Yesterday seemed to go on forever. I guess I am getting tired.

Ray is feeling better every day. He actually sits up in bed -- with the back of the bed elevated, but that is a great deal more than he has done for the past week. While in that position he can eat and drink on his own -- although he drinks mostly water, and eats very little. In fact, he has to be badgered into eating anything. It's a vicious circle -- nausea - food - nausea -- ?

The focus has moved from keeping him alive to wound management (he picks at every scab that appears, turning them into ugly sores), mobility and nutrition. That is a very good change.

On the home front, I brought home the piers for the new ramp to the front door yesterday. Remember that I am a CITY girl, despite living nearly 30 years in Tuolumne county! Hauling stuff in the back of a pick-up is out of my comfort range -- especially stuff that is covered with a tarp that threatenes to blow out for most of the distance. OK, concrete blocks shouldn't blow out of the truck or need to be covered. But they had to sit in the hospital parking lot for an entire afternoon, and needed to be just a little bit out of sight. So the kid at the lumber yard who loaded the truck tarped them for me. No problem for the two blocks from the lumber yard to the hospsital. Another issue over the 30 miles from the hosptial to home at highway speeds! Every time I looked in the rear view mirror is saw flapping tarp and was CERTAIN that the whole thing was going to fly out of the back of the truck and across someone else's windshield ..... It's OK to laugh. I probably will laugh about it too, one of these days. Just not last night. Was terribly thankful to pull into the driveway and still have the tarp safely tucked under all that concrete. Jeff will pick up the lumber for the decking!

Jeff. Have I introducted Jeff? Many years ago Ray heard about a 17-year-old who was living on the hill behind the park in town, a run-away from back east somewhere. He had been riding a motorcycle with one of the local hoodlums, gotten into a wreck, and broken his wrist and his ankle. Hadn't gone to the doctor. Ray rounded the kid up with a few well-aimed threats, dragged him off to the doctor, and brought him home. Jeff became one of our "big kids", so called because our foster kids were always older than our own. Jeff was with us for several months before he disappeared into the underworld of Tuolumne County drug users and abusers. We heard about him occasionally, but never saw him. Then last spring he showed up on the doorstep. He had decided to get clean and sober, needed to move away from his circle of user friends in Jamestown and Sonora, and had taken a job as a carpenter (his trade) working for an owner-builder in Groveland. He lived in the campground for a couple of months before Ray demanded that he come home again. He appeared just about the time I had realized that there is just too much involved with maintaining a house in this area for me to tackle by myself, and Jeff has picked up the slack. Besides, it is wonderful just to have another human being here to talk to.

Give thanks. Keep praying.

Everyone agrees that Ray has turned a corner and is on the way to recovery. His last cultures have gone 2 days without producing any bacteria. He sat up in bed twice yesterday -- with difficulty, but he did it. His occupational therapist turns out to be a Chinese woman from Hawaii, and we did the "old home week" thing while he was sitting up on the edge of the bed! Never mind that she graduated from Hawaiian Mission Academy a full 21 years after I graduated from University High School -- there's still lots to talk about!

I can cook Ray meals to be warmed in the ICU microwave if he won't eat the hospital food. Dr. Le's familly did that for his mother because she ate only Vietnamese food, not American food, and the American hospitals couldn't accommodate her. We can also bring him anything else that will tempt him. Just now, that's things that slide down the throat with little or no chewing. The more he eats on his own, the sooner he can have the naso-gastric tube removed.

Dr. Le adds that he is NOT letting Ray into the general medical/surgical floor (aka med/surg)any time soon; he wants to take no chances of Ray catching something else and doing another nose dive. He said Dr. Drakes told him about Ray's cancer battle, and said it is a miracle he is still alive. Nice to hear a doctor confirm what we have believed all along.

So -- the medical discharge planners are talking moving him over to the old Sonora Community Hospital site off where they now have an inpatient rehab center, but not until he is medically ready for discharge. There they will be sure that he is sufficiently mobile to function at home. Also we have to remove all the stairs to get into our house. Jeff and I are planning how that will work, and Jeff will have it built before Ray comes home. We will ramp from the driveway to the front door, which turns out to be an almost level line -- no slope issues at all. Jeff says "Easy!" He has been drawing a plan and coaxed builders all over Pine Mountain Lake to donate excess lumber from their projects to get this one done. It looks like our out of pocket cost will be minimal.

Thank you for all your prayers and faith and good wishes that have gotten Ray to where he is today.

Give thanks! Keep praying.

Ray is still critical, but Dr. Le is finally feeling encouraged instead of puzzled. The CT scan gave an answer that PET scans, MRIs and x-rays did not see. He has pneumonia, possibly in both lungs. It is difficult to tell from images what the "bubble" is in the old tumor site, but it is NOT more cancer. It may be pneumonia in the second lung. The urinary tract infection may be resolved, for a clean sample came back yesterday. They are sending another sample down today hoping it, too, will be clean.

