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Update (3-04-08): Since Wanda started chemotherapy, now Tim has been diagnosed with lung cancer. Please pray for them, their families and the medical staff who are treating them and making decisions about treatment options.
Update (4-18-08): Wanda has responded wonderfully to her chemo treatments and the last tests show no cancer cells. Tim, on the other hand has not responded well to treatments and will be coming home soon under hospice care. Please keep this family in prayer as they care for Tim in his last days and for Wanda as she recovers from the treatments while caring for Tim and for Tim to find comfort and peace and feel the love of God through his family and friends.
Update (2-28-08): I just had a great visit with Wanda and Alan. He is in a room (#7136, Mercy Hospital near Miami) overlooking Biscayne Bay- amazing view. Both are in really good spirits. Alan had a central line put in yesterday and has been receiving sustenance via the line. His color is better than it was Monday. He was able to get out of bed unassisted this morning. The surgeon came in while I was there. He really is a gentle soul and very straight forward. The surgery is scheduled for tomorrow (Feb 29) around 9am. There will be a surgical team present which includes a thoracic surgeon. They are going to attempt to do everything laproscopiacally. Dr. Jacobs stated at least three times in the conversation that this surgery is very serious. They will remove a piece of the esophagus and stomach and then piece it all back together. If there are any complications, the thoracic surgeon will step in and crack the chest to do what needs to be done. He did not state how long the procedure would take. If there are no complications, Alan could be home by Tuesday. The first two weeks will be critical as this is when the most serious complications will occur. A feeding tube will be placed at the incision site so Alan can continue to receive nutrition as the esophagus and stomach heal. The oncologist does want to do chemo after Alan has recuped from surgery. The surgeon reiterated that this is an agressive cancer. He called it a "mean cancer". So, that's where it all stands.
Wanda's sister and brother-in-law are flying in today so as to be there tomorrow. I plan to be there as well. It may be well into the afternoon before I can give an update. I will try to call strategic people so as to get the word out. Please be in prayer for Wanda and Alan as this is a very anxious time. Pray for the surgical team. Pray that there are no complications and everything is it appears on the CT Scan. Alan and Wanda are very appreciative of all the prayers and calls. Because of all that will be going on tomorrow, it may be better to call me than Wanda. My number is (786) 877-3773. Thank you as well for the kind and encouraging words many of you have extended to me. I'll be in touch.
Grace and peace.
Leah
Update (3-01-08): Alan went into surgery at 11am yesterday (Fri, Feb 29). Altogether, the surgery lasted between 4 and 4 1/2 hours. They were able to do everything laproscopically which is amazing. Because of the size of the tumor they had to remove a little more of the esophagus than anticipated. Nonetheless, they were able to reattach everything without complication. The surgeon, Dr. Jacobs, felt good about the reattachment. They were able to ex-tubate Alan without incident, and he was back in his regular room by 8:30 last night. There was no need for ICU. All of this is a huge answer to prayer.
Now for the not so good news. The tumor had attached to the pancreas and diaphram. Because of the critical nature of these organs, neither can be removed. Dr. Jacobs said that he scraped as much as he could, but they had to leave a few cells behind. He stated that chemo and radiation are absolutely imperative. He also stated that the cancer is advanced. He did not lable it with a stage. I speculate that is something the oncologist will do after viewing the pathology. When asked about long-term prognosis his response was,"I don't know." He quickly tempered that with "No one knows." He stated that we are to keep up hope and keep up Alan's hope.
Update (3-14-08): Alan met with the surgeon yesterday, and all went well. They did remove the drain; however, they did not remove the feeding tube. Dr. Jacobs stated that he wanted to leave the tube in place until they know how Alan will react to the chemo/radiation. His point being, if the chemo/radiation make Alan terribly nauseous then the tube will already be in place for Alan to receive much needed nutrition. Dr. Jacobs didn't want to risk Alan becoming too weak for treatment because of lack of nutrition. Alan went to his family doctor this morning to be cleared for the minor surgical procedure needed to insert the portacath for the chemo. Wanda didn't think they'd begin chemo before April 7. Alan was somewhat discouraged but understands Dr. Jacobs' point. Continue to pray for this team of medical professionals as they make decisions regarding Alan's treatment. Pray that there are no complications as they insert the portacath. Pray for Alan's body to be strengthened enough to begin treatment as soon as possible. Pray for Wanda as she continues to support Alan.
