Melinda

Shirley, I am so sorry to hear about your dad. There are no words... I am glad to hear that you and your family got to spend this last week with him and that you were all there when he went. I'm sure that meant a great deal to all of you. Please know that our thoughts are with you and we are "here" in case you need to talk through these difficult times. Sincerely, Melinda

Heather-- Good for you!!! I have to admit that I love my hometown of New York City a whole lot more now that there is a city-wide ban on smoking in resturants and bars. Yes--a lot of New Yorkers have been complaining (I am not one of them) and yes, I still have to hold my breath as I enter or leave a popular venue just to get through the hoard of smokers huddled outside the entrance--but it is still a VAST improvement!!! (Especially for those who work in those establishments!) And I was a huge fan of this new policy LONG before my MIL's dx. We just need more Heathers out there... Melinda

Thanks for the info--I have passed it along. What is our world coming to? Melinda

Thank you for your posts. I am at a loss for words... I, too, am a thirty-one year old teacher--and I wish I could have worked with and/or sent my former students on to study under Katie. Teaching, in my opinion, is calling--not a job. Katie was certainly called to teach. How lucky are those that knew and loved her. My thoughts are with you and the rest of your family (esp. her husband and son) during this difficult time. Sincerely, Melinda

Andrea, I am so sorry to hear about your mom. There are no words... Please know that our thoughts are with you and we are "here" in case you need to talk through these difficult times. Sincerely, Melinda

Dee-- I am so sorry to read about your grandmother. Please know that our thoughts and prayers are with you during this difficult time. Sincerely, Melinda and Geoff

Paddy-- I hope you all have a wonderful time together. Our thoughts are with you. Melinda

Dear all, Curtis just posted a detailed update under the family/caregivers section. Melinda

Dear all, Curtis just posted a detailed update on how he and Katie are doing in the family/caregivers section. Melinda

Dear Curtis, Thank you for the update on you and Katie. You have both been in all of our daily thoughts and prayers. I am at a loss for words now that I realize how much more difficult life was for you, Becky, and Katie over the past eight months given your commute. My gosh... I am not surprised a bit that Becky left all the papers in perfect order--although I did not "know" her, it seems just like the kind of thing she would make sure was taken care of. She truly was an amazing person. I feel compelled to address your comment that you don't feel very smart right now: a) you were smart enough to grab a prize like Becky, marry her, and have a beautiful child with her you wouldn't have been able to "win" Becky if she didn't think of you as her equal and partner in life and c) you are juggling 101 tasks at one of the most stressful times of your life with efficiency, rationality, humbleness, and grace. That's better proof of genius in my book then a Rhodes Scholarship or a Nobel Prize. I am glad to hear that you won't have to worry about making two house payments--but know how stressful moving can be (esp. trying to find a home in a good school district!). I hope you have someone (preferably, many people!) to lean on and help you out. At least the University is treating you humanely. I wish I knew something about (or someone in) in San Antonio--but, alas, I am a New York City gal. That being said, if there is ever anything I can do to assist you and Katie from this corner of the country--simply PM me. Thank you for staying in touch with us--we wish you all the best. Sincerely, Melinda

