Brain MRI Results July 2011

We went to MD Anderson in Houston for a post-surgery MRI on Monday and on Tuesday we saw Dr. Conrad, my Neuro-Oncologist. He said that everything looks good and they do not see any signs of the tumor. The cavity that was left after the tumor was resected has filled in a bit and it looks like the swelling has reduced significantly. All of this is great news! The doctor was pleased with my progress and we go back in three months for another MRI, which will be in October 2011. At that time we will also visit with a Radiation-Oncologist to see what their thoughts are regarding radiation therapy. All in all, great news as we expected.

This week I also discussed my progress in physical therapy with my therapist, Jacqueline. I am meeting and/or exceeding many of the goals that she set for me three months ago. As a result, we will be moving from three one hour PT sessions a week to just two starting in August. This is important because I will start working full time again in late July and this will allow me to start working at a more regular time three days a week instead of two. I will still need to focus on exercising at home at least thirty minutes a day, which I always don’t want to do, so please pray for me on that one.

Physically, I feel fine and am rarely napping anymore. My energy level is much higher and we recently had the wheelchair that we were renting picked up as we didn’t feel that we needed it any longer. I am no longer using the cane and can walk fairly well on my own. I am still lacking strength in my hamstring and ankle, and don’t seem to have any voluntary movement in my toes or the ability to move my foot side to side, those losses are a bummer, but life will go on because I’ll be able to walk better and better even without those functions.

Thanks for checking in once again. I should get the new MRI images next week and will post pics from it when I get a moment.

-Roger

Back to MD Anderson for follow-up

I have to make this a short one. I’ve been doing very well and am getting stronger every day. I’m still doing physical therapy three days a week from 8-9am. My therapist, Jacqueline, is a master. She is young but very creative and always knows how to challenge me, which I like. She is a Godsend! I started back to work (at home) a few weeks ago… four hours a day at first. This last week I bumped up to six hours per day. I go back to a full time schedule in late July. PT along with work has been challenging for me to stay energized all day long. I have to remember to eat well and get rest when I can. Amazingly, I am not napping during the day at all anymore, which means my endurance level is picking up.

Tomorrow and Tuesday (7/11-12) we head back to MD Anderson in Houston for a follow-up MRI and visit with my Neuro-Oncologist, Dr. Conrad. We pray that tumor has not grown back… will you pray with us? We have decided against doing radiation therapy this time around because my gains in PT are still very significant. Once I plateau, we’ll start with the radiation. I’ll post again later this week with the results of our visit. Thanks everyone! We feel your prayers.

-Roger

Radiation and... Foot Movement!

Sorry for the long delay between posts… two weeks ago today we went to see my Neuro-Oncologist, Dr. Conrad. He will be following me primarily now that my Neurosurgeon, Dr. Lang, has done his work. Dr. Conrad was very satisfied with the MRI and agreed that Dr. Lang did a spectacular resection. What is next? Dr. Conrad does think that we should hit the resection area with radiation to make sure that any tumor cells that were left behind are killed. Any type of radiation that I have to do will be done every weekday for a period of four to eight weeks. I don’t plan to do it anywhere else but at MD Anderson so I assume I’ll have to go on Disability again. But I have absolutely no leave left and in fact, I’m in the hole about 50 hours. At this rate I’ll never be able to take a vacation since I have to ‘pay’ it all back by working. But we will not do any radiation therapy until after I have plateaued in my Physical Therapy. I am scheduled to return to MD Anderson in July for a follow up MRI and if I have plateaued, or am not having any more improvement in PT, we will meet with a Radiation-Oncologist and talk about our options for Radiation. But if I am still seeing gains we’ll put the radiation off for another three months after that. Pretty standard and very safe… I like how they think.

Speaking of gains in PT! Last Friday night I thought I’d cross my right foot over and rest it on my left knee and see if I could move my right foot just for the heck of it. And guess what?!? It moved!! It wasn’t much, maybe just ½ an inch at the ankle, but darn it, I moved it!! The next night I tied it again and not only did my foot move at the ankle but all my small toes also rose up! This is big people… this is the foot that my surgeon didn’t think would come back. Since then I have been able to move it every day. Yesterday, we were doing E-Stim on the foot and after the E-Stim turned off, I was able to keep my foot in the up position and then release it. So we are definitely seeing some gains and I am very excited. The only problem is that when I have a rigorous day at PT I am completely exhausted. It is more of a mental exhaustion than anything else. I can’t describe how difficult and draining it is to try to move a limb that was paralyzed and now very weak. I look at my foot and just try to think about moving it and sometimes it moves and sometimes it doesn’t. It is so hard to do, very draining; in fact I grit my teeth and my am straining so hard that I forget to breathe. But we’ll get there... slowly but surely.

I am supposed to return to work next week on May 5th, but my therapist doesn’t think I am ready and neither do I. How am I going to get up at 6am, go to therapy at 8am and then start working at about 9:30-10 and finish working at 7pm or so and I still need a nap after therapy now as it is? I just don’t know how I’m going to do it and I don’t think I want to. The short term disability people are going to call to see how I am progressing this week and I’ll let them know my concerns and I also have a follow up appointment next week at MD Anderson to meet with my Physical and Occupational Therapist doctor there so that they can check on my progress. I think we’ll get it all figured out soon enough.

My good buddy, John Rich, is coming to Austin from DC this Thursday for a few days to help get me around and just to catch up. He’s a great guy and I need the decompression laughter that I know will ensue when he arrives. And Holly has been taking pictures and videos of my therapy but we have to work on getting them posted, so keep an eye out for that.

That’s all I have for today. Thanks for reading and please keep on praying for my leg to be healed and for my energy level to stay up so that I can do my exercises at home.

-roger

Home Sweet Home, but back to MDACC Tomorrow

Hello, world! It’s me, Roger... blogging again. First of all, many thanks to my sweetie, Holly, for being so diligent and blogging almost every day while we were at MD Anderson. And for being there every day, by my side no matter what. I love you babe! When we last left you here on the blog we were still in Houston and ready to be discharged on April 5th. Everything went as scheduled and we managed to get discharged early enough to venture out and get some lunch, shop for a pair of jeans for me for dinner and then celebrate our 8th wedding anniversary over a delicious nine course dinner in the evening.

