Final Arrangements

For anyone interested of attending the services for Stan, we will have one in Maryland and in Utah.
Monday, Oct. 11
10 AM-Viewing 11 AM-Funeral
LDS Stake Center
10000 Stoneybrook Drive
Kensington, MD 20895

Saturday, Oct. 16
9 AM-Viewing 10 AM-Funeral
Allen-Hall Mortuary
34 East Center Street
Logan, UT 84321

A New Beginning

Stan went home peacefully to his Heavely Father this morning. Thanks for all of your support, love and prayers.

New Normal

One day when we were at the doctors we were told that as we moved through this process we would hit bumps and then they would be the new normal. I think back to just a month ago and how worried I would be is Stan was in this shape, but he has moved through the stages gracefully and without complaint. After about two days and some anti-nausea medicine, Stan is feeling better. He is able to drink one Carnation Breakfast a day. He is pretty weak so he spends his day in the chair or the bed.

Hospice Care

Stan's Hospice nurse came yesterday and the social worker came today. They are very helpful and really have Stan's best interest at heart. Stan started having waves of nausea yesterday. This has made if very difficult for him to want to eat or drink anything. Yesterday he was able to keep down a carnation breakfast he ate, just before he went to bed. It is after lunch today and Stan has only been able to drink about a half a glass of Gatorade. I hope this will pass soon so that he can take in more food. The social worker said she would have his nurse check on some anti-nausea medicine. Stan enjoys the book he is reading, "Retreat from Gettysburg" and the visits from our church friends.

Anniversary

Thirty-five years ago today, Stan and I started our eternal journey together as husband and wife. He has, and is continuing to bless and teach.
He has not been able to attend church for the past 3 weeks, so the young men brought him the Sacrament today. He has only been able to eat a few bites of solids in the past week so he is quite weak, but his spirits are high.
Tom was able to spend a few hours with us this morning, on his drive home from Georgia. He put 8 1/2" by 11" pictures of Stan with each one of his grandchildren, on the wall across from Stan's chair. Stan has enjoyed just sitting there looking at the pictures. His family is so important to him. Thank you so much Tom and Erin for getting the pictures and framing them.

Busy Times

Tuesday Stan and I went down to his office for a couple of hours. I took his pictures off his walls and collected some of his personal items. Wednesday the hospice Chaplin came and we had a wonderful visit. He talked with us about what we believed about dying and the afterlife. He was pleased that we both felt the same about what would happen. He told Stan that he would continue to teach those around right to the end. He let me know that Stan's desire to eat would continue to decline until he would stop eating and I was not to feel guilty, and that Stan would stop talking but that we were not to stop talking to him. It was hard to hear but there was also a peace. I did need some time after Stan took a nap to just wrap in the 'magic quilt' and feel loved. Today I took Stan to his HR office to sign his retirement papers. They will take effect on September 30.

Time Together

I start my long term leave today. I was lucky to get some great substitute teachers for my classroom so that I can relax and just concentrate on being at home. Stan continues to decline. He hasn't felt well enough to attend church for the last two weeks. He hasn't left the house for about a week and a half, when his boss had to drive him home because he had a dizzy spell at work. As his body slowly gives up on him his mind still plans for the days when he will feel a little better. He is still hoping to get to work to put in about 3 hours, to put the finishing touches on his last project. We had some wonderful visits from church friends last night and he lit up at the package of pictures of his grandchildren from Tom and Erin.
Thank you for being there to share this journey with us. We love you and thank you for your support.

Hospice

This has been a busy week getting set up with hospice. Tuesday we meet for two hours with the intake nurse. Ben, Tom and our high priest group leader were here to lend their support. Wednesday, the hospice social worker met with Stan and Tom while I was at work. Stan's hospital bed, wheelchair, walker, shower chair etc. were delivered. Stan's nurse came just, as I was getting home. He is from the Philippines. Stan showed him his pictures from his mission in the Philippians. I think it will be a good match. Everyone has been so caring.
The hospital bed has helped Stan get a little more comfortable.

