12/30/08 - Pam has experienced highs and lows over the past one and one-half weeks. She was full of energy on the days leading up to Christmas. Her sister and brother-in-law arrived for a week's visit on Christmas night and Pam was really excited. After a chemo treatment on December 26th, Pam began to feel less energetic and tired easily. She began to have abdominal pains attributed to fluid retention due to blockage of the lymph system. She is scheduled to have the abdominal area drained again on January 5th, the earliest date available.

Pam's sister and brother-in-law have helped immensely to keep Pam upbeat and positive. They have worked around the house, completed errands for Pam, and provided wonderful fellowship. They will leave for home in Connecticut tomorrow.

We continue to thank you for your prayers and blessings and wish you a Happy New Year.

December 19, 2008 Pam has been blessed this week with stamina and optimism. After a period of recovery from the shift in chemo treatment drugs, Pam has slept better and begun to have some appetite. We traveled to Orlando for two days to see our four grandchildren and their mother in a performance of the Nutcracker at the Orange County Convention Center. Despite the rigors of travel to and from and around town, the hustle and bustle of visiting excited children, and being away from home, Pam held up very well and immensely enjoyed herself. The granddaughters are compassionate and are comfortable talking to Pam about the cancer.

Pam had a chemo treatment today. She was apprehensive that her hemoglobin count would prevent her from receiving treatment; however, the blood test was fine and Pam has not lost or gained weight. This means she is stabilizing her weight and has not suffered any accumulation of fluid in the abdominal areas. This is a reassuring condition.

We won't know if the chemo is working for several weeks. Pam's doctor will be arranging a visit to New York for late January or early February to have a second opinion. If the chemo is working we will still go. If the chemo is not working, we'll try to find a procedure that will work.

Pam and I have been overwhelmed with prayers, comforting words, and expressions of optimism. We feel greater inner strength and know the Lord is watching over us. Thank you, friends.

12-13-2008 On December 11th, Pam learned that the cancer has not measurably changed. The original mass on the liver has decreased in size; however, several cells were noted near the spleen. The cancer marker is up a bit, but that index is subject to fluctuation. The clogged lymphatic system which caused the buildup of fluid was indicative of cancer cells moving around the abdominal area. The new cancer drug, Gemzar, is designed to be effective in the entire abdominal region, liver, pancreas and ovaries. Side effects should be less noticeable than the previous treatments.

Pam is doing reasonably well and remains optimistic for chemotherapy success. She is eating more food and more often and resting frequently, while getting ready to visit the central Florida grandchildren next week, as we will not be with them on Christmas, and sing the Messiah at church. Blessings to all who have been so kind, prayerful, and comforting to Pam and me during this ordeal.

12-9-2008 The drainage of the abdominal area was a success. The technicians drained 6 liters, over 13 pounds, of fluid. The procedure was efficient, relatively short, and painless. Pam has eaten her first solid food in a week and is resting comfortably at home. She feels a bit weak and the doctor told her to expect some discomfort while the organs settle back to their original positions. Pam will be ready for chemo with the new drugs tomorrow.

We thank you all for your prayers, expressions of faith, and comforting calls as Pam struggles with the cancer. Every small success is uplifting.

12-8-2008 It was an uncomfortable weekend for Pam. The diuretics had no effect in eliminating the fluid in her abdomen. The pain was intense, at times, and we consulted her doctor on Saturday. We learned that the diuretics take several days to take effect and he suggested she call him if no improvement is noted.

Pam stumbled over a lip in the sidewalk at the church on Sunday night just before the children's Christmas program (which she directed) began. She bent her glasses, skinned her forehead, bruised her right side where the fluid has accumulated, and cracked a toenail. She believes this was the result of a dead foot-numbed by the chemo therapy. Nothing was broken. The children's presentation was a success-with the contributions and assistance of many people.

Pam's doctor saw her on short notice today after a restless night and increased abdominal pain. She will have the fluid in her abdomen drained on Wednesday, December 10th. The drainage will no doubt enable her to eat normal food and not feel constant heartburn or reflux. The cancer has clogged the lymphatic system and prevented normal fluid drainage. The new cancer treatment drug is intended to defeat the cancer cells and restore the system to normal operation. She starts the new treatment on Thursday and we expect to have more information as to the location of the cancer. Any improvements in defeating the cancer with the new drug should be noticeable in 4-8 weeks.

