December 17th scheduled visit to MDAnderson - first leg of the trip, the ferry crossing at Port Aransas....if you look closely, you can see the dolphin surfacing near the middle of the photo.)

Very routine visit this time.  Lab work, regular visits with Neurology Team and Melanoma Team followed by immunotherapy infusion.  Lab results stable...still some anemia, (caused by bone marrow depression from the chemotherapy) which causes Rusty some fatigue and weakness, but it is slowly improving.   Both neurology and melanoma teams are pleased that Rusty is doing well.  Neurology team will see him again in three months and Melanoma team will continue to see him every 28 days to assess him for immunotherapy infusion. 

The clinics at MDAnderson compete for best Christmas Tree...this is the Infusion Therapy Clinic tree themed "Journey to Mars."

You probably heard last month that Jim Allison, Ph.D., an MDAnderson immunologist, was awarded the Nobel Prize in Medicine.  He is responsible for the development of immunotherapeutic agents which are now prolonging and saving the lives of many cancer patients, including Rusty.  MDAnderson is celebrating this humble scientist, and so are we!

We plan on staying in Houston for a few days to absorb some of the Houston Christmas culture, to spend a day with Cadge and Bob at the Houston Museum of Natural Science and to see the Houston Symphony production of The Messiah. 

We wish you all a very Happy Christmas and a Blessed New Year...our family and friends are truly  gifts in our lives, and we are sincerely grateful for each of you, your support and your love!

We arrived at MDAnderson in Houston on Sunday afternoon in preparation for labs, Brain MRI and  body CT scans on Monday.  On Tuesday Rusty saw the Melanoma team and got the results of the CT scans ... "stable...no definite evidence of progressive metastatic disease in the chest, abdomen or pelvis"!!!  WooHoo!!  The Melanoma team is feeling very positive about Rusty's status.

From there he had an appointment with the neuro-oncology radiologist who is managing the radiation necrosis in Rusty's brain.  The brain MRI  indicated that the inflammation is still decreasing and there is no evidence of recurrence of tumors and no new intracranial metastasis.  Once again... WooHoo!!

Rusty is still experiencing some involuntary twitching which the doc feels may indicate some very low level seizure activity, as well as some vision problems, short term memory loss and intermittent confusion.  These issues are considered "treatment related" (probably from the Gamma Knife radiation) but also may be related to Rusty's natural aging processes.  (Either way, it beats brain tumors!) He has a regular neurologist at MDAnderson who monitors these symptoms, and an ophthalmologist here in Corpus Christi to manage his vision.

After Rusty's regular immunotherapy infusion, we celebrated our good news with dinner at our favorite Italian Restaurant ...D'Amico's in Rice Village... and counted our blessings.

We're not too good with selfies to begin with, 

and a couple of glasses of spirits did not improve our photog skills!)

This MDAnderson visit was directly on the heels of two jewelry shows, the first on Friday at the Ortiz Center in Corpus Christi and the second on Saturday at Market Day in Hallettsville.  For both shows Rusty was almost back to his pre-cancer form - loading and unloading boxes, tables, displays and equipment and helping with sales.

We are immensely thankful for our many blessings - for health, for each other, for an amazing medical experience at MDAnderson, for our local primary physician, Dr. Gerry Boynton, for time, for faith, and always for the continued support, interest, help and love we receive from our family and friends.  Thank you and Happy Thanksgiving...we love you!   

   

October 23 visit to MDAnderson...we are reveling in these 28 day visit/trip intervals!  This visit was kind of a non-event.  No scans or testing other than routine labs and EKG - both of which were good.  The  Melanoma team is still pleased with Rusty's response to the immunotherapy.  He had his immunotherapy infusion after the visit with Melanoma team.  The infusion takes about 30 - 40 minutes and is administered in one of the Ambulatory Treatment Centers at MDAnderson - there are at least three such centers on the MDA campus. 

