SORTING THROUGH THE OPTIONS

Friends and Family,

A lot has happened since the last update but we still are not certain of the next steps for treatment.  Since then Dan has had the stereotactic radiographic surgery on his brain.  The tumor there was about the size of a BB.  The doctors felt the procedure went well. Dan said he just laid down and took a short nap and then it was "over".  It is easier than most doctor's office visits!   We won't fully know the results until sometime in May (unless a clinical trial before then requires earlier tests), when they retest him, but we are assuming the results will be as excellent  as they have been in the past. 

On Feb.12 we went to the Biblical Discipleship/Counseling Conference at Faith Church in Lafayette, IN.  Not only were we there with 8 others from our church in NY, but we ran into a friend from PA and 3 friends from College Hill days who now attend Faith Bible Church here in Cincinnati.  It isn't too surprising to run into folks you know there.  There were 1725 in attendance!  

Dan and I were in two different tracks so we were hearing different topics.  We were in class from 8:15 a.m. until 6:30 p.m. most days.  It wasn't as emotionally or mentally draining as last year, but hard physically to sit so long each day....and still challenging.  

We returned home from that on Feb. 17 in time for Dan to attend the Men's Retreat from ECC (our OH church).  Monday, we had our appointment with Dr. Rixe, the kidney cancer researcher at U. of Cincinnati.  Much to our dismay, we learned that he, too, is leaving our fair city.  We did meet the doctor who will be taking over the research projects and we heard about one possible clinical trial that Dan would qualify for.  It is a "phase 1" trial. That means that Dan would be in the first group of humans to receive the drug.  Up until now, only lab rats/mice were given it.  hmmmmm.  Not our first choice.  The other option we learned about was a new kind of stem cell transplant being done in Bethesda, MD.  While that sounded a bit more promising, it would require a sibling "match" and living in Bethesda for about 4 months.  Dan only has one living sibling and there is probably less than a 50% chance of her being a close enough "match".  Plus I know that he really wants to get this discipleship/counseling ministry up and running and doesn't want to be in Bethesda, MD for 4 months.  But it remains a possibility.

Dr. Rixe also recommended that we talk with Dr. Rini, at The Cleveland Clinic.  He thought they might have a clinical trial or two there that Dan might qualify for.

After talking with Dr. Rixe, we felt that much of what we had to do in the next week or two was to do a lot of research, phone calling and thinking and praying and all of that could be done from NY.  We had planned on being in NY but were not sure we could go.  We decided sort of "spur of the moment" to go home, pack and leave the next day.  

While we were driving to NY, I thought...."we drive right through Cleveland.  Maybe, if we are really lucky, we could get an appt. at The Cleveland Clinic the day we are driving back home and save ourselves a separate trip."  Well that sounded like a good idea.  And I think out of respect for Dr. Rixe who had referred us, Dr. Rini made time to see us that day.  The only problem was that it meant NEEDING to leave NY at a specific time and we had sort of planned NOT to need to do that so we could work around winter weather.  You know what is coming...right?    Yeah.  NY hasn't gotten hardly any snow all year but right after we got there, they got a fair amount of snow.  And just before we left a big snowstorm arrived.  We kind of worried about when we should leave for 3 days and after all of that, ended up leaving in the middle of the storm!    More on that a bit later.

Well, we ended up visiting when the NY schools have "winter break".  Their school year is from Labor Day to the end of June and they get a winter break in addition to a spring break b/c the winters are so long and hard there (usually).  So many of our friends were gone on family vacations and a few more regular snow-birds were still down south.  BUT we did get to see several friends and had good visits.  We also got one day of fun in the snow....snow shoeing around the ministry center lake.

This is Dan (center) with Al and Audrey on our trek around the Ministry Center's Lily Lake.  

Dan and I were enjoying the snow.  Cocoa was enjoying the hike too! You can see that it was truly a "winter wonderland" that day.

A dear friend let us stay at her beautiful home rather than to have to open and close our cabin.  I know that that made the trip easier and more enjoyable for Dan, not having to worry about all of that.  

                        Dan, relaxing, doing his beloved Sudoku.

Thanks, Joan!!  Just wish you would have been there with us!!

