I know my last post may have caused some concern so I wanted to add this update. Susan had a good night and felt well enough to go to church today. In addition she was even up to having Wayne, Kathy and Megan come over for a visit in the afternoon. Tonight she's having the usual evening nausea, but not so much that she's taken medication (yet). She's thinking that the TLK is having a cumulative effect as far as nausea is concerned, and so is living with it. As far as nutrition is concerned, we estimate she's had 1000 calories today. Not the 1400 she needs, but pretty close for her. She may even have more before bedtime. Thanks for your prayers.
After a pretty quiet day, Susan felt the need to take both a vicodin and a phenergan pill tonight for pain and nausea. I'm hoping that this is just the usual reaction to the chemo and not something more serious. We were told that the TLK itself only circulates in the body for 24 hours. However, any TLK that penetrates the cancer cells continues to do its "death squad" work for an additional period. I suppose this might give rise to nausea. Since this is a clinical trial, we don't have a lot of data to go on about the side effects of previous patients. Your prayers as always will be appreciated for both pain control and nausea reduction.
Pastor Dave—a Vietnam war veteran—often talks about “the fog of war.” As I understand it this refers to the fact that on a battlefield nothing turns out exactly like you plan because the real time events present a set of often conflicting data that are hard to interpret properly, and then respond to appropriately. We’re seeing this in a big way on Fox News each night in Iraq, but I submit that there’s a similar fog that occurs during the individual cancer-sufferer’s battle with the disease.
This week, for example, has been considerably foggy for Susan and me. After a wonderful weekend with the family, Monday and Tuesday were tough ones for Susan in terms of how she felt. Yesterday, for example, she felt so bad in the morning that she said: “I think I’m getting worse.” But by yesterday evening, after our arrival in Houston, she was feeling better. As I write this she is getting her sixth dose of TLK286, after getting some really good news: her weight went UP this week back over 100 lbs to 100.5. I guess all those cheese-topped potatoes are doing some good. On the other hand (more fog) she is feeling new pressure in different spots. In discussing this with our nurse Lisa, she said that with other patients it has been difficult to determine if symptoms are from the tumor growing or the tumor dying.
Clearing some of the fog that resulted from Saturday’s visit with Dr. Munoz, Lisa—after talking to Dr. Kavanagh—confirmed that TLK286 is NOT a pegylated taxol. Taxol works by preventing cell division throughout the body. (That’s why it causes your hair to fall out.) TLK, on the other hand, works by being attracted to and penetrating the cancer cells only, and then initiating cell death (apoptosis). This bit of “fog-clearing” certainly eases our minds somewhat after Dr. Munoz’s comment on Saturday.
Another patch of fog concerns Susan’s blood work. The latest indicates her white cells are doing well, but her red cells are down. We’ve been through the latter problem before during chemo. So today she will receive a shot of procrit to help boost her red count. In addition Lisa has recommended daily vitamins including daily iron tablets, as well as calcium.
Next week is the big week. Susan will get her CT scan and that will determine whether TLK is working and whether Susan continues in the trial. This will be a long trip to Houston, so we will greatly appreciate your prayers for both Susan’s ability to endure the trip and the scan, and that the data will indeed show that TLK is being effective. Once again thanks for supporting us in prayer so faithfully.
Hi. I'm interrupting the normal reports on Susan to give a report on yours truly. I just got a call from the urologist's office, who reported "no cancer found" in my biopsy on Friday. I know some of you were concerned about that, so I wanted to share that with you as soon as I found out. Thanks for praying for me! "I will sing to the Lord because He has dealt bountifully with me." (Ps. 13:6)
Susan is feeling better after a tough day yesteday. She was "icky" most of the day, and by bedtime was hurting so bad she had to ask me to get her a vicodin. This morning, however, she was feeling much better. Tomorrow we head back to Houston for her weekly treatment.
