7.30 p.m.

Thanks for checking in.  Irene enjoyed yesterday with Nancy Worden and into the evening with Jocelyn & Vince.  Today was a rough day at dialysis and this evening she’s endeavoring to endure the discomfort.

Brutal cycle…and hoping, as is the norm, that tomorrow is a better day.

Thanks for caring,
Dave

8.30 p.m.

I read this the other day:

“God has generously granted you the privilege, not only of believing in Christ but also of suffering for Christ’s sake.”
Philippians 1:29

I am musing on that verse….....and have a few questions for you and me…....

* Would you (would I) consider it a privilege to suffer for Christ?

* Is Irene suffering for Christ’s sake?

* How does or doesn’t Irene’s journey relate to the suffering of Christ?

Food…for thought,
Dave

5.30 p.m.

Irene was able to muscle through dialysis treatment today without significant pain…...so the only challenge this evening is the ongoing nausea and chronic fatigue.  Sounds kind of funny to write that…........

Thanks for caring,
Dave

8.30 p.m.

Thanks for checking in!  Irene had much better weekend. 

On Saturday we enjoyed a drive to the greater Monterey/Pacific Grove region and this morning around the greater Santa Cruz area before just relaxing around the “neighborhood” for the balance of the day.  Her nausea remained “at bay”.

We’re hoping this next week she overcomes the challenges that she’s recently experienced @ dialysis.

Thanks for caring,
Dave

7 p.m.

This late breaking email from Dr. Damon is encouraging!

Enjoy!

Dave
_____________________________

Dave,
Below are Irene’s lab tests – nothing remarkable. The free light ratio remains normal, so she continues to be in complete remission of amyloid!!

The labs do not explain her anemia beyond renal failure. The TSH is a bit high, and might suggest a low thyroid function (which can cause anemia), but her T4 is normal, ruling out a low thyroid function. Her ferritin is high, seen in renal failure, and high enough to rule out iron deficiency. The retic count was a bit high, reflecting young red blood cells made by the bone marrow in response to her epo dose the day before. In sum, this lab work does not explain her anemia, except for the renal failure. If the anemia continues to be an issue, then we’ll need to do a bone marrow biopsy – time will tell. L. Damon, MD