Despite the pneumonia, his oxygen levels are good -- so, according to yesterday's nurse, his lung function is not significantly compromised. He did not have a significant temperature spike during the day yesterday. His body systems are working normally. His throat hurts from the feeding tube, and his mouth and lips are very dry so he is always asking for water. He's groggy from all the meds. But he is still fighting.

Yesterday he sat up in bed and hung his feet over the side. Not for long, but he did it. Today's goal is to sit up in a chair at bedside. The physical and occupational therapists are working with him. I took him one of those balls that are sold to keep at your desk to exercise your "mouse hand". It works for all sorts of things.

For a touch of humor, there's a list of real questions sent to the Austrailan Tourist Board floating around the Internet. A cousin in Australia sent it to me. One, from the USA: "What direction is North in Australia?" Their answer? "Face south. Turn 180 degrees. When you get there we will send you the rest of the directions."

Give thanks. Keep praying!

Well, we jumped to conclusions about the bacteria. The 24-hr growth was negative; the 48-hr growth was positive. But we also know more about where this infection didn't start. It didn't start in the bones, and there is no indication of metastatic lung cancer in the bones of the spine or hip where the pain appears to be centered. It is not in the heart -- he does not have myocardosis (he doesn't have a vegetable garden growing in his heart!) It is not in the brain -- we know that from the brain scan taken on the 13th. If the source is not readily apparent in the CT's they are taking tomorrow of chest and abdomen, then Dr. Le is calling in the infectious disease specialist. I don't know who that is, but is sounds serious.

On the positive side, Ray's white cell count is back in the normal range. He is strong enough to push the self-medication button reliably by himself -- he couldn't do that yesterday. The swelling in his hands is beginning to go down as he deliberately moves them. While he was still medicated and feeling no pain from the TEE on his heart this afternoon, Dr. Le ordered a naso-gastric feeding tube. I deliberately left before he woke up, but now they will be able to force feed him even when he doesn't want to make the effort to swallow. Better nutrition will help the healing, too.

So once again we are giving thanks for the baby steps, and praying for more miracles.
Keep praying!

Today was our wedding anniversary. It would have been nicer if Ray were not sick and in hospital, but it could have been worse as well. First, the lab results from cultures taken yesterday came back showing no bacteria! This was the first time since Tuesday that we have been winning that particular battle. Second, while the MRI shows there is spinal damage, it is not from metastatic cancer -- or cancer of any variety. It may be associated with chemotherapy, but it is NOT new cancer. Third, the doctor said he has to get more food, particularly protein, into his body. The doctor's solution was is a naso-gastric feeding tube. Yup, feed him through the nose. We compromised: no feeding tube if he can consume four cans of Boost or Ensure or one of those meal supplement drinks that together will give minimum nutrition for the day. So we're back on the Boost diet. Fourth, a sonogram this morning showed no blood clots in the legs. And finally, the cardiologist came in to say that he will do the TEE test some time tomorrow and will I please stay in the room to help keep Ray calm. TEE -- that Traichial-something-echocardiogram -- looking at the heart with the echocardiogram device inserted into the trachia. I don't know why this is better than a standard echocardiogram done from outside the body ....

They have put him back on a low dose of his blood pressure medication to keep his heart rate in check. They have added a very low dose of continuous medication (it's synthetic morphine)for pain control rather than depending entirely on Ray to keep himself medicated. He has a hard time pushing that button when he is awake, and cannot push it at all when he is asleep so was waking up from naps in considerable pain.

Give thanks for the good news. Keep praying!

Yesterday (Friday) when I arrived Ray was alert and talking. He enjoyed brief visits with two couples, and he was eating jello and sipping ice water -- but not able to hold a glass or feed himself. His arms are badly swollen for a variety of reasons, and he has been taught some simple exercises to keep his body moving. That helps reduce the swelling. But in the afternoon he did another of those temperature spike-blood pressure rise-heart racing things -- right in the middle of a blood transfusion. Nursing staff believed it was a reaction to the blood. Doctor Le (say Lay; I misspelled it earlier) says it is likely just a coincidence it happened when the transfusion was being given. Once that passed, he just slept.

Meanwhile, the look at the heart could not happen because of his critical phase. He still has bacteria in his blood, and that has to be eliminated before any other treatment can begin. He is still very sick.

Give thanks for the doctors and nursing staff caring for him. Keep praying.

Ray is very much better this evening. Still not out of the woods, but lots better. They removed his "port catheter" -- the direct access into his blood stream through an implant in his chest. These things are wonderful for the patient, but must be used with caution as they are prone to be infection site after extended instsallation. His may be the culprit in this infection, but we will not know for another 48 hours after the cultures have been grown and analyzed. We don't even know for certain the exact nature of the staph bacteria that has invaded his body.

