Sunday, May 31, 2009

May Exits; Summertime Draws Nigh


Photograph Copyright Stacie

Lil Man Update

Thank you for your prayers for Lil Man. He is much improved today. I am grateful that we serve a God who hears our prayers and Who helps us when there is nothing we, as humans, can do.

Friday, May 29, 2009

Please Pray for our Lil Man

Our grandson, Lil Man, is the sickest he has been in his 8 months. He has a very high temperature and is breaking out in a rash. It is heartbreaking to see our precious grandson who is always so healthy, feeling so poorly.

I know God has His hand upon Lil Man. Please take time to pray for him to have a speedy recovery and pray that he will feel better in no time at all.

With gratitude!

Thursday, May 28, 2009

THE Treatment Plan for 2009

RITUXAN
Over the past 12+ years with leukemia, I have used the monoclonal antibody drug, Rituxan on four occasions. The first exposure resulted in a near-fatal reaction. It was the only time I was pushed on a stretcher with people running me to ICU. After the completion of that round of treatment, I was covered in a head to toe rash (that itched something fierce) for six weeks. The second and third exposures to Rituxan resulted in a case of pneumonia and need for Red Blood Cell transfusions. My last use of Rituxan was in 2004. I developed five infections associated with that treatment and spent almost two weeks in ICU.

Despite this past history, in my heart and through my research, I believe it remains the safest treatment option for me. To learn more about Rituxan go to: http://www.rituxan.com/lymphoma/hcp/index.m

In addition to receiving this treatment for eight weeks, combined with my long list of supplements, there are a few prescription drugs that will be engaged to boost the effectiveness of this drug and to help prevent reactions.

NEUPOGEN
Most of you are aware that I have been chronically neutropenic since early 2009 (the cause of the serious fungal infections, in my humble opinion). I have been taking Neupogen every 7-10 days in an attempt to maintain a neutrophil count outside of neutropenic levels. This enables my body to fight serious infections, especially life-threatning gram negative infections and septicemia.

Additional benefits of Neupogen have emerged in relation to Rituxan treatments. I will be taking these injections to treat ongoing neutropenia and to help battle ongoing infections. I also will be taking it to prevent Rituxan-induced neutropenia. Review these abstracts to see what potential new benefits might be derived for me as I combine Rituxan with Neupogen.

Phase 3 Study Shows First-Cycle Administration Of Neulasta Significantly Lowers Incidence Of Infection And Hospitalization

Amgen Inc. (Nasdaq:AMGN), the world's largest biotechnology company, today announced data from a Phase 3 study showing that administration of Neulasta(R) (pegfilgrastim) in the first and subsequent cycles of chemotherapy significantly lowers the rate of infection, as manifested by febrile neutropenia (low white blood cell count with fever), hospitalization and the use of intravenous anti-infectives in breast cancer patients receiving moderately myelosuppressive (strong) chemotherapy. The results will be presented by one of the study's lead investigators, Lee Schwartzberg, M.D., medical director of The West Clinic, Memphis, Tenn., in a plenary session tomorrow at the Multinational Association of Supportive Care in Cancer (MASCC) Annual Meeting. (MASCC Abstract #A-52)"This study provides compelling evidence that administering Neulasta in the first and subsequent cycles of moderately myelosuppressive chemotherapy can significantly reduce the risk of potentially life- threatening infections that can result in hospitalizations and require IV antibiotics," said Schwartzberg. "Approximately 600,000 chemotherapy patients are at risk for developing neutropenia, which has traditionally been treated reactively. Doctors usually reserve proactive use of Neulasta for only those patients considered at very high risk of developing chemotherapy-induced neutropenia."Data from the randomized, double-blind, placebo-controlled study of 928 patients show that first and subsequent-cycle administration of Neulasta resulted in a 94 percent reduction in the incidence of febrile neutropenia, a 93 percent reduction in the incidence of hospitalization and an 80 percent reduction in the incidence of intravenous anti-infective use in patients previously considered at moderate risk for neutropenic complications.Specifically, one percent of patients in the Neulasta arm (6/463) developed febrile neutropenia compared with 17 percent of patients in the placebo arm (78/465). Neulasta was also associated with a significantly lower incidence of hospitalizations with one percent of patients (6/463) requiring hospitalization versus 14 percent of patients receiving placebo (64/465). Two percent of patients in the Neulasta arm (7/463) required intravenous anti-infectives versus 10 percent of patients in the placebo arm (48/465). Febrile neutropenia occurred most often in placebo patients during the first cycle of chemotherapy (65 percent). There were two deaths from septic shock on the placebo arm compared to zero in the Neulasta arm."This study may give physicians the evidence they need to help protect cancer patients from chemotherapy-induced neutropenic complications beginning in the first cycle of chemotherapy treatment," added Schwartzberg.Breast cancer patients (Stage 1-4; ECOG performance of 0-2) receiving 100 mg/m2 docetaxel every three weeks for up to four cycles were randomized to receive either 6 mg Neulasta (n=463) or placebo (n=465) once-per-cycle on the day after docetaxel administration for up to four cycles. Docetaxel is associated with an average reported febrile neutropenia incidence of approximately 10 to 20 percent in the absence of growth factor support. Febrile neutropenia was defined as a temperature greater than or equal to 38.2 degrees C and an absolute neutrophil count (ANC) less than 0.5 x 109/L measured the same day or the day after fever was documented.Neulasta was well-tolerated in this study. Bone pain was the most frequently observed adverse event in both arms of the study (31 percent with Neulasta versus 27 percent with placebo). A lower percentage of serious adverse events were reported for Neulasta patients compared with placebo patients (12 percent versus 24 percent); this difference was attributable to the lower percentage of febrile neutropenia events reported in Neulasta patients compared with placebo patients.

Leukemia. 2003 Aug;17(8):1658-64.
Treatment of relapsed B-cell non-Hodgkin's lymphoma with a combination of chimeric anti-CD20 monoclonal antibodies (rituximab) and G-CSF: final report on safety and efficacy.

van der Kolk LE, Grillo-Lopez AJ, Baars JW, van Oers MH.Department of Hematology, Academic Medical Center, Amsterdam, The Netherlands.

Antibody-dependent cellular cytotoxicity (ADCC) is one of the possible mechanisms of action of the chimeric CD20 monoclonal antibody IDEC-C2B8 (rituximab). As granulocyte-colony stimulating factor (G-CSF) greatly enhances the cytotoxicity of neutrophils in ADCC, the efficacy of rituximab might be enhanced by the addition of G-CSF. In a phase I/II clinical trial, we investigated the safety and efficacy of the combination of rituximab and G-CSF (5 microg/kg/day, administered for 3 days, starting 2 days before each infusion) in 26 relapsed low-grade lymphoma patients. Adverse events occurred in 25/26 patients and mainly consisted of (grade I/II) fever (29%) and allergic reactions (19%). In phases I and II (375 mg/m(2) rituximab+G-CSF), 19 patients were evaluable for efficacy. The response rate was 42% (8/19; 95% CI 20-67%), with 16% (3/19) complete remissions and 26% (5/19) partial remissions. The median duration of response was 18 months, the median time to progression was 24 months. We conclude that the combination of rituximab and G-CSF is well tolerated. Although the overall response rate seems comparable to that reported for rituximab monotherapy, remission duration in this pilot phase II study is remarkably long. Randomized comparison with rituximab monotherapy should substantiate this promising finding.
PMID: 12886256


Clin Cancer Res. 2003 Dec 1;9(16 Pt 1):5866-73.
Neutrophils contribute to the biological antitumor activity of rituximab in a non-Hodgkin's lymphoma severe combined immunodeficiency mouse model.

Hernandez-Ilizaliturri FJ, Jupudy V, Ostberg J, Oflazoglu E, Huberman A, Repasky E, Czuczman MS.Department of Medicine, Roswell Park Cancer Institute Buffalo, New York 14263,
PURPOSE: Rituximab is a chimeric antibody (Ab) directed against the cluster designated (CD) 20 antigen found on normal and malignant B cells. Rituximab activity has been associated with complement-mediated cytotoxicity, Ab-dependent cellular cytotoxicity (ADCC), and induction of apoptosis. Recent studies performed in severe combined immunodeficiency (SCID) mouse models suggest that in vivo rituximab-associated ADCC is mediated via the FcgammaRIII receptor on effector cells. Despite low level expression of FcgammaRIII, neutrophils are also known to induce ADCC primarily via FcgammaRI receptor (CD64). The purpose of this work was to study the effect(s) of neutrophils on the in vivo antitumor activity of rituximab.
EXPERIMENTAL DESIGN: To better characterize the biological activity of rituximab, we used a human non-Hodgkin's lymphoma animal model by injecting Raji cells i.v. into natural killer (NK) cell-depleted SCID mice. Disseminated disease involving liver, lung, and central nervous system developed, with subsequent death occurring approximately 3 weeks after tumor inoculation. Specifically, 6-8-week-old NK cell-depleted SCID mice were inoculated by tail vein injection with 1 x 10(6) Raji cells on day 0. The animals then were divided into three cohorts: (a) group A received placebo (PBS); (b) group B received rituximab administered via tail vein injection at 10 mg/kg on days 3, 5, 7, and 11; and (c) group C consisted of neutrophil-depleted SCID mice treated with rituximab at 10 mg/kg on the same schedule. Neutrophils were depleted by i.p. administration of 80 microg of rat antimouse Ly-6G (Gr-1) Ab (BD PharMingen, Inc.) on days -1, 4, 9, and 14. The end point of the study was survival. Differences in outcome between treatment groups were analyzed by Kaplan-Meier methodology.
RESULTS: Neutrophil- and NK cell-depleted SCID mice (group C) did not respond to rituximab, and the mean survival time was not significantly different from that of control mice. NK cell-depleted SCID mice with intact neutrophil function (group B) responded to rituximab, and 66% remained alive and appeared healthy after a mean follow-up period of 246 days. Overall, NK cell-depleted SCID mice with intact neutrophil function treated with rituximab had statistically longer mean survival as compared with mice in neutrophil-depleted and control groups (161 days versus 28 days versus 22 days, P=0.003).
CONCLUSIONS: In the absence of neutrophils, rituximab was less effective in controlling lymphoma cell growth or prolonging survival in our B-cell lymphoma SCID mouse model. Neutrophil-induced ADCC appears to contribute to the in vivo antitumor activity of rituximab. Strategies that improve the function of neutrophils, such as granulocyte-macrophage colony-stimulating factor or G-CSF priming, may increase the antitumor effects of rituximab. Additional in vivo animal studies are warranted.PMID: 14676108

