Showing posts with label Pain. Show all posts
Showing posts with label Pain. Show all posts

Monday, December 13, 2010

Billy's Christmas Tree

I know many of you are curious to know what kinds of things we have decorating Billy's tree, so I thought I'd share some photos.


From the LaBlues



Blackhawk Helicopter (Ft. Rucker) (From Wes & Adrienne)



Boston Red Sox Snowman (From the Stanvicks)



A Soldier Named Billy (From the Stanvicks)



"Mr. McCotter Head" (From Kelsey)



A Grill (From Kelsey)



Holiday Wishes (From the LaBlues)



Snowflake (From Michael and Karen)



From Bonnie and Steve



Freedom Star (From the LaBlues)



Texas HUGS (From Alice)



Anasazi Ladder (From the Clarks)



USA Nutcracker (From Aunt Linda)



Flying High (From Uncle Paul)



Weimaraner Puppy (From Mike and Kristie)



Patriotic Christmas Garland (From the Stanvicks)



Weimaraner Puppy for Christmas! (From Mike and Kristie)



A Hippopotamus Ballerina (From Aunt Robin)



Flying High & Fighting Hard (From Our Family)



Ask Me About BILLY (From Our Family)



The Christmas Tree


Thank you to everyone who has sent ornaments!  Billy has enjoyed opening them, and they've brought many stories and smiles.  Thanks for helping us to celebrate Christmas!

How is Billy?
He has been in a lot more pain recently, and the oncologists haven't been able to figure out why.  Billy had an ultrasound and a CT scan this past week, and neither have showed any reason for the increased pain.  His small bowel seems to be about the same.  The blockage is the same.  He doesn't have a lot of new swelling.  So they're thinking that Billy is probably becoming resistant to dilaudid (the pain medication he has been on since September).  They've increased the dilaudid for now to try to address the increased pain, and they're thinking about trying other pain medications in the future.

At this point, Billy sleeps a lot.  He seems to be sleeping more since they increased the dilaudid a couple of days ago.  Even with his increased drowsiness, he still gets up for almost-daily walks, and he still likes to watch movies with us in the evenings--though he falls asleep a few times before we get to the end.

It's movie time now...so I'm going to go.  But before I do, here are a few things you can pray for...

How to Pray
  • For Billy's Liver and Small Bowel.  His bilirubin has been increasing.  The blockage in Billy's small bowel is taking its toll on his liver.  Pray for his liver to hold up, for the bilirubin to go back down, and for the blockage in his small bowel to release.
  • Pain Management.  Pray that the doctors would be able to figure out a pain management regimen that works really well for Billy--one that addresses his pain effectively but also allows him to stay awake and interact with family and friends.
  • Family Time.  Pray that we'd have good time together as a family as Christmas approaches.  When we heard about Billy's diagnosis, I told God I wanted one more Christmas with Billy.  Just one.  And that's all I want this year.  

Thank you for praying.

Thursday, December 9, 2010

Chocolate Milk

This past Monday night, my mom, Chris, Danny, and I were hanging out together with Billy in his room.  Not being one to pay attention to the NFL schedule, I asked Billy if he wanted to watch a movie.  I knew the Patriots were scheduled to play sometime soon, as our cousin, Bryan, had mentioned his game tickets over the weekend when he was here.  So when I asked about watching a movie, Billy declined.  "I want to watch the game," he said.  And that was that.

I didn't mind.  I was glad to see Billy awake, and I was enjoying the time spent with my family.

As we waited for game time, Billy asked Chris for some chocolate milk from the pantry.  Chris went to get it.  I'm not sure when he returned with the chocolate milk.  Chris just came in and quietly placed the bottle on Billy's bedside table.


Chocolate Milk!


Sometime later, during the game, Danny stood up and said, "I'll be right back."  "Where you going?" Billy asked.  "To the pantry?"  Billy wanted more chocolate milk, so Danny gladly went to find some.


The Pantry...where we usually find chocolate milk.


After a while, Danny still hadn't returned.  Billy looked at me.  "There's no chocolate milk in the pantry, is there?" he asked.  "Why?" I asked.  "Is Danny taking a long time?"  Billy nodded, saying, "Chris took a long time, too."


The pantry fridge...where the chocolate milk bottles usually sit.