Pop Quiz

I know this blog is about Stan but since Stan and I and eternal partners I will write about me today. I don't want this to sound old, but I am so overcome at how much or Heavenly Father loves and knows each one of us and what we need. Today I received a pop quiz. Stan was in the shower so I picked up the yard and got the lawn mower out. I decided to check see how the laundry was coming along before I started mowing the lawn. When I went downstairs I found the basement flooded. The extra credit on this quiz was I had just put all the towels in the washer. I was so grateful that I had this challenge while I still have a coach and on a day I was home from work. I think I received an A on the quiz since I cleaned up so nicely after myself but Stan received an A+. He was a great coach.
Tom and his family were here for the weekend. I told Tom that I was concerned about Stan being at home all day by himself. I felt the days would get very long for him. As soon as we got to church yesterday, Brother Peterson came up to Stan and asked him when he could come visit. We are all right because we have so many wonderful friends and family.

Oncology Visit

Stan had a visit with his oncologist today. The meeting was mainly about making Stan as comfortable as possible. He signed a paper so we could get a handicap sticker for the car. He also changed Stan's pain meds. and emailed Hospice to contact us about receiving help at home. The oncologist did not give us the percent of Stan's liver function, but he said it was working adequately. He will have the papers filled out for long term leave as soon as Stan wants it done. Stan is still going to work on the days when he feels well enough to go.

Birthday Greetings

Stan appericates all of the well wishes he received today for his big 60. He also reads the comments on the blog and is very greatful for all of your prayers.
Stan's has been able to slow down his weight loss by drinking Carnation Instant Breakfast.
I struggled to come up with some way to celebrate Stan's birthday, since most celebrations are around food. On Sunday Stan mentioned that he would like to try Velveeta cheese. I bought some on Monday but didn't give it to him until today.
I cut a small square of cheese into a heart and stuck a birthday candle in it. He was very suprised and happy when he saw it. And the best part, HE ATE ALL OF IT !

Back At Home

We spent almost a week in the Salt Lake area visiting our children, grandchildren and Lila's mom. We were able to get a wheelchair so Stan enjoyed the zoo and other activities with the grandchildren. Our son Tom and his 6 year old daughter, Emma flew out from New York to join us on our trip. On Thursday, Aug. 5th we went to Saint George. We had a wonderful weekend with Stan's brother Max and his sisters. On Monday, Aug. 9th we started our drive home. Tom and Emma came with us. It took us 4 days to get out of Utah because of all the beautiful country. Stan has always loved southern Utah. Our honeymoon was hiking the Grand Canyon. We took it slow and visited many National Parks. When we went to the Great Sand Dunes National Park in Colorado, they had special wheelchairs for sand. Tom was able to push Stan up the dunes so that he had a great time.
We arrived home Monday, Aug. 16. Stan went back to work on Wednesday.
He feels weak and has a difficult time eating. This has caused a drastic weight loss. He emailed his doctor and after some blood work, he was scheduled for a blood transfusion.
He had his blood transfusion today, as an outpatient at the hospital. It took all day. We were hoping that it would give him some energy but so far he said he just feels strange. Hopefully he will feel better tomorrow.

The Journey Continues

Stan and I started our trip across the US last Thursday (July 22^nd), but before we left Stan had a wonderful surprise. Amanda came over Wed. night and presented the 'magic quilt' to Stan. In her quiet caring way she told him about the quilt and the love that went into its creation. Stan was very touched.

We brought the quilt on the trip and have told people of its message as we have traveled.

Our first destination was Nauvoo. We rented a house, overlooking the Mississippi, just outside of Nauvoo. All of Lila's living siblings except one, and some spouses spent 4 days touring, watching the pageant, in the rain and attending the Nauvoo Temple. The spirit of the sacrifice and their devotion to God, stayed with us wherever we were. Unbeknown to us when the trip was planned, it was a miracle that we were there at that time. In mid-December I decided to rent the house and set the dates, even though very few could commit at that time (I have seven sisters and one living brother). Stan's cancer had not been confirmed when the trip was planned but by the time we left on the trip he was at a point where he could leave the doctors behind but still be well enough to travel. A few days before she was to leave for Nauvoo, my youngest sister was diagnosed with bladder cancer. She went right to surgery but was well enough to travel to Nauvoo and be back for her next appointment. We didn't know this would be our only window of time, but the Lord knew and he knew how important that it was that we spent this time together.

After Nauvoo Stan and Lila and 4 of our relatives went to Mt. Rushmore. Stan got very sick at the site and Zelda, (Lila's sister) picked a man out of the crowd and asked him if he was a Mormon and could he help give a blessing. We found a spot that was away from the crowd and circled Stan. This young man, that was a stranger to us, gave Stan the most powerful blessing. As his voice cracked he spoke to our Heavenly Father and to Stan as if they were both his best friends. It was such a moving moment.

