Youville, Cambridge MA

So Mom moved to the Youville Rehabilitation Center on 1575 Cambridge St., Cambridge, MA. As Missy Connors commented it sounds like something out of a Dr. Seuss book. The brusque announcement of the change was a surprise for all of us. Between 1 and 3 in the afternoon, Ciola Bennett (the patient care coordinator) stopped by Mom's room and said she would be moving at 5:00 pm. Anna, Andrew, Stephen, Uncle John & Aunt Mary helped pack up and move Mom's accumulated belongings. When we arrived at Youville (its website is www.youville.org) we were immediately stuck by how peaceful it seemed compared to BWH. Mom will definitely be able to rest more here. Andrew also saw a piano in a recreation room - so we told Mom that rather than walk in circles, she could walk to the piano instead. She has one roommate, and the room has less amenities than BWH (e.g. there is no personal refrigerator and no closet space), but the building is nice. It is a lot harder to drive to than BWH - a lot of traffic and convoluted roadways, but the parking is free after 5. I think Mom, Andrew, and I definitely had a nostalgic feeling when we said goodbye to the many nurses, patient care assistants, and doctors whom we come to know over the past two weeks at BWH - in many ways it had become our home... Dad and Anna are visiting Mom now. She seemed quite tired when Andrew and I left.

Stephen

Another Monday at BWH

It has been 2 weeks since surgery. Mom is continuing to recover. She still is having trouble finding opportunities to rest. She is also plagued by sundry pains. The doctors came in to change the sponges in Mom's wound - something she was dreading. Once again it was a painful process, but Mom got through it. The doctors once again confirmed that it is healing quite well. Also, she has been eliminating fluid on a consistent basis, which has substantially reduced her edema. Meanwhile there has been some discussion about moving Mom into a rehab clinic to provide a contained environment to allow her wound to heal. The exact place has not been confirmed yet. It seems like she will not be discharged from BWH until a new place is ready to receive her. This could take place in the next few days.

Stephen

Sunday Morning Visit from Doctors

Dr. Muto (a substitute for Dr. Berkowitz), Dr. Herndon, and Dr. Fleming came in to see Mom at 8. Dr. Herndon examined her incision and was quite pleased by how it is healing. Furthermore, her kidneys have been working to eliminate a lot of fluid (almost hourly), which means her body is gradually restoring itself to normal. This was something they hoped for. This is causing her swelling to go down. Also, Dr. Muto said that the chemotherapy begins to work on the cancer after 10-14 days. This will cause her start feeling better and its effectiveness is measurable. The doctors also said Mom could eat eggs, which is one of her favorite breakfast foods). Overall the entire conversation was quite encouraging.

Stephen

Saturday Night

Dad just returned from the hospital. Mom needs rest. She has been waking up every few hours so she is pretty worn out. Also, the persistent pain, now in her lower back and gas pain in her abdomen, are also wearing her out. These things are demoralizing her. Please pray that she would sleep well tonight and the pain would be minimized.

Stephen

Friday Night & Saturday Morning

Dad met Dr. Berlin last night. Apparently, she grew up near a town in which Mom's great aunt owned a farm and Mom used to visit as kids. This generated quite a bit of conversation between Mom and Dr. Berlin. One of the topics they discussed was "the spot," a popular hangout for farm workers and young Kowalski's coming to visit and were horrified by the roaches and bug infested produce associated with farm life.

Mom didn't sleep very well last night. Because her body is eliminating so much fluid she hasn't been able to sleep for longer than 45 minutes. On the other hand, her swelling is down, which is positive. She is feeling and looking stronger every day though. She has been able to get up out of bed on her own. She is still experiencing a lot of pain in her abdomen and lower back. If you could continue to pray for her to get adequate sleep and that the pain would subside.

Dr. Fleming, Dr. Herndon, and Dr. Muto came in to see Mom. They didn't have too much to say. There is no need for more Lasix, she is eliminating fluid on a regular basis on her own. They will not change the sponges in her incision today (probably tomorrow).

Stephen

Friday Afternoon

Mom has been resting most of the morning. After 12 both Ciola, the patient care coordinator, and Irene, the social worker visited Mom. Irene told Mom not to be surprised if during chemotherapy she had trouble focusing on books or if her short-term memory got work. These are temporary side effects. Later, the 3rd year medical student, Zach, saw Mom and informed her that they will be giving her Lasix. He also answered some questions she had about kidney stones as a side effect of Lasix.

Stephen

Friday Doctor's Visit

Dr. Berkowitz, Dr. Fleming, Dr. Herndon, Dr. Boyce, Marisa, and yet another new medical student came in to see Mom this morning. Mom told them that she didn't get too much rest because of a lot of diarrhea she had last night. Dr. Berkowitz said that with or without chemotherapy, diarrhea is expected once her bowels wake up and that it is a good problem to have. He said there is no rush to start eating since she is getting all her nutrition through TPN, but she may begin to eat whenever she feels hungry. The incision looks great, it is draining well. They will only change the setting on the vacuum today, not hte sponges. They will probably give Mom more Lasix later to help her drain fluids. There is still a lot of swelling in her legs.

Mom enjoyed a verse from hymn 432 this morning:

"O Joy, that seekest me through pain,
I cannot close my heart to Thee;
I trace the rainbow through the rain,
And feel the promise is not vain
That morn shall tearless be."

Stephen

Post Chemo

Mom finished her first round of chemotherapy peacefully. Dr. Berlin stopped in to see her. I spoke with her briefly afterward. She said she was quite glad that Mom's bowel is waking up - this was definitely a function she wanted to see restored. She also said that we should maintain a positive attitude as the advanced stage of the cancer is negative enough. We need to look forward and see how the cancer reacts to the chemotherapy. Overall, Mom is heading in the right direction. Dr. Berlin intends to drop in to see her tomorrow. I was quite impressed with this doctor. She is very compassionate and familar with treating this kind of cancer. She has succeeded in putting Mom at ease through their various encounters thus far.

Stephen

Chemo - Round 1

Mom received the 3 hour dose of Taxol and has started the 1 hour dose of Carboplatin. She has been surprisingly quite and relaxed throughout this whole process. I asked her how she was doing and she said she is being carried by all your prayers. She ate a little cream of wheat before the process and feels a little nauseous, but the antiemetic she is on seems to be working. Dr. Berlin will be coming in later to check on her.

Stephen Juraschek

Thursday Afternoon

Quiet morning. Mom's bowel continues to wake up. The will soon have her try eating soft foods. A little after 1 pm, Dr. Fleming came in to change Mom's sponge/vacuum set up. It was a little painful (Anna's hand lost circulation in the process). Then the physical therapist, Rachel Maiocco, came in to help run through some exercises with Mom. They did six exercises to strengthen Mom's legs.

In an hour they will start chemotherapy. Mom is really anxious about this. Please pray that her anxiety would be reduced and there would be minimal side effects/complications.