We thank you for all your prayers and support. We are optimistic that effective treatment of the cancer will be coming soon.

12-4-2008 Pam's cancer treatment has hit a bump in the road. She expected a chemo treatment, but her doctor noticed the excessive bloating of her abdomen and immediately concluded that the topotecan drug was not working. Then bloating really became apparent over the past two weeks and caused Pam extreme discomfort. Fluid accumulated in her abdomen because cancer cells prevented efficient distribution.This condition convinced the doctor that the cancer may not actually be ovarian and may be classified as a cancer of unknown origin. If the topotecan were working as predicted, the cancer cells would most likely be destroyed since that drug is targeted to ovarian cancer. This situation will need further evaluation because the last cancer marker test obtained after 4 of the planned 8 treatments indicated a reduction in cancer cells.

Pam will undergo a CT scan on 12/5 and meet with her doctor again next week. The current plan involves using a drug that has been effective against general abdominal cancer and has been effective for lung and pancreas cancer. The bottom line is that the ovary may not be the primary source of cancer and that is the next step-isolate the source of the cancer cells.

Radiation is currently ruled out because it would encompass the entire abdominal area. Referrals to other cancer centers at this time would most likely not be accepted because the primary cancer source has not been located and no clinical trials are known to be available.

Pam will work on eliminating the fluid with diuretics and that will certainly make her feel more comfortable.

We thank you for your prayers and best wishes as we continue to control this disease.

12-1-2008 The past ten days have been busy and rewarding yet a bit trying for Pam. She has experienced fatigue, little or no appetite, and abdominal pains every day. On the very positive side, we enjoyed Thanksgiving in Orlando with David and Diane, Diane and Steven, Beverly and six grandchildren. The weather was perfect and we had a grand opportunity to catch up on the happenings of the children and adults and make plans for our December visit. Thanksgiving Day was the only day Pam felt anything like her old self.

Pam's sister Diane came in from Connecticut for the weekend to lend moral support and help Pam get ready for Christmas. Shopping was grueling, but productive, and the ordeal is over for this year. Diane and her husband, Art, will be back for Christmas.

Pam will have another chemo treatment on Thursday this week. We have a long list of questions to pose to her doctor with respect to further treatments and treatment alternatives. We should have a progress report on the effect of the current treatments in a week.

Thank you all for your prayers and encouragement. They keep Pam and me strong to face this health issue.

11-20-2008 After a busy, yet rewarding, weekend with her out-of-town friends and her routine Sunday schedule, Pam was on an emotional high even though she was physically exhausted. This week found her resting during most of the day and singing with her Treasure Coast Community Singers and the Celebration Choir on Monday and Wednesday. Pam was suffering from constant abdominal pains most of the time and felt she might not be able to complete the chemo scheduled for today. Her hemoglobin count was acceptable and she completed the chemo treatment. This was the eighth treatment with topotecan as the chemical agent. Her doctor will order a CA 125 test on the next visit on December 4th and arrange for a CT scan and a PET scan to assess the effectiveness of the chemo treatments. If the test results show progress in shrinking the tumor, chemo will probably be continued. If the test results so indicate, her doctor will evaluate the next step.

Throughout this 5 month ordeal, Pam has maintained a sense of optimism buoyed by the love and support of her friends at church, in the community, and around the country. She is focused on a successful treatment plan and wants nothing more than to feel good again. We thank you all for your prayers, cards, letters, and hugs. They give us strength and resolve to meet each day.
Bless you!

11-14-2008 Pam had a chemo treatment on Thursday, the 13th, and she left the office a bit tired. Her hemoglobin count was down from last week, yet not too low to delay the treatment. We certainly are looking for no further decrease in the hemoglobin because that will probably trigger more transfusions. There was no test for cancer markers this week. The doctor will order another test in a couple of weeks when this series of treatments nears completion. The time table for these treatments is indefinite at this time. We remain optimistic for good news. It's just that the negative effect of the chemicals on Pam's energy level is cumulative.

Today, however, Pam is her old self. Three of her closest friends converged at our house for this weekend. These ladies try to get together every year and they wanted to come see Pam this year. So, her friends from Atlanta, New Orleans, and the Dallas area are here to have a great time with no set schedule. Pam is really energized.

We thank you all for your continuing prayers, expressions of hope, and support. These thoughts truly make a positive impact and a great source of comfort to Pam and me.