Stitch removal - Click for more

The following day we had our follow up appointment with Dr. Lang, my neurosurgeon. We were relieved that he decided that the stitches could be removed. That meant we did not have to stay overnight again in Houston and have them removed on Thursday. He answered all of the questions that we had for him and he also explained to us that the tumor had been analyzed and it returned as the more aggressive Anaplastic Ependymoma, WHO Grade 3. What does this mean? It was more aggressive this time around and this is the highest grade for an ependymoma. Did they get it all? Looking under the microscope during the surgery, Dr. Lang believes so. But it would be foolish to think that every single cancer cell was removed. As a result, tomorrow we are off to MD Anderson again to once again visit with Dr. Conrad, my Neuro-Oncologist. He is the doctor that we did the clinical trial with and we will receive further guidance from him from this point forward. I have no idea what he is going to recommend so I will not speculate but will fill you in on the details after we meet.

OT/PT Eval - Click for more

Last Friday I had my Occupational and Physical Therapy evaluations at St. David’s Outpatient Rehabilitation Services and started both today. I will have two 30-minute sessions of OT for four weeks and three 60-minute sessions of PT for six weeks if not longer. The sessions are challenging and tiring, especially PT. At this point I am not able to move anything in my right ankle or foot and the muscles in my right leg are very weak, but I do have complete sensation. The down side right now because of this deficiency is that I cannot drive.

PT / E-Stim - Click for more

Today we did what is called electrical stimulation (E-Stim) where pads are placed on specific places on the skin and an electrical charge is passed through to make the muscle contract. It basically feels like getting shocked, but is not dangerous and is controlled. The premise is that while the electricity is being applied and activating a particular muscle I am to also ‘think’ of moving the muscle at the same time. This can create a new pathway in the brain to activate the muscle that is no longer working due to damage in the brain. Five years ago I was not able to move my ankle at all and this technique taught me how to do it again. We are giving it another shot. I know… fascinating, right?

Lastly, I wanted to share the MRIs from the day before the surgery and the day after the surgery.

MRI Pre-Surgery: 23Mar2011 (Click to enlarge)

The final size of the tumor pre-surgery: 3.8cm front to back x 2.3cm side to side x 2.4cm top to bottom.

MRI Post-Surgery: 25Mar2011 (Click to enlarge)

Yep, there’s a big o’ hole in my brain now.

-Roger

Less than two weeks!

We are less than two weeks away from ‘Game Day’. It is pretty much official that my surgery will take place starting the morning of Thu, Mar 24, 2011. We are driving to Houston the afternoon of Mar 21 because I have some tests early the next morning. I have a blood test tomorrow (3/15) and am seeing an internal medicine doctor at MDACC on 3/22 so that they can take more blood and clear me for surgery on 3/24. If at any time the doctors think the Pancreatitis is still lingering, they will call off the surgery. Apparently some type of anesthetics can make the pancreas act up again and they obviously don’t want that to happen.

The question we have been getting as of late is ‘how will people know the status of the surgery while it is progress and when it is completed?’ We obviously can’t call everyone. Holly will be posting updates here on the blog. The blog then updates Facebook and Twitter. All information will be posted on the blog first, so this is the place to hang out on game day. In addition, if you are not all that much into Facebook and Twitter, and you can’t get to the blog, you can sign up to have the latest updates emailed to you for free. Just go to www.mommaerts.org on the right side there is a section titled “Get blog updates via email, Facebook, Twitter and others” just enter your email address in the box and click the ‘Subscribe me!’ button. This feature was apparently broken for a while, but I have fixed it. It will email you, post an update you on your Facebook wall or send a message to you on Twitter; it can even let you know via LinkedIn, Skype, and AOL, Microsoft and Yahoo Messengers. Please check it out. Did I mention that this service is free? I scour only the best free stuff for you my friends!

That’s about it. We’re almost done doing our 2010 taxes. And we have the finances under control. We leave for Houston in a week!

-Roger

Surprise Hospitalization and Surgery Postponed

I noticed a few weeks ago that I had a lot of heartburn or acid reflux. On my birthday (2/13/11) we were having dinner at Brea and Eric’s house, which we do every Sunday after bible study. My heartburn was pretty intense that evening and I actually drove home quickly (they live around the corner) to get some chewable Pepto tablets. The tablets seemed to do the trick.

Later on that week we had to drive to MD Anderson in Houston for tests and scans to prepare for my surgery. On Wednesday 3/16 I had a CT where they inject a dye so that the blood vessels can be seen in the scan. In my case, an iodine based dye was used. When they inject iodine dye in someone, the most common side effect of iodine is a warm or "flushed" sensation during the actual injection of the iodine, followed sometimes by a metallic taste in the mouth that usually lasts for less than a minute. This was all true for me except that I also felt a very intense warming around or below the area of my heart. I’ve had a CT before and didn’t remember the feeling being that intense before, but I figured it was no big deal. The CT scan was done to map all the blood vessels in my brain for the surgery.

After the CT scan I had about two hours of cognitive testing where I had to remember words and groups of numbers forward and backward. I also had to think of words that began with specific letters and had to do some logic puzzles. These were all done to provide a baseline for before and after the surgery to see if any capacity was lost.

After the CT we met with the anesthesiologist, a very nice guy. He spent about an hour with us explaining the procedure and walking us through every step. He said that the surgery is planned to be about six hours. The first two hours will be taking me into the BrainSUITE operating room, anesthetizing me and cutting through my skin, skull and the dura, the tissue covering the brain. He said that during the next stage of the surgery I will be woken up and the surgeons will remove the tumor from my brain. Yes, that’s right… I will be fully AWAKE. Not in a haze, not kinda awake/kinda asleep, freaking AWAKE!! He said that they don’t want any drugs to inhibit me in any way. If something gets touched or whatever they want a real time 100% accurate reaction and description from me. WEIRD!!! They will also have the convenience of having an MRI machine in the BrainSUITE so that they can scan me to make sure they got everything before they close me up. When they are sure they are done, they will put me back to sleep, close me up and roll me into recovery. Pretty much all of the staff think I’ll be out of the hospital in 3-5 days. We will see about that.

The next day, Thursday, I had a regular MRI and also an fMRI or functional MRI. During the functional MRI they asked me to think of words that start with a specific letter but I was not to speak them, only think them. Then I would have to open and close either my right or left hand, then I would get another letter, then have to open/close my hand. I think we did this for three letters. We did some other similar tests and that was it. This was to map out in my brain where the area of my thinking during each activity was located. Apparently all the blood rushes to that specific area and they can see it on the computer screen. This will help the surgeons know where certain functions are in my brain during the surgery. They will combine all these scans together into 3D images so that the surgeons can navigate my brain properly and avoid critical areas.