Stephen

Dr. Berkowitz's Recap of Chemo Treatment

Dr. Berkowitz came to visit Mom. He said he was happy her bowel began to function. He is still not sure it will function normally because of all the tumor nodules. He said Mom will have the vacuum for a while as her wound heals. The chemotherapy will slow this process, but fighting the cancer is more important. Furthermore, they will give Mom antiemetic medication to prevent nausea.

Stephen

Thursday Morning

Mom looked great this morning. She hasn't being taking that much pain killer so her cognitive perception was quite acute. She was even joking around with me and Anna.

Dr. Fleming, Dr. Herndon, Dr. Boyce, Marisa, and Zach came to see Mom at 6:50. They were quite pleased with Mom's bowel movement and revealed that this was an additional requirement for her to receive chemotherapy today. So she will definitely receive Taxol administered over the course of 3 hours and Carboplatin administered over the course of 30-45 minutes. Because of the chemotherapy, there will be no Lasix today, she will receive more on Friday. The next round of chemotherapy will occur after 21 days. She will probably receive 6 rounds of chemotherapy. In order to offset some of the adverse affects of Taxol they will give Mom some steroids - Decadron. They will also need to change the sponge in Mom's incision - the sponge is not the right size. This means they will have to dress her wound another time.

Mom is sleeping now. She was quite anxious about the chemotherapy treatment, especially when one on the physicians said that her cancer was "advanced," but she seems at greater peace about the process this morning.

Stephen Juraschek

Wednesday Night - 1 week after surgery

Mom met with Dr. Berlin to discuss chemotherapy treatment. It most likely they will begin on Thursday and plan to give Mom Taxol and Carboplatin. Some potential side effects include tingling in fingers, aches and pains, and mouth sores. Hair loss will occur 15-16 days after 1st treatment. She will have a treatment once every 3 weeks and they will monitor blood counts and take a CAT scan after the 3rd or 4th round. The doctors will check Mom's incision tomorrow to make sure it is safe to proceed.

Dr. Russell also came in to see Mom's incision and felt that it was healing well.

Lasix started functioning late again, fortunately Anna spent the night to help Mom. Also, Mom's bowel "woke up" last night, but we need to continue praying that they would fully awake.

Stephen

Posting Comments on the Blog

Hi everyone,

I just wanted to clarify the intention of the blog. The site is mainly to efficiently convey information related to Mom's progress to her concerned friends, family, and colleagues. It is also a forum for individuals to voice their love, support, and care to help ease Mom through this difficult time. We welcome your comments as Mom is always asking us to read them to her. If you have recommendations for treatment, they are also welcome, but we would like to avoid such dialogues on this blog site. If you have any medical procedure recommendations please send us an email to jjuraschekcare@gmail.com. We will be checking it on a daily basis.

Thank you for all your love and support so far.

Stephen Juraschek

Cleaning the Wound

We walked once today, doing a lap around the Connor Center.

The social worker came to visit and was very supportive of the challenges Mom is facing.

We were also visited by some volunteers who talked about a 1 to 1 program, by which patients diagnosed with cancer could speak with some who passed through a similar experience.

Dr. Fleming & Dr. Boyce at 2:15 pm to clean out more of Mom's wound. They decided to use a vacuum, which will increase the rate of healing by 50%. Also, the vacuum uses sponges which will only have to be changed every 3 days. It will still probably take over two weeks for the wound to heal. This procedure was a little painful, but Dr. Fleming said it becomes easier after the first time.

Furthermore, Dr. Fleming said they will start using Lasik on a regular basis to help Mom eliminate excess fluid. This time they will try to time it better so she is able to sleep well at night.

Stephen

More Lasix

Dr. Fleming, Dr. Herndon, Dr. Boyce, Marisa, and Zach came in to see Mom at 6:55. They examined her incision and noticed more infection, which means they will remove some more staples to let it drain. Also, they want to reduce Mom's edema (swelling), which means more Lasix, and derivatively less sleep. Mom's not looking forward to it.

Also, Dr. Fleming said that the oncologist, Dr. Berlin, should be coming in sometime today.

Stephen

Rough Night

Dad and I crossed paths at home this morning at 5:15am. He was returning from the hospital, having spent the entire night with Mom. Apparently Mom received two pints of blood last night as well as a drug called Lasix meant to help her eliminate the excess fluid. Unfortunately they administered this to her after 10 pm. As a result she spent the entire night making rushes to the bathroom, which, given Mom's surgery, was an extremely difficult task - she didn't really go to sleep until 4 am. It seems like the effects of the drug have worn down now, but Mom is quite tired (and Dad too).

Stephen Juraschek

Tuesday Early Evening - 1 week after surgery

Dr. Ebony Boyce came in at about 4 and looked at Mom's incision, which she said looks healthy and is healing by "secondary intention." Dr. Boyce then returned an hour later to discuss the need for a blood transfusion. Her blood count is a little low at 29, which may be because of all the fluids she has been receiving. It is normal to have a blood count in the 40s, and before chemotherapy it should be over 30. Some of the side effects of the transfusion, if any, are flu-like symptoms, but they will give her some Benadril and Tylenol to preempt this from happening.

Meanwhile, Mom still has not seen the oncologist. We hope we can talk to her soon since Mom has a lot of questions.

After Dr. Boyce's visit, we went for another lap around the Connor Center. By this point they have detached all tubes from Mom and are giving her pain medicine orally. TPN is being administered only 12 hours a day. Getting up from supine and sitting positions is still challenging, but Mom reported that her legs feel stronger from all the walking.

Stephen

Tuesday Afternoon - 1 week after surgery

This has been a relatively uneventful morning as Mom recuperates here at Brigham and Women's Hospital. We walked twice - one lap each around the Connors Center. Mom seems a lot weaker than usual. Also, she has a lot more pain. She feels like the medication is not helping that effectively. Mom is still anxious about going home. We met with a social worker (Irene Ross-Werner) who provided Mom the opportunity to voice some of her specific concerns about home dynamics now that she is a dependent and no longer a care provider. Irene was very supportive and said she would be coming to see Mom on a regular basis. She will help provide the psychological support needed to address these changes as well as work with Ciola Bennett, a patient care coordinator, to arrange for any adaptive equipment necessary for Mom's move back home. Even long after surgery, she and her team are available to meet with Mom and the family to help us utilize existing resources in the community.

Anna came to visit, which Mom really appreciated. When she was leaving Mom began to cry. Mom continues to have these cyclic, outbursts of emotional feeling, which may be due to the pain medication.

Stephen Juraschek

Monday Night & Tuesday Morning

Last night was a little difficult. The nurses were a little busy and were not so available to help Mom during the night. It seems like there was also some internal strife between the nursing staff and some technicians that unfortunately affected their patient care. This morning Dr. Muto filled in for Dr. Berkowitz assuring her that she was on the right track. A little later Dr. Fleming, Dr. Herndon, Dr. Boyce, Marissa, and Zach came in to see Mom. Dr. Fleming mentioned Mom's shortness of breath and explained that it is due to fluid pushing on her lung. Dr. Fleming said that they are watching it and if it gets worse they may need to remove some of the fluid through a minor procedure.

