A Christmas Story.....

I'm writing this post with my feet propped up on dad's hospital bed. We've been reading posts on pancreatic cancer message boards and watching CBS Sunday Morning. We've had an eventful Christmas. Dad woke up with a fever Christmas morning. That did not stop him from showering us with gifts and praise around the beautifully lit Christmas tree. He did not want to miss the family gathering at John and Laura's, so he insisted on taking some Tylenol and going. We had a nice lunch, but dad obviously did not feel well. Mom took him home early. His temp spiked, resulting in a Christmas trip to the ER. His temp rose to 103.1, and he was having pain and fatigue. Anything over 100.5 is considered alarming in dad's current condition.

His labs looked pretty good at the ER, which was encouraging since his WBC count was down to 2.0 at his oncology visit Tuesday. Because his labs were within the normal range and there was no obvious source of infection, they admitted him to SE hospital to monitor him and to place him on a continuous flow of broad spectrum antibiotics. I drove mom home and Tim spent an uncomfortable Christmas night in a luxurious pull out plastic covered chair in dad's corner "suite." Impressive was the bright yellow bathroom in the "suite." I was reading in this morning's paper that yellow is making quite a comeback in 2009. Evidently Southeast Hospital is quite en vogue.

He was feeling much better on Friday, and even better on Saturday. However, his WBC went from 4.8 on Thursday to 3.4 on Saturday, and this morning were down to 2.9. This is not an overly concerning level, but it is concerning that the level continues to drop. RBC are hovering at 9ish, so they may want to give him a blood transfusion next week.

The doctor was in this morning and told us all of the cultures came back negative, which is great. Though, we still don't know what caused the fever and associated symptoms. They are discharging him today; so he is thrilled. We just need to monitor his WBC....so, as much as dad loves everyone coming by for visits...if you have a cold or have been around anyone with the flu or other illness, please call him rather than dropping by. (He won't like it that I wrote that...sorry Dad....just being protective).

Don't feel bad that we spend part of Christmas in the hospital. We had a wonderful Christmas eve. We cooked and baked, watched A Christmas Story, played games, relaxed, ate, ate, and ate. It was truly what a holiday should be. It was a treat for us all to see Benjamin really get into the Christmas spirit. He exercised his true right to toddlerhood by getting into absolutely every shiny, wrapped, glittery, sweet Christmas treat he could get his little fingers on....including peanut butter fudge.....which nearly gave his nutritional nazi of a mother a stroke.

Mom taught Ben all of the names of the characters in the nativity. It's so sweet...instead of Mary and Joseph, Ben says, "Baby Jesus mommy" and "Baby Jesus daddy." Once, when mom was "quizzing" him on the characters, he pointed to a wise man and said, "Baby Jesus daddy"......we all agreed that he was trying to start quite the scandal!!

Children are the best type of medicine, and dad agrees that being around Ben makes him feel better. We brought Ben up to dad's hospital room. He tried to "bounce bounce" on the hospital bed, but was very disappointed in the firmness of the mattress....but not nearly as disappointed as dad, I'm sure. I'll try to post a video later.

We will go see Dr. Sorscher, dad's oncologist, Tuesday. He will complete another CBC and determine if he can get a gemzar treatment and if he needs a transfusion. As of Tuesday, the plan was to get three more gemzar treatments, then to get another CT scan. We're not sure if the events of the last few days have changed the course of the treatment/scans or not.

As always, dad tries to stay as positive as possible. However, even the most optimistic soul could not escape at least a little blow given the most recent circumstances. To be very honest, this disease is cruel and devastating and creates symptoms, emotions, and circumstances that no one should have to endure. Having said that, there are blessings to be found in every experience. We realize that there people suffering more and suffering less, but that God is with us all. We realize that time is the most valuable human resource. We realize that some paths are completely unpredicted and unappealing, but the direction is not ours to choose. It's easy for me to make these observations because I am not in the hospital bed. I might feel differently if I were. Perspective is everything.

I'm rambling....we are so humbled by the continued outpouring of love, support, and prayers. We are so deeply grateful for every single prayer, every single card and visit, and every single piece of peanut butter fudge.

Happy New Year to all of you.
Love,
Angie

December 4, 2008

Just a quick update...Dad received his first gemcitabin treatment Tuesday, following two weeks off. Having the break last week allowed dad to enjoy Thanksgiving without experiencing as many side effects of the chemo. He has continued taking Tarceva daily (the chemo drug he takes orally). However, its associated side effects are not nearly as debilitating as those imposed by the gemcitabin.

