has a great week and I will let everyone know if there are any "unfortunate" results from the cultures which would result in a possible "Duke Spa" visit....UGH!  Thank you for the prayers and words of support.  We are so grateful. 

Day One of Taxol Begins

Today the new chemo regimen begins. The technical name is Paclitaxel, but they just refer to it as Taxol (the brand name). The list of possible reactions is long but the most common are signs of infection/fever, chills, cough; low white blood cell counts; numbness and tingling in hands and feet; muscle or joint pain; nausea and vomiting; shortness of breath, flushing of face; hair thinning or hair loss; skin rash, itch; diarrhea; bruising, bleeding, red spots on skin. Sounds pleasant huh? But most every one of these were side effects from his last two regimens and his were minimal so at this point we can only hope for the best. Only a couple are new possibilities. The one major change, the fever limit is 100 degrees now. We will be doing more triage calls rather than emergency department visits, hopefully. There is a recurring theme here today: hope.

We are back in infusion now waiting for the pharmacy to send up his chemo. Good part, Joe's former Stedman Jr. High student, Jason, is his nurse today. Joe always gets a little extra attention when Jason is in charge. Right now he is getting his pre-fluids and relaxing in the lounge chair. Since this infusion is shorter, he got a choice of a chair or bed and chose the chair. That is my selfish choice too since I get a nice cushioned semi-recliner too.

This weekend was a very good one for Joe. He was able to do the Durham Public Schools All-County Chorus rehearsal on Friday and then the performance on Saturday as the accompanist as well as both church services at PGUMC on Sunday. Then last night. Our cousins Steve and Darr visited from Asheville and we went out to dinner and then to DPAC to see "Warhorse". I hope lots of people had the chance to see it as it was an incredible show. Emotional, extremely well acted and the mechanical/puppeteer horses were amazing. We were all awestruck by it. Truly a great way to end the weekend.

I dropped Joe off at 7 a.m. at the Duke Cancer Center for him to have his labs today and I went on to the office for an hour and a half. I was back here a little after 9 a.m. (his scheduled chemo time) but instead found him still waiting to see Dr. Zafar. So I got to join in for the doctors appointment too. Now we wait for his infusion, and see what if any reactions/side effects he has. Time will tell. Right now he is on the edge of a nap. Once they do get him going, I might try that myself.

It was a great weekend and we are looking forward to an equally great week. Take care folks and thank you for the caring and the support.

Good News, Bad News

Or not so great news, but not terrible news.  Trying to put a positive spin on today's doctors appointment at the Duke Cancer Center to get the CT scan results from Sunday.  The not so great news, at least a couple of the lesions on Joe's liver have increased in size.  The better news is that the tumor in the pancreas seems to have shrunk just a bit.  The growths in the liver are not large, but growth none the less.  Dr. Zafar and Leigh Howard were hopefull that the new 3 chemo infusion regimen would show better results and therefore he is switching Joe to another regimen.  Another reason for the change, all the fevers that Joe has been having.  Although they can't difinitively point to the chemo, they can't rule it out as a side effect.  Therefore it's on to a new treatment. 

Initially this one will be every Monday, about 2 hours of infusion time.  If Joe tolerates that well, then it can be administered once every three weeks as one 6 hour infusion.   So we will start with the weekly and possibly move up to the longer treatment.  Needless to say, once every 3 weeks would work better scheduling wise, but if he doesn't have a positive reaction with regard to side effects, then a massive 6 hour dose might not be a good alternative.  Only time will tell. 

Of course we are somewhat bummed.  But since it wasn't all bad news, we will just forge forward.  Joe seems to have taken it in stride (he usually does better than me).  One other positive aspect, no more home infusions.  So I won't have to go off and have a hissy fit when the home infusion nurse comes in the room Monday...because she won't have any need to!  I can't speak for Joe but I think he is just really tired.  Tired of bad news.  Tired of not feeling well.  I know that I am tired.  Tired of many things!

Many, many thanks for the well wishes and words of concern.  Your prayers and words of encouragement are truly helping both of us.

Oops, I Did It Again!

I forgot to amend yesterday's post to include the fact that Joe DID come home last night. He did have to wait until after dinner was served at Duke so he did at least get one more meal out of them. They have put him on an antibiotic for 5 days so we shall see. He did run a little fever this afternoon but a couple of Tylenol took care of it within an hour.