Stephen

Dr. Berkowitz & Dr. Russell's visit

Dr. Berkowitz, Dr. Russell, and Dr. Fleming came to see Mom at 11:55. Dr. Berkowitz examined the infection in Mom's incision. He said he thought it looked pretty clean. If it stays clean for the next few days, they will start chemotherapy on Thursday with a discharge likely soon after. Unfortunately, the incision will need to stay open to heal and the chemotherapy will delay the wound's ability to heal. Dr. Berkowitz explained, however, that the open wound is an inconvenience, while the cancer is life-threatening. The chemotherapy needs to be started right away. Also, in the long run the chemotherapy will help the healing because the cancer will stop robbing Mom's body of nutrition.

Also, Mom's bowel is not "awake" yet. It may not wake up until after the chemotherapy treatment because the cancer nodules are disrupting the small bowel's nervous system.

This means that Mom will likely go home with a need for TPN (intravenous nutrition) and an open wound in her stomach. The doctors will try to connect us with a visiting nurse and a company that will deliver the TPN, but Mom is quite concerned about the process of going home. She fears being in such a helpless state with the demands of family. The hospital has been a contained environment - home is less predictable. The idea of the open wound made her cry.

Stephen

1 week after surgery - morning Doctor's visit

Dr. Fleming, Dr. Herndon, Marissa Gonzalez, and a new 3rd year medical student (named Zach) visited at 7 am. Mom mentioned that she had pain despite taking pain medication an hour ago. The doctors checked the dressing on her infection. It looks good. We are still waiting for the bowel to wake up. Dr. Berlin will come in later today or tomorrow to discuss chemotherapy treatment. They will probably need to wait until Mom’s infection heals before they can start chemotherapy. Infections are quite common after extensive abdominal surgery - nutrition is thrown off, so healing is more difficult.

In summary the two things holding up Mom's chemotherapy treatments are her bowel and the infection. Without the chemotherapy the cancer will continue to go untreated.

Meanwhile Mom moved on to a little more solid food - she took a bite of jello this morning.

A verse Mom enjoyed this morning Romans 4:18: "He beyond hope believed in hope in order that he might become the father of many nations, according to that which was spoken, "So shall your seed be."

Stephen

Sunday Late Night/Early Morning

Dad stayed with Mom until 1:00 am. She was really happy to see him. They did one lap around the Connors Center.

One of the staff her is a Christian who told Mom that she was praying for her every day. This encouraged her immensely.

This morning Mom and I enjoyed a verse from a hymn:

"Lord, Thy life abundant,
Flowing, rich and free,
Constantly refreshes
And empowers me.
Death by life is swallowed,
Weakness is made strong,
All my bonds are broken,
Gloom is turned to song."


We are still waiting for Mom's bowel to wake up. This is an important step in the recovery process. Please continue to pray for this.

Stephen

Sunday Evening

Mom has been resting most of the day. Occasionally she wakes up and cries out of concern for the family. She was telling me how worried she is about going home and not being able to meet everyone's expectation for her to care for them. She is worried about Andrew. It seems like these cyclic bursts of sadness are just a part of the struggle.

Meanwhile, a nurse explained a little more about Mom's infection - they will clean out the infected area twice a day and have given Mom some antibiotics. Apparently, infections are quite common, but need to be monitored and treated. Hopefully, this will not affect when she will be discharged from the hospital and when her chemotherapy treatment will begin.

Also, Mom's pain has been much better managed. Her pain medication still makes her a little loopy/sleepy, but it has been great for her rest.

Stephen

Sunday Afternoon

This afternoon, Mom and I went to the solarium. It was quite an adventure trying to maneuver the wheelchair and the IV pole. I did not do such a good job but Mom and I made it to the 6th floor without any major catastrophe. The solarium is a lovely garden on the floor of the neonatal intensive care unit (NICU). We somehow managed to get out and sat in the sun for an hour listening to poetry being read on a CD. Mom got up and walked around the patio and looked at the daffodils and tulips and topiaries. It was so warm and there was a nice breeze. I think Mom got a little sunburned on her left cheek (oops!). We had a little trouble getting the wheelchair through the door on the way out so Mom walked to the elevators. On the way we saw a newborn baby.

We walked back to the room and Mom ate a little chicken broth and had a bite of orange italian ice. A resident doctor came in to examine Mom's incision and decided that it was infected. She did a procedure where she removed several staples and irrigated the wound. She tried to remove the infected areas and clean it out. They filled the wound with gauze soaked in saline. Pray that the antibiotics will work quickly and the infection will be quickly cleared out. Now that the wound is open, Mom will have to have her dressing changed several times a day which will be quite uncomfortable as they are trying to draw the infection out.

Mom has started taking pain medication by mouth and is getting used to the new effects of these drugs. She is resting now. Stephen just arrived. Elizabeth visited briefly this morning.

Sunday Morning

Mom slept really well last night. The nurse had her on a great pain medication cycle that helped her sleep. Mom was worried about the swelling in her legs, but Dr. Christopher Herndon came in and told her that was normal due to all the fluids given to her during surgery - eventually the swelling would be gone.

Dr. Berkowitz came a little later with Dr. Fleming and Dr. Herndon. He explained that the swelling in her legs is due to her under nourishment (low albumin), pressure in the stomach, and fluids in her body from the surgery - it will go away. Also, he talked about exercising - he was impressed by the amount she had walked - and told her not to overexert herself. Once she passes gas she can start drinking fluids without much regulation - then they can start moving forward with the chemotherapy treatment discussion involving Dr. Berlin.

Stephen

Saturday Night

Mom had a fairly quiet night. She went for two more walks with Andrew and Stephen. Unfortunately, she has been complaining of pain - the nurse contacted the doctor and they have her increased pain killer medication. Also, she has been complaining of swelling in her legs. The nurse said this is not normal, but that Mom should not be concerned about it now. Because of the pain killer she is presently sleeping.

Stephen

Saturday Afternoon

Mom looks much better. She walked around a lot today - once without the walker - and is now sipping some ginger ale and talking with the nurse about opera. Also, she feels hungry, which is a good sign that her digestive tract is beginning to operate again. Thank you for your prayers - may she continue to recover swiftly!

The nurse will also try taking Mom off Dilaudid (an intravenous pain killer) and will try giving her oral pain medication. This will be done on a trial basis - if she gets nauseous they will go back to the Dilaudid.

Stephen

Friday Night & Saturday Morning - Things Slowing Down

Mom seemed pretty lucid last night. She walked around and seems a lot less confused than before. She slept soundly for 30-40 minutes. Went walking twice and brushed her teeth. Mom commented that "for the first time I feel like I'm not dying of cancer." Yes Mom - you're not dying, you're LIVING!

