Radiation Ends Early

Rudy's lab work today showed his platelets were down even lower.  The radiologist said we could still continue radiation, but when he realized we were set to start immunotherapy next week, he decided to stop radiation now.  It's already done what we wanted - cut the back pain.  Rudy only had 3 days left anyway.  Radiation is rough on platelets so having the extra days for his body to heal will help.  

Dr. Hyde said immunotherapy is "the best thing since sliced bread"
and is more important for Rudy than having more radiation.

At CTCA, when a patient finishes chemo or radiation, they have a little celebration.  When the patient comes out they ring a bell.

Rudy was a little surprised at how much he enjoyed the celebration.

They gave him a t-shirt, a cupcake and a few other little goodies. 

We thought our celebration was set for Friday, so we were totally unprepared. Rudy and I were dressed like slobs.  Linda and Nancy just happened to be there. They come for all the doctor appointments, but usually, it's just Rudy and I for radiation.  A bunch of CTCA folks who happened to be nearby joined in.  

One of the ladies who joined in the celebration was a housekeeping lady that we have all fallen in love with.  This lady is truly a ray of sunshine to everyone she meets.

This is the radiation receptionist who has greeted us most days for the past month.  This is a terrible photo of her - she's cute as a button.  

Once home, we were both exhausted.  Neither of us have slept well the last couple of days.  I've had an attack of seasonal allergies.  I bought 24 hour Zyrtec yesterday and for 24 hours I was miserable.  I think it's out of my system now and I feel much better.  I was able to take a long nap and I feel like a new woman.  The allergies were easier than the Zyrtec side effects.

Rudy tried to take a nap, too, but wasn't so lucky.  His last radiation today triggered some hacking.  His 7 day Sancuso patch for nausea was ending and it takes a while for the new patch to kick in.  Bottom line - he's feeling yucky.  His pain is down though - he's trying out dropping down to 1 pill a day now.  It was 3 a day.

Around dinnertime, it got exciting.  We had quite a hail storm.  I sure hope there's no damage.   I took a photo of it, but the hail hardly showed up in the photos.  Most of it was around an inch in diameter.  They got a little larger for a short time.  I went to the porch and said, "Seriously, God?" and the hail stopped.  I'm not kidding.  I guess God knew I didn't have time to deal with insurance and replacing our roof again.

I'll be having a lot more conversations with God this week.  I really want Rudy's body to rebound so he'll be able to do well with immunotherapy.  If his platelets are not up, it may have to be postponed.  Even if it's not postponed, it just make sense that his body needs to be in good shape in order for his immune system to wage a war against those cancer cells.

Also, he needs to put on some weight. He's down to 172 pounds.  That just won't do.  His appetite it practically non-existent.  I'm not known for my cooking skills, but I'm doing the best I can to make things that will tempt him. I'm failing miserably.  If anyone has extras of something yummy that's not too rich or spicy, bring it on over!  Don't bring a whole casserole - just enough for one serving.  His taste buds are still way off from chemo and there are lots of things he used to love that taste terrible right now.  His current favorite food are fried eggs.  We haven't eaten fried eggs in years.  Gooey, rich casseroles - especially the kind with condensed soups - disgust him.  Once I find a food he likes, I run it into the ground because it's so hard to think of what to cook that might tempt him.  The dogs take care of our leftovers and they've never had it so good.

Speaking of pets, have I shown this photo already?  I can't remember.  Little George looks so sweet as he sleeps snuggling up to Sadie.

Here's another pet photo.  It's a bit dark, but that's Sissy sitting in Shirley's cow chair.  I put a big pillow in the chair hoping to keep it pet-hair-free for company.  Sissy pushed that pillow back and claimed her spot.  I guess I'm going to need to make a slipcover soon.

I know there will be lots of people praying along with us these next weeks. Prayers have helped us through so many hard times.  We are praying hard that immunotherapy will prove wildly successful for Rudy and for all the other patients who are fighting.

One day, 

maybe the word incurable 

will only be used in history books.

I liked that sentence so well that I decided it needed to be large and bold!  

Three Long Days

We are finished with our three long days of appointments at CTCA.  We're glad all that's over so we can get back to a more relaxing schedule.

Day 1 included the CT Scan.