Well, we waited for that storm to come and go.  Originally, it was predicted to be finished by mid afternoon on Thurs.  We planned to leave then, drive a few hours, spend the night and then drive the rest of the way to Cleveland on Friday morning.  Our appt. was at 1 p.m.  Cleveland is about 7 hours from our place in NY under good conditions so we knew we would need longer.  Based on the forecast, the worst of the driving conditions should have been between where we were

and Syracuse.  But they kept moving the end time of the storm later and later.  At first we thought we'd just wait till it ended (supposedly at midnight now) and leave around 3 a.m.  But then it looked like the snow  was going to last all night Thurs.  THAT was NOT good.  I finally decided that if I was going to have to drive in the snowstorm, I'd rather do it in daylight so we left about noon on Thurs.  

The drive from Lake Pleasant to Utica normally takes about 55 minutes.  That day it took an hour and 45 minutes.  Thankfully there were not many other people dumb enough to be driving, but there were logging trucks.  You do NOT want a logging truck behind you on SNOWY, curvy, steep mountain roads!!  I finally found a place where there was a little bit of shoulder so I could pull over and let the truck go by me.  That was a relief!!  We were going anywhere from 20 mph to 40 mph, depending on the steepness of the road and the depth of the snow cover.  The plows just couldn't keep up with the snowfall.

We were very thankful to get down the mountain safely.  Once we were about 15 miles west of Utica, the snow turned to rain and the driving got a lot easier.  We went as far as Erie, PA that day.  Since we had Cocoa with us, we needed to find a pet-friendly motel.  My sister takes her dog on many trips and recommended the LaQuinta chain, so that is where we stayed.  The thought of staying in a room where other dogs stayed was not too appealing, but hey...you do what ya gotta do!  Other than the key card system being down, requiring that we be let in our room by a staff person, it wasn't too bad.

The next day we arrived in Cleveland in plenty of time to find the right building at the clinic, find the parking and then find a restaurant.  We are learning to appreciate my iPhone at times like these.  "Ms. Siri" helped us find a Panera for lunch and find our way back to the Clinic.  (for you non-APPLE folks, "Siri" is the computer voice that gives vocal info from the phone ...sort of like an audible GPS but offers a wider range of info).

Dr. Rini did not have any clinical trials to offer us but he did have some insights on Avastin, the drug that Dan had taken for 2 years.  We had read that some people who were successfully treated with Avastin and had had to go off of it for some reason for a time; when they went back on the drug, it was no longer effective.  He said he had treated many people with Avastin and had not seen that happen.  He felt that it worked before and was probably the best course of action for right now.  He said that since it is now approved for renal cell cancer treatment, the oncologist could be more flexible in handling the possible complications that caused Dan to have to go off of it the last time and at the very least, might buy time until a new clinical trial that seems to fit his circumstances better is found.

We still have one more researcher to talk with.  We will be visiting Dr. Olencki at Ohio State's  "The James Cancer Center" on Monday.  He may or may not have a clinical trial that would be appropriate.  If he does, I'm thinking Dan may still opt to go the Avastin route for right now and see if it has the same good impact it had before, possibly saving the clinical trial for later.

He has an appointment with a new local oncologist set up for Tues. and we are  hoping he can get his treatment started sometime next week.

As always, thank you each so much for continuing to pray for us.  We still are learning about things like "trust" and "faith" and God's sovereignty and His faithfulness.  Your prayers have meant much to us, helping to carry us along the journey!!  Thank you!!  Jodee and Dan.

WHERE WE ARE NOW

Dear Friends and Family,


We are so thankful that even with this latest turn of events (the new cancer growth on Dan's 10th rib +) that we were still able to take our ski trip to Colorado.  The weather had been a little stingy with the snow in the mountains of Colorado so folks were asking us if we still were planning on going.   Looking back over the more than 20 years we have been traveling to Colorado to ski, we realized that while we have had a range of skiing conditions, we had never had a really bad week.  SO.....if this was, indeed, that one bad week, well, we would have little room for complaining.  We figured we could rent bikes and do some biking and/or hiking if skiing was really bad.

After surviving a baggage mix-up at the airport (our fault!) and a blizzard on I-70 as we drove from Denver to Breckenridge, we were able to find new ski boots for me (Jodee) that actually FIT (this is always a huge challenge), get checked into our condo, pick up our rental skis and buy groceries...all before collapsing after a very long day.

The new snow drew MANY skiers to the mountains and Sat. and Sunday were really crowded.  It was just like spring skiing during spring break!  But the rest of the week was wonderful, including a couple more days of new snow.  So once again, Colorado was awesome!!  We skied all 7 days, enjoyed meeting up with friends and got a LOT of fresh air and exercise!