This morning she saw Dr. Berkowitz, who said that she should expect an "uneventful" weekend. She then walked around the Connors Center twice. They also were able to remove the oxygen tube - so one more tube gone. Mom is now also allowed to drink clear fluids, one table spoon an hour. She has been asking to smell people's food in lieu of being able to eat, so this is definitely a step in the right direction. Please pray that her bowel would wake up this weekend and that she gets an adequate amount of time to walk, and that her pain would be controlled better.

Otherwise it should be a quiet day.

Friday Late Afternoon

Mom went for walk and then was visited by Dr. Herndon. He warned Mom not to eat too many ice chips, but to let the bowel wake up slowly, on its own. Then Dr. Russell came to see Mom's stomach and see how it was doing. She reiterated that the important thing now was for her to walk to wake up her bowel. She also pointed out that Mom is tolerating not having the NG tube very well.

Right now she is resting listening to Stephen Bradley's first CD.

Stephen

NG Tube is Out!

Dr. Ebony Boyce and Marissa Gonzalez (3:15) came back to remove Mom’s NG tube. It came out quite smoothly. Her nose was bleeding a lot afterwards - Mom said it was quite painful (she thought she was dying). A physical therapist came by and will be taking Mom for a walk later.

Later, she was visited by a chaplain who gave Mom a large print Gideons bible and then gave Mom some Psalms to pray-read. This made Mom quite happy.

Stephen

Friday Afternoon

Dr. Ebony Boyce and Marisa Gonzalez visited Mom to discuss removing the NG tube. Mom wants to keep it in - she is worried about it being removed too soon and needing to be reinserted, which is really painful. They agreed to give her a few more hours with the NG turned off and then removing the tube. It is important to remove the tube so she take pain killer orally.

Otherwise, Mom has been resting. She took a walk earlier which was also great.

Stephen

Pathology Report

Dr. Berkowitz came in and told Mom that the pathology report is back and consistent with what they believed - Mom has peritoneal cancer (a cousin of ovarian cancer - they behave very similarly). He said this was good in that it is quite responsive to chemotherapy (as opposed to something like pancreatic cancer). The plan for now is to let Mom mend over the weekend and then on Monday meet with Dr. Susan Berlin, the oncologist. Based on how Mom feels and what Dr. Berlin says, they will hopefully be able to start chemotherapy soon. It's not that it is extremely urgent to start soon, Dr. Berkowitz just wants Mom's "course" to recovery to begin as quickly as possible. Mom asked about stage IV - Dr. Berkowitz said they have no proof of stage IV - the cancer is definitely stage III with fluid in the pleural cavity (which is common), but there is no proof of stage IV - to prove this they would have to draw fluid out of the lung with a syringe. These cancers are universally observed at stages III or IV.

Right now Mom needs to walk to wake up her small bowel.

Also, they clamped her NG tube - so Mom will be looking for symptoms of nausea or vomiting. If she experiences neither of these symptoms then they will consider removing the tube.

Stephen

Friday Morning

Mom looked better when I walked in this morning. She was able to see the sun rise. Dr. Fleming, Dr. Herndon, Dr. Ebony, and Marisa (the 4th year Harvard medical student) came in to see Mom. They explained their plan to turn off the NG (nasogastric) tube later today and see if any nausea results. If there is nausea, they will turn it back on. If there is no nausea they will take is out. Also, her ear was hurting, but Tylenol administered intravenously seems to have helped that pain.

Stephen

Visiting Mom

Mom received several visitors today and while it was comforting to know how much she is loved, she is exhausted. Mom is naturally hospitable and is trying to ignore her present condition to care for those who visit her. She is still on a lot of pain meds and still in a lot of pain. She is kept busy during the day walking, taking tests, going through medical procedures, and meeting with doctors and a social worker. The most important thing right now is for mom to heal from her operation and gain strength to eventually eat solid foods and get ready for chemo treatments.

If you are interested in visiting Mom, please continue to contact Missy Connors at 781-326-5861 in the evening or by email amconnors@yahoo.com. She will help organize a manageable visiting plan over the next month in coordination with each family member. We know that so many of you love mom and want to help. We will try to have a calendar with a schedule for help, meals and eventually driving to/from chemo treatments as soon as possible. Mom loves every one of you, and would never want anyone to feel left out or not appreciated but now needs rest, walking and more rest.

Thank you so much for your support,

The Jurascheks

Back in One Piece

Dad just walked back into the room. The x-ray was normal. One of the blood samples came back normal. There was a little abnormality during the stress test. He may need a beta-blocker drug. There is not imminent risk of a heart attack and they recommended that he see his primary care physician. They gave him some medicine to help him relax and rest. He is back in the room with us. He still feels tense in his chest but his dystolic blood pressure has come down.

Dr. Fleming and Marisa Gonzalez just came to see Mom. They looked at her incision and listened to her belly sounds. Dr. Fleming said that she did not think the NG tube should come out now. She said that because she did not hear many bowel sounds (i.e. gurgling) she thought it was premature to remove the tube. She said that if they took it out tonight there was an increased chance that they would have to replace it. What they will do instead in the morning is take it off of suction and clamp it so the secretions can build up and hopefully move normally through the bowels. If it doesn't back up that will indicate good movement. They will also re-hook it up to suction and see what comes out. If not much they will then take it out tomorrow. The idea is to stop the suction and see what the body does but leaving the tube so they wouldn’t have to replace it later. They just don’t want to take it out prematurely.

Dr. Fleming listened to her stomach and then she let Mom listen to her stomach while Dr. Fleming pushed air down the NG tube so Mom could hear what the gurgling should sound like.

Mom asked about her TPN and Dr. Fleming explained that Mom's body has to get used to it so they input it now continually. It is complicated and complex to replace nutrients in a liquid form and it takes the body a while to adjust. Eventually they will transition to a more concentrated solution of one bag over 12 hours overnight.

Mom's ear is hurting because of the NG tube. It is a pressure problem, not a hurt from infection but because the pressure is abnormal. She will take Tylenol and use a heating pad tonight to alleviate the discomfort.

5 PM

Just a brief update: Dad is still completing his stress test on the 1st floor. Stephen went home to see Andrew and Elizabeth. I will be going back down to the Emergency Department at 5:30.

Dr. Russell just came in and checked Mom's belly. She noticed that now the NG tube is in too far?!? But, it isn't draining much liquid and she recommended it come out. She said their was a slight chance it would have to be put back in but she mentioned that there was this chance regardless of when they took it out. This means that all of Mom's walking is helping her bowels' function be restored.

We are listening to a hospital staff member read Psalms now. Mom's eyes are closed and she looks very restful.

We will send the final update on Dad when it is available.

Just When You Thought Things Couldn't Get Worse :)

Dad came into to see Mom this afternoon and complained of heart pain and high blood pressure. Mom was immediately alarmed and insisted that he see the doctor. Anna brought him down to the emergency room and he was admitted. They took an x-ray and ran an EKG but all his resting numbers seemed normal. They are currently running a stress test to see how he reacts to stress, but they hope to let him go home tonight.

