Corpus Christi bound!


Rusty was discharged from MDAnderson yesterday, Friday.  While he is still weak, he is lucid and mostly back to his old self.  Thanks to a most conscientious physical therapist he is walking with a walker and can get in and out of bed, chairs and trouble unassisted.  Jeff convoyed home with us and our first stop, after leaving Houston and its suburbs, was at our regular haunt, Prasek's Smokehouse, where Rusty really lit into a plate of ribs...making up for lost time!

Rusty is having some discomfort in the muscle of one leg and the doc believes that it may be a small cancer.  We are due back in the melanoma clinic on January 9, and it will be assessed then.  In the meantime, we can call in and go back anytime before then if he in having severe pain or problems.

There was never a conclusive decision as to the definitive cause for this episode of fever, confusion and lethargy, but he was treated for bacterial and viral encephalitis/meningitis, and well as for seizure activity.  In the event that the targeted chemotherapeutic agents he was taking daily were the culprit, those were discontinued.  An EEG did indicate some minor seizure activity, and he is now back on driving restrictions which is SO hard for him.  He is, however,  infinitely grateful for the outstanding medical care he received for these past 11 days, for his recovery, and for the chance to now be back in his happy place in Flour Bluff America!

Merry Christmas and Love to all of you...

As you can imagine, now that Rusty is feeling better day by day, he is itching to go home.  There is still no certainty as to what caused the brain swelling.  Bacterial infection and cumulative reactions to the targeted cancer drugs are still considered by all the doctors to be the most likely causes.  Rusty has been on massive doses of IV antibiotics for a week now and must continue them for two more days, so they are looking at discharge for Friday if all stays well.

Rusty continues to improve and is slowly getting back to normal activity level.  He still tires easily, but his spirit is strong.  Primary Melanoma doc and team will see him in clinic after the first of the year and then we will agree on a new treatment modality.  Unfortunately, the three drugs he had been on since February are, in the docs words, the best drugs they have for treating Melanoma, but given his recent neurological episode, he cannot stay on them.  They plan to try the next best drug regime for his situation.

Thank you so much for all your prayers, supportive messages and love...you cannot know how much that means to us.

Mental status continues to improve little by little.  All lab tests on the spinal fluid so far are negative...many are still pending.  Rusty has been fever free for 48 hours, and was up walking with physical therapist today.

Today was the 4th radiation treatment to the tumor in the upper arm. Inflammation in the radiation site caused some severe pain last evening, but the staff were diligent about pain medication and today the pain is way less.

                             "De-stressing" photographs lining the halls of the radiation unit.


Rusty's primary Melanoma physician, Dr. Amaria, paid us a long visit today.  CT scans taken on Friday reveal that there has been new tumor growth in the chest and abdomen.  Dr. Amaria says that the assumption is that the new growth is Melanoma and describes the tumor growth as "aggressive."  This, of course, indicates that the drug regimen he was on has ceased to be effective.  The tumors become "smart" (go through genetic changes) and resist the drugs.  He will no longer be on the clinical trial he has been on since February, and the team will attempt a new treatment modality for him, probably a combination of chemotherapy and immunotherapy.  They want him to recover fully from this recent brain episode before they start new treatment for the melanoma, and will wait until after Jan. 1 to make a final decision and start treatment.

So...we are back to the drawing board...taking one step at a time, still with absolute confidence in the medical personnel here at MDAnderson.

To compliment our new truck, we ordered a new travel trailer and picked it up on our way up to Houston last Monday.  She is an Imagine, a beauty by Grand Design, and is our Christmas gift to each other.  She will make our frequent trips to Houston much more comfortable.

Spinal tap lab results are starting to come in and, while there is nothing conclusive, it appears that there is inflammation and possibly infection in either the brain or the meninges which could cause the symptoms Rusty is having.  They are bombarding him with IV antibiotics and anti viral drugs, trying to cover all bases while we wait for the cultures and other lab work.  It could be next week before all labs are back and we still may not have a conclusive answer.

In the meantime, Rusty continues to improve little by little.  He has longer periods of wakefulness and lucidity and has begun getting out of bed with a walker for short distances.  He is regularly surrounded by teams of physicians, practitioners, "fellows" and nurses...Melanoma team, neuro-oncology team, infectious disease team and radiology team, as well as occupational therapist, physical therapist, dietician, lab techs and IV team. We are waiting now for the melanoma team with results from yesterday's CT scans.