After all of our appointments on Thursday we had lunch and again I felt like I had a bit or heartburn. That feeling stayed with me until I got home and I took some Gas-X before going to bed. I woke up Friday morning 2/18 and commuted to work (about 100 feet from my bed to the office… HA!) for a 9am start. But by 11am the pain in my chest was getting worse and worse. It felt like the pain was under my sternum in the middle of my chest. I told my manager that I needed to stop working and I called our doctor to see if they could get me in but the pain was too much and I asked Holly to call 911. The pain was in my chest and if it was my heart, I didn’t want to mess around. The paramedics and fire truck showed up about 5-10 minutes later and they stuck about 16 sensors on my chest, arms and legs and were able to rule out my heart. At that point the firemen left and the paramedics asked me some more questions. They suggested that with my pain and where it was located that they should take me to the ER, I agreed. Off we went to the hospital. The hospital was able to diagnose me with pancreatitis (inflammation of the pancreas) within two hours of my arrival. I was told that they would like to admit me and that my treatment would be no drink or food until the doctor deemed I was well enough to go home. They also gave me some IV pain medicine to kill the pain in my chest. And let me tell you, the meds were great! They gave me Dilaudid, which is an awesome pain killer.

What does the pancreas do? The pancreas makes pancreatic juices and hormones, including insulin. The pancreatic juices are enzymes that help digest food in the small intestine. Insulin controls the amount of sugar in the blood. For more detailed info, check out MedicineNet. And I don’t want to bore you with all the details, but if you want to read more about pancreatitis, you can at eMedicine. The usual causes of pancreatitis are gall bladder stones and alcoholism. They ruled out stones with an ultrasound and I definitely do not abuse alcohol. But there is one possible cause: my anti-seizure medication. Before I could start the clinical trial at MD Anderson I was told that I would have to stop taking Tegretol-XR and would have to take Depakote ER instead. Well, if you read the drug label for Depakote at RxList, you’ll see that the third paragraph says Depakote can cause pancreatitis… BINGO! We stopped Depakote Friday night and went back to Tegretol. I ended up spending the whole weekend in the hospital hooked up to only an IV but began to feel better on Monday 2/21 was allowed to have chicken broth for dinner that night and then had cream of wheat for breakfast the following morning. I wasn’t taking much of the pain meds Mon and Tue so I was discharged Tue afternoon.

When I got home on Tue I weighed myself and I had lost seven pounds from not eating. I rested most of Wed and worked a few hours Thu and Fri. I felt fine over the weekend and was back to work today. Unfortunately, MD Anderson called me last week and told me that because of my hospitalization, they were going to have to postpone the surgery and reschedule it for late March. Since they do the surgeries on Thursdays, I think it will be on either March 24 or 31. So, maybe it was a blessing in disguise. I need to get back to 100% and although I feel like I am there now, the doctors are right. Plus, Holly and I lost a whole weekend of being able to do stuff and we have a lot of financial and paperwork to complete before then. Plus, I wanted to get our taxes done. So, we’re fine with that. The past few weeks have been a little nuts for us. Especially with Holly’s surgery, my hospitalization, can it get any crazier?!? Stay tuned to find out.

The Verdict: Brain Surgery... Again

Well folks, the verdict is in… the next step is brain surgery... Again.

It was kinda funny to me that we drove 200 miles and 3 hours and only talked to my neurosurgeon, Dr. Lang, for about 15 minutes. He really didn’t sugarcoat it at all, which I appreciate. He just came out and said that it needs to come out. We asked about the trials that Dr. Conrad mentioned. The virus trial is only for patients that had a grade 3 Ependymoma that was removed and then came back. I only had a grade 2, so that one is out. The other two chemo treatments are done after removal of the tumor so we can't do those yet. He said that it is growing, and really needs to come out before it causes any damage.

There are both good and bad things:

• The bad? It’s freaking brain surgery people! There a lot of things that could go wrong.
• The worst? I could die. Just saying.
• The not so worst? I could lose movement and possibly feeling in my right leg forever, maybe my right arm and torso, and my speech center could be damaged.
• The best? I’m a little tired and weak at first but make a pretty good comeback.
• The bestest of all? I’m having my surgery at MD Anderson! It is one of the best, if not the premier cancer hospital in the world. That’s pretty awesome. (I hope my insurance doesn't disown me. Can they do that? Especially if it’s the government’s Tricare??)

First they have to look at the calendars to make sure all the staff are necessary available to perform the procedure. We’re currently looking at a time frame between Feb 22 and Mar 3. Incidentally, Mar 3 is the 5 year anniversary of my first craniotomy. Weird, huh?

Dr. Lang told us that because of the blood vessel that runs through the tumor they want to do a CT Angiogram; this will allow them to map the blood vessels in my brain so that they can see what this vessel might be feeding.

Next, they may do a portion of the surgery with me awake. They would start the surgery like normal, with me completely out, but then bring me out of anesthesia so that I could answer questions and they might also stimulate parts of my brain to see what happens to map it. I found an interesting excerpt from the Ohio State University Medical Center website in an interview with Dr. E. Antonio Chiocca, director of neurological surgery at Ohio State University Medical Center, regarding awake brain surgery:

Patients undergoing awake brain surgery are anesthetized just enough so they will doze during the incision in their skin and removal of a section of the skull. Anesthesia is then withdrawn and patients are coaxed into consciousness so they can speak during procedures on the brain itself.

“You need a very good team to do this. Neuroanesthesiologists give patients just enough medicine so they will sleep during the first phase, and then they will wake them up when we get to the brain,” Chiocca says. “We have a speech pathologist talk to the patient as we remove the tumor. If we notice any trouble speaking, or if the patient develops a halting pattern of speech, we know we’ve gone too far and we stop.”

"Though these brain centers are universal among patients, the mapping and imaging allow physicians to adapt to the “uniqueness of each brain,” Chiocca says. “And having the patient awake allows us to take care of individual differences.”

Patients who undergo awake brain surgery often are able to leave the hospital and return to normal activities within 48 to 72 hours.

Sleeping patients whose surgeries occur near these speech, memory and motion centers of the brain are at higher risk for suffering temporary or permanent deficits, but some patients will opt not to be awake, Chiocca says.

I am totally for being awake during the procedure if it helps them and gives me a better chance of coming out with less deficiencies.

MD Anderson BrainSUITE

Last, if they deem it necessary (I think it is, but that’s just me) they will perform the surgery in MD Anderson’s BrainSUITE. It is basically an operating room with an MRI machine in it so that the doctors can see what they are doing in real time. It helps them to see if they have removed the entire tumor before they end the procedure. In 2006, MD Anderson was the first hospital in the world to purchase and implement one of these systems. There are currently only six in the US. This thing is cutting edge and I hope that they decide to utilize this awesome technology.

