Monday, December 29, 2008

Back at work

Steve felt well enough this morning to go to work! He's working a few hours in the office today and hopes to repeat that Tuesday and Wednesday this week.

He hasn't had a fever in a couple of days. He's had no adverse reactions to the antibiotics. His left side is still sluggish, but he's able to walk and move his left arm. He felt well enough to attend Sunday school and church yesterday -- the first time in more than a month.

We both are comfortable with the PICC line/antibiotic process -- it's become routine. Every morning and every night, I clean the line with saline solution (salt water, as Katie calls it) and attach the bag of Vancomycin (the good buggies that are chasing away the bad buggies, as Katie says). About two hours later, I remove the bag and flush the line with more saline and then Heparin.

The home health RN was here Friday to apply a new dressing around the PICC line. She'll return to do it again Thursday.

On Friday, Steve will return to the UT-SW cancer center to receive the next dose of Avastin and CPT-11, two weeks and a day behind schedule. We're both eager to get back on track.

Sunday, December 28, 2008

Tales from the week, Part 2

Before Thanksgiving, Sarah and John helped me wrap all the gifts I had already purchased.

I never did get to the rest of the gifts, the ones I bought after Thanksgiving. Liz and Holly came to the rescue.

On Monday night, Liz came to the house and helped me sort presents. She took them all, plus some supplies, and wrapped them the next day at her house (before she even wrapped her own family's gifts). Then she handed them off to Holly, who spruced them up with beautiful ribbons and bows.

Holly delivered them all to our house on Christmas Eve, putting them under the tree before we came home.

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The only family member who was slighted was Margie. Poor dog. I usually shop for pets at the last minute, and this year I ran out of last minutes.

Stephen and Leslie had been offering to do anything, so I asked them to be Santa for Margie. They delivered more toys than could fit in her stocking! Cooper was especially excited that Santa had been so generous.

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How many grande Starbucks drinks are too many in one day?

Apparently I can handle at least three! One day this week, I bought one on my way into the hospital. Sharon delivered another in the early afternoon. Then Betty and Uncle Jim brought another as a sweet surprise in the late afternoon.

I drank all three and was still able to sleep that night. I don't expect to re-create the experiment any time soon.

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Yesterday we received a beautiful hand-written card from the Littles, friends from church and Sunday school who moved two years ago. They included an incredibly generous and most unexpected gift.

Steve and I were both weepy. Cooper wanted to know why, and we told him.

"I think I know why they sent it, Daddy," Cooper said. "It's for your health care." (This coming from our sweet boy who until the past few weeks didn't even want to acknowledge aloud that Steve has been ill.)

He ran off and returned a few minutes later with a sign that he created: God Bless Steve.

Then he stood on our bed and taped the sign above our headboard.


Saturday, December 27, 2008

Tales from the week: Part 1

On Steve's last night in the hospital, James and Kris treated us to a romantic evening -- as romantic as possible in sad little room 364.

James delivered Italian food and dessert. If you know Kris, you know that a meal wasn't enough. She loves to entertain and decorate and express her love in creative ways.

Kris also sent him with a basket of goodies: Christmas napkins, napkin rings and tablecloth to transform the standard-issue hospital food tray, flameless candle (she wanted James to sneak in a real candle, but he didn't want to get kicked out), funny movies.


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On Christmas Eve, Steve sat in the dining room as I removed tubing from his first dose of at-home antibiotics. Katie sidled up next to him and gave him a hug.

"Daddy, I missed you," she said. "I'm happy you're home."

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The week that Steve was in the hospital was crazy at home. The kids and I often weren't home, and when we were, we dashed in and out. We're not the neatest family under the best circumstances; in times of chaos, we are even messier.

I managed to wash and dry clothes but had little time to fold and put away laundry. Sometimes I loaded the dishwasher. I never made the kids' beds. My usual piles of paper started to topple. Throw in extra Christmas goodies and cards and end-of-semester schoolwork, and it was just a disaster.

Meghan, Julie and Allison intervened. When Meghan was here taking care of Margie, she took care of laundry and clutter.

The night before we came home, Julie and Allison spent much of the evening here, going from room to room to tidy. They are both busy moms who work full time outside their homes; they both spent precious time two days from Christmas to make sure our home looked especially cozy when we returned.

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Uncle Jim spent much of his vacation taking care of his niece and nephew. He picked them up from Aunt Mel and Uncle Greg's house in Anna on Monday and brought them to Frisco. He managed to prepare dinner, clean up after a Katie accident, take care of Margie, run errands, fill my car with gas and more, all in one night.

He continued to help Tuesday and Wednesday, when the kids moved in with Jim and Betty. The three of them juggled Christmas preparations while keeping Cooper and Katie well entertained, well fed and well loved.

Thursday, December 25, 2008

Merry Christmas!

We are incredibly thankful that Steve was released from the hospital in time for Christmas Eve and Christmas Day at home with family.

We were dangerously close to spending another five days at St. Paul.

Apparently there was no way that he would be allowed to be released without the supervision of a home health agency, despite the solution the case manager and I settled on (me administering drugs on my own). We would have been there until Monday.

The case manager finally found an agency that was able to offer a nurse. My little impassioned speech apparently had moved the case manager, who in turn softened the heart of an agency's director, who in turn convinced one of her registered nurses to add an extra stop to her already-busy Christmas Eve schedule. (Either that or Dr. M raised her voice loud enough to move the case manager.)

About an hour after we arrived home Wednesday, a courier company dropped of a big bag of drugs and supplies.

A couple of hours later, our home health RN appeared. We reviewed policies, signed paperwork and then received infusion instructions.

The at-home process is much simpler than the hospital process. The antibiotic is premixed and in a fancy little bag that pushes out the drug without the use of an infusion pump. It doesn't even rely on gravity; Steve can just carry the plastic ball of Vancomycin in his pocket while it's connected to his PICC line.

My biggest challenge right now is releasing bubbles from the syringes of saline and Heparin. I hold the syringe up and push the plunger to push out the bubbles. So far, I push a little too far every time, and shoot clear liquid straight up to the ceiling. If I don't move out of the way, the liquid drips back down on my head a few minutes later.

Our friend and neighbor Tisa, who is a home health nurse manager for another company (that doesn't contract with our insurance), is my backup. She was here for the first training session, for the first time I removed the tubing, and again at 6:30 a.m. today to supervise Steve's morning infusion. We are comforted knowing we can call at any time for help if necessary.

Steve continues to express how blessed he is to be home. He's tired and running a slight fever (not high enough to report yet), but he's still happier this Christmas than any other.

Some of you may have already read a column I wrote for Briefing last week. I want to include it here today, as a reminder of everyday miracles on this very special day.

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Miracle's size has little to do with its impact

How do you define a miracle?

Do you need a big production – oil that lasts longer than logically possible, burning bush not consumed, thousands fed with just a handful of fish and two loaves of bread?

Or do you see little signs of a higher power and count them as miracles?

For a year, I have been praying for a big miracle: that my husband Steve be cured of brain cancer, that every last one of the tumor cells die and that there be no recurrence.

It's a bold request.

I have also been collecting miracle stories: the aunt who should have died of a brain aneurysm but still hasn't; the child whose cancer is inexplicably in remission; the mom who was given six months to live but is active a decade later.

As we wait for Steve's big miracle, I am working on being mindful of the less flashy miracles.

Our minister spoke of them this week, quoting the United Methodist belief: "The gift of miracles does not focus on the extraordinary, but sees the miraculous in the mundane and normal. Living in the spirit of the miraculous, people see God in nature, in relationships, in kind acts, and in the power of love."

Just after Thanksgiving, we learned that Steve's tumor, which had been dormant for a few months, had started growing again. That diagnosis required a quick response; within 48 hours he started a new chemotherapy regimen.

As we sat together in the infusion room and I watched clear liquids drip into a port in Steve's chest, I marveled that such a small quantity of fluid contained the power to extend his life. And as days passed and we watched for adverse reactions that never came and instead saw rapid improvement of his motor skills, I was incredibly thankful.