SINGULAIR
Singulair is used by asthma patients, including me. This research impressively demonstrates that it might have value to leukemia patients.

The Leukotriene Receptor CysLT1 Is Involved in Migration and Survival of Chronic Lymphocytic Leukemia (CLL) Cells: Potential Role of CysLT1Antagonists in the treatment of CLL

Andreas M. Boehmler, Gabriele Seitz, Tina Wiesner, Lothar Kanz, Robert Mhle Department of Medicine II, University of Tbingen, Tbingen, Germany

G protein-coupled receptors (GPR) mediate chemotactic and proliferative effects in both normal and malignant hematopoietic cells. CysLT1, a GPR for a subgroup of lipid mediators (cysteinyl-leukotrienes), is involved in inflammatory reactions such as allergic asthma, but its ligands are also released in the bone marrow by stromal and endothelial cells similar to the chemokine SDF-1. In RT-PCR analyses, we now demonstrate expression of CysLT1 in the CLL cell lines EHEB and MEC-1, as well as in CD19+ cells isolated immunomagnetically from the peripheral blood of patients with B-CLL. Stimulation of CLL cells with the natural CysLT1 ligand cysteinyl leukotriene D4 (LTD4) resulted in a sustained effect on the cytoskeleton with a 37.8% increase in the concentration of filamentous actin. In transmigration experiments throughfenestrated polycarbonate membranes (pore size: 5 M), CLL cells responded positively chemotactic to LTD4, with an increase in the total number of transmigrated cells of up to 6-fold as compared to carrier alone. In addition, the CysLT1 receptor antagonist MK-571 drastically decreased the in vitro survival of primary CLL cells as well as of CLL cell lines. Interestingly, antiproliferative effects were seen at receptor antagonist concentrations (low micromolar), which could potentially be achieved by oral treatment in vivo. We conclude that expression of CysLT1 may contribute to bone marrow tropism of CLL cells and their maintenance in the hematopoietic microenvironment. More important, the highly antiproliferative effect of CysLT1 receptor antagonists, which are currently used only in asthma therapy, might offer a new approach in the therapy of CLL.

CIMETIDINE
Cimetidine is a multi-tasking drug. I take it to help control reflux disease. In turn, my treating the reflux, my asthma improved. Then we discovered through consultations with allergists that Cimetidine is an h-2 antagonist and can help to prevent drug reactions. Clinical research has now demonstrated that Cimetidine can improve Natural Killer Cell activity in leukemia patients. And all for a $5.00 co-pay. This might be the deal of the century.
Cimetidine modulates natural killer cell function of patients with chronic lymphocytic leukemia.
Allen JI, Syropoulos HJ, Grant B, Eagon JC, Kay NE.
Peripheral blood natural killer (NK) activity in patients with B-cell chronic lymphocytic leukemia (B-CLL) is frequently low or absent. Because cimetidine (a histamine-2 antagonist) has been shown to alter human lymphocyte function in vitro, we decided to study cimetidine's effect on peripheral blood NK activity of patients with B-CLL and controls. We administered cimetidine orally (1.2 gm per day) to seven patients with B-CLL and 12 controls for up to 28 days. Peripheral blood NK activity of patients with B-CLL rose from a pretreatment level of 0.7 +/- 0.5 (mean +/- SEM) lytic units/10(6) cells (LU) to 8.7 +/- 2.4 LU (P less than 0.05) at day 28. Peripheral blood NK activity of controls decreased after 14 days of cimetidine treatment but returned to pretreatment levels by day 28. When peripheral blood cells from controls were exposed to cimetidine during in vitro incubation (10 micrograms/ml), mean NK activity was increased at 48 hours (54% +/- 22% increase over controls, n = 5, P less than 0.05). Single cell cytotoxicity assays revealed increased killing of target cells (but not effector-target conjugation) with cimetidine-exposed effector cells. These data suggest that cimetidine may be useful to augment peripheral blood NK activity for patients with B-CLL.
PMID: 349331

"Supplemental" Support

Alternative medicine has its fans and its critics. I have discovered in the past decade that alternative treatments are more heartily embraced in countries other than the United States. I have used alternative treatments from Canada, Mexico and Europe. In the past twelve years, we visited an alternative cancer specialist in New York City. I received high dose Vitamin C IV’s and hydrogen peroxide IV’s. Weekly I have acupuncture and have received Chinese massage. I wonder what, if any, of these therapies have helped to contribute to my longevity with cancer?

During the upcoming treatment, I will be using several alternative medicine approaches. I wanted to share these with my readers and the scientific data to support each decision.

BETA GLUCANS

My note: Researchers at the University of Louisville have been investigating the role of beta glucans with Rituxan therapy. We are going to replicate this research as I begin Rituxan treatments. I will begin the Beta Glucans next week.

Hong F, Hansen RD, Yan J, Allendorf DJ, Baran JT, Ostroff GR, Ross GD.
James Graham Brown Cancer Center and. Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky 40202, USA.
The tumor-killing mechanisms available to monoclonal antibodies (mAbs; e.g., antagonism of growth factor receptors, antibody-dependent cell-mediated cytotoxicity) limit efficacy. Previous studies suggested that i.v. beta-glucan might function as an adjuvant for antitumor mAbs. beta- Glucan had been shown to function via the iC3b-receptor complement receptor 3 (CR3; CD11b/CD18) thereby enhancing leukocyte killing of tumor cells coated with iC3b via naturally occurring antitumor antibodies. Therapy with beta-glucans was limited by levels of natural antibodies and by tumor escape through elimination of antigen-positive cells. Accordingly, it was hypothesized that beta-glucan responses could be improved by combined administration with antitumor mAbs. Five tumor models were explored in BALB/c or C57Bl/6 mice using tumors that expressed either high levels of naturally occurring antigens (e.g., G(D2) ganglioside) or recombinant human MUC1. In comparison with antitumor mAb or beta-glucan alone, combined treatment with mAb plus beta-glucan produced significantly greater tumor regression in all models that included mammary, s.c., and hepatic tumors. Tumor-free survival only occurred in models that incorporated stable expression of the target antigen. beta-Glucan enhancement of the mAb tumoricidal response did not occur in mice deficient in either leukocyte CR3 (CD11b(-/-)) or serum C3, confirming the requirement for CR3 on leukocytes and iC3b on tumors. Granulocytes appeared to be primarily responsible for tumoricidal activity, because beta-glucan therapeutic responses did not occur in granulocyte-depleted mice. These data suggest that the therapeutic efficacy of mAbs known to activate complement (e.g., Herceptin, Rituxan, and Erbitux) could be significantly enhanced if they were combined with beta-glucan.
PMID: 14695221

CURCUMIN

My note: I have taken Curcumin for sometime. It is a derivative of the Tumeric spice, widely used in Indian cooking. This supplement has anti-cancer and anti-inflammatory properties. (WARNING: The brilliant yellow Curcumin can ruin white carpeting when your pet dog breaks a capsule open!)

Curcumin Inhibits Prosurvival Pathways in Chronic
Lymphocytic Leukemia B Cells and May Overcome
Their Stromal Protection in Combination with EGCG
Asish K. Ghosh, Neil E. Kay, Charla R. Secreto, and TaitD.Shanafelt
Clin Cancer Res 2009;15(4) February 15, 2009

Results: Curcumin induced apoptosis in CLLB cells in a dose-dependent (5-20 umol/L) manners and inhibited constitutively active prosurvival pathways, including signal transducers and activators of transcription 3 (STAT3), AKT, nuclear factor nB. Moreover, curcumin suppressed expression of the anti-apoptotic proteins Mcl-1and X-linked inhibitor of apoptosis protein (XIAP), and up-regulated the pro-apoptotic protein BIM. Coculture of CLL B cells with stromal cells resulted in elevated levels of STAT3, increased expression of Mcl-1and XIAP, and decreased sensitivity to curcumin. When curcumin was administered simultaneously with EGCG, antagonism was observed formost patient samples. In contrast, sequential administration of these
agents led to substantial increases in CLLB-cell death and could overcome stromal protection.

