5/7/17 Happy May Thoughts

May 6, 2017

Dear Family and Friends,

It’s a sunny Saturday here at Casa Shoreline.  Daniel is napping, Steve is at work, and I have a few quiet moments to get out a quick blog post.  What follows are a few random thoughts from the past week.  For those of you who are more linear, and like a thesis sentence, followed by defense of said thesis and a snappy conclusion, you better stop reading right now, for these are truly random bits of news and thoughts!

·   On Monday when I had my CA125 ovarian cancer tumor marker tested, it had dropped to 32!  So after just six treatments with the new double chemo regimen, the marker dropped from 166 to 32!  The normal range is 0 to 35.  I am still a bit stunned at this amazing news!  Thanks be to God, and thanks to all of you who pray for our family so faithfully.  I will continue with chemo for the time being, but a scan will be scheduled in the not too distant future to determine when I can take a much-needed chemo break!

·   I finally gave up blow-drying three or four wisps of hair each day and asked Riley to shave it all off!   We did this with Jericho present so that he wouldn’t be shocked when his Ga Ga suddenly appeared before him looking like a naked mole-rat.  But more importantly, one of Jericho’s favorite pastimes is vacuuming (“More dirt! More dirt!”), so I knew he would be filled with delight to vacuum up the last remnants of his Ga Ga’s brown hair.  And he was!

·   Within one day of shaving my head, I was told my parking fee was “on the house” at a frequently used parking garage (sweet), and two people mistook my gender (figures).  The first to err was a woman who looked right at me as I waited in line until she said, “Sir, I can help you now.”  Oops.  And the other was my soon to be five-year-old across the driveway neighbor, Marina.  When stopping to chat, she asked me what my name was and where I lived.  I said, “Marina, it’s me—Gabrielle—your neighbor.  I live right there.” (Picture my finger pointing at my house).  She replied, “Oh.  I thought you were a boy.”  Reasonable supposition.  Unfortunately, what did NOT happen within one day of shaving my head was that I was NOT offered two samples when Steve and I stopped by See’s Chocolates at Northgate.  I thought for sure the bald head would clinch that deal.  Rats!

·   Today, my two aunts showed up at our door for a shopping day at Alderwood Mall with Daniel and me.  One of my aunts had said “We need Daniel to help us pick out dresses to wear to Renee and Riley’s wedding,” so I had eagerly reserved this day on Daniel’s and my schedules accordingly.  As we chatted a bit before heading out, one aunt said, “I’m not buying anything today, I’m just along for the fun.”  Then the other aunt said, “I don’t need a dress either, but it will be fun to help you pick a dress, and I might need a t-shirt.”  To which I replied, “I already got my dress online.  So…wait a minute.  If you don’t need a dress (finger pointing at aunt number one), and you don’t need a dress (finger moving to aunt number two), and I’ve got my dress, then what are we all doing here?!  A laugh ensued and off we all went to Alderwood Mall anyway, where we bought Jericho his adorable ring bearer outfit and enjoyed a nice lunch out. 

·   Yesterday was such a precious day.  I didn’t mind one bit that it was finally sunny out while I was indoors all day, because I got to spend the day with my beautiful daughter, Renee, watching her try on wedding dresses!  Words can’t describe how it feels to a Mom to see her little baby girl all grown up and ready to marry the love of her life.  She looked incredible in every dress she tried on, but after visiting four bridal shops, we both knew without a doubt which dress was to be “her dress.”  Can you guess which one it was?  The most expensive one we tried, of course!  LOL.  Thank goodness I’m the one who pays the Visa bill each month to spare Steve from keeling over! 

·   For Cinco de Mayo yesterday, we had cinco cool guys from Daniel’s old 4^th Hill Dorm at SPU reunited around our dining table, along with one new and fabulous girlfriend, for Daniel’s delicious beef barbacoa tacos, Elliot’s ten-avocado guacamole, and Kenneth’s hand-shaken, agave sweetened margaritas.  How great is that?!

·   Lastly, in my Bible study we have been studying the New Testament book of 1 John.  A couple of verses have stood out to me as our family has spent a lot of time, leading up to the wedding, discussing people who seem to love everyone, and those who hate, and people who accept those who are different from them, and those who are blinded by bigotry.  In this short book of the Bible we read “But whoever hates his brother is in darkness and walks around in the darkness; he does not know where he is going, because the darkness has blinded him.” 1 John 1:11  In an effort to have compassion on those who hate, and those who are bigots, I am trying to see them, as this verse describes, as being blinded by darkness.  Their beliefs and cruelty of words and/or deeds are things they have been wrongly taught, and which continue through an unrecognized ignorance that prevents understanding.  They are walking around in darkness, and I hope, one day, will find light.  If you read 1 John you will see numerous verses imploring us to love one another.  “Dear friends, let us love one another, for love comes from God.”  1 John 4:7  It’s really as simple as that.  Thanks to all of you, and especially to Steve, Renee, and Daniel, who have taught me, and modeled for me, how to love, and extend light and grace toward all. 