It is Saturday and Jeff will be leaving to go back to Corpus to play his part of a "party dad" in tonight's performance of the Nutcracker...Abby is dancing as a "party girl."  Jeff expects to come back tomorrow.  It really does help to have tag team care-taking.

I am OK.  I have gotten rest, I revel in each small improvement, and I am confident that we are in the best hands possible...God and MDAnderson.

Rusty's status continues to improve....he has longer and longer periods of wakefulness and lucidity.  A team of neuro-oncologists assessed him Thursday to rule out small "absence" seizures and meningitis.  Neither has been ruled out, and they will do a Spinal tap today hoping for further clarification.  Meanwhile he is receiving IV antibiotics and anti-viral drugs.  In the words of his primary doctor, hopefully he has turned the corner.

The teams have also decided to do his complete set of "restaging" scans a month earlier than they would normally be done.  They started yesterday with a brain MRI which showed no changes from the one in August (Yay!!!!). Today will be CT scans of abdomen and chest and a physical therapy consult to start Rusty walking again.

He had the first of five radiation treatments to the upper right arm yesterday and will have the second today.

As Rusty's lucidity returns little by little, so does his sense of humor, his sarcasm and his independent nature...thankfully.  We cannot say enough about the excellence of care at every level here at MDAnderson.  In an institution brimming with persons dealing with illness, fear, despair and death on a daily basis, there is still joyful preparation for Christmas, music, graciousness and a spirit of generosity and sincere caring.

Thanks to Jeff, we have a room in the Rotary House Hotel, the hotel run by Marriot that is attached to the hospital.  Jeff and I take shifts, sleeping and being at Rusty's side.

Update on Rusty...

We spent most of the day in the ER waiting for an appropriate bed to come free in the hospital...not as bad as it sounds...the ER here has small private rooms for each patient, big enough for me, Jeff, Rusty, equipment and a place for a gaggle of doctors to stand.

Rusty was less groggy and a little more lucid this morning..fever was down...still no definitive explanation of reason for fever...best guesses are viral infection or side effects of targeted oral chemo.  They are treating for dehydration.  The mass in Rusty's right upper arm has changed somewhat and an MRI today revealed a tumor.  He will start the first of five radiation treatments to that area tomorrow...all the prep was done this afternoon.

After the radiation prep we were brought to Rusty's new room, G1042.  At this time the plan is to keep him for "a few days."

Jeff plans to stay with us as long as Rusty is in the hospital. We are hopeful, and we take great comfort in your support and love.

Need prayers, positive vibes and good thoughts.

Rusty is having a bit of a rough go right now.  He started running fever and feeling fatigued and sleepy last week.  After exams and testing our local primary doc could not find the cause ad referred us to MDAnderson docs.   Dr. Amaria, his primary Melanoma doc saw him yesterday and he is dehydrated.  By late afternoon it became clear that he was worsening and he was admitted to MDAndersn ER.  As of 8 AM we are still in the ER awaiting assignment to a room.  The physicians and nurses here are amazing, and they seem to be stumped as to the origin of the fever and fatigue.  Multiple tests being done.

Jeff arrived here at 9:30 last evening. Will keep you updated.

Breathing a guarded sigh of relief after today's appointments, tests and discussions with melanoma team.  For about the past week, Rusty has has a tender area in his right upper arm that has been getting slightly larger daily....so... in addition to the rountine tests, they ordered a Doppler ultrasound on his arm.  He got that familiar dirty-old-man twinkle in his eye when he saw the department they sent him to for the ultrasound....

Late this afternoon, we learned that the swelling and discomfort in his arm are due to some fluid accumulation...probably a "hematoma" from oozing blood after a venipuncture.  The problem does not appear to be a tumor and they expect it to resolve without treatment.  Melanoma doc is pleased with Rusty's status and agreed to postpone one immunotherapy infusion in February so that we can take our annual trip to New Mexico with the Stegalls.  Rusty's primary Melanoma physician, Dr Amaria, has a "quality of life" patient philosophy rather than a rigid adherence to perfect patient compliance....we are learning to value and appreciate that.