• So how do I feel about all this? Well, I’m ready, I’ll tell you that.
• Is it scary? Yes, I’m not going to lie.
• What are my fears? I’m not afraid of death. These guys are going to take care of me and I know that’s not going to happen. But if it does, Holly and I have talked about the ‘ifs’ and there are some preparations we need to make. We’re not stupid. I mean heck, someone could trip over a cord in the OR and kaput, I’m toast. You have to think about these things!
• Am I worried about how it might affect my body? I’d be lying if I said no. But, if I survive and they get this monster out of me forever, no matter what deficiency I have, I’ll be the happiest man in the world. I’ll deal with it. I have learned how to live with limited mobility on my right side and I can do it again.

Dr. Lang said that I’d probably have to recover at MD Anderson for 3-5 days and could go home if there are no complications. If I do require therapy they have physical and occupational therapy in the hospital and could stay there for a few additional weeks if necessary. I’m looking forward to putting this all behind us and moving on. I’m tired of cancer lurking over me. I just want to give cancer the finger like my friend Eric did. No, really. He had cancer on his finger and they amputated it at MD Anderson. I’m not kidding. Well, I’m not going to give them my finger, but they can have my tumor, and just a little bit of brain tissue for clear margins. As soon as we have more info, we’ll let you know.

Thanks for reading and please continue to pray for me and Holly. We’ve got a lot going on right now, (Holly is having laparoscopy next Thursday) but somehow just being here together for each other makes it all better.

-Roger

First Trial Ends, Back to MDACC for Other Options

Holly and I made the trip back to MD Anderson in Houston last week for my every other month checkup while on the trial. For some reason I had a feeling this was different, and I was right. When we started the trial, one of the guidelines was that if the tumor grows 25% larger than it was at the start of the trial, we must stop the trial. We found out that we are now at that point, and we have to stop this trial. I have to say, I don’t know why, but I had a feeling this was going to happen. Now, stopping the trial is not necessarily a bad thing. First of all, I don’t have to take gobs of pills everyday now! Another plus? I’m regular again and don’t have to rely on stool softeners and fiber to counteract the drugs every other week! (I know, gross, but you don’t know what this means to me.) Lastly, they don’t know for sure, but even though the tumor is still growing, the drugs may have slowed its growth. So they got some data from me for the trial and that’s a good thing. I hope it is useful for someone down the line.

Where do we go from here? Last week when we visited with my Neuro-Oncologist, Dr. Conrad, we discussed the MRI. They are unclear of exactly what they are seeing. It could be tumor, necrosis (dead tissue), cystic tissue or something else. He believes that at this point the best thing to do would be to perform a biopsy of the tumor to find out exactly what they are dealing with so that it can be treated properly. After that there are several options available:

• Virus trial, where a reengineered virus is inserted directly into the tumor, the virus eats the tumor, stops at brain tissue and then dies. I wrote more about this trial back in June, check it out.
• There is one chemo treatment option that is new that I can’t remember if it is a trial or not and another that is a trial that Ii think is not quite available yet; both are IV chemos.
• Lastly, all out surgery, which we are trying to avoid.

We have an appointment to see my neurosurgeon, Dr. Lang, tomorrow (2/2/11) at MD Anderson to talk all of these over and see where we go from here. As soon as we know what’s going on, I’ll let you, our faithful readers and supporters know.

I wanted to share some stats and images with you so that you can see where how things are progressing.

First of all, I decided I'd make a table so that I could see for myself how the tumor is growing. I know it sounds weird, but I need to know these things and thought it would finally be good for me to put it on paper. I did it in Excel but can't make a table in HTML to save my life, so I took a screenshot. All the measurements are in millimeters and I took them from all the Radiologist Reports I get from each MRI. As you can see, even with the medications there has been pretty steady growth, but to the doctors, they see it as slow growth.

Next, I wanted to share two sets of MRIs. The first was taken at MD Anderson on Jun 1, 2010. The tumor is still fairly small and compact. Click each one to see a larger version.:

Brain MRI - June 1, 2010

Last, here's the latest MRI from last Monday, Jan 24, 2011. As you can see, there are some areas of black that have a white border, they think those might be cysts, but just are not sure:

Brain MRI - January 24, 2011

I just noticed that the images from last week are a bit darker, but i think you get the point. There are definitely some changes and the doctors want to know why it looks the way that it does. So, off to Houston again tomorrow. We'll let you know what the plan is soon.

Thanks again for all your prayers and support.

-Roger

Eligible for the Clinical Trial

Holly and I spent two days at MD Anderson and after a battery of tests yesterday we now know that I am healthy enough and eligible for the clinical trial. Only issue is, the insurance would not approve it until after I was approved. So now the good people at MDACC are waiting for Tricare/Humana to approve and then once they do we'll have to drive BACK to Houston to sign more paperwork, get the instructions and the meds. We'll have more information about the tests and all (they were pretty cool!) but I just wanted to get this out for now. I'll let you know when we get the final approval. I think the earliest we'll be able to get back to Houston at this point is Monday. Love you all! Thanks for the prayers and keep on praying!!

-Roger

Possible Clinical Trial

If you have not read our last blog, take a look at it now before you read any further or you might be a bit lost. You can find it here. Holly and I went over our options again yesterday and think we know what we’d like to do as long as Dr. Lang is in agreement. So after that, we set out to Minute Maid Park to watch the Houston Astros take on the Washington Nationals. The beginning of the game was a little boring, but the end was fantastic. Bottom of the 9th, 2 outs, 2 men on base and Astros are down with a score of 6-7. We thought all hope was lost, but then Lance Berkman singles to left and two runs come in to win the game. It was pretty cool… literally too! They closed the roof and turned on the A/C, so it was actually pleasant to be there. We thought we were going to sweat like crazy in the humid evening air, but it turned out to be a great evening after all.

Today we were scheduled to see Dr. Lang, my Neurologist, at 2:45pm; but we got a call yesterday asking if we’d be interesting in moving the appt earlier so that we could leave town earlier and we gladly said yes. We got there at 11:30am and finally saw him at 12:30pm. It would have been sooner, but their paging system was down and they had a tough time letting him know we were ready. It’s okay though… I had fun lounging on his recliner in his exam room and playing with the tools they use to show things to patients… my favorite was the brain I could take apart and put together and wouldn’t you know it, he walked in just as I got it apart. I put it together again though pretty fast. Seemed kinda easy; just saying.

Anyway, he said that he had spoken to Dr. Conrad, my oncologist, regarding the trials and explained each one to us. He agreed that the Lapatinib and Temozolomide trial is worth trying. The Delta-24 trial is really only for people that have a grade 3 ependymoma. They don’t know if my tumor is now a grade 3 and the only way to find out is to do a biopsy by cracking me open. But if they are already in there they might as well remove it, so it is a catch-22. There are some other factors for that trial that make it a not so great fit for me, so for now, that one is off the table. The last trial, 744, he didn’t know about, so that too is off the table for now. He feels that in the end, the tumor will have to be surgically resected (removed), but since it is so slow growing, the first trial is worth a shot.