Stan and I left so that we could find him some medicine and help if he needed it. The next day we drove past Martin's Cove and decided to stop. It was too early for the buildings to be open so we started the two-mile walk to the cove. We took it slow and stopped at the benches to admire the view and rest. Stan was getting very tired but we could see a little cabin ahead and pushed on. The cabin was manned by 3 senior missionaries. Stan sat on the bench and asked them if this was the cove. When they said that it was a mile farther up the trail you could see the pain on his face because he wanted so much to see the cove, but he knew he could go no father. I explained to the missionaries his condition and his desire. One of the sisters went into the cabin. She used a walk-e-talkie to ask them to send a rover up to pick up Stan. A wonderful missionary drove us up to the cove. At the cove he explained what happened there and told us we could take all the time we wanted. The spirit was so strong, as we held onto each other and looked at the spot were so many had given so much, I couldn’t stop crying. Their faith was so strong and even though their trials were great, they were never alone. As we drove down I looked out across the mountains and saw a handcart company coming in. It was about a mile long of youth and leaders experiencing their own faith promoting experiences.

Friday night we were in the arms of our sweet little grandchildren. Stan wanted them all to see the 'magic quilt'. As I told them the story of the quilt I could see Stan lovingly rub his hand over the quilt. This is when I knew how much the quilt meant to him. I would like everyone who was involved in this magic to know how much it has touched our lives and the lives of all of those who love Stan.

A New Beginning

We went to John Hopkins Kimmel Cancer Center today, in hopes that they would have something new to try. The doctor was very well prepared. She had studied Stan's case and listened to all our concerns. Because gall bladder cancer is so rare, there will not be any clinical trials for just for his type of cancer. She said we could likely get into a phase one trial where they test new drugs. The other option is to go back to Stan's oncologist and start with another round of chemo. None of the options have much of a chance of helping him. At this time we have decided it may be time to stop with the medical procedures and just enjoy life. We will start with a reunion in Nauvoo, Ill and then go to Utah to visit our families. This is not the end but a new beginning.

Meeting with Oncology

We meet with the oncologist today to get the information about the CT scan and what comes next. The tumor in the liver has grown some but the tumor in the gall bladder has about doubled in size. It is now about 7 1/2 cm. We discussed the chemo options. The first type of chemo they tried was they type that was most likely to succeed. When it failed they went to the second most likely. We are now on our third type. The decision was made to wait on the tablet form of chemo until we check to see if there are any clinical trials, that will take him. We are checking with NIH and Johns Hopkins. When we have heard back from both of them, we will meet and decide where to go from here.

Bad News

Stan got a call from his oncologist today. The chemo he is on is not working. Stan took it pretty hard. He will start Tarceva on Thursday. It is a tablet form of chemo. We can only hope for the best. It was wonderful to come home to a bowl of mulberries on the front step. Thank you Amanda and family.

Mulberries

I wasn't going to update the blog until we had more information about the CT scan, but this was too good to pass up. Yesterday we were driving to the hardward store to get material to finish the deck. When we were sitting at a light, I noticed a mulberry tree dropping it's fruit all over the sidewalk. Stan loves mulberries. We talked about the many times he would come home from a walk with purple hands and face. Because he hasn't taken walks this summer he has not eaten any mulberries. When we got home Stan sat out on the deck to rest. A little while latter he came in and said, "Look at this". There in his had was a perfect little mulberry with it's stem. Knowing we didn't have any trees I asked him where he got it. As he was sitting on the deck it fell out of the sky onto his lap. Birds fly over and leave their poop but I have never have them leave their food. I have always been told, He has no had but our hands, I think he may have more than our hands. Have a wonderful day.

Warm Weather

Stan had a CT scan today. We will find out the results next Thursday. He has been pretty sick today. I think it was mainly the two big bottles of thick milky stuff he has to drink for the scan. I am so glad it is summer. Stan gets cold very easy. The 80 - 90 degree weather we are having, has made him feel more comfortable. Monday 5/30, we went to Mount Vernon with a niece and her two sons, that were visiting from Idaho. I can't think of a better place to be, than the home of George Washington, our founding father on Memorial Day. We had a wonderful time. Stan is still going to work. Some days he comes home pretty tired but he has such a drive to keep going. Your prayers and well wishes are greatly appreciated.

A Few Things

Last night was a beautiful evening so we decided to sleep out on the new deck that we built last fall. The stars were hard to see but we were entertained with a firefly show.