Day 2 was the day I was most anxious about because we met with Rudy's lead doctor, Dr. Thompson.  I wrote a short post on Facebook about that yesterday while we were in the infusion room getting two bags of platelets.  Here's what I wrote in case you missed it -

Here's a fast update on today's appointments. The cancer has grown. That was not really a big surprise. We are stopping chemo and getting on immunotherapy. Nivolumab Is an immunotherapy drug that was just FDA approved 10 days ago. It has shown good results and CTCA is very familiar with it from participating in the trials.
Rudy will finish up radiation, work to get his platelets built up and start immunotherapy in early April. That's exactly what we were hoping for so that was our first smile. With immunotherapy, almost all supplements were taken off the list. Only two remain. That was our second smile. Rudy is so tired of pills.When activity was discussed, Anya, the naturopath, made it perfectly clear that if he felt like cutting grass, he certainly could. He can do most anything he feels like doing. That was our third smile.
Rudy's platelets are low so he's getting a transfusion. That should help his energy a little. As for the hack attacks and mucus, there's not a lot to be done, but pineapple and papaya both contain an enzyme that helps. Seltzer water or sparkling water can also help. We can also add the sparkling water to the Ensure drinks he likes best. That should make them a little less syrupy.

We didn't get home last night til after 9pm.  We were wiped out.  Even so, I was relieved.  Dr. Thompson is wonderful.  I can't figure it out exactly, but she has a calming presence when she enters the room and you just feel cared for.

Today, we headed back out for a full day, but nothing as long as yesterday.  We met with 3 doctors today.

The first was Dr. Hyde, a radiologist.  The most interesting thing from that appointment was the news that radiation helps immunotherapy.  The radiation makes it easier for your immune system to target the cancer cells.

The next meeting was with the pulmonary doctor, Dr Parks.  He showed us Rudy's lung scan and explained it bit by bit.  He also gave Rudy an inhaler that will work on the mucus issue.  He's taken his first dose and so far is liking the change.

The third doctor was Dr. Boomsaad, the pain management doctor.  He told Rudy how to wean off the pain meds when he's ready.   We hope he can do that soon.  The doctor thought Rudy might want to wait til after radiation was over, but he's leaving it up to Rudy.  And of course, if he starts weaning off and finds he still needs it, he can just go back to 3x a day.    It's the lowest dose possible, but it's still pretty mood altering.  It definitely eliminates the pain, but at times, it makes Rudy agitated, irritable, and unable unwilling to censor his displeasure.  Thankfully, it's not all the time.  He's been happy as can be for the last couple of hours.  Earlier today, especially while talking to the pain department nurse, he "demonstrated" exactly how easily he could become agitated.  It wasn't all that bad, but when she writes her notes on that meeting, I'm sure exclamation marks will be included.  :-D   Warning: If you happen to call while he's still on that medication, don't take it personally if he acts up.

I've been wearing my hat like this alot.

Things can change on a dime, so I'm reluctant to say this, but...  tonight he seems to be feeling good.  He's very tired - he didn't sleep much at all last night, but still he's perky and relaxed and improved.  Must be those platelets he got yesterday!

Nervous as a CAT SCAN

I'm getting a little nervous about our appointments this week.  Rudy has a cat scan one day, then the next two days, he'll see four different doctors - his oncologist, his radiologist, his pulmonary doctor and his pain management doctor.  The most important meeting will be with his oncologist, Dr. Thompson.

Dr. Thompson will tell us what she thinks after seeing the results of the scan.  I'm praying for good news, but truthfully, I don't even know what exactly to hope for.  If his scan shows improvement, that's good, but it might keep him from going into the immunotherapy program. (I don't know that for sure.)  On the other hand, if the scan doesn't show improvement, then that means Rudy is getting worse.  I couldn't possibly wish for that, right?  But is that what we have to have in order to get into the immunotherapy program?  And don't even get me started about the worry of somehow missing out on that program altogether!  What if he can't get in?  What if it's closed?

With every big appointment we've had on this journey, I've tried to have an upbeat attitude.  I've worked hard to squash down fears and let positive thinking rule.  Almost every time, I've had the rug pulled out from under me.  My new strategy is avoidance.  I try not to think about it.  Nothing I think will change the outcome.  I haven't been able to anticipate most of the things that have happened.  It seems something crazy and unanticipated is always waiting around the corner.  I've come to terms with the fact that, in this situation, I have very little control. We're being swept off by a tidal wave and I have no idea where we'll end up.  By the way, I've referred to me through this paragraph because Rudy has acted incredibly strong.  If he's worried, he's doing a great job of hiding it.