Tomorrow they will call in a cardiologist to see if there is any bacterial growth in his heart ... a truly appaling thought. Dr. Le (say LAY, and he will have to forgive me for calling him Chinese -- he is Vietnamese!) says if it is in the heart it just means a different treatment protocol and a prolonged course of IV antibiotics. I don't know yet if that means weeks or months. Hopefully, we will not have to find out!

The nursing supervisor on the floor this afternoon explained to me that an infection on the surface of the skin can get into the blood stream in many ways, but especially through an open would. Ray's pick-pick-pick scab spots are a perfect source. Since the blood is filtered by the kidneys, the bacteria can collect in the kidneys and VOILA! Urinary track infection.

Give thanks. Keep praying!

It is 2 AM on Thursday morning. I have just gotten home from the hospital. Ray is one very sick puppy, but once again we are benefiting from the knowledge and skills of a brand new specialist at Sonora Community Hospital -- who right now is VERY unhappy with the hosptial emergency room and adminitrative policies.

Did I mention that at 8:00 last night (pharmacy in Groveland closes at 6 pm) I listened to a message left at 6:05 pm from the ER doctor in Sonora? Ray's urine specimine, taken as a "I got caught out a couple of weeks ago with something that presented as a back problem and turned out to be a urinary tract infection, so let's just do this as a precaution." turned out positive. At 9 am today I was on the doorstep of the Groveland pharmacy collecting the antibiotics prescribed, and by 9:30 Ray had taken one. The pharmacist's parting words were, "If he does not pee by this afternoon, take him back to the hospital." At 3:15 we left Groveland again, this time by ambulance. At the direction of the oncologist, he was to go directly to ER where theoretically he would get better attention than if he was a direct admit to the floor.

We arrived in Sonora just after 4:15. By 5:30 Dr. Drakes had shown up, written orders, and prepared to have Ray admitted. The ER nurse/practitioner (who we like) had talked Dr. Drakes into ordering a catheter; in the first 3 minutes his bladder drained TWICE what is normally considered the contents of a full bladder! It continued to drain all night, an indication the kidneys are still functioning.

Just after 6:00 the med/surg (medical/surgical) nursing supervisor said they would accept him as soon as a bed was available. Nursing shifts change at 7 pm. Patients begin to move out of ER about 7:30. About that time things began to unwind. Although he was getting a good, strong antibiotic and a litre of fluid, Ray's blood pressure dropped and his heart rate leaped to 130/minute. By 10:00 it was up to 150/minute and he was spiking a fever of just over 101 degrees F. He had two separate doses of tylenol to bring down the fever, there must have been two spikes, one when the heart rate jumped to 130 and again when it went to 150. By about 8:30 the decision was made that he really needed to go to ICU where he could get closer monitoring than he would on the med/surg floors. Now they had to clear a bed in ICU (I was assured this was a patient who was legitimately ready to move to med/surge) and THEN steralize it as well as clean the room. Couldn't just bring a bed from med/surge on the other side of the hall. There must be a good reason for this, and I am certain that the RNs among you will explain what those reasons are.

The positive note to all this is that Sonora Regional has just in the last month hired a young Chinese doctor, Dr. Lei, who is a pulmonologist and an Intensivist -- one with specialized experience and training in treating Intensive Care patients. Ray's urinary tract infection, because he (1) did not get any antibiotics yesterday and (2) lay in ER for several hours without enough fluids to restore his blood pressure and reduce his heart rate (this as explained to me by Dr. Lei) has become urinary sepsis -- an infection that is working its way through the rest of his body. He was immediately given a second IV line so that two litres of fluid are being delivered simultaneously. Yes, there are also more antibiotic. When they asked, "Does he have an advanced medical directive?" (yes) and "What are his wishes about CPR, etc?" (save life, don't prolong it) I fell apart.

Dr. Lei feels optimistic, but it's going to be a tough fight. I asked if I should call the family. He said, "Not yet." So we are not doing a death watch. Witness that I am here at my own computer and not 30 miles away in Sonora.

Give thanks that there is someone in that hospital who knows what to do in this kind of a situation Keep praying.

It took just under 1.5 hours to get Ray from bed to the truck this morning -- a matter of 50 feet, including 5 stairs. He was supposed to see the oncologist. Instead, he went to the ER where x-rays suggested the mobility problem is caused by sciatica as there is evidence of a significantly weakened disk in the lower back, probably the result of chemotherapy. They sent him home with instructions to return to the pain patch (which we had already done) and switch from Vicoden to Percocet -- which is supposed to be the next higher level of med for pain reduction. When we got home there was a message on the answering machine -- urine tested positive for infection, probably in the kidneys. Antibiotics will be ready tomorrow a.m. at Groveland Pharmacy.

