Choose The Bolder...

"When you cannot make up your mind between two evenly balanced courses of action, choose the bolder".

-  W. J. Slim

Today, Char reached a difficult decision regarding her course of treatment.  She is going to move  forward with the clinical trial for Bevacizumab.  Bevacizumab is a drug currently approved for use in late stage Colon, Lung and Breast Cancer.  It has shown some promising results in early human testing on combating tumor growth and formation in woman with recurrent Ovarian Epithelial Cancer.  In addition to the standard protocol for Chemotherapy, the idea is that Bevacizumab will assist in fighting the potential of future recurrence of tumor growth and formation.  She has an appointment tomorrow at 2:00 PM to finalize paperwork and assessments, schedule further testing and to set her initial chemo appointment.  

The medical and scientific portion of my brain is a solid proponent of clinical trials in the interest of health, science and a better life for generations to come.  The son side of my brain, as my friend Heather informed me it would, was having difficulty with the idea of my Mom taking part in a clinical trial with uncertain interventions, uncertain outcomes and some scary potential side effects.  

This challenging decision for Mom to make caused me to reflect on the true selflessness of an individual committing to such a clinical trial.  There is no certainty of the personal health benefit from clinical trials.  There is no guaranteed treasure for your time, your labors and your sacrifices.  There is no cost savings on treatment.  Certainly, when a person commits to a clinical trial there is hope of a potential new medical advancement that could positively impact their journey.  But truly when they commit themselves they are dedicating themselves as one piece of an enormously complex medical puzzle that down the road, who knows how many years or how many generations, just may help another person fight a battle for their health and for their life.  That is an incredibly noble, selfless and wonderful gift for an individual to give.  

Mom, thank you for this gift that you are giving.  To everyone who has committed and sacrificed to get medical advancements to where they are today so that my Mom has a great chance at a healthy life where she will be an active loving part of my children's lives, thank you so very very much.  

Love,

Char's Gang

Caterpillar in the tree...

I was sitting in a movie theater w/ Lindsey & a friend on Easter Sunday, watching none other than, you guessed it, "Hannah Montana", a movie I wasn't expecting to like to much, but hey, we do these things to make our kids happy, right? As the movie went on & different songs were sung, one song in particular sung by Miley Cyrus & her father really hit me, & brought tears to my eyes. Suddenly, I remembered being a little girl scared to try something new, or too shy to talk to someone, & there was always this voice, my mothers voice telling me to go for it, you can do anything you set your mind to. As I grew older, I made some really dumb choices, got into worlds of trouble, & now in my adult life am facing very stressful situations as a parent & with my job, my mom has ALWAYS been there, She is my rock, my everything, without her, I would not be who I am today. My biggest dream as a mother is to be as wonderful of a mother to Lindsey & Jason as my mom has been to me. There have been so many times I have just wanted to give up, I was tired of fighting, but mom is always there pushing me along, helping me to be strong. I saw myself as the little girl she was singing about & it reminded me of just how mom always is, she's ALWAYS been there to comfort me, encourage me, & to catch me when I fall. I wanted to share the words to the song with you mom, so that you know everything you do & have done for us has never gone un-noticed & how much I love you! You mean the world to me!!!

Caterpillar in the tree...

By Miley & Billy Ray Cyrus

You tucked me in, turned out the light,

kept me safe & sound at night.

Little girls depend on things like that.

you brushed my teeth & combed my hair,

had to drive me everywhere,

you were always there when I look back.

You had to do it all alone, make a living, make a home,

It must have been as hard as it could be.

And when I couldn't sleep at night,

scared things wouldnt turn out right,

you would hold my hand & sing to me:

Caterpillar in the tree, how you wonder who you'll be,

can't go far but you can always dream.

Wish you may & wish you might,

don't you worry, hold on tight,

I promise you there will come a day,

Butterfly fly away, butterfly fly away,

You got your wings now you can't stay,

take those dreams & make them all come true.

Butterfly fly away, butterfly fly away,

You've been waiting for this day,

all along you've known just what to do.

Butterfly, butterfly, butterfly,

Butterfly fly away!