He will have treatments the following three weeks and will receive another CAT scan the week after Christmas.

Hope you all are enjoying your holiday season. Take care.

GOOD NEWS!!!!!

The tumor has shrunk! The original size was 4.2 x 5.2 cm. It is now 3.7 x 4.1 with no metastasis to the liver or other organs!! According to research findings, only 24% of tumors like dad's shrink. He has found his way into that celebrated minority, just like he said he would. So, the M.D. wants to do four more rounds of chemo and reassess. He remains unsure if the spots identified on the lungs a few months ago are malignant, so he is going to have a radiologist examine the image when they reevaluate next month.

Dad's red blood cell count was low, so they want to do a blood transfusion tomorrow. His other counts looked good.

When I was praying for dad this morning, I asked God that He would let something happen today to let mom and dad know that He hears their prayers and is listening to the pleas of their hearts. I know that prayer was answered.

Dad still has a long road ahead of him, as we all know the statistics related to pancreatic cancer. But, today is a day to celebrate and to be thankful! How befitting that this news was delivered during the Thanksgiving season.

Thank you for all your continued prayers and support.

Please write your legislators to support more funding for pancreatic cancer research.

"A joyful and pleasant thing it is to be thankful."
The Book of Common Prayer

CATscan on Monday

Dad received chemo yesterday. His blood levels all looked good with the exception of his sugar, which was a bit high. He has lost a few more pounds, which has put his total weight loss at around 65 pounds. The Thursday following his Tuesday treatments is always his toughest day. He usually experiences fever spikes, significant fatitue, and complete loss of appetite.

He is looking forward to this weekend when he will make the annual family pilgrimage to southwest Missouri to go deer hunting with all the Bixler men. He will return Sunday and receive his ultrasound Monday. This is the first CATscan the oncologist has ordered since dad began chemo. Obviously, we are all a bit anxious to hear the results, and are optimistic that the tumor has stopped growing.

November is Pancreatic Cancer Awareness Month

November is National Pancreatic Cancer Awareness Month. Follow the link below to see how you can help raise awareness (and funds) to fight this disease.

Thanks!!

http://www.pancan.org/raiseyourvoice/index.html

October 24

Dad and mom went to St. Louis today. Dad had the temporary stint in the bile duct that drains from the liver replaced with a permanent one. The procedure went well and they will return home tomorrow morning. Dad has to remain on a liquid diet for the next several days. Monday, he will receive a port through which the gemcitabin treatments can be facilitated with more ease. He will receive chemo again Tuesday.

The oncologist wants dad to receive two more treatments of gemcitabin before re-imaging him. So, the CAT scan will be scheduled a few weeks out. His appetite is very poor, and he remains fatigued. His potassium was low on Tuesday, but other levels looked good! Dad's spirit and optimism remain strong.

We're at the two month mark now. It's incredible how much we've learned and experienced in these two months. Our vocabularies have changed, as have the nature of our conversations. When I have free time, I find myself browsing cancer blogs, research abstracts, and clinical trials updates rather than overstock.com. I am also much more aware of the extensive network that inhabits cancer survivors, patients, and caregivers. It's hard to believe we are now in that web. It seems more people than I ever realized have loved ones with some type of cancer. This network spans all ages and cultures. I met a woman online from L.A. whose father also has pancreatic cancer with lung metastasis. She and I exchange any new information we find. We continue to explore medical and alternative treatments, supplements, etc. that are being tested with patients with pancreatic cancer.

Thanks for your continued support of mom and dad.

Tall Cotton.....

We took Ben to John's cotton field for his first lesson in picking cotton. He demonstrated natural talent that surprised us all! He didn't want to leave! Here's part of his lesson....Click on the arrow to view.

Hello from Gary

I just want to thank everyone for your responses and comments here on the blog, and for people calling, sending cards and food, and for coming by to visit.

On October 9th, I had been retired for exactly one year. Since that time I've had some great times with different people including travelling to the Grand Canyon and LA, visiting with Angie, James, and Ben in Tuscaloosa, attending Angie's graduation from her Ph.D. program in Florida, helping Tim get settled into his new home and job in Columbia, visiting with Craw and the Springfield crew as often as I could, hanging out with Joyce and Merlin, and many other wonderful experiences. I definitely have made the most of retirement.

It's exciting that Tim is working for the Department of Conservation. I told him to be sure to print plenty of deer tags for the family. :-) As I am writing this, Tim just called me from his deer stand. Wish I was with him.