He is supposed to see the oncologist on Thursday, with the possibility of a spinal MRI to see what is happening with the disks. The kidney infection diagnosis may change that. But the oncologist was quick to point out that the most recent PET scan shows that there is no likelihood that what he is feeling is caused by a metastatic tumor! Thanks be to God!!

So give thanks! Keep praying!!

It took longer than expected to get a report from the doctor on last week's scan. We made the assumption that if we had not heard differently, all was clear. It was.

Meanwhile, the 'hitch in the git-along' has turned into a major problem. It's behaving just like my mother's description of her sciatica -- shooting pain up the leg with even the lightest pressure on that side of his body, whether standing or sitting or lying down. Tomorrow, when he is due for chemotherapy, will be a definite challenge. Pray for us over the next 14 hours.

Give thanks for the healing. Pray that this pain will be eased. Keep praying!

We have finally succumbed to church politics, transferred our Episcopal Church membership out of the Diocese of San Joaquin (one of the leaders in the group that is separating itself from the National church, all the while declaring "We are not leaving the church, the church is leaving us.") and stopped attending any Episcopal church in our area. Maybe if we are in the Bay area, Sacramento or Reno on a Sunday .... Meanwhile, we attended services Sunday at the local Luthern church. They are liturgical enough to satisfy Bonnie. They don't have kneelers in their pews -- which pleases Ray. They will survive even if we miss a week or two -- which pleases both of us. And the people we met there are reasonably friendly. We already know several of them, who seemed pleased to see us.

If one believes that good and evil are fighting for Ray's loyalty, Sunday was an interesting study. It is the first time in months we have attended a church service. And although he felt good BEFORE church, AFTER church was another story altogether. It was one miserable experience after another -- severe headache (approaching migrane intensity, strong enough that the pain makes you sick) requiring microwave-heated washcloths on his face; nausea; exhaustion; bloating; more nausea. At least his blood pressure is within normal range, and he is forcing water to keep from dehydrating. He feels like he will need blood, but doesn't want to be hospitalized for that to happen.

Today he is feeling a little better, although his energy level is low. We were able to get his Thursday appointment with the oncologist moved to tomorrow. Neither Satan nor the cancer can win this battle!

Keep praying!!!!! Give thanks!

The weather has been "funny" and Ray's sinus have been blocked up. That means his head drains, and that upsets his stomach .... So he's had some difficult days with mild nausea, but nothing like he has had in the past. Of course, fires all around us have not helped.

Otherwise, each day is a new day. He gets frustrated by being house-bound, and it's worse because he cannot see well enough to drive. He badly needs some "guy time", so if any of you gentlemen out there are in the mood to socialize, come fetch him! Don't tell him I said so, though!! He does best with a day or so advance notice, but last minute drop-ins -- especially in the morning when he is unlikely to be taking a nap -- work, too. At least he is feeling well enough to WANT to get out!

Give thanks! Keep praying!!!

We did something for ourselves on Saturday, and used our new membership in Railtown 1897, located in Jamestown. TV watchers and movie goers would recognize the train. Remember the train and the water tank on that old sitcom, Pettycoat Junction? How about train scenese in many western movies, including Bad Girls and Back to the Future III? How about the Aflac commercial currently airing, filmed like an old silent movie with the damsel in distress tied to the railroad tracks and rescued by a duck??? Yup, all filmed practically in our own back yard using track and rolling stock from the Sierra Railroad.

Excursion trains have run on weekends from theo station in Jamestown ever since we have been here, but ownership and operating details have been spotty -- through the Sierra Railroad, a commercial operation which originally carried frieght and occasionally passengers between Oakdale and Tuolumne City (Sierra Railroad also operated the Hetch Hetchy Railroad during the 1930's); as a unit of the State Park System; and presently in a joint venture between the Sierra Railroad and private ownership with an individual who operates both the Skunk Railroad between Fort Bragg and Eureka, and the River Train, running north along the Sacramento River out of the State Railway Museum. At any rate, we had never ridden the train before. This year we became suporting members of Railtown, so get to ride for free. We got there, picked up our tickets, and the woman asked, "Would you like to ride in 2901, the special First Class car that is running this weekend?" So we did, and had a delightful trip. Ray was moving slowly, but he was able to get himself into and out of the train, and perfectly happy once he plunked himself into a nice, plush armchair. The car has been completely restored by volunteers, including totally new paneling on one side of the car (refubished original on the other side, fancy molding arching above stained glass windows, and light fixtures based on the original design, fabricated in the railroad's own shops. Pretty talented craftsman they are!

So we go from day to day, taking care of the have-to's, squeezing in a want-to now and then to keep life pleasant. We know more want-to time will come as Ray regains his strength and endurance.

Give thanks!! Keep praying !!!!!