Surely there were miracles involved in that process – in the research that allowed the drugs to be developed, in his weak body's ability to not only endure the toxins but also triumph with increased strength and mobility.

The improvements came just in time.

We were able to attend the Neiman Marcus Adolphus Children's parade as a family, cementing a tradition started last year.

And on Sunday, Steve was able to watch friends, family members and even some strangers cross the Dallas White Rock Marathon finish line in his honor.

It was a beautiful day. He was surrounded by overlapping circles of loved ones, all wearing identical bright yellow shirts. He watched with pride as people performed athletic tasks that were once easy for him but are now impossible.

He smiled so big and so often that his face hurt.

Surely there were miracles involved in that day – in gathering that many people from across the state safely, in the training that each runner endured, in the ideal conditions and logistics that allowed Steve to navigate Victory Park and comfortably sit outside in mid-December.

Early that evening, we walked outside our front door to a crowd of about 50 friends singing Christmas carols for our family. It was the perfect end to a perfect weekend.

Later that night, Steve, who has an inoperable brain tumor and has battled courageously for 12 grueling months, declared the day "miraculous" and himself "the luckiest man on Earth."

It's not the big, bold miracle I pray for all day, every day.

It is the best miracle I've never asked for.

Tyra Damm is a Briefing columnist. E-mail her at tyradamm@gmail.com.

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Merry Christmas, dear friends!

Wednesday, December 24, 2008

Home!

After a long week, Steve is home.

Merry Christmas!

PICC line in

Steve has returned to the room from the PICC line placement. It was successfully placed in his upper right arm. A huge step toward going home!

I administered the two last doses of IV antibiotics. It's not difficult, but there are many steps to remember -- reconstituting the drug, clamping, unclamping, releasing air, plugging, etc. Yesterday's RN assured us that I won't be able to do anything to hurt Steve, and I know there are a few of you out there I can call on for help or advice.

We had a moment of concern last night/early this morning. The drug schedule has stretched over the week. He was receiving doses every six hours, then every eight. Last night they changed it to every 12 hours -- more medicine, less frequently. That meant we needed to wake at 1 a.m. to give the drugs and 3 a.m. to remove the IV.

One of the rounding doctors this morning says we can be flexible with the times, so we're not stuck with 1 a.m. and 1 p.m. for the next two weeks. We'll choose a time that's more compatible with our need to sleep when Cooper and Katie sleep.

Today's RN seems to be on a mission to get Steve out of here before noon. We're waiting on the case manager to stop by with more information on equipment and drugs for home.

We hope you all are enjoying Christmas Eve!

Tuesday, December 23, 2008

Avoiding a glitch

I've had a bit of an unsettled feeling about Steve leaving on Christmas Eve. The processes are so slow here, and it's Christmas week, and there have been enough glitches already that we have faultering confidence in the system (and how all the little systems work together).

About 1:30 p.m. today a case manager stopped by the room to get the home health process started.

Started? Really? We've known since Friday that he would require help at home receiving IV antibiotics.

The case manager didn't exude confidence that everything would be in place by tomorrow. She also said she was leaving early today. Around 3ish.

My unsettled feeling heightened.

About an hour later I stopped by her desk to inquire about progress. She seemed less certain that Steve would have home health in place on Christmas Eve. It's been difficult to get staffing this week, as many home health nurses are on vacation.

My impassioned speech in reply was something like this:
"I can't think of anything more important than getting him home in time for Christmas. He was hospitalized last year on Christmas, in the middle of his cancer diagnosis. We have a 3-year-old and 7-year-old at home who desperately want to see their daddy. Steve's morale will be devastated if he has to stay in the hospital because there isn't enough staffing to administer IV drugs."

(I didn't tell her that last night, as Cooper was falling asleep, he asked me to pray aloud that Daddy be home for Christmas. And that he's been assuring Margie the dog that Daddy would be home for Christmas. And that Katie tells me every day that she's sad that Daddy is in the hospital.)

Then we started working on other solutions. Perhaps the nursing staff here could teach me how to administer the drugs. (As a bonus, there are no needles required!)

I returned to the room and then today's RN arrived. She's going to let me give him the next dose of antibiotic in the room, under her supervision. I'm going to ask to do it every time so that I'm comfortable (and Steve, too!) with the process.

I'm supposed to follow the SASH method: saline, antibiotic, saline, heparin. (Today's process will be a little different than tomorrow -- today he has a short IV line, tomorrow he'll have the PICC line.)

We're starting to feel a little better about a Christmas Eve solution. The nurse is going to start inquiring about the necessary equipment and pharmacy's role. I'll continue to be assertive until we're certain.

Steve looks good today. Yesterday he started walking around the third floor. Today he made two laps and even ventured into the gift shop. He's wobbly, but his left knee isn't locking as it has in the past. He's eating really well, thanks to many welcome deliveries of meals and treats. He's still running a huge sleep deficit, but we'll take care of that when he gets home.

He continues to show no sign of active infection. His temperature is back to his "normal" 97. His cough and wheezing are completely resolved.

As always, we're gaining strength from your prayers and ours, your faith and ours, your love and ours.

We're also enormously thankful for help in the past 24 hours, during this especially busy season:
Jim and Betty: meals, caring for Cooper and Katie, arrangements and rearrangements for Christmas celebrations
Uncle Jim: caring for Cooper and Katie, handling the ensuing chaos (fun chaos, but still) and helping around the house
Mel and Greg: caring for Cooper and Katie
Mary MT: meals and Christmas treats
Sharon: afternoon Starbucks and snacks
Andy and Julie: gift hiding, heroic package delivery and problem solving
Liz and Holly: gift wrapping
Allison: grocery shopping, card addressing
Pastor Andy: visit
Geneva: dinner and gift delivery
Meghan: caring for Margie and the house

Monday, December 22, 2008

An extended stay

The good news:
Steve's chest port was successfully removed in his room.

The less-than-good news:
He'll be at St. Paul until Wednesday. (At least it's Christmas Eve and not Christmas Day!)

The same doctor who placed the port in his chest two weeks ago arrived in his room to remove it. I tried to stay in the room for moral support, but as soon as I saw the needles come out, I had to leave. (I am not good with needles or stitches or blood.) Betty was here, though, and held his hand during the entire procedure. He didn't feel a thing after the Lidocaine shot, which numbed the site.

Just before the removal, Dr. M called the room to visit with me.

She is reluctant to have a new line of any kind placed right now, for fear that the bacteria would just latch on and start reproducing again.

Instead, he'll receive the antibiotic through regular IVs the rest of today and all day tomorrow. (This is no easy task for Steve, whose veins were already bad pre-cancer but are just ravaged after a year of chemotherapy, steroids and other chemicals. As I'm typing, his nurse is trying her best for a good stick. It's not happening so far. The charge nurse is going to be called in next.)

By Wednesday morning, he should be OK to receive a PICC line. And then he'll be able to go home and continue receiving the bacteria-fighting drugs with the help of home health care.

Steve is handling the news well, though he would much rather be packing for home right now than settling in for two more nights.

Today's plan

After much discussion and waiting, we have a new plan for Steve.

It couldn't come any sooner, as Steve has been "NPO" since midnight -- he couldn't eat or drink anything except his necessary medication. With the new plan, he's been given permission to eat and drink.

In about an hour, a doctor will come to the room to remove the port from the right side of his chest. From what we understand, a procedure room isn't available. Everyone keeps reassuring me that the environment will be sterile.

Later today, another team will whisk him away for a PICC line insertion. PICC stands for peripherally inserted central catheter. It will be placed in his arm and provide access for IV drugs for now.

Dr. M was not comfortable with the hematology plan to insert a new port today, for fear of re-infection. We haven't actually seen her yet today but have corresponded via e-mail. She'll stop by sometime this afternoon so we can discuss the PICC line and future port placement.

There is a chance that if everything goes smoothly, he'll get to go home today. We're both thinking tomorrow is more likely but would love to be surprised!