Ben and Angie are here now and we're having a great time. I'm pretty fatigued this weekend, but doing ok. Lou Lou and my children, my brothers, sister, church family, and good friends have been so very supportive. To my past coworkers, be safe and take care. All of you are so helpful in many ways and are very special people. This is no step for a stepper. That's all the scoop for now.
Gar-o is still the man!

10-3-08

Dad has an appointment with his oncologist on Tuesday. Hopefully, we will get everything cleared up at that time. Dad's been pretty tired the past few days, which is expected. However, he is keeping his spirits up thanks, in part, to the wonderful displays of care and concern from all of you. Thank you.

"I have heard there are troubles of more than one kind.
Some come from ahead and some come from behind.
But I've bought a big bat. I'm all ready you see.
Now my troubles are going to have troubles with me!"
~ Dr. Seuss

Confusion....

It's difficult to describe our day. Unfortunately, we were the victims of a huge lack of communication among our medical team. To make a very long, confusing story very short....we know nothing new. Dad's oncologist was ill today and his replacement was....um...ill prepared. He was unable to provide any information regarding the most recent images, labs, or radiology reports. While this, naturally, was very frustrating, there were blessings in the chaos. Dad's labs looked much better and he received a treatment of gemcitabine intraveneously (which we were not expecting). Dad's typical oncologist will be following up with us within the week. So....the waiting game continues.

Here's a cute story...after dad went back to have his chemo, Uncle Craw, Tim, Mom, Ben and I left to get something to eat. We were outside-almost to the parking lot and Benjamin turned around and started running back toward the automatic doors. I grabbed his hand and said, "No, we're going bye bye to eat lunch." He continued to protest, "No" (his favorite new word). So, I let him walk through the automatic doors and followed him as he headed back into the empty waiting room. He turned sadly to me, lifted his little arms and said, "PawPaw?" He thought we were forgetting to take his PawPaw with us to lunch. He was only satisfied after I took him into the Infusion Room to see dad. He gave him a hug and waved bye bye happily to him, and off we went to lunch. He is only 16 months old, but is already such a sensitive child.

Many of you have expressed difficulty leaving comments on this site. I changed the settings today, so give it another try and let me know.

We're all very tired tonight. Have a good one.

We took Ben to meet the Clydesdales....

Gary, Lou, and Ben

9-25-08

Yesterday, an internist at Southeast Missouri Hospital informed dad that his cancer has grown much more rapidly than expected. It has metastasized to both lungs and into the tissue and arteries surrounding the pancreas. One of the nodules in the lungs is pressing against his heart. Representatives from Hospice met with our family and made plans. Dad will meet with his oncologist Tuesday morning to determine if any other possible treatments are warranted or encouraged. The news was obviously devastating. Within moments we all found ourselves reaching into the depths of resources for the strength, steadfastness, and patience we have spent years storing up in case a situation like this should arise. These are the things we have to cling to since our own understanding evades us now.

Uncle Craw had been at the hospital with mom and dad and, thankfully, was there when the doctor delivered the news. Two nights before we learned the cancer had spread, Uncle Craw and dad spent hours telling stories and laughing about the trouble they've gotten themselves into over the years.

I couldn't sleep last night and found myself thinking about the idea of greatness. Greatness is typically defined by grandiose achievements and Nobel Prizes and world championships. I think greatness truly exists when one walks through the valley of the shadow of death and fears no evil. In the same conversation in which dad was telling me aspects of the doctor's news, he was truly more concerned about Ben and James' pink eye. Greatness exists in the true acts of selflessness evidenced by putting others before yourself even during a time of individual crisis.

How many of us could have news like this and not have to think about mending broken relationships or forgiving enemies? These things are not among the overwhelming thoughts clouding dad's mind as he has no enemies or animosity toward anyone.

I couldn't sleep last night through the anxiety shadowing my thoughts. I couldn't help but think about the road before us. I couldn't help but think about the unbearable feelings I have watching my mom endure this. I also couldn't help but think about the blessings in knowing the true value and magnitude of time. Honestly, there are a spectrum of emotions here. A bit of anger from some of us, a huge lack of comprehension, and a flurry of things in between. I thought last night....I guess in our process of this, we start with anger and disbelief and will eventually transcend to "It is well with my soul."

This sounds so depressing. We still have hope. In the face of the seemingly insurmountable, we still have hope. God is larger than cancer. We rest in this knowledge. A wonderful friend of mine told me she is praying that a blanket of love and comfort be layered over all of us. I think that is a beautiful prayer, and especially pray that God make his presence known and real to mom...in the form of physical hugs.