EGCG (Green Tea Extract)

My note: I have been taking this extract long before Mayo Clinic researchers decided to investigate its potential to help CLL patients.

Journal of Clinical Oncology, 10.1200/JCO. 2008.21.1284

Phase I Trial of Daily Oral Polyphenon E in Patients With Asymptomatic Rai Stage 0 to II Chronic Lymphocytic Leukemia

Tait D. Shanafelt,* Tim G. Call, Clive S. Zent, Betsy LaPlant, Deborah A. Bowen, Michelle Roos, Charla R. Secreto, Asish K. Ghosh, Brian F. Kabat, Mao-Jung Lee, Chung S. Yang, Diane F. Jelinek, Charles Erlichman, and Neil E. Kay
From the Department of Internal Medicine, Division of Hematology; Division of Biostatistics, and Departments of Immunology and Oncology, Mayo Clinical, Rochester, MN; and the Department of Chemical Biology, and the Ernest Mario School of Pharmacy Rutgers, the State University of New Jersey, Piscataway, NJ.

Purpose: To define the optimal dose of Polyphenon E for chronic daily administration and tolerability in patients with chronic lymphocytic leukemia (CLL).

Patients and Methods: Previously untreated patients with asymptomatic Rai stage 0 to II CLL were eligible for participation. Polyphenon E with a standardized dose of epigallocatechin- 3-gallate (EGCG) was administered using the standard phase I design with three to six patients per dose level (range, 400 to 2,000 mg by mouth twice a day). Trough plasma EGCG levels were measured 1 month after initiation of therapy. Response was classified using the National Cancer Institute (NCI) Working Group (WG) Criteria.

Results: Thirty-three eligible patients were accrued to dose levels 1 to 8. The maximum-tolerated dose was not reached. The most common adverse effects included transaminitis (33%, all grade 1), abdominal pain (30% grade 1, 0% grade 2, and 3% grade 3), and nausea (39% grade 1 and 9% grade 2). One patient experienced an NCI WG partial remission. Other signs of clinical activity were also observed, with 11 patients (33%) having a sustained 20% reduction in absolute lymphocyte count (ALC) and 11 (92%) of 12 patients with palpable adenopathy experiencing at least a 50% reduction in the sum of the products of all nodal areas during treatment. Trough plasma EGCG levels after 1 month of treatment ranged from 2.9 to 3,974 ng/mL (median, 40.4 ng/mL).

Conclusion: Daily oral EGCG in the Polyphenon E preparation was well tolerated by CLL patients in this phase I trial. Declines in ALC and/or lymphadenopathy were observed in the majority of patients. A phase II trial to evaluate efficacy using 2,000 mg twice a day began in November 2007.

ACUPUNCTURE

My Note: I receive weekly acupuncture to treat my pain. As I enter into treatment, the acupuncture points will be addressed that can assist with nausea relief, hematological improvements, and immune function.

Dr, Michael Murray, author of “How to Treat and Prevent Cancer with Natural Medicine” writes:

“From a scientific standpoint, stimulating these acupuncture points produces measurable biological effects. It serves as a natural pain reliever, produces favorable changes in blood chemistries, and affects electrical stimulation of nerves. Several studies have shown that acupuncture enhances immune function by increasing the number of white blood cells…. All these effects are valuable in the treatment of cancer.”

VITAMIN D3

My Note: I have taken Vitamin D3 for years now. Current research has proven that it has a vital role in cancer prevention and helpful for other medical conditions. My
Vitamin D3 level was extremely low when tested.

The vitamin D3 analog EB1089 induces apoptosis via a p53-independent mechanism involving p38 MAP kinase activation and suppression of ERK activity in B-cell chronic lymphocytic leukemia cells in vitro.
Pepper C, Thomas A, Hoy T, Milligan D, Bentley P, Fegan C.
Department of Haematology, Llandough Hospital, Penarth, Vale of Glamorgan, United Kingdom. chrisp@llanhaem.demon.co.uk
EB1089, a novel vitamin D3 analog, has been shown to have cytotoxic and antiproliferative properties in a variety of malignant cells. However, its potential as a treatment for B-cell chronic lymphocytic leukemia (B-CLL) has not been evaluated. EB1089 induced apoptosis in all of the 102 B-CLL samples tested with a mean LD(50) (the concentration of EB1089 required to kill 50% of cells) value (+/- SD) of 2.1 x 10(-8) M (+/- 1.4 x 10(-8) M). Furthermore, no significant difference was found in the cytotoxicity of EB1089 in B-CLL samples from previously treated and untreated patients (P =.1637). Induction of apoptosis was associated with a reduction in Bcl-2 and Mcl-1 protein expression, but this was evident only in the apoptotic cells. In contrast, the expression of Bax, p21, and p53 was not altered in the viable or apoptotic cells from either B- or T-lymphocyte lineages. EB1089-induced apoptosis was preceded by activation of p38 mitogen-activated protein (MAP) kinase and suppression of extracellular signal-regulated kinase (ERK) activity, and this was associated with downstream activation of caspase-3. The pancaspase inhibitor (Z-VAD-FMK) and the caspase-9 inhibitor (Z-LEHD-FMK) were able to partially abrogate the apoptotic effects of EB1089 but did not affect the phosphorylation of p38 MAP kinase or the suppression of ERK. The B-CLL cells in the study were shown to highly express vitamin D receptor, but an additional receptor-independent mechanism of cell killing cannot be ruled out at this stage. These findings show that EB1089 is a potent apoptosis-inducing agent in B-CLL cells and may be useful in the treatment of B-CLL patients, particularly those with p53 mutations or drug-resistant disease.
PMID: 12446453

PROBIOTCS

My Note: The use of probiotics has transformed my life. Side effects of many antibiotics are simply eliminated for me when I take probiotics with the antibiotics. Other health potentials are emerging.

Probiotics: delineation of prophylactic and therapeutic benefits.
Kaur IP, Kuhad A, Garg A, Chopra K.
Division of Pharmaceutics, University Institute of Pharmaceutical Sciences, UGC Center for Advanced Studies, Panjab University, Chandigarh, India.
Probiotics produce a beneficial impact on the host by improving the endogenous flora. It has been advocated that nonpathogenic bacteria like Lactobacillus and Bifidobacterium may undergo antagonistic interactions with other bacterial strains and can be used to control pathogenic bacteria. Novel modes of therapeutic and prophylactic interventions are based on their consumption either alone or in combination with prebiotics. Usefulness of probiotics has been implicated in allergies, cancer, AIDS, and respiratory and urinary tract infections. In this review we have listed various findings suggesting their benefits in alleviating symptoms associated with aging, fatigue, and autism. Newer claims indicating their role in reducing the risks of osteoporosis, obesity, and possibly type 2 diabetes are also discussed. Considering the wide array of such activities, the present review comprehensively elaborates upon the proposed benefits of probiotics. The concept of synbiotics, a combination of probiotics and prebiotics beneficially affecting the survival and implantation of such live organisms, is also discussed. Available probiotic strains, their commercial preparations, and newer approaches to improve the efficacy and overcome limitations of the therapy are also discussed in relation to the future of probiotic therapy. Considering that the purported claims about disease risk reduction are tentative, the review also encompasses various aspects regarding the safety of probiotics and their possible future role in disease prevention.
PMID: 19459724

GREEN DRINKS

Have you ever tried a green drink – good mixes of spirulina, wheat grasses, algae and barley? If you say you don’t remember drinking one, I can almost assure you that you have not. These brilliant green drinks are nutritiously dense and a boost to cancer patients (and oh, so tasty)!. The green drink I use also throws in dozens of other healthy substances – kind of like throwing everything but the kitchen sink into a blender and pushing puree.

FISH OILS

J Nutr. 2002 Nov;132(11 Suppl):3508S-3512S.
Omega-3 fatty acids to augment cancer therapy.
Hardman WE.
Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
The results of animal studies have demonstrated that the consumption of omega-3 fatty acids can slow the growth of cancer xenografts, increase the efficacy of chemotherapy and reduce the side effects of the chemotherapy or of the cancer. Molecular mechanisms postulated to contribute to the multiple benefits of omega-3 fatty acids include 1) suppressing the expression of cyclooxygenase-2 in tumors, thus decreasing proliferation of cancer cells and reducing angiogenesis in the tumor; 2) decreasing the expression of AP-1 and ras, two oncogenes implicated in tumor promotion; 3) inducing differentiation of cancer cells; 4) suppressing nuclear factor-kappaB activation and bcl-2 expression, thus allowing apoptosis of cancer cells; and 5) reducing cancer-induced cachexia. It seems reasonable to assume that after appropriate cancer therapy, consumption of omega-3 fatty acids might slow or stop the growth of metastatic cancer cells, increase longevity of cancer patients and improve their quality of life.
PMID: 12421878

