Merry Christmas Everyone

We just wanted to wish everyone a very Merry Christmas!!

Cindy and Kyle

Last Treatment Scheduled - Yeah!!

Well - my last of 8 chemo treatments is scheduled for January 7, 2010 - YEAH!! I will begin follow-up appts. & CT scans after that on February 25, 2010. My doctor told us today that my blood work has shown that the cancer cells should be long gone by now and all should be well. I will have to follow-up and closely monitor things for the next several years as well (that includes blood work for monitoring any future blood clots).

Kyle and I received a wonderful Christmas present today with this news. The power of prayer is an extraordinary thing.

Thank you all for your thoughts and prayers ... you have helped us more than you know.

God Bless and Merry Christmas.

Cindy

#7 - DONE

Yeah - white blood count was up enough today so that I could go ahead and get treatment #7 done and out of the way. I haven't scheduled my 8th and final treatment yet since everything got postponed from last week. Should find out more on Dec. 17th at my next doctor's appt.

Wishing everyone a happy and safe Christamas.

"And this too shall pass....."

Cindy

Only on a Monday

Well folks my 7th treatment has been delayed and messed up my schedule for the holidays. My white blood counts were a little low, so my treatment has been delayed for a week. My 7th treatment is now scheduled for Dec. 7th.

The best laid plans always go awry!

"And this too shall pass......"

Cindy

Holidays are over and back to reality

Hi All - well it's back to reality tomorrow. The Thanksgiving holiday is now over. I am feeling pretty good and was able to go all the way to East TN to visit with my parents and my siblings (along with their spouses and all my nieces and nephew). We had a wonderful and busy visit - always seems to happen when 16 people are all in one house. Abby had a wonderful time roaming free in the fields at my parents - she roused a rabbit from its morning slumber and saw two deer running in the back woods. She slept the entire 7.5 hour trip home and will most likely sleep all of tomorrow as well.

Now we are back in Memphis and have to return to our "normal" life. My 7th treatment is scheduled for just after 8 AM tomorrow and I'm not really looking forward to this week as I will feel under the weather until around Friday or Saturday.

Have a wonderful and safe week.

Cindy

Another one bites the dust

To all my friends and family,

My 6th treatment was yesterday (Wed. Nov. 11th) and I only have 2 more to go.

I was able to have my port-a-cath (2nd one - other one had to be removed because it never healed correctly) put in yesterday as well and have the Hickman line removed - Yeah!!

I have also qualified for a drup called Aranesp which helps with the production of red blood cells - this will help eliminate some of the fatigue and light-headedness as well as help me become more ready for my next treatment. My next treatments are scheduled for Monday, November 30th and Thursday December 17th. I moved them so I wouldn't feel quite so bad for Christmas and New Year's.

We are having beautiful, sunny and warm days here in Memphis which lets me get out and move around with Abby as well as run errands without having to wear duck shoes. No rain for at least the last week - yeah our yard has finally dried out and Abby isn't constantly covering my kitchen floor with mud.

Wishing everyone a very Happy Thanksgiving and safe to all those that are traveling.

"And this too shall pass......"

Cindy

Week 17 & Alls Well

We are off to Knoxville for the weekend. I'm feeling pretty good, just a
little tired. My hematocrit is a little low but not low enough for a
transfusion.

We heard back from the geneticist this week. The good news is that I
do not have the BRCA 1 or BRCA 2 mutation (breast cancer genes). We
are now waiting to hear from the insurance to see if they will cover
one other test - looking for Lynch Syndrome. I should hear more in
another week or so.

My 6th chemo treatment is next Wednesday.

"And this too shall pass......"

Cindy

Rain, Rain Go Away!!

Treatment 5 is down and I'm on the upswing to feeling better already. Mom has been here for the last 5 days or so to help out since Kyle had to go out of town. Abby has been loving it since my Mom spoils her worse than we do. She's had more treats and playtime than ever before and will no doubt drive us crazy for several days after my Mom leaves.

I'm ready to start exercising again and get my energy level back up so I can do things around the house. My hemoglobin levels were a little lower again just before the last treatment, so they are talking about me having to have another transfusion. With any luck we will be able to talk the insurance company into paying for a drug to help with the stimulation of red blood cells instead of the transfusion. Should know more about this sometime this week. My catheter that they put in last week instead of another port-a-cath is healing slowly. The incision from my initial port-a-cath still has not healed completely, so they will leave the catheter in until then. At least they can use that instead of having to stick me everytime they need blood or I get chemo.