Sunday, December 21, 2008

MRSA

It's official. Steve's current condition has been caused by methicillin-resistant Staphylococcus aureus, otherwise known as MRSA.

MRSA is possibly the meanest form of staph. Most antibiotics are powerless in its path.

The antibiotic Vancomycin, which he has been taking via IV since Thursday, is often effective in fighting MRSA. He'll continue receiving that drug.

There are some precautions in place for visitors. The hospital recommends that anyone who touches Steve wear a mask, robe and gloves. That seems to be more for the visitor's protection than the other way around. The nurse says that as long as you don't hug all over him, you should be safe. I know that he's irresistible, but we'll have to restrain ourselves for now!

The current plan is to remove the port from the right side of his chest then have a new port placed on the left side of his chest.

The staff here is working on getting him on the surgery schedule for Monday. There is a slight chance he could go home Monday; Tuesday seems more likely.

After he gets home, a home health care service will be responsible for administering the antibiotics through the newly placed port.

Steve is just wiped out. He's not sleeping well here (though right now he is taking a little nap) -- but that's almost always the case in hospitals.

The kids and I arrived home last night to find that Julie had worked her magic -- folding laundry, cleaning dishes, making beds, straightening piles. She and Meghan are in charge of Margie (the dog) while we're gone.

Uncle Jim kept Steve company this morning (and Jackie and the Earwoods dropped by) while Cooper, Katie and I were at church for the last Sunday in Advent.

Katie and fellow preschool singers were adorable during the prelude. Cooper and I had a front-row seat for the singing and wiggling.

They are now with Aunt Mel, Uncle Greg, Brooke and Molli for a cousins sleepover.

I'm staying the night at St. Paul so that I don't miss rounds in the morning or Steve's surgery.

We appreciate your continued prayers.

Saturday, December 20, 2008

Saturday

Steve is still at St. Paul and may be here until Monday.

A couple of medical teams have visited -- hematology/oncology and infectious disease. We are continually reminded that medicine is a science with some wiggle room. One team focuses on one problem, set of data, expected outcomes. The next team focuses on another. They may communicate with one another, but sometimes that's not obvious to the patient.

Here's what we think we know:
1. The bacteria is a form of staph, based on what the infectious disease attending, Dr. S, said. We don't know specifically which strain of staph.
2. A blood sample taken yesterday did not show signs of bacteria. I don't think this means it's gone altogether, but it's still good news.
3. Infectious disease recommends that Steve's chest port be removed. (Dr. S says that there's no way to sterilize the plastic once it's in. He could be on antibiotics for three months to keep the staph away, but as soon as he stops the antibiotics, the staph would return.)
4. Another chest port could be placed. Or a PICC line, a semi-permanent IV line, could be placed in his arm.
5. He'll most likely stay at St. Paul until Monday.

Steve's spirits are good. He's eating really well and enjoying short visits and silly movies.

Will visited for a few hours last night, bearing ice cream and the movie Stepbrothers.

Cooper, Katie and I arrived this morning. The kids have handled the past few days well, but they were obviously missing their sweet Daddy. They had bed rides, pushing all the buttons for maximum fun; watched Enchanted in bed; ate ice cream and drank chocolate milk raided from the refreshment pantry; and walked around the campus with our friend Stuart and his daughter, Hannah.

Jim and Betty picked them up for lunch and an afternoon of Grandma and Papa time.

We took advantage of the quiet time; Steve and I rested and napped off and on. Sharon brought lunch and treats and brightened the room.

I'm headed north soon. The kids and I will sleep at home, and Katie will sing with fellow preschoolers at church in the morning.

We have a long prayer list. We want Steve to recover quickly and completely from this latest episode. We also want him home and healthy for Christmas this year. It's hard to forget that last year we spent most of Christmas Day in the emergency room and then a hospital room.

We are confident, though, that no matter where he is, we will fully experience the spirit and joy of Christmas.

Reunited


Friday, December 19, 2008

Bacteria

Yesterday's blood work revealed bacteria as the culprit behind Steve's illness.

Two samples were drawn -- directly from the new port in his chest and from his arm. Both samples showed bacteria. The working theory is that it's the port's fault. Perhaps a tiny bit of bacteria was pushed into the port during infusion or a blood draw, and then the cell just started doing what cells do -- multiplying.

Damm port. (Ha! Damm humor just never gets old.)

It will take more lab work and more time to determine the exact strain of bacteria. We do know that it's gram-positive cocci (it showed up blue under the microscope and it's round). That alone tells the doctors which antibiotic he should continue to take for now. Yesterday he was receiving two different umbrella antibiotics; now he's receiving just one.

When lab results show which bacteria it is, doctors will know precisely which antibiotic to give him.

He will require two weeks of IV antibiotics. Thank goodness that doesn't mean he'll be here for two weeks.

Steve will be here until at least Saturday, maybe until Sunday. While he's here, the staff will be arranging for home health care so that he can receive the IV drugs at home.

Dr. G, the attending oncologist/hematologist, recommends that Steve not resume chemotherapy treatment until the end of the two-week treatment.

He explained that there are few things as scary as a brain tumor. But in the short term, bacteria in the blood is scarier.

Steve is feeling so much better than yesterday. He is sitting up without assistance, able to walk slowly, eating huge portions, laughing, asking questions, charming the nurses.

Jim reports that he slept well on the cot. After Betty arrived, he left to get ready for a meeting. Then Katie and I arrived. Katie cuddled with her Daddy for a while, and then we went on a little adventure.

Both she and Cooper were born on the fifth floor here. Katie loves babies, so I took her to labor and delivery to find some newborns. We saw four tiny babies -- three sleeping, one screaming. Then we visited with the nurses. Katie twirled in her Christmas dress and talked about being 3.

Betty took Katie back to her house, and I've been with Steve ever since.

Just before Layne arrived with pizza for lunch, a technician arrived for an in-room echocardiogram. She spent about 30 minutes capturing images of his heart and supporting systems. It was fascinating lunch entertainment.

Today is Cooper's last day of school before the new year; it's also his winter party. After the unsettled week at home, I didn't want him "alone" at the party. Uncle Greg left work early today to be his adult, plus Holly left her own boys' parties to check in and take photos.

Cooper, with Uncle Greg in back


Recap:

1. Bacteria caused Steve's sudden illness.
2. More lab time is needed to identify the exact strain.
3. With that information, the best antibiotic will be given.
4. Steve will stay at St. Paul tonight and maybe longer.
5. He'll require two weeks of IV antibiotics at home.

Thursday, December 18, 2008

Divided Damms

After Steve was delivered to his room, my frustration level peaked. There were no orders upon his arrival -- no instructions for the nursing staff, no permission to access his port, no orders for the IV antibiotics, no clue about when a CT scan of his chest would be scheduled, not even permission to administer Tylenol.

Plus, his temperature was 102.

His RN did the best she could with limited instructions. I wandered the floor, asking questions, then paged and spoke with Dr. M about the lack of a plan.

I had to leave before anything could be resolved, and I was not comfortable. Steve was in good hands, though -- Mary M.T. was left in charge as I drove north to pick up Katie and eventually Cooper.

Mary called about an hour after I had left to report progress. He had received drugs and was on his way to imaging for the chest scan. (They're looking for something that an X-ray might have missed.)

Betty then arrived to relieve Mary. Then Sharon arrived with dinner for Steve and Betty. (We love many aspects of St. Paul but know from experience that the food there is awful. Really inedible.)

After Sharon left the hospital, she called to tell me that Steve was in great spirits -- he was cheerful, completely lucid and able to move his left arm. Oh, what a difference 12 hours, rest and IV antibiotics make!

I am home with the kids, who are asleep after their exciting day. (Katie sang in her preschool program and celebrated Christmas with her class. Cooper spent the early morning with friends and the whole afternoon at the Bassen home.) Steve is in his hospital room. Betty will be with him until Jim can arrive (after an evening board meeting). Jim will spend the night -- and sleep, we hope -- on a sad little cot.