I love you mom, with all my heart, I am here for you every step of the way! It is beacuse of your love & support throughout all my trials & tribulations, that I am who I am today. I know I don't say it as much as I should, but not a day goes by that I don't thank God for giving me the best mother in the world. I love you mama!!!

Love always,
Ann Marie =)

(ps: for those of you reading, I wrote this under moms name cuz I'm not very good w/ computers, so I don't know how to do it under my own name.LOL! Sorry, my brother got the brains, but at least I got the looks! haha! Love you too Jay!)

A Plan...Yet Tough Decisions To Be Made

So today was the next big step.  Char met with Dr. McCullom and the folks at Virginia Oncology Associates for her first post-surgical out-patient visit.  Our dear family friend and Mom's "Right Hand Woman", Sherry was at her side, at her service and her partner in crime as always.  Thank you Sherry.  

It happens that Mom may have been feeling a tad cooped up these last few weeks.  You see, her first trip from home turned into a twelve hour day of appointments, lunch with the girls, running around for visits and ladies night at Blockbuster.  I had to laugh when I chatted with her at 9:45 PM and she had just gotten home a short while ago.  Good for you Mom!  Way to hit the ground running.  I will tell Annie to have coffee ready in the morning.  I have a feeling you may need a cup or three.  As your son and as a therapist, I applaud your "I am not going to sit on the sidelines attitude".  That was a brave thing to get out there and push yourself today.  More importantly, it was a great thing to get out there and enjoy yourself.  We are very happy that you did!

We all went into today expecting some answers, some news and some decisions.  Well, we got some of each and all of none.  Here are a few key points:

• Staples gone.  YEAH!!!
  
• Diagnosis is Stage IIIC Ovarian Epithelial Cancer
  
• Chemotherapy protocol tentatively scheduled to start next week
  
• Chemotherapy protocol will consist of Intravenous (IV) administration of Carboplatin and Paclitaxel over 6 cycles of 21 days each.  In other words, she will start Day One receiving chemo treatment on an out-patient basis followed by 3 weeks at home to recover, rest and let the "good stuff" work its magic in preparation for the next cycle.
  
• Decisions need to be made as to whether or not Mom will choose to participate in a clinical trial for a new potential treatment protocol for women with new diagnosis of Epithelial Ovarian Cancer.  Technical jargon title of trial is: Phase III Randomized Study of Carboplatin and Paclitaxel Versus Carboplatin, Paclitaxel, and Concurrent Bevacizumab With Versus Without Extended Bevacizumab in Patients With Stage III or IV Ovarian Epithelial, Primary Peritoneal Cancer, or Fallopian Tube Cancer.  In this trial, she would receive the standard IV protocol of Carboplatin and Paclitaxel over 6 cycles.  In addition, she would either receive continued treatment with: a placebo, IV administered Bevacizumab (a Bio Therapy) or IV administered Bevacizumab for an extended period of time.  Being a double blind random study, Mom nor her Oncology team chooses or knows whether or not she will be receiving the Bevacizumab or the placebo.  There has been research that proves there can be some benefit from Bevacizumab alone in decreasing the size of tumors and/or showing no active tumor formation over a six month period.  The size of this trial and the backing of this trial are impressive.  There are many many amazing institutions and Oncologists taking part in conducting this trial.  There is also a laundry list of potential side effects that were not so easy to swallow once we learned more.  We still have some questions for her Oncology team before Mom will be prepared to make her decision about this trial.  We hope to have these questions answered within the next day or two so that Mom can have at least "a minute" to digest the information prior to finalizing her decision. 
  

So, there is a plan.  IV administered chemotherapy will start within a week or so.  The drugs of choice have been determined.  Now we get more answers and Mom makes HER choice as to what treatment protocol she feels is best for HER.  It is likely that the answer will be either she chooses to participate in this trial or she chooses to follow the standard IV chemo treatment protocol discussed.  We will provide more updates as they become available over the next few days.    

