Next steps

Hello all! Not as significant a day today, but some new info. Dee Dee's blood work came back and showed incredibly high blood levels of gastrin. The normal range is below 150; hers was over 2200. Believe it or not, that is actually a good thing. The theory here is that patients with pernicious anemia (which as I mentioned she has had for at least ten years) do not have the ability to regulate their production of gastrin, which is a hormone produced in the lower stomach (antrum). Gastrin causes the production of gastric acid, which aids in digestion. Gastrin is inhibited by acid, and pernicious anemia patients do not have the proper acid amounts, so gastrin goes without inhibition. The theory continues that the elevated gastrin actually causes the formation of the carcinoid tumors. Carcinoids, by the way, also produce hormones of their own, so it is all kind of cyclical. So, if you remove the initiator of the problem, the gastrin-producing antrum of the stomach, the risk of recurrence is almost nil.

Also, I wanted to give ya'll a link provided to me by the editor of "Oncology Today," one of the leading cancer periodicals. She has been very good about advice, who to see, etc. (So maybe say a prayer of thanks for Dr. Holly Atkinson, and also pray for her as well.) This site has more info than you can really digest (sorry about the pun), but it is written in large part for non-physicians. http://www.carcinoid.org/

The doctors at Duke are Theodore Pappas and Michael Morse; at Mayo Clinic will be Joseph Rubin and Geoff Thompson. Please pray that they would be wise, understanding, and that they would all be of like mind.

We have our first appointment at Duke, with Dr. Pappas, on Monday 10/2/2006 at 11:30. Hopefully he will quickly order the remaining scan (Octreotide scan), as well as whatever needs to be done to definitively settle the lymph node question. Then we will probably have a conference visit with he and Dr. Morse, the primary oncologist (Pappas is the surgeon). I will go ahead and schedule our time in Minnesota for the Mayo clinic as soon as we meet with Pappas next week.

We continue to be grateful, and truly blessed, by the outpouring of cards and notes. It is a blessing to be so wonderfully bathed in prayer. It was exactly ten years ago that we were in the hospital with Gabe, then 4 months old, as the physicians told us he was going to die. The body of Christ so comforted us, and so many people prayed, that for the first time in my life I actually believed in the reality of prayer. It was a humbling and in retrospect sweet time of God teaching us amazing things. A decade later, we find ourselves in a familiar health-related valley, yet we are once again beginning to sense the comforting work of the Spirit as you all pray.

What I often did not realize then, but am keenly aware of now, is that not only are God's people praying, Christ Himself is praying on our behalf (Hebrews 7:25 "Consequently, he is able to save to the uttermost those who draw near to God through him, since he always lives to make intercession for them," and thanks to Scott T. for the verse reminder). The Holy Spirit is interceding for us as well (Romans 8:26 "Likewise the Spirit helps us in our weakness. For we do not know what to pray for as we ought, but the Spirit himself intercedes for us with groanings too deep for words.") So, there's a lot of praying for the Clarks, and we are thankful!

God is good, and He loves to bless His children.

Tony