Wednesday, April 5, 2017

4/5/17 Each night I pause, remembering, some lovely, precious thing

Dear Family and Friends,

I hardly know where to start, as so much has happened since my last post.  But let’s just start by saying “Adios” to my hair!  Yep, after just one month of my new double chemo, my hair is falling out by the fistful and making a huge mess everywhere.  Thus, today at 5:20 PM, I have an appointment to have it shaved off.  Poor Jericho!  When he sees me on Saturday, he will wonder who the bald-headed woman is and where did his Ga Ga go?!

Yesterday I finished chemo number four, which almost didn’t happen.  My neutrophils, the part of your white blood cells that fight infection, were only 1.17, and the cutoff for it being too risky to get chemo is 1.0.  Yikes!  My doctor was out yesterday, but today she will call and tell me to start the neupogen shots in my stomach for four to five days in a row this week.  Neupogen is the drug that helps your bone marrow make more neutrophils.  The shots hurt and bruise your abdomen, but the worst part is that neupogen makes your bones ache as it stimulates your bone marrow to work harder to make blood cells.  This week will be challenging, but as I’ve shared so many times, even through the hardest parts of battling cancer, God seems to send an equivalent amount of joy to make my days not just survivable, but truly worth living.

For instance, our beautiful daughter, Renee, got engaged to her long-time love and best friend, Riley, a week ago!  We are overjoyed to welcome Riley to our family, and I am thanking God that He has kept me alive to attend my daughter’s wedding!  Do Mother-of-the-bride dresses have to have sequined sparkly things all over the fabric?  Wig or hat?  Heels or shoes I can dance all night with?  These are the musings in my head this week as my mind turns to wedding planning! 

In other news, the new cancer drug we have been waiting for, and that many of you have joined us in praying for, slated for fast track approval by the NIH by June 30, got approved EARLY—this very week!  It is designed exactly for my type of ovarian cancer, and while not able to cure the cancer, it is shown to extend life expectancy in most women who took part in the clinical trials.  We are praising God for this answer to prayer!  The oncologist won’t start me on Niraparib automatically, but will wait to see how my current drugs are working when I get my next scan on May 19th, and then will decide if it’s time to start the new drug or not.  But knowing it is approved and on the market, if/when I need it, is a tremendous blessing.

Another blessing has been that even after just four treatments, the pain in my stomach and back have decreased to barely noticeable most days!  I have been eating normal amounts of food again and have been able to walk three to four miles or work out on our elliptical machine about four days a week.  So thankful for these simple pleasures I took for granted for so many years. 

Other joys have included teaching Jericho to make our famous chocolate chip cookies, Daniel turning 27 on April 1 and finishing his arduous surgery clerkship the Friday before, and Steve fixing our leaky kitchen faucet.  Oh, and have you noticed—things are finally blooming (like our pink dogwood tree and tulips)!

My dear Uncle Roger, who just lost his own daughter, my cousin Andrea, to cancer, sent me a wonderful poem this week about the coexistence of joy and adversity, and how even through the worst of times, splashes of joy appear to make life so worth living.  Here is the poem, given to him by a friend in 1964, author unknown:

“The day will bring some lovely thing” –
I say it over each new dawn –
“Some lovely, precious thing to hold
against my heart when it is gone.”
And so I rise and go to meet
the day with wings upon my feet.

I come upon it unaware,
Some sudden beauty without name:
a snatch of song, a breath of pine,
a poem lit with golden flame;
high tangled bird notes keenly thinned,
like flying colors on the wind.

No day has ever failed me quite –
Before the grayest day is done,
I come upon some misty bloom
or a late line of setting sun.
Each night I pause, remembering,
some lovely, precious thing.

And I will add in closing, “Let the heavens be glad and the earth rejoice; let the sea and what fills it resound; let the plains be joyful and all that is in them.  Then let all the trees of the forest rejoice before the Lord who comes, who comes to govern the earth, to govern the world with justice and the peoples with faithfulness.”  Psalm 96:11-13

Love,
Gabrielle Dudley

Daniel and girlfriend, Adrienne, serenading us with "City of Stars" from the movie, "La La Land!"