I smiled.  Something interesting was happening!  Chris and Danny must have walked to the pantry and discovered that there was no chocolate milk.  Then, they each must have taken the elevator to the 3rd floor, bought chocolate milk from Walt's (the snack shop), and come back to the 7th floor.  They both did all of that without saying anything, without expecting any recognition for the effort the put forth in getting chocolate milk for Billy.  It's the kind of thing that Billy has always done.

I had always thought of Billy as the sneaky one--the one who noticed little things he could do for people and then went off quietly to complete his mission, no matter how far he had to go or how long it would take to finish the job.  But now Chris and Danny were in on it.  And I had witnessed Bobby doing things like that before he went back to Colorado.  This kind of thing makes me smile.

When Danny finally came back in the room with chocolate milk, Billy and I made eye contact.  Without saying anything, we both smiled.  Danny saw it, and wondered what the joke was about.  But it wasn't a joke.  We were just appreciating the care Danny and Chris had shown to Billy.

Billy has done so many things for so many people.  We love it when we get to do things for him.

How is Billy?
He's quiet these days, and he sleeps a lot.  His energy level seems a lot lower than at other times.  It has been a while since I wrote an update, so I'll include some summaries:

Nausea  
Billy had been experiencing a lot of nausea last week.  The oncologists thought it was probably due to his liver and his gall bladder not draining properly.  Since the liver and gall bladder drain into the small bowel, and Billy's small bowel is blocked, the liver and gall bladder are probably backing up.  To alleviate this, the oncologists had suggested a percutaneous ("through the skin") catheter to drain his gall bladder.  That was supposed to happen sometime this week.

By Wednesday, most of Billy's nausea had subsided.  The doctors couldn't explain it; his symptoms somehow improved on their own.  At that point, the oncologists and radiologists thought it would be better not to insert the catheter.  Since Billy's nausea seemed to be under control (using scopolamine and phenergan), it would be better not to take on the risks of inserting a catheter into the gall bladder (risks like infection from another puncture or bleeding from the liver).

Pain
The nurses always ask Billy to rate his pain on a scale of 1 to 10.  Overall, Billy's pain seems to be in good control.  He's on a PCA (patient-controlled anesthesia) pump, which delivers dilaudid continuously.  He can always "push his button" if he needs an extra little spurt.  Usually, Billy says he's at a level 1.  He seldom complains about pain--but he seems to have intermittent, unexplained pain.  Some days, his left side hurts.  Other days, it's his right side.

Yesterday, his left side was feeling fairly sensitive, so he had an ultrasound to check for possible pockets of fluid.  They didn't find any pockets, and that's a good thing.

Today, his right side was hurting, so he had another CT scan.  We're still waiting on the results.

Drinking
When Billy is feeling good, he likes to drink ice water, juice, or chocolate milk.  At some points, he has enjoyed milk shakes or smoothies from Walt's (the snack shop on the 3rd floor).  When he started feeling really nauseous, he stopped drinking anything.  Over the past few days, however, Billy has been drinking more--not the shakes and smoothies from downstairs--but juice and chocolate milk.

Ornaments
We've had several fun packages come in the mail.  Thank you to all who have sent ornaments.  Billy enjoys them.  We all do.  (I will post more pictures soon.)

Visitors
This past weekend, Aunt Robin (one of my mom's younger sisters) and Bryan (Robin's son) came.  Uncle Paul (my mom's oldest brother), Aunt Linda (Paul's wife), and Aunt Janet (my mom's oldest sister) have been here all week.  Kelsey comes most weekends.  And last night, we got to meet Sarah--the girlfriend of one of Billy's army friends.  It has been fun to have visitors here.

How to Pray
  • For Rest and Energy.  There are so many interruptions in the hospital; it is often difficult to sleep through the night.  Pray for peaceful nights, good rest, and energy for Billy to sit up and go for walks during the day.  (Sitting and walking help keep his lungs healthy.)
  • For Healing.  Billy's left side is healing from a fairly large incision.  His liver isn't working as it should.  His bowel is still blocked.  And his abdomen still has a lot of fluid, with cancer cells spread throughout.  Pray for healing for all of these things.
  • For Perseverance and Goals to Work Toward.  It's kind of like a marathon, only longer.  Pray for all of us--to know what the next goal should be, and to know what we need in order to keep going.  Day after day in the hospital can be wearying.  Pray for fun things, good memories, and things to work toward to break up the monotony.  