On the genetics front, we have yet to hear from the genetics lab with the results of my blood work. We hope to know something by the end of the week.

Happy Halloween Everyone!!

"And this too shall pass....."

Treatment 5

Well, I'm off tomorrow to spend the day getting treatment. I am now on the backside of my treatments (only 3 more after this) and I'm feeling better than I have in the last 5 months. I'm able to exercise on a more regular basis and I'm not getting light-headed nearly as much as I used to.

Mom comes in town this week to keep me company and play with Abby while Kyle is in and out of town. Supposed to be beautiful weather so I'm sure Abby will have Mom playing with the soccer ball alot in the backyard.

Thanks to everyone for their thoughts and prayers.

"And this too shall pass......"

Oh No - I'll be 42

Well, tomorrow I turn 42 and I'm verry happy to be able to celebrate turning 42. We will be in Knoxville watching the VOLS play against Georgia. I'm hoping that the fall leaves have turned and will be able to enjoy the beauty of the mountains.

My nausea and pain showed up a little early after treatment 4, but it also went away about a day earlier than it has. I've been able to enjoy most of this week - minus the rain of course - and I have big plans for next week ...... cleaning a room upstairs and some flower beds out front before it gets cold.

Remember, October is Breast Cancer Awareness Month and even though you may not think that you know someone who is affected you would be surprised at how many truly are. So remind everyone to be more diligent in screening not only for female breast cancer but for male breast cancer, ovarian cancer, colon cancer and prostate cancer. These can all related genetically and can be traced to some of the same gene mutations. Doesn't hurt to be proactive in ones own health.

"And this too shall pass......"

4th Treatment Down - 4 to Go

Well, I had my 4th chemo treatment yesterday and only have 4 more to go. Yeah, halfway done!!!

I did get a chance to speak to a genetic counselor yesterday. My doctor has suggested genetic testing due to my age and the type of cancer that I have (unusual to have ovarian cancer in your early 40s). They suspect a family history and want to delve further into my family tree. This should be interesting. If something is found, at least my siblings and their kids will be better informed and be a little more closely watched in the future.

Its another beautiful fall day. I'm going to be a couch potato for the next several days as I am anticipating not feeling all that great. I should be back up and feeling much better by mid next week.

"And this too shall pass......"

What a Beautiful Fall Day

Not a cloud in the sky......temperature in the mid-seventies....wow, what beautiful day!! I'm sitting outside enjoying the sunshine on a fall day with my Lab, Abby. Kyle and I had a wonderful (but rainy) weekend in Knoxville watching the UT football game. How I wish we could have stayed an extra few days and gone hiking in the Smokey Mountains...not that I would have had the energy to go on a hike longer than 100 feet!! When we left, the sun was shining and mild temperatures were expected for the day.

Another couple of days and another treatment....just another bump in the road to a full recovery.

"And this too shall pass......"

It's Now Week 11 since my surgery

It's now week 11 since my abdominal surgery and I'm moving right along.

My 4th chemo treatment is scheduled for next week and I will be half way thru the treatments. The past week or so has not been quite as expected.....a lot more fatigued than I was expecting. Before I've been able to feel almost normal after about day 8 following a treatment but this past week has been a little different. I'm bored and restless but when I try to get up to do things I'm out of breath and easily tired. I've been told that this is just part of the process and it will continue to slowly get worse until its all over and I'm thru with all my treatments. I'm just not used to sitting around watching TV and reading ALL the time. I've never been one to sit around and just "surf then net" either.

Kyle and I are going to get out of town again this weekend and go see the VOLS play in Knoxville. It will be a tiring trip but well worth it for a change in scenery.

Abby is doing great and still growing .... she's up to 70 lbs. now and still only 9 months.....she's going to be a big girl.

All your thoughts and prayers are greatly appreciated. "And this too shall pass......."

Third Treatment Down - 5 to go

Well, I had my third chemo treatment last Wednesday and I'm on the mend. My weekend wasn't too bad.....a little more fatigued than the last time. Going to have some blood work today to see if I need another transfusion or not. If my red blood cells are too low then that would account for the fatigue.

Been rainy here in Memphis, so sleeping while not feeling well worked out well....just look outside, all cloudy and misty and all anyone would want to do is curl up and snooze.