We could really use lots of prayers.  Please pray for a good outcome, whatever that is.  We really could use some HAPPY!  I don't want us to come away from our appointments scared or disappointed, or worse, in shock.  We've had enough of all of that.

Now, I'll quit thinking about it and switch to happier topics.

Our sweet friends, Susan and Rick Holcombe gave us a bucket of fun!  Just look at all the fun things they packed in that bucket.  There's certainly plenty there to distract us!

Hack Hack Hack update - Claritin to the rescue.  Rudy's hacking and gurgling issues were way beyond acceptable. I used to have horrible allergies and many bad winters with bronchitis and I've never seen anything like this.   I have been particularly concerned about how he'd be able to get through the 3 long days of appointments this week.  We decided to try out the Claritin today.  He usually gets that around chemo time, so it should be just fine.  He only took it 3 or 4 hours ago, so I'm not ready to declare it a success, but he sure has improved so far!  Of course, we'll discuss it more with our doctor this week to see if that's the best thing to do.

Hack Attacks

Pardon this post about a very un-pretty topic.  Apparently, Rudy's chemo produces excess phlegm.  That is a serious understatement.  It's annoying throughout the day, but there are certain times when it's really REALLY bad.  When Rudy first gets up, he hacks for ages.  Riding seems to bring on hacking, too.  The ride over to CTCA and back seems to jostle his lungs pretty good and he hacks like crazy for ages after we get home.

There are other things that bring on hacking attacks as well.  He had been looking forward to cutting the grass. He thought it would be nice to do something other than sit in his recliner or at his computer.  We had some nice weather this week.  He got on the mower for a short time.  Big mistake.  Hack hack hack.

He wanted to do this so badly.

He may try it again one day with a mask.  I have very mixed emotions about him mowing. On the one hand, breathing pollen has got to be a bad idea. I want to insist he not do it.  On the other hand, he is really sad at how little he is able to do.  That's wearing him down.  Way down.  He wants to do something useful and he's not into doing dishes or cooking.  He wants to do some of the guy-things he's always done.  I'm not sure if that's in the cards right now.    Maybe after pollen season???

Another breathing issue has to do with neighbors burning.   Our property is surrounded by people who own large plots of land.  They burn their woods regularly to keep down undergrowth.  They also often burn limbs and trash. This week there was a pretty large burn on one side of us.  Rudy had radiation appointments, so there was no avoiding going outside twice - to get in and out of the car.  Our house was enveloped by smoke.  For some reason, when neighbors burn on any side of us, the smoke often settles on our property.  It's crazy.  Rudy's still paying for what that did to his breathing.

The wind begins to shift and the smoke started making its way towards the house.
We had to leave soon after this photo was taken and by that time,
it was so smokey around our house, you could hardly see.  

In the neighbor's defense, they have no idea that Rudy is sick.  I keep hoping to run into them, but it just hasn't happened.  I know they'd be very upset about causing any distress if they knew.

As for today... thankfully, the rain has cleaned the air.  It's not warm or pretty, but Rudy was able to go to the car and back without a hack attack.

Good Days!

Rudy has had two very good days and we are hoping they will continue for a while.  Today is looking like it's going to be extra nice as well.  We are not taking these good days for granted.

Rudy had to get back on pain meds a few days ago.  We have quite a collection of tried and failed meds.  He has hated all of them because taking them means he can't drive his hotrod.  Beyond that, most of them have had awful side effects and didn't completely control the pain.  Luckily CTCA kept working to find a solution.

After a focused visit with our pain management doctor, Dr. Boomsaad, Rudy is on a program that is working great.  It's a three pill combo - a once a day pill for inflammation, a 3x a day pain med, and another pill for break-through pain (which he is thankfully not needing at all).  He also has a cream that he rubs on specific areas.  The cream helps pain, inflammation and chemo-related neuropathy, which we hope he doesn't get.

The pain med name is familiar and scary because you hear it on the news, but it's the lowest possible dose - nothing close to what people might look for on the black market.  A drug dealer would scoff at such a paltry dose.  Rudy's pain is totally under control.  He is not loopy at all.  At most, I'd say he's a little more mellow than usual, but that could also be from the joy of no pain.  Like most pain meds, it can cause some constipation, but we have that under control.  Many of his favorite foods are famous for keeping things moving. :-D

He started by taking the inflammation pill and the cream.  Those seemed to give a good bit of relief, and he hoped to use only them, but it didn't quite do the trick.  He was extremely reluctant to start the main one - the 3x a day pain med.  That's understandable knowing the crazy reactions he's had to a number of prescriptions.  He avoided it until it was obvious he had to get some relief.  First, he went for a long ride in his Challenger, then he came home and popped the pill.  He's so glad he did.  He is feeling like he has a life again (in between naps).