Dinner tonight al fresco at D'Amico's in Rice Village, (Italian, of course!) followed by a visit to a Houston tradition, the Christmas "Zoo Lights"' ...the Houston Zoo is transformed into a holiday wonderland with music,  15 miles of amazing lights, food and drink.  The extravaganza is sponsored by TXU Energy Company and is a fund raiser for the Zoo.  It runs from Nov. 18 throughput Jan 14, from 6 to 11 PM.  The zoo animals get to "take a long winter's nap" during each evening's event.

Hoping that you all had a good Thanksgiving.  We have much to be thankful for...please know how thankful we are for each of you.

Our RV resort is decked out in Christmas finery, and it is a happy time.

We'll be back in two weeks.

Pretty routine to MDAnderson visit today.   Lab work, immunotherapy infusion, visit wth neurologist to reassess seizure activity (Rusty has had none since the two in August) and visit with ophthalmologist.  The two oral chemotherapeutic drugs that Rusty is on may cause fluid collection that would affect his eye sight...so far no sign of that.  Both neuro and ophthalmic reports were very good.  At this stage, Rusty only sees the Melanoma team once a month.

                                      Cellist in the MDAnderson lobby on Tuesday afternoon

About 2 weeks ago it became apparent that there was a large area of the right side Rusty's beard that had fallen out due to the radiation to his neck, so he shaved the whole beard off.  He's unhappy about having to shave every day after so many years of a beard, but it's a small price to pay.

                                                      The "New" beardless Rusty

Rusty is feeling good.  This week in addition to helping me transport and set up for two shows, he scouted around Corpus Christi for a new truck....test driving, negotiating, comparing and having a pretty good time.  We are now the proud owners of a new Ford crew cab pick-up.

Happy Thanksgiving to each and every one of you!  We are thankful for you, and your love, concern, messages, prayers and support.

I am starting this blog post with a pic of Rusty and Jeff preparing to head out fishing at 7 AM last Thursday.  Rusty feels good and is up to most of his old tricks.  (Notice I said "fishing", and not "catching." 😉)

On our way up to Houston on Saturday, we stopped in Katy where my roommate from nursing school, "Cadge" and husband, Bob, were visiting her daughter...we have enjoyed a 59 year friendship.  Their home is in Tennesse.  Good visit.

Rusty had an early Sunday morning MDAnderson appointment for "restaging" scans.  Restaging diagnostics are performed every three months and compare prior diagnostics to current ones to assess comparative size of tumors, effectiveness of treatment and general state of the disease.

Monday was lab work, EKG, Echocardiogram and MRI, and Tuesday morning before seeing the Melanoma team, Rusty had an EEG.  We saw the Doc and the Melanoma team Tuesday and the tests show improvement in all areas...in many cases, tumors have completely disappeared. There is one small tumor near the right kidney which they will watch closely.  The tumors which appeared on his shoulder and neck in July are much diminished since the radiation and are not painful.  Brain lesions are improved and according to doc "brain is happy."  In all, it was a positive "restaging" visit.

Rusty has more energy, is encouraged, and is, in his word, "giddy" about todays reports.

Sunday afternoon was free and we attended the Houston Symphony concert at Jones Hall.  What a performance!, and what a pleasure to experience a city with such rich offerings!

We'll be on the road home Wednesday and we leave on Friday for our regular monthly Market gig in Wimberley...about a 3 1/2 drive from home.  We take the RV, set up on Friday, sell on Saturday and come home Sunday...it really is fun.

Thanks for the support, wonderful messages and prayers.  We are so grateful.

A rather routine MDAnderson bi-weekly visit was greatly enhanced by a cool front bringing low humidity and chilly temperatures...finally, fall is in the air!

Picnic lunch on the Infusion Therapy porch

Rusty has not been driving, as per doctor's order, since the seizures in August.  He has been VERY anxious to get back behind the wheel, and today's visit with the oncology-neurologist was encouraging.  Since he has had no further seizures, since the seizures were confined to the muscles in his face without loss of consciousness and since he is tolerating the anti-seizure medication well, he can begin driving again on Nov. 14...three months from the date of the seizures....providing he has no further seizures.  His neuro examination detected no problems, and the oncology-neurologist does not need to see him again for six months.

In addition to the neuro visit, Rusty had routine blood work and his regular immunotherapy infusion...a short day for us.  Rusty's nurse told us that MDAnderson does on an average of 400 chemotherapy infusions daily.  Staggering!...and the staff treats each person as if they were the only patient needing care.

