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.