Hopefully, the pain meds won't be necessary for long.  This week, he'll begin the targeted radiation on his chest while continuing the targeted radiation on his pelvic area.  He'll have two back to back radiation treatments every day.  The pelvic radiation will be over early next week.

Rudy is super skinny right now - he had dropped down to 170.  His appetite is back and Operation Pack on the Pounds Before the Next Chemo is underway.  Lots of comfort foods are being consumed and nutritious choices are included as much as possible.  At this point, we are just focusing on what makes him want to eat more.  I don't think anyone would brag about our choices... except for those who have been there done that.  One of his recent favorites was chicken and dumplin's made by Trish.  He said it was perfect - not too rich, not too salty - just right.  One of Rudy's chemo taste changes has to do with foods that are too rich.  Trish also made a sweet potato pie and that was fantastic as well.  I'll bet he's up to at least 175 now!  Maybe even more.

3-15-2015, 8 PM Update - he weighed 179 this evening!

Yesterday, we had a bunch of company.  First, our niece, Kelly and her daughter Eiligh, came down from S.Carolina.  The Johnson siblings - Mike, Beverly, Wanda Kay, and Carrie - spent the afternoon with us.  Rudy group up with them and even though we don't see them often, it's as if no time has passed at all.  It was SUCH a fun day.   Rudy did great through the whole day and completely enjoyed himself.  He was pooped yesterday evening, but it was soooo worth it.

Friends and family have been doing so much to keep our spirits up.  We've gotten wonderful gifts and food and calls and cards and fun newspaper clippings and more.   (Thanks Susan, Carly, Shirley, Pam, Lou and Jeff, Diane, Denise W, and I know I'm forgetting somebody).

Oh  and Denise L and Daniel got Rudy a wonderful package that allows Rudy to watch Braves spring training games on his computer!  Did I mention that already?  It's working great and now that Rudy  FINALLY has a bit of energy, he can actually enjoy it.  Last week, he was too tired to even watch TV.

Phil Niekro signed the 1985 Fanbook that includes a photo of Ricky, Dale and Rudy at a game.
Check out those stylish mustaches!

Also, our niece, Denise, sent us the originals of the Phil Niekro autograph and photo.  Now that we are having a little bit of company, we're finally able to show that off.

It's wonderful to enjoy the magic of ordinary days - that's my current favorite phrase (from a movie title).  It's beautiful outside today.  I hope you can enjoy it as much as we are!

Immunotherapy

Just like many with lung cancer, we are hoping Rudy can try immunotherapy soon.   Most of these are still in trial phases.

So, what is immune therapy?  The treatment directs your immune system to fight cancer cells.  Typically, your immune system doesn't attack tumors because the cancer cells are cells from your own body.  Your immune system isn't supposed to attack your own body.  This article is one of the best I've seen for explaining it. 

This article mentions some specific immune therapies showing good results with more than 20% of patients were alive at two years

NEW DRUG APPROVED
Three days ago, a new drug was approved by the Food and Drug Administration.  It's been found to be helpful to those fighting non-small cell lung cancer.  It's called Opdivo.  It's a type of immunotherapy.  I have no idea if this is something that will be in Rudy's future.  It's not something that I remember being mentioned.  I just happened on this news this morning while browsing online.

 This article explains how Opdivo works pretty well.  Opdivo is put out by Bristol Myers.

Here's an article with a slightly more personal bent.  One horrid little factoid from this article - "But another big question about these drugs is how much they cost: more than $120,000 for each round. That has drawn some intense criticism."  Criticism?  How about fainting dead away from shock?  OMG.  How much is this going to cost?  When a patient is in a trial, are they having to pay?  Even if we had to pay half or even a fourth, that would still be insane.  AND how many rounds are given?  I've always been fascinated with tiny house living.  A round or two of this stuff and we'd be lucky to afford a shed.

This article has an even more personal take on immunotherapy, but it centers around a different type of cancer.