We treated ourselves to dinner al fresco at D'Amico's Italian restaurant in Rice Village...a very good day.  Back to Corpus tomorrow to prepare the Bangles booth for the Texas Jazz Festival weekend.

Know of our continued sincere gratitude for your concern, prayers and messages.

We came to Houston a day early this time in order for Rusty to take part in a research project conducted by MDAnderson.  In a nutshell, the research is aiming to develop brain imaging techniques that will be able to differentiate between scar tissue and tumor tissue in the brain.  Since Rusty has some of both, he was deemed a suitable research subject, and had a CT scan and an MRI of the brain using the enhanced techniques.  The study will image the brains of 100 such subjects.

Tuesday was our routine bi-weekly visit...lab, EKG, Melanoma team visit and immunotherapy infusion.  Doc is pleased that Rusty has stabilized since the shoulder radiation, seizures, and Gamma Knife procedure.  Since he had the seizures he has been on anti-seizure medication and has had no further seizures.  A side effect of the seizure med is weakness with fatigue, and Rusty was having both, to an extreme degree for the past two weeks.  The doc decreased the dosage and already Rusty is feeling more like himself.

As you might expect, the fatigue did not stop him from working with Jeff for two days on a major outdoor plumbing problem or doing extensive repair work on our lawn tractor.

It is Wednesday and we will head home today to prepare to leave Friday for our regular monthly Wimberley gig.  Life is good.  Keep those prayers and good thoughts coming!

We left Corpus Christi in the wee hours yesterday in order to park the RV and get into MDAnderson in time for afternoon appointments for testing...blood work and MRI...as a follow up to the Gamma Knife surgery.

                               Rusty checking out his "surgeon" image in his MRI scrubs

As we left the Main Clinic at MDAnderson we were caught in severe Houston thunderstorms with flash flooding...the shuttle did not get us back to the campground until about 7:30 PM.  Houston did not need the extra water...once again, there is standing water in areas of the city.

                                                       Waiting for the shuttle

Our first appointment today was with the Radiation Neurologist who performed the Gamma Knife procedure.  She is very pleased with the results...one tumor appears to be completely ablated and the second tumor, which was very small to begin with, is smaller and she expects that it will continue to shrink.  She will see him again in six months.

Rusty had his routine immunology infusion later today and after a laid back afternoon and a nap, we had barbecue at "Pappas" famous Barbecue restaurant.

We are both feeling particularly blessed to have received such a grim diagnosis 9 months ago and to have Rusty feeling so good and taking part in most of his usual activities .... thanks to prayer, palpable support from familyand friends and the incredible staff and facilities at MDAnderson.

We'll  be back in two weeks...I'll post again then.

Harpist playing in the Waterfall sitting area at MDA.

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We drove back up to Houston on Wednesday for Rusty's regular infusion and doctor visit on Thursday.  The tumors in his neck and shoulder are smaller since the five radiation treatments last month and he is having no pain in his neck or shoulder now.  His doctor told us that she had seen the scans of Rusty's brain after the Gamma Knife procedure and the two small tumors that had been there appear to be gone.  All in all a very positive visit and Rusty is feeling good.

August was an active month for the Ranks in Houston...five days of radiation treatments, the Gamma Knife surgery, ER visit for seizures, routine immunotherapy infusions, a visit from the Seattle Ranks, and a hurricane.  We are looking forward to a quieter September.

Now we have to start cleaning up the yard from the mess Harvey left!

We return to MDAnderson on September 18 and I'll post again after that visit.  I will try to remember to take pix!  Thanks for your prayers and good thoughts.

WE ARE HOME SAFELY as of about 30 minutes ago!!!  

John, Tracy and Joey are safely in San Antonio airport waiting for an evening flight to SeaTac.  We are among the lucky ones. We witnessed an incredible amount of water, devastation and suffering.

We all got new raincoats in Houston, compliments of the maid service at the hotel.

Rusty is feeling good...in his words "perfectly normal."  It was a blessing to have John and Tracy with us for Rusty's procedure.  Also a blessing to wake to a clear blue sky this morning along with a (relatively) dry path out of the city.  Thank you all for your prayers, concerns, messages and good energy during our Harvey experience.  We know we were so very fortunate.