We are now concentrating on food. Stan has been told to keep his weight up but food has started to have no taste or a bad taste. Even water now has a strange taste. He has found a few things that he enjoys. This has led to separate suppers because I am not up to 2 pieces of garlic toast for supper.

Chemo Again

Chemo again today. All went well. CT scan scheduled for June 3rd to see if this form of Chemo is working.

Blessings

Today I opened my email and found this message from a sister, "miracles are not a suspension of a natural law, but the operation of a higher law." We have had so many miracles in our lives. At this time we have felt our Heavenly Father's love surround us and comfort us. A few weeks ago our desktop computer crashed. We lost all of our records. Stan had been teaching me how to do the finances. Being an engineer he was very organized. He taught me how to pay bills on line an use a wonderful spreadsheet he had created to track our expenses. Then the computer crashed and it was all gone. Last night Stan started rebuilding it all on the new computer. I am so grateful to a loving father that has given us this time, to help me be prepared and a patient husband who is a wonderful teacher.

No More Hair

We didn't get to have the hair cutting party, the hair came out too fast. The next morning he had lost so much that he wanted it shaved before he went to work. And wow, does he ever look handsome (not that he wasn't already handsome). Stan's sisters from Utah visited this week and his brother drove up from Virginia. It was a great family time of playing games and visiting. Stan is holding his own. As long as he gets a few naps a day he is able to participate in everything. He is still able to hold his pain at bay with Tylenol.

The Hair

The hair is coming out. When Stan got up this morning he noticed more on his pillow and in the shower. He has asked me to shave his head. I'm thinking we may need a hair shaving party. His sisters from Utah are coming tomorrow for a visit. I think that would be a great time for the party. I will keep you posted on this new hair raising event.

Rough

Stan has had a rough couple of days. He is back on pain pills but he is continuing to go to work. We had a great visit with Stan's brother Duane last weekend. Thank you for all your thoughts and prayers.

New Chemo

Yesterday, 4/26 Stan went to his Oncologist. The outcome is the scheduling of more chemo,but with different drugs. They will try another type that he will take once a week every three weeks. They hope this strain will have some affect on the tumor. Stan has been blessed with strength and stamina to continue with work and other activities. He is putting benches on the deck that he stared last fall.

Chemoembolization

Stan went to the hospital for his chemoembolization today (4/15/2010). The plan was to find the arteries feeding the tumor, put chemo into them and cut off the blood supply to the tumor. Tumors in the liver are usually fed by the arteries. Since they only supply the liver with about 10% of it's blood supply, the arteries can be cut off without damaging the liver. The liver gets almost all of its blood from veins, not arteries. After mapping the arteries they were unable to find any arteries feeding the tumor, so they were unable to do the procedure. This particular tumor must be absorbing blood and nutrition from adjacent areas, rather than through blood vessels. The doctor said that after viewing Stan's CT scan, it looks like about 55-60% of his liver is still functioning. We are so grateful for all of your love and prays. The Lord has blessed us with peace as we move forward.

CAT Scan Results

Wednesday 3/31 Stan only had three-fourths of his chemo because his blood platelets were low. After Chemo, Stan and Lila drove to New York to visit with Tom, Erin and family. He had a wonderful hike with Tom in the hills around Tom's home. Monday 4/5 he had a CAT scan. Today, Wednesday 4/7 he met with his surgeon. His surgeon said the tumor in his liver is continuing to grow and that another tumor has appeared in front of the larger tumor. He has been referred to a radiologist to proceed with the chemo-embolization. This is where high doses of chemo are put directly into the tumor. His oncologist has canceled his regular chemo due to the upcoming chemo-embolization and that he feels that the chemo hasn't seemed to help.

Chemo Week 2

Yesterday (2/23/2010), Stan saw a transplant specialist about a liver transplant. Stan is definitely not a candidate for a liver transplant. The transplant doctor suggested that a prob be inserted into the area affected by the cancer, to get a better look at how much of the liver is impacted. We are waiting for a call from his staff to follow up on his recommendation.

Today, Stan had his second session of Chemotherapy. With the anti-nausea medicine he receives, he is tired but he feels fine. At the session they noticed red lines and swelling in his arms, so they sent him for a sonogram. The sonogram reveled that he has blood clots in both arms. He is now back on his daily injection of blood thinner.

Chemotherapy: Day 1

Dad started chemotherapy today. It’s the next step in a medical journey that started back in October.

