Two months

Well the dad update for now is not much different than the last. He's still fighting to come back from the set backs caused by an adverse reaction to one of the drugs administered during the last round of chemotherapy and harder still the fungal infection that has him in the medical intensive care unit at the University of Iowa Hospitals and Clinics. As of today he still hasn't come around as much as we would hope, but the doctors have told us that it might take more time for him to bounce back.

The title of this post is "Two months". It's been two months since Ronnie, Mom and Dad made that fateful trip to Iowa City. I could write a lot about the past two months but I'd just be repeating the pages of this blog. For now I'm going to keep it short and sweet.

Get better pop. Like that poster in your office used to say "Get out there and GET WELL WELL WELL!" (The original said "Get out there and SELL SELL SELL")

Little increases

Hello again. The dad update after yesterday goes a little something like this. The MRI from Friday night didn't show any size increase of the five lesions that were found earlier in the week. They're not going to be able to determine the real extent of any damage caused by the lesions until dad wakes up more and they can run some tests on him. He is showing signs of coming out of the fog. Yesterday he was able to open his eyes and move them from side to side when the neurologist asked him to so. He also made eye contact with us for a bit and tried to lift his head off the pillow at one time. There are a couple theories right now as to why he's not coming around as quick as the doctors would like him to. (NOTE: Theories only, there has been no final diagnosis.) The fungal infection spreading to the brain most likely caused the lesions and there might be some stroke like damage in his brain. They are not seeing any damage to the thinking part of his brain, which is good. His EEG showed more activity than they would expect for somebody in a state like dad. Translation: dad's brainwaves are showing his brain is more awake than his body is. They think it's possible he's extremely weak from fighting the infection and simple lacks the energy to move much. Overall they are seeing tiny improvements day to day just not enough as of yesterday to wean him off the respirator. He has been passing and exceeding the ventilator trials each day, it's just that they want him more alert and in control of his throat before they extubate him. Oh and his arms are still swollen from the blood clots, hopefully his body starts rerouting things. The PICC line is out and he is only on two venipuncture IV's in his legs for the medications. So again, we're making tiny steps forward.

From talking to everybody over the past week you start to realize how much of a medical education you get when somebody has an illness like cancer, especially if they develop other conditions as a result of the treatment. Questions like "How is your dad doing?" become conversations about blood counts, respiration numbers, chemotherapy schedules, listing off medications, fluid balance, etc. Another thing you start to realize is how truly special the people are that are in the medical field. Every single person that I've met that has helped dad has been nothing short of a saint. For those of you that are reading this that are a nurse, a doctor, a technician or in any of the health professions - thank you for what you do everyday.

Among the plethora of advice dad has given people over the years is the story of the bulls. I'll have to modify the story a touch considering the audience of the blog, but it goes something like this:

Two bulls, an old bull and a young bull, are standing on top of a hill side looking down on a pasture of the most succulent oats they've ever seen. The young bull turns to the old bull and says "Hey, lets run down there and eat some of those oats!" The old bull replies, "Let's WALK down there and eat them all."

Dad, keep on getting better even if it's a walking pace and not a sprint.

Where we are

I'm going to keep this brief tonight as I don't feel like writing but know that there are many of you who want to know the latest. The echocardiogram last night did not reveal any issues with dad's heart, which is good news. However, he's still not showing any signs of becoming more awake other than occasionally opening an eye which is a big concern to the doctors. They feel he shouldn't be in this state at this point and should be looking better than he is. Another MRI is on order for tonight to see if the lesions are growing or shrinking. I believe they are also going to do an EEG to see what sort of brain activity is going on. Mom, Ed, and I are headed out there tomorrow for consultation with the doctors to determine what the next steps are in this.

Ron2

The hits keep coming

They say its darkest right before the dawn, lets hope thats true. The MRI yesterday revealed five "spots of interest" on dad's brain. It's not known at this point if these are lesions caused by decreased blood/oxygen flow or if they are caused by the infection. Doctors took spinal fluid yesterday to culture it to rule out the infection. Until they know what is going on with his brain, they can't give any anti-clotting agents for fear of what it might do.

In addition to that, he has developed a clot in his right arm now so we're quickly aproaching a point where something needs to give. And if that weren't enough, dad will be getting another echocardiogram today because they want to check to make sure he doesn't have a hole in his heart, which can apparently reveal itself in the form of the brain lesions he is showing.

Peace,

Ron2

More complications

Things continue to pile up on dad. He has developed a clot in his left arm but before they can treat it he needs another MRI of his head to make sure the infection he has didn't do anything to his brain. If any lesions are discovered, he'll need surgery to repair them. Let's pray it doesn't get to that point. Otherwise they'll start giving him medicine to treat the clot.