So that was it. Decision made. They notified Dr. Conrad that we are interested in the Lapatinib and Temozolomide trial and we should be hearing back from them soon. Apparently we will have to go back to MDACC again to again meet with Dr. Conrad to talk about the trial and all the specifics behind it. I am hoping it is as soon as next week. If we start the trial in the next weeks, at the end of the two rounds of the trial, if no progress is seen and the tumor needs to be resected, it will most likely happen no earlier than August 2010. This will allow us to make all our trips we scheduled this summer! I might feel like crap, but we’ll get to be with friends and family, which will be a huge blessing.

A few last notes… To be sure that this tumor was an ependymoma, MDACC wanted some slices of the tumor sent to them from Washington, DC. I put in the requests to the DoD in DC and MDACC got them, examined the slides and agreed that the tumor was an ependymoma, grade 2. Also, the MRI from yesterday revealed that the tumor has grown a bit more, just 1-2mm in three months, which is slow.

I'll let you know when we have anymore news. Thanks for the prayers and support.

-Roger

Non-Surgical Options??

We had an interesting visit today at MD Anderson! We started early with an MRI, blood tests and then moved on to see my Neuro-Oncologist, Dr. Conrad. He already looked at my MRIs from this morning and told us that in his opinion, the growth was recurring tumor growth, not radiation necrosis. We went over the new images and it appears that the tumor has grown an additional 1-2mm since February 2010, which is very slow. With that in mind, he told us that we have the luxury of time, and with that, several options. First of all, surgery is always an option. But there are a few clinical trials I may be a candidate for.

We discussed the surgery again and Holly brought up the blood vessel that goes right through the tumor. Dr. Conrad said that Dr. Lang (my neurosurgeon) is very patient and again gave me a warm fuzzy that he is, in fact, a badass. Dr. Conrad said Dr. Lang is very patient and would do everything possible to avoid cutting the vessel out. But since the tumor is taking it sweet time and I’m healthy he suggested several clinical trials which are very interesting.

First, there is a trial being conducted by the Collaborative Ependymoma Research Network (CERN) Foundation specifically for my type of tumor, which is an ependymoma. Basically I’d be on a chemo drug and a new drug that is a signal inhibitor. It targets this type of tumor and I am a perfect candidate. I’ll have more details on this later, but you can read about it here. This would put any surgery off for several months until they see if this works. I could be on this treatment while in Austin, have blood tests there and only have to return to MDACC every two months for MRIs and would continue with the treatment as long as they see progress. Progress would be the tumor shrinking.

Another trial that I am eligible for is a very interesting one. There are two groups in this trial which has been researched by both of my doctors along with other doctors. In group A, they make a small incision to get to the tumor and inject a virus named Delta-24. It is a modified live virus. Sounds Sci-Fi, eh? They inject the virus directly into the tumor and it kills the tumor cells but leaves brain cells alone. In group B, they insert a catheter into the tumor and leave it there. They then inject the virus and in two weeks they suck the tumor out. Group B should be approved by the FDA for testing in the next few weeks. You can read about Delta-24 here and see both of my docs.

Lastly, there is another drug called 744 that will be out in trials in the near future. He didn’t talk a lot about it, but said it may also be a non-surgery option in another few months. There's a little about it here.

All of this is very interesting and does not mean this is my last hope, but rather because the tumor is so slow growing, is an opportunity to try an alternate treatment before another invasive surgery. Tomorrow morning we meet with Dr. Lang and discuss all these options again with him and maybe make a decision. I am excited to have the opportunity to participate in a trial and possibly make history with a new drug and maybe help save more lives in the future. We’ll have more info tomorrow after the appointment.

Again, thank you all for your prayers. Wow, what a road we have been traveling down. As for Holly and I, we are off to have some fun and are going to catch an Astros game tonight against the Washington Nationals, Can you believe I rooted for the Nats when I was in DC? I guess I felt sorry for them because they were new.

-Roger

Cancer Update: Next Steps

First of all, thanks again to everyone. Thank you for the cards, calls, texts, Facebook comments… it is amazing to me how quickly and efficiently we can get the word out about what is going on in the moment compared to four years ago. The first time we went through this we had the blog and that was it. The closest thing we had to an instant update was the ability for Holly to create an audio post that could be listened to on the blog immediately after it was posted. We don’t have the ability to do that anymore but now we have the ability to post quick text/picture updates from our phones to Twitter, Facebook or the blog. And the blog instantly posts a link to Twitter and then to Facebook… Amazing.

Even if you don’t have a Facebook account, you can still see our short Twitter updates for free on Twitter; just see the links on the right of the blog website. And just like we setup four years ago, you can still be emailed when a new blog is posted (scroll down to the bottom of the blog website to sign up.) Only problem with that is it is not very fast, the free version we have for that has its own schedule. But it is there if you need it. Any way you choose to keep updated, thank you for reading and checking in.

So, what is next? Well, quite a bit. This a long post but it’ll go quick, I promise. Let me start by telling you about our visit to MD Anderson Cancer Center (MDACC) on Wed, 4/26/10. We drove up Tues night and stayed with Holly’s battle buddy from Army Advanced Individual Training, Tina, and her husband Kyle and two kiddos Kyle Jr and Evan. They had not seen each other in 14 years! It was nice for them to visit and get a chance to catch up. They truly made our evening relaxing and Tina even made us breakfast at 5:30 in the morning. Thank you Tina! We headed south to the hospital at 6am and got there around 6:45am. When we got there we were a bit overwhelmed by the size of the place. This place is huge. Just southwest of downtown Houston, it is nestled in the middle of the Texas Medical Center that consists of 49 institutions including 13 Hospitals. We found our garage, figured out how we were supposed to pay and made it to the Brain and Spine Center on the 7th floor before they seemed to be open. They called us back a little after 7am, did some paperwork and paid our co-pay then sat and waited for vitals to be taken. After vitals were recorded we sat for a bit again and then were taken by our nurse, Stacy Flach (BSN, RN, OCN, Ambulatory Care Nurse), to an exam room. After another short wait the door opened and in marched our Nurse Practitioner, Cheryl Martin (RN, MS, FNP-C, Advanced Practical Nurse), Resident doctor (poor student) and our Neurosurgeon, Dr. Frederick F. Lang (M.D., F.A.C.S., Professor and Director of Clinical Research at MDACC). These people are going to save my life.