CRANBERRY EXTRACT

Cranberry or trimethoprim for the prevention of recurrent urinary tract infections? A randomized controlled trial in older women.
McMurdo ME, Argo I, Phillips G, Daly F, Davey P.
Ageing and Health, Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, Scotland, UK. m.e.t.mcmurdo@dundee.ac.uk
OBJECTIVES: To compare the effectiveness of cranberry extract with low-dose trimethoprim in the prevention of recurrent urinary tract infections (UTIs) in older women. PATIENTS AND METHODS: One hundred and thirty-seven women with two or more antibiotic-treated UTIs in the previous 12 months were randomized to receive either 500 mg of cranberry extract or 100 mg of trimethoprim for 6 months. RESULTS: Thirty-nine of 137 participants (28%) had an antibiotic-treated UTI (25 in the cranberry group and 14 in the trimethoprim group); difference in proportions relative risk 1.616 (95% CI: 0.93, 2.79) P = 0.084. The time to first recurrence of UTI was not significantly different between the groups (P = 0.100). The median time to recurrence of UTI was 84.5 days for the cranberry group and 91 days for the trimethoprim group (U = 166, P = 0.479). There were 17/137 (12%) withdrawals from the study, 6/69 (9%) from the cranberry group and 11/68 (16%) from the trimethoprim group (P = 0.205), with a relative risk of withdrawal from the cranberry group of 0.54 (95% CI: 0.19, 1.37). CONCLUSIONS: Trimethoprim had a very limited advantage over cranberry extract in the prevention of recurrent UTIs in older women and had more adverse effects. Our findings will allow older women with recurrent UTIs to weigh up with their clinicians the inherent attractions of a cheap, natural product like cranberry extract whose use does not carry the risk of antimicrobial resistance or super-infection with Clostridium difficile or fungi.
PMID: 19042940

VITAMIN B3

MY NOTE: Most of my readers are aware of the battles I have had with my immune system. I have been taking weekly Neupogen injections (approximately $400 each) to eradicate neutropenia. Therefore, you can understand the addition of this product.

Vitamin B3 Fuels Neutrophil Production

As the first line of defense against invading microbes, neutrophils
are the “foot soldiers” of the innate immune system. Upon release
from the bone marrow, neutrophils circulate in the blood for only a
few hours before homing to peripheral tissues where they survive at
most for 2 or 3 days. To keep up with the heavy demand for these
short-lived cells, a normal healthy adult produces approximately 10 to the 11th power
neutrophils each day and up to 10 times that number in the setting of
acute infection.

Cancer patients undergoing chemotherapy often experience disruptions
in neutrophil homeostasis, which places them at increased risk for
infection. The ability to boost neutrophil production with
recombinant granulocyte colony stimulating factor (G-CSF) has
revolutionized care for patients with chemotherapy-induced febrile (fever)
neutropenia. However, the molecular mechanism by which G-CSF induces
myeloid differentiation remains poorly understood.

A team of researchers at Hannover Medical School in Germany recently
reported a major breakthrough in neutrophil development that may have
important clinical implications. Upon binding to its receptor on the
surface of myeloid progenitor cells, G-CSF turns on an enzyme that
converts intracellular vitamin B3 (nicotinamide) into an activate
metabolite (nicotinamide monocleotide). The researchers found that
this is the rate-limiting step in a signal transduction pathway that
triggers granulopoiesis.

Addition of vitamin B3 or its precursor induced granulocyte
differentiation of cultured hematopoietic stem cells. Administration
of high doses (10-20mg/kg/day) of vitamin B3 to six healthy
individuals resulted in significant increases in neutrophil count over
a 7 day period and a return to physiological cell counts when vitamin
B3 was withdrawn.

These findings identify a new role for vitamin B3 in granulopoiesis
and beg for clinical trials to evaluate the use of vitamin B3 either
alone or in combination with G-CSF for the treatment of neutropenia.

Source:
Skokowa J, Lan D, Thakur BK, et al. NAMPT is essential for the
G-CSF-induced myeloid differentiation via a NAD+-sirtuin-1-dependent
pathway. Nat Med. 2009;15(2):151-158.

MELATONIN

Not only is melatonin induce sleep, research has also documented that melatonin has the potential to signal cellular apoptosis. The leukemia that I have is, in part, due to apoptosis defects where the cells do not normally die off.

MULTIVITAMIN
I also take six quality, multivitamins each day.

Wednesday, May 27, 2009

My Japanese Iris Plant

The following iris poem is from an old catalog of "Green Gate Gardens 1931".

The garden with its little gate of green,
Invites you to enter, and view mysteries unseen,
Its vine laden bowers and overhanging trees,
The air filled with sweetness, the hum of the bees,
The flagged walks with Iris galore,
Of most beautiful coloring, unknown before,
Pink, white, purple, yellow, azure blue,
Mixed and mingled of every hue,
You come away wondering, can more beauty be seen
Than in the garden with its little gate of green.




Photograph copyright Stacie

My Prayer for Today: May 27, 2009

My Precious Lord,

We gratefully bow and praise You for the Lord that You are to each of us. Each of your creations, you are ever-patient with, wanting all to come to salvation. Thank you for your patience with each of us, Father. We love You and rejoice that we can be called Your children. Nothing in this world compares to the peace, joy, and companionship that a relationship with You brings to our lives.

Forgive us our sins, Lord, so that our lives will be one that reflect You and Your love to a lost world. Forgive us when we fail to display Your love to those seeking You. Forgive us when we are not the witnesses for Your Kingdom that we are called to be.

I know you are listening to our prayers and petitions, Lord. That reassures our hearts during difficult days. Infections need conquering. Treatment plans need anointing. Relationships need restored. Heartache needs replaced with hope. Financial needs require Your provisional touch. Our country needs Your guidance. The lost need a Savior. Fractured lives demand salvation and forgiveness. The faint in spirit need empowerment. You are able.

I praise You for the sacrifice of my Savior on the cross for the saving of my soul. No words can ever thank You enough for Your great loss for the great gain of the world.

In Jesus’ Mighty Name I pray. AMEN.

My Treatment Theme Song

Some of the lyrics of this Josh Wilson song, "Savior, Please" are poignant to me. I cannot do this treatment on my own - Savior, please hold onto me.

Link to the video: http://www.youtube.com/watch?v=HCLr_pvuwH4

Savior, please take my hand.
I work so hard, I live so fast.
This life begins, then it ends.
And then I do the best that I can,
but I don't know how long I'll last.

I try to be so tough,
but I'm just not strong enough.
I can't do this alone,
God I need you to hold on to me.

I try to be good enough,
but I'm nothing without your love.
Savior, please keep saving me.
Savior, please help me stand.

I fall so hard, I fade so fast.
Will you begin right where I end?
And be the God of all I am
because you're all I have.

Hallelujah!
Everything you are to me
is everything I'll ever need.
and i am learning to believe
cause you're the one who's saving me.

Pray Then Praise

Have you ever encountered a spoiled, whining child? One who begs and pleads to obtain what she wants, over and over and over again? One who exasperates her parents as she pleads for the desires of her heart? Consider the face of this child’s father. He is thinking to himself, “If she has asked me once for a pony, she has asked me a hundred times.”

I believe that our Heavenly Father must get equally exasperated with us. How many times have I stomped my foot and bowed my head, praying over and over for Him to heal my broken body? And as an honest confession, perhaps I have even exceeded praying for pleading and pouting. These descriptions would better describe my heart-felt, desperate cries.

“Devote yourselves to prayer, being watchful and thankful” (Colossians 4:12).

My Petitions – Please agree in prayer with me:

-Destroy leukemia cells while rebuilding my immune system (for those of you who know much about cancer treatment, you know this is a real oxymoron for which to ask)
-Help my body to fight off harmful organisms and dangerous infections
-Return my spleen and liver to normal size
-Return enlarged lymph nodes
-Return all blood counts to normal
-Let doctors and other caregivers stand in amazement at God’s work through this treatment
-Prevent any drug reaction or side-effect

“Yet you do not have because you do not ask” (James 4:2b).

Let our focus now shift to prayers of thanksgiving with pure hearts; believing spirits; and doubt-free thoughts.

"Have faith in God," Jesus answered. "I tell you the truth, if anyone says to this mountain, 'Go, throw yourself into the sea,' and does not doubt in his heart but believes that what he says will happen, it will be done for him. Therefore I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours. And when you stand praying, if you hold anything against anyone, forgive him, so that your Father in heaven may forgive you your sins” (Mark 11:20-24).

God’s way of doing things requires patience. Making this treatment decision has not demanded hours or days or weeks, but months. I wanted to lack nothing as I made this challenging decision for myself. I wanted understanding and wisdom and knowledge and God’s peace. At times, symptoms, infections, or bad reports have taunted me and attempted to rush me to finalize this decision. At each of these intersections, I paused, prayed, and persevered in patience as I pursued the perfect plan (repeat that quickly ten times).

“But let patience have its perfect work, that you may be perfect and complete, lacking nothing” (James 1:4).

The Holy Spirit has truly enlightened me. The protocol I have decided upon is replete with research, conventional medicine, and complementary medicine. I believe God has all of the bases covered. As I have prayed and penned the protocol, the pages multiplied. I now have over 40 pages of typed material that contain the treatment approach I am going to begin.

One might ask, “Why did this decision take so long to decide upon?” You must remember that in recent months, I have been told: (1) I am in “end stage” leukemia; (2) Surviving any treatment will be a challenge; and (3) I need a replacement immune system. With statements such as these looming large in my memory, I was certain God’s involvement in this planning was mandatory.

