Cathy lost her battle against cancer on Wednesday, February 17, 2010 at 12:30 AM surrounded by her family and a dear friend. The grief is horrible, but we do not "grieve like the rest of men, who have no hope" [1 Thes 4:13]. We share her belief in the atoning sacrifice of Christ for salvation and the hope of glory.
Cathy's love of God and passion to share the gospel of Christ animated her and endeared her to so many who loved her in return.
Visitation will be in the commons of College Church in Wheaton from 3:00 - 8:00 PM, Monday February 22 and her memorial service will be in the sanctuary on Tuesday, February 23 at 11:00 AM. Burial will be private.
Soon more information will be available at hultgrenfh.com
Wednesday, February 17, 2010
Wednesday, February 10, 2010
Dateline 2/10/10
We [Cathy, her sister Kay & brother-in-law Dan and I] met with Dr. Bayer on Monday, 2/8 PM for what will become a weekly blood draw & observation. While he was heartened to hear Cathy state her current intention to fight on, he did tell us some new and difficult things:
- He described Cathy's "state" as catabolic. While I can't describe that well enough or thorough enough, suffice it to say it is daunting.
- He mentioned that Cathy's bilirubin needs to get down to no higher than 2 to enable her to get on the PARP inhibitor study.
- He told us that the ascitic fluid in her abdomen is rich in protein. While it is good to remove the fluid such that cancer is not bathing in / fed by it and she experiences some relief from the swelling, it means that after a draining, more fluid is produced which continues to deplete her body of the protein she needs. Also there is a concern not to eat too much protein to make up for the loss, as that could cause kidney failure - we walk a fine line.
Finally today we learned of her bilirubin levels from the 2/8 blood draw: 9.4
While this is discouraging, both Dr Bayer and Conzen [U of C breast cancer specialist] cautioned us that it will take 3-4 weeks before we'll know of the efficacy of the current chemo Cathy is on, Xeloda. I'll recap the bilirubin levels over the last month:
1/15 5.2
1/26 9.9
1/28 11.3 [drawn @ U of C]
1/30 7.9
2/8 9.4
I just wonder about the accuracy of 1/28 or 1/30 or the potential that the U of C lab equipment is calibrated to different standards than Delnor's eqpt.
The side effects of Xeloda are mounting up on Cathy, in addition to her pain & discomfort from the cancer and ascites, but she'll get a week's reprieve after her last dose on Friday evening. We continue to COVET your prayers for strength, comfort, healing and mercy from God our father.
Thursday, February 4, 2010
Update ...
It was a rough day for the most part for Cathy. Most who spent time with her over the last two days have expressed deep concern for my sweetheart.
I spent the late afternoon with Cathy taking her to Delnor Hospital to learn how to use the catheter to drain the fluid in her abdomen. 1650 ml of fluid was taken and I observed some relief and an uptick in Cathy's countenance.
Being "my evening off", I took the occasion to attend an "Adult Service Provider Resource Fair" [agencies offering services for individuals with disabilities]. I mention this for two reasons:
I spent the late afternoon with Cathy taking her to Delnor Hospital to learn how to use the catheter to drain the fluid in her abdomen. 1650 ml of fluid was taken and I observed some relief and an uptick in Cathy's countenance.
Being "my evening off", I took the occasion to attend an "Adult Service Provider Resource Fair" [agencies offering services for individuals with disabilities]. I mention this for two reasons:
- I bumped into a number of people who know my wife and daughter. In discussing Cathy's situation, I was encouraged and so proud of my wife AND daughter with the comments about the impression they both have made through the years - bright sunshine!
- I returned home to find my wife back in the throes of her familiar and increasing pain
Thankfully, Cathy is able to sleep fairly well, thanks either to Advil or the prescribed Vicadin, and is doing so now. Thanks for your continued prayers, cards and acts of service, meals, etc.
Tuesday, February 2, 2010
Another intervention ...
The ascites was back in a big way on Sunday, within 24 hours of the "paracentesis ". Cathy had vowed she would not replay Saturday's intervention due to the pain - and SHE IS A TOUGH COOKIE!
This side affect of liver compromise will not go away with one draining of the peritoneal cavity, it is chronic unless and until liver function improves. The new chemo [Xeloda] Cathy is on has the potential of helping the liver to improve by destroying the cancerous breast cells that are now in her liver and allow the liver to replace those cancerous cells with healthy liver cells.
In order to "buy time" for Xeloda to provide this improvement [Dr. Bayer estimated 3-4 weeks], we needed a way to mitigate the agony she is experiencing with the significant abdominal distension - thus we had her abdomen "tapped" again today but with a PleurX catheter that will allow us to drain the fluid as often as daily.
Cathy is in extreme discomfort from the liver and ascites and experiences sharp pain whenever she moves quickly or in the wrong direction [which is just about any direction]. Chronic fatigue is a common side effect of ascites due to cancer so when in a comfortable position, she can rest well.