This is a big weekend at our house as we welcome Peter home for Spring break, David & Elizabeth for a weekend visit, and Susan's cousins Jill and Dick who are in town for a convention from the LA area. Susan is feeling pretty good today, albeit with the usual nutritional challenges. We had a regular office visit with Dr. Munoz who was very frank about where Susan was from his point of view. This was a rather discouraging discussion, and I'm glad that the boys are here to distract me from the implications of Dr. Munoz's inputs. He wasn't too impressed with TLK-286, and called it a pegylated version of taxol. I'm not sure that I agree with him on this point, since I can't find anything in the literature that uses these terms. Nevertheless, as Susan keeps on saying: "we know Who's in charge." And as the Apostle said: "If we hope for what we do not see we wait for it in patience." In that spirit we continue to hope for the best possible outcome of the latest treatment, and wait patiently for the Lord's continued blessing in very special ways. Peter's analysis of our web site shows that we are getting "hits" from every continent. I'm not sure what this means, but to all those of you who visit--both known and unknown--we thank you for your praying for us. May God bless you, and in this time of war, may God bless America.
PS: On a personal note I thank you for praying for me as I underwent the biopsy yesterday. I got through it OK (though I don't recommend it if you've got something better to do). I should hear back from the doctor's office by the end of next week.
It was such a beautiful day yesterday when we arrived in Houston—and Susan was feeling so much better—that we decided to motor the 40 miles down to Galveston to check out the beach and have an early dinner at Landry’s. Spring break is winding down, but the Galveston beachfront was still pretty crowded. But there were plenty of tables at Landry’s, and Susan did a very good job on her lobster bisque, while I enjoyed my Gulf red snapper topped with crawfish etouffee.
After a “restful” evening watching the next war start, we had an early breakfast and arrived for chemo around 8:15 AM. We were met as usual by our faithful research nurse, Lisa. Lisa is a fellow believer, and in a nice “coincidence” her son is a member of a new PCA church plant (by PCPC) here in Houston. As she and Susan dialogued about how chemo was going, and what happens next, her eyes began to tear over when Susan said, “if this doesn’t work, that’s it.” She assured Susan that other clinical trials or treatments would be available if needed. Susan’s reply was, “we know Who’s in charge!” to which Lisa positively agreed. Then she presented Susan with a beautiful book of meditations for women—then hugged her twice before taking her leave. We were both greatly touched by Lisa’s compassion and generosity. It’s just another example of how the Lord shows His presence—through his people—of how He is with us during this time.
Although Lisa noticed how much improved Susan’s appearance was, we were both concerned by the results of today’s weigh-in which showed Susan’s weight had dropped below 100 pounds, to 99.9. Again we will be asking you to continue to pray that Susan will be able to improve her nutritional intake in the coming weeks. At this time of war we would also ask you to join us in prayer for protection of our armed forces—and particularly for Scott Pollock (son of Doug and Karla), a marine on the front line in Kuwait, who is a member of our local church and a contemporary of our own sons.
We arrived home this afternoon after an uneventful trip with help from our “limousine” driver Judy H. (thanks, Judy!). At Susan’s encouragement I decided to make my signature dinner: waffles. So as not to bore you with the details, I placed a little story on "Making Waffles" on "Pop's Page."
I’m happy to say that Susan is feeling sufficiently better that we are resuming our trip to Houston today with chemo tomorrow. Judy H. is picking us up at 1 PM for our weekly jaunt to Love Field (thanks again Judy!). We had expected to hurry back tomorrow for Susan’s monthly appointment with Dr. Munoz, but we found out today that he is having a “family emergency” and has had to cancel all his appointments. We’ll see him on Saturday instead. This is a bit of a headache because both Peter and David (and maybe Elizabeth we hope!) are expected in for the weekend. Sorry guys, but Dr. Munoz is always a priority.
We will appreciate your continued prayers for Susan’s nausea and pain that it will be minimal during the trip. On a personal note, I would appreciate your prayers for me as well as I am to have a prostate biopsy on Friday. Thanks!