We were happy to get fresh snow several times that week.

The view from our condo resort

          
Fresh corduroy as viewed from our first ride up the chair that morning.  Couldn't wait to make our own tracks.

A professional photo of us at the top of Peak 7 using our "Epic Mix" passes.  They automatically tracked our skiing...from number of lift rides to total amount of elevation skied.  Amazing.

We would take a late morning break and then a late lunch to try to miss the crowds.

We tried to have relatively "healthy" snacks.  Chocolate is hard to pass up.  And to avoid altitude sickness, we had to drink lots and lots of water.  I do confess to adding a little hot cocoa to my decaf coffee a couple of times.

                        

Leaving the mountain via the gondola after a week of great skiing.

                                     
Before we had left for Colorado, we had contacted Dan's former oncologist (now the medical director of Vanderbilt University's Cancer Center) to get his input.  He was very gracious in quickly returning my email as well as setting up a phone conference with us.  From him, we learned that doing radiation on the rib might eliminate the possibility of qualifying for a clinical trial.  This had not been mentioned by our current doctor.  He also said that while the medication to strengthen Dan's bones sounded like a reasonable thing to do, there was no rush to do so and we might want to gather all the info on his options before beginning any particular treatment.  We chose to send him all of Dan's records so the clinical trial folks at Vanderbilt could see if he would qualify for any trials they were doing.  We are SO grateful for this doctor/friend!!

We also met with Dr. Brenneman, an oncology radiologist, to talk about radiation options for Dan. After looking at the current scans, he told us he was surprised that Dan was not having a lot more pain than he is.  He stated that pain would be one reason Dan might want to radiate the rib right now, rather than waiting for a possible clinical trial for a systemic chemotherapy.   He also said that radiating that spot would not categorically eliminate us from all future clinical trials, but would delay that possibility until a new "spot" evidenced itself.   Since Dan was not experiencing anything more than an awareness of this new tumor and an occasional tinge of pain, we decided to wait on radiation there, but scheduled an MRI of his brain to make sure that nothing new was going on there.  We scheduled it for right after our return from Breckenridge.

We did have all of his records sent to Vanderbilt and while we were out in Colorado, we had several conversations with a clinical trial nurse there.  At first we thought there would be a new trial opening up this week, but just after arriving home, we heard it had been delayed.  It would have required much travel back and forth so we were undecided if that was the best route to take anyway....and had been praying for clear direction.  For right now, that decision has been made for us.

Last Wednesday Dan had the brain MRI done.  On Thursday, he talked with Dr. Brenneman and learned that there was a small spot that would need to be radiated.  Appointments were made for a CT scan and mask adjustment (today), a meeting with the neurosurgeon (tomorrow) and the stereotactic radiographic surgery (Friday).  We were disappointed to learn of this additional new growth, but so grateful that it was discovered while still small enough to be able to be treated with this miraculous form of radiation.  And unlike radiating other parts of the body, this will not have an impact on most clinical trials.

We also have an appointment on Feb. 20th with a doctor at the University of Cincinnati who specializes in kidney cancer research and may know of a clinical trial that would be appropriate for Dan.  I'm uncertain whether or not he would function as our primary oncologist or whether we need another one and he would be more like a consultant.  So I am trying to convince Dan to investigate a couple other oncologists in the meantime.

As you can tell, our schedules just got quite a bit busier and more complicated.  But even so, Dan is forging ahead in trying to get the discipleship/counseling ministry up and running at Evangelical Community Church and we are still planning on attending the Christian Discipleship and Counseling Seminar at Faith Church in Lafayette, IN next week (Feb. 12-18)  Several folks from our church in NY are attending as well.  We will be in different levels of learning, but will have some time together, so we are looking forward to that!

With Dan's cancer and treatment, we are still very much in the info-gathering stage.  Please pray that God would make the path clear and that He would provide us with an oncologist who is a good listener, compassionate, knowledgeable and skilled. (We know we are asking a lot, but God is an AWESOME God!!).  We thank him regularly for all of you who have loved us throughout this journey and are consistently praying for us.  We are so grateful for each of you!   Jodee and Dan


The Earlier McCabe Blog

BACK AT IT

Dear Friends and Family,

The last entry here was at the end of Sept. b/c that was after Dan had his scans done. And since that time, no news has meant "good news". We had a wonderful fall and early winter which included: 3 weekends of training (Christian Discipleship and Counseling) at Grace Fellowship Church in Florence, KY, a wonderful Thanksgiving with the McCabe/Morris clans, celebrating our grandson, Matthew's, birthday and my birthday, a week-long visit to Mom's in Pompano Beach Florida in early Dec. and a truly wonderful family Christmas. We have so much to be thankful for.