Big thanks to Frisco paramedics, Layne, Liz, Holly, Bob, Andy, Zita, Julie, Pastor Andy, Mary M.T., Aimee, Carol, Angie, Kevin, Sharon and Melissa S. for help today.

We look forward to some answers (or at least eliminated culprits) tomorrow and to Steve's continued progress.

In a room

Steve has been moved to a tiny room on the third floor. The view is dreary -- rooftops and parking lots. We look forward to his healthy release soon!

Because of the size of the room, Steve's exhaustion and uncertainty about what ails him, we'll need to limit hospital visits. Please e-mail me (tyradamm(at)gmail.com) or call my cell if you'd like to arrange a visit.

Thank you!

ER background and update

Steve felt more tired than usual yesterday. His left side started weakening. He napped longer than usual after work.

Before bed he had a fever of 100.2, which is equivalent to about 102 (the steroids he takes masks a fever).

We called Dr. M, who advised him to take Tylenol and wait to be examined until morning. (He was scheduled for his second dose of chemotherapy at 9 a.m. today.)

He slept poorly and continued to lose control of his left arm. At 5 a.m., his fever was 103 -- the equivalent of 105.

We talked with Dr. M again, who advised us to call an ambulance so he could be seen immediately.

We were able to request transport to St. Paul -- a huge victory. The nearest major hospital is Plano Presbyterian, which is a fine hospital but not part of the UT-SW system. We wanted him here so that records would be available and so that we would be able to see Dr. M and her team.

The kids were still sleeping when the ambulance and fire truck arrived. We are thankful that they didn't have to see the bright lights, which looked frightening in the foggy dark sky.

I called Steve's parents and asked them to be at St. Paul to meet him. Layne came over to help me with the kids, who woke earlier than usual. Layne took Cooper to his house and then to the Bassen house, and he arrived at school in plenty of time and with good spirits, sources say.

I took Katie to Andy and Zita's. Zita cared for her and dressed her for the Christmas program and party at preschool.

Andy drove with me in the dark fog, and we arrived at St. Paul in time to relieve Jim and Betty, who attended Katie's program.

Steve has been in an uncomfortable ER bed since he arrived -- the bed is much too short for his 6-foot-1-inch frame.

The staff took a chest X-ray, which came back clear. They took blood samples; results will take 24 hours.

His temperature is lower, though it has fluctuated and he is experiencing chills right now.

The problem could be an infection at the port site in his chest. The skin isn't swollen, red, warm or painful, though. He could have a random virus.

We are waiting for a room to open upstairs. He'll be officially admitted then and will stay at least overnight.

There is no possibility that he'll receive his chemo treatment today. There is a slight chance he'll receive it Friday. Saturday and Sunday aren't options (the oncology clinic is closed). We desperately pray that he'll receive it by Monday. We're not comfortable waiting, giving the tumor room to grow, but we also understand the importance of waiting until his body can better handle the powerful drugs.

He is so tired and so weak. Some of that may be because he didn't take his normal morning medications until 1 p.m. -- the steroids, Diamox and Provigil are essential.

He napped some this morning and appears to be sleeping right now.

Recap:
1. Steve's high fever required quick attention.
2. Blood test results should give us a better idea of the source of the infection.
3. He will spend at least tonight at St. Paul.

Of course, we welcome your prayers for his health and strength and for wisdom for the medical team.

ER

We are at the St. Paul ER. Steve had a rough night and woke up at 5 with a 103-degree fever and significant left-side weakness. Dr. M wanted him seen right away, so an ambulance picked him up.



More details soon.

Wednesday, December 17, 2008

Music for the soul

So, how do you make an awesome day even better? You add carolers, of course!

After we watched the final See Spot Run team member cross the finish line, Steve and I received and gave more hugs and then headed north for lunch and home.

Jim and Betty took Cooper and Katie back to their house, so we had a few hours of quiet time to rest and recover.



Liz and Kris (pictured above) had asked that the whole family be home by 5 p.m. for a surprise. And I was told to not be in my pajamas already!

Jim, Betty and Uncle Jim brought the kids home just in time for a great treat -- almost 50 friends gathered on our front lawn to serenade us with Christmas carols.



The group represented so many of the members of our beloved community -- family, friends from Bledsoe Elementary, neighbors, Jim and Betty's friends (who have known Steve since he was a teen and have some great stories to share). Some of them had already devoted hours for our family that weekend -- at the pre-race dinner and the race itself.


We sat on the front walkway and enjoyed the sweet gift of their time and talents. Our spirits were already soaring from the weekend. The carols just pushed us even higher.


They sang:
Deck the Halls
Angels We Have Heard on High
Away in a Manger
The First Noel
Frosty the Snowman
Jingle Bells
Rudolph the Red-Nosed Reindeer
Santa Claus is Coming to Town
Silent Night
Joy to the World
Oh Holy Night
We Wish You a Merry Christmas

As soon as the last note ended, Cooper bolted from his spot next to us to say hello to his teacher, Aimee Sanchez (pictured above). He was over-the-top excited that she visited his house.

We are blessed to be a part of the Bledsoe family and incredibly thankful for the teachers and staff members who continue to take special care of our family. We are touched that so many families devoted time on a Sunday to wish us a merry Christmas. We are in awe of folks like Liz, Kris and Holly, who take great care of their own families and still make time to take care of us.

We're just a week from Christmas, and some of you may be stressed. Maybe you think you have more gifts to buy. Perhaps instead of spending money, you could give the loved ones on your list your time. You could sing for them, or cook for them, or set aside an afternoon to visit.

Late Sunday night, Steve declared himself "the luckiest man on earth."

He didn't receive any material gift that prompted that bold statement. He received an outpouring of love that overwhelmed him in the best possible way.

Monday, December 15, 2008

Radiant


Steve with Katie, Sharon, Clay, Melane and Molli

Steve was absolutely radiant yesterday. The See Spot Run runners and huge support team lifted his spirits beyond anything I could have imagined. Last night he declared himself the luckiest man in the world.
More than one person has reminded me lately that as we are praying for the "big miracle" -- the cure for Steve's cancer -- we can't ignore the other miracles. At a church meeting tonight, Pastor Andy talked about miracles as signs of God that we notice in everyday life.

Sunday was definitely a day of miracles.
Steve was surrounded by love and peace and joy. His energy was infectious.

The weather was warmer and windier than I think most of us runners wanted. (I am thankful that we ran before the bitter cold blew through Dallas late Sunday.) And I think the thousands of White Rock spectators appreciated the pleasant conditions.

Steve, Allison and I stayed at the W Hotel the night before, thanks to Liz's early reservation. We were able to sleep relatively late and take our time getting ready -- we just took the elevator downstairs and walked outside to the starting area.

As the runners sectioned off into three starting corrals (based on expected running time), Liz and Holly took charge of Steve, helping him find a good spot to watch the start.
Liz and Holly
Then we were off!

Veteran Rock runner Steve had told Allison and me about the handbell choir we'd encounter on the first mile. And there they were, a reward at the top of a daunting Ross Avenue hill. I loved seeing and hearing the choir, knowing how much Steve enjoyed the music when he ran.

The next great treat was Sarah Wilke and Nancy Kruh cheering us on in Uptown. Not long after, we ran across the Domen family (Jeff and three adorable children), showing support for their Melanie and the See Spot Run team.

Melanie, Allison and I ran together for the first six miles. Melanie was the first leg of one of the relay teams, which switched at mile 6. About that time we spied most of the Smith family (Layne and three beautiful children), taking photos and giving high fives.

Allison and I kept running. As we ran along one side of Matilda, we saw Sally, then Stuart, then Jim, run back the other side. They were all ahead of us, and they all looked strong.

Just after we crossed Central Expressway for the second time and we started running south, the wind and accompanying dirt hit us hard. We trudged along.

The Katy Trail offered more surprises. The Brown family (Kris, James and their three gorgeous girls) plus the Domens again were there to boost our spirits. As soon as they saw us coming, they started hollering, and they didn't stop until we were out of earshot.

With about a mile to go, I was really dragging. I knew we would finish, but my legs and feet were unhappy.