I have peace about my decision. I own this decision. I have invested days and days of prayer time, research and writing this protocol. Let’s roll ………

Countdown to Treatment


if

if i lay down and wallow in self-pity
then i have already died

if I dread days with breath remaining in my lungs
then I have already died

if i exist discouraged and down-hearted
then i have already died

if i dwell on death before my heart quits beating
then i have already died

if i focus on the what ifs and could have beens
then i have already died

if I live reflecting on the past and amid regrets,
then I have already died


if i lay down at night with a heart filled with gratitude
then I am truly living

if i dread the disease yet treasure my time
then I am truly living

if i exist to bring praise and glory to Him,
then I am truly living

if i dwell on eternal life versus temporary death
then I am truly living

if I focus on family, friends and faith
then I am truly living

if I live reflecting on His blessings and not my missteps
then I am truly living


if my time arrives and death intercedes
THEN I TRULY WILL BE LIVING.

--Stacie

Friday, May 22, 2009

He Will Be With Us Always

The chorus and last stanza of these lyrics encourage me. The video is a tear-jerker but it is the perfect video-translation of Romans 8:28, "And we know that all things work together for good to those who love God, to those who are the called according to His purpose."

Life's darkest moments can touched by the Hand and Love of God. He never fails His children.

Video Link: http://www.youtube.com/watch?v=G6LTfueFPpM&feature=related

"Always"
By Building 429

I was standing in the pour raining
One dark November night
Fighting off the bitter cold
When she caught my eye
Her face was torn and her eyes were filled
And then to my surprise
She pulled out a photograph
And my heart just stopped inside
She said He would have been three todayI miss his smile, I miss his face
What was I supposed to say
But I believe always always
Our Savior never fails
Even when all hope is gone
God knows our pain and His promise remains
He will be with you always
He was living in a broken world dreaming of a home
His heart was barely keeping pace
When I found him all alone
Remembering the way he felt
When his daddy said goodbye
Fighting just to keep the tears
And the anger locked inside
He's barely holding on to faith
But deliverance is on its way

'Cuz I believe always always
Our Savior never fails
Even when all hope is gone
God knows our pain and His promise remains
He will be with you always

Friend I don't know where you are
And I don't know where you've been
Maybe you're fighting for your life
Or just about to throw the towel in
But if you're crying out for mercy
If there's no hope left at all
If you've given everything you've got
And you're still about to fall
Well hold on, hold on, hold on

Cuz I believe always always
Our Savior never fails
Even when all faith is gone
God knows our pain and His promise remains
Always, Always
He will be with you always
He will be with you always
He will be with you

Thursday, May 21, 2009

Update and Request for Prayer: May 21, 2009

I am in another cycle of infections. Prior to our trip to the NIH, I had started another antibiotic for chest congestion and a skin infection (May 6). I began running a temperature on this past Monday, in spite of antibiotics, antiviral, and antifungal. Yesterday, I saw my doctor. We are awaiting results from blood and urine cultures. I have yet another sinus infection, so last night I had to resume the Tobramycin that I put into the sinuses three times daily.

I also met with my local oncologist yesterday. I will have my eight hour IVIG treatment next Thursday. I will continue with the weekly Neupogen injections that help my leukemia-impacted bone marrow to generate some much needed neutrophils.

The decision that must now be made is whether I am going to do no treatment or begin half-dose Rituxan as soon as I have a break in infections. Rituxan is similar to chemo but is actually a Monoclonal Antibody. B-lymphocytes (cell line that is cancerous for me) contain a marker referred to as CD20. Rituxan attaches to the CD20 targets. Cancerous cells are killed as with chemo, however, the Monoclonal Antibodies do not destroy other healthy cells (except for the very few healthy B-cells that I have mingled in with the large population of cancerous B-cells). Although neutrophils are not targeted by Rituxan, neutropenia (and resulting infections) occur because neutrophils die off in the cell kill process.

IF I elect to treat, I will receive treatment two days per week for eight weeks. It will be a challenging, difficult time for us. Most likely, the first two weeks' of treatment will be given in the hospital, since I had a near fatal reaction to this drug in the past. I hope that with two successful weeks with inpatient treatment, I will be able to move to the outpatient infusion center at my oncologists' office for the remaining six weeks.

Please pray that these infections resolve and that I will have God's peace about the decision to treat or not to treat.

A Prayer for Today: May 21, 2009

Precious Father,

We rejoice at the mention of Your Name. Life would be void and meaningless without the indwelling of Your Holy Spirit. We are comforted, guided, instructed and inspired as we rely heavily on the Holy Spirit. We praise You that, "... surely I am with you always, to the very end of the age (Matthew 28:20b). Through the Holy Spirit living within us, we are never alone.

"Since we have these promises, dear friends, let us purify ourselves from everything that contaminates body and spirit, perfecting holiness out of reverence for God (2 Corinthians 7:1). Help us to seek your forgiveness for the sins that so easily entangle us as often as we seek answers to our petitions, maintaining cleansed lives is that are pleasing to You.

Lord, my own mind cannot recall all of the needs that need brought before Your throne. Touch each heart and make each of our lives a reflection of You. Grant clarity and discernment to all who seek the paths we should pursue. Provide an extra measure of strength and encouragement for all who are weary. May each one seeking employment be blessed with more than just a job - but great opportunities for personal happiness and service to You.

Your ways are not our ways. What may seem like very difficult life experiences to us, may be the very life experience that draws us most near to You and the plans You have for our lives. And there is nothing more important.

We praise you and thank You in Jesus' Name. Amen.

Monday, May 18, 2009

Self-Confessed Transplant Wimp

Since diagnosis, I have referred to myself as the “Self-Confessed Transplant Wimp”. Just the mention of a stem cell transplant sends shivers up my spine. Over the leukemic years, I have researched and read about transplants, but I tend to spit the information out and never digest it. I have watched other relatively young leukemia patients dive into transplant, only to be dead in a short amount of time. Recently, a man (who I knew from Ohio State) died during transplant. He left his wife and young children. The statistics do not offer much more incentive to sway my transplant intentions.

Do you ever stop to consider what you would do, if you were faced with this dilemma? A typical transplant doctor surmises, “Without a transplant, there is a 100 percent chance you are going to die.” In that context, the 30 or 40 percent chance of transplant mortality or morbidity looks like impressive odds. What a deal!

Then there is the matter of locating a matched unrelated donor. That process has been initiated. My blood was drawn at the NIH and HLA typing will be completed. HLA stands for human leukocyte antigen. HLA typing identifies the specific antigens on white blood cells that will determine if a donor’s stem cells are perfectly matched to my HLA markers. Once my HLA markers are determined, that information will be put into the national database of the National Marrow Donor Program. This will generate a list of potential donors who are a 10 out of 10 match (my HLA antigens match their HLA antigens). Some transplant centers will transplant with a 9/10 match but that further complicates the transplant’s outcome.

IF there are any confirmed matches, then these matched individuals will be contacted. Some may have died or moved. Others may have health challenges that will prevent them from donating. And for others, when the rubber meets the road and they are called upon to be a donor, suddenly that is not an appealing consideration. Unlike organ donations where cadaver organs are often transplanted, the stem cells are harvested from a living donor for this type of transplant.

Once in awhile, I close my eyes and allow my mind to wander to the transplant unit where I’ve survived the transplant and the leukemia has been pummeled to death. For that moment, transplant begins to lure and tempt me to consider. I have had leukemia for so many years, that I cannot even recall life without leukemia, pain or infections. I cannot even fathom life without this daunting invader in my body.

To transplant or not to transplant, that is the question at hand ……

Jump from the Burning Building?

As I attempt to process the NIH recommendation for me to be transplanted, this analogy appeared on The New York Times website. Theresa Brown, RN posts a blog entitled, "When Cancer Treatment Might Kill You". After reading this, you might better understand the dilemma I am facing.


“I compare his choice with deciding whether to jump from a burning building. Staying in the building means certain death. But if you jump, you might break both legs and take months to heal or sustain injuries serious enough that the complications eventually kill you. But you would be alive when you hit the ground. Maybe it will only buy you a few more rough years. But you might just walk away and live."

“When it comes down to cancer patients making the choice, a few decide to stay in the building. They opt for the quicker, surer death of cancer. Others, for different reasons, don’t have the option of a transplant. But even knowing the risks, I’m pretty sure I would make the leap, endure the free-fall, feel the impact, and hope to be one of the lucky ones who survives to walk back into the life that is waiting for me.”

Sunday, May 17, 2009

Music to My Ears

This morning I was watching a service that Joel Osteen was preaching. He spoke these words and they were life giving and heart encouraging to me.

"You are not going to die yet.
You have too much potential
that God needs
for you to still use on earth.
Refuse to die with the music still in you."

--Joel Osteen 5/17/2009

Voice of Truth

Casting Crown's song Voice of Truth reveals great truths. In this world, there are numerous voices crying out to us. Voices of falsehood, voices of fear, voices speaking bad reports or voices of discouragement can all taint and taunt our minds and spirits. There remains one standard of truth - The Holy Bible - where we can turn to increase our faith and to shake off the voices of negativity and doubt that attempt to influence how we live out our lives.

Those waves are taunting me right now, reminding me of all the attempts to eradicate leukemia have failed. Yet this powerful Voice of Truth - God Almighty and His Holy Word - tells me an entirely different scenario and story for my future. Of all of these worldly voices calling out to me with dire predictions and diagnoses, I will choose to believe His Word.