Steve and me on a rainy day walk at Alki, followed by our favorite pizza at Pegasus!

I could look at this photo all day.  Renee reading Thomas the Tank Engine books to Jericho ("Thomas, more Thomas")!

After doing all the adding of ingredients and stirring himself, Jericho squeezes the scooper, dropping his cookies onto the pan to bake!

My beautiful girls--Renee and Riley--at their engagement celebration at Lantern Brewery!

Daniel and me by the Montlake Cut on his birthday when we went with Steve to see the cherry blossom trees at the UW Campus!

My handsome, 27-year-old, April Fool's Day "baby"--never too old for his Winnie the Pooh birthday banner!





Thursday, March 9, 2017

3/9/17 Urgent Prayer Needed

Dear Friends and Family,

This is just a quick, urgent request for your prayers.  In December, the company Tesaro, which makes cancer drugs, applied for fast track approval by the FDA of a new fully tested drug called Niraparib, which is designed to treat my exact type of cancer.


The FDA has agreed to fast track approval with a "target date" of June 30, 2017.


I am getting toward the end of my options at this point, and am praying so hard that my current therapy will be something my body can sustain, and that will hold the cancer in check, until Niraparib is approved.  


Niraparib could double to quadruple my current life expectancy.  I could see my son graduate from medical school.  I could perhaps see my daughter get married.  I could continue to love and nurture my beloved grandson, Jericho.  And of course, enjoy the blessing of more time with Steve, Renee, Daniel, and all of you--my dearest family and friends.


Will you pray with us for this drug to be approved on time and for God to give me strength to endure this current difficult therapy in the meantime?  


Thank you!!  


Love,

Gabrielle

Philippians 4:6-7 "Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus."

Monday, March 6, 2017

3/6/17 New plans

     Hi, family and friends.  Steve here with an update.  As some of you know, Gabrielle has been having worsening symptoms for the past month with more stomach pain, back pain, loss of appetite, and more.  It got even worse while we were on vacation on Maui last week.  So bad, in fact, that we tried to get an early flight out of there just to get back home, which is the only place you want to be when you don't feel good.  Gotta feel pretty lousy if you can't wait to leave paradise, don't you think?