The Melanoma team feels that the minor confusion and processing problems Rusty is experiencing are due to last August's brain radiation, which was necessary to treat a growing brain tumor.  At the November visit he will have body scans and a brain MRI to assess status.  He will also see his radiation neuro-oncologist as well as the Melanoma team in November.

On our way up to the Melanoma Clinic we met and talked with a woman who is a 9 year survivor of stage four melanoma.  Rusty was very encouraged and up after hearing that.  He has an amazing will and is determined to make the most of each day. 

Last weekend one of Rusty's closest Marine Corps friends and his wife from our Yuma Arizona days came from Chicago to spend the weekend with us.  We had a wonderful weekend - lots of reminiscing, laughing, and a few Shiners.  Pictures below of Mike and Marsha as well as Rusty with all his hair and beard grown back.

Thanks again for all your support, love and prayers.  We both agree that we are blessed on this journey.

 

On the heels of two glorious weeks in the Pacific Northwest, we flew directly from Seattle to MDAnderson Houston for Rusty's regular monthly visit.  He had scans on Monday evening and visit with neurologist, visit with Melanoma team and labs on Tuesday.  The news is very good!

Scans show that there are no longer any tumors visible in Rusty's organs!  It seems that the immunotherapy is being effective in attacking the melanoma.  We were told that it could take over a year for the immunotherapy to ramp up and become effective - and so it has.  There are a couple of small, shrinking visible tumors in soft tissue, but Dr. Amaria (Rusty's primary Melanoma physician) is confident that they are not a problem...She is very pleased with the positive scan reports and plans to keep Rusty on the 28 day immunotherapy infusion schedule for the foreseeable future.

Cannot even start to express our gratitude ...to God, to Rusty's medical providers, and to all of you for your support, prayers and love.

More next month after our October visit.



 

After a lunch visit with Cadge and Bob in Richmond, we arrived in Houston for Rusty's regular monthly MDAnderson visit on Monday afternoon.  Lakeview RV Resort, where we stay, has a free shuttle that runs about every 1 1/2 in the morning and stops at all the major institutions in the Medical Center...it is a great benefit of this RV park since it relieves us of having to battle Houston morning traffic and saves us parking costs.

Waiting for the shuttle

Other than routine labs, which results "look good", Rusty had no other diagnostics on this visit.  He met with the melanoma team, including Dr. Amaria, and they were positive in their assessments and comments.  He was cleared for his immunotherapy infusion and heartily encouraged to undertake the travel we are planning for later in the month.  We are planning a trip to the Pacific Northwest to visit John and Tracy, Jacob and Jess, and our great grand, Julian Austin (Jude), who is now 15 months old.  We also plan to spend some time exploring the area.

Finishing up Tuesday's infusion

We return in a month for scans, team visit and treatment.  At that point it will have been 21 months since Rusty's dire diagnosis - we still feel incredibly blessed, still treasure every day, and are so grateful for the support, caring, understanding, and prayers of all of you.   

On Monday and Tuesday, Aug 13 and 14 Rusty had interim appointments at MDAnderson to assess the status of the brain lesion that was problematic after the gamma knife surgery.  The lesion was treated with a potent infused drug over two months in April and May.  Yesterday (Monday) he had labs and a brain MRI,  and today (Tuesday) we saw the neuro-oncology radiation team. 

Good news.  The lesion has stablized and there is no new necrosis or inflammation.  While the tumor that was irradiated is still present, it is "dead".  The team feels that Rusty has improved in his appearance and his cognitive and motor competencies, and they are happy with his status.  They will check him again in two or three months. 

In the meantime he is getting physical therapy three times a week to help with balance and stamina.  The therapy seems to be helping, although Rusty is impatient and wants much faster results!  As if all of this were not enough, he had some major dental work here last week for problems under two old crowns...it went smoothly and was relatively painless, thank goodness.  He will get his new crowns next week.

We return to MDAnderson at the end of August for appointments with the Melanoma team and an immunotherapy infusion. 

We're feeling very blessed, grateful and happy with the today's news.  Thank you for the prayers, love, support and good wishes!       