A few weeks ago I sent copies of my MRI CDs from three different military hospitals to them to look at. Dr. Lang brought up the images from those CDs on his computer… they were able to import those images and they were now part of my electronic medical record. I thought that was pretty high tech, even for me, an IT guy! So these are the key points that we discussed:

• Looking at the MRIs there is a change from the MRI taken in July 2009 to the one I had in Feb 2010; the mass is approximately .7mm larger from front to back
• The mass could be radiation necrosis (dead brain tissue from radiation therapy in 2006) or the tumor growing back
• There is a blood vessel passing right through or over the area of concern that might still have had some tumor cells left on it after the first surgery and it could have grown back from that
• Four years ago, the tumor was diagnosed as a grade 2 ependymoma, and those can come back more aggressive
• The surgeon’s first opinion is to take whatever it is out, but the risks this time are greater than the first; going back in a second time has a higher risk of infection, coma, permanent right side paralysis and possible damage to my speech center in the brain
• It is also best to remove the blood vessel because tumor cells may still remain on it and the tumor could just grow back again, but removal of the blood vessel means that whatever it feeds in the brain will die (They don’t know what it feeds yet)
• Another option would be to use the Gamma Knife (targeted high dose radiation therapy) but they need to know if the tumor is a grade 2 or 3 or radiation necrosis and that cannot be determined unless they remove the tumor (Yes this is a catch 22)

So now what happens?

• MDACC wants to study the tissue that was removed from my brain in 2006 because they want to make their own diagnosis of the tumor pathology; I have already contacted the two institutions in the DC area (NNMC-The Naval National Medical Center in Bethesda, MD where my first surgery was performed, and AFIP-The Armed Forced Institute of Pathology, the institute that provided the pathology report in 2006) that have my tissue samples and requested slides be sent to MDACC as soon as possible
• They will seek insurance approval for new MRIs at MDACC and to see a Neuro-Oncologist
• Have new Labs and MRIs taken at MDACC
• See a Neuro-Oncologist at MDACC (specialists of cancer in the brain) and have them review my case to see what their opinion is of what should be done next

We will most likely have the labs and new MRI and Neuro-Oncology visit done on the same day in Houston in the coming 2-3 weeks. The Neuro-Oncologist will give us his opinion and then our two doctors will discuss my case. If they both decide that surgery is the most prudent option, we will go with that. The first possible date for surgery is June.

So that was what we discussed with the doctor and he stepped out along with the resident and the Nurse Practitioner was ready to talk to us, but I needed a moment. She offered to step out and I had to let it go. What the doctor said scared me. I knew that the risk would be inherently higher this time, but dang. And paralysis would really suck, but all of it is just damn scary. I just needed to cry and pray that fear out, both of us did. She finally came back in and started discussing the next steps and dates and I mentioned that all of this was really going to destroy our summer plans. We already have four short trips planned in June and July. I know those are really not important, but we started thinking of everything. She asked us what our plans were and we told her the first was in June and she mentioned that we probably would not make that one. Then she asked us what else we had going on and we told her about the two weddings in July and a five year family reunion. Then she said that we’d probably be able to make those. I didn’t get it and I mentioned that I didn’t know how because I’d probably be in Physical Rehabilitation for a while… she leaned in toward me and she said that we ‘would not have to worry about that.’ I didn’t get it. It threw me off. Then she said, ‘Dr. Lang is good,’ that ‘people wake up from their surgeries moving their arms and legs saying that they love Dr. Lang.’ I still don’t think I got it after everything she told us. I was a bit stunned. We talked about what we needed to do next and that was it. We were done. We got there at 7am and were done by 10am.

What she said made me feel better, but know we have to be ready for the risks and possible outcomes. Holly and I have a lot to discuss, prepare for and pray about. But I will tell you one thing… I have no doubts about this hospital or our medical staff. They gave us a bunch of business cards and a neat little protector to organize everything in. Our team consists of the following:

• Patient Advocate
• Social Work Counselor
• Patient Access Coordinator (deals with Insurance)
• Nurse
• Nurse Practitioner
• Neurosurgeon
• Neuro-Oncologist
• And many other professionals we have not even met yet

I feel pretty good about this whole thing and I’m ready for whatever God throws our way. But I am also trying to live in the moment and enjoy my time with Holly right now because I know it will be difficult after the surgery. So, please do us a favor? Pray for us. Pray for peace for our minds, wisdom for the medical staff, courage to get through this again, provision for all the logistical needs that we don’t even know we need yet, and for God to be glorified through this.

Okay, that’s it for now. This is like the longest blog post ever, but this answers all the questions we have been getting. I’ll try to post MRI images soon so stay tuned. Thank you for reading and staying by our side. We love you.

-Roger

Getting Reacquainted With Cancer

As you might know, I had an abnormal MRI in Feb. We are not sure exactly if there is anything wrong. I was being followed by the Army hospital in San Antonio, but had a relatively unpleasant experience when I saw a neurosurgeon about this last MRI and my confidence in their care plummeted. Care at a military facility is free, but I was willing to spend some money to get better care. Last week Holly and I were looking at the slim pickings of neurosurgeons in Austin when I discovered that the doctors at the MD Anderson Cancer Center in Houston also take my insurance. I called them up last week and was told to gather as much information for them as I could and overnight it to them. I burned a few copies of MRI CDs and some pathology and radiology reports and sent them off yesterday. I also wrote the doctor a letter that I want to share with you. For those of you that are not up to speed with my history, it is a quick overview:

April 19, 2010

FEDEX PRIORITY OVERNIGHT 793461030701

Dr. Frederick F. Lang, Jr., MD

MD Anderson Cancer Center

1515 Holcombe Blvd

Houston, TX 77030-4000

Attention: Wandra R 7.1651

Dear Dr. Lang,

Thank you for reviewing my case.

I am a resident of Austin, Texas. I was living in Austin when, as a US Army Reservist, I was deployed to Washington, DC in May 2004 for an unexpectedly long time. In November 2005 I began to feel involuntary jerking in my right arm. I was being treated for a back injury at the time and my primary Doctor at Bolling Air Force Base thought that it might be related to the pain medication I was taking. It was not until February 2006, when after my back treatment was complete and the jerking continued, that my doctor referred me to a Neurologist at Andrews Air Force Base. The Neurologist performed an EEG which was normal and prescribed an MRI. I went to the National Naval Medical Center (NNMC) in Bethesda, MD for my MRI in the morning and the Neurologist set me up to see a Neurosurgeon in the afternoon. The Neurosurgeon set me up for a craniotomy to be performed in several days.

My surgery was performed at NNMC on March 3, 2006. The tumor was identified by the Armed Forces Institute of Pathology (AFIP) as a grade II Ependymoma. The surgery went well with no complications other than the fact that the right side of my body was completely paralyzed. The hemi-paresis lasted ten days and NNMC transferred me to the National Rehabilitation Hospital (NRH-MedStar Health) in Washington, DC. After a little speech therapy, moderate occupational therapy and extensive physical therapy, I was able to walk again with a cane and was discharged on April 4, 2006. At that time, my right side was still very weak and the muscles from my ankle and below had not begun to move yet.