Anyhow, while we languished in the Pacific, doing our best to make the most of our forced exile, Gabrielle was in contact with her doctors back home.  They arranged for her to have some tests the moment she got back.  We got in late last Thursday, rolling home after midnight.  Six hours later, it was time to get up and head down for an endoscopy (“upper GI” study) to be followed shortly afterwards by a CT scan to see what could be causing her symptoms. 
I spoke with the GI doctor just after the test and it was pretty good: no ulcers or significant findings.  We had a nervous time over the weekend, waiting for her appointment at 8:00 this morning to go over the CT scan results with her cancer doctor.  Unfortunately, the results were less than favorable.  In a nutshell, the cancer has spread to the liver with at least three new spots that were not there on the scan in late December.  Several lymph nodes in the abdomen have gotten larger as well and appear to be compressing some of the important structures in the area such as the main vein that enters the liver (portal vein).  Doctor said that this could also be causing “gastric outlet syndrome” in which she is hungry, but the food just doesn’t leave the stomach all that easily.  Can also account for all the horrible back and abdominal pain she has been having.
So, in clinical terms, the cancer is progressing and clearly the two medications she had been on since the first of the year weren’t doing a lick of good.  Treatment of cancer involves trial and error.  Some drugs are winners, and some are not.  New plan is to step things up to a much more aggressive approach with weekly chemotherapy which starts tomorrow.  Plan is to get two drugs: Taxol (the one which makes your hair fall out) and Avastin.  Had labs today to make sure that her blood counts are good enough to get Taxol, which we are hoping for, as this is the cancer fighting component of her new treatment.  Avastin is supposed to cut off the blood supply to the cancer cells, but doesn’t have any cancer killing properties of its own.  She has had both medications before.  We are a little nervous about the Avastin as that’s the one that has a potential side effect of bowel rupture, which is potentially life threatening, but we do not have a whole lot of other options at this point.   
Doctor said she had been in contact with our insurance company (Regence, not like I’m naming any names or anything) and they are being downright persnickety about approving the Avastin, unless it is combined with the Taxol.  So far, so good, since she is supposed to get the Taxol as well, but the concerning thing is that if she can’t get the Taxol due to low counts, they may not approve Avastin by itself.  When the doctor told us about this, she said it was infuriating that they would not approve it, and plans to go toe to toe with them soon.  She is, after all, the expert’s expert on ovarian cancer treatment, not the insurance companies.  We are confident that things will work out such that Gabrielle will get the drugs, but it is still very frustrating to deal with insurance issues in the midst of all this.  Having said that, am thankful for the insurance that we do have.
            This is all quite an adjustment for us, to see such rapid change in the CT scan and see such worsening symptoms in such a short period of time.  We are all nervous about what lies ahead, but are confident that with God’s strength we will weather the storms.  His grace is indeed sufficient.  We appreciate your kind thoughts, prayers, and support.  It looks like we are in for a bumpy ride ahead.
            I will end by saying that this sad news comes as a shock to all of us.  It also seems a tad incongruent in light of how good she looks.  Time and again, people have commented on the fact that she appears so healthy.  This is a testimony to her iron resolve and determination not to let the cancer define her or bog her down.  Being around her a fair bit, I have been so impressed with how she has faced this cancer from the very beginning with an attitude of strength, determination, and sheer guts.  She has never let the setbacks get to her.  She always has kind words and smiles for the medical staff attending her, and thanks them for their service.  She faces pain with a fortitude that I cannot even begin to fathom.  Her faith in God and His providence and goodness is unwavering and an inspiration to us all.  In short, she is my hero.  As she goes into this next battle, I have no doubt that she will continue with the same bravery and courage that she has demonstrated all along.
            Even now, as I am finishing this little note, she is sitting across from me, reading passages to me from C.S. Lewis’ Mere Christianity (phenomenal book by the way).  She just hit on a passage about the contrast between this life and the next being similar to the difference between cold stone statues and the real living, breathing organisms that we all are.  There is a hush about the sculptor’s studio as there is a rumor that some of us statues are going to come to life some day.  That will indeed be a glorious day.
Maui, last week.  People always say "You look so good!" which, of course, is nice to hear.  But just like in much of life, what you see on the outside is not always reflective of what's going on on the inside of a person.  Best to get beyond the surface if you really want to know what a person is going through and if you want to learn how best you can come alongside them in the journey.   



Thursday, February 16, 2017

2/16/17 Thoughts on Cancer and Churchill

Dear Family and Friends,

At the Dudley home, we have an elliptical machine in our basement that faces the TV.  This makes it immeasurably more fun to work out!  Recently while sweating away, I watched an outstanding documentary about Winston Churchill’s wartime years called “Appointment with Destiny.  I had always admired Churchill before, but after watching this portrayal, he rose to the auspicious rank as one of my top five favorite famous humans (apologies for the “f-words alliteration). 

Five of his quotes have particularly stuck with me, as I am in a life and death battle with cancer, obviously on a much smaller scale than Churchill’s (hereafter WC) battle with Hitler.

1)  Since Steve last reported to you after my 12/29 scan, a few things have happened.  I began a new daily oral chemo drug called Cytoxan on January 10th, and two weeks later, had to go to the ER due to intense pain from my chest down to my lower abdomen that would not go away.  The ER doc was to rule out things like heart attack or a blood clot in my lungs.  Thankfully, I was cleared of both worries, so I soldiered on with the Cytoxan.  “If you’re going through hell, keep going.”--WC  The hourly, daily suffering continued—indigestion, gas, bloating, heartburn, and a general unwell feeling.  After a month, I couldn’t take it any more and the doc told me to stop the Cytoxan immediately, as it was doing more harm than good.  