After 4 really good days (see yesterday's post) Susan is having a bad day today. Her nausea is intense. As a result we have postponed her trip to MDA by one day. We will appreciate your prayers that she will be able to make it to Houston tomorrow. Perhaps it was inevitable that the activities of the last few days have "caught up with her." However, she strongly disagrees. As I write this she is having her first feeding of the day: ice cream with powdered milk sprinkled on. Hopefully this will stay down.
My mother used to say that she was a "double Irish," since somewhere in her line two distant Flanery cousins got married to one another. That gave rise, I imagine, to her own double dose of good humor in face of any situation. About now we are really missing her. All kinds of questions about our family have cropped up since her passing, and I am totally clueless. Her memory was incredible. Once I was working with her putting my Dishman ancestors on a computer program and just to tease her I asked her about some obscure wife (with no known last name) married to a Dishman--five generations back. She got all flustered because she couldn't recall her name by memory instantly. But an hour later, while we were working on an entirely different matter, she blurted out the name. As for me, I have trouble remembering who my great grand parents were, much less 5 generations back. But even more than her memory we miss her smile. And on this day of Irish smiles, we miss that sweet smile all the more.
I suppose it's that inherited Irish optimism that is coloring my thinking today as I observe Susan. It seems to me that she is gaining strength and more nutrition every day. For example these past four days have seen an ever increasing stream of visitors, and I have tolerated that since she seems to relish it so. "I crave female compansionship," she says. Trying to hide my heart wounded by this remark (what? you are getting tired of watching 8 hours of college basketball every day??)....I have allowed visits by Kathy S. on Friday, Susanna & Lydia & Angie on Saturday (including a trip to Ying's Chinese), and later that day by Kathy B. and Megan, and by Jane last night, etc. Oh yes, we went to church (and then to Krogers again) on Sunday and she handled that well. Then today Dan & Kathy came over with Tori and Nate, whose birthday--way back in January--we finally celebrated. In addition she engineered the carpet cleaning folks to come in and clean every carpet in our house today. (I'm sitting here in the only non-carpeted area in the house...exiled from my study and computer.) She's also finished all three high calorie drinks provided by MDA, and we are getting ready to try the Scandishakes tomorrow before we head out to Houston. Furthermore, she even had two crackers topped with cottage cheese, and she's almost finished all the potato soup provided by Terrie. I hope I'm not looking through rose colored glasses as I report these impressions. On the other hand the one negative indicator was the CA-125 report from last week's visit at MDA. It's risen to an all time high of 1725. However, even this can be interpreted optimistically: as the body is stimulated by the successful war of the TLK over the cancer cells it secretes more tumor marker. So, other than that one ambiguous indicator, Irish eyes are smiling on Ash Circle today. Thanks again for your prayers.
Several other readers of this page have said "they understood" if I didn't post every day, although I sensed a bit of disappointment if there was no new news on this page. For example, young Spencer Anthony checks this page every night to see how he should pray for Mrs. Dishman. After reading an update one evening, he prayed, "Lord, please push back with your mighty arm whatever is making Mrs. Dishman not want to eat so she can eat enough." Thanks, Spencer, your prayer said it perfectly--and that remains our overall prayer request as well. I am glad to say that the Lord has been answering your prayer, because Mrs. Dishman has been eating better. Last night she began her VHC drink, and was able to finish it today. Now she's started on a can of another brand that has slightly less calories per milliliter. In addition she's been enjoying the potato soup that Terrie Jones provided right after she picked us up at the airport on Friday (thanks, Terrie!) She's also looking forward to trying our samples of Scandishake that arrived in the mail today. It claims to pack 600 calories in 8 oz when it's mixed with whole milk. In the meantime I have been sustained by wonderful meals provided by Kathy S., Kathy B. and Megan. Thanks, ladies!