Our Thanksgiving Centerpiece

Mom, waiting for the start of the John Knox Village Christmas Parade

Matthew at the Birthday Party he shared with two classmates.

Birthday Cookies for Matthew's class.

Christmas afternoon at Mimi and PopPop's house.

But all of that transpired over a 4 month span of time and since he is scheduled for a CT scan and a bone scan every 4 months, Jan. meant that it was time for the next round of tests. Yesterday was the day and he went into Jewish Hospital for both procedures.

Always before, he has waited and gotten a copy of the digital and written reports before leaving the hospital. (We learned early on that keeping our own records was highly advisable!) But yesterday, for some reason, they "could not" provide him with the written report of the CT scan.

Dan didn't think much about that, but I was wondering if that was because they were getting a second opinion on a questionable area. As a nurse, these kinds of questions tend to surface fairly quickly. A question that probably should have come to mind was, "Are they not giving him the report b/c there is bad news in it?"

So we had to wait until today for the results.

On the positive side, Dan looks great and has been feeling really well. We both have been working out at the gym to try to prepare ourselves for skiing (in less than 2 weeks from today!) and he definitely is gaining muscle strength and is back to a healthy weight. So life has been very good lately.

As you have already deduced, the news at the doctor's was not so positive. After the last scans in Sept. there was some question about an area on his 10th rib on the right side. The changes seemed minute and could possibly be the result of a different angle or a different radiologist's interpretation. We, of course, were hoping that was the case. The results this time, however, were not as ambiguous, and show some progression in that same area. There were no new areas of disease detected and for that, we are very grateful.

There isn't much available that is left to use in the chemo arsenal that is effective against renal cell cancer. So the first line of attack for right now is to possibly use radiation on that area and to add an intravenous medication that helps the bone fight against (slightly) or "inhibit" further metastasis and prevent against calcium loss.

We have an appt. for next Thursday with the radiologist to get his input and an appt. in two weeks with the oncologist to most likely begin the intravenous treatment. That drug will be given every 6 weeks.

I'm not sure either of us has fully processed this turn of events, but we know that we are trusting the same God who has been with us through all of it and who

has His Glory and our eternal good as priority #1. While life is still full of twists and turns, we know there is ultimate (eternal) safety in His plan for us.

Thank you for continuing to pray for us as we move forward.

Jodee and Dan

ANOTHER MRI

Written by Jodee McCabe    

Sunday, 04 January 2009  4:25 PM

It has been quite awhile since you have heard from us.  We survived December although we did not get to take our trip with our whole family to New York.  Our kids had worked hard to arrange for all of us to be able to spend Christmas together at our cabin.  Karla's family celebrated their Christmas a week early so that we could have them for both Christmas Eve and Christmas Day (THANK YOU!!)   But......the weather on our east/west route of I-90 became too unpredictable for our kids who had limited windows of opportunity to get to and from N.Y. and so rather than becoming separated or spending Christmas worrying about the weather, we chose to stay in OH.  We had a wonderful Christmas Eve and Day all together and made many lovely memories.  Yes, we were disappointed to not be able to play in the snow and not to be able to visit our good friends in NY, but we are continually reminded of all of the blessings we have even in the midst of disappointment.

It was so much fun to have the kids and grandkids home for some of the Christmas preparations!  Meg is helping Morgan decorate the cookies.

Megan guided the construction and decorating of their own Gingerbread House.

Looks pretty awesome, if you ask me!!

Part of the fun is cleaning up.

Meg and Morgan work on a surprise for PopPop...a NOTRE DAME blanket!!

Finally!  Christmas Eve!!

Somebody got a fireman's hat.  Wonder who that was from?

It was such a treat to have them here on Christmas Morning!!  And look what Santa brought Morgan!

We are so grateful for this special Christmas together.  It was tempered a bit by our not being able to have our dream of being at the cabin and by not being able to say good-bye to our dear friend in NY who passed away on Dec. 23, but it was so wonderful to have that time together....all together for Christmas.  We are very, very grateful.

