On 11/3/2010 11:29 PM, Don Foreman wrote:
I have friends here that care, other readers please ignore.

We were at Mayo Monday and Wednesday.

We now have a course of action and treatment.

Diagnosis is 99% sure that Mary's disease is primary light-chain
amyloidosis involving her heart and gut. The 1% doubt that will be
resolved with lab results not yet available concerns the particular
form of the disease but it's really a matter of i-dotting and
t-crossing confirmation of other diagnostic results.

This is an incurable disease, a form of cancer. It's akin to leukemia
in that it involves white blood cells, different in that it involves
different white cells.

It's rare, 8 people per million rare. Nobody knows more about it
than Mayo. It is a very difficult disease to treat because it has
many dimensions and manifestations, and interactions with other
issues like cardiac, gastrointestinal and all other organs though
Mary's issues at present are cardiac and GI.

Because there is clearly cardiac involvement and damage, sudden death
by heart failure is more probable than for a person without such
damage. We agree that sudden death by heart failure or whatever
purely beats the hell out of a lingering death fraught with pain.
Neither of us wants to survive the other. We've been teammates since
forever. We each and both are a bit selfish in not wanting to be a
grieving survivor, and we share a sense of humor about that. It's a
bad idea to **** my Mary off, but she does appreciate a good joke.

We think we have top-notch professionals in hemotology, oncology and
cardiology on Mary's team.

An initial chemotherapy regimen has been defined, which Mary will
begin immedately. Meanwhile, the cardiologists will try to manage
the conflicting issues of low blood pressure (hence seriously
diminished physical capacity) vs edema, vs side effects from the
chemo.

Mary's sense of humor is undiminished.

The cardiologist of late appointment today, upon first encounter with
Mary, noted discoloration of her nose. What up with that? I
paraphrase, the cardiologist was Indian, not Afro. Anyway, Mar
noted that a fellow patient in an aside in the waiting room said "I
sure hope you're having a better day than I am." The guy was 79 and
we think that he received some very bad news about either himself or
his wife but probably himself (the self-centered asshole!) I'd
noticed the despair in this man when he plopped into a chair in the
waiting area but I didn't observe the interaction between him and
Mary. Mary had cried a bit for him so her nose was red.

Why do I love her so?

We noted this evening that Rochester is 90 minutes bed-to-bed. That's
an easy commute. We'll probably be doing that with some frequency.



Hey, you never know how these things will turn out. I know a guy, in his
early fifties that had cancer. It was bad, real bad. No one really knew
how to even treat it. He went to all kinds of doctors and they just
didn't know what to do. Eventually he went to a specialist in Spokane,
Wa. They treated him in a way I've never heard of before. The doctors
told him that his internal organs were all covered with cancer. The way
they handled his case was to operate on him and remove all his internal
organs and physically scrape away all the cancer and then put them back
in. When I heard this I figured he was history. That was about a month
ago and he's still alive. I have no idea what will happen but he's not
dead yet. So keep that in mind. You just don't know how medical things
are going to turn out. There is still a part of medicine that is an art
and a part that is just plain luck. I guess all you can do is get the
best doctors you can and hope for the best. Because you never really
know how things are going to play out. So I wish you luck.

Hawke