He has an appointment with Dr. Zafar or Leigh Howard on Thursday morning. A sort of "follow up & get CT scan results" visit. Not thrilled with the wait but I know they prefer for his regular oncologist to give the results rather than the oncologist on duty at the hospital. Nevertheless, it's no fun waiting. But I should focus on the positive. Joe is home, feeling well and had a good day. I'll take that and run with it! We even had a rainbow over our house this evening.

Never Count on Things Running on Time

The tone for Joe's chemo treatment was set relatively early today. I dropped him off in front of the Duke Cancer Center at 7:03 am this morning for his 7:20 labs appointment and headed off to my office to get my Monday morning work done, arriving by 7:15 am. Joe texted me at 7:28 that he was in the food court getting his Subway breakfast (still not patronizing Chick-fil-a). At 7:52 am he was up on the 3rd floor and checked in for his doctor's appointment. However, apparently Dr. Zafar had a meeting and Leigh was busy as well so his 8:30 am appointment turned into more of a 9:15 am appointment. When that happens, there is a cascade effect. 9:30 am chemo turned into a 10:45 chemo and the chemicals didn't start flowing until around 11:00 am. So at this point if the rest of the day goes as normal, we should be out of here around 4:00 pm. Still better than the post 5pm of last time.

Today's nurse, Holly, has been on top of things and we haven't had to listen to beeping long in between chemo changes.  Joe, as you can see doesn't seem to phased by anything yet as he is laying back watching The View.  All 6 bags of chemicals are hung and waiting for their turn.

The biggest decision today is what to have for lunch. And the decision was made at 12:30.....chicken fingers and fries. Yes, I know, that's my norm but Joe usually chooses something else, but today he wanted the same. So off to the Atrium Cafe I went. It's no short walk either, so at least I got some exercise in today! Neither one of us however could finish the chicken so we have a good snack for later tonight, or whenever. Don't you just love these interesting details? Just goes to show how boring it can get up here.

Right now I'm counting the drips of the Oxaliplatin. He has a nice rhythm....drip,drip,drip,
pause...drip,drip,drip, pause, drip,drip,drip, pause. The Irinotecan had more of a slow drip, pause,
drip, pause, drip, pause cadence. Not nearly as interesting. Maybe I'm loosing my mind? 2 1/2 hours to go!  The 5-Flu infusion ball has already been delivered so maybe that will get hooked up quickly after the Magnesium is through (that comes after the Oxaliplatin finishes).

Now that Joe's all fed he's ready to watch last nights "Treme" episode on HBO Go.  I insisted on the headphones because he had the volume at max,  which interfered with my Netflix viewing.  Not sure why I keep him company when he sits with his headphones on ignoring me.  I have to wave my arms to get his attention.

Joe and I have determined that we could live in a room the size of this treatment room since it has an attached bathroom.  The bath is huge so there would be plenty of room to add a shower.  There is already a sink, so we would just need a microwave and a two burner hot plate.  The counter by the

sink doesn't go all the way to the ground so we could have a refrigerator put under there.  Throw in a 

Murphy bed and a couple of more comfortable chairs and we would be all set.

Just think of the savings on parking and travel time to and from Duke!  As you can see, there is room to spare even with the hospital bed in the room and those things are huge!  I might have to repaint though and definitely get rid of the fluorescent lighting.

Joe finished up his treatment at 3:45pm and we made the trek to the parking deck.  That means that the Duke Home Health will be at the house on Wednesday at 1:45pm to disconnect the 5-flu infusion bottle and then Joe will have 11 days free before it starts again.  However, we were not home 5 minutes before the nausea took its toll and Joe fled for the bathroom (of course he had just taken a nausea pill 2 minutes earlier.  Isn't that always the case???).  After that trip he is now settling down on the couch not feeling very well, obviously.  On a positive note, at least it waited until we got home instead of in the car.  It's stacking up to be a long evening!

Thank you for all the messages of concern and support.  They are all greatly appreciated and needed.