Then we saw Will, not too far from the end of the Katy Trail. He told us that we were almost there, that the rest of the run was downhill, and that there was a big crowd of yellow waiting.

What an awesome sight! Liz, Holly and Melane had scoped out a great watching post and planted a camp chair for Steve. He was surrounded by Cooper and Katie (chaperoned by Grandma and Papa), a great crowd of more family, friends and runners who'd already finished. Over the fence I handed sweet Steve my finisher's medal.

He exuded joy.

Just after Allison and I finished

After lots of congratulatory hugs and kisses, we headed to the other side of the American Airlines Center to watch the full marathon runners cross.

Mark crossed with great speed and a huge smile. The See Spot Run relay team gathered to cross the finish line together. Then the See Spot Run 2 team finished strong.

Steve with See Spot Run: Randy, Andy (with son Jared), Paul, Chris and Melanie

Lisa (of See Spot Run 2) and Steve


Steve was exhausted, but he was drawing strength from "his" runners. He positively glowed, reflecting the love that was surrounding him.


And the day got even better. Check back soon for details on our surprise carolers!

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Photos

For more photos, taken by Melane, Steve, Layne and me, click here.

John

Greg


Steve and Melane


Sharon


Steve and Stuart

Uncle Jim


Tyra and Allison

Brooke, Katie and Molli


Jim, Betty, Uncle Jim, Cooper and Katie

Cooper and Will

Mark


Cooper, Katie and Sally


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Results

For results, click on each name:
Greg Woodbury
Sharon Grigsby
John Wise
Sally Sims
Stuart Cutright
Jim Damm
Allison Earwood
Tyra Damm (Allison and I actually finished four minutes faster than expected!)
Mark Tittle
See Spot Run relay team (Melanie Domen, Randy Lasley, Paul Duddleston, Andy Lewis, Chris Werner)
See Spot Run 2 relay team (Lisa Cutright, Kelly Huffman, James Demasi, Jackie Trey Harrison, Jason Lee)

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Thank you to ...
* All the See Spot Run runners and their families and friends who supported them during training
* Liz, captain of the team, organizer extraordinaire and supreme motivator
* Jim and Betty
* Jim and Betty's awesome gang of friends
* Elaine Dunn
* Layne
* Holly Bassen
* Melane
* Kris Brown
* Sally
* Allison
* Richie Whitt
* Everyone who bought a shirt in support of Steve (Melissa, Norm and Roy: I'll mail yours this week!)
* Folks who sent good luck notes
* Everyone who prayed for us
* And to Steve, our inspiration. Out Damm Spot!

Pre-race photos

Jim & Betty's friend Leonard was the official Damm photographer Saturday night. Click here to get a feel for the great fellowship the night before the big race.

Sunday, December 14, 2008

We rocked the Rock

Allison, Tyra and Melanie at about mile 6

I will post a more complete account later. For now, know that all runners crossed the finish line and there were many cheerleaders along the way. Steve is worn out but happy. He called today "miraculous."

Saturday, December 13, 2008

Run for Steve runners

Steve's parents and brother hosted a lovely and lively pre-race dinner this afternoon. Many of the Run for Steve runners were there. Pictured above: Tyra, Steve, Sally S., Allison E., Randy L., Sharon G., Melanie D., Lisa C., Andy L., Paul D., Greg W., Stuart C., Jim D. and John W.


Mark T. was out driving the course and missed the group shot. I told him I'd "Photoshop" him in later. I overstated my skills. So here he is, on his own.


Here's another group shop, with many of our children added, plus Liz Smith (on the far left), the organizer extraordinaire and team captain of Run for Steve: See Spot Run.


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Updated with Mark!
As Layne often does, he swooped in and made things better. Here's the group photo, now with Mark.

Friday, December 12, 2008

'Lots of yellow people'

Katie and I walked Steve into work today. I wanted to help Steve carry his computer bag, and Katie wanted a piece of candy.

Katie was excited to see so many people dressed just like her -- in a See Spot Run T-shirt! As a show of support, staff members from the clinics where Steve works bought more than 50 shirts.

As we gathered for a group photo, Katie bounced up and down, chanting, "Lots of yellow people!"

Here we are with the Plano clinic staff. Thanks, PFC!

Thursday, December 11, 2008

Happy new year!

A year ago today an MRI showed a lesion in the pons of Steve's brain stem.

Many of you have been a part of our adventure ever since. Others have hopped aboard along the way. Every day, when I say prayers of thanks, I include you -- the folks who have prayed with us and for us, who have offered gifts, who have cared for us and our children.

Instead of retelling the pain of the last year, I asked Steve to share some of his favorite things. I first asked for a list of 10. Not enough, he said. I asked for 20. Still, not enough. Whatever it takes, I said!

His list isn't inclusive, and it's in no particular order:

Some of Steve's favorite things from the past year
Katie dancing
Cooper playing soccer
N999DM
Easter
Margie (Sweeters)
Taking Cooper to see Wicked in Chicago
Disneyland
Tyra
Birthdays
Autumn’s colors
The Wire
Love from friends old and new, neighbors, co-workers and strangers
Facebook
Lazy rivers
Books
Family
Chickens
Every new day
Bathing my kids
Electric blankets
Washing the dishes
Fleece
Parades
Our Christmas tree
Amazing doctors, nurses and staff
Baskin Robbins’ Peanut Butter 'n Chocolate Ice Cream
Superbad
My iPod
Run for Steve
Cracking myself up
The Nasher
Too many more blessings to possibly list here

Wednesday, December 10, 2008

Steve in the Dallas Observer

This week's Dallas Observer hit newsstands today. Inside you'll find a column by Richie Whitt about brave Steve and the Damm Spot.

In case you can't find a copy, you can read the column online. Click here.

Clean X-ray

Steve narrowly avoided a hospital stay today. His low pulse-oxygen level, shortness of breath, crackling, wheezing and cough worried Dr. M and the internal medicine doctor she brought along with her. Dr. M said they were prepared to admit him.

His chest X-ray came back clear, though. Woo hoo!

So instead of checking into a hospital room tonight, we are thrilled to be in our cozy home with our sweet babies. (And we came home to a delicious dinner, created by one of my high school friends rediscovered on Facebook. Thanks, Angela!)

The doctors think Steve has reactive airway disease -- perhaps a virus that's caught in his chest. Tonight he'll start breathing treatments, which require a nebulizer, to more quickly relieve his symptoms.

The Frisco medical supply store that carries nebulizers was closing as we were in traffic on the Tollway, so we thought he would have to wait until the morning. But then the Spears family came to the rescue! They're letting us borrow theirs for the night.

He'll also begin using an additional steroid.

Dr. M was, of course, relieved that Steve hasn't aspirated and that he shows no signs of pneumonia. And she was delighted to see how well Steve is walking and using his left arm. She wrapped us both in big hugs.

She says she doesn't like to overstate anything, but that she feels confident that the combination of Avastin and CPT-11 is killing cancer cells. Another miracle for Steve!

To be safe

Steve's cough has worsened the past two days. Coughing fits are waking him up at night, and then he's awake for a couple of hours. His pulse-oxygen level has dropped again, and there is wheezing in both lungs.

He's been taking an antibiotic for about a week, plus he's been on an anti-pneumonia drug since January. Still, we want to be sure he's completely OK.

We're headed to UT-SW for a chest X-ray and appointment with Dr. M.

With just two phone calls, I was able to get afternoon care for both Cooper and Katie lined up. Thanks, Betty and Cathy, for always making our lives easier!

Monday, December 8, 2008

Symptom update

It's hard to believe that we are just five days removed from Steve's treatment. His symptoms are so much improved. In fact, he felt well enough to work in the office for a few hours and again when he came home.

His left arm and hand are almost as responsive as his right arm and hand.

He's tired but closer to his "normal" exhaustion level.

His walk is much steadier. It's actually less stable today than yesterday, but it's still far better than Thursday.

His voice is weak, probably weaker than Thursday, but he's blaming part of that on his parade exuberance.