We have been safely sheltered on the 4th floor of a Houston hotel in the Medical Center area ever since Rusty was discharged from MDAnderson after his radiosurgery on Friday.  He was required to stay in Houston for 24 hours in the event of post-op problems, and by the time the 24 hours was up it was too late to leave ahead of the storm.  John, Tracy and Joey are bunked up with us since both airports are closed due to flooded runways.  They were due to fly home on Saturday but flights were cancelled.

Do not know how much longer we will be here...roads are impassable.  We have power, water, and picnic food.

After being fitted with the "frame" and having an MRI of the brain, Rusty's two small brain tumors were zapped with Gamma rays for 72.1 minutes this morning...Gamma Knife perfexion radiosurgery. He did beautifully...was awake through part of the procedure and then fell asleep for part.  Ate a hearty lunch about 10 minutes out of the procedure, and his neuro-radiologist was pleased with his tolerance of the procedure.
 

We are to stay in Houston near the hospital for 24 hours in the event of problems, then we plan on heading north away from the flooding.  Since the storm is due to make landfall tonight, and is predicted to have 110 mph winds, we will not be staying in the RV, but have reserved a room in a local hotel.

Thanks for thoughts, good wishes, prayers and flippant comments! 😍

Thanks for all the concerned messages and queries about the hurricane!  We are in Houston...today Rusty had appointments in preparation for tomorrow morning's gamma knife surgery on the remaining brain tumor.

John, Tracy and Joey are here with us...they had planned to be here for the radiosurgery and to fly back to Washington state from IAH Saturday morning

We are now just all rolling with the punches....surgery is still scheduled, and since it's outpatient, we are thinking that we will hook up the trailer and head northwest as soon as possible after the surgery.  Whether or not John and family come with us depends on the weather and on the feasibility of flying back to WA.  All plans are tentative at this point.

Family and friends in Corpus are putting up our hurricane shutters and preparing the house for us.  We have a couple who house sit for us and care for our dogs when we are gone...they will stay at our house.  SO happy to have John, Tracy and Joey here to help and support.  We spent part of yesterday at the Houston Museum of Natural Science with 14 year old Joey who also loves the pool here at the RV park.

Greatgrandson Julian and his parents left or home on Tuesday...Jacob, who is in the Army, had to be back to work on Wed.  What a happy time we had with the baby!

Rusty's fifth and final radiation treatment was yesterday.  While we think the mass is only slightly (if any) smaller, his pain is practically non-existent now, so the doc believes that pressure on surrounding nerves has diminished.  Rusty feels good and, so far, he is not glowing green.

                          Traditional "RINGING OUT" at the completion of radiation treatments.

No further seizures since Monday - the medication seems to be working fine.

We saw the Pain Management team here at MD Anderson today.  The appointment was made for Rusty a couple of weeks ago when pain was significant.  At this point they patted him on the back and said to come back if and when pain becomes an issue.

The radiosurgery (Gamma Knife) on the small brain tumor will be here at the radiology center next Friday, August 25.  We'll have a Thursday appointment for measurements and preparation.  It is an outpatient procedure, and they only ask that we stay in Houston one overnight after the procedure in case of problems.

John, Tracy, Joey, Jacob, Jessica and baby Jude are due in at George Bush Intercontinental tomorrow morning at 7 AM!!  We will transport Jacob, Jess and Jude to Corpus Christi and John, Tracy and Joey will have a rental car.  Jacob and family return to Washington state on Tuesday and John, Tracy and Joey will return to Houston with us next week for the Gamma Knife procedure before leaving on Saturday, Aug. 26.  We have a photo session set up with Patricia to photograph the four generations of Rank men and I will get to see, hold, and smooch my first great-grandchild!

101 degrees in Houston today, with a heat index of 113.  Whew!

I'll post again next week after the radiosurgery - (along with pictures of baby Jude!)

Another first today...shortly after awakening this morning, Rusty had twitching and numbness in his face...it lasted only a couple of minutes, and he was conscious and able to talk,  but was scary enough to warrant a speedy truck trip into the MDAnderson ER.  CT scan, neurological team consult and observation of a second similiar episode, caused them to believe that the small tumor in Rusty's brain is causing "motor seizures".  That is the tumor scheduled for radiosurgery (Gamma knife) treatment next week.

He was put on an anticonvulsive drug, cautioned not to drive, and discharged at about 3 PM....but not before shocking the small, Asian, female neurologist who cautioned him not to drive.  He told her that not driving would be a great hardship since he is a race car driver.  She stared at him, incredulous, until the rest of the neuro team (males) started laughing, then she understood that it was humor...and Rusty grinned at her and said "gotcha!"