DIAS, IRENE                           USER:Damon
===============================================================================
*=abnormal   l*=low   h*=high   L*=panic low   H*=panic high   #=normal unknown
SITE   DATE   TIME LABORATORY         RESULTS   UNITS   NORMAL   ACRO
===============================================================================
PARN 3-15-12 12:11 DIRECT COOMBS TEST                         DRCT
              DIR. ANTIGLOBULIN TEST   NEG                 %DBS
          09:52 UNACCEPTABLE SPECIMEN                       USPE
              BLOOD BANK                             UBBS
                Patient info on requisition missing, incorrect or
                illegible
                DIRECT ANTI HUMAN GLOGULIN TEST (DCT)
                Unit or MD notified
                PAULA ACC TX AT 3 2252/RJT
          08:30 CBC WITH/DIFF & PLT CT
              WBC COUNT           5.1   x10E9/L 3.4-10   WBC
              RBC COUNT         l*2.90   x10E12/L 4.0-5.2   RBC
              HEMOGLOBIN         l*10.1   g/dL   12.0-15.5 HGB
              HEMATOCRIT         l*29.8   PERCENT 36-46     HCT
              MCV             h*103   fL     80-100   MCV
              MCH             h*34.7   pg     26-34     MCH
              MCHC               33.8   g/dL   31-36     MCHC
(Q=Quit, =Continue, P=Patient, C=Copy to ptr, ?=Help,
ARN 3-15-12 08:30   PLATELETS           169   x10E9/L 140-450   PLT
              NEUTS             2.99   x10E9/L 1.8-6.8   N-A
              LYMPHS             1.64   x10E9/L 1.0-3.4   L-A
              MONOS             0.35   x10E9/L 0.2-0.8   M-A
              EOS               0.12   x10E9/L 0.0-0.4   E-A
              BASOS             0.03   x10E9/L 0.0-0.1   B-A
              RETIC CT BY FLOW CYT   h*109.8   x10E9/L 21-80     RETF
              ELECTROLYTE PANEL
              SODIUM, SERUM         144   mmol/L   135-145   NA
              POTASSIUM, SERUM       4.0   mmol/L   3.8-5.1   K
              CHLORIDE           100   mmol/L   97-108   CL
              CARBON DIOXIDE, TOTAL   30     mmol/L   22-32     CO2
              ANION GAP           14           4-14     ANGA
                Anion gap is calculated as Na-(Cl+CO2)
              UREA NITROGEN         h*37     mg/dL   6-22     BUN
              AST                 19     U/L     17-42     AST
              ALT                 24     U/L     11-50     ALT
PARN 3-15-12 08:30 BILIRUBIN TOTAL         0.5   mg/dL   0.2-1.3   BILT
              ALKALINE PHOSPHATASE   h*152   U/L     31-95     ALKP
              PROT ELECTROPHORESIS                 XXXX     PE
                Normal pattern
              PROTEIN, TOTAL       7.1   g/dL   6.0-8.1   TP
              ALBUMIN (PART OF PE)    4.6   g/dL   3.1-5.4   ALBL
              ALPHA-1 GLOBULIN       0.1   g/dL   0.1-0.3   A1G
              ALPHA-2 GLOBULIN       0.8   g/dL   0.4-1.2   A2G
              BETA GLOBULIN         0.8   g/dL   0.6-1.2   BGL
              GAMMA GLOBULIN       0.8   g/dL   0.6-1.6   GG
                Interpreted by: Theodore W. Kurtz M.D.
                Perfrm’d at UCSF China Basin Lab, 185 Berry, San
                Francisco, CA 94107
PARN 3-15-12 08:30 IMMUNOFIXATION, SERUM               XXXX     IFE
                No paraproteins present
                Interpreted by: Theodore W. Kurtz M.D.
                Perfrm’d at UCSF China Basin Lab, 185 Berry, San
                Francisco, CA 94107
              IGG                 1040   mg/dL   672-1760   IGG
                Perfrm’d at UCSF China Basin Lab, 185 Berry, San
                Francisco, CA 94107
              IGM                 68     mg/dL   39-333   IGM
                Perfrm’d at UCSF China Basin Lab, 185 Berry, San
                Francisco, CA 94107
              IGA                 163   mg/dL   89-581   IGA
                Perfrm’d at UCSF China Basin Lab, 185 Berry, San
                Francisco, CA 94107
PARN 3-15-12 08:30 TSH(THYROTROPHIN)      h*6.48   mIU/L   0.40-4.00 TSH
                ADD 3/15 @9:12 PER JEN 38167
                Perfrm’d at UCSF China Basin Lab, 185 Berry, San
                Francisco, CA 94107
              FERRITIN           h*994   ug/L   10-291   FERR
                ADD 3/15 @9:12 PER JEN 38167
                Perfrm’d at UCSF China Basin Lab, 185 Berry, San
                Francisco, CA 94107
              CREAT WITH eGFR
              CREATININE         h*5.90   mg/dL   0.52-1.06 CR
              eGFR IF CAUCASIAN     l*7     mL/min   >60     GFRC
              eGFR IF AFRICAN AMER   l*9     mL/min   >60     GFRA
                eGFR corrected for 1.73 sq meters body surface area
                NOTE: eGFR is only an estimation. Please see on-line
                Lab Manual for potential limitations
PARN 3-15-12 08:30 FREE T4             11     pmol/L   9-24     FT4
                ADD 3/15 @9:12 PER JEN 38167
                Perfrm’d at UCSF China Basin Lab, 185 Berry, San
                Francisco, CA 94107
              VITAMIN B12           432   ng/L   211-911   VB12
                Request added on
                Perfrm’d at UCSF China Basin Lab, 185 Berry, San
                Francisco, CA 94107
              FOLATE, RBC         h*1254   ug/L RBC 280-791   RFOL
                ADD 3/15 @9:12 PER JEN 38167
                Perfrm’d at UCSF China Basin Lab, 185 Berry, San
                Francisco, CA 94107
              CHOL, TRIG, HDL, & LDL
              CHOLESTEROL, TOTAL     184   mg/dL   <200 CHOL
Desirable
TRIGLYCERIDES h*230 mg/dL <150 TRIG
Suggests high cardiovascular risk
PARN 3-15-12 08:30 HDL CHOLESTEROL 49 mg/dL >39     HDL
                Acceptable
              CHOL HDL RATIO       3.8         <6.0     CHOR
              NON HDL CHOLESTEROL     135   mg/dL   <160     NHDL
                Near or above optimal
              LDL CHOLESTEROL       89     mg/dL   <130     LDL
                Optimal
              K/L LT CHAINS,FREE
              KAPPA/LAMBDA RATIO     0.93         0.26-1.65 KLR
                Perfrm’d at UCSF China Basin Lab, 185 Berry, San
                Francisco, CA 94107
              KAPPA LT CHAIN,FREE   h*66.0   mg/L   3.3-19.4   KAPF
              LAMBDA LT CHAIN,FREE   h*71.1   mg/L   5.7-26.3   LAMF