Love,

Gabrielle

Daniel and I took Jericho to the Easter Eggstravaganza at our church.  A great time was had by all!

Steve, his Mom, Abby, and my Sister-in-Law, Tania, enjoyed a day together seeing the tulips!

Renee and me during our Girls' Weekend at Cannon Beach! Beach walks, long talks, pepperoni pizza, Scrabble, magazines, and lying in bed watching movies while eating the full fat popcorn.  Priceless!

Steve, Daniel, and I enjoyed a day-trip to Whidbey Island for our favorite hike at Ebey's Landing and the most delicious Penn Cove mussels at Christopher's Restaurant!

This is not the dress we picked.  Oh no.  It didn't cost enough for us to have picked it!  :-)

4/18/17 April Showers

Dear Family and Friends,

Well, I have some good news and some bad news, so I think I am supposed to ask you—which do you want first?  Since I can’t hear your answer, let’s just start with the good news!  I recently received the results of my CA125 ovarian cancer tumor marker test and my tumor marker dropped from 166 to 59 after just my first three chemotherapy treatments!  That's more than 100 points lower!  The two drugs I’m on must be doing something right, and we are praising God for this good news!

Now for the bad news.  Yesterday was chemo day number six, and the first news I got was that my blood counts were below the levels required to receive chemotherapy.  My neutrophils, those precious little white cells that fight infection, were at .7, and are supposed to be at 1.0 to be safe to get chemo.  A healthy person’s neutrophil range is 2 to 7.  And my platelets, the wonderful cells that allow your blood to clot if you get a cut or a nose bleed, were at 78, and to get chemo they should be at 80.  A healthy person’s platelets would be in the range of 150 to 400.  No wonder my nose has been bleeding all week!

Despite the lower than optimal counts, the doc still gave me the chemo, for she deemed the risk of me getting a life-threatening infection or bleeding to death as less than the risk of withholding the chemo and letting my cancer grow.  As soon as I’m done writing this Daniel will give me one of those nasty stomach shots (Neupogen), and I must continue them for a total of five days to force my bone marrow produce more blood cells.  Two weeks ago when I had these shots for five days I experienced terrible bone pain for that week, so you can imagine I’m not looking forward to how I will feel for the remainder of this week.  But onward I will go.  A dear friend just gave me a necklace with a silver charm that is etched with the word “Brave.”  Will see if I'm worthy to wear the necklace or not this week!

The other piece of bad news I received yesterday is that I am no longer a candidate for the drug Niraparib, which we had prayed the FDA would hurry up and approve, and which they did just approve.  Unfortunately the FDA only approved it for ovarian cancer patients who are “platinum sensitive.”  I thought I was platinum sensitive, as that was my original diagnosis—“platinum sensitive ovarian cancer.”  But since the carboplatin chemo I was on last year stopped working for me in December, as shown by dramatic disease progression, they now deem my cancer to be “non-platinum sensitive.”  I hadn’t realized this and had to shed a few tears yesterday over this disappointing news.  But now the tears have dried and I ask you to join us in praying for new treatments to be discovered, to pass their clinical trials, and to be available to me, and other women, in the future.  And please pray that God will keep me going on my current double chemo regimen until something new comes on the horizon.  Thank you!

When you have a chronic or life-threatening illness, you are extra susceptible to depression.  And why wouldn’t you be?  It IS depressing to feel unwell day after day and to have to think about and tend to one’s health all the time, not to mention if you also have to ponder and prepare for the possibility of a shortened lifespan.  Today I read a brief devotional on depression by a woman named Mary Southerland, and I want to share a part of it with you:

“Anything or anyone that makes me desperate for God can be counted as a blessing. Honestly, I hate that truth – but I also love it. God has used it to make my life a living illustration of the wonderful horrible certainty that His power shines best through the broken places. He is drawn to broken people. Broken people are why He came.”

When I can’t be in crowds or hug people I love because I have no immune system, when a drug that held promise to extend my life turns out to not be an option for me, when my bones are about to ache 24/7 for the next five days, and when I can’t plan a trip further out than a month because I don’t know how my health will be—these are the things that make me desperate for God.  And how timely for me, that just two days ago we celebrated Easter.  A day in which I am reminded that God is alive and with me always.  “Lord, please let your power shine through my broken places this week.  Thank you that you came for broken people, like me.  And please send your strength, hope, peace, and comfort to all my family and friends experiencing their own brokenness this week.  Amen.” 

Love,

Gabrielle

 

When you are feeling sad, dress up goofy and get your picture taken, then look at it several times a day.  Sure to produce a big smile!

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!

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."

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.