  

At the RV Resort pool after a day at MDAnderson Cancer Center

It has been a month since our last visit to MDAnderson, and the time at home without Houston travel was lovely.  We gave it our best effort but were unable to catch up on all the neglected yard work and house maintenance...fun trying though!  We did catch up on visits with family, friends and local activities.

Today's MDAnderson visit was positive again.  Lab work good, melanoma team and doc happy with Rusty's improving condition, and immunotherapy infusion without problem.  The mediport Rusty now sports means that he does not have to have venipunctures for lab work and infusions...he is thrilled with the "no stick" program!

Finished early enough today to rest and relax at the RV park before heading home tomorrow.

A bright spot in our travel back to Corpus Christi tomorrow will be a stop in Richmond for a visit with My nursing school roommate, Cadge Morley, and her husband Bob.  They have just moved from Tennessee to Richmond, Texas where they will be closer to their daughter Karen and her family. 

We'll be back up here in two weeks for another follow up with the neuro-oncology radiation team who performed Rusty's Gamma Knife surgery last August.  After that, Rusty's visits are expected to be monthly.

 

Written on Tuesday afternoon...

After a grueling nine hour trip over to Houston Monday, the gods of cosmic justice repaid Rusty with GOOD NEWS yesterday!  His CT scan revealed that all tumors have again decreased and some that were visible three months ago have are now not visible!

Our trip over was complicated by a two and a half  hour delay getting out of Corpus Christi while a tractor trailer accident on the Nueces Bay Causeway was cleared, and then again by three restroom breaks, a lunch break and a gas stop.  We got into the RV park and started setting up the cords, hoses, etc. at about 8:30 PM...

Tuiesday's early morning labs, CT scan and medi-port evaluation all went smoothly.  Visit with melanoma team was a real upper!  They related the improved CT results, commented favorably on the lab results and told us that their plan now is to see Rusty only once a month now for evaluation and a maintenance “Opdivo” (Nivolumab) immunotherapy infusion.

Celebrating welcome news with a sinful lunch at the Rotary House

Rusty is also to start physical therapy at home to work on balance and stamina.  We have a good friend in Corpus who is a wonderful therapist, so he’s looking forward to the therapy.  He is still having periods of confusion and short term memory loss, but they are less frequent.

All the worrisome issues from last visit are in resolution.  The cardiology diagnostics were unremarkable, and our local prinary doc, Dr. Boynton, is managing the blood pressure and fluid retention problems which are most likely a result of some of the chemo Rusty has received.  Blood counts are slowly returning to normal, and his hair and beard are starting to grow back!

Today was the first immunotherapy infusion of this regime and we are on the infusion unit as I write this.  Rusty is catching up on some z’s and I’m just resting from doing my happy dance!

We had hoped to go to the Houston Symphony Independence Day concert in the Woodlands this evening, but it's been a busy 12 hour day with appointments and we are both feeling the need for a quiet evening and an early bedtime.  Home tomorrow and back in a month...praise God!

Good news and bad news on our visits to MDAnderson yesterday...

The brain MRI Tuesday morning showed that the necrosis in the brain has all but disappeared.  The neuro-oncology radiation team is very happy with Rusty's response to the infusions of Avastin.  They will check him again in six weeks.

Blood pressure was very high at each clinic visit today, he is a little short of breath and is retaining some fluid, so the melanoma team recommended cardiology evaluation and echocardiogram. Rusty has a cardiologist in Corpus, so we will follow up with him.

Blood count is almost back to normal, but chemo infusion was cancelled today because of low platelet count.  They plan on starting maintenance treatment infusions with immunotherapeutic agent in three weeks.  At that time they also plan to do "staging" scans...scans which reveal the extent of melanoma remaining in the body.

Thursday morning, Rusty will have a "port" inserted into his upper chest, locally at a Corpus Christi hospital.  The port will allow infusions and medications to be given intravenously without the need to start an IV in a vein each time...medical personnel will simply access the port.