Actually, the personal details are the ones I've been trying to find.  Most of the articles seem to center around impersonal studies and statistics.  I want to know what it will be like for Rudy.  I have yet to find that information.  If Rudy does go through this therapy, I will definitely write about it.  The doctors can worry about the statistics and which therapy would be best.  A patient wants to know what is involved - How often are treatments?  What are the side affects?  Is it like chemo in that you truly have no life while you are being treated?  What is the cost?

MONEY MONEY MONEY
Interestingly, in another article, I read that "Sanford Bernstein analyst Tim Anderson sees Opdivo sales reaching $4.6 billion in 2020." Also, from the same article, "Bristol-Myers shares were up $4.71 at $58.87 on the New York Stock Exchange."  Cancer certainly seems to be good for the economy.  :-(  If you play the stock market, you may want to buy some Bristol-Myers stock.  Remember me when you are rolling in the dough.

In fact, there are a number of big companies in line to make big bucks from new cancer therapies.  Finding therapies for lung cancer could be extremely lucrative. Lung is the leading cause of cancer deaths globally, with about 1.5 million each year.  Lung cancer killed 1.6 million people globally in 2012—more than liver and stomach cancers, the next two most fatal cancers, combined.  Non-small-cell lung cancer accounts for about 85 percent of lung cancer cases, so finding drugs for that type is probably a top priority.


HOW IS RUDY TODAY?
He's been incredibly tired the last few days.  Too weak and tired to watch TV.  So tired that walking from our bedroom to the living room took all the strength he could muster.  These were the worst of the bad chemo days he's had in terms of fatigue. We know firsthand it could be worse. He's not nauseas and he doesn't have unbearable tumor-on-nerve pain and we are thankful for that.

Yesterday, he began to show signs of improvement.  He was able to have a conversation.  He needed to change positions so he sat at his desk and played a game of solitaire.  If this is a typical chemo cycle, he should feel a tiny bit better each day... and then we start the cycle again.  Today there's not much improvement.  We have a late radiation appointment - 6:50pm.  We'll be leaving in a few minutes and he's really dreading having to move.

He is feeling a bit of back pain caused from sitting and lying down for 4+ months.  It's very very uncomfortable, but not excruciating like the tumor-on-nerve pain.  He asks for back massages frequently and they bring him some relief.  Today I bought several other topical pain products.  He tried the Icy Hot Smart Relief Tens Therapy just a little while ago.  It definitely gave a nice sensation and so far he likes it.  We haven't used it enough to declare it a success.

His appetite has increased just a tad.  Ensure is our best friend.  His current favorite is Ensure Active in Peach.  He also likes the Berry flavor.  I've started drinking them as well - mostly the ones he doesn't care for.  That's probably a good idea because I know I'm not eating like I should.  One night my supper was gluten free crackers.  That's disgusting and not at all nutritious, but it was the best I could do at the time.  

Yesterday, the weather was nice and we sat outside twice.  That was great.  Neither of us have spent much time outside during the last four months.  I hope he can get his energy up quickly.

Radiation Begins

Rudy began radiation yesterday.  It turns out, he'll have two 14 day sessions.  They'll be weekdays only.  The first session targets two areas in the lower back / pelvic region.  The second session will target his chest / back.  Today, he had the second treatment in the first session.  It took only about 10 minutes.

Yesterday was his first treatment and it took longer.  They let Nancy and I go back with him as they set up.  They took time to explain how things work.

The above photo shows the radiation machine.  There may be a proper medical name for it, but I don't know it.

Once Rudy lays down in the mold made just for him, they line up all the marks on Rudy in the laser crosshairs.  The photo above is not lined up yet, but it's close.   Then they adjust specifically to target the areas they've chosen to go after.

The entire machine rotates.

Information they need is shown on large screens.  Also, they can see and hear Rudy from their room, safely away from the radiation.  The door into the radiation room is super thick - about 10 inches I'd guess.

They do what they can to make the area cheerful.  There are elaborate murals and fun music is playing the whole time.  The funny thing is, it's music you want to tap your toes to, but once situated for radiation, you aren't supposed to move a muscle.

Rudy's two nurse / technicians were cute as could be.  I wish I'd gotten photos of them both.

The radiation treatments haven't hurt and he doesn't seem to be having any issues from it that he can tell.  This is however, the worst day of his chemo cycle.  Tomorrow likely won't be much better. Today, he has been so tired that taking a shower was a major ordeal.  Nancy made him a casserole with cornbread.  Susan baked him muffins.  He hasn't had either yet.  When we got home from radiation, he sat in a chair for a few minutes without even turning on the TV.  Then he gave up and went to bed.  He's still asleep.