Meanwhile, Mom calmed down once she knew Dad was receiving the medical attention he needed and recognized that open heart surgery would no longer be necessary. Later she saw a physical therapist who showed her how to get out of bed. Mom was assessed and she will be taken care of by a physical therapist with the nickname "pitbull." This sobriquet made Mom a little nervous.

Then she was visited by a social worker, which was positive. Mom was able to share with her how her faith helps Mom manage stress.

She hasn't been have too many opportunities to rest. Otherwise her cheeks are now red, which is positive.

Stephen

Mom's Prayer Request

Mom requested that you pray that she would be able to cough, that getting up from bed would be less daunting, that she would get some rest, and that her abdominal pain would be reduced.

Mom said, "I enjoy hearing from all of you and yes the Lord is sufficient." Mom heard some news today that made her a little anxious, but she was reminded of Peter in his experience walking on water and footnote 32 of Mt. 14:32 (recovery version) "This miracle testifies not only that the Lord is the Ruler of the heavens and the earth but also that He takes care of the hardships endured by His followers as they follow Him on the way...whatever the situation, He was able to provide for their need and carry them through the hardships." Eventually they don't need Him to appear to them physically because "whom having not seen, you love; into whom though not seeing Him at present, yet believing, you exult with joy that is unspeakable and full of glory" (1 Pet. 1:8).

Stephen on behalf of Mom

Thursday Mid-morning

A nutritionist named Kristen came in to explain TPN (Total Parental Nutrition) to Mom. Someone new always seems to come in just when she has fallen asleep (Mom unfortunately volunteered to allow nursing students to work with her - so they are always coming in to try procedures with their instructor). TPN administers the necessary calories, proteins, and vitamins to Mom so that she is adequately nourished. The next step in her nutrition will be to remove the NG tube to see how her bowels can handle nutrition. After they will try soft (low in fiber) foods.

Then nurses took Mom for another walk - she did an entire lap around the Connor Center. Mom likes to walk here - there are "no dogs in the hospital." They also removed the catheter from Mom, which will force her to use the restroom - Mom is a little anxious about having to get up from bed.

Dr. Berkowitz came in to talk Mom. He said it is important for her to be well nourished to restore her strength and fight the cancer. They should have the pathology report tomorrow and hopefully start chemotherapy on Monday despite her current pain. The reason is that in order for her health to improve they need to reduce the tumor - the sooner the better. There is generally 21 days between each round of chemo and it takes a few weeks for one's body to respond to chemo anyway. Her goals for today are to walk to keep up strength, prevent fever, and let her chest clear. They did start the anti coagulation medicine.

A few minutes later a nurse came in to remove her peripheral IV, which means one less tube in her body.

Stephen

Thursday Morning

I just went for a walk with Mom around the Connors Center floor (obviously with the help of both a nurse and an aide). She looks much better. It seems like the nutrition is definitely strengthening her. She slept on and off last night. Her throat is a little sore due to moving the NG tube deeper into her stomach. There is still a lot of pain in the incision. One thing Mom said is that "she would love to smell spring." The nurse on this last shift is great with Mom, which has really uplifted her spirit.

Dr. Evelyn Fleming, Dr. Christopher Herndon, and Dr. Ebony visited briefly and asked a few questions about pain, nausea, and gas. They also said that it tooks like the NG tube is draining better now that it has been repositioned.

Stephen

Evening Update

Dr. Fleming came to see Mom. According to the notes, Dr. Fleming reviewed some of the events of the past day. Dr. Fleming mentioned that the tentative plan would be to do 3 treatments of chemotherapy, another surgery to try to remove more gross disease, and then 3 more treatments of chemotherapy. The chemotherapy will be administered by Dr. Berlin.

Dr. Russell came around 7:30 to see Mom. Mom mentioned the incident with the NG tube. (Dr. Russell will be the one who makes the final decision about when the tube comes out.) Dr. Russell pointed out that Mom's NG tube has to be advanced in further because right now it is not doing as much as it could. It is in the esophagus and not where it needs to be which is further into the bowel. That is why it isn’t draining as much. So, the doctor feels that if Mom is going through the discomfort of having the tube it should be doing more.

They are going to insert it further which is uncomfortable. But, if tomorrow there is not much more output, they can take the tube out. They want to ensure that there is more liquid being removed so that the bowel can recover from being so dilated in hopes that it will soon resume normal activity. Dr. Russell requested an x-ray—so she can see how distended the bowels are right now. She noted that Mom's incision looked good and that her belly is softer than yesterday which is a good sign.

Mom asked about when the pathology report would be in and Dr. Russell mentioned that it can sometimes be tricky to determine the original source of the cancer. It may act like ovarian cancer but be from somewhere else. Pray that there is no complication determining the pathology so that the chemotherapy treatment can be easily determined.

The plan for this evening is to advance the tube and take Mom for another walk. Then she will go to bed. In the morning she will walk again. She currently is being fed intravenously through her new port in order to increase her strength.

Wednesday Noon Update

This morning Mom had a surgical procedure done. They inserted a port-a-cath, which will serve as an access point for both TPN (intravenous nutrition) and chemotherapy later down the road. The surgery went well (Dr. said great results), but transportation there was a little tough. One of the nurses elbowed Mom in the stomach causing her to cry out and start sobbing. Her shoulder hurts a little from the procedure, but otherwise is fine.

Later in the morning Dr. Christopher Herndon, a third year surgical fellow on Berkowitz's team, came in to discuss the results of Mom's CT scan last night. They conducted the CT scan because of Mom's low oxygen intake and were concerned about the formation of a pulmonary (lung) blood clot, which she is at high risk for because of her immobility, her form of cancer, and the location of her tumor. Originally they thought the CT scan was negative, but then noticed a small pulmonary embolism (blood clot) and want to start her on "lovenox" - a blood thinner. It was fortuitous that they found it so soon. The primary risk of this drug is bleeding, which they will monitor. Most likely they will need to administer blood thinner for 6 months, repeatedly reassessing her situation. They are still discussing when to start administering the blood thinner. Unfortunately, this clot also means that they will bring the leg boots back, which are quite uncomfortable for Mom.

Meanwhile the nurses moved Mom into a chair - they were a little insensitive - speaking about her in third person - this made her cry a little again, but she is sitting up now, which is important for blood circulation.

Stephen

Wednesday Morning

When I came in to see Mom the doctors were here. Dr. Berkowitz mainly reiterated the plan to wake up the bowel, discussed insertion of the pick line, and mentioned Dr. Berlin. Mom was concerned about nausea/vomiting during chemotherapy. Dr. Berkowitz explained that this was much more unusual nowadays than 10 years ago. He also mentioned that Dr. Russell, the general surgeon responsible for the bypass in Mom's small intestines, is the one who determines how long the NG tube must stay in.