We celebrated my birthday with lunch today on the way home from Houston...Baytown Seafood in Van Vleck - yum. 

We will be back in Houston in three weeks...just in time to celebrate July 4th on the road!

NASA display in the Pavilion Lobby at MDAnderson

We traveled to Houston from Hallettsville on Sunday, after doing a good Hallettsville Market Day on Saturday. Monday was a day off at the RV resort in Houston...we did some world class vegging.

Today, after lab work and IV start, we saw Dr. Amaria, Rusty's primary Melanoma physician.  He was cleared to have his final infusion of Avastin, the drug to treat the radiation necrosis in the brain, and otherwise she said that Rusty "looks good".  The plan at this point is to do a brain MRI in three weeks and to see Dr. Chung, the radiation neuro-oncologist to evaluate the the success of the four Avastin infusions in treating the necrosis.

Dr Amaria also plans to see him on that day (June 12), and will make a determination about additional chemo treatments with Abraxane, a chemotherapeutic agent used to treat melanoma.  The infusion was given...took about an hour...and we did a little shopping, then back to the trailer where Rusty crashed at 8 PM....he's always tired after these days of walking, waiting, and getting stuck.

In general, he feels pretty good.  He does tire easily in the hot weather, but is able to do repairs around the house, take care of the yard, truck, car and trailer and to help around the house.  He has times of confusion and memory lapses which we attribute to "chemo brain", a somewhat common, temporary condition of many folks being treated with chemotherapeutic agents.  Rusty gets frustrated by that and by the fact that, since he had a seizure in April, he is restricted from driving for six months, but his attitude is mostly positive.

Headed home tomorrow morning. No pix this time,....I forgot to shoot some...sorry.   We'll be back in three weeks.  Keep storming heaven with prayers for us (in the words of Ruth Baltz.)...and thanks.

First, we want to thank our next door neighbor, Max Britton, for voluntarily taking care of our yards when we are out of town!  A true good neighbor and a great help to us. 

On Saturday, Cinco de Mayo, we did our regular gig at the Wimberley Market and had an active sales day.

We took a day off Sunday in Wimberley before heading over to Houston on Monday.

Sugar Shack Bakery after church on Sunday 

Entrance to Mr. McDonald's farm on Green Acres Road in Wimberley

After our Monday trip over to Houston, we started appointments early Tuesday, and had lab work followed by infusion of the drug to treat the necrotic brain lesion...uneventful day.  We were through by noon on Tuesday and returned to Corpus Christi that afternoon.  Rusty is feeling good and is less fatigued.  We return to MDAnderson in two weeks and will see the melanoma team then.  Please keep us in your prayers.

We traveled back into Houston from Galveston yesterday.  Today (Tuesday) after lab tests, Rusty met with the Melanoma team.  At this point they feel that Rusty is stable.  They are pleased with lab results and plan to administer one more infusion of the chemo targeting the melanoma.  There will be three more infusions of the drug targeting the necrosis in the brain.  The primary melanoma doc, Dr. Amaria, feels that she does not need to see Rusty now for a month, however he will come back in two weeks for labs and chemo treatment.

We had a restful, if chilly, few days in Galveston.  No beach weather, but in addition to vegging out, we visited some of our old Galveston haunts.  Jeff received his undergraduate degree from Texas A&M Galveston, and little has changed since the mid 90's.  We explored the Galveston Island State Park,  visited Moody Gardens, visited the 21 Ave. Pier, and took the ferry to Bolivar Peninsula for the day.

Mary Goering,  our dear artist friend, and her husband Homer were in town doing a show at Galveston "Featherfest", so we got to visit and break bread with them a couple of times.  I've posted a few Galveston pics below - every trip and every adventure are a blessing.

   

We traveled back to Houston on Sunday afternoon and Monday Rusty had lab tests and an EEG (Electroencephalogram...a test to analyze brain waves) in preparation for an appointment with the neuro-oncologist.  He has had no further seizures since leaving the hospital last Sunday.