The doctors took him off of sedation yesterday morning and are waiting for him to come around. Our hope is that once he come's to, we'll get a better assesment of where he is with his breathing and if he's doing well he can come of the respirator.

Thats all for now.

Peace,

Ron2

Monday update

Because we've gone a few days without any excitement, dad decided to add a new trick to his show by having a bout this morning with a rapid/irregular heartbeat. Fortunately, the doctors were on hand to witness and in talking to them afterwards they indicated that what happened is very common in patients that are fighting pneumonia. They gave him a new med to keep his heart in check and he didn't have any episodes the rest of the day. His lung xrays continue to come back with improvements but he did need two units of blood today. His hemoglobin had got just low enough that they felt it would be good time for an infusion. Maybe a fresh supply will do him some good.

He continues to be stable and is fighting hard to get over this. Please keep him in your prayers until we are out of the woods with this.

Peace,

Ron2

An open letter to dad on Fathers Day

Dad,

Not sure how much you've been picking up from everybody in the room over the past few days but right now they're adding another medicine to help treat the fungal infection in your lungs, this one in concert with another hopefully will start helping you get better. Your blood counts are holding steady or improving which is showing us that your immune system is battling things and your bone marrow is producing the various parts of your blood that you need. Right now you're stable and resting as comfortably as possible for somebody who is very sick. If you don't remember any part of the ICU experience I don't blame you one bit.

Today is your 53rd day away from home and Fathers Day. Hopefully the medicine starts to work and we can get you out of the ICU, out of Iowa City and back home sometime soon. Until then, rest easy and get better.

Love,

Eddie

Morning update

Well, it was a fairly quiet night for Dad. It started out a little rough as we had several mishaps with the feeding tube that was installed earlier in the day. The first tube that was put in was defective and had to be removed. The second tube that was installed coiled around and didn't reach his stomach. The third attempt didn't show up on the xray. Finally, on the fourth try the saw the tube on the xray but when the nurse went to pull the guide wire it appeared stuck like the first one. As my blood pressure steadily increased, two nurses working together were able to get it removed. At 11:00PM, he finally began to receive some nourishment through the tube. The liquid that he is getting is much better for him than the IV fluids and will give his body more nutrients to work with.

His vitals continue to look good. So we'll be playing the waiting game and see what happens. On the plus side, he hasn't had a fever in a while and his breathing appears to be much more relaxed. Hopefully this will get him past the hump and let his body recover a bit as it continues to fight the infection. I watched yesterday as they did the bronchoscopy and was able to see the infection he's fighting. We should know within a day or two exactly what it is and see if there are any other antibiotics that can assist. Also on the plus side, Dad's blood counts continue to look good. It's been a long time since he's had any platelets or blood products, which is a sign that the chemo has knocked back his lymphoma a bit.

So, we're back to where we started: he has to get past this infection. Being on the respirator is a major setback for him and all of us, but despite the difficulties there are still possibilities that benefit him and are worth trying at this point.

As Ed mentioned in the previous post, Pastor Mike and Helen came out yesterday and did a great job comforting us. They gave up some other commitments to be here and we are very grateful to them. Also Natalie's sister Michelle and her friend Robyn stopped in to cheer us on.

In closing, as I always do, I ask that you keep Dad and Mom in your prayers. That God would guide the doctors and nurses and that there hands would be His. That Dad's body would get the rest it needs during intubation and be capable of fighting the infection and continue to get stronger. That the test results would give us a better chance of finding an antibiotic that will work. And finally, that Mom would continue to have the strength and courage to face all of this. She's been doing such a good job, but we all have a breaking point. We've been in a down cycle for a long time now, it's time for some better things to start happening.

God's Peace,

Ron2

How we stand

Dad was intubated early this morning and put on a ventilator. He is now sedated and his body is relaxing as the ventilator does the job of breathing for him. Today was a pretty busy day for him in the Medical Intensive Care Unit; after getting him stabilized in the morning they performed a couple procedures on his lungs to help clean things out and get some samples of the buildup to analyze. They haven't performed a tissue cultivation as they feel this could be harmful to his already taxed lungs. He had a chest X-ray today that showed the infection has now spread to both of his lungs. The doctors are constantly refining their treatment plan in order to get dad better. He's in good hands out there.