11-6-08 Pam had encouraging news today. The cancer marker CA125 showed a decrease from her previous test several treatments ago. A trend of decreasing cancer marker results over several test is a sign the cancer is being attacked. Her doctor seemed pleased with the results and will further evaluate the shrinkage of the tumor upon completion of this series of chemo treatments, which may be extended a bit.

Pam continues to be active with the church activities involving choir and hand bells. She has discovered that her diabetes is acting up. Acute changes in her blood sugar have affected her energy level and cause periods of dizziness. Pam is closely watching her diet and schedule of meals and snacks and a change in diabetes medication will help reduce these conditions. She is optimistic about getting everything under control so she can regain an active lifestyle.

We are comforted by your prayers, expressions of hope and encouragement. Thank you, everyone!

11-2-08 Pam had her fifth chemo treatment last Thursday, the 30th. Her hemoglobin count was higher than she had after the transfusions two weeks ago. It seems the 8-treatment schedule is taking a long time and we are anxious to learn the effectiveness of the treatments. We hopefully will get results from a cancer marker test this week to tell us if the topotecan chemicals are working. Pam will undergo CT and PET scans after the final treatment so her doctor will be able to assess the entire chemo procedure.

Pam has little sustained energy now and gets tired easily. That did not stop her from delivering Thanksgiving baskets to her clients last week or singing in the two concerts of the Treasure Coast Community Singers this weekend. She is determined to balance the effects of the chemo and her diabetes to remain active, albeit at a slower pace than she is accustomed to.

We feel the comfort and support of all your prayers, thoughts and wishes during this time. Pam is doing her very best to beat this condition and sends her love to all.

10-23-2008 Good news for Pam. The transfusions she had last week left enough hemoglobin in her system to enable her to complete a chemo treatment today. This was the fourth of eight treatments in the current plan. Her doctor will probably order a blood test for cancer markers next week to learn how effective this chemical is in shrinking the tumor. The current plan does not call for any more scans until after the eighth treatment.

Pam still gets tired easily and works part time. Her involvement in the church activities and the support of all our friends and family keep her going. Thank you for your prayers and concerns. We are blessed!

10-20-2008 After receiving the transfusion of two units of blood to counter anemia, Pam enjoyed the weekend with renewed energy. She relaxed on Saturday doing all the little things she likes without feeling weak and prepared for her Sunday activities of leading a Bible study and singing in the choir. It was a good weekend! Pam took it easy today and found time for periods of rest. Tomorrow will be a real test of her stamina when she and her partner travel for several hours on a marketing call to a facility she has not been to. I know she will do well.

Bless everyone for the prayers, cards, and expressions of support.

10-16-2008 Pam was scheduled for her 4th chemo treatment today but it was canceled because her hemoglobin count was very low. She is scheduled for a transfusion tomorrow morning to help counter this anemia. We learned the chemicals used in this chemo plan attack good cells as well as the cancer cells and are the most likely cause of Pam's lack of energy and need for excessive rest.
Pam remains in good spirits and is anticipating a much more comfortable weekend after her blood is stabilized. Thank you for your prayers and expressions of love which keep us going.

10-14-2008 Our internet service has been out of whack for several days so we have not updated this site.

Pam experienced continuous pain and a total lack of energy last Friday after a long day of travel and meetings in Fort Lauderdale. Those symptoms extended through Saturday. Pam recovered a bit on Sunday and led her small discussion group for our current study, directed the hand bell choir and sang with the sanctuary choir in the morning. She rested all afternoon and we were able to coordinate and deliver a meal to one of our group members in the evening.

Pam was able to work at home on Monday and spent part of Tuesday giving several talks at a local center. She will take it easy until her next chemo treatment on Thursday.

We thank you for your prayers and your love. They are working and great source of comfort to us.

10-9-2008 Pam had her third chemo treatment in the current plan of 8 weekly treatments today. She experienced some feelings of weakness and tiredness but did not require any injection of hemoglobin to overcome her anemia. Her doctor will wait until the conclusion of the treatment plan before evaluating the effect of the chemo. A decision will then be made to continue local treatments or be referred to another cancer center for further testing. Her doctor believes the best centers to evaluate her type of cancer are in Boston, New York or Gainsville, Florida. Her doctor remains positive for a successful outcome.

We thank each one of you for your prayers, cards, calls and expressions of faith in this challenge put before us. God bless you!

10-2-2008 Pam has been very tired this week after after celebrating a milestone birthday on Sunday and working with patients and making marketing calls. She has had little energy and stamina at home.