Monday evening we saw Bill Murray (yes, THE Bill Murray) and cellist Jan Vogler in a delightful performance at the Houston Symphony.  Actually, I thought it was delightful...Rusty thought it was meh.

Tuesday morning (today), Rusty met with the neuro-oncology team.  The news was good.  Brain waves indicate that there is less erratic activity at the site of the brain inflammation which probably indicates that the infused medication Rusty is receiving for the necrosis is being effective.  That medication will be given every two weeks for a total of four doses.  The next infusion is a week from today.  In addition to the infused medication to treat the brain lesion, Rusty is taking anti-seizure medication daily.

After leaving MDAnderson, we celebrated at Ben and Jerry's.  Rather than travel back to Corpus Christi tomorrow and then return on next Monday, we are going to drive over to Galveston, about an hour away,  and veg out in a campground on the beach for five days.  We'll be back at MDAnderson next Tuesday for Rusty to meet with the Melanoma team and have the next infusion.

 
Rusty has asked me to let you all know that he appreciates and thanks you for the support and love you have shown for him and for our family.

Since my last post, Rusty had a very specialized MRI which confirmed that the inflammation in the brain was  indeed "avascular necrosis."  The physicians planned on starting an infusion of the chemo to treat this problem on Friday, but Rusty's blood pressure was too high to proceed.  For Friday and Saturday, they worked to lower his blood pressure.

Jeff came up on Thursday evening...and was a great help and comfort for both of us.  I feel more comfortable leaving to go back to the camper to shower and rest when he is there, and Rusty appreciated having company to watch the Masters with.

Watching the Masters tournament 

Nicole, Abby and Theo came up on Friday evening to cheer all of us up, and left early Sunday afternoon for the trek back to Corpus....after a visit to an upscale Houston toy store.

  

Finally on Sunday afternoon, the pressure was low enough to administer the chemo.  Within an hour after the infusion finished, Rusty was discharged, and the three of us dropped off a few things at the camper and headed to D'Amico's for Italian comfort food and drink!

We plan to travel back to Corpus tomorrow, and we have appointments to return weekly for the next two weeks. 

Short blog to update on seizure related hospitalization.  Just received results from three days of intensive testing, scanning, etc.  The inflammation in Rusty's brain whch triggered the seizures, appears to be caused by "avascular necrosis", ...or dying cells, in the area of the brain treated with gamma radiation. It is treatable with a chemo agent.  First treatment will start today in the hospital.  Subsequent treatments will be every two weeks for a total of eight treatments.  In the meantime, he will still receive one more dose of the chemo for melanoma.  Needless to say, we are relieved on two fronts...first, no apparent recurrance of brain tumor, ...and second, we are dealing with a treatable problem.  Prayers are answered, and God is watching over us.

Update to yesterday's sunny news.

As we were preparing to leave Houston this morning, Rusty had a seizure...first one since January and more severe than any previous seizures.  Ambulance ride into MDAnderson ER...teams of neuro specialists, CT scan, MRI, EEG, EKG, x-ray and multiple physician exams.  It appears that there is some inflammation in the brain...hopefully the MRI will be more definitive regarding the nature of the inflammation.  In the meantime, Rusty will be admitted this evening for 3-4 days, they have increased his seizure medication and have started steroids to decrease the inflammation.

Prayers please.

After a moving Easter Sunrise Service on the beach, and an Easter egg hunt at our house for Jeff's children, we traveled to Houston for April 2 and 3 appointments.

The last of Rusty's four scheduled chemo / immunotherapy treatments was March 13.  The appointments on April 2 and 3 were to determine the status of the cancer and the effectiveness of the treatments.  CT scans, heart diagnostics and blood work Monday were followed by more testing and a visit with the melanoma team Tuesday.  Good News!  The scans indicate "significant improvement" (words on scan report) in tumors in chest, abdomen, pelvis and leg!  Some tumors previously visualized are so diminished as to no longer be measurable.   We are so grateful!  The melanoma team  is happy with the response to treatment, and has decided to do at least two more chemotherapy treatments, one today and one three weeks from today, then stop the treatments for awhile and keep assessing status.