Treadmill time - stress control....

Second of five radiation treatments completed today, and the tumor already seems smaller and there is less pain. Rusty is spending the rest of today fiddling with our new RV television and I am logging hours at the pool with a good book... radical self care.  We have the weekend off and resume treatments Monday.

I am sorry that I cannot individually answer all your wonderful messages and responses to posts.  Please know that we are grateful for prayers, good wishes and support.  I will post again next week.

We started our marathon day at MDAnderson with the first of ten appointments at 6:15 AM.  The day included a CT scan of the neck tumor, visits with Melanoma specialists and radiation specialists as well as opthamology, cardiology, infusion and lab work.

Rusty's course over the next two weeks will include five days of radiation to the neck/shoulder area commencing on Thursday this week.  Tomorrow they will do "mapping " in preparation for this radiation.  I understand that mapping is a complex process which includes measurements, math, physics and medical technology to insure that the radiation is targeting the affected area and avoids critical structures in the area.  The actual radiation treatments will start Thursday.  The hope is to stop the tumor growth and hopefully shrink it.

Then, during the week of August 22 Rusty will undergo "Gamma Knife Radiosurgery" targeted to a very small (about 8mm) tumor in the brain.  Gamma Knife treatment is a single dose of precisely targeted radiation to a tumor.  Preparation is extensive and includes stabilizing the head in a frame that directs the radiation with pinpoint accuracy.

Immunotherapy infusions will continue every two weeks as before.  Until all the radiation is complete, he will discontinue the oral chemotherapy.

We're planning to stay in Houston through next Wednesday when he has the final radiation treatment to the shoulder/neck.  John, Tracy and Joey are coming to visit on August 19 for a week, so we'll wait till they get here to finalize plans for Gamma Knife week.

Since this new tumor has caused Rusty an increasing amount of pain, we are thrilled to be moving towards resolution!  As always, the intensity, quality, timeliness and level of care here at MDAnderson is incredible!

Quick update on the recent shoulder/neck tumor.  We saw Dr. Amaria, Rusty's primary Melanoma physician, today.  MRI and scans taken yesterday indicate that brain, chest, abdomen and pelvis tumors have greatly improved since last scans in May.  Because of that, and as long as he feels good,  they are going to keep Rusty on the clinical trial protocol and treat this new growth with radiation to shrink it or keep it from growing larger.  They are very optimistic about the decrease in the body tumors, and feel that "palliative" "local" radiation to he shoulder and neck is all that is needed now.

We are very happy with the results.  Will be back up here next week for regular visit.

Thanks to all for support, caring and love!

Regular visit to MDA today for blood tests and immunotherapy infusion.  Melanoma team including doctor sawRusty today to monitor mass in neck/shoulder.  They have rescheduled body scans and MRI to Monday July 31.  According to Dr. Amaria and the team, they can make no plans for dealing with this new tumor untill the scans and MRI are complete.  They hope to have a plan for Rusty after reviewing all the tests.

We seem to have hit on a medication regeime that keeps Rusty more comfortable and in less pain, and the team suggested that we increase the dosage of pain med if needed.

We flew up to Houston this morning and are now in the airport waiting to fly home and Rusty has had his best day in a long time....relatively pain free and sporting some of his old energy and irreverence.  We'll be back up here in 6 days and will update you then.

Thanks for all your messages, calls, prayers and good vibes!

Many thanks to all of you for your supportive, encouraging, loving messages is response to these posts.  We both feel connected, and lifted up.

Today's biopsy was not good news.  The preliminary pathology report on the mass in Rusty's shoulder/neck is that it is a new melanoma.  Of course, the melanoma physician is concerned that the treatment is no longer working.  They are moving up the date for the whole body scans and tests that were due in August...we are waiting for rescheduled dates.  After those tests we will know how they recommend for Rusty to proceed.

We had been planning on spending a week at John and Tracy's in Washington State the last week of July...we will postpone that visit pending treatment plans.

Rusty is having some pain in his neck and shoulder and is looking forward to the stepped up scans so we can have a more complete, accurate picture of the disease situation.  He is adamant that we will do the Kerrville show as planned, so tomorrow morning we leave for Kerrville.  Nurse Ratchet concedes.