I am reminded how the young live as if immortal / invincible. At this time we are painfully aware of how fragile we are; given each heartbeat and breath by our omniscient and loving God. Please pray for Cathy's pain control, the efficacy of the catheter and chemo and grace & mercy from the Lord.
This side affect of liver compromise will not go away with one draining of the peritoneal cavity, it is chronic unless and until liver function improves. The new chemo [Xeloda] Cathy is on has the potential of helping the liver to improve by destroying the cancerous breast cells that are now in her liver and allow the liver to replace those cancerous cells with healthy liver cells.
In order to "buy time" for Xeloda to provide this improvement [Dr. Bayer estimated 3-4 weeks], we needed a way to mitigate the agony she is experiencing with the significant abdominal distension - thus we had her abdomen "tapped" again today but with a PleurX catheter that will allow us to drain the fluid as often as daily.
Cathy is in extreme discomfort from the liver and ascites and experiences sharp pain whenever she moves quickly or in the wrong direction [which is just about any direction]. Chronic fatigue is a common side effect of ascites due to cancer so when in a comfortable position, she can rest well.
I am reminded how the young live as if immortal / invincible. At this time we are painfully aware of how fragile we are; given each heartbeat and breath by our omniscient and loving God. Please pray for Cathy's pain control, the efficacy of the catheter and chemo and grace & mercy from the Lord.
Saturday, January 30, 2010
OUCH!
It's called "ascites" and it is the pooling of excess / fugitive fluid pooling in the abdominal cavity - and Cathy has developed it over the last two weeks. The 5-6 month "pregnancy" look is the result and Cathy could no longer tolerate the pain. Thus, we spent 7 hours of today in the ER at Delnor awaiting tests, results, and finally the "paracentesis" whereby the fluid was removed.
Cathy didn't sleep last night so when they finally gave Cathy some Dilaudid [pain killer], she rested deeply ... for ten minutes at a time as I had to "force" down the solution she needed to drink before another CT scan. That, in and of itself, was not easy as Cathy already was so swollen that she didn't have the room for more, and yucky at that, fluids in her abdomen.
The paracentesis / tummy tap was very painful even with local anesthetic as they poked a needle into Cathy's abdominal cavity. A lot of fluid was removed and she's a tired ragamuffin so I'm hoping sleep will breathe new life into her frame tomorrow.
Cathy didn't sleep last night so when they finally gave Cathy some Dilaudid [pain killer], she rested deeply ... for ten minutes at a time as I had to "force" down the solution she needed to drink before another CT scan. That, in and of itself, was not easy as Cathy already was so swollen that she didn't have the room for more, and yucky at that, fluids in her abdomen.
The paracentesis / tummy tap was very painful even with local anesthetic as they poked a needle into Cathy's abdominal cavity. A lot of fluid was removed and she's a tired ragamuffin so I'm hoping sleep will breathe new life into her frame tomorrow.
Thursday, January 28, 2010
If You Could See Her Now ...
Wow, what a difference a day can make when you have metastatic breast cancer in your liver! Cathy was awful on Wednesday and by the time we reached the U of C clinic today, she had double the energy and "voice".
We met with Dr. Suzanne Conzen and staff and were very pleased with her professionalism, candor and competency. Due to additional bleeding [cancer loves sources of blood], trauma, potential infection, and a firm belief that the underlying liver issue causing elevated enzymes is the cancer, Dr. Conzen thought it wiser NOT to biopsy the liver.
Since most chemotherapies are metabolized / processed IN the liver and Cathy's bilirubin is elevated to the point she can NOT receive most chemos, Dr. Conzen prescribed a much less toxic [to the hair, fingernails, etc] ORAL chemo [XELODA] that Cathy can self administer and is not processed in the liver. Additionally, there is strong evidence that this drug can be highly effective in helping to restore better liver function [proved by reduced bilirubin].
Like any drug, this one has potential side effects but a patient of Dr. Conzen's has been on this chemo for 40+ weeks and her bilirubin has fallen from 18 to ~1.5 [normal]. As usual, Cathy will follow the Drs. regimen and we will remain faithful and look forward to seeing what this treatment will yield. Praise God!
We met with Dr. Suzanne Conzen and staff and were very pleased with her professionalism, candor and competency. Due to additional bleeding [cancer loves sources of blood], trauma, potential infection, and a firm belief that the underlying liver issue causing elevated enzymes is the cancer, Dr. Conzen thought it wiser NOT to biopsy the liver.
Since most chemotherapies are metabolized / processed IN the liver and Cathy's bilirubin is elevated to the point she can NOT receive most chemos, Dr. Conzen prescribed a much less toxic [to the hair, fingernails, etc] ORAL chemo [XELODA] that Cathy can self administer and is not processed in the liver. Additionally, there is strong evidence that this drug can be highly effective in helping to restore better liver function [proved by reduced bilirubin].
Like any drug, this one has potential side effects but a patient of Dr. Conzen's has been on this chemo for 40+ weeks and her bilirubin has fallen from 18 to ~1.5 [normal]. As usual, Cathy will follow the Drs. regimen and we will remain faithful and look forward to seeing what this treatment will yield. Praise God!