Missing Kyle yesterday and today as he is out of town for work. Abby really misses him when he's not here (so do I).

Hopefully the next two weeks will be uneventful....trying to go to Knoxville again for the UT v Ohio game....have to wait and see how I feel a couple of days before we go. Should be a great time to be in East Tennessee as the leaves will be beginning to turn which always makes the trip more relaxing and enjoyable (I feel like I'm going home......).

My next treatment is scheduled for September 30th so you may not hear much between now and then. I usually just try to exercise per docs instructions and take it easy with house work and laundry....wouldn't figure anyone would want to hear how much laundry I've done today.

"And this too shall pass......"

Well, I made it thru

Yes, I had a wonderful trip to Knoxville.....got to go see my VOLS win and visit with friends we only get to see once or twice a year. I'm feeling almost normal these last several days, but that is about to change. My next treatment is scheduled for tomorrow, so I plan on not feeling good over this up coming weekend.

My friends and family have been continued support throughout my illness and I want to again let them know how much there help and prayers have meant to me. Without your continued presence in my life, whether thru email, comments or personal contact you are there for me no matter what has come up, Thank you.

"And this too shall pass....."

Happy Labor Day Weekend Everyone

Well, I'm feeling good enough to definitely go to Knoxville this weekend. I've been taking it easy and resting a lot. I've been able to get together with friends and visit for a while .... nice to get out of the house for a change.

Wishing everyone a happy and safe Labor Day weekend.

"And this too shall pass......"

Ankle Update - Good News

Well, I got good news the other day in physical therapy. My right ankle has progressed well enough to be able to be released from phyiscal therapy and just follow thru at home. We are making progress in the healing of my many health issues.

As for my chemo and how I feel.....I have recovered much more quickly this time that after the first chemo treatment. I am now able to go for walks and build up my strength and endurance a little more, which should help me in the long run. I even feel well enough and have enough energy (won't know until I try) to go to the opening UT football game on Labor Day weekend in Knoxville. Go Vols!!

My next chemo treatment is scheduled on September 9th and I'm hoping it will proceed much as the second one has....with a little less bone pain if possible.

Only 6 more to go

Well, my second treatment has come and gone. I didn't feel quite as bad after this one as the first. I also didn't start out anemic either. The extra blood that I got the week before my treatment has really helped me out. Kyle didn't feel all alone this weekend...I didn't sleep the entire weekend. I'm already feeling much better and able to get up and do things a couple of days earlier than last time.

Again, thank you to all our friends and family for your thoughts and prayers. Your continued support and thoughtfulness has helped both Kyle and I more than you will ever know.

It's that time again...

Well, today is my second chemo treatment. I'm feeling good right now energy wise and eating well. The 2 units of blood they gave me last week really helped me with the fatigue. Hopefully all will go as it did last time and I will just sleep for about 5 days and then start to feel almost normal again...I can even start to exercise now that its been 6 weeks since my surgery. Just one step closer to all of this being over and being able to get on with our lives. Just one day at a time....................

"And this too shall pass....."

On the mend from Chemo

Well, its day 6 since my 1st chemo treatment. I'm on the mend and feeling better, so hopefully I will have a couple of weeks of feeling good before the next treatment. Days 3 & 4 were rough but sleep took care of those days.

"And this too shall pass....."

One Down - Seven to Go

Well, my first day of chemo is done with. Not too bad actually....will really depend on how the next couple of days go. Had a good nap when I got home. They gave me Taxol and Carboplatin today along with anti-nausea meds and a few other side drugs. My next chemo treatment is scheduled for August 19th, so I should have a couple of weeks feeling good before they hit me with more drugs again.

Abby is still being wonderful and careful around me, she is so sweet (she can be a little devil at times though and drive Kyle crazy!!)

All in all, not a bad day.

"And This Too Shall Pass......"

Its about to Start

Okay, the chemo starts tomorrow. I'm feeling pretty good and getting around good as well. I'm a little apprehensive but I'm sure that's to be expected. It will be an all-day treatment, so hopefully I can catch a nap or two while the chemo is doing its thing.

"And This Too Shall Pass......."

Cindy's Pre-Chemo Haircut!

Chemo is now scheduled

Hi Everyone,

Its wonderful to be home! I've been home now for a week and feeling much better. Abby has behaved wonderfully and not jumped on me to irritate my incision at all. Abby is really glad to have all of us home and her regular routine in place again. She did enjoy her week long visit with "Grandma" (my mother came to stay for a week) as she was spoiled more than normal.