Last night was apparently a little difficult for Mom. At about 3:00 am, Mom had a fever of 101.7 degrees. The nurse tried to help her cool down by having her sit up and rubbing down her back. She also took advantage of the opportunity to get Mom out of bed and walk a few feet in the room (this is important in helping her pass gas and avoid blood clots in her legs). The nurse said that she will have to do more walking later in the morning - Mom seemed petrified of this. She really doesn't want to walk around, but if she doesn't walk they will have to put the boots back on (which are extremely uncomfortable). Another thing bothering Mom is some muscle spasms in her left side. The nurse said this may be due to some gas caused by the bowel waking up. The nurse warned that more gas pain is inevitable. Her throat also hurts a lot because of the whole incident with the NG tube last night.

Mom continues to feel uncomfortable, but looked better to me this morning than yesterday. She's sleeping right now and will hopefully get some good rest today now that she is back in the Connor Center in her own room.

Stephen

Pray for rest

The NG tube was successfully replaced. We are waiting for a chest x-ray to confirm the tube is in her stomach. She has been taking much pain medicine and has been occasionally bewildered and confused. She asked where she was and seems very scared at times. She is resting now but keeps waking up complaining of nightmares. Please pray for deep rest. She has not been able to sleep much and we are hoping that being in her own room will allow her to sleep.

Tuesday Evening Update

The surgical oncologist who assisted Dr. Berkowitz with the GI portion of her surgery visited Mom this evening. She re-explained the surgical procedure she performed and Mom asked several questions. She mentioned that almost all of Mom's small bowel was extremely dilated above the section with the tumors and that they removed the fluid from her small bowel. The doctor mentioned that she was very backed up. The NG tube through her nose into her stomach is removing fluids from her stomach that can no longer move through her bowels because they are "sleeping." She will receive fluid nutrition until the bowels "wake up." Mom was encouraged to sit up and walk. She will no longer need a breathing mask (which was really uncomfortable) and they will also reduce her fluid intake. Then Mom had a CT scan of her chest, which came back negative (this is a good thing) - there was no pulmonary blood clot, which they suspected due to her abnormal blood pressure. Then Mom was moved back to the Connors Center.

Later, Mom's oncologist, Dr. Susan Berlin stopped by. She pointed out that the pathology report is not back yet, but she hopes Mom's bowel will be functioning soon. The next couple days will be very important in determining Mom's treatment plan. Mom will probably be in the hospital through next week at which point they hope to begin chemotherapy. Once the pathology report comes in they will be able to get a read on the right chemotherapy agents. Chemotherapy will be administered through an outpatient clinic at Dana Farber. Some of the agents she thought might be possibilities include Taxil or Carpoplactin.

After Dr. Berlin left, Mom was moved to a chair in her room. During the move, her NG tube (the tube going through one of her nostrils down to her stomach) got snagged on a nearby object and pulled out of her nose. This was quite painful for Mom who began to sob. The tube performs a necessary function of draining stomach fluids to prevent them from passing into the bowel, effectively resting the bowel. Because of its importance the tube needs to be reinserted. This has been quite a taxing event for Mom, whose nose has been extremely irritated already because of the tube.

Tuesday Afternoon Update

Anna is at the hospital now. We are taking turns scratching Mom's legs and asking the nurse for things. She is trying to sleep with the usual challenges. She seems more optimistic though - Anna really encouraged her. We are still waiting to see the oncologist. One of the things that has been discussed today has been a TPN (via a PIC line) for intravenous nutrition. A doctor came by with a consent form about the insertion procedure/operation. It will take place tomorrow afternoon and requires only minor sedation. Altogether the procedure will take 1 hour. Basically they will be inserting a lumen (opening) right above her chest that will serve as an entry point for medication, nutrition, chemotherapy, and blood drawing. Having this pick line will reduce future discomfort and risks are minimal.

Dr. Ebony (one of Dr. Berkowitz's team) has also stopped by and checked on Mom's pain management and allowed her to air out her legs - the cause of all the itchiness is two leg boots meant to reduce the risk of blood clots developing in her legs. The boots generate a lot of heat and make her legs sweat. She was able to address some of Mom's concerns and answer some of Anna's questions. She also mentioned that Mom's blood counts were great - even better than her own which is a definite sign of recovery.

On another note, Mom is always asking me to read the latest comments posted on the blog. Thank you all for your postings. They have been a great way to draw her out of her situation and encourage her.

Stephen

Tuesday noon update

Mom has been sleeping intermittently. There is a lot of noise from her roommate, the hall, and from all the machines around her, making sleep difficult. Also, technicians and nurses are always coming in to take vital signs and conduct new procedures. Mom has been quite sad that her cancer is stage IV. She has been crying on and off. Otherwise she seems to be becoming more responsive and moving more. Dryness in her mouth, an ill-formed face mask, a sore throat, and itchiness on her legs are her principal sources of discomfort.

Stephen

Dr. Berkowitz's visit

We met with Dr. Berkowitz and Mom had a number of questions. He answered most of them but emphasized that the important focus of the next few days is Mom's recovery from the surgery without further complications. The next matters that they will focus on are waking up her bowel, nutrional support like an intravenous nutrional supply if the bowel does not wake up immediately, the final pathology (this will take 4 business days), and then a chemotherapy plan to be determined by the oncologist, Dr. Susan Berlin. These will be the significant matters for consideration in the next 4-6 days.

Stephen

Mom's meeting with Doctors

Dr. Fleming (Dr. Berkowitz's colleague) came through to see Mom and gave her an overview of what she observed in the operating room as well as answered some of her questions. One significant question Mom had was regarding staging the cancer. Dr. Fleming said that the fluid in Mom's lung led both her and Dr. Berkowitz to believe that it was stage IV primary peritoneal cancer. At this point Mom started crying, Dr. Fleming assured her that this was typical for women diagnosed with ovarian cancer and that there was reason to be hopeful, because this cancer was generally responsive to chemotherapy. She also pointed out that they are still waiting for the pathology report, which will be available within four days. Dr. Berkowitz will drop in later today around 9:30 am with additional details to answer her questions.

Dr. Fleming also mentioned that she will need to walk around today to help prevent the formation of blood clots - this made Mom a little anxious as well.

Keep praying for her.

Stephen

Monday Night

I just spoke with Dad. The floor of the hospital where they've recently placed Mom is not as organized as the Connor Center where she was roomed earlier. Dad has been having trouble locating healthcare personnel and Mom still seems to be under the influence of anesthesia - she forgets where basic items like the location of her pain killer button are and often seems bewildered. She is also experiencing significant discomfort and pain. Dad intends to spend the entire night with her in the hospital. We believe if she can just make it through this night, Dr. Berkowitz will be able to rectify all the confusion in the morning.