Although the doctor said it's too early to tell if the TLK is working, I can't help but notice Susan's increasing energy since treatment started. It seemed before our trips to Houston that she was on a downward slide, physically. I personally believe that slide has been arrested and even reversed. We attribute that to the Lord's gracious provision in response to the prayers of our many, many friends. One of the wonders of Christ's love for His people is that He allows them to participate in the blessing He bestows on His children as they join Him in prayer for others. As Romans 8:34 puts it: "Christ Jesus is the one who died--more than that, who was raised--who is at the right hand of God, who indeed is interceding for us." Thank you for your continued intercession for us!
It was hurry up and wait today at the normally-efficient M. D. Anderson. We waited for a couple of hours during our appointment with Dr. Kavanagh and again at the chemo session. The latter was scheduled for 2 PM but we didn't get in until 4 PM.
Here are some "bullet points" from today's activities:
* Dr. Kavanagh explained that the CT scan was consistent with Susan's symptoms that she "feels full" after consuming only a small amount of food. He endorsed the idea of a puree-based diet.
* He also said it was too early to know if the TLK286 was working, but recommended continuing.
* The dietician, Maria, came up with some really high-powered nutrients for Susan to try. One of these, Nestle's VHC packs 2.25 calories per millileter, so that she would get 560 calories in 8.45 oz of liquid--the highest rating so far. We asked her about Scandishake, but she said that the data she had on it was inconsistent as to the actual calories per ounce. She gave us a sample of the VHC as well as two other products for Susan to try. If she is able to consume only 2 1/2 cans of the VHC, she would be at break even on calories and protein. At her weigh-in today she had lost only a single pound, not two as in past weeks, so already she seems to be doing better in this department
* On the other hand, the more of the TLK she takes, the more nausea she has--suggesting that this side effect is accumulating in her system. Today's chemo went well, but Susan was more nauseous than usual. Tonight, after a 1/2 cup of acorn squash soup, she is resting comfortably.
Tonight at dinner Susan said that I tended to give too many details about her physical condition. "You ought to say more about the spiritual aspects," she said. "What would you like for me to tell them?" I asked. "First, ask them to pray that the chemo kills the bad cells. Then ask them to pray that we would see how all things work together for good in our situation. Then ask them to pray that we will see the Lord's incredible love through it all."
So there you are. She has said it all, as usual. And as regards the third request, as I look deep into the eyes of my beloved wife, who has courageously battled this disease for almost 3 years, I do indeed see the Lord's love shining through! Thanks for praying.
Our good friend Kelly from New Jersey wrote (via email) the following comment: “I love your updates..….By the way, I know you said on the website post that you know a lot of us hit this site everyday to find out how Sue and you are doing, but if it comes to spending time with Sue vs spending time filling us in - spend the time with Sue, we can hold off a day or two being patient.” I appreciate this comment from Kelly, and, as you can see, I am taking it to heart. There are a couple of reasons for this. First, Susan seems to have increasing energy these days, and that’s keeping me busy. Son Mark made the same observation. For instance, we ate out for the first time in months on Saturday. Then on Sunday we went to church and then to Kroger. Today we visited my mother’s gravesite at Restland, and then did some “plot shopping” for ourselves, followed by a long trip over to Vista Ridge for Susan to get a haircut. (The TLK does not cause hair loss.)
The second reason I need to reduce my frequency of posts has to do with Susan’s concern that I am posting too many details of her physical condition. In that regard let me inform you that your prayers that Susan’s possible intestinal blockage would be relieved were dramatically answered yesterday. At the same time relief from nausea and getting sufficient food intake continue to be items for ongoing prayer. On the latter front we had a good suggestion from Yvonne Brown via Gayle Clelland regarding a product called Scandishake that seems to be superior to Enlive Plus, which Susan seems to have trouble digesting. We have a free sample of Scandishake flavors coming to us from the manufacturer. At the hair/wig salon today we also found out about a product called Juice Plus, which it turns out is being trialed at M. D. Anderson on ovarian cancer patients. Susan doesn’t seem to be eligible for that trial, but the product is apparently of sufficient scientific interest that it merited MDA’s attention. We’ll be checking it out when we get down to Houston this week.