We had our first post-op visit with the oncologist this morning. Things are progressing nicely and looking good. I am scheduled to begin my chemo treatment next Wednesday, July 29th @ 8:30 AM. Each treatment after that will follow every 21 days.

As far as my ankle injury, I hope to begin rehab on it in the next couple of weeks. Things are finally moving forward on all fronts.

Thank you all for your thoughts and prayers over the last several weeks. Knowing that there are so many people that care has really been a Godsend.

God Bless.

Cindy

First day home

We're all very glad to be back home. Cindy's mom is here helping out for the rest of the week. Starting yesterday morning, Cindy has felt much better and is able to get up and around with minimal effort or pain. I know she prefers the food here to what they served in the hospital, too.

This afternoon she got a port-a-cath inserted that will be used to give the chemotherapy. Her first follow up appoinment with the Gyn-oncologist is next Wednesday. That's when we'll discuss the chemo regimen and get her stomach staples out.

After 12 long days . . .

We're headed home!!

One more day down . . .

Things keep moving along well. Cindy has been up walking a few times today and is tolerating a regular diet. Her oral pain meds have been cut back a bit and, other than a few muscle spasms, seem to be controlling the pain pretty well. Unfortunately, some pain will just come with the territory as her abdominal incision heals.

Her renal function has continued to improve and her other labs look good too. Barring any unforseen difficulties, the medical team is planning on sending her home on Monday.

Fingers crossed . . .

Things are going very well right now. Cindy was moved from the ICU bed to the surgical oncology wing yesterday (and walked from one room to the other!) The IV pain meds have been discontinued and she's getting oral meds now. There's talk of getting her a regular diet today, which would really help her energy level - broth and red jello just aren't cutting it!

She should get to go home in the next couple of days. She already has an appointment for Tuesday afternoon to get a port-a-cath inserted at the clinic office. She will probably be treated with cispatin or carboplatin and taxol every three weeks for 6 cycles.

A little more about what we found out from the pathology report: the tumor was confined to the right ovary and the fallopian tube on that side. All visible tumor was removed and none of the abdominal washings or samples that were sent (lymph nodes, omentum, etc) showed signs of cancer. That means her cancer is stage IIa. The majority of ovarian cancers are diagnosed at a later stage, so Cindy was very lucky that this was caught early. It makes the likelihood of successful treatment much higher.

Lymph nodes are NEGATIVE!!!!!

This morning we got the best news of the last 2 weeks - the inflammed lymph nodes that were removed during surgery are negative for cancer! That means that Cindy's cancer is only stage II. The Gyn-Oncologist was very happy and said that it will be easier to treat. Since all of this started when Cindy tripped over Abby's baby gate, she's the hero in all of this that let us catch it early. Cindy's mom is going to give her a big hug when she arrives tomorrow!

Other signs are looking good, too: her creatinine is down some, meaning her renal function is improving and her white count is back to normal. We're crossing our fingers that we'll get to move out of the ICU room today.

Thank you all so much for your prayers. Other than having the surgeon say "Oops, we were wrong and there wasn't any cancer in your ovary", this is about the best possible news we could have gotten.

After further review . . .

. . . the ruling on the field is overturned.

Well, I spoke too soon earlier. After I left for lunch, the intensivist came back and decided that he'd prefer to keep her in the ICU room to more closely monitor her renal function. Her white count is also up again, but the ID specialist thinks its just a post op reaction. Either way, she's still hooked up to the monitors and we're hanging out in ICU. No results from the renal ultrasound yet.

Lots going on today . . .

. . . most of it good! Cindy had a good day yesterday. The nurses got her up in a chair a couple of times and her pain was pretty well controlled. Overnight she slept really well (which means I did too - the couch in her room isn't the worst place I've ever slept, but it sure isn't the Four Seasons !)

Today she's going to be transferred out of the ICU area of the oncology floor to the regular surgical oncology unit. The tube that was draining her stomach has been removed, and so have most of the monitoring devices, so she'll feel a lot less tethered to the bed. She was able to start a clear liquid diet today. Her stomach incision looks good and her temp is normal. She was getting a little loopy from the pain meds, so the dose has been decreased so she can feel a little more with it and hopefully continue to keep moving around. I've heard that the nurses on the unit she's moving to can be like drill sergeants, but the sooner she gets up and walks around the better.