Pam had the second chemo session in the revised treatment plan which calls for topotecan as the principal agent for attacking the cancer.

Pam had learned her hemoglobin was low which may have affected her energy. Part of the chemo treatment involved a shot of Arinesp, which elevates red blood cells and will probably provide more energy. It's hard on her to be a run-down energizer bunny!

A call to M.D. Anderson Hospital from the doctor's office revealed that they would not even set up an appointment until this phase of chemotherapy had been completed and the disease re-staged. That was disappointing but we understand the rationale behind the decision and continue to pray that the new chemo "cocktail" will work.

Your prayers and well-wishes keep us going. Thank you from the bottom of our hearts.

9-25-2008 Pam learned the previous treatment was not attacking the cancer as her doctor had hoped. Her test results indicated that the cancer is no better or worse than at the beginning of treatments in July. The results indicated that cancer cells have multiplied around her liver; however, the tumor has not grown. Pam's doctor remains optimistic and Pam thanked him for being on top of her case. Her original treatment plan called for 6 treatments 3 weeks apart and her doctor scheduled the interim scans to monitor progress. The new treatment plan calls for a less intense chemical (topotecan) every week for 8 weeks. Topotecan is designed to kill dividing cancer cells to prevent abnormal growth activity.

Pam is okay with this report. She had an inclination the chemotherapy was not working as planned and she is very pleased that a change in chemicals is occurring now rather than after the initial 6 treatments. Her doctor does not anticipate much change in the side effects with the switch to topotecan and remains committed to finding the most effective treatment.

We thank you for your continued prayers cards and expressions of support. They are working because Pam remains upbeat and committed to overcome this condition.

9-17-208 Pam endured the PET scan very well. She was most apprehensive about the claustrophobic environment but she overcame that feeling with a tranquilizer and singing hymns in her mind during the procedure. The entire preparation and procedure took two hours, yet Pam felt good enough after being released to go grocery shopping and fixing a big dinner. Pam rested well in the evening and had a good night's sleep.

We will meet with her doctor next week to discuss the effectiveness of the chemo treatments. The next chemo is scheduled for September 25th.

We thank you all for your continued prayers and encouragement.

9-12-2008 Pam underwent a CT scan yesterday as one of the tests her doctor needs to evaluate the chemo treatment. She did very well, with little apprehension of the procedure. Later in the day, she was in distress from abdominal pains (probably effects from the barium sulfate drinks) and feelings of general weakness and exhaustion. She cancelled two patients and spent a good amount of time resting. Today, Pam is feeling somehat better, but she still suffers from feeling exhausted with little effort. She looks forward to overcoming these effects in the next day or so.

She is scheduled for a PET scan on Tuesday, September 16th. Her next chemo treatment is set for Thursday, September 25th.

Pam sincerely appreciates your prayers, cards, calls, emails and all expressions of support. She remains optimistic while being impatient with "feeling bad."

9-5-2008 Pam feels pretty good today after her third chemo session yesterday. The lack of discomfort may be due to the continued effect of the medications she took yesterday for her treatment. Since she has had frequent abdominal pain her doctor has set up another CT scan and PET scan to determine the effectiveness of this mixture of chemicals. His goal is to heal her and will do what is necessary to be confident that the tumor is being reduced.

All your prayers, emails, cards and calls have had a very positive impact on Pam's desire and ability to keep focused on her work, Treasure Coast Singers, and church activities. These activities are therapy for her.

9-1-2008 Pam has been active with patient care and church activities on a regular basis. She has experienced frequent abdominal pain; however, pain relief medication is slow acting and leaves her tired and drowsy. This really affects her ability to drive her car and maintain her desired activity level. Her next chemo treatment is scheduled for Thursday. September 4th. We believe the pains are caused by the vigorous action of the chemicals.

8-21-2008 Pam's blood test yielded cancer markers higher than her previous test. Her doctor was not overly concerned but he indicated that a similar increase in the markers at the next test would necessitate a change in chemicals. The next blood test will come after the next chemo treatment on September 4th.

Meanwhile, Pam relaxed and took life easy earlier this week while Tropical Storm Fay stayed around. Our yard swales were overflowing and neighborhood intersections were flooded and impassable. We were literally restricted to our house, which was not threatened by water. Pinecrest Lakes dried out somewhat today and Pam was able to leave for treating patients.

We thank you for your continued prayers and support.