Mom, Natalie and Ronnie are going to be out there tonight. Hopefully the magic touch they had earlier this week will work again. On behalf of our family I want to thank Pastor Mike and Helen for coming out to talk with all of us today. I've never been through anything like this before and both of you were very comforting.

Eddie

Bad news

We got an early morning call from mom. Dad has to be put on a respirator. We're not sure what happened overnight, but mom, Ed, and I are on our way out there. Please pray for us.

God's Peace,

Ron2

Better than yesterday

I'll just give you a quick run down of the last 24 hours. Last night I sent Mom and Natalie away and spent the night with Dad. For the most part he did pretty well overnight. He had a few episodes where he got feisty and removed his mask. I let him have his temper tantrums then quietly slipped it back on. As tiring as it got to be at times, let me tell up front it is was an absolute honor to be by his bedside taking care of him. It was only a small repayment on my part of the all the years he stood by my in a time that seems so long ago.

By 3:00AM, he began to sleep pretty soundly so I finally laid down myself. Mom got to the hospital around 6:30AM and he was still sleeping and held that pattern for most of the morning. He did run a few fevers during the day, but they didn't seem to last as long as before. He still has a lot of confused moments and delirium, but there was also more of a hint of his old self creeping back in: being bossy, micro-managing the nurses, and even some attempts at humor. He's clearly a different person than the guy I saw on Tuesday, but he's still weak, worn-out, exhausted, and trying his best to keep going.

Twice today he sat on the edge of the bed and even stood up for a bit. His nurses were there to help, but they claim he did most of it himself. Each time took the wind from him and it took time to get his breathing and heart rate back down. But he wanted to get moving which shows just how unbelievably strong he's trying to be and how he keeps fighting.

The word from the plethora of doctors that are working with him is that they want to see him continue to breathe with the aid of oxygen and show steady improvement. The overall consensus is that what might normally take you or I several days to overcome could take Dad weeks. The other tidbit of good news today was that his white blood cell count came back up. Yesterday it was 5.3. Today it was 7.5. In general, this means his body recognizes that there is an infection and is doing what it can to fight it. Additionally, his right lung where the infection is sounded better than yesterday. More slivers to hang on to.

Ed and Rachel came out tonight to check in on him and brought with them two beautiful and thoughtful presents: a picture book they made of all Dad's flowerbeds in bloom at the house, and a framed picture of their stunning engagement photo. Dad's face lit up at both. He takes so much pride in his gardens and my heart broke when I realized that he hasn't been home in so long he hasn't been able to see how pretty they are.

I realize my quick update has turned out to be quiet lengthy, so I'll wrap up with two other highlights of the day. First was a surprise visit by Sue and Dave DeDecker. They've always been such good friends of the family and today we were reminded of why. The second highlight of the day was watching Dad pray The Lord's Prayer with Pastor Breed when she came to visit. He appeared to be asleep but as soon as she started with the words, he piped in right with her and then thanked her when she was done. As hard as the last three days have been, I realize that we have been and are still being blessed through all of this. Please pray that we continue to have strength for the coming days. The road is still very long and filled with uncertainty.

Love & Peace,

Ron2

Holding pattern

Just a quick run-down of the events from the last 24 hours. Last night I got home at about 10:15 leaving Natalie and Mom to rest at Michael and Christina's in Tiffin. About 10:40, the nurses in the ICU called me and asked if someone could come in and be with him as he had become extremely restless and agitated. I called Natalie and she immediately came in and worked wonders in calming dad down and getting him to sleep. The BiPap face mask was driving him crazy, but to her credit she got him to settle down.

About 5:00AM, dad woke up so Natalie asked the nurses if he could have the BiPap removed for just a bit to clean up and get a break. They agreed and soon found that he was doing ok without it, but still needed oxygen. So, the big BiPap muzzle was replaced with a much more friendly and normal oxygen mask. Dad had perked up a bit by then and even sat at the edge of the bed for a spell. He didn't have much awareness of the previous night, but according to Natalie he had a good long stretch of being aware and more like the old dad we know and love.

We've talked in detail with the doctors and everything is coming down to one factor: how well dad's body is going to do in fending off this pneumonia he has. They've tested his heart, looked at all other possibilities and nothing else is revealing itself. They continue to give him a broad spectrum of antibiotics and hope that his white blood cells can do their trick.

Tonight I sent Natalie home and mom back to Tiffin. I will be here overnight and into tomorrow until Ed can get out here. For now, things are holding steady but as I've come to learn and expect, things can change quickly. Please keep praying. He continues to get fevers every 12 hours or so and gets pretty delirious when they occur. We're in a delicate dance.

God's Peace,

Ron2

Please pray.......