Really the only thing that's not going great right now is her kidney function. After getting a little better the last couple of days its gotten a little worse again. She's still peeing - which is good - but some of the lab tests are still abnormal. She's going to have a renal ultrasound this afternoon to see if that can give us any answers.

Overall, though, things are going really well. We're still waiting for the pathology reports from the samples taken during surgery. Those will be used to more accurately stage her cancer and guide the chemo treatments that will start in the next couple of weeks.

Good news - they decided to go ahead and take the breathing tube out last night. Hopefully that's one less day of recovery she'll need. She's about as comfortable as can be expected and has a PCA pump for pain control.

Cindy's surgery was completed about 7:30 tonight. They did identify a tumor on her left ovary. Dr Smiley told us that it seemed fairly well contained, with no apparent seeding of the other ovary or organs. The lymph nodes were inflammed, but we'll have to wait a few days for the pathology report to know if they were cancerous. Based on that her cancer is either stage II or III. She had a total hysterectomy, but there was no need to operate on her large intestine.

After recovery, she'll be going to the ICU part of the oncology floor. Because it'll be relatively late by the time she gets settled, they're going to leave the ventilator in place until at least tomorrow. With the large incision, the pre-existing PE, etc she may be on it for another full day.

We've crossed one hurdle but there are more to come. Cindy will be in the hospital for 5-7 more days. Chemotherapy will begin in about 10 days, but we obviously haven't discussed how often or for how long.

Nothing new today . . .

We're just hanging out waiting for surgery tomorrow afternoon. Cindy's temp has been normal/near normal all day so she's felt OK. She tried to get some sleep today, but the parade of people coming through - respiratory, case workers, hospital volunteers, hospital chaplain, etc - was busier than ever. I think she only got about 30 min of sleep at a time. Oh well, like one of the med students said, she'll get a good nap during surgery tomorrow. Her serum creatinine is still elevated (meaning her kidney function is decreased), but its the same as yesterday. Hopefully, it'll normalize after surgery.

Today was a pretty good day. Cindy's temp was more or less normal most of the day and she was able to get some rest. Her renal function is still the same, and a nephrologist saw her this afternoon. The decrease in kidney function could still be because of the dye used or from one of the antibiotics. We'll just have to watch it closely for the next few days. Otherwise, its just status quo until surgery.

Cindy's fever was lower most of the day yesterday and is normal so far today. She feels much better when her temp is normal. The abdominal distention and pressure is still there and that's what's giving her the most trouble right now.

They decided to move her surgery up a day, so it'll be on Tuesday afternoon. We're still very nervous about what they'll find, but hopefully that will finally answer our questions. So far none of the tests - blood cultures, sinus CT, chest x-ray, etc - have identified the source of her fever, but at least we're crossing things off the list. Right now the two best possibilities seem to be an intra-abdominal infection or an inflammatory reaction as I mentioned yesterday. Unfortunately, that also means that Cindy will be in the hospital until after surgery, but that's probably the best place right now.

Cindy's hematocrit was a little low this morning, so she's getting a couple of units of blood in preparation for surgery. Lab tests also show some reduction in her renal function, which is a bit concerning. Physically it still seems normal, so hopefully its a transient reaction to the dye used in some of her scans.

On another note, many of you have asked if we need help with Abby, our lab puppy. We had already planned to board her when we thought the filter placement was going to be done as an outpatient and we just extended her stay. She loves the group playtimes and is worn out at night . . . a tired puppy is a happy puppy! I picked her up today and she'll stay at home until Tuesday when she'll go back again for another couple of days.

A long day and night . . .

Cindy's first full day in the hospital was busy. In the morning, all of her doctors made rounds. The infectious disease consultant is not convinced that her fevers are the result of an infection. Its possible that it could be an inflammatory reaction from either the DVT/PE, the ovarian mass, or both. He did order an echo to rule out endocarditis (it was normal), and a CT of her sinuses to evaluate the possibility of a severe sinusitis. That's being done this morning (Friday).

On Thursday afternoon, the umbrella filter was placed with no complications, and Cindy was finally able to eat after being NPO all day. Because of the fluid in her abdomen though, she gets full with only a small quanity and then feels miserable. That was the main cause of our long night. A baruim enema is scheduled today to evaluate her large intestine and colon, so she had to drink a prep solution every hour for eight hours overnight. We tried to do it in as little fluid as possible, but the bloating and abdominal pressure made it very uncomfortable. Hopefully she'll be able to get some sleep today and have a more restful night tonight.