Peggy, I, too, am still trying to figure out what some of the terms are (PCI, COPD, and WBRT, for example). PET scan: (from http://www.radiologyinfo.org/content/petomography.htm) What is Positron Emission Tomography? Positron emission tomography, also called PET imaging or a PET scan, is a diagnostic examination that involves the acquisition of physiologic images based on the detection of subatomic particles. These particles are emitted from a radioactive substance given to the patient. The subsequent views of the human body are used to evaluate function. What are some common uses of the procedure? PET scans are used most often to detect cancer and to examine the effects of cancer therapy by characterizing biochemical changes in the cancer. These scans are performed on the whole body. PET scans of the heart can be used to determine blood flow to the heart muscle and help evaluate signs of coronary artery disease. Combined with a myocardial metabolism study, PET scans differentiate non-functioning heart muscle from heart muscle that would benefit from a procedure, such as angioplasty or coronary artery bypass surgery, which would re-establish adequate blood flow. PET scans of the brain are used to evaluate patients who have memory disorders of an undetermined cause; who have suspected or proven brain tumors; or who have seizure disorders that are not responsive to medical therapy, and therefore, are candidates for surgery. How should I prepare for the procedure? PET is usually done on an outpatient basis. Your doctor will give you detailed instructions on how to prepare for your examination. You should wear comfortable, loose-fitting clothes. You should not eat for four hours before the scan. You will be encouraged to drink water. Your doctor will instruct you regarding the use of medications before the test. Note: Diabetic patients should discuss specific diet guidelines to control glucose levels during the day of the test. What does the equipment look like? You will be taken to an examination room that houses the PET scanner, which has a hole in the middle and looks like a large, doughnut. Within this machine are multiple rings of detectors that record the emission of energy from the radioactive substance in your body. While lying on a cushioned examination table, you will be moved into the hole of the machine. The images are displayed on the monitor of a nearby computer, which is similar in appearance to the personal computer you may have in your home. How does the procedure work? Before the examination begins, a radioactive substance is produced in a machine called a cyclotron and attached, or tagged, to a natural body compound, most commonly glucose, but sometimes water or ammonia. This process is called radiolabeling. Once this attached substance is administered to the patient, the radioactivity localizes in the appropriate areas of the body and is detected by the PET scanner. Different colors or degrees of brightness on a PET image represent different levels of tissue or organ function. For example, because healthy tissue uses glucose for energy, it accumulates some of the radiolabled glucose, which will show up on the PET images. However, cancerous tissue, which uses more glucose than normal tissue, will absorb more of the substance and appear brighter than normal tissue on the PET images. Scientifically speaking, the radioactive substance decay leads to the ejection of positive particles called positrons. A positron travels about one to two millimeters before colliding with an electron. The collision results in a conversion from mass to energy, resulting in the emission of two gamma rays heading off in exact opposite directions. Special crystals, called photomultiplier-scintillator detectors, within the PET scanner detect the gamma rays. The scanner's special camera records the millions of gamma rays being emitted, and a connected computer uses the information and complicated mathematical formulas, called algorithms, to map an image of the area where the radioactive substance has accumulated. How is the procedure performed? A nurse or technologist will take you into a special PET examination room. You will lie down on an examination table and be given the radioactive substance as an intravenous injection (although, in some cases, it will be given through an existing intravenous line or inhaled as a gas). It will then take approximately 30 to 60 minutes for the substance to travel through your body and be absorbed by the tissue under study. During this time, you will be asked to rest quietly in a partially darkened room and to avoid significant movement or talking, which may alter the localization of the administered substance. After that time, scanning begins. This takes an additional 30 to 45 minutes. Some patients, specifically those with heart disease, may undergo a stress test in which PET scans are obtained while they are at rest, then after undergoing the administration of a pharmaceutical to alter the blood flow to the heart. Usually, there are no restrictions on daily routine after the test, although you should drink plenty of fluids to flush the radioactive substance from your body. What will I experience during the procedure? The administration of the radioactive substance will feel like a slight pinprick if given by intravenous injection. You will then be made as comfortable as possible on the examination table before you are positioned in the PET scanner for the test. You will be asked to remain still for the duration of the examination. Patients who are claustrophobic may feel some anxiety while positioned in the scanner. Also, some patients find it uncomfortable to hold one position for more than a few minutes. You will not feel anything related to the radioactivity of the substance in your body. Who interprets the results and how do I get them? Patients undergo PET because their referring physician has recommended it. A radiologist who has specialized training in PET will interpret the images and forward a report to your referring physician. It usually takes one to three days to interpret, report, and deliver the results. What are the benefits vs. risks? Because PET allows study of body function, it can help physicians detect alterations in biochemical processes that suggest disease before changes in anatomy are apparent on other imaging tests such as CT or MRI scans. Because the radioactivity is very short-lived, your radiation exposure is extremely low. The substance amount is so small that it does not affect the normal processes of the body. The radioactive substance may expose the fetus of patients who are pregnant or the infants of women who are breast-feeding to the radiation. The risk to the fetus or infant should be considered related to the potential information gain from the result of the PET examination. What are the limitations of Positron Emission Tomography? PET can give false results if a patient's chemical balances are not normal. Specifically, test results of diabetic patients can be adversely affected because of blood sugar or blood insulin levels. Also, because the radioactive substance decays quickly and is effective for a short period of time, it must be produced in a laboratory near the PET scanner. It is important to be on time for the appointment and to receive the radioactive substance at the scheduled time. PET must be done by a radiologist who has specialized in nuclear medicine and has substantial experience with PET. Most large medical centers now have PET services available to their patients. Medicare and insurance companies cover many of the applications of PET, and coverage continues to increase. Finally, the value of a PET scan is enhanced when it is part of a larger diagnostic work-up. This often entails comparison of the PET scan with other imaging studies such as CT or MRI.