                                         

Navigating the MDAnderson campus by shuttle

In general, Rusty feels better .  Even thought he is still anemic according to the lab work, he has somewhat more energy and stamina than last month.   He is able to do a little work in the yard, in his workshop and on the truck.

 

Jeff and Rusty installing toolbox in new truck

Spring is bustin' out all over Houston!  The weather is beautiful, the trees are in full leaf , and flowers are everywhere on the MDA campus!...a fitting environment for healing and for spiritual distraction from the worries of cancer and its treatment.

We will be coming back on April 16 and 17 for  diagnostic brain studies (MRI and EEG), to visit with the neuro-oncologist, and  to have an additional follow-up visit with the radiation neuro-oncologist who performed the gamma knife surgery.

These two MDA days have started at 5 AM and finished at about 6 PM...we are both pretty beat.  Tomorrow we are headed, with the RV, from Houston to Blanco State Park in the Hill Country for some R&R on the river for a couple of days, then on to Wimberley for our regular monthly Market Days gig.  We plan to be back home on Sunday April 8.

Thank you SO sincerely for your prayers, good thoughts, messages, cards, faith and love!  I think it "takes a village"...and we are blessed to have the best village in the world!

March 12 and 13 routine visit to MDAnderson.  Monday was travel day to Houston and Rusty had lab tests and a brain MRI in the late afternoon.  Afterwards we unwound at happy hour in the MDAnderson Rotary House....the singer was delightful!
   

Tuesday he had 5 appointments including more diagnostics, 2 doctor appointments and a chemo treatment.  Melanoma team is pleased with his condition at this point.  The mass on his back seems to be much smaller, presumably due to the chemo.  His blood count has improved and he has more energy and stamina.  We expect that to dip again 7 to 10 days after a chemo treatment, but he seems to be bouncing back nicely. 

Follow up appointment with the Gamma Knife radiation team which reports some swelling at the site of the August gamma knife procedure...not uncommon, according to the doc.  They will watch Rusty closely, do a repeat MRI in April, and treat with steroids if necessary.  They believe that it is "post-treatment" related and not new tumor growth.

Last appointment of the day was the final chemo treatment in this cycle.  In three weeks he will have CT scans to determine status of the cancers.  At that point, melanoma team will decide what comes next.

Rusty's primary melanoma physician, Dr. Rodabe Amaria, has been incredibly wonderful since we first met her 15 months ago.  Not only is she super smart, competent, and compassionate, Rusty trusts her completely.  She so "gets" Rusty...his humor, his intellect, his philosophy and his needs vis-a-vis this disease.  More than once she has commented favorably on his suspenders, which are a regular part of his attire.  At this visit he presented her with her very own pair of suspenders - Dr. Amaria beamed when she opened the package and there followed much laughter, joy and picture taking in the clinic.  It was a happy time...There truly are blessings in this journey!

We will return in three weeks for "staging" scans.  More then....

   

At Rusty's request, we are continuing to do our scheduled jewelry travel and shows, so prior to our Houston visit on Monday and Tuesday, we were in Hallettsville (about three hours from Corpus) for the February Hallettsville Market Day.  Hallettsville is now the third largest Market Day in Texas, after Canton and Wimberley, and they have a great RV Park right on the grounds!  Good sales and good time.

From Hallettsville we went directly over to Houston for routine appointments at MDAnderson.  The tumor mass in Rusty's leg has shrunk so that it is no longer palpable, so the team believes that the new chemo is being effective.  There is however, a new tumor mass in Rusty's upper back.  They will keep a close eye on the new mass, and are hoping that it too will respond to the new chemo, which includes an immunotherapy component.