Quite a full day today . . .

Well, today ended up a lot more complicated than we thought it was going to be. Cindy had a follow appointment at the Gyn-Onc this morning and then her orthopedic appointment this afternoon.

The low grade fever hit early today, and when we saw Dr Smiley, she wasn't happy with Cindy's continued fever, chills , and increased white count despite her being on oral antibiotics since Friday. She decided to admit her to the hospital, check some blood cultures, and get her started on some IV antibiotics. The good news from her was that Cindy's surgery was able to be scheduled next week - Wednesday, July 8. we're both really glad she won't have to wait until the week of the 13th.

She did allow us to make a detour to the Ortho appointment, though. There we got some more good news - Cindy's ankle probably won't need surgery! Dr Murphy put her in a walking boot and hopefully the ankle will heal with some time and PT.

The IVC filter is still being placed tomorrow, but unfortunately it'll be an inpatient procedure rather than an outpatient one. Hopefully, though, she's on the road to getting rid of the persistent fevers which were really wearing her out.

How we got here . . .

For those that haven't heard the whole story, here it is. It's long, so bear with me.

On Mother's Day, Cindy tripped over the baby gate we use to keep Abby (our 6 mo old lab puppy) in the kitchen. She landed on her left knee, and other than being a little sore there seemed to be no problems. Two days later, she began having pain in her right ankle and calf. The next day, the pain had gotten considerably worse, so she went to a minor med office and was diagnosed with a deep bruise in her calf and possibly a sprained ankle. X-rays of the ankle were negative. Ice and elevation didn't really help, and by Sunday, May 17 the pain was worse than ever and we went to the ER. An ultrasound of her calf revealed a DVT (deep vein thrombosis) in the peroneal & popliteal veins of her calf & knee. Treatment was started with Lovenox and coumadin.

Over the next couple of weeks, she improved and was able to walk off of her crutches and go back to work. By the weekend of June 6, though, the ankle and calf were swollen again. On June 11, Cindy had an MRI of her ankle which showed disrupted (i.e. detached) ligaments in her ankle. She was back on the crutches and scheduled to see an orthopedic surgeon on July 1.

In the meantime, we continued regular visits to our internist to monitor her coumadin. At one of these visits, Cindy asked about a persistent dry cough she'd had for a while. A chest x-ray in the office was negative. The doctor was concerned that there might be a blood clot in her lung (a pulmonary embolism) and scheduled a CT angiogram of her chest on June 22. We went in for the angiogram at 7 am. The radiologist noticed something irregular and wanted to do an abdominal and pelvic CT as well. We went up to the internists office, and he told us that the scan showed that there was a clot in her lungs, but that wasn't all. They had also discovered a 10cm mass on one of her ovaries. While the meaning of this news sunk in, we set up an appointment with a Gyn-Oncologist.

Our first visit with the Gyn-Oncologist - Dr Linda Smiley from the West Clinic -was on Friday, June 26. She reviewed the CT scan with us and confirmed our suspicion that Cindy would need surgery to remove the mass and would also likely undergo a total hysterectomy. Because of the existing blood clot in her leg, an "umbrella filter" needs to be placed in her inferior vena cava before surgery. The purpose of this device is to catch any part of a clot that broke off from her leg before it could reach her lungs. Luckily, this can be done as an outpatient and we'll be at Baptist Hospital tomorrow morning (July 2) for the procedure.

Right now, Cindy feels OK most of the time. She does have a low-grade fever that comes and goes, and when it hits she feels pretty lousy. She's also still hobbling around because we haven't been able to do anything about her ankle yet. Because of all the upcoming procedures, she's been switched from coumadin to Lovenox to treat the blood clot. Lovenox is an anticoagulant that's injected subcutaneously (like insulin) in the abdomen twice a day. It also happens to be the drug that I've been educating health care practitioners about for the last 9 years.

That's where we stand right now. Today, we have a follow up appiontment with Dr Smiley to review some more test results and schedule the surgery. We also get to meet with the orthopedic surgeon. Originally, we assumed that he would do surgery to reattach the ligaments in her ankle, but that seems unlikely now, at least for a while.