Thank you all for your thoughts, your prayers, your encouragement and your support.  Please keep all kinds of positivity and prayer coming her way.  It means more than we can express and it is definitely felt.  Also, please be patient, as for all of us emotions are running rampant from one moment to the next right now.  Once in a while Char maybe sad, or angry, or well.. just plain pissed as hell and that is perfectly fine, perfectly normal and COMPLETELY understandable.  Don't worry though, she never lets us get away with that for too long.  Nor shall we let her. ;)

Love to everyone.

Char's Gang    

Accepting Uncertainty As A Blessing

Life is.  I am.  Anything might happen.  And I believe I may invest my life with meaning.  The uncertainty is a blessing in disguise.  If I were absolutely certain about all things, I would spend my life in anxious misery, fearful of losing my way.  But since everything and anything are always possible, the miraculous is always nearby and wonders shall never, ever cease.

-Robert Fulghum

  in Maybe (Maybe Not)

Mom,

We never know what tomorrow holds.  Each day that we wake, each breath that we take is a blessing.  Tonight, Mom, for you we pray for each blessing, each event miraculous and each wonder that shall never ever cease.  Tomorrow does not hold an outcome for your journey.  It simply holds a piece of a puzzle to maximize your health and well being.  The rest of that puzzle is yours to put together, with God showing you the box and handing you the right pieces.  We know that you are strong.  We know that you are blessed.  We know that you have been granted many many blessings in your life that you intend to fight for.  We know that you have just begun to love, laugh and invest your life with meaning. 

Sweet Dreams.  We love you.  

Oh, To Sleep In My Own Bed

So the stairs can be a bit of a lofty challenge following major abdominal surgery.  But, sounds like Char is getting antsy and is just about ready to tackle the challenge.  Of course, I don't understand why.  Pull-out couches are declared in advertisements as nothing but super comfortable these days right??  Yeah...right.  I think you could take the matress off of your own bed and put it on top of a pull-out and it would still find a way to be uncomfortable.  Ah, a restful night in her own bed after 10 days of hospital beds and on a built up pull-out couch.  If that isn't motivation to tackle the goal of stairs, I don't know what is!

Today Mom is feeling pretty good.  Staples are a bit uncomfortable as is just the over-all post-surgical feeling.  She is going to get out and spend some nice time outside watching the kids play and dogs run around in the yard today.  It is certainly a beautiful day for it!  70 degress, the sun is shining, the weather is sweet, but she says she's not quite ready to move her dancing feet. 

Mom sends her appreciation to everyone for your support and encouragement.  Annie is printing off blog pages and comments for her to read.  Once she is getting upstairs and to her computer area comfortably, she will begin to follow closer.  Once she has her appointment with Dr. MCCullom on Tuesday, April 28th, she will have more information on her coming treatment and care plan.  She looks forward to making her blog posting debut sometime early next week.

Thank you again to everyone for your thoughts, your prayers, your assistance and your care.

Love,

Char's Gang

Mom, Lets buy you that bat

I found this very fitting. Definitely the right attitude to maximize health and to approach disease and illness of any kind.   

I have heard there are troubles of more than one kind.
Some come from ahead and some come from behind.
But I've bought a big bat.  I'm all ready you see.
Now my troubles are going to have troubles with me!
~Dr. Seuss

Char's Walk On The Beach

Last week, Mom got some news that was like a wave sweeping us all off of our feet.  She had spent a few weeks of back and forth to the doctor with increasing stomach pain, abdominal swelling,  fluid weight gain and new onset shortness of breath.  Initially, there was calcification noted through X-rays on her Gall Bladder.  She was pending an appointment for Ultrasound and potential Gall Bladder surgery within a week, when she simply could not take the pain and discomfort any longer.  She went to the Emergency Room and a diagnosis was uncertain at that point.  They did a CAT Scan and the radiology reports came back that she had a very large Ovarian tumor.  Immediately the doctors told her that it was quite likely Ovarian Cancer in a progressed stage.  Wow, to put it mildly, those were the absolute roughest words that Mom has ever had to share with us.  