4 p.m.

No word from UCSF today relative the blood test results which were were hoping to have by now.

Irene had significant pain today during dialysis but patiently endured. Her right arm could not straighten for about 30 minutes following her session today. She's at home wrestling with the unrelenting nausea.

Thank for caring,
Dave

8 p.m.

Irene wrestled through dialysis today and ALMOST completed the session. Her nausea is raging this evening but she's still smiling...as usual...!

Hoping for recovery and a better tomorrow.

Thanks for caring,
Dave

I want to know Christ—yes, to know the power of his resurrection and participation in his sufferings, becoming like him in his death, and so, somehow, attaining to the resurrection from the dead.

Philippians 3:10-11 (NIV)

[For my determined purpose is] that I may know Him [that I may progressively become more deeply and intimately acquainted with Him, perceiving and recognizing and understanding the wonders of His Person more strongly and more clearly], and that I may in that same way come to know the power outflowing from His resurrection [which it exerts over believers], and that I may so share His sufferings as to be continually transformed [in spirit into His likeness even] to His death, [in the hope]
That if possible I may attain to the [spiritual and moral] resurrection [that lifts me] out from among the dead [even while in the body].

Philippians 3:10-11 (Amplified)
_________________________

I have been reflecting on this verse in each of those translations and wondering how many followers of Christ can sincerely align with Paul’s prayer. Do we long to participate in Christ’s sufferings? Is it our desire to “share” in His sufferings? My guess is that for most of us the answer is an emphatic “NO…!”

In the amplified version I’m even more intrigued with the emphasis on WHY Paul longs to participate in Christ sufferings, “…as to be continually transformed…” Most of us would probably conclude that we don’t want a transformational life that badly…or do we?

No one in their right mind would choose the bed of suffering that Irene continues to “joyfully” endure. She is not in denial; she is not oblivious of the challenge. Yet she faces the ongoing trial with a spiritual strength and underpinning that most would have relented to long ago. “Redemption” in the midst of suffering is the transformational life that Irene demonstrates before us. Her participation in the “sufferings of Christ” is producing spiritual fruit for today and beyond…as many of us observe with humility and grace. It is unexplainable and beyond comprehension, how one can continue to face the unyielding, 24/7 onslaught without concluding the powerful manifestation of Christ’s love that is in our midst.

I want to know Christ—yes, to know the power of his resurrection and participation in his sufferings, becoming like him in his death, and so, somehow, attaining to the resurrection from the dead.

Philippians 3:10-11 (NIV)

Thanks for caring,
Dave

7.30 p.m.

Thanks for checking in.

Irene's dialysis treatment today was a significant struggle and it's carried over to this evening. She's fighting significant nausea after today's bout.

Earlier today the technicians had great difficulty getting the needles working appropriately in the fistula region and Irene had chronic pain but finished the session.

Thanks for caring,
Dave

9 p.m.

About 2 months ago Irene and I discussed a weekend "getaway"...for some R&R from the routine. We have always enjoyed Scottsdale, Arizona and I was able to make arrangements at one of my client's properties, the Scottsdale Resort.

Friday's dialysis for Irene went extremely well. Because it did, we were able to execute on the plan..........