8-14-2008 After treating a patient early this morning, Pam had her second chemo therapy treatment ( nearly 4 hours worth). Her doctor seemed pleased with her progress and noted that a 5 pound weight loss was due to tumor shrinkage. We expect a report on the cancer markers next week. The next chemo treatment comes up in three weeks. Pam thanks everyone for the cards, letters, calls and especially the prayers during this time. We are blessed with loving friends and family.

8-13-2008-Pam's hair has been falling out for several days. Her doctor estimated she would begin losing her hair approximately 3 weeks after her first chemo treatment, which was on July 25th. Accordingly, Pam had all her hair removed today. It was an emotional event for her. She looks beautiful with her hairpiece and will work and undergo her second chemo treatment tomorrow.

8-9-08 Pam experienced several days of treating patients and spending free hours with the grandchildren. They made vacation booklets with drawings, photos of the visits to the oceanographic exhibit and pirate festival and spent hours on jigsaw puzzles. The older boys really shepherded the younger children and everyone pitched in to help with all activities and chores and really supported Grandma. Pam was quite active and experienced little obvious pain and discomfort. She is anxious about her thinning hair and faces a busy week before the next chemo session on Thursday the 14th.

8/6/08-Pam is doing very well without a lot of cancer-related discomfort. She will have a lot of joy and company this week. Our three grandchildren from Orlando (ages 8,8, and 10) will be here through Sunday the 10th. Local grandsons (ages 17, 17, and 16) and daughters Diane and Beverly will assist as camp counselors and chauffeurs, as needed. Pam will treat some patients and participate in the church and community choirs when not with the children. As of this writing, Pam is working on puzzles and crafts with the youngsters.

8/03/08-It has been a busy weekend. After working nearly a full schedule last week, Pam tried to relax as her sister arrived for a weekend visit for support and comfort. Pam loves seafood but learned that shellfish may have an adverse interaction with her medications. She came down with a rash and extreme discomfort after a lobster dinner on Saturday. The ill effects disappeared today and she was able to participate in all the morning church activities and school clothes shopping with two of our grandsons. The events of the day were tiring and Pam rebounded after a power nap. Pam has experienced continuous inner strength from your prayers and thoughts. This will be another work week with no chemotherapy treatments scheduled until August 14th.

7/30/08-Pam had a great day. After a good night's sleep, she went to work treating patients for a good portion of the day and found time to take Dave to and from an eye appointment.
When Pam returned home at about 3:30, she promptly napped until it was time to go to the Wednesday supper at church. The evening was spent at handbell and choir practice and a choir party.

Pam said she is a solicitor of prayers as she faces these treatments. We can feel the power of your prayers each day.

This is a chronology of the events leading up to the current diagnosis of Pam's condition.

6/10/08-Ultrasound to check tender area above her stomach. An 8 cm. mass was located in the upper left area of the liver. Further testing to be scheduled.

6/13/08-CAT scan of the abdomen and pelvic areas. The mass appeared to be isolated in the liver area.

6/30/08-Biopsy of the liver.

7/8/08 - The mass was determined to be malignant. It was classified as an adenocarcinoma, a type of cancer that originated in another location. Another CAT Scan was scheduled.

7/11/08- A second CAT scan of the abdomen, chest and pelvis was completed. A PET scan was scheduled.

7/14/08- PET scan completed.

7/18/08- Diagnosis was cancer of the left ovary with traces in the abdomen and lymph nodes. The treatment plan called for six chemotherapy treatments three weeks apart. The treatments would shrink the cancer cells and further evaluation would determine the next step. The doctors were all concerned with quality of life and were optimistic for a successful treatment.

7/21/08- Pam had a workup in preparation for insertion of a chemotherapy infusion port.

7/22/08- Pam had an EKG and blood tests in preparing for the surgery for the port.

7/23/08-Infusion port was inserted.

7/25/08-Pam's first chemotherapy treatment completed. She had no ill effects and felt fairly well after the 3-4 hours of treatment. Our son, David, came in from Orlando to check on Pam and get first hand reports of Pam's condition.

7/27/08-The lower abdominal pain and nausea developed and kept Pam at home and resting for the day. Two daughters and two grandsons cleaned floors, patios, dishes, and laundry to help out Pam. This assistance was spontaneous on the part of the boys and they were eager and effective.

7/29/08-Pam felt much better and treated several patients. She is determined to be upbeat during this time.