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Greetings!

We just finished meeting with the Dr. Thompson substitute doc (Porterfield?), and the results of everything were, to summarize, "excellent." Praise God!

We continue to learn more about the disease with each encounter, so there was some education this time as well. The over-arching disease that has caused everything else is "atrophic gastritis." This autoimmune disease erodes the stomach lining, prevents B12 uptake, which leads to pernicious anemia; this perfect storm then gives rise to gastric carcinoids. The carcinoids are not the primary disease, they are merely the result of the cascade.

As such, they are expected to wax and wane over time. Some years will show less tumors, some years more. Some years the tumors will be larger, some years smaller. This year: smaller tumors and less of them. So, while that is obviously better than more and larger, it shouldn't be that huge a thing if next year there are more, or if some are larger. It is expected that they will sort of come and go a bit.

The only thing new this year was that her stomach lining overall seemed a bit more irritated, so they are putting her on a short course of a medication to calm that down. Again, not unexpected with the underlying atrophic gastritis primary disease, and no one is that terribly worried about this.

The other revelation, which we probably heard in the past but it just didn't register (I really need to concentrate on great patient education in my own office!), is that the carcinoids themselves are not the main reason for the yearly testing. They really are not worried about them doing anything "bad" at all. The reason for routine and close follow-up examinations is that the atrophic gastritis elevates the risk of adenocarcinoma, a truly bad cancer of the stomach. SHE DOES NOT HAVE THIS! They just want to watch closely due to the elevated risk. They did not have a good estimation of the % likelihood of this cancer, but it was not high.

So, another year here in charming Rochester is complete. It was 58 degrees here yesterday and today, so we're bracing ourselves for the 97 degree NC that will welcome us home later today. Thank you all for your continued steadfastness in lifting us before the throne of grace. His mercies are new every morning, and this morning that feels even more evident than usual.

It is a wondrous thing to be a part of the body of Christ. Thank you all for your prayers and love and care for us and our children. Let us know when and how we can be His hands and feet for you!

Tony