Rusty had his chemo and immunotherapy infusion Tuesday afternoon.  It is a rather lengthy procedure because he also receives an anti-nausea infusion and each drug has to be given individually...they cannot given at the same time....Rusty usually sleeps through the infusions and I knit, read or walk the halls visiting gift shops.  These drugs really knock Rusty for a loop...he is very fatigued for the first week after infusion, and has little energy or motivation.  Red blood count dips low and blood transfusion may be necessary.  This was the third of four of these treatments.  He has been fortunate that, thus far, energy depletion has been his most serious side effect.

We left Houston Wednesday morning and came over to Bulverde, just north of San Antonio in the hill country.  On Saturday, I have a metalsmithing Master's Class here with a nationally known metal stamp artist.  We are in a rustic RV Park where we hope to have some R and R for a couple of days.

We plan to be back in Houston in three weeks...just in time for the throngs of folks in town for the Houston Rodeo.  Please know how much we appreciate your concern and support.

Back at MDAnderson yesterday and today for our three week routine visit.  On the prior protocol our visits were every two weeks and on this new protocol, visits are every three weeks for four times, then they will re-evaluate.  The new protocol, a chemotherapeutic agent "Abraxane" and an immunotherapeutic agent, "Ipilimumab", have, within two weeks of the first dose, caused Rusty's hair and beard to fall out...he is now a doppelgänger for his late father, John, and his son, John!

In scrubs (his "doctor suit") waiting for imaging.

CT scan yesterday revealed a cluster of melanoma tumors in the left thigh which, according to lab results and decreased pain levels, are responding well to the chemo.  He was assessed for possible radiation to the thigh, but the consensus is that since the chemo appears to be effective, and since radiation is palliative only, they will not do radiation at this point.

Rusty also had a brain MRI yesterday in preparation for a follow up visit with the neuro-oncology radiologist who performed the Gamma Knife surgery for two brain tumors in August.  One tumor is gone and the other has slight inflammation..."treatment related".  They will continue to follow and will repeat MRI in six weeks.

It is so reassuring to know that all these treatment teams communicate with one another during the days that we are here.  Each one confers with all the others prior to determining a course of treatment.

Generally, Rusty feels pretty good.  No more seizures since seizure meds were adjusted.   He has some intermittent short term memory loss and he is frustrated that he is not allowed to drive because of the seizures.  Fatigue limits his activities and is caused, in part, by the effects of bone marrow depression from the chemo.  He was reassured today that, once the chemo is finished, some of these issues should return to normal or almost normal.  The staff continually reminds him that he is 77 years old and should adjust his expectations accordingly.

When we leave Houston tomorrow we are heading east to Sabine Pass to spend a few days camping at Sea Rim State Park...exploring, walking, watching sea birds and taking long naps.  We'll be back at MDA in three weeks.  

As always, your interest, prayers, love and support sustain and comfort us.  Thank you.

Back up to MDAnderson yesterday afternoon to prepare for visits today (January 9). We had some anxiety because, since the encephalitis episode, Rusty had been withdrawn from the Clinical Study protocol, and we were sure about what the new recommendations for treatment might entail.  Since we had been told three weeks ago that there were new tumors, we were afraid that we might have to make some difficult choices...i.e. Quality vs quantity of life.

Happily, that was not the case.  The Melanoma team recommended a new, different combination of IV chemotherapy and immunotherapy.  Pending Rusty's consent it was scheduled to start today.  The chemo is intended to shrink or obliterate existing tumors, including the one in his leg which has limited his mobility.  The immunotherapy is intended to boost the immune system so that it recognizes and attacks tumors.   Immunotherapy takes some time (weeks or months) to be effective, but the chemo is expected to work immediately. Discussion of possible side effects was a little scary, but Rusty is very ready to begin the new regimen, and side effects do not happen in all cases.  There will be four cycles of the drugs, three weeks apart, then a series of scans to determine status.

 Jeff was with us again for this visit and the three of us were very relieved and grateful.  Rusty had the first of the chemo and immunotherapy infusions today, and we'll come back in three weeks for the next round.

Rusty and Jeff back at the travel trailer with take out ribs from Pappa's Barbecue.

Thank you for your prayers, messages and support.  I'll post again when there are changes or when we come back in three weeks.