Update (4-08-08): I have some info for you regarding Alan and Wanda. They have met with both the Radiation oncologist and the medical oncologist. Alan is scheduled to begin treatment on April 16. Due to the intensity of the treatment, Dr. Larcada will admit Alan to the hospital during treatment sessions. He will enter the hospital (South Mercy) on Tues., April 15 and begin chemo/radiation on Wed., Apr 16. They will administer both chemo and radiation Wed-Fri, and then do another chemo session on Saturday. Depending on Alan's strength, they will hopefully let him come home Sunday, Apr. 20. If I understand it right, he then goes back the next day for more radiation, but I do not think that will be done in-patient. As of right now, Alan's health isn't the best. He has lost five more pounds because he feels so nauseous. The most recent CT scan did not show a new blockage. The doctor feels the nausea may be residual from the barium used during the CT scan. However, any weight loss at this point is not beneficial. Dr. Larcada was very forward with Alan and told him that if he doesn't do exactly what he is asked to do by medical professionals he will not survive this. He is supposed to be taking in 6 cans of supplements and has only been doing three. Wanda feels that Dr. L's forwardness may have shaken him up enough to do what he needs to do. Wanda continues to be amazing. She does not let Alan feel sorry for himself. When he begins to talk negatively, she makes him take a walk with her which, of course, has numerous benefits.
Please pray that Alan will have the physical strength needed for the upcoming treatments. Pray that his blood counts remain whatever they need to be. Pray that the side effects will not be overwhelming. Pray that Alan can maintain a positive attitude. Pray for Wanda's physical and emotional strength. Pray that God will replace her fears and anxiety with peace and comfort. As of right now, I am not aware of any tangible needs that they have. I will let you know how things progress. Thank you for all your prayers and support.
Grace and peace.
Leah
Update (4-16-08): Please pray for Alan today as we struggle to get a room at South Miami Hospital. We went to check in last night only to discover there was "no room at the inn." We went back this morning, and still no rooms. Dr. Larcada talked with us in the waiting area. He had physically walked the 6th pavillion and literally saw a bed in every corner. They are anticipating 2 - 3 discharges today, so hopefully, they can get Alan in to start the Platinum. We will still go to Radiation today at 1:30 p.m. regardless of the room situation.
The other bad news is our insurance only approved 1 day of inpatient care while Alan is receiving the platinum. Cigna insists the other chemo drug - 5F - can be administered as an outpatient. The bad news is doing it as an outpatient for 4 days would require attention on the weekend, so we will not be able to start the second drug until next week. Dr. Larcada will start the drug on Monday at his office through the port they installed and send Alan home with a pump. We will continue with the radiation everyday on an outpatient basis.
I am heartbroken that an insurance company can decide Alan's treatment plan. Our best chance of medically defeating this cancer was to follow Dr. Larcada's plan to do both chemo drugs and the radiation concurrently this week.
Alan is not sleeping and has a lot of back pain. I think he was hopeful some time in the hospital would provide the medical attention he needs to get some relief.
Update (4-21-08): The past few days have been particularly frustrating and disheartening for Wanda and Alan. As you may remember from my last email, they were having trouble with the insurance company. Some of that trouble has been alleviated. They were finally able to admit Alan to the hospital Wed. (Apr. 16). That afternoon they were able to get him calibrated to the radiation machine and actually did the first radiation treatment. Late Wed. evening they were able to administer the first dose of chemo as well. Dr. Larcada has placed Alan back on the continuous feeding tube as Alan can't seem to keep anything down and had lost another 8 pounds. Dr. Larcada has also decided that he can administer both chemo drugs simultaneously as outpatient and does not feel that Alan's treatment has been compromised. They were able to administer a second dose of radiation and chemo on Thurs. Unfortunately, Friday the radiation machine broke down. (Can you believe that?) Because everything has been set to that particular machine, they didn't want to use another machine, and the second machine is not as precise or powerful. Needless to say, they both were very frustrated and disheartened by this latest snafu. They have been told repeatedly that Alan's best chance for survival, medically speaking, is to receive radiation and chemo simultaneously. Wanda also made the comment that being on the cancer ward was very sobering as they witnessed people far worse off than Alan. It was very difficult to see such suffering and realize that that is most likely in their future.
As if they weren't dealing with enough, Wanda and Alan received word Thurs afternoon that Alan's grandaughter fell asleep behind the wheel of her car and wrecked. She is still hospitalized with a badly broken wrist (they put in pins on Fri or Sat), broken foot and broken nose. There were no internal injuries. Alan was very emotional talking about Nicky and wanting to be there for her (NC).
So...as for specific prayers, pray for traveling mercies as they drive back and forth to the hospital. They are there now receiving chemo and will drive back for radiation at 7pm tonight. Pray that the radiation machine is repaired as this effects all the patients, not just Alan. Pray for encouragement and strength for both Wanda and Alan. Pray for rapid healing for Alan's grandaughter, Nicky. Pray that both Alan and Wanda are able to get some rest.
From Leah: This is a very quick email to let you know that I just received comfirmation that I will be commissioned as an AYG Affiliate this June. Matt Norman just gave me the official call. Thank you so much for your prayers and support. I am most humbled and honored by this appointment.
Grace and peace.
Leah
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