I guess it's not supposed to be easy, huh?

Well, I waited a long time to post again, because I felt that once we got past the business of the holidays, we would make a final decision and I could post that. Sure enough, I had opportunity to talk to the doc at MD Anderson in Houston, Dr. Yao, and he felt that observation would be perfectly acceptable. He is a leading expert on carcinoid, and he likes to use the "What makes you sleep well at night" test. In other words, if you are going to have this everyday sense of anxiety and foreboding, then do the surgery and be done with the cancer. Accept that you will have some (either a lot or a little) consequences, but rest easy because the cancer is gone. On the other hand, if you can live life without that sense of dread, then don't do the surgery.

As we finished up our conversation, he mentioned that he would like me to talk to a doc in NY named Richard Warner, who has treated as many of these as anyone in America. He said that Warner has reported anecdotal success with slowing the progression via an elaborate diet. Yao's point was that if we are going to do observation, we could easily add the diet thing to that.

As you hopefully know, Dee Dee and I are not really fearful folks, and we can sleep quite well at night (well, she can; I never sleep much anyhow) regardless of things like this. We slept well when we thought this might have already spread, and would not have been treatable. So, we decided not to do the surgery, and began making plans for our next trip to Mayo.

However, to satisfy Yao's recommendation, and my wife's love of healthy diet, I called Warner. He listened to her case data, then said, "If she were my patient, I would not try the diet. She has too many tumors, and at least one that is too big for the diet to work. I would remove the biggest tumor with wedge resection, and then do the antrectomy surgery to remove the lower 40% of her stomach. I am concerned that the one larger tumor may be self-feeding already, and not dependant upon the gastrin (hormone) that caused the tumors to form initially." While he agreed that metastasis was unlikely with gastric carcinoid, he said that in his clinic (Sinai Medical Hospital and University) he has seen it spread in 5% of cases. Honest to goodness, I nearly hung up on him as soon as he started talking, 'cause I did not want to hear what he was saying. And I didn't want to report it to Dee Dee either! Sure enough, as I walked in the door that night, she asked if I had gotten to speak with "the NY doctor."

So, the buoyancy that I had seen in Dee Dee for about a week, after we made the (we thought) final decision, has lessened. It has not vanished, but I could physically see her countenance falling as we discussed Warner's thoughts. At the least, it introduces doubt; doubt that will, I am afraid, make her less able to rest confidently in an observation approach. I still suspect that we will opt for no surgery, but we will have a period now where we wrestle with it all again. Maybe we would have had that every time we went for follow-up evaluation? I don't know. We will definitely ask our Mayo doc about these issues.

Please pray for peace. Pray for confidence. I know that God has ordained and decreed how this will turn out; I know that He loves us, and is showing that love by refining us. Pray that he would enable us to boldly live in light of that love. Pray that we/she would not get discouraged. Amazing - 5 hospitals, and at least three opinions.

Thank you all for praying so much, and so long. You all encourage us so much! If a few of you could email Dee Dee, or send a card, it would help put some wind in her sails. With me blogging less, fewer notes come in. That was actually great when we thought we were done working through things; it helped with a feeling that this chapter was closed. Now that it is at least partially re-opened, I know she'd appreciate hearing from you.

By the way, she and I had the opportunity to see the Monet in Normandy exhibit at the NC Museum of Art this afternoon. Amazing! I thank God that He gifted some, that they could put onto canvas a sense of the splendor of His creation. I felt like saying, "Amen" as I looked in wonder at the original works of Monet. I don't know if he felt like he was honoring God as he painted, but I felt like I had worshipped as I enjoyed his work. That is what art should do - reflect God's majesty and glory in creation. That's what we should do in our daily lives, because in some ways, we are the canvas that God paints upon!

God bless ya'll!

Tony