P.S. I've finally reached my limit of what I can handle. I've had my hands in Joe's bloody belly when his wound vac failed, I've watched as staples were ripped from his stomach while thick wads of gauze sopped up infectious hematomas, I've watched him heave over the toilet numerous times...but tonight, he is coughing up big ol goobers and it is totaling grossing me out! To make matters worse, he's putting the tissues in his puke pan right next to me. GROSS!

'twas the night before......

...CT Scan results and there were lots of whispers, loud talking, television playing, typing and anything to detract from the elephant in the room--the results.  Joe had his labs and the CT scan on Wednesday morning.  Everything went fine and on time.  By 9am he was back home and relaxing with Dolly.  We haven't really talked about it but it's there, we both know it and the anxiety level just creeps higher as the night falls.

We did take an anxiety break Wednesday night and took a drive down the new 540 before the toll begins on Thursday.  I'm sure everyone is surprised at us taking such a thrilling adventure on the night before we get the scan results.  Yes it was an amazing experience.  We were both overwhelmed with excitement. We came back home exhilarated and astonished at all the fun we had.  Imagine, riding down 6 miles of highway without paying for it.  It's hard to match that when it comes to having fun!! :) (for anyone confused, that was filled with sarcasm).

But after a very long night, a VERY long mostly sleepless until this morning just prior to the alarm screaming in my ear, we're off to the Duke Cancer Center for the appointment with Dr. Zafar and/or Leigh Howard at 8:20 am this morning.

It may seem like it was a lonely walk for Joe over to the Cancer Center but I just had to hang back for the photo op.  I ran to catch up afterwards.  We're all checked in and waiting. 

The waiting is over and the results were anything but what we were hoping for.  Since the last scan 6 weeks ago, the tumor in the pancreas has grown approximately 20% more and is now at 3.8cm.  Also, several lesions have appeared on his liver, the largest of which is 1.7cm.  What this means, time to change to a much more aggressive chemo treatment.  First up, Joe will have a port inserted next Wednesday and then the first treatment will be Monday, August 13th.  No more of the 1 hr treatments.  The new procedure will last 5-8 hrs every 2 weeks with the addition of a 46 hr pump that he will go home with and then Home Health Care will come disconnect on Wednesday.  There are three drugs involved: Irinotecan, Oxaliplatin and 5-Fluorouracil (in case anyone wants to Google them).  The side effects will be more severe so we will just have to monitor and adjust accordingly.

Of course we are a little overwhelmed right now, and not in a good way.  It will probably take a few days or maybe longer for it to really sink in.  Numb is the word of the day I guess.  Joe has just gone back for some lab work in prep for next weeks port insertion and I'm sitting here typing and crying.  Strangely, here at the Cancer Center, that isn't unique behavior.

Joe came out from labs and we went downstairs to the food court so he could have breakfast since he hadn't eaten all day. A few more tears flowed from both of us down there as well.  It was while there that Joe had the realization that since he wasn't having chemo today he would have to pay for parking.  As if our day wasn't bad enough, now he has to fork over $3.00. 

To all those who have reached out to us with prayers and support, we thank you and hope you will continue to help us.  You are loved by each of us and greatly appreciated.

Decisions, Decisions

Tomorrow we have a doctors appointment at 9:20am with Dr. Zafar or Leigh Howard at the Duke Cancer Center. The reason for two doctor's appointments in a row is that we are to give the doctor Joe's decision on what treatment he wants to proceed with due to the growth of the tumor revealed in his last CT scan. Last week Dr. Zafar presented two options. Option 1: continue with his current treatment and have another CT scan in 6 weeks (which would be earlier than his normal schedule for scans) or Option 2: Change the treatment now to a more aggressive type of chemotherapy that unfortunately would have more debilitating side effects. I won't go into what some of those side effects are, but lets just say they would not be pleasant, especially for Joe. If we go with Option 1, then depending on what the scan in 6 weeks shows, we would re-visit the idea of changing his treatment. Meaning, if the tumor has continued to grow, then we would switch to the new treatment. If there was no growth or minimal growth, then we would stay with his current treatment. We have thought about it since last Thursday and have come to a decision to stay with the current treatment and have the earlier CT scan. However, we have lots of questions about the other treatment so we might as well go ahead and ask all of them this visit in the event we have to change in the future. Better to be informed ahead of time rather than get blind-sided by something.