Stephen

Late night news

Mom was finally moved out of the recovery room after 7 long hours of monitoring and careful treatment. They decided to move her to a room in another section of the hospital that had equipment available for monitoring her heart rate as the Connors floor doesn't have that technology available yet. The section she is in is not quite as nice as her room on the Connors floor. She has to share a room and the nurses are not as personal as the others she had. Also, Dad can't stay overnight with her. As Stephen and I were leaving she held onto our hands, not wanting us to leave and was even worried that Dad would be leaving as well. He will stay as late as he can and go back as early as possible tomorrow morning. May the Lord's presence continue to comfort Mom throughout the night and may she realize that despite the outward circumstance she is never alone.

Post-surgery visit

Dad and Andrew visited Mom in the post-operative recovery room. She is in a lot of pain, has a high blood pressure, and her temperature is high. She still needs our prayer. Her high blood pressure is a cause for concern. The nurse doesn't foresee her leaving the recovery room soon because of these complications. Seeing Mom in such a vulnerable state has been particularly hard for Andrew - please remember to pray for him as well.

Stephen

Summary of Surgeon's Observations

Mom is stable and in recovery. Mom's surgery lasted 3 hours, there was no large tumor mass found, but numerous cancer nodules that had infiltrated the omentum, and the mesentery surrounding the bowel (small intestines). It was confirmed that she does have a form of ovarian cancer. Because there was no large mass found, the surgeon did not think it was worthwhile to conduct the hysterectomy. He did call in a GI surgeon to help bypass a particularly diseased portion of the small intestine to restore her ability to eat, but nothing was removed.

The next step is chemotherapy, which the surgeon wants to start before she leaves the hospital in the next 4-6 days. When asked how effective the chemotherapy would be, they expected it to be 75-80%. Right now we are waiting on the analysis of the pathology report from the oncologist, who will determine the treatment regimen for the future months. The surgeon hopes that her eating function will be restored quickly but until then it may be necessary to have an intravenous feeding tube which will require some home support. The coming months will be challenging until the fall - at which point we hope she will begin to feel much better. The surgeon hopes that the chemotherapy will take care of most of the tumors and he said that another surgery will be needed to "mop up" all the residual tumor.

Mom is currently recovering. Dad and Anna went to talk with her, but she is still under the effects of the anesthesia. She will be in recovery for several more hours until her fluids are replaced and her electrolytes are balanced. Please pray that Mom's recovery would be swift, the oncologist would accurately diagnose the cancer and develop an effective treatment plan, her pain would be minimized, her eating function would be restored, and she would be encouraged and optimistic through the coming days.

Mom cannot receive visitors or take calls at this time. We are conveying all messages of love and encouragement to her regularly. Please let us know if you have any questions via the blog. We will do our best to answer any questions you have and pass on all messages. Thank you for your support.

We met with Dr. Berkowitz at 2:30, marking the end of Mom's surgery. Her situation is stable and she is recovering. We will go in to see her around 4:00. A detailed summary of the doctor's notes is coming.

Stephen

Surgery begins...

We just left Mom in the pre-op room and are now in the family liaison center of the Brigham (it is actually quite nice - it's amazing how much care they show patients' families). When we first started going to the pre-op room Mom started crying and commented that it was hard to believe her life was going to change so much. We attempted to assure her that this is just a temporary procedure and is only part in the process of the future life she still has to live. She seemed somewhat comforted by these words... Meanwhile we met the surgeon, the anesthesiologist, and the OR nurses. They were all very professional and compassionate, assuring us all that Mom is receiving the best care. One of the escort technicians was a Christian who told my mother that she was in God's hands and we need to have faith. This was also quite comforting.

The surgeon said that the operation could take as little as 2 hours but as many as 5 hours. They will notify us of any delays or changes in procedure, but for the most part we must resign ourselves to waiting for the surgery to be complete. If anything changes we will post it.

"For our momentary lightness of affliction works out for us, more surpassingly, an eternal weight of glory, because we do not regard the things which are seen but the things which are not seen; for the things which are seen are temporary, but the things which are not seen are eternal." 2 Cor 4:17-18

Stephen

Monday Morning

We just prayed with Mom for the surgery. She will be going down to the operating room any moment. Last night was quite rough for her. She did not sleep all night due to the vomiting associated with her bowel obstruction. She is still quite concerned about the surgery, but was encouraged by your prayers and blogs (we read them to her this morning).

Mom wanted to share Col. 1:24 with everyone: "I now rejoice in my sufferings on your behalf and fill up on my part that which is lacking of the afflictions of Christ in my flesh for His Body, which is the church."

She also wanted to say, "Thank you for all your prayers, they are sustaining me moment by moment."

Stephen

Surgery Schedule

If all goes well, Mom will be having surgery on Monday April 16th at 10:00 am, which should end no later than 2:00 pm. We will keep everyone updated throughout the surgery as we learn more about the nature of her cancer.

Stephen

Sunday Request for Prayer

I just spoke with Anna and it seems like Mom is having a difficult time with the oral medication meant to clear her intestines before surgery. Apparently, she has been vomiting the medication and is simultaneously in a lot of pain. Due to the pain, the doctors administered additional pain killer medication that reduced her heart beat so much it necessitated the need for an oxygen mask. These events are posing challenges to her preparation for surgery tomorrow.

In summary, please pray that they would successfully prep her for the surgery, that there would be no additional complications, and that the pain she is experiencing would be reduced.

Stephen Juraschek

Preparation for Surgery

Hi everyone,

Mom has been at Brigham and Women's since Friday. It is such a nice hospital and the floor she is on is wonderful. The nurses offer excellent care and her room is private and very comfortable. She has been experiencing some pain, but is much better than she was at home. My uncle and aunt from New York drove down with their families to visit Mom--it was great to see them. Stephen flew in yesterday from California and seeing him brought a big smile to her face. Thank you all for your kind and loving comments. We bring them to her at the hospital everyday and I know they bring her much joy.

Also, thank you so much for heeding Mrs. Connors' request about peace and quiet. Mom has certainly been able to get much needed rest and for that we are so grateful. Her surgery will take place mid-morning Monday and will last about three hours. There will be a five day recovery period after the surgery. The doctors are very confident and had an optimistic talk with her today which was certainly reassuring. They plan to remove the large tumor and smaller nodules which should help reduce the nausea she has been feeling. Please be sure to pray that it goes smoothly and is effective in diagnosing and beginning to deal with the cancer. She will be preparing for the surgery until about 7:00 tonight, so it is absolutely necessary that she receive no visitors or phone calls to insure she gets the rest and time needed to adequately prepare for surgery tomorrow.

I think we all have begun to miss her presence at home. She is certainly needed on so many levels and it has been a challenge to get used to her absence. I do hope after surgery she can come back home. Please continue to pray for continued grace and supply for all of us in the coming days.

Thank you all so much for your prayers and support--they are so precious to us. We will keep you posted on any developments.