Thank you for cards, and ornaments, and notes, and thank you for praying!

Thursday, November 18, 2010

Discoveries

It has been quite a week of ups and downs!

Monday was a hard day--difficult for us and difficult for Billy.  After weeks of small improvements every day, it was difficult to watch Billy struggle again.

Several weeks ago, Billy successfully completed a CT scan with contrast.  The whole process was amazing, really.  Being off of the NG suction is difficult for Billy.  The fluid backs up in his stomach and makes him nauseous.  Several weeks ago, despite that, Billy was off of NG suction for 7 hours!  He ingested 700mL of contrast and kept it in.  And the CT scan was successful.

On Monday night, after a rough day, a new NG tube, lots of nausea and some vomiting (sorry for the graphic detail), a CT scan with contrast seemed impossible.  Billy tried anyway, but it just wouldn't work.  His stomach refused to tolerate it.

They tried again on Tuesday.  Billy kept 100mL of the contrast in, but that was it.  It wasn't enough for a CT scan with contrast, but they took a scan anyway.

We were hoping the scan would show positive results:  a reduction in Billy's tumor and some large pockets of fluid that could be drained.

Even though Billy wasn't able to keep the contrast down, the scan was clear enough for the doctors to see what's going on.  Yesterday, we heard the results, and the results were mixed.  The scan showed four things:
  1. The infection in his left side is smaller.  (The catheter is doing its job!)
  2. There is no large pocket of fluid in his belly.  This raises a question:  why is his belly so "distended" (full)?  
  3. There is more fluid under his left lung than under his right lung.  This raises another question:  why is his right side pinching so much?
  4. The small bowel is more swollen that it was the last time, so they think it's probably obstructed.  A question remains:  what is causing the obstruction?


So what does all of this mean?  
It goes back to Billy's diagnosis.  Poorly differentiated gastric adenocarcinoma is an incredibly difficult condition to treat.  Scientists have made huge advances in cancer treatment over the years, but very little progress has been made in the realm of gastric cancer.  In patients who have Billy's particular version of gastric cancer, 3 types of chemotherapy are used together.  More recently, herceptin has been found to be effective when used in combination with the 3 kinds of chemotherapy.  However, herceptin, when used alone, has very little killing power.  It can slow the cancer, but it probably won't do much to kill it.

Why not use chemo and herceptin for Billy?
Simply put, Billy's body isn't strong enough for chemo.  Billy took one round of chemo in Miami, and it was very destructive.  Billy's body is too weak, and the chemo is too hard on the liver and the immune system for Billy to be able to tolerate it.

Those are the facts--or what we know to be the facts right now.  But in this world, things can change quickly.  Billy is doing well, but as we saw on Monday morning and again today, slight changes can make a whole day feel hard.  When the NG tube gets blocked up, Billy feels nauseous, and the activity in the room becomes about clearing the blocked NG tube.  When his side pinches, conversation stops as he gets his pain under control.  Billy was all set to go outside today (the first time since he arrived on October 6), but his side pinched too much during his morning walk--and the focus on the day became about getting his pain under control.  All of us--the doctors, the nurses, and his family and friends--are doing as much as we can to take care of Billy.

But we're starting to come across questions we can't answer.  The doctors don't know why Billy's right side is pinching.  It doesn't seem to be the liver or the gall bladder.  The doctors think it's from pressure further down his side, from inflammation caused by the cancer.  There's very little room in his belly for the fluid to build up anymore, and hence there are no pockets of fluid they can drain.

At this point, there aren't any drastic measures that we can undertake to fight Billy's cancer.  We can do things to improve Billy's quality of life, and that's where the doctors are focusing their efforts.  There's plenty of pain medicine, and a lot of different options.  There's benadryl for the incessantly itchy skin.  Herceptin is an antibody that is generally well-tolerated, so Billy can keep taking that as long as his heart stays healthy.  But outside of a miracle, the cancer will eventually win.

It was hard to type that last sentence, and thinking of publishing it makes the tears come.  It's not something we ever expected to face.