His cough, which was wheezy and slightly crackly this weekend, is better. After talking with Dr. M on the phone yesterday, he started using a rescue inhaler, which has helped.

Dr. M cautioned us that as the tumor cells die, they expand and release toxins. So, some of his symptoms could worsen again before they settle again to a manageable level.

We have so much to look forward to during the next few weeks -- Christmas parties, the marathon, special celebrations. And now we look forward to the next round of Avastin and CPT-11 on Dec. 18. Out Damm Spot!

Sunday, December 7, 2008

Guest blogger Liz: Cheer on Steve's team!

All,

One week from today, the See Spot Run Team will be hitting the streets of Dallas in honor of our dear friend Steve Damm!

For months the runners have been diligently training for their opportunity to support Steve. Now, it's time for the support crew to prepare.

We need to have as many supporters as possible lining the course, cheering on our team! As it stands now, we have about 16 people running the half, one running the whole, and two relay teams running the whole.

To make this as easy as possible, we'd like for supporters to spread out along the course. We suggest picking an aid station from the map at the link attached and email me with your preferred location so we can let the runners know to keep an eye out for you. When you look at the map, the aid stations are indicated by red dots. Those are the locations we'd like you to pick from. However, your support is much more important than your location so if you have a favorite spot or a place that's works better for you, by all means, show your support however and wherever you can.

The map is located at the following address: http://runtherock.com/race_info/pdfs/TheRockMap2008combined_CLIF.pdf

We don't want everyone bunched up at the beginning of the race so if you can find a station or location towards the end of the course, I'm sure the runners would appreciate it. Your encouragement is VERY important during the final miles!

All the runners vary in speed. Some run eight minute miles, some 12. Please keep that in mind as you choose your spot because that will give you some idea of when you should arrive and how long you might want to stay. You don't just have to cheer for our team, I know EVERYONE out there would appreciate a little support.

Anyone and everyone reading this who would like to support the team is encouraged to reply.

The team colors are yellow and blue with a grey ribbon representing brain cancer awareness. If you'd like to wear yellow, that would help the runners know that you're there for Steve. If you'd like to make a poster then maybe a yellow one with the team name See Spot Run would be awesome!

What supporters need to do:
1.Download or view the map at the link above.
2. Choose a location from the course map.
3. Email Liz at runforsteve@gmail.com and let her know about where you'll be standing.
Please check back often for updates.

For those interested, Steve and Tyra will be staying at the W Hotel near the American Airlines Center the night before. If you would like to come to the start of the race, Steve and the runners will be in the lobby of the hotel at approximately 7:30 a.m. Look for the team in the yellow shirts.

We're only days away from the big event. Let's all show Steve and the team just how much we support them and their accomplishments!!!

-- Liz

Steve loves a parade

Last year for the first time our family of four attended the Neiman Marcus Adolphus Children's parade in downtown Dallas. The Smith family has been going for years, and they invited us to join in their tradition.

During last year's parade, we had no idea how ill Steve would become. We were just days away from the MRI that showed the tumor. We loved the parade and talked about it all year long.

With great faith, we bought bleacher seat tickets again this year. (Anyone can go to the parade for free, but the bleacher tickets guarantee a spot with a good views.)

Two weeks ago, before we knew that there was new tumor growth, I started worrying about how Steve would walk from the parking lot to our seats outside City Hall. I contacted Jessica with the Children's PR department (Steve works for Children's) to ask if she could help us solve the problem.

She didn't hesitate to offer a golf cart.

After we learned Tuesday night that the Damm Spot is growing with live tumor cells, we weren't sure if Steve would make it to the parade. We were even more unsure Thursday, after he received Avastin and CPT-11. He was so exhausted -- we didn't know if he'd even be able to leave the house.

But, as you know, Steve is determined.

He rested all day Friday and skipped a neighborhood party so he could store energy for Saturday morning.

He woke up Saturday feeling strong enough to go, so we bundled him up, picked up his parents (Kris gave us extra tickets) and drove downtown.

As promised, Jessica (who had many important tasks that day) picked us up and dropped us off at our seats. The six of us sat in the first two rows and enjoyed the joyous parade.

Steve smiled more than any of us. He kept saying, "I'm so glad I'm here."



Cooper and Steve


Katie

Steve has a soft spot for marching bands (he played trumpet in marching bands for W.T. White High School and the University of Michigan), and clapped especially loud for all the kids who performed just feet in front of us. He hollered a lot, too -- not an easy task with his raspy, faltering voice.

When the parade ended, most folks walked away from the plaza quickly. We waited for the crowds to thin and for a plan to get Steve back to the car. (Ack! I hadn't thought about how to get him back!)


Cooper and Grandma

Hero Layne Smith took charge. He asked around until he found a golf cart. The Children's volunteer wasn't sure how to drive it, so she scooted over, and Layne took the wheel, driving most of our party back to the car.

Steve, Layne, Katie and Papa

We are incredibly thankful for everyone who helped us get to and from the parade. We are even more thankful for miracle drugs that allowed Steve to feel better after less than two days of treatment.

Steve is tired again today, probably in part because of our morning outdoors. His voice is extremely weak. But his spirits were bolstered by watching a Christmas parade with his family, by continuing a tradition we started just a year ago.

Steve and Tyra

Friday, December 5, 2008

Signs of improvement

Steve has been resting since we came home yesterday. He is exhausted, possibly the most worn out he's been for the past year.

He has not had any adverse side effects, though. Isn't that wonderful?!

Even more encouraging: He's showing signs of improvement. He has been able to wiggle the fingers on his left hand for the first time in days. With some effort, he's able to lift his left arm higher than his shoulder.

We pray that the decreased symptoms are directly related to the Avastin and CPT-11 combination and that symptoms continue to improve.

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Speaking of prayer ...

Our friend Jamie H. has proposed a challenge. Here are her words:

I'd like to repeat a small message I sent to Tyra a few weeks ago. A challenge, maybe. During our church services a while back our pastor asked everyone in the congregation to shout out their own names; after the count of three a very loud, undecipherable noise burst out. Then he asked that we all shout out Jesus at the count of three. And the sound was clear, crystal. This exercise was supposed to show how much more clearly we can be heard by God when we shout in unison. I would like to suggest that everyone say a prayer for our dear, dear friend Steve at noon each day for the next week. That gives everyone a chance to pray in unison, a collective shout for Steve and the entire Damm family ...

Thursday, December 4, 2008

Worn out

We are home from Steve's first dose of the first cycle of Avastin and CPT-11.

Resting in the infusion room, waiting to be released

Steve has had no adverse side effects so far! He is exhausted, though. He napped for about an hour. He's now sitting up in the comfy green family room chair with closed eyes, listening to Cooper read a G.I. Joe comic book aloud to Grandma.

He'll keep a low profile tomorrow, watching for signs of nausea. He also needs to be extra cautious with his balance. Dr. M says that fatigue, stress, medications and now the new treatment PLUS the growing tumor are affecting his balance and left-side sluggishness. He needs to get caught up on sleep and let his body rest so he can be safer when moving.

This week wouldn't have been possible without help from so many selfless friends and family members. No one has hesitated to help with Cooper and Katie or to help around the house or to bring food. Thank you for making our lives easier.

Live from the infusion room

Steve has been reclining in an infusion chair for more than three hours and is doing well.

His nurse was able to draw three vials of blood from his new port -- so much easier than the needle sticks he usually endures. Those labs showed that his counts are enough in range to start the new treatment plan.

We reviewed possible side effects and remedies with Dr. M and again with a pharmacist. Then they started him on a saline solution, Decadron and anti-nausea meds.

The Avastin drip began sometime after 10 a.m. That will be followed by the CPT-11 (chemotherapy) drip.

The room is comfortable. We have a television with VCR and DVD player (he's watching Major League right now) and three visitors' chairs. We've already hosted our first guest! Pastor Andy spent more than an hour with us and closed our visit with a beautiful prayer.

A few steps away is a refreshment room, stocked with juices, Ensure and Boost. (Steve prefers Boost -- he thinks it's more youthful than Ensure.)