Wednesday, January 27, 2010
In God's Hands
Today Cathy had her follow up appointments with the infectious disease Dr. [Lewis] and Dr. Bayer, and not a moment too soon. Cathy has been very fatigued, in increasing pain, itching from elevated Bilirubin and uncomfortable from distended abdomen - an "expert" in mothering, Carol Casey having given birth to 7 children, estimated Cathy's girth to resemble a 5-6 month pregnant women. While Cathy's vitals were all good / within range, her weight has increased around 11 # in the last 9 days. Cathy has also been concerned about increasing yellowing of her skin due to jaundice, and it was confirmed to her today as a result of yesterday's blood draw results - her bilirubin has increased from 6.2 on 1/18 to 9.9 as of 1/26.
The daily intravenous antibiotic Cathy has been administered for the last 9 days has proven, if anything, only to exacerbate her liver malfunction [or perhaps of no assistance at the very least]. Cathy's other elevated liver enzymes have not come down since her hospital stay so the antibiotic was discontinued.
Carol Casey was along for both appointments and like us, she was impressed with the candor, compassion and efficient manner in which Dr Bayer got things going. Two bits of good news came out of this meeting. Although he admitted the current regimen has proven unsuccessful, Cathy's WBC is up to 10 [WOW!] and he has moved Cathy along to the University of Chicago for them to conduct tests, evaluate Cathy, and potentially get her in the PARP Inhibitor phase III study.
We have a 4:00 appointment on 1/28 through which we hope and pray the U of C Drs. can biopsy Cathy's liver, drain excess fluid, and determine that she is a viable candidate for the study [the cancer in her liver is rather "diffuse" / integrated front portion of her liver and not an identifiable and measurable tumor].
I believe this is a "double blind" study [the Drs. don't know which patients are initially prescribed the PARP inhibitor] and the recipients of it are chosen by lottery [she has a 50% chance of receiving chemo with placebo or a 50% chance of getting chemo and PARP inhibitor].
Though much has to be done [and this might presume she is ABLE to get chemo at all in light of her elevated liver enzymes] we gratified to know she is being cared for and the Drs. are being proactive rather than having Cathy languish at home without being monitored. We're also praying that a biopsy of the liver might provide better direction for her care. Additionally, IF Cathy can receive chemo, even if she doesn't get the PARP inhibitor, at least she'll get more than she has received in the last three weeks because of low WBC or elevated liver enzymes.
Finally, Lord willing, if Cathy does get the PARP inhibitor, it has shown great promise in fighting triple negative breast cancer: http://www.wavy.com/dpp/news/health_news/health_wavy_norfolk_parpstudy_20090909
When we've been successful in distracting Cathy from her pain, we've seen glimpses of her trademark sense of humor and love of life and others. Please pray with us for compassionate and good doctors, test results that provide hopeful treatment, that Cathy would receive the PARP inhibitor and that we would remain in God's care and loving hands.
The daily intravenous antibiotic Cathy has been administered for the last 9 days has proven, if anything, only to exacerbate her liver malfunction [or perhaps of no assistance at the very least]. Cathy's other elevated liver enzymes have not come down since her hospital stay so the antibiotic was discontinued.
Carol Casey was along for both appointments and like us, she was impressed with the candor, compassion and efficient manner in which Dr Bayer got things going. Two bits of good news came out of this meeting. Although he admitted the current regimen has proven unsuccessful, Cathy's WBC is up to 10 [WOW!] and he has moved Cathy along to the University of Chicago for them to conduct tests, evaluate Cathy, and potentially get her in the PARP Inhibitor phase III study.
We have a 4:00 appointment on 1/28 through which we hope and pray the U of C Drs. can biopsy Cathy's liver, drain excess fluid, and determine that she is a viable candidate for the study [the cancer in her liver is rather "diffuse" / integrated front portion of her liver and not an identifiable and measurable tumor].
I believe this is a "double blind" study [the Drs. don't know which patients are initially prescribed the PARP inhibitor] and the recipients of it are chosen by lottery [she has a 50% chance of receiving chemo with placebo or a 50% chance of getting chemo and PARP inhibitor].
Though much has to be done [and this might presume she is ABLE to get chemo at all in light of her elevated liver enzymes] we gratified to know she is being cared for and the Drs. are being proactive rather than having Cathy languish at home without being monitored. We're also praying that a biopsy of the liver might provide better direction for her care. Additionally, IF Cathy can receive chemo, even if she doesn't get the PARP inhibitor, at least she'll get more than she has received in the last three weeks because of low WBC or elevated liver enzymes.
Finally, Lord willing, if Cathy does get the PARP inhibitor, it has shown great promise in fighting triple negative breast cancer: http://www.wavy.com/dpp/news/health_news/health_wavy_norfolk_parpstudy_20090909
When we've been successful in distracting Cathy from her pain, we've seen glimpses of her trademark sense of humor and love of life and others. Please pray with us for compassionate and good doctors, test results that provide hopeful treatment, that Cathy would receive the PARP inhibitor and that we would remain in God's care and loving hands.
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