James, Ben, Tim and I came in last night. Today, we're going to pick out pumpkins at the farm and going to see the Anheiser Busch Clydesdales with Jessica and Austin. Dad's looking forward to taking Ben to his first Cotton Carnival Parade tomorrow.
Our family is never short of one liners, good food, and wacky ideas. We are running short on none, and enjoying them all.

Thank you all so much for your cards, meals, prayers, support, fasting, and love. Dad has the stack of cards you've all sent by his recliner and reads them daily....we all do. He also reads the comments you post here. The outpouring of love and support has been a true testament to dad's character.

"I will lead the blind by ways they have not known, along unfamiliar paths I will guide them; I will turn the darkness into light before them and make the rough places smooth. These are the things I will do; I will not forsake them."
Isaiah 42:15-17

Hug your family. Cherish each moment. Life is precious.

There is no amount of darkness that can extinguish the inner light. The important thing is not to spend our lives trying to control the environment around us. The task is to control the environment within us.
-Joan Chittester

Starting Chemo

Dad's oncologist from Barnes was in Cape today and saw him there, which saved mom and dad another trip to St. Louis. They finalized a treatment protocol which consists of a combination of chemo (Gemcitabine) and Tarceva. After the first cycle we may replace the Tarceva with a drug called Oxaliplatin. His treatments will start tomorrow morning at Southeast Hospital in Cape. Radiation will probably come later depending on how the tumor responds to chemo.

James, Ben, and I were home this weekend. Laughter and grandchildren are good for the soul...dad had several doses of both. Tim came down to be at the appointment today.

We will keep you posted as the therapy progresses. Thank you for the continued support.

The Median isn't the Message

I have been thinking a lot lately about time. When people are diagnosed with life threatening illnesses, there is almost always a number linked with the prognosis. We have been very discouraged by the numbers we've been given by doctors, but we have not lost faith. They are months, hours, seconds, units on a digital clock face. They are not whispered by God or written in stone. Therefore, we are not bound by them. While, yes, there is a sobering dose of reality delivered with the prognosis of pancreatic cancer, dad is not constrained by the statistics of that diagnosis. People surpass insurmountable odds everyday. Of all of the new terminology, emotion, discouragement, encouragement, and general surrealism that has come with a loved family member being diagnosed with a terminal illness, I have been the most struck by one sentence. An oncologist looked at my dad and told him that only 4 out of 100 people survive pancreatic cancer. Dad didn't hesitate....he looked at him and said, "I'm one of those 4." I wasn't in the room, Tim told me about it later. It gives me chills each time I think about it. In the face of fear, he hears odds like that, and is at the blackjack table with a hand full of chips. We are all cheering him on and hoping for that 21. We rest in the hand of God and pray without anxiety and with thanksgiving for healing, strength, and positive focus.

In the meantime, all these thoughts about time reminded me of a brilliant essay passed to me a few years ago. It was even more inspirational now for obvious reasons...
http://www.phoenix5.org/articles/GouldMessage.html
(copy and paste the link into your browser)

8-25-08

Dad had a great day yesterday. He sat up for a long time, entertained a few guests, and kept his sense of humor with the medical staff. Angie snuck him a few bites of mashed potatoes and gravy, which was his first "real food." Tim helped him get up out of bed a few times, which made Gary feel like he was getting back to normal.

This morning at 7 am dad received a nerve block procedure. He did very well with it and is in recovery now. This procedure will eliminate pain in the region housing the tumor for a full year. The doctors think he will be able to return home tomorrow.

Thanks for the continued cards, comments, visits, and prayers.

8-24-08

Today proved to be another eventful day in the lives of the Bixlers. This morning, the nurses sat dad up in a chair after giving him his medications. He fell asleep shortly thereafter. Tim noticed that he was sleeping more soundly than normal, but was grateful he was getting some much needed rest. When Angie and Louanna arrived, Gary didn't stir, which was unusual. The nurse came in to take vitals and his blood pressure was 53/41. We immediately began trying to awaken him, to which was completely unresponsive. They called for the RRT (Rapid Response Team) and the room was suddenly flooded with 8 medical staff. It was like being in an episode of Grey's Anatomy--lots of orders being tossed around followed by "STAT!" Then, dad was lifted in this tent-like contraption in a pose I've seen before in yoga class into the bed for further assessment.

All kidding aside, it was a terrifying experience for the family, and for Gary. It took all day for him to recover from the apparent overdose of the medications he was given. His speech was slurred, and he was very lethargic. However, his pain was less and his spirit remained jovial. Since this episode, we have had an overly attentive medical team.