Oh what I would do to have

The kind of faith it takes

To climb out of this boat I'm in

Onto the crashing waves

To step out of my comfort zone

Into the realm of the unknown where Jesus is

And He's holding out His hand

But the waves are calling out my name

And they laugh at me

Reminding me of all the times I've tried before and failed

The waves they keep on telling me

Time and time again. "Boy, you'll never win!"

"You'll never win!"

Chorus: But the voice of truth tells me a different story

The voice of truth says, "Do not be afraid!"

The voice of truth says, "This is for My glory"

Out of all the voices calling out to me

I will choose to listen and believe the voice of truth

Oh what I would do to have

The kind of strength it takes to stand before a giant

With just a sling and a stone

Surrounded by the sound of a thousand warriors

Shaking in their armor

Wishing they'd have had the strength to stand

But the giant's calling out my name And he laughs at me

Reminding me of all the times I've tried before and failed

The giant keeps on telling me

Time and time again. "Boy you'll never win!""You'll never win!"

But the stone was just the right size

To put the giant on the ground

And the waves they don't seem so high

From on top of them lookin' down

I will soar with the wings of eagles

When I stop and listen to the sound of Jesus

Singing over me

I will choose to listen and believe the voice of truth

Here is the link to the song on YouTube:

http://www.youtube.com/watch?v=KwsvqVmFV6Y

Saturday, May 16, 2009

NIH Journey Day 5: May 16, 2009

We are home from the NIH. Dorothy of the Wizard of Oz, was correct, "There is no place like home!"

I will write more later as I am very, very tired and in pain. Thank you all for your prayers and inspiring words.

Isn't God good to His children?

Someone asked me about praying for me to have a match for transplant. Thanks for NOT praying for a matched donor for me - I am not praying for that. If I am not to have a transplant and God knows if it will take my life, I pray there won't be a donor so a door can be firmly shut on that option. I want God to orchestrate the best plan in such a way that I will be certain of my decision, whether it be to do no further treatments or to try something different.

What I am praying for is courage - I want to remain solidified in my faith and full of joy, no matter if this is the "end" as my NIH trusted physician suggested. I want to relocate to my Heavenly Home with grace and to show Jesus to a lost world. I know He will give me such courage, as I do not have it myself.

Friday, May 15, 2009

Laboratory


Is this the exit for blood draws? We had a good laugh when we saw this exit sign. After all of the blood they took from me, we sped right past the Laboratory exit. :-)

National Institutes of Health (NIH) Photos


This is a scale model of the NIH - it is not a quality photo but it will give you the best overall vantage point of the NIH. You can see the beams of the building in the glass encasement.


Main Lobby NIH Building Ten.


Photo of new construction at NIH. This building was nothing but steel beams the last time I was there.


The mission of the NIH.



Front entrance Building Ten.

FACTS: There are 27 Institutes at the NIH - each one addressing a different disease or area of medicine and research. There are over 18,000 employees and the last budget was around $29 million dollars for the year.

NIH Journey Day 4: May 15, 2009

A quick update ......

First, thank you for all of your prayers and precious words of encouragement. I am not defeated. I am not giving up. My faith remains solidified. He has not and will not forsake me. These reports are, simply put, words of mortal man. They are not the giver of life or death.

We have made it to West Virginia. I am in alot of pain as it was the most difficult bone marrow biopsy I have ever had - the only one that made me cry. And I had to get straight up then be on my feet all day for my other appointments at the NIH and then had to get in the car. We have made it about 250 miles.

The blood draw to begin the donor search was difficult to do. It was though I had made one small step toward that dreaded process. If I have no donors, this information will be welcomed as that will enable me to give no further thoughts to transplant. In a curious way, I hope God did break the mold when He created me. :-)

Several hours were spent in consultation today with leading doctors. They agreed that Rituxan is my best option to serve as a "bridge" to transplant. All I can say is, I hope that bridge is long - like the Seven Mile Bridge in the Florida Keys! :-) That bridge seems unending. The views on that bridge are beautiful. I pray my remaining life can be the same - long and beautiful. I know my life will be unending with the promise of eternal life.

As Christians, when we are asked to look at death straight in the face, our response must be dictated by His Word. We shouldn't shake and shudder at the prospect of death as the unsaved man or woman might do in response to death. Death has lost its sting for me. We shall not die but live forever in God's Heavenly Kingdom. I don't want to live in fear or dread of death. Granted, time with my family will be warmly embraced. Yet, I pray with all my heart that I can remain full of God, positive, and have no fear pounding at the doors of my heart and mind.

I will be in touch later. I am going to try to upload some pictures from the NIH for those of you who are interested. Their transplant program appears amazing and I am certain of one thing - IF I pursue transplant it will be done at the NIH.

THANK YOU Drs. Marti and Weistner and all of the other NIH physicians, PA's, and other heath care providers for your wonderful, compassionate care. This is what the face of medicine should look like!


2 Corinthians 5:1-8

1 For we know that if our earthly house, this tent, is destroyed, we have a building from God, a house not made with hands, eternal in the heavens. 2 For in this we groan, earnestly desiring to be clothed with our habitation which is from heaven, 3 if indeed, having been clothed, we shall not be found naked. 4 For we who are in this tent groan, being burdened, not because we want to be unclothed, but further clothed, that mortality may be swallowed up by life. 5 Now He who has prepared us for this very thing is God, who also has given us the Spirit as a guarantee.
6 So we are always confident, knowing that while we are at home in the body we are absent from the Lord. 7 For we walk by faith, not by sight. 8 We are confident, yes, well pleased rather to be absent from the body and to be present with the Lord.

Thursday, May 14, 2009

More Washington, DC Photos


World War II Memorial


Washington Monument and Reflection Pool


Jefferson Monument

NIH Journey Day 3: May 14, 2009

It's been an exhausting 12 hour day at the NIH. I will send more details later. This was a very sobering, late day, meeting with 6 doctors and alot of testing. Dr Marti was spokesperson and told me that I was in end stage disease. That is difficult to hear and receive.

My counts were too poor to qualify for either the Revlimid or ABT 263 trials. So those doors (especially the Revlimid trial) have been closed for me. The only option they are suggesting is transplant. (You know my feelings there - however, I consented to begin the donor search tomorrow. It will be valuable information to receive - if there is no 10/10 match then that door will also close for me.)

We return at 7 AM tomorrow - another full day - bone marrow biopsy at 8 and again, nonstop testing and consults all day. I must return to my faith and know that God is the giver and the taker of life. He has ordained my number of days for me before I was born. Yet, it was heartbreaking to hear spoken what I probably already knew somewhere in my heart.

I brought up the prospect of Low Dose Rituxan at home. I will pursue that more tomorrow as I know I need someone to support it and who will instruct the local oncologist as to how most safely administer that. It remains a consideration in my playbook.

Hemoglobin was 8.8 and that is approaching transfusion level. No one could believe I walked nearly 4 miles in DC yesterday afternoon with counts that low. I am once agin neutropenic - I was going to take Neupogen tonight as I brought a vial, but I don't believe the pain I'm in tonight combined with Neupogen bone pain will be a good combination for tomorrow and our trip home. So I may delay that injection.

I am amazed at the number of people I still know here (my last trip was in 2002). To have access to hospital care like this, on a local basis, would be amazing. Before my CT they came and wrapped me up in a warmed blanket. It was so comforting.

Lymphadenopathy was minimal but you know the spleen's story. They said splenectomy will pose about the same risks as other treatments - substantial. So their logic is if I am going to risk my life, I might as well risk it going for a transplant.It was so good to see Dr Marti - he has cared for me for over 10 years and is a wonderful physician. He is coming to see me again tomorrow before we leave.

Wednesday, May 13, 2009

NIH Journey Day 2: May 13, 2009

The White House.
The World War (WW I) Monument located in a beautiful garden setting.

Korean War monument. These stone soldier replicas were numerous and lifelike.

World War II Monument. This has been constructed since our last visit to DC.

We have arrived! It was a long day of travel and then we drifted into a moment of insanity and decided to drive onto DC. Traffic is indescribable and we went 10 blocks in 1 hour at one point. God was gracious and we had no difficulties on the trip -- no accidents, tickets, road construction, or wrong turns!

Tomorrow will be an early, long day. We have to catch the shuttle to the NIH at 7 AM. Tomorrow will be another long day. In the morning I will have blood draws, a CT Scan, EKG, physical, and some other testing. In the afternoon, I first meet with the Leukemia and Lymphoma Team and then I will meet with the Transplant Team.

I had to walk several miles with my hemoglobin of 9 to capture these photos for my faithful Blog Buddies. Enjoy.

Tuesday, May 12, 2009

NIH Journey Day 1: May 12, 2009


View outside of our hotel room: village of Easton, Ohio. A shopping haven for shopaholics!


Hot air balloon meets tractor!


Encounter with hot air balloon!


One state down, four to go!


For all of you Colts fans, this is their new home, the Lucas Oil Stadium.

We have made it to Columbus, Ohio tonight. Thank you for your prayers. I have decided to snap some photos along the trip to help chronicle it with my words. Tomorrow will be a very long day for us -- over 400 miles remain.

The Ohio Branch of the American Cancer Society (Kathleen) obtained a complimentary room for us at the Columbus Hilton at Easton (Pat). They outdid themselves as we are in a beautiful suite. God is so good to provide for all our needs according to His glorious riches in Christ Jesus. THANK YOU KATHLEEN AND PAT!