Finally we’re grateful not only for all the prayers that the readers of this page have been raising up to our gracious and loving Father, but also the practical food help from Jane, Tricia, Teresa and Anna. The love of Christ is incredible to observe in action.
I’ll plan to update this page again on Thursday after we talk to the doctor.
My cousin Pat Talkington gets the prize for the best suggestion of the week. "Freeze the liquid supplement," she said, and maybe Susan will find it easier to eat. Sure enough when Susan called Dr. Munoz today to report the digestive slowdown, he echoed Pat's suggestion. "Eat frozen Ensure Plus. We find that works well in starting things moving again." Pat may have a bright future in a second career as a gastroenterologist!
Last night was a better night for Susan. She slept until 4 AM and only had to take Tylenol for the pain. Today she felt strong enough to attend church for the second week in a row. After church we stopped by Kroger and stocked up on Ensure Plus and other medical supplies. This is always an adventure when she drives one of those electric carts. This one had one of those annoying beepers that sounds whenever you put it into reverse. With all the construction at Kroger these days she had to use reverse frequently. However, I was very proud at her improved driving skills. This time she didn't come near to taking out the cashier--although I did get a little nudge on my leg as she maneuvered into the checkout lane. Actually, I think she enjoyed her driving. She took the cart all the way to our car in the parking lot and then insisted on driving it back into the store. Talk about a beautiful woman stopping traffic--everyone came to a screeching stop as she zipped the cart adroitly back into the store, parked it and plugged it in like she'd been doing it all her life. My Susie is an amazing woman, and every day she gives me a new thrill!
Last night and today seem to be a carbon copy of yesterday. Once again Susan experienced severe pain about 3 AM, took a vicodin, and by morning was better. Better enough, in fact, to have the granddaughters (and their parents) come by for a good visit, including a cup of egg drop soup at the local Chinese restaurant. It seems that she's had more nourishment today than yesterday. On the other hand she reports that, despite two doses of mineral oil a day, her digestive processes have slowed once again. The latter is consistent with another blockage, but that doesn't square with the lack of constant pain and nausea like the last time. We will appreciate your prayers for relief in this area, and for a full night's rest.
If I don't get these daily updates up on the web in a timely manner, I hear about it from various sources! I'll try to be more punctual, but please be aware that now that I am the "chief cook" of the household, I tend to get bogged down in domestic chores for which I am totally incompetent. I'm really looking forward to when Susan can resume her former responsibilities in this area--because she is a fantastic cook! (Tonight's menu: Lean Cusine Fiesta Chicken. Yahoo!)
Last night was a tough one for Susan. The pain got so bad that she finally gave in and took a vicodin. By morning she was much improved, and today has been free of nausea, and only the "usual" discomfort. However, about this time of the day she starts feeling increasing discomfort. Her food intake has been about the same as yesterday. We will appreciate your prayers for a good night's sleep for her, and improving ability to eat. Next Thursday we will have our checkup with the MDA doctor, and hopefully begin to get more insight into if she's responding to the TLK.
Sorry for the late post--I was fighting a computer crash for most of the day. Otherwise, "it was a quiet day in Lake Wobegon" as Garrison Keeler liked to say. Susan spent most of the day on the couch fighting nausea. Nothing severe, just the usual that she gets from this particular chemo. For the most part zofran controlled it throughout the day. But because of it, the food intake was pretty low. We'll appreciate your prayers for an improved ability to eat. It's not that she's not hungry, but rather that her stomach feels full--and painful--after a relatively small volume. So, she needs to be eating/drinking throughout the day--but with the nausea that's hard to do.
Those numbers are our new targets for Susan’s nutritional input after our consult (during chemo) today with the MDA nutritionist. 1400 calories, 56 grams of protein, and 3 cups of liquid. Based on Susan’s average weight loss per week of 2 lb., the nutritionist thinks that Susan’s intake has been somewhere around 800-1000 calories per day. Getting her consumption level up by 40%-50% is going to be a challenge for her, but we got some good ideas from the nutritionist.
