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.