So in the meantime, in the limited time we have, we're trying to savor every day we have.  Every day we have is a miracle.  I'm treasuring the time I get to spend with Billy and with my family.  And I'm discovering some of the things that make us who we are...
  • This September, my parents and I went to Fort Rucker, AL, for his graduation from flight school.  On the morning of graduation, my dad handed me a box.  "That's from Billy for you to wear to the graduation," he said.  It was a necklace.  A set of wings.  Billy had two of them made--one for me and one for my mom.  


Billy's graduation gift for me.


When I saw Billy later, I asked him about it.  "It's your graduation, silly," I said.  "I'm supposed to be buying you a gift!"  He disagreed.  "You came to visit me," he said.  "And that's enough."  That's Billy for you--always a giver.
  • I went in the family room last night to wash the crock pot after I had made chili.  (Thank you for the ingredients, Sara!)  All the dishes had been washed.  I asked Bobby and Danny about it, and all evidence pointed to my mom.  She's so sneaky sometimes!  
  • Several weeks ago, my mom and I had gone to get massages at a local spa, courtesy of Walter Reed.  I was supposed to have a pedicure that day, but something got messed up, and I wasn't on the schedule.  So my mom decided to give me a pedicure last night, and it was awesome!  


A pedicure...just because my mom wanted to give me one!


  • Yesterday, my mom went to Dunkin Donuts to get my favorite coffee.  Later that morning, as I was drinking my coffee, Bobby and Danny showed up for the family meeting.  Bobby was carrying a cup of coffee.  He extended the cup, saying "This is for you, 'Chelle."  He had made coffee in the French press, and added sugar-free hazelnut and half-and-half, just the way I like it.  I didn't know what to do with 2 cups of strong coffee--but I felt incredibly blessed and loved.
We're a family of givers, and I love it.

Ways to Pray
  • For miracles.  For the impossible.  For us to continue to be hopeful.  
  • For special moments as family and friends.
  • For endurance in this journey that has no definitive timeline.
  • For the pain in Billy's side to dissipate.
  • For Billy to be able to go outside.  
  • For Billy to be able to celebrate Thanksgiving.


Thanks for everything! For the friendship, hugs, notes, groceries, money, encouragement, prayers... We could not do this without all of you!

Tuesday, October 12, 2010

Difficult Conversations and Small Celebrations

Every day here feels so long!  It’s not that the days drag on.  They fly by.  But so much happens in a 24-hour period, it’s hard to believe all of it happened in just one day. 

Today, my parents had gotten up early to be at the hospital by 6:30, so they could be there when the physicians made their “rounds” (when all the doctors go around and see the patients each morning).  Somehow, they still missed the rounds. 

Later this morning, my mom and I got to spend some time with Billy in the ICU.  His room was small, so we stood on either side of his bed while he slept.  And all of a sudden, the physicians came by!  We had missed “rounds”—but for some reason the doctors came by again anyway.

This time, it was Dr. Lettieri from internal medicine.  He gave us an update on Billy.  His pain seems to be under control now.  (They got Pain Management involved, and some of the recommendations seemed to be working!)  His platelet counts were low, and that was something they were continuing to watch.  And they were as “on top of the infection as much as they could be,” so they were planning to move him out of the ICU up to the Hematology/Oncology ward.  Back to the 7th floor! 

As Billy slept and we talked, the conversation turned to harder things.  Last Thursday, according to Dr. Lettieri, they would have said Billy might live a few more days.  But it was Monday now, and Billy was doing better than they ever expected!  It was good news.  He was interacting with people more.  He seemed to be in less pain.  After the intensity of the past few days, it felt relieving to hear about Billy’s improvement. 

However, according to the doctor, Billy’s cancer is still a big factor, and it’s a factor they don’t think they can beat.  As my mom asked questions, I could see the pain on her face.  The fear of losing her son was overwhelming her.  The doctor shared some hard news—news I’ve always been reluctant to share.  I want to hold onto hope, to have faith that God could heal Billy. 

So I asked the doctors a hard question.   “I’m writing a blog,” I said, “to keep people informed about what’s going on.  I’ve focusing on celebrating our victories, even if they’re really small ones.  This journey is incredibly hard, and I don’t want to focus on what’s hard all of the time.  But there’s a difficult reality to this.  How do I continue to celebrate, without giving people a false picture of what’s going on?  How do I let them in on some of the things we just talked about?” 