We’re back home in Richardson tonight. Susan’s blood work continues to show that the chemo is not zapping her white cells too badly, like other previous chemos. However, she is having substantial nausea today, probably a result of the TLK. The interval was only 6 days between chemos this week due to last week’s ice storm, so this is probably making today’s treatment a bit more severe in terms of side effects.
The episode of nausea last night seems to trace its source to the fact that Susan cut up some lemons, squeezed some juice out, and then consumed about a tablespoon of the juice. For some reason she craves lemon juice. Given how it affected her, however, I think she’s going to put that on the back burner. Today she’s felt much better, and we had no trouble getting to Houston right on schedule. (Thanks again Judy!) Southwest had wheelchairs (or electric carts) all the way for us, and we found another immediately upon entering MDA, so the impact of the trip on Susan’s energy level was much less than last week.
Tonight she will get blood work here in the hotel (MDA likes to make it easy), and get a good night’s sleep before chemo number 3 tomorrow at 8 AM sharp. We hope to have a consult with a nutritionist during chemo. What seems to be working best for her is home-mashed potatoes, pureed, and topped with finely-shredded cheddar cheese. She also now has 27 boxes of a 300 calorie drink called Enlive. Between the Enlive and the potatoes (which are even better than rice in terms of calories per unit volume), we are hoping she is holding her own nutritionally. The weekly weigh-in tomorrow should give us insight into how it’s going. One other positive indicator is the fact that Susan is able to control her pain pretty much totally using Tylenol, without resorting to vicodin. This is doubly good, since it may indicate the TLK is working, and vicodin tends to slow down the digestive system.
Last night was a much better night for Susan. She slept the whole night through without getting up. Today seemed better, too, with improved food intake and digestive functioning. Tonight, however, she's taken a turn for the worse--in just the last half hour. Much more intense pain and nausea. She's even afraid to take an anti-nausea pill for fear that it won't stay down. We will appreciate your prayers that she will get through this and we can still go to Houston tomorrow.
I know that some readers may think I am referring to a certain university by that name in Houston, but in fact I'm talking about that simple white (or brown) vegetable we all take for granted--and eaten by literally billions of people around the world as their major staple. I now know why they can live on rice, almost exclusively. While watching Susan prepare some carrots for her "solids to liquids" campaign, I decided to do a search on the Internet for nutritional values of common foods. What I found was a nutritional site sponsored by Northwestern University. It showed that you'd have to eat a lot of carrots to match just a cup of rice in terms of calories per unit volume (44 calories per cup for the latter). Only potatoes and yogurt were higher. Since we were fresh out of rice, off I went to the local Tom Thumb to get a few pounds of the white stuff, and a box of rice pudding mix. On my arrival home Susan cooked up the latter and as I write this is waiting to see how it lands.
She had a tough night last night: pain and nausea again. I'm hoping this was the chemo and not a worsening of last week's digestive symptoms. On the positive side, she felt well enough by mid-morning to go with me to church--her first attendance there in over a month.
Susan and I both agree that she is feeling much better than a week ago. Why is this the case? One explanation could be that her system was clogged up and now is unclogged due to "standard remedies." Another is that the TLK286 is actually already taking out the cancer cells that were causing the clog. I vote for the latter, but I know that it could be the former.
Today she's had a modest increase in her nutritional intake. She came up with her own blend of potatoes and carrots which she liquefied in our blender. Despite all her new found sensitivity to smells, this concoction seems pleasant to her and she's been snacking on it all day. We were also grateful for meals from Wayne & Kathy as well as Jane Willis, and vanilla ice cream from Terrie J. We've had a pretty busy day which included a two hour house cleaning by our usual crew, and then several friends who dropped by. Tonight I plan to keep her on the couch if at all possible in order to build back her energy stores for this coming week's trip to Houston. After a pretty rough week, we've seen some real answers to prayer. Once again we thank you for your intercession in our behalf.