He's been having side effects from the pain meds.  He's incredibly groggy on them.  They take his appetite away, which is not good since he's dropped 13 pounds from his recent vomiting episodes.  There more annoying side effects.  We both hope he doesn't have to stay on those long.  He's particularly eager to stop taking them so he can drive his hotrod again.

I sure hope all this pays off by knocking that cancer back down.  I also pray that the immunotherapy starts soon and turns out to be easier and more successful.

Pain and Nausea at Bay

The last few days have been crazy, but all the crises are under control (for now).  Rudy dealt with unrelenting vomiting and nausea.  He dealt with swallowing being a challenge - it felt like everything was sticking in his throat.  Pills were the worst.  Finally, he dealt with pain that became so unbearable he was unable to function.

Humor gets me through!  I've been chanting the real serenity prayer for days.  I came across this one this morning.  It gave me a good chuckle. 

I *think* we're fine now.  I slept and am able to think and function again.  Rudy is currently not nauseous or in pain.    He has better, longer acting meds for both issues and right now they are working like a charm.  His esophagus issue seems to be getting better.  He has an appointment scheduled to get that checked just in case.  If there is a problem, there are things they can do.

The pain meds are some that are fairly addictive, but it's hoped that he won't need them long - maybe a week at most????  Possibly less.   We hope the chemo (HE DID HAVE CHEMO YESTERDAY!!! :-D ) and targeted radiation will knock the tumor down fast and get it off that nerve.  From what I've seen so far, the pain meds don't seem to make him too loopy.  He seems like himself, just maybe a tad more cheerful.  The cheerful might be more of a result of the lack of pain and nausea.  That's certainly reason enough!  I hope the cheerful effect lasts a long time.

This was me yesterday. 

We'll meet with pain management again next week.  They may even be able to  go in and deaden the nerve to the annoying tumor so that even if it does expand again, it won't make him so miserable.

Yesterday, Terri talked a little more about the immunotherapy.   Rudy will have another scan in 3 weeks to see how he's responding to the current chemo - the Carboplatin-Gemzar regimen.  If it's not a big success, then we'll look at switching to immunotherapy.  That treatment is in the last phases of trial and it's been amazingly successful on many types of cancer.  Rudy's type of cancer is one it's particularly good with.

Maybe immunotherapy will replace chemo one day.

Rudy doesn't seem to be cut out for chemo, so we're really hoping he's being led to immunotherapy for a reason.  We'd love to be one of their success stories!

Birthday Rollercoaster

Apparently, Advil on an empty stomach leads to major trouble for Rudy.  He dealt with unceasing nausea from 2am to around 9am.  At CTCA, they gave him an IV mix that dealt with pain, nausea and fluid loss and now he is almost back to normal.  He's a little nervous about eating yet, but hopefully, he'll be back on track as the day goes on.  His sister, Nancy, baked him a chocolate cake with her famous homemade icing.  Surely he'll be able to sample that sometime later today.  It's one of his favorites.

We're home now and both of us are wiped out.  We'll be turning off the phones and chillin' out for a while.

GOOD NEWS - they did his lab work while at CTCA today and he's on for chemo!!!!  I had the word definitely in that sentence, then took it out.  It seemed like pushing our luck.  We've learned that things can change fast.  One minute we're up.  The next we're down.  I never did care for roller coasters.  There's a movie I see listed often, called The Magic of Ordinary Days.  That title grabbed my attention and I can't hardly stop thinking about it.  We really miss ordinary days.  I know I'm rambling, but I'm so tired that I'm not even going to go back and edit.

CTCA took great care of us, as usual.  Tiffany was our nurse today.  This is our third time with her and she feels like family.  We also had a physicians assistant named Brandy, who was fabulous.  We're becoming close to so many people there.  Daniel, one of the valets, is a real sweetheart.  He took care of us today, too.  Brooke, from Dr. Thompson's office, spotted us near the cafeteria and bolted over to check on how Rudy was doing.  She let us know what all they were doing from Dr. Thompson's office.  Everyone coordinates so well from department to department.  We know full well how rare this is.

My point is, our path is not smooth.  Our journey is not easy.   But having so many wonderful people giving us such love and support along the way makes it bearable.

I'm sure I'm forgetting some details, but it's all I can write for now.  Rudy is already asleep.

Everyone - thank you for your prayers and love!  Hopefully, the rest of his birthday will be nice.