I realize the post has been quiet for too long, but there has been a lot going on and updating this site has been last on any of our priority lists these days. To sum things up, dad has been moved to the ICU because he is battling an infection in his lungs and he is having a hard time breathing. He has been placed on a biPap machine to help him get the oxygen he needs. Overall, his vitals are good and his blood counts are where they should be. It just appears his body can't shake this infection for whatever reason. At this point it would appear to be either a bacterial or fungal form of pneumonia, but the doctors are still trying to draw a bead on it.

So at this point, he'll continue to stay on the biPap until his lungs can recover on their own. They will continue to administer antibiotics as well. If he gets worse, he'll be intubated, which carries with it a whole new set of concerns and risks, so please pray that he bounces back quickly.

Being on the biPap machine is proving to be difficult for dad as he feels claustrophobic with it on. Several times this evening he tried to remove it and had to be calmed down and reassured that it was good for him. I guess the positive in those actions is that he still has some fight in him, which is good. But it feels like to all of us that everything that can go wrong, has gone wrong and it's hard not to feel snake-bitten at this point. Every small sliver of hope we can find keeps slipping through our fingers and for me personally it's getting harder to find the good in all of this.

Please, keep our family in your prayers. That dad would recover from all of this and be kept comfortable as he battles through this. For my mom, Ed, Rachel, Natalie, and our kids as we struggle with the physical, mental, and emotional exhaustion that is quickly creeping in.

Peace,

Ron2

Two steps forward, one step back

Patience is a virtue, so us Farwell's must becoming pretty virtuous I guess. Dad had another rough day mixed with good and not so good events. On the down side, the infection he has been battling appears to have originated in his PICC line. It was due for removal tomorrow so they stepped it up a day and pulled it this afternoon. The only real downer to this is that he'll be back on an IV for other meds, but its not a show-stopper. Hopefully he'll start to rebound a bit after this. He was short of breath again this morning, but all his vitals are still looking strong, so it's being chalked up to his fluid retention and battling the infection. He was pretty much wiped the whole day so mom stayed home and chatted with him off an on. She'll be trekking out there again tomorrow. Please pray that she finds him with more energy and feeling better.

On the plus side, his white blood cell count this morning was at 2.5. That's quadruple what it was yesterday which is a great sign. Despite fighting an infection, his body is making white blood cells again and showing signs of getting back on-line in terms of blood production. Pray that this continues to trend up for him. If you put things in perspective and consider all that he has going, I would be exhausted too.

Anyway, thats all I have for today. Hope tomorrow brings better tidings.

Peace,

Ron2

Turning a corner?

Well, it's been a trying few days here but maybe, just maybe we're turning a corner......

Last night I went out and sat with dad for a couple of hours and I have to be honest, it broke my heart. Never in my life before have I wanted to trade places so badly, wishing I could somehow, someway give him some of the energy and strength that I have so he could feel normal just for a while. He still has a lot of things going on all at once: fighting the methatrexate side effects, a bacterial infection, mouth sores, and other miscellaneous issues that come from fighting cancer. But not once in the entire time I was there did he complain or wish for different circumstances. Despite his extreme fatigue and exhaustion, dad has kept all of this in perspective. In his own words, what he is going through "beats the alternative." It's not false bravado, he's way too exhausted to put up a front. But it's his positive mindset and despite the blows he's been given, he's pressing on. I cried 74 of the 75 miles I drove home last night thinking how brave he's being and how he keeps fighting.

Today, we got what we hope is the beginning of a new "up"cycle. First, his white blood count (WBC) was up to .5. Yesterday it was at zero. This means that his body once again is starting to produce white blood cells, which is exactly what we need to see. His hemoglobin count was up a bit too. Platelets were looking good. He's also starting to show more of his sense of humor and has even teased mom off and on today, which is a great sign in and of itself. He seemed to have more energy today and the doctors have told us that once he stabilizes further he'll be able to come home. He'll start his third round of chemo once he's had a chance to bounce back a bit further. We've still got a long, long way to go, but today was the first hint of a bright spot in a long time.

I'll close by asking what I always ask: please keep mom and dad in your prayers and thank you to all the loyal followers of this post for your support and encouragement. You all are making a difference to us and we are truly blessed.

Peace,

Ron2

Quick Update

Hey all, sorry its been so quiet here lately. In all honesty, its been hard to write anything given there hasn't been much to write about other than the baby steps that dad has been taking the last several days.