Now the holidays are over, the tree is down, the decorations are put away and it is time for more medical appts.  If you remember, Dan completed one last round of Sutent, his oral chemo, right before Christmas, just to give him the best possible chance to NOT have more brain tumors form before the next MRI.  That last round was pretty tough.  All of his side effects were worse than before and for the first time, he experienced quite a bit of nausea and GI discomfort.  We were attributing that to the chemo.  But now that he has been off chemo for 2 weeks and still has some GI symptoms, we are not so sure. Perhaps, just as the side effects were stronger, it will take longer for the side effects to completely go away.

Even though he was very uncomfortable through that last round, he stuck it out and completed it.  Now at least we know he did everything he could do.

Tomorrow early in the morning we go in for his high def MRI to see the results of the stereotactic radiographic surgery he had done 8 weeks ago and to see if there are any new tumors.  We are praying that no new tumors would be there and that the results from the SRS would be better than before, if that is possible.

If there are no new tumors and the other tumors have been adequately diminished he will begin an IV administered chemotherapy.  We do not know if it will be as part of a clinical trial or not. Results of the SRS and also negotiations with our medical insurance are pending.  Please pray for the best solution to be worked out, both medically and financially.

If we only looked at our future in terms of medicine and man's knowledge, we would be quite discouraged.  But as many of you remind us and as we read in Scripture, our present and our future is in God's hands.  Dan has already passed by the prognosis of 3 to 6 months and most people would not be able to tell, by looking at him, that he is not well.  Some days it is even hard for us to believe. We are grateful for each day.

Please pray for us to be able to sense God's presence with us tomorrow as we learn just where Dan is: the results of the SRS and whether or not there is any new growth of the disease in his brain.  Please pray that the knowledge of His presence will not only give us peace in all circumstances but that it would shine through us to those around us, offering hope to the hopeless.

Thank you once again for being on our "team" and literally holding us in prayer.  We will let you know what the docs say tomorrow.

STEREOTACTIC RADIOGRAPHIC PROCEDURE

Written by Jodee McCabe    

Thursday, 20 November 2008   6:15 AM

This last week or so has been pretty busy.  Last Friday Dan had a CT scan (yes, another one) and then Monday he had a high definition MRI to prepare for another stereotactic radiographic procedure.

Later this morning, Dan will have that procedure on his brain.  The first one back in July, treated 3 tumors successfully.  Today they will be zapping two small tumors, one on each side.  The docs say these are small enough that Dan doesn't need to be on the anti seizure meds.  We are very relieved about that b/c they made him feel terrible and pretty much killed his appetite.

The mask that was used the first time to stabilize his head just needed some minor adjustments so they did that last Friday and used it to position his head for the CT scan and will be able to reuse it today.

He needs to wait for 8 weeks after this procedure and then have another MRI to check those tumors.  IF they are gone and no other tumors have formed, then he might be able to begin the clinical study for AVASTIN.  In the meantime, he will do one more round of Sutent.  Even though it has not been effective enough, we are hoping that it will still minimize the progression of the disease while we wait to be enrolled in this clinical study.  He will be off the drug for nearly 4 weeks prior to beginning that new study.

His pain has increased somewhat.  It is mostly in his lower back but he also has some in his shoulder and upper back.  He has increased his pain med slightly by taking it in slightly shorter intervals.

Please pray for his own body to begin to figure out how to fight off the disease.  All the chemo drugs can offer is a little more time for that to happen.

Please pray for me as well.  Last night I developed a sudden sore throat.  I'm gonna try to see the doc late this afternoon.

Our first thought is always of healing.  But we know from reading Scripture and from listening to wonderful teaching and from hearing other life stories, that while God often displays His power and glory through healing, there is so much more to learn about Him, and about us,  through these trials.  We don't want to miss any of it.

Thank you to each of you for your continued prayers for us.  It is difficult to explain all that it means to us but as we gather with our family around the Thanksgiving Table, be sure that we will be thinking of each one of you as we thank God for all of His Blessings.

SECOND MRI RESULTS

Written by Jodee McCabe    

Tuesday, 11 November 2008 10:45 AM

Yesterday was our visit to the oncologist to get the results of the MRI of the brain.  We were told that there are two new lesions in Dan's brain, one on each side and both are small.  This kicks him out of the clinical trial for now.  We were very disappointed but not surprised.  It seemed logical to us based on the results of the CT scan, which had shown that in other parts of his body, while some tumors disappeared, other, new tumors had formed.