Immediately the ER Doctor referred her to Dr. McCullom with Virginia Oncology Associates.  The next morning, April 14, 2009, Mom had her evaluation with Dr. McCullom.  After tests and assessments, he confirmed that in fact she was dealing with Ovarian Cancer in a progressed stage.  He scheduled surgery for the next morning.  There were many questions about the outcome and extent of surgery that was going to be involved.  Unfortunately, prior to surgery, there were not too many definitive answers.  

Of course we all had a million questions.  Of course being her son and in the medical profession, I had and have a million more.  Only one seemed to matter though..."Why was this happening to our Mom?"  For those of you who don't know, in our eyes, our Mom could not be any closer to being an angel unless she suddenly sprouted wings and a glowing golden halo.  She is one of the most caring and selfless people that I have ever or will ever have the privilege of knowing.  She is absolutely amazing.

One of our biggest concerns of course, was who was going to be leading the pack in the race for our Mom's health and well-being.  Mom had no concerns.  Dr. McCullom could not have made her feel anymore comfortable, confident or safe in his abilities and in her journey to health.  He did not paint a picture that was easy or pretty.  He painted one of reality, courage, experience, perseverance and faith.  Did I mention that she lacks in none of these areas.

At 6:30 AM on April 15, 2009 one by one, we were asked to keep only one to two people in the Pre-surgical room with her at a time.  One by one, we did our best to accommodate...although they could not have drug us out of there if they tried.  The support, love and faith in that room with her and with us was incredible.  Before they came to take her to surgery we all said a prayer with her and a calm seemed to come to her much sooner than it came to any of us.  She was prepared.  She was confident in Dr. McCullom and his team.  Confident in her care and grateful for the opportunity that she has to receive such care.  Most of all, as always, she was comforted and grateful because she knew that God knew what the plan was for her that morning.  About four hours later, we were so happy and so relieved to know that His plan for her that day was to have many many many more days here with us.  Dr. McCullom came to share with us the success of the surgery.  "Its not how it looks when we go into the surgery that matters.  It is how things look after surgery that counts.  Things look good."  Step one of her journey to health was complete and it was a success.  She got the official diagnosis of Stage IIIC Ovarian Cancer.  There are more steps to come though she has the courage and faith to take them on one by one.

So as Mom was waking from her anesthesia, we saw a new and VERY funny side of her.  Her sweet demeanor became sarcastic, quick witted and well deservedly pointed hilarious jokes and comments were targeted at a few of her close family and friends that were present in her post-op room.  It was hilarious.  Obviously, she had a few things to lovingly get off of her chest.  Obviously, we listened and are the better for it.  Having seven brothers, three "kids" and living many years in a military environment, I knew she had it in her.  It was super funny to see. 

The hospital could not keep her.  It was no time before she was sipping and nibbling.  Then up in the room to the chair.  Then getting herself washed up and ready for the day.  Then finally and with no lack of excitement getting in and out of the bathroom independently.  Then came the walks.  "Each time I leave my room, I can go one door further from my room".  Two days later, she was walking out the door.  She was determined and ready to get home.  Again credit needs to be given to Dr. McCullom and her Oncology Team.  They were with her and there for her every minute of her stay. 

Mom came home on Sunday, April 19, 2009 shortly after we celebrated Lindsey's Carnival Birthday bash.  As much as I know Mom would have loved to be there, it definitely would not have been a restful event for her.  The kids had a blast.  The day was beautiful and what a perfect ending for the party but to see Mom walking through the door.

Each day she is getting stronger following surgery.  Each day she is able to eat and drink a bit more.  Nausea is still no fun and creeps its ugly head every once in a while.  But have no fear, Mom is a tough cookie.  

She has her treatment planning appointment with Dr. McCullom on Tuesday, April 28, 2009.  From there she will learn the details of her Chemo protocol and get more information to guide her in her fight to be healthy and to live long and to live well.  With her faith, her support, and her determination, that is exactly what she plans to do.

Thank you to everyone for your thoughts, your prayers, your kindness,  your friendship and your support.  It means the world to us and it means the world to Mom.  Please keep the positive thoughts and prayer coming her way.

With all of our love and all of our gratitude to you Mom!

Your Gang