Rosemary and Fred-- Our thoughts will be with both of you tomorrow. Melinda

Thank you for posting the news, Norme. Melinda

Brava!!! What great news, Mo. Give yourself a real pat on the back. Melinda

Mo, I am so truly sorry to hear about Shaba. I just learned last week that the family cat I inherited when my mom got sick has renal failure (she is 16). She also seems to be developing neurological problems. She truly is a member of our family--and I am watching her fall to pieces before my very eyes. Two moms with cancer and now our beloved cat. They always say that things come in threes, right? So I truly empathize. I am so sorry that you had to have something so sad occur when you are battling on other fronts. My thoughts are with you and Shaba. Melinda

Dear all, My soon-to-be mother in law is scheduled to have radiation to the brain for two weeks starting on Monday at Memorial Sloan-Kettering. She went to see an alternative doctor (he is a psychiatrist who has branched out into alternative cancer medication) for advice on complementary treatment (nutrition, etc.) today and he told her that she may want to FORGO tradional treatments (i.e.--chemo and radiation). He made her EXTREMELY scared that the radiation may damage her brain (she may be a vegetable if she has these treatments) and she is considering cancelling her scheduled treatments. She has been told by her onc. that the mets to her brain are NOT yet substantial (she does not have any symptoms--swelling, headaches, is not on meds for it). a) I know that MANY of you have undergone radiation to the brain and are still wonderful, intelligent, functional creatures. Could any of you share your experiences with me so that I may pass them along? If any of you might be willing to speak with her about your experiences, would you be kind enough to PM me? She is a very religious woman who responds better to speaking to other people than reading my pages of research. Regardless, ANY advice or guidance would be most appreciated. Geoff and I are really scared by this unexpected turn of events. Thank you. Melinda

HOORAY for SHRINKAGE!!!! What simply glorious news. Melinda

Yippee!!! Melinda

Dear Carolyn and Jim, Happy Anniversary! Melinda

My gosh... What can one even say upon hearing something like that? I hope the information did get passed along. Thanks, Lillian.

I am glad to read that you are feeling a little better--so hard to do when you can't get a good night's sleep! Please do keep us posted on the scans. Best wishes, Melinda

Here's to smooth sailing to Denmark! You'll be in our thoughts even if you are off-line. We can't wait to hear about eveything in Copenhagen. Best wishes, Melinda

Mo, You will be in my thoughts while I am in chapel with the students tomorrow morning. Hang in there! Melinda

Thank you for the post, Ry. David, our thoughts are with you; please come out of that hospital swiftly and safely! Melinda

Fay, I know nothing-absolutely nothing. Sorry. What does your doc. recommend? Have you gone to get a second opinion from another doc.? I find that a second opinion (even if it completely contradicts the first) forces me to discover what I really think--and after all the research, consultations, etc., I am more sure of my gut instinct on a matter. But that's just me... Please keep us posted on a) what you learn what you decide and c) when you decide to go ahead with either procedure. You are in our thoughts, Melinda