We are staying at home this morning waiting for the radiologist to call to discuss further "options". We are hoping that he will agree to repeat the procedure that Dan had early this summer (stereo-tactic radiographic surgery) to remove the new growths in his brain so that we can continue with chemotherapy.  The current drug is not effective enough and we hope to get him included in a clinical trial once the new brain lesions are dealt with.

Some of you have written and reminded us that we are not limited to the discouraging news of the doctors, however accurate it is, and to keep our minds and hearts centered on God's Word, which is full of life and hope.  We are well aware that that hope is in being a part of Christ's Body for eternity; not in an endless life here.  But it does include an "abundant life" here, which we understand to mean that God will provide what we need to endure for now as we prepare for eternity.

Our children/grandchildren have been very attentive and friends have been doing all they can to support and encourage.  How blessed we are!  As Thanksgiving approaches, we have more than ever to be thankful and grateful for.  Each one of you is high on the list!  

NEXT STEPS

Written by Jodee McCabe    

Sunday, 02 November 2008 1:00 PM

Well, it has been an eventful week and yet little has been accomplished; or at least it feels like that.  Eventually, as I related in the last update, the oncologist did get the full report from the radiologist re: the CT Scan.  The results show that the Sutent is not adequately fighting off the cancer.  The doctor called twice last week to fill us in on the situation.  He explained that we needed to keep the appt. on Friday (i.e., not move it earlier)  b/c he wanted to consult with Dr. Logan, from I.U. Medical Center and he needed that time to be sure they could connect.  We were glad he was not SENDING us.  On Thurs. he called again to tell us that Dr. Logan had no other treatment options  to offer than when we spoke with him in June.  

Our oncologist had been made aware of two new studies that were using a drug called "Avastin".  One study was using Avastin in conjunction with another chemo drug and the second study only used Avastin.  He said Dan would need another MRI of his brain before he qualified for either study.  If there are new brain lesions, he would not be able to participate.  He felt there was no need to see him again until after the MRI was done but suggested we come in on Friday to speak to the research nurse who would inform us about the two studies so we could read the information carefully and have time to consider them before we had to make a decision

When we got to the appt. on Friday, one of the studies had already been closed out.  Some  folks would be disappointed but we are understanding this as an answer to your prayers for us: to keep our paths for treatment clear.  So now we wait some more.

Friday, the MRI will be done.  Tues. we will see the oncologist and talk about results and our options, if any.  IF the brain scan is clear, Wed. Dan will go for a bone scan.  That is for the benefit of the study (if he is eligible) so they will have a clear record of the starting point.  Also, if he qualifies for this study, he will discontinue the Sutent he is now taking and then wait for two weeks before beginning the new treatment.  This new drug will be administered IV once every other week.  After some time, results will be evaluated.  IF he is one of the few who is showing good response, those people will be randomly divided.  Some will be treated every week and others will remain with the once every OTHER week dosage.  In both cases the dosage is higher than previously used.  If you read the list of possible "side effects", you'd be worried.

In the meantime, Dan's pain has migrated from his flank down to his sacrum.  He has pretty much been on pain meds around the clock.  There are other areas that hurt but that is the major one.

It is very possible that Dan will not qualify for this study or that by the time we comply with all the tests, that it will be filled as well.  Even knowing that, it is hard to adequately prepare to HEAR it.  We though we were prepared for the results of the CT scan but discovered it is very hard to corral emotions.

Although the MRI will be done on Friday, we do not anticipate knowing anything until next Tues. (Nov. 11).  Although the wait seems long, I cannot imagine dealing with socialized medicine where you wait for months for diagnostic tests.  We are praying about that issue as well.

We also have increasing concerns about Dan's brother, David.  He has been having fainting spells at work and they have discovered his blood pressure is very low.  They took him off a medication he had been getting for Down's Dementia but that did not help his blood pressure go up to normal range.  They tried using a halter monitor to check his heart function, but he ended up breaking it.  We are guessing it will not be very long before we need to place him in a nursing home.  We are praying that God will grant David mercy and allow him to remain in the group home and sheltered workshop until the end of his days.

Please continue to pray for wisdom for the medical people; for wisdom/ discernment for us as we make decisions regarding their recommendations for both David and for Dan; and for that "Peace  that Passes Understanding" that flows out of total trust in our Savior and King, Jesus, and ALL that He has for us in this life and the next.