Okay, now for some photographs (most aren't quality as we were driving about 85 miles per hour so that I could arrive before American Idol began). My husband asked, "Do you remember the movie Rainman?" And I told him I did.

He continued, "You are just like the Rainman when he couldn't miss Judge Wopner and he kept telling his brother, 'Thirty minutes to Wopner.' 'Ten minutes til Wopner." I was a bit like that only my show was American Idol. VOTE FOR DANNY!

Monday, May 11, 2009

Life

My beloved family physician gave me a magnet the other day that featured this quote from Abraham Lincoln:

"It's not the years in your
life that count.
It's the life
in your years."

Nothing Too Difficult

Preparations are nearly complete for my trip to the National Cancer Institute. I wish I could report that packing and preparing for this trip has had the excitement of a vacation. Such is not the case. I pack and ponder. I prepare and pray. I will leave and listen.

Making this next treatment decision ranks as one of the most difficult decisions I have ever been forced to make in my life. If I don’t treat the leukemia, chances are I will die. If I do treat the leukemia, there is a chance that I will die. If I don’t treat, it is anticipated that my quality of life will continue to decline. If I do treat, quality of life always takes a slap in the face.

The other night as I tossed and turned and sought God to grant me peace of my mind and spirit and clarity of mind to make this decision, the Holy Spirit continually kept reminding me, “Trust ME, Stacie. Trust Me, Stacie.” God has never forsaken me or misdirected my steps.

The Holy Spirit must help me to remove self from this decision. If I trust God (and I trust Him with my life), then He will impress upon my spirit the answer to my decision. Fear and doubt and confusion that are clouding my ability to contemplate this decision, are not of God. All of these are sin. Forgive me Lord. (“For my iniquities have gone over my head; like a heavy burden they are too heavy for me" (Psalm 38:4). Please pray with me that I will overcome these sinful roadblocks on my way to making the flawless decision. I cannot do this on my own. Apart from Him, I am nothing.

Today, this Scripture offered me a vivid reminder, “Solomon answered all her questions; there was nothing so difficult for the king that he could not explain it to her” (I Kings 10:3). My King will answer all my questions and there is nothing too difficult for the Holy Spirit to explain to me.

Making the best treatment choice is a weighty burden I have been bearing versus laying it at the foot of my Savior’s cross. That has been the hindrance. I am certain as I remove myself, my impressions, my research, and my contemplations from this process, the answer will become crystal clear.

“My help comes from the LORD, Who made heaven and earth” (Psalm 12:12).

Sunday, May 10, 2009

What the Mothers I Love Most Have Taught Me

My own Mom has modeled selflessness and dedication to her children. She has always put the needs of her children ahead of her own needs. Mom taught me to treasure our daughters. She has always worked tirelessly. Mom taught me to celebrate birthdays and holidays with bravo and much ado. She has remained strong and unfailing with her support and assistance throughout my illness. She is resolute to remind me to keep fighting and not to entertain negative thoughts and speech.

Our daughter (aka Lil Man's Mother) has taught me that she must have been watching and listening to me as I raised her. She exemplifies the same love, dedication and watchfulness over Lil Man that I demonstrated to her as I cared for her and her two sisters. She laughs and has fun with Lil Man and reminds me to embrace and enjoy life. She has shown me how difficulties in life can evolve into life's most amazing blessings.

My Grandma has offered insights from her own life to me through the years. She lived through the depression and taught me to be thrifty and wise with money. She values family and traditions. She and my Grandpa traveled extensively and she taught me that the memories from those travels and life experiences are all that one has when a loved one dies. My longing to see and experience the world trickled down from this trait of Grandma's.

I love each of you. Thank you for modeling mothering and other traits to me.

Happy Mothers' Day!

Dedicated to my Mom, my Grandma, and our daughter who is now a mother to Lil Man.

No Love like a Mother's Love

There is no love, like a mother's love,
no stronger bond on earth...
like the precious bond that comes from God,
to a mother, when she gives birth.

A mother's love is forever strong,
never changing for all time...
and when her children need her most,
a mother's love will shine.

God bless these special mothers,
God bless them every one...
for all the tears and heartache,
and for the special work they've done.

When her days on earth are over,
a mother's love lives on...
through many generations,
with God's blessings on each one.

Be thankful for our mothers,
for they love with a higher love...
from the power God has given,
and the strength from up above.

By Jill Lemming

Saturday, May 9, 2009

Happy Eight Month Birthday, Lil Man

free avatars I cannot fathom that eight months ago today we were exhausted and rejoicing over the arrival of our Lil Man (grandson) that afternoon. We camped out at the hospital for nearly 18 hours before he gave up his warm, motherly home and made his entrance into this world. Our lives changed forever as new grandparents. Our duties of raising our own three daughters had been completed and our nest was rather empty and quiet. Lil Man has changed all that. He fills the house with joy, toys everywhere, and hours of fun and entertainment. I highly recommend grandparenting to everyone. This serves as an official endorsement!

Friday, May 8, 2009

To Live is Christ, To Die is Gain

For to me, to live is Christ, and to die is gain.
(Philippians 1:21)


This Scripture, penned by the apostle Paul, is a personal favorite. I have requested that this be engraved on my tombstone, should I pass from this earth before I am raptured. Physical death is gain for those who are certain of their eternal destiny. The man who is safe and secure in his eternal destination, views physical death as a welcome caller. The promise of Heaven evokes joy and excitement as the believer knows all of his pain, misery, and suffering will be abolished. Physical death is not final for the believer.

For the man who has never met and invited Jesus Christ into his heart and life, the threat of impending death is repulsive. It is frightening and the deep hole dug in the ground for his coffin has little appeal as a final resting place. This man is certain that all things of value to him – treasure, time, a future - all are lost and consumed when death calls. Death is irrevocable and conclusive for the unbeliever.

If you have not made Jesus your Personal Savior, don’t ignore Him. If you have rebelled and rejected God’s perfect plan for your own life, don’t tarry. If you have grasped at the notion that just living a “good” life is enough to gain entry to Heaven, don’t be surprised if the Heavenly portals are closed to you. If you believe accepting Christ and seeking forgiveness for your sins are not in your plans right now, death is not going to be a welcome caller to you.

God is a gentleman. He will knock and knock and knock at your heart’s door. Keep ignoring his knock. Don’t open the door. And He will never push and shove His way into your life and heart. He is patient. He will wait. The problem with this plan of waiting is that none of us know if life will belong to us tomorrow. It is not about religion. Matter of fact, it sends shudders up my spine if someone refers to me as a “religious” person – I am a person who deeply loves and serves my Lord and Savior. This is all about relationship - the relationship God has desired since the day He created You. For you to embrace Him, His Word, and His free gift of forgiveness and salvation ...... that is all He is asking of you.

"For the wages of sin is death, but the gift of God is eternal life in Christ Jesus our Lord."
Romans 6:23

"So they said, 'Believe on the Lord Jesus Christ, and you will be saved, you and your household'.”
Acts 16:31

"They have all turned aside; they have together become unprofitable; there is none who does good, no, not one.”
Romans 3:12

"Most assuredly, I say to you, if anyone keeps My word he shall never see death.”
John 8:51

If you are uncertain of your eternal destination, begin by praying this simple prayer. Pray it with all of your heart and intent. Find a Bible and begin reading the books of John and Romans. There are many websites with accurate Bible teaching. Check those out (some suggestions listed below).

Father,

I am a sinner. I know I have messed up and

disappointed You. I believe that Your Son,

Jesus Christ, died on the cross just for me

and the forgiveness of my sins. I come today,

seeking Your forgiveness. I welcome You

into my heart and life.

In Jesus' Name I pray. Amen.

Links for Bible Learning:

http://www.biblegateway.com/

http://www.joycemeyer.org/default.htm

http://www.kcm.org/index.php?p=home

If you are curious about how current events are playing into the Kingdom calendar, this link will take you to Chapter One of the book Left Behind. Although the Left Behind book and series is fictional, it is based upon Scripture.

Go to for Chapter One:

http://files.tyndale.com/thpdata/FirstChapters/978-0-8423-2911-8.pdf




An Update: May 8, 2009

Praises to report! The bone scan I had performed on Tuesday returned with normal results. Thank You, Lord. There was concern since my sinus CT scan had shown the bones of my sinus cavity thinning, that the long-term steroid use was thinning my bones. My spine and major bones showed no bone loss, for which I am most grateful.

My WBC (white blood count) increased by nearly 50,000 in one week. This is concerning because the cancerous lymphocyte line compiled over 40,000 of that increase.

I began antibiotics yesterday due to a skin infection and a suspected lung infection. Oh, how I need God to restore my immune system. Please pray specifically for my immune function.

Trip preparations are nearing completion and we will leave on Tuesday for the National Cancer Institute outside of Washington, DC. If you want to take a look at where I am going, access the NIH website at: http://www.nih.gov/ or the NCI website at: http://www.cancer.gov/.

A Tribute to My Grandson

Our grandson will turn eight months old this weekend. It seems as though only yesterday I was introduced to his red, wrinkled face and newborn wail. As he slept today and I marveled at the gift he has been to our family, I penned these words.