I participated in outpatient physical therapy for several more months and eventually gained limited ankle and toe movement. One month after being discharged from NRH I began radiation therapy at NNMC. I went to NNMC every day for over a month and received the fullest dosage of radiation I could get (as I understood from my Radiation Oncologist.) Also, while in DC, I suffered from three tonic-clonic seizures. All three started on my right side with my big toe; it felt like I was having a cramp in my foot with my big toe and then progressed to a full seizure. These have been controlled with anti seizure medication (Keppra 500mg AM and 500mg PM / Tegretol XR 400mg AM and 600mg PM); my last seizure was April 2007. Although my seizures have been controlled, I have always had twitching of my right foot’s big toe and also of the muscles on the left side of my right foot… consistent with the focal point of the seizures I did have. My right calf still exhibits quite of bit of muscle atrophy and my writing has never really gone back to what it used to be.

The Army insisted I stay in the beautiful Washington, DC area at Walter Reed Army Medical Center (WRAMC) to determine my disability status and after almost a year I was finally determined to be 70% disabled by the VA and the Army placed me on the Temporary and Disabled Retired List (TDRL) with 100% Army Disability. I finally returned home to Austin, TX in March 2008.

While in DC my MRIs were performed at three then four month intervals. Back in Texas, being followed by Radiation Oncology at Brooke Army Medical Center (BAMC) in San Antonio, I was only having MRIs every six months. All MRIs through July 2009 were normal showing no changes. My last MRI was taken February 2010 and the Radiologist report indicated a .7mm change in size of a mass and I was advised to follow up with another MRI in three months. I did receive a referral to a Neurosurgeon at BAMC who we did see, and he did look at the images, but he seemed more annoyed with us than anything and told us to have the other scan in three months and then come back and see him.

I was content to follow those instructions, but about three weeks after seeing the neurosurgeon, I started noticing that the twitching on my right foot was more forceful and moving for a longer period of time. The twitching has also moved up my right leg and is now present in my lower calf, upper calf behind my knee, right of my shin, above my ankle and seems to be moving to my hamstring. The twitching feels like someone is tapping my body, or feels somewhat tingly. It is a sensation I have not had before and that is what concerns me. With this new activity, I decided to only trust my life with the professionals at the MD Anderson Cancer Center.

Enclosed you will find my last four MRI radiologist reports, the pathology report from the tumor and four CD containing MRIs from 2006 through the most recent in February 2010. Please note that the two oldest CDs will not work on Windows Vista or 7, they only seem to work on Windows XP. The newer CDs will work on any Windows PC. You may contact me with any questions at --- or by email at ---.

I look forward to working with you to seek answers and solutions to this possible recurrence.

Sincerely,

Roger J. Mommaerts, Jr.

SFC, USAR, RET

I saw that the package was delivered before noon. I didn’t get a call from them today and decided to call them around 3pm but was only able to leave a message. I don’t know where we go from here. I don’t know if they will ask me to come to Houston to run tests or ask me to just have my next MRI with the Army at the end of May. I really just want to go to Houston and have them test the heck out of me to determine if there is anything wrong or not. I’m not going to say that I’m not scared because that would be a lie. I have cried a lot at work and at home in my wife’s arms thinking about all of this. But with MD Anderson as a possible solution, I feel a lot better. I try to keep my mind off things by working and spending time with Holly. There sure are a lot of I’s in this post, so I’m going to stop for now and just post it. When they call me tomorrow I will let you know what they say. Right now we just need your prayers… prayers for peace and for healing. And also please pray for my friend and co-worker Jay. We sit across from each other and both of us are going through quite a bit right now. But I think he needs more prayer than I do. He has lung cancer now which is a reoccurrence from when he had cancer in a different part of his body five years ago. So, yes… prayers for healing big time.

Thanks,

-Roger

New Location for the Blog

Hi everyone, as you may have noticed, the blog has moved to a new address. We host our blog with Blogger, who is owned by Google. They were no longer supporting the way we publish our blog posts so we had to move it to a different server. This really should not matter to you. If you subscribe to the emails you will still get them.

We don't post a whole lot on the blog these days, Facebook and Twitter are just more convenient. If you want to follow us there you can find us at the following addresses:

• Facebook Roger
• Facebook Holly
• Twitter Roger
• Twitter Holly

That's all for now... more soon!

Restore the Orphan

So I decided about a month ago I was going to put triathlon on hold this year and concentrate on my running. I have a few reasons why I want to concentrate on my running, some I am not ready to share yet. But one is that I'm just not feeling swimming for some reason. Which is strange. I love to swim. I don't know what's going on with me. But I am loving running right now. I think I am feeling running right now because my body needs it. Have you ever heard that saying about your body knows what you need. Like when you crave certain foods it's because your body needs the nutrients or whatever from that food. I think my body needs me to be running right now. My goal was to run more frequently and then longer and faster. So last week I started running three times a week. It was great. I loved it. See, my body must need it right now for me to think running three times in one week feels great. I know, I'm weird. I've heard it my whole life. "You don't like chocolate and you love to run? You are so weird." I'm used to hearing it.

So last week I ran 13.5 miles total. And I want to keep up with that for as long as I can. To help my triathlon training, I always registered for a triathlon to have a reason for all the training. But I didn't really have any running event to keep me going except for the tons of 5K's and 10K's in Austin almost every weekend. Then Sunday at church, our pastor mentioned a half and full marathon for adoption in October. For a second or two I thought, I could do the half marathon by then. I even spoke to a friend after church who's doing the full marathon and told her I'd think about running the half. Then today I got an email from another pastor at our church about a team from our church for the adoption marathon and I got excited. I always had to do triathlons by myself since no one ever wanted to do one with me, but there are tons of runners in our church and I did several runs last fall with them. It was nice to do a run with friends. God has spoken to many people at our church recently about adoption and many of them are going through the adoption process now. And I can't think of a better reason or time to have a team from our church run as a team in a marathon for adoption. It's just so cool. I love how God works. I get goose bumps just thinking about it.

So I'm registered for the half marathon. And I would love for you to join me and the team from my church. You can read more information and get the links to register, etc here: Restore the Orphan. I completely understand if you don't want to run a half or full marathon, so please consider supporting our team. If you are wondering what kind of training it would take to run a half or full marathon, check out this website Cool Running. They have lots of good training programs, for free! Not only would you be supporting adoption, but you would be improving your health. So join me. ~Holly

Business Update

I wanted to give a quick little update about my new business to let you know how things are going. I am having so much fun and every day this business gets more and more exciting. I think the best part of this business for me is I am helping people and building great relationships. I didn't think when I started this about how much I would be helping people or about the relationships it would create and build. It's really amazing. I prayed a lot while I was doing research about this company before I decided to join it. I can see now how God is going to use me through it.