Overall, he appears to be doing better than last week. He seems to be much more aware and even showing signs of his humor returning. He's also starting to micro-manage his day again, which is another positive sign. Probably the biggest issue at this point is his overall weakness and the mouth ulcers. Obviously, eating is a chore but talking can be painful as well. In dad's own words, if it weren't for the sores, he would feel "ok". Then again, its all part of this wonderful journey we're on with this.

We're not sure if/when he'll be able to come home yet but we keep hearing talk that he'll start his third round within the next 10-14 days. The doctors are going to change his regimen given his reaction to the methatrexate, so we're not sure what the meds will be, timing, etc. We won't know much more until dad is recouped a bit and getting his counts back up. At this point, he had to have blood and platelets today, which is par for the course.

Anyway, we're holding steady. Wish he was feeling better, but he seems to be doing better than last week and we're seeing signs of the "old" Ron coming back. Keep praying and drop him a line when you get a chance. He could use a little encouragement.

Peace,

Ron2

Holding Pattern

Just a quick update for the day. Dad seems to be making small improvements but is still very weak and battling the side effects of the chemo. Blood counts are down, his weight is down, and our moods are down. He's not wanting to eat and who could blame him? It's counter-intuitive to try to force something down your throat when you have no appetite.

Mom did decide to come home today to take a break from the "fun". She's been such a trooper through all of this and its hard for her to break away. Love, duty, and commitment are strong bonds and leaving dad behind at the hospital is not easily done. Still, the kids and I convinced her to join us tonight at Central Park for the Community Band concert and movie in the park. I think it was good for her to get out and experience some normal life again. And talking about things with her friends is always good therapy!

As things progress, we'll keep updating the blog here, but we're in a holding pattern right now. Keep the prayers coming, please. And for all of you out there following this, please send a word of encouragement or two to dad if you get the chance. Every little bit helps.

Peace,

Ron2

Nothing new........

Just a quick update for everyone................according to mom, dad has maybe made some slight improvements today. His speech is still slurred, but when he was awake he appeared more alert. He ended up sleeping most of the day though. I'm sure the cough syrup (with codeine) is playing a role in that. His MRI from last night came back negative and some other tests have also come back negative, so at this point it wouldn't appear to be anything more than how his body is reacting to the methatrexate. The doctors will continue to monitor and see what happens. They have told mom that they wouldn't expect any benefits from the cough syrup therapy for at least 24 hours, so as the world turns in cancer treatment, we sit and wait, and wonder. Please keep him and mom in your prayers tonight. Clearly we're in a "down" phase this week.

Much love to you all...........

Ron2

Well we're stabilish for now...

Well we still don't know what is wrong with any amount of certainty. The medical professional "hunch" right now is that dad's nervous system may be adversely reacting to the methatrexate which was a part of this last phase of chemotherapy. The treatment....cough syrup. Yeah no kidding, cough syrup. Now this is not the complete or final diagnosis of this latest development but it gives them something to try with dad that may help. The MRI is still on tap to take a better look at his brain. They also did nervous and respiratory system tests this afternoon both of which were OK.

Eddie

Days like this aren't fun

I'm kind of at a loss on how best to phrase everything that's happening today so bear with me. Dad's not doing the best right now due to some sort of neurological issue that has flared up. Ronnie noticed dad had slurred speech last night when talking on the phone and then mom noticed it again when she called him this morning. He has very little energy right now and has had at least two episodes today where he zones out and his speech is impaired, something isn't right. He's already had a CAT scan which so far hasn't yielded anything conclusive. His vital signs are still good. The staff here at the University of Iowa Hospitals are trying to get him an MRI ran sometime this afternoon in addition to performing a battery of tests to try and diagnose this new problem. We might not have an answer tonight.

Keep the fingers crossed.

Eddie

The anticipation...

Talked to dad again tonight briefly. The past few weeks have taken a lot out of him and he's been pretty tired. He had his I believe 4th spinal tap this afternoon and that should be it procedure wise for this round of chemotherapy. Now we're waiting to find out when he will be released and if he'll get to come back to Orion for a little bit before heading out to the Hawkey Healing Headquarters to begin another round of treatment. On a side note there is talk of him getting a port implanted in the coming weeks to aid in the overall process. As some of you reading this blog already know from past experiences a port is a good thing as it reduces the risk of infections associated with a PICC line or constant use of a veinapuncture IV.

On an administrative note, since we really don't know where dad will be week to week it is best to send cards and other notes to their house in Orion. We've got a system in place to get the mail collected, sorted and delivered to them no matter where they are in the two state region.

Hopefully the next post will be from dad while he sits in the comfort of their house, keep your fingers crossed!!!

Eddie