We didn't come by the decision lightly. Part of me would like for them to throw the biggest nastiest hardest form of chemo at the tumor and squash it. However, the rest of me knows what that would do physically and emotionally to Joe. The side effects would be horrible. I don't want that and I'm sure Joe doesn't either. Maybe some people will think this is not the right decision, I even question it myself. But nothing is guaranteed. There are no guarantees in life. That we learned in November of 2010. But enough of the downer talk, right? One solid reason for our decision is that the markers from the labs done at the time of the scan were good. No real change with them. Another reason, although I respect those professionals who read the scans, no one is perfect and I would like to have another scan done earlier.

We got a dose of what we might expect from a change in Joe's chemo treatment this past week. Joe started having stomach pains on Friday evening along with running a low grade fever. This continued on into Saturday. That day pretty much was a wash as both of us just laid around the house. I did manage to leave the house twice, first to get lunch and then dinner. Joe slept and complained of his stomach feeling bad. His fever never got to the 100 mark, but stayed in the mid 99 range most of the day. By late that night the fever seemed to have subsided so Joe was able to play for both services at PGUMC on Sunday and then accompany TGMC for their last concert of the year. Although he was able to get through it all, he was very tired and by Sunday evening his fever had returned and his stomach was once again hurting. Monday morning his fever was gone, but he was still experiencing stomach issues. This continued until late in the day on Tuesday when Joe started describing it as just a slight discomfort. Of course, we don't know why his stomach was hurting: tumor issues? hernia issues? or just stomach ache? We may never know, but it was a taste of Joe feeling bad for several days in a row.
I think one of the reasons why we took the news last Thursday so badly is that we've grown accustomed to Joe having good scans, feeling well most of the time and probably were just in a little complacent. The news was a dose of reality, at least for me.

But the week hasn't been all stressful and gloomy. On Tuesday, Joe took Dolly to the kitty spa. She got to spend 4 hours being bathed and pampered. She came out all fluffy and smelling good.

Thank you to everyone for the outpouring of love this past week. It has been a hard time for Joe and me but knowing so many people care so deeply is a great comfort

CT results

The CT scan results are in and they are not what we were hoping for. The tumor showed a 10% growth. What this means: possibly changing Joe's chemo regiment. The change would be to chemo that could be more debilitating with more severe side effects. We don't have to make the decision today so Joe will have his normal chemo treatment today and then next week we will meet with the doctors again with a decision. If he stays on the same treatment, we would have another scan in 6 weeks to check for further growth. If there is growth, then the decision would basically be a no brainer: change to the other treatment. If no growth, he could stay on the current treatment. The other option is at next weeks doctors appointment is we just make the decision to go ahead and change treatments. We have a week to think about it. I want to thank both Dr. Zafar and Leigh Howard for the extra time spent with us this morning. They were both still very positive and optimistic about the treatment and Joes health in general. It helped a lot and meant a lot to both of us. It was a long night and now will be a long week. Maybe we will spend more time in the "quiet room" at Duke this morning.

Today's Scan and Tomorrow's Results

Joe had his scan this morning at 8:30am after having his lab work an hour earlier. Everything went a little ahead of time. I couldn't be there for the scan this morning, but I did Facetime with him awhile after he had changed into his cute little hospital gown. I should have saved a photo of that, but I'm trying to be good.

We won't have the results from his scan until tomorrow morning when we have an 8:20am appointment with Dr. Zafar or Leigh Howard. It will be a long evening. As I've said before however, at least it is only 1 day instead of the 4 days like back in April.

The highlight of the day however, was when Joe sent me the following photo at work. I have seen photos of him from high school before in his Roanoke Rapids High School band uniform, but this one takes the cake. Please read the caption about the "rock band". How many "rock bands" have you seen wearing marching band uniforms? Don't you just know they could really jam!!!

As soon as you finish laughing and get control of yourselves, I will continue. How could such a high school nerd turn into the cool, suave gentleman that is Joe Lupton today? Ok, ok....now I'm laughing. We all know that Joe is very much still quite the nerd. But we love him!

Thank you for all your prayers and support. We love and appreciate all of you. As soon as we are out of the doctor tomorrow I will update the site. Talk to you tomorrow. Thank you.