Steve is layered with warm blankets. He's wearing a gray stocking cap and maize and blue gloves (Go Blue!). He looks "cozy rosy," as Dr. M said when she walked in.

Dr. M expects that Steve will be severely fatigued tomorrow and perhaps throughout the weekend. By Monday he should be feeling much better, she says.

Wednesday, December 3, 2008

Home for a few hours

Steve and I arrived home this afternoon just in time to greet Katie coming home from preschool. (Grandma Betty almost always picks her up for us, driving three days a week from North Dallas to Carrollton to Frisco and back to North Dallas.)

Steve has rested this afternoon and is starting to hobble around a little now. He is so much more unstable today than just two days ago. Part of that may be because of poor sleep the past two nights, despite sleeping pills. The poor sleep may be in part because of the increased steroid dose. He's up to 6 mg of Decadron a day -- a huge jump from the 2 mg he'd been taking for months.

We are eager to get this next treatment started and to see some results. We expect to spend most of Thursday at the UT-SW cancer center: labs, meet with Dr. M and then the introduction of toxins begins!

I'm happy to report that Steve's sense of humor is still intact. Of course, he's emotional about this latest turn. But he never fails to amaze me with his wit and appreciation for the quirky.

I want to share two things that always make us laugh.

First: A riddle that Cooper "invented."
Why are thermometers so good in college?
Because they have so many degrees.

Second: A video of Katie dancing a couple of weeks ago.

video

Live from St. Paul: Looking good

Steve has just been wheeled back into the private prep/recovery room. The RN reports that he did well. He's awake and lucid (maybe just a little loopy) and about to drink water for the first time since last night.

Live from St. Paul

Steve and I are on the sixth floor of St. Paul University Hospital. Betty just arrived, too!

St. Paul is the site of great moments in Damm family history. Cooper was born here in July 2001, and Katie made her debut here in June 2005. Will, our dear friend who introduced us, was born here in May 1969.

We're in a room on the cardiac floor. Nurses have reviewed his medical history and have hooked him up with a Heparin lock for the IV he'll have going during the procedure.

He'll be in the procedure room for about an hour, where they'll place the port in his chest. (We keep saying "installed," but that makes him sound more like an automobile than a person.) He'll return to his room, and the staff will monitor his vital signs for an hour or two. Then we should be able to go home.

Tuesday, December 2, 2008

Growth

Dr. M called early this evening to tell us that the PET scan shows that the enlarged mass is the result of tumor growth.

She said that everyone was shocked. No one expected this.

She said that this is bad news. (Deep breath.)

Now, let's move on to how we're going to keep fighting the Damm Spot.

Steve will report to the invasive cardiac center at St. Paul on Wednesday morning. The folks there will place a port in his chest. The port will allow convenient access for the drugs he'll receive every two weeks to chip away at the tumor.

(When the St. Paul scheduling people call, they remind Steve to make sure someone drives him home after the procedure. That always makes us giggle -- he hasn't driven for almost a year.)

On Thursday morning, we'll report to the UT-SW cancer center. Steve will have blood drawn, and then we'll meet with Dr. M and her team to go over the new chemotherapy regimen.

Then we'll be ushered to a private infusion room. He'll settle into a recliner and begin receiving Avastin and CPT-11 through the new port.

Avastin is the drug that affects blood vessels. CPT-11 is a form of chemotherapy. The combination is about 70 percent effective in fighting brain tumors. There are side effects and risks with both, but the risks are worth the potential benefit.

Steve will return every other week for the infusion.

We never expected to be at this point this soon. We were praying for a few more years before we needed to start using this second line of treatment.

Now that we're here, we are committed to devoting our strength and faith toward fighting the new growth. We are committed to celebrating how far we've come.

For some perspective: Sharon was at the house tonight. She took Cooper to his Cub Scout meeting and then visited with Steve and washed dishes, including our Spode Christmas dishes. She reminded us that about a year ago she was at the house, visiting with Steve and washing dishes, including our Spode Christmas dishes.

Steve is almost a one-year survivor of a Grade IV glioblastoma in the pons of his brain stem. To borrow a phrase from the late Rev. Kathleen Baskin-Ball, "Glory be!"

Please join us in giving thanks that we have come this far. And join us in praying that the next line of treatment will obliterate the Damm Spot.

No news yet

We haven't yet heard PET results from Dr. M's office. Steve didn't receive a call to start Avastin today, so we're assuming that the injection will begin tomorrow.

I'll post when we know more.

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Beloved minister Kathleen Baskin-Ball passed away this morning at her home. She served three years at our church, long before we were there. She left a huge imprint on our congregation's spirit. She most recently led Suncreek United Methodist Church in Allen.

To hear Kathleen speak was to be wrapped in warmth. There is no doubt that she was chosen by God to inspire, share and preach.

I interviewed her for a Dallas Morning News article in December 2006, days before her cancer diagnosis. She shared her favorite biblical verses. Here is the Kathleen excerpt that ran:

Romans 8:35 and 37 (New Revised Standard Version)
"Who will separate us from the love of Christ? Will hardship, or distress, or persecution, or famine, or nakedness, or peril, or sword? No, in all these things we are more than conquerors through him who loved us."

The Rev. Kathleen Baskin-Ball said this passage, which she returns to often, is appropriate for funerals, but also for folks struggling with deteriorating relationships, troubles with children and other conflicts. "It's a passage that can be read in the midst of life, wondering if the love is ever going to rise again. We sort of wonder sometimes, with war, starvation, hunger, Is God at work? It says to me and the faithful, there is nothing more powerful than the love. Nothing can separate us from it."

The Rev. Kathleen Baskin-Ball
Senior pastor
Suncreek United Methodist Church, Allen

Monday, December 1, 2008

Everyone is voting for necrosis

Steve's PET scan was uneventful this morning. I took Cooper to school, Liz picked up Katie for the morning, and Steve and I headed south for the cancer center. He was injected with a radioactive tracer (just one stick!), waited a while and then rested in a scanning machine.

Dr. M expects to receive results late today or early Tuesday. She says she'll call us when she gets the reading. The scan will tell us if the enlarged mass is live tumor activity.

We spoke with Dr. M yesterday to let her know about Steve's worsening symptoms. She spent a while on the phone explaining what the doctors agree on so far.

Everyone believes that the growing Spot is the result of radiation and chemotherapy. The technical term is necrosis. Necrosis is when healthy tissue and cells die. So, all the consulting doctors think that the treatment Steve has received so far, which was absolutely necessary, is also what has caused healthy cells to die.

It's impossible to know from an MRI. (A biopsy is the best way to be sure, but there's no way that's going to happen again.) But all the doctors and UT-SW and M.D. Anderson feel certain based on the timing of his returned symptoms and the location of the dead healthy tissue.

The PET scan will confirm their theory.

It will be fabulous news if the tumor itself isn't growing. Still, there is the issue of the healthy tissue dying. The brain stem is small but controls all the nerve and sensory systems. A little change in the brain stem can cause big changes in the body. Steve can't afford many more little changes.

So, the next issue is how to stop necrosis.

Dr. C at M.D. Anderson recommends the use of Avastin. Avastin was first used to extend the life of colon cancer patients. It is now used for a number of cancers. (Use for brain tumors is considered "off label." Dr. M's office has already started working on pre-authorization from our insurance company. So far, our United HealthCare plan has been awesome. They have covered more than we expected.)

Avastin works by affecting blood vessels. The hope is that Avastin will stop capillary leaks at the site and therefore stop the deadness from spreading. (Another hope is that I'm explaining this correctly!)

Steve will begin taking Avastin tomorrow or Wednesday, we think.

He is scheduled to have the port placed in his chest Wednesday morning. If it's possible to begin using the port the same day as placement, they'll start using it then to administer Avastin.

If medical providers think it's not a good idea to start using the port right away, they are going to try to get him scheduled for an IV appointment Tuesday, and he'd start Avastin then. Avastin is given every two weeks. We need it to start working right away!