While helping Mike fix up his new house last fall, Dad fell off a ladder and cracked a couple of ribs. He continued to work through the pain until the job was done a couple of weeks later.
After returning to Maryland, Dad went in for an x-ray for the ribs. The doctors wanted a better look, so they ordered a CAT scan which revealed a tumor in the liver. About the same time they also discovered a blood clot in the leg and put him on anticoagulation medication. All this eventually led to a biopsy of the liver on December 30th and a PET scan on January 19th which confirmed cancer. The diagnosis is gallbladder cancer which has metastasized to the liver.

Typical treatment, and the only way to cure such cancer, is through surgery to remove the gallbladder and the infected portion of the liver. Unfortunately the right lobe of the liver is nearly entirely consumed with the tumor and the left lobe is not large enough to safely proceed with immediate surgery.

To combat the blood clot threat, on February 5th the doctors installed a vena cava filter. This is a last line of defense to catch blood clots and prevent them from entering the heart which can be fatal. Patients who have previously had a blood clot are at a higher risk of future blood clots and cancer tumors can also cause blood clots.

In an effort to prepare dad for surgery, on Feb 11th, the doctors attempted a procedure called portal vein embolization. This happened to coincide with the epic snowstorm in DC. Although few patients made it to the hospital, the doctors were there. They inserted a needle through Dad’s neck and, using x-ray, guided it to the liver where they hoped to block the portal vein which provides blood to the right lobe of the liver. By decreasing blood flow to the right lobe of the liver and increasing blood to the left, the hope was to grow the left lobe of the liver in preparation for surgery. Unfortunately, due to the size of the tumor, the doctors were unable to complete the procedure despite entering the liver from three different angles. This decreases and likely eliminates the possibility dad will become a candidate for liver surgery.

Despite the grim prognosis, all day in the hospital, and our urging him to rest, after returning from the hospital Dad spent most of the evening digging our neighbors out of the snow. Although he tires easily, has lost some weight and has a few aches and pains, Dad’s overall health is such that he is able to largely maintain his pre-cancer lifestyle.

Today we moved into the chemotherapy phase. Over about five hours dad received Gemzar and Cisplatin intravenously. These chemotherapy drugs will be followed by a bevy of anti-nausea medication over the following hours and days. Although the potential side effects are numerous, most, if not all, can be mitigated, controlled, or eliminated through medication. Dad will receive a day’s worth of chemo medication via IV once a week for three weeks and then take a week off. This routine will continue for 3-6 months when the situation will be re-evaluated.

Dad had some pain on the top of the foot which he reported to the doctor today. The doctor believes it is a blood clot and Dad will also start taking anticoagulation medication again.

My brother-in-law is working on a post doctorate at Johns Hopkins University. On Friday I took my dad's medical records up to JHU and had them reviewed by his boss. Although she doesn't know my dad, she has taken a keen interest in his case. She took time to discuss his case with her colleagues and has placed it on the docket for a multi-disciplinary conference today that has surgeons, radiologists, interventionalists, and medical oncologists. We are hopeful something will come of this.

Initial Findings from Jan 21

During the past week Stan had a colonoscopy and PET scan to determine the extent of his cancer. His earlier biopsy of the liver shows a cancerous tumor in the right lobe of the liver which is believed to be gallbladder cancer. A three cm polyp was removed during the colonoscopy but the biopsy results are not back from that. If positive, then we likely have metastatic colon cancer and chemotherapy will precede surgery to remove his gallbladder and right node of his liver. If negative, the treatment will be liver/gallbladder surgery.

The PET scan only showed cancerous activity in the vicinity of the liver. While this is good news, it was taken after the colonoscopy and removal of the polyp.

Unfortunately, the left lobe of the liver is not large enough to proceed safely with immediate surgery. There is a procedure called portal vein embolization where blood flow is cut off to the right lobe which causes the left lobe to grow. This essentially tricks the body into recovery before the surgery. The doctor would like to allow the liver to grow for six weeks after the portal vein embolization before surgery.

In November Stan had deep vein thrombosis (a blot clot in the leg) and has been on medication to recover from that. To mitigate the risk factors associated with blood clots, a vascular surgeon will insert a vena cava filter to prevent clots from entering the heart if they were to form and break loose.

The vena cava filter and portal vein embolization are both outpatient procedures done in a couple of hours.

In summary, while we don’t have an exact diagnosis yet there is a treatment plan in place and we are making the first few steps of a what will likely be a medical journey which takes several months. Stan is otherwise healthy, active and pain free. He has lots of love, prayers and support but can use any extra prayers.