Wednesday, August 29th

Well, this may be a hard report. There is more that I don't know than I do.

For the second time, I developed a pain in the left side of my stomach and chest about three days after the last day of chemo. We did CAT scans of the area and (thankfully) found no damaged organs. So, while the source of the pain is not determined we do know it is not being caused by something that would make us stop treatment. Just chemo; just deal with it. It does interfere with golf, though. Oh, well...

Dr. Doty and I agree that the lymph nodes are smaller, though no current scans confirm this. The real test will be the comparison between the 08/14 scan and the one we will do about 09/19. That will tell us the plan for the rest of the year. I still think we'll do 2 more chemos after that and start SCT about mid November.

I'll keep you posted.

RICK

This was Brady's first trip (her dad, Will's, too). The whole family was there: my mother, Sadie, Cindy, Regan and Will, Nick and Kendra, and Chris. They went on 3 float trips, played in the water, tossed washers, played cards and ate. It was a great family outing even though I didn't feel well. Expected, I guess, since it was only 3 days after chemo.

Fazio Canyons at Barton Creek the afternoon of the second day of my last round of chemo with my friend, Bart Couch. I felt pretty good that day. It didn't last. The poison soaks in by the weekend following chemo.

Latest Decisions

Cindy & I saw Dr. LeMaistre Monday and Dr. Doty Tuesday.

I had a PET/CAT scan last week but the only scan they had in Austin to compare to was done in February. As expected, that comparison showed disease progression. They have requested one done at MDA in June. Hopefully, that comparison will show regression since June. These comparisons will dictate plan of attack:

• If we have regression since June, I will continue R-ICE #3 and #4 and test/scan again about September 19th.


• If I am in remission in September we will stop R-ICE and go on to transplant about the first of October.


• If we have continued regression in September, but not remission I will take two more rounds of R-ICE and plan on starting transplant mid-November.


• If we have progression (now or mid-September) we will change bug spray and plan SCT at an appropriate later time.

Personally, I believe there has been regression of the disease since June and am on track for SCT. My sister (the "perfect match" donor) will do her prepatory tests August 30th and have cells collected soon after. I really need her to not have Hepatitis or any one of the many other "hidden infections" that are possible.

Well, I'm off to Day 2 of R-ICE #3. Another fun morning at the Chemo Country Club!

Thanks for all your good wishes and prayers. They are working.

Rick

Monday, August 13th

I saw Dr. Doty Saturday night at his home. He and Cathy were hosting our Sunday School class kickoff party. We watched the movie "Inherit the Wind" for discussion the next morning.

He said he and LeMaistre agreed we may do as many as 4 more R-ICE chemos here in Austin (for a total of 6) before starting stem cell transplant (SCT) in San Antonio. He said the goal of SCT was to "step on the last cockroach." Consequently, we will "kill as many as we can here - as long as the bug spray we are using is working and as long as the bug spray we are using doesn't kill me, too." Dr. Doty has certainly mastered the art of communication!

I have a PET scan tomorrow. Next Monday we see Dr. LeMaistre and then spend the rest of the day with his staff. I think that will be SCT Class. Next Tuesday we see Dr. Doty (to discuss PET scan results) before starting chemo #3. I will post new info by Wednesday of next week.

RICK

at my desk 08/09/07

Well, I finally clipped off the few remaining stubborn hairs. You can officially call me "Slick" again. It is amazing how much cooler it is in an air conditioned room without hair. Perhaps we should require everyone to shave their heads in the summertime so we can turn the a/c up and save the world from global warming?

news as of 08/07/07

Well, the good news is that the chemo is working. Lymph nodes are clearly smaller and blood flow has returned to the right arm. I can grip the club and I can finish the swing; I just can't remember where the ball went!

Chemo side-effects are cumulative, so I am feeling it more as we progress through the series. The most prominent side effects are fatigue (like jet lag) and a weak, raspy voice. But no nausea so far.

The doctors want to take advantage of this so we are scheduling 2 to 4 more rounds of R-ICE here in Austin. Since those are 3 weeks apart I may not start transplant until early November now.

Thanks to all of you for caring enough to check in on me. I sincerely appreciate each and every one of you.

Rick

R-ICE round 2 at The Chemo Country Club

R-ICE is a a combination of Rituxan, Ifosfamide, Carboplatin, and Etoposide with a little Diphenhydram and Mensa thrown in for good measure. Strong side-effects were predicted but, so far, mine have been mild. I've had some indigestion/heartburn/hiccups/reflux but no nausea. The reflux weakens my voice some and causes me to sound a little hoarse, but you'll be happy to know (or not!)that I can still talk. As of yesterday my hair is falling out again so I'll answer to "Slick" again soon.

These treatments come in threes - 3 days in a row, 3 weeks apart, so I will be at the Chemo Country Club again today and tomorrow (about 3 to 4 hours each day). The first day (yesterday) they give me the Rituxan so they add Benedryl, which makes me loopy. The first day takes 7 to 8 hours - a long day.

The first day I miss a lot of calls because I sleep a lot (Benedryl), but days 2 and 3 I have my cell phone and use it and I'm back in the office in the afternoon. The first couple of weeks of stem cell transfer calls may be more challenging, but I will have a computer and email, and I will return calls as quickly as I can, and I will be checking with the office several times a day. Please send business email to the Retirement Counselors site as Norma will be checking that too. Or better yet, CC: Norma@RetirementCounselors.net

The game plan is to achieve as much remission as possible with R-ICE (administered in Austin at SWRCC - the Chemo Country Club). This stuff is working well so we are considering a couple of extra rounds before stem cell transplant. The decision will probably be made August 21st. That means transferring to San Antonio to start stem cell transplant will be anywhere between August 27th and October 1st. We will be in San Antonio for about 2 months, but most of that time is just to keep me close to their hospital (Methodist) in case I experience "Graft vs. Host Disease" or "GVHD" which is really my body rejecting my donor's cells. Very understandable considering that my sister is my donor. Man, is she going to be hard to live with after this!

Enough for now. I'll post again in a few days.

Thanks to all of you for your prayers and good wishes. They sustain me and the prayers are being answered every day.

RICK