Steve will also continue taking Accutane. (As a reminder, the high dose of Accutane is used to trick the cancer stem cells into behaving like regular ol' cancer cells.)

He will not be on an official chemotherapy for now. The doctors agree that the Temodar has outlived its effectiveness.

If the tumor cells do start growing again, he'll most likely start a second chemotherapy (CPT-11).

Recap:
1. We're waiting for the PET results to confirm that the enlarged mass is necrosis.
2. We're waiting to find out if Steve will begin Avastin on Tuesday or Wednesday.
3. We're praying that the Avastin will do its job quickly and relieve Steve of his worsening symptoms.

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I've been keeping track of thank-yous on the upper right side of the page. Yesterday was an especially eventful day here.

Bill K. spent about two hours in the front yard, trimming bushes (Cooper assisted with raking). Jim and Betty came over so I could grocery shop. While they were here, they played with Katie, helped Cooper with a school project and picked up the kids' rooms. Jeannie D. came over at night so I could run eight miles with Allison (the half marathon is two weeks away). And an unnamed elf left two small Christmas trees on the front steps -- one for each child to put in their rooms.

We are so blessed. "Thank you" just doesn't seem sufficient some days.

Sunday, November 30, 2008

Since we've been home

The four of us spent a few days in Austin this week, enjoying family time at the Jones house -- home of Aunt Ami, Uncle Rich and cousins Sasha and Tara. My sister Melane and her family were there, too.

We all drove to Temple on Friday to spend some time with my mom, who is still in a nursing home. We were a huge crowd -- Uncle Tim, Aunt Cheryl and cousins Sarah and Trevor joined us. My stepdad Daryl was able to take his lunch break in time to join us all in the nursing home's conference room for a post-Thanksgiving Day lunch.

Steve did well on the trip. He spent his days eating, watching movies, visiting, napping and reading. (He's almost done with my favorite novel, East of Eden.) His left-side sluggishness and instability were about the same, though this weekend they seem exaggerated. He is getting headaches again with more frequency. And hiccups have returned.

When we came home Friday night, we were thrilled to see that someone had dressed up our house with Christmas lights. Some of the Spiritual Journeymen (a men's group at our church), decorated before we came home. Cooper and Katie are so proud to have lights. Thanks, guys!

Cooper and Katie woke up Saturday with awful coughs, so we headed to pediatrician's office. They both have colds but thankfully no strep. Later we decorated the inside of the house. One of my favorite days of the year is the day we hang the stockings, pull out the annual Santa photos, rediscover favorite ornaments.

We enjoyed dinner at Jim and Betty's house Saturday night.

Steve had trouble sleeping last night, so he headed to the family room to read. Katie stumbled out at some point, and they cuddled on the sofa. Then he took her back to her room. He laid down with her for a while. When he got out of her bed, he fell. He crashed into her wooden dollhouse, cutting his mouth and bruising his side.

Now he's back in bed, just a few pages from the end of East of Eden. He's taken pain relievers for his headache and the aches from falling. We hope he's able to nap this morning.

The week ahead may give us some answers on the larger mass in his brain stem. Steve's PET scan is scheduled for 9 a.m. Monday. We don't expect results right away -- probably by the middle of the week.

He has an appointment to have the chemotherapy port placed on Wednesday morning.

We have many specific prayers today.
  • That Steve's symptoms stop increasing
  • That he doesn't feel pain after this early morning's fall
  • That the results of the PET scan show treatment-effect growth, not growth related to new tumor activity
  • That, no matter the results of the PET scan, we are able to find treatment that will reduce the size of the Damm Spot

Wednesday, November 26, 2008

Thanksgiving

A year ago, Steve, the kids and I were in Austin with family, as is our annual tradition.

Steve had been experiencing strange symptoms -- headaches, difficulty swallowing, slurred speech, frequent hiccups. He and I were concerned but not overly so. We agreed that he should call his primary care physician as soon as we returned to Dallas. We had no idea what was in store.

Our Thanksgiving list is so much longer this year than any year past -- partly because we've been enveloped by the world's greatest support group and partly because we're even more aware of the blessings we had all along.

We're back in Austin now. After almost a year of battling cancer, our lives are drastically different, and yet they are comfortingly the same. Same traditional Thanksgiving dishes, same joyous sounds from the four young cousins, same sense of family, same feeling of God's love. The blessings are amplified. And we are so thankful.

Some of you shared what you're thankful for this year. It's a beautiful list.

People who reflect God's love
-- Cheryl B.

Friendships during the holidays
-- Kris B.

Friends and family
-- Shannon R.

The support, the love and the prayers shown to my family over the last year
-- Natalie W.

The laughter of my children and the love I feel from Jeff the minute he walks in the door. I am thankful for this very moment of my children's lives and the joy it is to raise them. I do not want to speed up one minute of it, yet I don't really want to slow it down either. I am just thankful for the moment!
-- Melanie D.

My family, my husband and our two precious, precious little boys. And for friendships I never thought I'd have or deserved -- so, so grateful.
-- Jamie H.

The power of God that gives us courage to meet the toughest challenges with grace and confidence. And to actually find joy along these sometimes-rocky roads.
-- Sharon G.

Family, friends, employment and a roof over my head
-- Jennifer P.

My two children, my grandchildren, my health and my job
-- Leti D.

God's promises: "I have told you these things, so that in me you may have peace. In this world you will have trouble, but take heart--I have overcome the world." (John 16:33)
-- Armayor family

I am so very, very thankful that: I live in a country in which I don't have to worry daily about my physical safety and that of my family; I can readily find affordable food to eat and clean water to drink; I have the freedom to worship God in my church; I have the right — as a woman — to work, wear and say what I want and have a voice in society and government; I know that my children, both my boy and my girl, will have a publicly funded education in a safe, heated building, without fail, August through May. I am profoundly grateful for all these things because I know most people in the world can't say the same.
-- Jennifer S.

All our caring friends who have stayed by our side this past year and for Stephen, Tyra, Cooper, Katie, and Jim, whose love and positive attitudes have continued to bless all the lives they have touched. Each new day is a gift. I am humbled with gratitude.
-- Betty D.

My family (especially my beautiful wife), good friends, music, laughter, hope, faith, memories, freedom, helping hands, warm blankets on cold nights, good food ... just to name a few.
-- Andy F.

Family and good friends
-- Liz S.

Tuesday, November 25, 2008

Giving thanks

We are surrounded by the kindest souls. I'd love to share with everyone else what you're thankful for.

E-mail me by 10 p.m. or so Wednesday with one word or one sentence: What are you thankful for this year?

I'll post the thankful list Thursday. If you want to remain anonymous, let me know and I'll leave your name off.

E-mail me at tyradamm@gmail.com.

Monday, November 24, 2008

Shirt reminder

If you'd like to order a See Spot Run T-shirt or tech shirt and haven't already done so, please e-mail Liz Smith at runforsteve@gmail.com right away!

Click here for full details.

Waiting

We're back in a familiar place -- waiting to hear from doctors.

Some correspondence with Dr. M and her office this weekend has the possibility of excellent news. One doctor looked at the MRI on Friday and thinks the growth is related to effects from radiation.

Based on that reading, apparently, UT-SW has slowed down this week's appointments. Steve is not getting a port placed in his chest today. The PET scan may be tomorrow, Wednesday or next Monday.

We would be beyond thrilled if the growth is treatment related. We'll both feel much better when there are PET scan results that show what kind of activity is taking place in the Damm Spot.

Still, until the mass gets smaller, Steve will continue to struggle with his latest symptoms. If the growth is related to treatment effect, will it just get smaller on its own? We have no idea.

So, we're about where we were Friday, but with more hope that the tumor isn't growing because cancer cells came out of dormancy.

Steve rested most of the weekend, enjoying food deliveries, very short visits with friends and lots of cuddling with his family and furry Margie.

UPDATE: Steve's PET scan is now scheduled for 9 a.m. next Monday.

Saturday, November 22, 2008

Good cheer

Katie and Cooper before church last Sunday