And the doctor recommended that I give you all the full picture—to let you see what’s really going on, and to invite you to choose to hope and celebrate with us, even in the middle of the hard stuff. 

In reality, Billy is very weak.  He’s doing better, but he has lost a lot of strength.  His platelet counts are low, and we’re not completely sure that the infection is entirely gone.  They’re not sure if or when he’d ever be able to take chemo again.  And when Billy was originally diagnosed on September 23, we knew that the only option was chemo.  If they can’t do chemo… 

I know.  It’s hard news to swallow.  I want to fix it.  To try whatever we can.  To extend his life as much as possible…  But Billy is not a science project.  He’s my brother.  And his spirit was never meant to live in a hospital bed.  Everyone who knows him well knows that.

“There are things,” the doctor said, “that we could try to be able to say that we did all we could.  But not all of those things are going to be good for Billy.”  So the question now is about giving him the fullest life possible, for the longest amount of time we can. 

When I think about all of this, it overwhelms me, and I cry.  I can’t imagine life without my brother.  There are so many things we planned—things we talked about (like running the marathon next summer in Hawaii), and things we haven’t spoken much about because life hasn’t gotten there yet (like having Billy in my wedding, or getting to introduce him to my kids…two things I hope for but aren’t yet part of my life).  I always imagined Billy in all of the wedding pictures for our family. 

I think all of us imagined a lot of things, and it hurts to think about those things not happening the way we had planned…

So now, what I’m hoping for has changed.  Big-picture, I still hope for Billy’s healing.  But there are smaller, more tangible things I’m hoping for here…

Today, I got to spend quite a bit of time with Billy in his room.  My family had gone to eat lunch, and I stayed behind to keep him company while he napped.  He woke up after a while, and was far more alert than he had been in a long time, probably since before we left Miami last week.    I told Billy about his infection.  I filled him in on the A-line on his right wrist.  And I got to ask him how he was feeling about moving back up to the 7th floor.  It was really good time with Billy—similar to the time we had shared in Atlanta a month ago.  Talking about life and about deep stuff with Billy, and just spending time with him…that has always been one of my favorite things in life.  And I got to do that today!

One of the life things we talked about was the idea of me going into nursing someday.  I’ve been thinking about it for the past 4 years, and I told Billy about how I enjoy helping people with medical stuff.  “You want to be a water nurse?” he quipped.  I thought for a second, and then I looked at his face.  Aha!  There was that smile!  He was cracking a joke…coming up with a fun way to ask me for some water.  I love seeing that smile, and hearing him joke around!

I shared some stories with him, and messages I’d heard from friends who had sent emails and texts over the past few days.  Sam, I shared some of your recent email about Buddy and some of your memories, and I told him about a few of the pictures you had sent.  He smiled when he heard about the one after you picked them up from SERE school, when they all had little moustaches.  His face said he was remembering good times with friends, and maybe some inside jokes or stories that would make you all laugh.  I know we’ve all laughed as we’ve heard some of them.

When Sam dropped them off for SERE school.



The morning Sam picked them up, 3 weeks later.  Note the mustaches!  

The things I hope for every day are smiles and laughter, good memories, and small signs of progress.  I want Billy to be able to celebrate and remember the friends and family in his life—and I want all of us to be able to do the same.

I know a lot of us are hurting.  It’s hard to see someone we love so much suffer.  And I long for times when some of you get to see Billy and to laugh, share stories, and celebrate his life.  I like seeing the banter that happens between friends.  Billy loves that stuff. 

I have one more quick story to share…and I should probably ask for permission…but I’m going to share it anyway.  I know many of you know my brother as Cooter or Will, but he will always be Billy to me.  And I know that some of you have attempted to use that name to refer to him, only to be reprimanded, or wrestled to the ground, or sprayed with a fire extinguisher.  To family, my brother is Billy.  To the army, he is Cooter or Will.  That’s how he wants it. 

Well, a funny thing has been happening.  As we’ve hung out with army friends, I’m hearing more and more people call him Billy.  How can you not, when that’s the name I use on the blog? 

Anyway, Billy’s friend and former room mate, Rob Smith, was telling me that he used to call my brother Billy all the time, and Billy used to get really mad.  So much earlier, before Rob got here, he sent me a text.  “Michelle,” he said, “please pass this along to Will.  He’ll understand because he hates when I call him Billy.  ‘BILLY!!!!!!!!!  I’m trying to arrange a trip.  I’ll get there as soon as I can foo.  Love ya.’” 