Will continue to keep you updated as things unfold.  

New wrinkle this time...after complaining about what he thought was a muscle strain in his shoulder for a few days, we noticed on the evening of July 3 that Rusty had a swollen area on his left shoulder at the base of his neck.  Saw our local doc and he communicated with Melanoma doc in Houston.   She advised that Rusty be seen by her at his regular two week appointment on July 11.

Today was that appointment and the team feels that the swollen lump is either a new melanoma or an inflammatory response to the medications Rusty is on.  A biopsy will be definitive and Rusty is scheduled for the ultrasound biopsy on Thursday, July 13. It should take 2 or 3 days for results.  Rusty has been having increasing discomfort  and dull pain at the site and they prescribed a pain med.  Today he had his immunotherapy infusion as usual.

We have been advised to just go home after the biopsy on Thursday rather than wait here for the results of the biopsy.  We had tentatively planned on doing a two day show at a Summer Market in Kerrville in the Hill Country.  Rusty still wants to do that...to leave here Thursday afternoon and go directly to Kerrville.  We packed for such an eventuality, but we'll see how Rusty's feeling.  Nurse Ratchet (me) gets the final say....sometimes...

Photos are back at the camper after a long day.

White knuckle drive to Houston yesterday...thunderstorms and teeming rain for much of the trip.  Abbreviated MDAnderson visit today since Rusty will only see the Melanoma team every other visit now.  We come up every two weeks and team visits are now once a month.  He had blood tests and his immunotherapy infusion today.  All went well and he is feeling good.  His energy is almost back to normal and his spirits are high.  As you would expect, he is pretty glib with irreverent joking about  having cancer, just as Joe was with his ALS.

We braved the storms this afternoon to venture out in the truck to find a knitting/yarn shop and to visit the Houston Natural Science Museum.  We found the knitting shop but skipped the trip to museum because of the approach of violent weather.  Storms came through after we got back to the RV park.

Tomorrow we depart Houston headed for our July 1 Wimberley Market gig with a two day stopover in Blanco State Park.  Due back at MDAnderson on July 11.

Trip up to Houston Monday was complicated by needing to make vet arrangements for our sick dog, Buttercup and learning that the repairs on our Puma were not complete and we would not be able to pick it up for the trip.  (You may recall that when the tire came apart a few weeks ago, the steel belts in the tire basically beat a hole in the floor of the camper.)  so, for this trip we are back to the little Casita.

The June 13 visit to MDAnderson was pretty routine...lab work, EKG, visit with Melanoma team and infusion.  Dr. Amaria is pleased that Rusty seems to have recovered fully from the pharyngitis episode and that his blood work is stable.  She chided him about his age when he complained of less energy and of some memory loss.

Before the immunotherapy infusion we ate our picnic lunch in one of the beautiful outdoor patio areas in the MDA complex.

Back at the RV Park via shuttle about 4 PM...just enough time for a quick swim before leaving for D'Amico's Italian Market and Cafe to celebrate my (Grace's) birthday.

We return to MDAnderson in two weeks.
Thank you so much for your interest, prayers and encouragement!

A week before our May 30 visit to MDAnderson, Rusty was diagnosed by our local ER with pharyngitis...a very sore throat, fever, cough and generally feeling awful.  Our family doc, Dr. Boynton, communicated with the Melanoma team at MDAnderson and they directed that he discontinue the oral chemo drugs until the episode resolved.  They felt that the symptoms could have been caused by the oral drugs.  Rusty was put on antibiotics and by the end of the week was doing better, other than feeling stressed and worried about being off the oral Melanoma drugs.

At our May 30 visit to MDAnderson, he was well enough that the drugs were restarted.  He had lab work, a visit with his melanoma team and his regular immunotherapy infusion.  He is feeling much better.

While in Houston, we are trying to learn the public transit system...parking is very expensive.  We take a shuttle from the RV resort to and from MDAnderson, but for all other travel we are learning how to become bus riders!

Since we are due in Wimberley in June 2, rather than return to Corpus then travel to Wimberley, we spent two days at Bastrop State Park in central Texas before heading over to Wimberley.  On the way, we stopped at the Blue Bell Creamery in Brenham, Texas for a little tour and tasting!

Today is the June 3 Market in Wimberley, then we head home to Corpus on Sunday, June 4.  We return to MDAnderson on June 13.