Grace to you all,
Andrew

Peace & Quiet

Joanne is in desperate need of sleep and peace & quiet-Doctor's orders. This last week has taken a great deal out of her and she needs to get prepared for surgery 1st thing Monday morning - the beginning of her own Boston Marathon. She has her cell phone so she can contact the outside world if she gets lonely or needs to pray with someone, so please no visits or phone calls right now. You can let her know how much you care for her by commenting on this blog or sending a card and the children will make sure she gets a copy of it.

Many have asked what they can do to help. We will try to have some information/schedule in the next few days so that everyone can partipate in a coordinated way.

The Jurascheks are in awe of the Lord's grace and supply ministered by all of you.

Missy

Current Plan

Hi All,

We have really enjoyed Mom staying at home these last few days. While she hasn't been too mobile, her presence has been a great comfort. When she arrived home Tuesday, she still was experiencing some abdominal pain which has continued until today. Various families have brought dinners and have helped clean, etc.--THANK YOU!! We can sense the prayers and overwhelming support from all of you.

Today Mom went with Anna and Dad to Brigham and Women's for a 12 o'clock appointment with Dr. Berkowitz (head of Gynecology and Gynecologic Oncology at BWH and Dana Farber). They had to wait for about 2 hours, and at first saw the Physician's Assistant. The PA was concerned about the pain Mom felt and thought she might need to be admitted as did the doctor. He also discussed surgery. He said they will use the surgery to diagnose the cancer, cut out all the cancerous tumors they can, assess how developed the cancer is, and prepare for chemotherapy. During the surgery, they will send a sample of the tumor to pathology for a quick diagnosis. If for some reason it is not gynecologic, they will immediately bring in other oncologists to make judgments. This surgery will take place Monday. Until then, Mom will stay at BWH on a comfortable floor with private rooms and excellent care. Dr. Berkowitz is on call this weekend, so he will be able to visit her frequently.

Mom, Dad, and Anna said Dr. Berkowitz seemed to be a very caring, genuinely trustworthy person and they feel Mom will be secure under his care. We have heard reports from several others who have seen him and all their comments were positive. BWH does appear to run more smoothly than BID, which has also brought peace and added security. As Mom said, it is truly God's sovereign arrangement that she is here and receiving treatment.

Mom is in need of much rest and sleep (she hasn't slept for more than a few hours a night in well over a week) so please offer her support by prayer and comments on the blog, email or cards which we can pass on to her. We will be sure to let you know when she can take visitors at the hospital, but for now, rest is most important.

We will try to update you all regularly using this blog. Please continue to pray for Mom's stay at the hospital, that she will get necessary rest and will not feel alone, afraid or depressed. Also pray that the surgery Monday will be effective in diagnosis and in the beginning of treatment.

Thank you so much for all of your care and concern--and especially your prayers. They are much needed and much appreciated.

For the the family,
Andrew

Next step

I've been awake since 4:30 with acute gas pain - not a pleasant feeling (and I don't mean to be so specific with gross details, but I felt I had to identify the type of pain.) Hopefully it will subside today but it sure makes it difficult to do just about anything - I am especially fearful of eating anything. So, please pray that the pains subside.

I was able to get an appointment with Dr. Berkowitz at Brigham and Women's Hospital for Friday at 12:00. Am scheduling another appointment with a doctor at Beth Israel - Young Kim, who is also highly recommended. Please pray that we know which way to go - BI or BWH.
I will let you know what the doctors report and what is next on the schedule.

Because I don't have too much information I thought I'd let you know what I'm doing during the day besides trying to find a way to get comfortable:

I am reading an absolutely inspiring book And Still We Rise - I highly recommend it to all educators and everyone else - this book is a tribute to 12 young people who rise above horrific adversity to graduate from high school and go on to college. There is a copy in the Boston Trinity library! Any other book recommendations are welcome!

I also enjoy playing the piano and singing hymns - what a refreshment to my anxiety-worn soul. Today Andrew (my 17 year old son) and I sang a little song together. The chorus was especially comforting:

God is there for me tomorrow as He is for me today.
He will take my cares and sorrows and will wipe them all away.
There's no crisis that He can't bear, no storm He can't abate.
He's my God, He's my God.

For those of you who don't know, prior to the cancer development, I had been establishing the Boston Trinity Academy library this year and still hope to be able to finish that project. I cataloged around 1800 books! It has been a lot of fun. I really enjoyed library visits from students and their excitment over books they find in our little library. They are my inspiration!

Your comments have been a great encouragement to me as I have times of discouragement and fear. I am thankful that I have a High Priest who is able to sympathize with the feeling of my weakness and has been tried in all respects like me - yet without sin.

Thanks to everyone for food and flowers and help and to Jen for the Little House DVDs! They will help keep me distracted. Keep posting - just click on the word comments and then you can post your comment. I am enjoying them to the uttermost!

A new adventure

I thought it would be therapeutic to blog my thoughts and progress since I'm often kind of tired and can't always talk on the phone. Also I had to drop my classes at Drexel this quarter (sigh!) since I might fall behind. I have to do something to fill up my time - and I can't really effectively clean my house (which WOULD fill up all my time if I had more energy). I created this blog with the name The Varied Grace of God from 1 Peter 4:10 - because this new experience is bringing me into another aspect of grace. Anyway, I am sure I will have many opportunities to experience many more aspects of grace as we go through this and I want to be able to share about the supply of grace as I go through everything.

First of all, I am home from Glover Hospital awaiting an appointment with a gynecologic oncologist - I am going to see 2 - one at the Beth Israel Hospital in Boston and one at Brigham and Women's Hospital. No appointments yet. I'm trying to avoid having the horrendous problem I had last week with a blockage to my intestines and extreme discomfort. I'm enjoying many different varieties of chicken broth!

For those of you who don't know about what is going on, I had a CT scan and I have tumors on my omentum which were pressing on the intestines and causing a problem with digestion and elimination. The tumors, and also abdominal ascites (fluid) look like ovarian cancer or else peritoneal carcinomatosis. The tumors can't be biopsied because that could spread the cancer throughout my abdomen. In an attempt to rule out other cancers I had a chest ct (negative) and an endoscopy (also negative). I couldn't have a colonoscopy because I couldn't tolerate drink or tolerate all the stuff they gave me to drink. It was by far the most awful stuff I've had to drink - and it was 1 gallon - I drank half and then threw it all up.....so no colonoscopy.

Blood tests showed a slightly elevated CA125 marker for ovarian cancer. So next step is to see the gyn-oc doctor and have surgery to "debulk" my abdomen. Finally - it will be debulked!!! Not exactly how I planned to do that. Oh well.

I have thoroughly enjoyed the visits in the hospital from everyone. Each one of you brought so much joy - and if you didn't come or couldn't come, don't feel bad, you ministered to me by letting me get that much more rest.

I'm not sure how this blog will work but I think you can post your thoughts etc. I'm going to make a cup of tea and try to find a comfortable way to sit down. Lying on the bed is not always comfortable. I look forward to hearing from everyone.