2)  Next, the doctor told me tests had revealed an infection, so she started me on antibiotics, and to heal my stomach and intestines from the toxicity of the Cytoxan, she put me on a “low residue diet.”  Basically I get to eat things that are low fiber, low fat, and super easy to digest until I heal.  I am normally a high fiber eater, so it is just mildly irritating to have to eat canned peaches and green beans and unbuttered peeled potatoes for dinner while Steve and Daniel are having roast chicken, lobster bisque, and broccoli!  Every day I anxiously wonder whether or not my guts will heal before my trip to Maui, for we have reservations at a top-rated sushi restaurant there that is exceedingly difficult to get into!  But I must quit worrying, for “It is a mistake to try to look too far ahead.  The chain of destiny can only be grasped one link at a time.”--WC

3)  I know that pride is a sin…but I am no saint, and I guess I have prided myself on being able to handle all the chemos the oncologists have thrown at me.  I’ve had chemos make me nauseous, ones that make me so tired and out of breath I can barely walk up our stairs, and had one that leaked out my surgery stitches in copious amounts such that I had to keep putting clean towels on top of my bandages on top of my stitches, and the towels would soak through every hour all day long!  And (with God’s help, of course) I handled it!  But this Cytoxan beat me to a pulp.  I couldn’t cope with 10-12 hours a day of pain that didn’t go away with medicine, despite the admonition to Never, never, never give up.”--WC  I still agree with Churchill’s famous phrase in theory, but sometimes, you just have to admit your latest chemo drug has defeated you and yes, give up. 

4)  The last news I received this week is that despite that horrific month of daily chemo, my CA-125 ovarian cancer tumor marker took quite a jump up, from 33 (normal is 0 to 35) to 57.  L  I had to cry most of yesterday over this news.  Renee is living in her own home now and Daniel and Steve were at work.  So I sat at home in mismatched jammies (navy with cherries on top and turquoise and white polar bears on bottom) and cried ‘til my eyes were pretty much puffed shut.  Then mid-afternoon, six hours before his work shift was to end, Steve’s Honda turned into our driveway.  I thought you might need me today, so I found someone to come in and finish my shift for me.--SD  There are moments when you are so filled with love for your spouse that you think you will burst.  This was one of those moments!  My spirits renewed, we played Scrabble, I enjoyed my tasteless, easy to digest dinner, and we held hands while watching our favorite shows.  

I am done crying for now, and though I will not soon forget the Cytoxan disaster, or the fact that four different chemo regimens have not cured me, I am moving forward.  Today I enjoyed a long walk with Steve in the spring-like weather and we worked on our conversion of Renee’s old bedroom to a “grandkids room” for Jericho and future grandkids, complete with “Welcome to the Jungle” themed bedding and large, framed prints of six different types of baby animals.  What fun!  And when we return from Maui, I will begin a fifth chemo regimen, ever prayerful and hopeful that the new approach will cause the enemy to retreat.  Success is the ability to go from one failure to another with no loss of enthusiasm.”--WC

Lastly, I could not imagine having to face this powerful foe without my deep faith in God, built through years of experiencing His love, strength, and peace, while watching Him supply all my needs.  Thanks be to God! I felt as if I were walking with destiny, and that all my past life had been but a preparation for this hour and for this trial.”--WC

Love,

Gabrielle

P.S.  See aforementioned jammie combo below.  Maybe on my 57th birthday, which is this Saturday, I will make an effort and wear a matched set!  J

Monday, January 9, 2017

1/19/17 Today's meeting with doctor

Hi friends and family,

Steve here.  


It was four years ago today that we got the word that Gabrielle was facing ovarian cancer.  Since then, we have all been on a roller coaster of emotions, treatments, experiences and such.  And today has been another ride on that same roller coaster with some not so great news.  It started out with the disappointing news that Gabrielle wasn't going to meet with her doctor as she had hoped, but one of her colleagues (highly experienced, quite good and all that, but still it was someone she had not met before).  Her doctor apparently had some medical issues of her own and couldn't be there.  