I shared the message with Billy.  And Rob’s message was clear.  Billy smiled. 

Just yesterday, as we were talking about Billy’s sense of humor, and how it seemed to be coming back, I told Rob he should call him Billy.  I thought my brother would appreciate that.  ;-)

I never heard how that went, but I saw the following message on the dry erase board on Billy’s room when I left his room tonight (Monday night).


I smiled.  Well-done!  “Billy, did you see what Rob wrote?” I asked.  "Yeah," he said.  And gave me the biggest eye roll!  So annoyed...  Rob’s message was perfect, because it was done in the slick, sneaky kind of way that Billy often uses (like leaving a case of beer in a friend’s refrigerator before he even knew he was there).  Billy loves people well, and he’s clever in his delivery.  He loves to surprise people!  Most of the time, you don’t know he was there until he’s long gone.

The banter between friends is a fun thing to watch.  And despite infections and cancer and hard questions, today I saw that my brother is very much alive.

Some ways to pray:
  • Pray specifically.  Today, my mom prayed that she’d see Billy sitting up, and that she’d get to see him without all the tubes and wires sticking out of him.  That was NOT the picture we've had recently.  But today, he was more alert than he’s been in almost a week!  And, many of the tubes and wires were removed because they were no longer needed outside of the ICU! 
  • Billy’s 26th birthday is coming on Thursday.  We want it to be a special day.  Pray for creativity in figuring out how to celebrate my brother.
  • For us, as a family, to figure out how to love each other well through all of this.  We’re hurting.  This is really hard stuff.  And we’re all dealing with this differently. 
  • God’s help in making hard decisions as the difficult questions come up. 
  • The fullest, best life possible for Billy.

A note...I've gotten a lot of calls, emails, messages, and texts.  And I haven't been able to respond to all of them.  But thank you!  Thank you for your concern, your encouragement, your thoughtfulness, and your prayers.  Even if I'm not able to tell you personally right now, it means the world to me and my family.  And Billy still can't believe so many people are praying for him!

Saturday, October 9, 2010

One Day at a Time

The Williams clan is here now…well, some of them.  My mom’s family is huge, and they’re amazing.  Once they heard about the severity of Billy’s infection, a bunch of family from Massachusetts got in a van to drive down here.  They left as soon as they could gather at my aunt’s house, and they got here at 4am yesterday (Friday) morning.  Here are some recent photos of most of the family who came…


From Left:  Aunt Robin, Billy, my mom (Jill), Aunt Chrissy
Location:  Loveland, CO  (Bobby and Blair's wedding)
June 20, 2009
**Robin and Chrissy are here from MA.



Cousins! From Left:  Billy, Steve (Chrissy's Son), Ben (Jack's son), Kyle (Kelly's husband), and Bryan (Robin's son)
Occasion:  Kelly and Kyle's wedding
August 21, 2010
**Kyle and Bryan are here from MA.


Billy and Aunt Robin
Location:  Kelly and Kyle's Wedding
August 21, 2010
**Aunt Robin is here from MA.




Kelly and Kyle
Location:  Kelly and Kyle's Wedding
August 21, 2010
**They're both here from MA.



Justin and Uncle Jack
Location:  Kelly and Kyle's Wedding
August 21, 2010
**Uncle Jack is here from MA.


I didn’t get to see them until I woke up much later.  I walked into the ICU and saw my Aunt Chrissy.  We hugged, and I cried.  After a while, I let go.  I turned toward Billy’s bed, and someone handed me a t-shirt.  “This is for you.  Aunt Robin made it.”  It was camouflage, and it said “BILLY’S BRIGADE” in army font.  It has a picture of an apache helicopter below the army text.  And below the picture, it reads “Flying High and Fighting Hard.” 





We know the details aren’t 100% accurate—but the shirts are perfect.  They helped band us together yesterday as our clan traipsed around Walter Reed.  Eventually, people started to recognize our shirts.  One guy even said he wished he could have one.

Our whole immediate family is here now.  Blair, my dad, and my brother Chris joined us yesterday.  We're all here, trying to love each other, be in this together, and to love Billy.