8-22-08

Dad's resting on and off today and enjoying broth and juice cocktails with the occassional bite of jello. He was in quite a bit of pain last night, but it is better controlled today with morphine, and the epidural. Between the "spinners" and the good looking nurses, I think both dad and Tim could be entertained for weeks. :-)

On Monday, dad will receive a procedure called celiac neurolysis which will deaden the nerves that feed the area which contains the tumor. This will control the pain resulting from the tumor, and will prevent him from having to take so many oral pain meds which would compromise his alertness.

We met with an oncologist today and are contemplating how to proceed with the chemo and radiation options he presented.

We know that several of you are having difficulty leaving messages on this blog. You have to set up a google blogger account to leave a comment (sorry about that). To do so, you don't have to enter any personal information....just a user name and password.

Have a good weekend.

8-21-08

Today has been quite an emotional day. We'll start with the good news. As planned, the surgeon made a small incision and examined the liver to find no signs of cancer! We are so thankful for that! He then proceeded with the Whipple procedure. However, upon visual examination he realized the tumor was too advanced to operate. It had grown too tightly around the arteries leading into the pancreas. Therefore, there was too great a risk to perform the operation. He closed the incision and informed the family. While this was not the news we had hoped for, we are focusing our energy toward discovering the best treatment options available. It will take approximately 3 weeks for Gary to heal from today's surgery, then he will begin chemo and radiation.

When he came out of the anesthesia, Gary was in high spirits. He was very thankful to God that the cancer had not spread. He was joking with all of his family and friends and, as usual, was more concerned with how everyone was doing rather than with himself.

We are praying for wisdom and guidance as we wade through the unfamiliar terminology and treatment options inherent to the diagnosis of cancer. The calls, visits, prayers, and support continue to be encouraging to Gary and sustaining to the family. Thank you for the kindness you continue to show us. We will try to keep you posted.

Gary will be at Missouri Baptist Hospital, Room 678 for the next 3-4 days, then will return home to Sikeston to continue his recovery there.

8-15-08

The CAT scan revealed two spots on Gary's liver. We are unsure at this point if they are malignant or not. Thursday morning, Dr. Howard will make a small incision and perform a biopsy of the liver. If the spots are malignant, he will not perform the Whipple procedure. Rather, Gary will begin chemo as soon as possible. If the spots are benign, he will go ahead and complete the operation. We are praying for the latter, of course.

Thanks again for the continued acts of support and kindness. We are trying to keep spirits high and hopes lifted. We are researching as much as we can to find successful treatment options.

8-14-08

Tuesday, August 12 Gary, Louanna, and Tim went to Barnes Jewish Hospital in St. Louis to have an ERCP performed. This procedure involved placing a stint in a blocked duct to drain the liver and open the pancreas. They were unable to place a stint in the pancreas as the passage was closed off. Therefore, he was sent to Baptist Hospital where an endoscopic ultrasound was performed. This test revealed the mass found on the pancreas the previous week was malignant.

The surgeon at Barnes, Dr. Howard, and his assistant, Jeanie are wonderful. We feel very blessed to be in their care. Dr. Howard is proficient at a surgery called the Whipple procedure. We will find out tomorrow if Gary is a candidate for this very invasive, but very hopeful surgery based on the results of a CAT scan completed late yesterday (8-13) afternoon. The results will indicate the stage and severity of the tumor. There is a 1 in 5 chance that he will qualify for this operation. If he is a candidate, the operation will take place at Missourie Baptist next Thursday, Aug. 21, at 7 a.m.

Needless to say, the last several days have been quite eventiful as well as exhausting. Gary has endured numerous tests and procedures....not without adventure. For example, due to his rolling veins, it took 6 nurses and one hour to insert the IV. Dad entertained the nurses during the fiasco and told stories about his grandson, Ben.

We will try to keep this site updated as best we can. Thank you for your calls, visits, support, prayers, cheerful messages, and warm thoughts. They are deeply appreciated.

Using dad's signature mantra....that's all the scoop we know.

Introduction

Thank you for visiting. We will try and provide updates and news about Gary and the family through this blog as they become available. Please leave a comment before leaving and post any messages for Gary and/or the Bixler family here. We appreciate your prayers and support during this time.

In order to decrease the volume of calls that the family has to make to keep loved ones and friends updated, we encourage you to visit this site often to keep in touch.

Thank you and God Bless-
The Bixlers