Today, we reviewed the results of the scan which was done on Dec. 29.  Cutting to the chase: "nothing is getting bigger, but equally nothing has gotten smaller either".  But the more concerning part of the report is that there is one area near the stomach and small intestines which has seen an uptick in the level of "activity" of the radioactive tracer.  In other words, her current medicines aren't doing much good and the cancer's heating up, or as the medical people like to call it "progressing", which is a term I'm not too fond of because I like to think of progress as something good, not of something getting worse.  You remodel a house and you make progress.  You order the extra large pizza and you make progress as you nosh your way through the whole thing.  I would like to think we're making progress against cancer, but sadly that's not the case.


Doctor said that the chemo is hitting Gabrielle pretty hard, with each successive treatment causing more problems to her health with more fatigue, suppressed bone marrow, bone pain, and nausea just to name a few.  We were given some options ranging from no meds at all, to a weekly double drug regimen (combo of drugs she has had before), but which came at the risk of bowel perforation (25% mortality rate if that occurred), to a daily pill (Cytoxan) for a couple of months.  After carefully weighing the options, and with good input from the doctor and her nurse, Gabrielle chose the daily pill.  We are also shifting gears a little.  Whereas before, the treatment plan was to kill the cancer (or a least try really, really hard), the new regimen is going to focus simply on keeping the cancer from getting worse, buying some time and giving her a break to improve her quality of life.    


Frankly, these results are the second to the last thing we had hoped for (last thing: it is spreading).  But no improvement and increased radioactive tracer uptake are quite discouraging.   Still, she feels OK physically.  We are all just getting reoriented to a new tack, to borrow a sailing term.  We are hoping that the Cytoxan will hold things in check for a while.  It's still tough on the immune system, so she needs regular labs as before, and must avoid being around anyone who is at all sick or has been exposed to a sick person at home/work.  It is also associated with some nausea, which may lessen after the first week (or may not).  We're hoping and praying for the best.


Well, friends, I wish I had better news to report, but that's not always the case.  I know many of you have been asking about Gabrielle lately, praying for her, and giving her (and all of us) much support in other ways (thanks for all the great fudge, by the way).  It means so very much to know you are with us in this very difficult journey.  


Daniel sent Gabrielle a song this morning before her doctor visit.  It is by the group, Casting Crowns, and is a perfect theme song for how we are feeling today.  Perhaps you can relate to having felt this way, or even feel this way now.   Let us encourage you with our firm belief that those tears we cry, God holds in His hand, and that He is by our side through all the joys and sorrows of this life.  The lyrics go like this:



I was sure by now, God you would have reached down

And wiped our tears away,

Stepped in and saved the day.

But once again, I say amen

That it's still raining

As the thunder rolls

I barely hear your whisper through the rain

I'm with you

And as your mercy falls

I raise my hands and praise

The God who gives and takes away

And I'll praise you in this storm

And I will lift my hands

That you are who you are

No matter where I am

And every tear I've cried

You hold in your hand

You never left my side

And though my heart is torn

I will praise you in this storm

I remember when I stumbled in the wind

You heard my cry you raised me up again

My strength is almost gone how can I carry on

If I can't find you

As the thunder rolls

I barely hear you whisper through the rain

I'm with you

And as your mercy falls

I raise my hands and praise

The God who gives and takes away

And I'll praise you in this storm

And I will lift my hands

That you are who you are

No matter where I am

And every tear I've cried

You hold in your hand

You never left my side

And though my heart is torn

I will praise you in this storm

I lift my eyes unto the hills

Where does my help come from?

My help comes from the Lord

The maker of heaven and earth

I lift my eyes unto the hills

Where does my help come from?

My help comes from the Lord

The maker of heaven and earth

And I'll praise you in this storm

And I will lift my hands

That you are who you are

No matter where I am

And every tear I've cried

You hold in your hand

You never left my side

And though my heart is torn

I will praise you in this storm

And though my heart is torn

I will praise you in this storm

  Casting Crowns - Praise You In This Storm Lyrics | MetroLyrics