Four of the Five McCotter/Bohren kids. Despite what modern medicine says, we're hoping for a miracle. There have always been five of us in this picture. We want there to be five again.


People all over the hospital know Billy’s story.  It was a urology doctor (Dr. McLeod) who fought to get us here.  The oncologists have been collaborating to help Billy the best they possibly can.  There have been GI doctors and surgeons involved.  The doctor who’s in charge of the medical center has asked for regular updates on Billy’s status.  In the ICU, there are policies on visitors—like a max of two people in the room at a time, and no one stays overnight with the patient.  But for Billy and our family, those things don’t seem to apply.  The ICU team know what’s going on, and they’re try to do everything they can to serve our family and to make Billy as comfortable as possible.  Billy’s story is a big deal.  It doesn’t make any sense to anyone here.  It’s very heavy and very sad.  Everyone seems to be impacted.

Yesterday, we had a family conference with the doctor who’s in charge of the ICU.  He wanted to make sure we were all on the same page, and we understood what was going on.  The details are very much the same as I wrote about last time.  Billy has stage IV gastric cancer.  In and of itself, that can be a devastating diagnosis.  In terms of statistics, gastric cancer doesn’t do well.  But on top of that, Billy has a major infection that could easily threaten his life.  The cancer has been very aggressive (many of the pictures above were taken within the last 6 weeks), and put Billy on a “decline” health-wise, as the surgeon told us.  But the infection sharpened the decline. 

At this point, the medical team is doing whatever they possibly can to help Billy beat this infection and to extend his life.  He’s already had one round of chemo.  Whether he could ever tolerate another is completely unpredictable.

The doctors don’t know what tomorrow will look like.  They’re just focusing on one day at a time, and they’ve encouraged us to do the same.

Billy has been in a lot of pain, and is pretty weak.  He now has a hard time moving in his bed on his own.  There is little strength left in his body.  I ran my fingers through his hair last night, and I got to use this interesting little shower cap to wash his hair.  (You don’t have to use water.  There’s soap in the cap.  You just put it on and rub the person’s head, and it washes his hair.  It takes just a few minutes.  And then you towel dry and comb the hair.)  Billy’s face said it all.  It was the power of human touch again.  A small taste of something wonderful in the middle of a painful and difficult journey.   As I combed his hair, it fell out in chunks.  It’s the chemo.  I knew it would probably happen, because his pillow had been covered with hair.  Billy’s body is weak.  He is fighting to survive, but he is so very weak. 

Sometimes, it’s hard for Billy to talk.  Sometimes, he’s really thirsty.  But he can’t drink anything at this point.  His stomach still doesn’t work, so everything that would go down would get sucked out by the NG tube.  His legs hurt a lot, and his ankles are swollen.  His belly keeps swelling with the fluid that’s being produced by the cancer cells.  And he has wires and tubes all over.  But he's more stable than he was two days ago, and that's a small miracle.  :-)

We rejoice in the little things.  Billy looked over the side of his bed and saw Rob yesterday (a army friend who had driven down from New York).  Billy didn’t say anything, but he smiled.  I love seeing him smile!  The look he gave Rob said more than words could ever say, and that is something worth celebrating.  The doctor told me that his white blood cell counts were coming down, and that seem like a small victory.  It means that the antibiotics are probably working to knock out the infection.  We have to keep watching them to make sure they don’t go too low.  But it looks like they’re working!

(Confused about white blood cell counts?  I know, it’s hard to understand all of this.  When Billy took the chemo, it attacked his body—as it’s supposed to do.  In doing its work, the chemo killed some of his white blood cells.  That can be dangerous, as it means that his immune system gets weakened.  So the doctors gave him neupogen to help his body to make more white blood cells.  When the body gets infected, it also produces more white blood cells.  An excessive level of white blood cells can indicate infection, which is also not good.  But it’s not bad that he has more white blood cells; it means that the body is doing its job to fight the infection.  And a decrease in an elevated white blood cell count can be good, because it can mean that the infection is going away.)

Billy is hanging in there.  We’re all living one day at a time, trying to spend time with him and with each other.  It’s a tough journey we’re walking.  Medically speaking, Billy doesn’t have much time left.  But I will hold onto hope as tightly as I can.  You never know what God might do.