September 30

Hi,

As Denny's condition seemed to get worse, I became increasingly worried and called his doctor yesterday afternoon. There are so many doctors treating him but I decided that his radiology oncologist, Dr. Steve Howard, would be the best choice. I am so happy I made that call.

This morning we went to Dr. Howard's office at 8:00, and within the hour Den was having a CT scan to see what is going on in his brain. They found considerable swelling as well as a "bleed". It seems that Denny should never have been taken off the steroids prescribed for him at the end of his chemo and radiation. We learned today that when a person takes steroids, the body's adrenal gland stops manufacturing cortisone. As a person is gradually weaned off steroids, the gland starts making cortisone again. In Denny's case, that doesn't appear to have happened. No wonder he was so lethargic, confused, and unable to concentrate! Dr. Howard seemed surprised that Den is as functional as he is.

So, to jump start things they gave Den 10mg of steroids intravenously. He already feels better. He will continue taking rather high doses of the steroids in an effort to get the swelling in the brain to subside. And that, we hope, will make that brain bleed correct/heal itself. Often shunts are put in to alleviate that pressure, but the danger of doing that for Den would be that if there are still active cancer cells
currently trapped in his brain, a shunt would be their transportation into the rest of his body. So, I've just given you something new to pray for! Drs. Howard and Yazbak have conversed and will wait until Thursday to see if that procedure is necessary. Please pray that it is NOT!!

Dr. Howard, God bless him, has also ordered Denny not to work until he gives him the official okay to go back. He implied that Den should stay home for about two weeks and "veg" (I believe that was his medical term for it!). This time I don't think Den will fight this directive, because it will be a long time before he forgets how miserable he has felt these past two weeks. I will stay home with him this week so he will get the right meds at the right times and I can watch for any other unusual symptoms.

All of this may or may not delay our trip to Madison. Dr. Howard will assess that as he sees Denny's progress. It's possible he'll have another scan in a couple of weeks. There would be no point in having an MRI to assess the condition of the tumor if the tissue around it is still swollen.

We want to thank Barb Craghan and Beth Rippl, who will be taking over our jobs at school. What wonderful friends and colleagues they are. And to all of you who will find time to pray that this obstacle will be managed as we hope, we send our grateful thanks.

Love,
Carla and Denny