His Handiwork

You sleep, peaceful and innocent.
Hairs placed perfectly by His hand.
Big, brown eyes, sculpted by your Savior.
Angelic cherub lips molded by your Maker.
You rest, comforted by His touch through me.
Breathing breaths, gifts from the Almighty.
Thinking thoughts imparted through His Spirit.
His creation, I stand guard over.
He is my grandson.
He is Your creation.

May Flowers

White bearded iris ....
Pink peony blossoms are beginning to bloom.
The peony is the state flower of Indiana.


After a rainy day, I ventured out to look at my flower gardens. Color is exploding everywhere. This iris reflects the rainy day -- look closely to see the raindrops on its petals.

No More Sorrow, No More Pain

My new favorite song is "I Will Rise" by Chris Tomlin. It is a song that will uplift you to a higher place of worship. The words, I treasure - the promise that Heaven holds for me and for all who have accepted His forgiveness and made Him Lord of their lives.

Here is the link to its video:
http://www.youtube.com/watch?v=RvrBQL8swLI&feature=related

Thursday, May 7, 2009

A Prayer for Today: May 7, 2009

Heavenly Father,

You are the One and Only True God – the Alpha and the Omega. You alone are worthy to be praised. We know You are the One True God when we read the Scriptures. John 17:3 remind us: “…. this is eternal life, that they may know You, the only true God, and Jesus Christ whom You have sent.”

May our focus ever be on eternal life and the path to eternal life which you paved for us through Jesus Christ. We praise You for the gift of eternal life.

Forgive us when we fail You, Lord. Forgive us when we become slack in sharing Your Word and gift of salvation with the lost around us. Prompt us and open our eyes and hearts to be ever prepared to share the Gospel with others. May we be “complete and thoroughly equipped for every good work” (2 Timothy 3:17) that might pose itself to us on our daily walks.

Hurting people surround us. As we minister to those who are hurting, may Your Hope flow through us. Many have lost jobs and are seeking employment. Provide for each person’s needs. Many have never heard the name of Jesus. May Your Name be exalted over all the earth. Many families are tortured and tormented by addictions. Break the chains that bind those who are struggling with these battles. Many are discouraged or distraught over life’s battles. Uplift their spirits and remind them that Satan is the instigator of strife and discouragement. Many are broken in their bodies. Pain and disease threaten their very lives. Heal each body in need of a divine touch.

Be our ever present help, Lord, as we seek to serve You, to honor You, to praise You, and to please You.

In Jesus’ Precious Name I pray. AMEN.

A Hairy Situation

I took a giant step for me Tuesday. Since I already had to go out in public for my bone scan (wearing my mask, of course), I decided to make an appointment at the hair salon. Anticipating my trip to the National Cancer Institute (outside of Washington, DC) next week, I went to the hair salon and had several inches of my hair cut off. Not knowing what treatment I will be taking and if it will cause me to lose my hair or not, I decided to give the stylist free reign on what she would do. And cut she did! My hair is probably shorter than it has been in ten years.

In nearly 13 years of living with leukemia, I have never completely lost all of my hair from any treatment. My hair has thinned at times and fallen out in piles; however, I have very thick hair, so no one noticed except for me. Pride and concern about appearance are not the reasons losing my hair even faze me. You can ask about anyone who knows me and even at my sickest points, I just do not look like a very ill person. I am grateful for that. And when a patient loses her hair, people attach the tag “sick” or “cancer” to that person. That is what bothers me the most about hair loss. It is easier for people to believe without doubt when praying for me when I look healthy.

People treat you differently when they know you have cancer. Even without a bald head, I have experienced the wide gamut of personal responses from people. Those who are intensely concerned and who constantly check on me are usually those people who have lost a loved one to cancer or who have had a loved one battle cancer. Others are indifferent and want nothing to do with me. I don’t know if my illness causes them to face their own mortality or makes them decide just to eradicate me from their lives because it is easier than coping with my sickness and hospitalizations.

I recalled a Scripture that I have prayed during past rounds of treatment – “But not a hair of your head shall be lost.” (Luke 21:18) Read in context in the book of Luke, this verse is reminding readers that those who are secure in the Lord will remain safe and unscathed during the end of the ages. The period of tribulation associated with the Rapture of the church from earth to Heaven, will be devastating and daunting. Yet, we are assured as His children that we will not have to endure these trying times of tribulation. Not a hair on our heads will be lost ………

For this time of personal tribulation, I will believe that He will help to preserve my health, my hair, and my hope. He will allow me to look in the mirror and see a woman of health – not illness. He will allow me to look strong and well to my family, not weak and weary, so that their faith and hearts will remain focused and encouraged.

Monday, May 4, 2009

Fashionable at last

Fashion has never had much appeal to me. I wear what I like and what is comfortable and give little thought to current fashion trends. I am just as happy wearing an outfit from Wal-Mart as I am wearing an outfit from Saks Fifth Avenue. What everyone else is wearing in the world has little bearing on what I select to wear.

Suddenly, I have stepped into the realm of being “fashionable”. I am on the fringe of being highly fashionable! Just take a glance at headlines on the Internet or cable news stations. The pandemic threat of H1N1 flu has brought droves of new wearers sporting face masks. I have been wearing these attractive blue or pink masks for years, since becoming immunocompromised and neutropenic. Designer masks are generating revenues for their makers, playing more on the fear of a flu pandemic than the desire to be fashionable. I recently saw masks with pig snouts, tongues, various beards and mustaches, and written messages on them.

I could have made a fortune years ago. Over the years I had many ideas for designer masks. When flying with my mask and other passengers would try to avoid sitting in my row or even looking at me, I was often tempted to write, I’M NOT CONTAGIOUS on my masks. Depending upon my mood, I often considered drawing happy or sad faces on my masks. Adding facial hair to my masks had little appeal as did the pig snout addition.

Just a word of warning – if you are considering a purchase of designer face masks, be certain they are up to the task of protecting you from H1N1 or other viral threats – masks carrying a rating of N95 or greater (also known as particulate respirators) are most effective at protecting the wearer.

My Hiding Place

"Thou art my hiding place; thou shalt preserve me from trouble; thou shalt compass me about with songs of deliverance."
(Psalm 32:7)

I am forever grateful that in a world swarming with H1N1 flu pandemic threats, that I have a hiding place where I am safe and secure. I can run to my Father and He covers me with His protection. That Hiding Place, Shelter, and Safe Haven has been a common site for me to return over and over again. When I am sick or afraid, I seek refuge with Him. When I am troubled and burdened, I am preserved and protected by Him. When I need deliverance from fear or doubt, He rescues me and lifts my eyes up to where my help always comes from – Him.

When I think of a hiding place or a shelter in earthly terms, I think of a storm shelter. My grandparents built a home in the early 1960’s, when then President Kennedy had encouraged families to construct bomb shelters in the midst of concerns over nuclear war. My grandfather took that directive to heart and built a regulation bomb shelter. Our family rode out many tornadoes in that cramped little shelter, but fortunately the nuclear threat never materialized.

As a child, I recall tornadoes sneaking through the fields surrounding the home and we sought safety and refuge in that hiding place. We knew we would be safe and delivered from the storms when we were encased in its thick, concrete walls. I remember the shelter not always being comfortable or warm or light, however, there was an inner knowing and a sense of deep peace that we would not be swept away by a ferocious spring tornado.

It is much the same when we seek refuge in God’s hiding place. Life can be crazed and chaotic all around us, but when we seek His shelter, an inner calm engulfs our minds and spirits. Pandemic flu threats, a declining economy, job loss, cancer, or a myriad of other life storms may be threatening our very lives. All we must do is to remember to crawl toward the Father. Seek Him in prayer and by reading His Word. By maintaining pure hearts and hands, He hears our voices and our pleas. And as His children, He is more than willing to come to our aid and to rescue us from the dangers of this world. He will always preserve us from trouble and provide His most perfect Hiding Place.

Sunday, May 3, 2009

A Brief Update: May 3, 2009

My IVIG treatment went well on Thursday. I did discover that morning that I was neutropenic again (very low white cells known as neutrophils that fight infections), so after the eight-hour IVIG treatment, I had to have a Neupogen injection.

I had my eye examination on Saturday. My eyes are watched closely as the pressure had increased in them (glaucoma) due to high doses of steroids. The leukemia can infiltrate the optic nerve and infections can settle in the eyes. My pressure in both eyes had improved and was normal! Praise God! The optomologist told me that my eyes looked like the eyes of a perfectly healthy person. (Except for the fact I have the over 45 year old problem of not being able to read without sliding my glasses down my nose, so I opted for two pairs of glasses - one for distance and one for reading, since my previous bifocal experience was not positive. After all, bifocals would mean I am old - right? Two pairs of glasses just mean I am old and have bi-glasses.)

This week is fairly benign with regard to medical procedures. I will have a bone scan on Tuesday to determine if the steroids are thinning and/or weakening my bones. Pray that they remain strong and healthy. Lil Man is not getting any smaller for this Grammy to carry around everyday! I will have labs drawn, acupuncture and my appointment with my family physician.

We are attempting to gather medical records, make travel arrangements, and prepare for my trip to the National Cancer Institute at the National Institutes of Health, outside of Washington, DC. We will be traveling the week following Mother's Day.

Thank you for your continued e-mails, cards, and prayers. I am blessed. I ask for continued prayers for strength, healing, discernment about my upcoming treatment decision, and safe travel for us.