Last Friday evening after Irene's dialysis we took a flight from San Jose to Phoenix and enjoyed a great time in the greater Scottsdale area. We had dinner at Los Olivos in Old Town Scottsdale, one of our favorite restaurants in the area where Irene's mom actually had a job prior to Irene even being born. Our activities included visiting the cemetery where Irene's father is buried and having lunch with Aunt Carol Moorehead, who lives in Sun City West and was married to the late Bill Moorehead, my mom's brother.

It was a relaxing weekend and a good diversion from the last couple of weeks of health challenges.

Thanks for caring,
Dave

Department Head and Oncologist, Dr. Lloyd Damon & Irene are all smiles as we met early this morning @ UCSF where he examined her and took a battery of her quarterly blood tests.  He’s been overseeing her care since the stem cell transplant in 2007.  It takes about a week to receive results related to the status of the Primary Amyloidosis.  We’ll report the findings as soon as we get them.

Irene also met with her vascular surgeon, Dr. Charles Eichler, related to the ongoing fistula ordeal.  After his examination, his recommendation is for Irene to see if she can muscle through the right forearm pain during dialysis using heat.  He’s hesitant for more aggressive treatment options at this time.  All of us are hopeful that the pain will subside.

8 p.m.

Thanks for checking in.

The dialysis center used 2 NEW entry points for Irene’s dialysis treatment today, trying to isolate the fistula region so that Irene’s pain is minimized.  Success was achieved today in that Irene made it through the 3 hour session but it was not without some pain….thankfully such that she could endure it.

ONE more dialysis day on Wednesday before the follow-up at UCSF with vascular surgeon Dr. Charles Eichler on Thursday….and also her “routine” amyloidosis appointment with Dr. Lloyd Damon.

Irene’s tustling through another embattled evening of nausea and fatigue.  Her heart rate skyrockets when she over “walks”...causing her to stop and take a breath….just to slow down the heart rate.

The surreal journey continues…and Irene’s still sharing her signature smile.

Thanks for caring,
Dave

Despite Irene’s blood pressure once again dropping fairly low…. 81 over 62, she was able to get through the 3 hour dialysis treatment today. Her heart rate was racing at 115 and it took awhile to subside before she was released for home. The arm pain was tolerable but certainly with some discomfort. 

Irene had a surprise and pleasant visit from friend, Victoria McCharen, which gave her great encouragement.

She’s still smiling and bouyant.

Thanks for caring,
Dave

6 p.m.

Irene was able to complete her dialysis treatment today after they used yet another needle entry point.  There was minor discomfort but NOTHING like what she experienced yesterday.

Here are some words of encouragement:

“True hope dwells on the possible, even when life seems to be a plot written by someone who wants to see how much adversity we can overcome.  True hope responds to the real world, to real life; it is an active effort.”
—Walter Anderson

“No pain, no palm; no thorns, no throne; no gall, no glory; no cross, no crown.”
—William Penn

“The harder the conflict, the more glorious the triumph.  What we obtain too cheap, we esteem too lightly; it is dearness only that gives everything value.  I love the man that can smile in trouble, that can gather strength from distress and grow.”
—Thomas Paine

“Do you not know?  Have you not heard?  The Lord is the everlasting God, the Creator of the ends of the earth.  He will not grow tired or weary, and his understanding no one can fathom.  He gives strength to the weary and increases the power of the weak.  Even youths grow tired and weary, and young men stumble and fall; but those who hope in the Lord will renew their strength.  They will soar on wings like eagles; they will run and not grow weary, they will walk and not grow faint.”
—Isaiah 40:28-31

“Consider it pure joy, my brothers and sisters, whenever you face trials of many kinds, because you know that the testing of your faith produces perseverence.  Let perseverence finish its work so that you may be mature and complete, not lacking anything.”
—James 1:2-4

I lift up my eyes to the mountains—
where does my help come from?
My help comes from the LORD,
the Maker of heaven and earth.
He will not let your foot slip—
he who watches over you will not slumber;
indeed, he who watches over Israel
will neither slumber nor sleep.
The LORD watches over you—
the LORD is your shade at your right hand;
the sun will not harm you by day,
nor the moon by night.
The LORD will keep you from all harm—
he will watch over your life;
the LORD will watch over your coming and going
both now and forevermore.
—Psalm 121

Irene’s back in the dialysis chair tomorrow.

Thanks for caring,
Dave