The other amazing thing about this business is this country has been in a recession for a while. People are watching every penny and our company is exploding. Our sales are sky rocketing and more and more people are jumping at the chance to join our company. We really are providing an economical service to people. We are saving people money with our custom apparel. The quality is great and therefore they aren't throwing their money away. That makes me feel good also.

For more information about our products and services, you can check out our website or ask me. If you are interested in joining this great company, let me know. Below are some links to recent articles about our company.

Tailored Around Your Man - The Examiner
September 20, 2009 Post: Holly's New Business

Thanks-Holly

Holly's New Business

I started a new business this weekend. I am now a Style Advisor and an Austin representative for J. Hilburn. I am so excited! J. Hilburn is a men's clothier. We make custom shirts of high quality Egyptian cotton milled into fabric at the same fabulous Italian mill as Zegna and Ike Behar. And they are at affordable prices. We also currently sell polos. This fall we are adding custom trousers and cashmere sweaters. Next year they are adding accessories and suits. So we will be a full wardrobe source for men and they will never have to leave the comfort of their home. I take ten measurements and help you select from over 200 fabrics. Then we style the shirt to your liking and your fit, in roughly twenty minutes. You get to pick the collar, cuff, pocket, placket and back pleat styles of your choice. A few weeks later, you receive an amazing shirt that reflects your body and style.

Here's what Denver Magazine and D magazine in Dallas had to say about J. Hilburn. You can also hear what one of our founders had to say about the company's success.

If you wear button down shirts every day for work, have difficulty finding shirts to fit you or with or without the features you like, or if you know of a man who does, I can help you. If you do not like to shop with your man or if you are a man and don't like to shop, I am your life saver. If there is a man in your life with a birthday coming up and you want to get him a unique gift, I can help you do that. You can give a special man in your life a gift card for a custom shirt and amaze him. Do you know of a graduate who will need an interview shirt, give him a gift card for a custom shirt. Know a guy who has everything and you don't know what to give him for his birthday, I do. If you are spending over $100 for off the rack shirts that are just okay, you need to see me. And through October 19th, I can offer you $20 off your first shirt order. Which means I can get you a custom fitting shirt for $59!!

If you are interested or have more questions, drop me a line. I would love to show you what we have to offer.

Health Happenings

Okay, so I know I said I would post some good health news a while back. I forgot. Sorry, but I have some more to add now which reminded me. First, I had my yearly visit with my gastroenterologist in June and I expressed to him how great I have been feeling since my visit last June. How I feel like I don't have a disease at all. Of course I do but since I take my medications regularly and have been having great results I just don't feel like it. So he let me taper my medications down. I am so happy to go down two less pills a day. It's a really good thing. Even though he added 1000 mg of calcium over my multivitamin which is two pills a day and nulls the two he took away. But I don't care. It's two less ulcerative colitis pills I have to take which is a great thing. And I'm super happy about it!

Now on to the latest health news. Roger and I went to Brooke Army Medical Center in San Antonio yesterday for his semiannual MRI and visit with his radiation/oncologist. We knew it would be the same as usual but it was even better. It looks like the scar tissue/junk that is still in Roger's brain where the tumor was removed has gotten smaller by 1 millimeter. I know that doesn't sound like a lot, but it is! We never thought it would go away or get smaller so fast. Roger had his craniotomy in March 2006 and his radiation ended at the end of the summer that year. So it's been three years and we are already seeing a decrease. Awesome!! The edema (aka fluid accumulation) hasn't changed much but like I said, we know it will take years and years. So to have the scar tissue area decrease in size is another great blessing. And three years cancer free! I think we are on cloud nine! We can't help but praise the Lord for yet again taking care of us.

And last but not least, Roger has decided to get serious again about his physical recovery from the paralysis he experienced after the craniotomy. He was rear ended in my vehicle a month or so ago and it aggravated his hip which is still not strong. So not only did he get a referral for physical therapy for that, but we also bit the bullet and purchased a Wii and a Wii fit. We started the EA Active 30 day challenge this week. And it's great. It's a really good workout for Roger and will help him to build his strength back up in his right hip and leg muscles. Which means we will soon be able to go for long walks and rides on our bikes. I can't wait to get back on the trails on our mountain bikes together. I will continue to do my regular morning workouts and workout with Roger in the evenings so we can do it together. Although the Wii EA Active workouts are good, they are kind of like a warm up for me so I'm not going to stop my other workouts. I recently went up to 2300 meters twice a week in the pool and have added weight resistance twice a week to my workouts. But the Wii is so much fun too. I can totally see Wii bowling party nights at our house in the future. Watch for your invitation!

Colds?

This has been our lives for the past week. Roger had some post nasal drip last week that led to congestion in his lungs. And I guess I caught his 'cold' Monday of this week. So he's going on a week of the junk and I just started. He kept us both up every night coughing. I'm keeping him up coughing this week. This week his lungs seem to be working on getting all that junk out. Lovely. Roger stayed home from work two days last week. But he's plugging away regardless. Poor thing. I've had to cancel about three engagements I was participating in this week and one birthday party. Boo. That's no fun. I hope it doesn't last long. We have lives to live. We don't have time to be sick. I feel like I'm not getting anything done. We do have some good news to share and I'll get to that soon. When I have more energy.

My First Grill

Okay, so the title sounds like a Fisher Price toy like My First Kitchen. But it's not. Tonight was my first night to grill completely by myself. Roger had to work late so I decided I wasn't going to wait for him to get home to start dinner. I didn't want to be eating at 10:00 p.m. And I didn't want the meat that was thawed and marinating in the refrigerator to wait any longer before we cooked it. So I grilled all by myself. Yeah! I tried to remember everything Roger does so I didn't miss any steps. Like preheating the grill, oiling the grates before, probing the meat with the thermometer and setting it for five degrees below the desired temperature because it will continue to cook once you remove it from the heat. I even remembered to turn all the burners to high when everything was done cooking so that the stuff stuck on the grates would burn off. And I brushed off the grates when it was done. I grilled southwestern marinated turkey tenderloin and corn on the cob seasoned with this stuff. It was very tasty. Man, I'm good. The only bad thing about grilling by myself is that Roger now knows I can grill on my own and I can't use it as an excuse to not cook and make him do the grilling now. Darn. The grill has cooled down completely so I have to go cover the grill back up. Oh, I forgot to turn the natural gas off at the house. Oops.