Update on Robin as of 08/15/2007

After the Blog update went out last weekend, Robin’s Ophthalmologist,
Dr. William Foster (see http://www.WilliamFosterMD.com) read it and called to ask if he could help with her vision before she started treatments for cancer. He reasoned that once she started radiation treatments, which require she lay on her back, the blood in her eyes would be stirred up and he would not be able to give her more laser to abate the diabetic retinopathy. She agreed, and on Friday, August 10th, Robin met with him . Dr. Foster (who, like Robin, is a pianist) examined her and suggested that she go to two pairs of glasses (rather than bifocals) for reading and distance. He thought that separate reading glasses (with a focal point designed for reading music on the piano) would help her vision with a wider and taller field of view. Her prescription had changed (in the six months since we purchased those EXPENSIVE DESIGNER BIFOCALS (but I’m not bitter)), so he wrote new prescriptions for her glasses. He was RIGHT!!! When Robin played on Sunday, she said the reading glasses were a improvement over the bifocals.

Did I tell you what a great guy Dr. Foster is? He arranged to meet Robin on Saturday (while his family from out of town was visiting him, mind you) to put more Laser in her right eye in hope of stopping the bleeding. He truly has our gratitude!!! We would like to recommend him to anyone who needs an Ophthalmologist. He specializes in retina disorders, but he is certainly qualified for any eye problem (see his website at the link above for more info). Dr. Foster plays the piano, and he has a PhD in Physics and an MD. Robin likes him because he plays piano, and I like him because he is a bit of a geek. And on top of that, he (IMHO) is true Catholic Christian gentleman. Please think of him if you know someone who has eye problems.

Back to Robin: On Tuesday, August 14th, Robin and I met with her Radiation Oncologist, Dr. Hatch at UTMB in Galveston. It was a very informative and helpful meeting. (You can read more about Dr. Hatch here: http://www.utmb.edu/radoncology/docs/hatch.htm (although it is a little out of date)). Dr. Hatch was Robin’s Radiation Oncologist for her breast cancer treatments, and we think very highly of her. She spent lots of time explaining what the test reports said (and what they didn’t say), and she answered our MANY questions. First, let me say that the reports were not definitive that the abnormality was cancer; just that the damage was consistent with metastasis to the bone, which is fairly common after breast cancer. She said the reports stated that the lesions were reported in the bone, not the spinal cord (the bundle of nerves which is connected to the brain). This was important because Robin, who works with people who have “brain insult,” is very concerned about potential for metastasis to the brain. If they had seen signs of cancer in the spinal cord, then spreading to the brain would be a serious concern because the spinal cord and brain are surrounded by Cerebrospinal fluid, which circulates between them. However, it appeared that the spinal cord was not even being pushed or pinched by the bone compression.

Dr. Hatch then discussed the path we would take to get definitive answers, and where we would go from there, based on some of the possible findings. First, she prescribed an MRI of the vertebra to get a better view of the site, and a PET/CT Scan of her body to determine if there were any other possible cancer sites. She said that, if the vertebra is the only site showing signs of possible cancer, then she would advise a needle biopsy to know what we are dealing with. She said that bone cancer in the vertebra is very manageable, and Robin would get radiation and chemo afterwards. If cancer shows in other places, the treatment plan would have to be different. She also discussed strategies for repair of the vertebra to reverse the damage and alleviate the pain. As we understood the process, this would be done before radiation. Overall, Dr. Hatch laid out a logical and methodical path towards defining exactly what we are dealing with, and then devising the best approaches for dealing with it. We felt great relief because we understand better where we are going and we have confidence that we are going to make progress now that Dr. Hatch is in charge. In fact, her associate, Dr. Rao, called the next day (Wednesday) to set up Robin’s MRI. We are off to the races.

Thanks to everyone who has been sending forth prayers and good thoughts on Robin’s behalf. Please continue to pray for us, especially Robin. We will continue to pray for each of you, and for all those with cancer.

Love from the Burnses,
Larry and Robin (and John)

Bad News From Texas 08/03/2007

There is no good way to say this, so I'll just blurt it out.

Robin's cancer is back!

She had her usual twice-a-year scans done about mid-June, then had to wait almost two weeks to see her Oncologist. When she got there, the blood tests showed an increase in the cancer markers, but they were still below a level of concern. The CAT Scan report didn't indicate anything, but the doctor didn't have the Bone Scan. She felt confident that it wouldn't show anything. Robin asked that they get the report and fax her a copy.

It turned out that the Bone Scan showed something described as "very bothersome" on Robin's vertebrae - T-10 or T-11 - basically, at the bottom of the rib cage. It said that it looked like "metastasis" - a horrible word for a cancer patient. It means "spreading" of the cancer to other areas of the body. She called her oncologist, who ordered a more-detailed CAT Scan of the region, and we finally got to see the doctor today. The report said that the cancer is in the T-11 vertebra, but it has not spread to the others (as far as they can tell). The cancer has damaged the T-11 vertebra, and caused about a 40% compression and some fracturing, but there does not appear to be any pressure on the spinal cord. She has been experiencing pain in that part of the back, but just attributed it to getting old.

Robin's Oncologist said the treatment will involve more radiation and then more chemotherapy. She wants Robin to get a PET scan first, to see if there is any other metastasis. This PET scan should happen next week. We hope to see the radiation oncologist ASAP after the PET scan. After the radiation is done, Chemo will start. The doctor is considering an oral chemo, which should be easier to tolerate.

ONE LESSON WE LEARNED:
Medical test results belong to you! When you have tests done, ask the testers to send you a copy of the report (or pick it up yourself). You do not have to wait to see the doctor to get your results. With the aid of the Internet, you can probably even make sense out of them, but even if you can't understand everything, you will get a sense of what's going on, and you will understand a lot more of what the doctor says.

OTHER NEWS:
Robin's eye situation is still not good. She is still almost blind and cannot drive. Reading (which she loves) is possible, but it is difficult and slow. She cannot scan-read, but must read word-by-word, taking much longer than before her vision problems began. Her left eye, which received the vitrectomy, is pretty good, but the cataract (a side effect of the vitrectomy), is getting worse, causing haze except in the center of her vision. Her right eye continues to bleed from time to time, and does not seem to be improving. Her opthamologist said he might consider another vitrectomy on the right eye, but now that she will be doing chemo again, that probably will not be wise. At this point, she can play the piano again, especially early in the day, but the music must be "blown up" and she needs bright light. Fortunately, our Liturgy director and his team have been great about accommodating her. It really does wonders for her spirit when she can play.

Robin's diabetes has been doing much better lately. She seldom has severe low blood sugar levels or extremely high blood sugar levels. They have been more stable and she is adjusting to the lifestyle changes. We both started Weight Watchers, and that may be helping, too.

The rest of the family is doing well. John's working at Walgreen's in College Station and going to Blinn Junior College. He has visited us a couple of times, and the visits were pretty good for all of us. In fact he's been here the last two days and spent a lot of quality time with his Mom.

I am still working at Boeing in Software Quality Assurance on the Shuttle Backup Flight Software Project and on the Shuttle DOLILU project (Day-of-Launch--I-Load Update). They announced today that the STS-118 launch will be delayed a day until Wednesday, August 8th. I also just started helping on another project, so I'm spread fairly thin, but giving it the best I can.

In closing
Let me say that it sounds like this recurrence of cancer is very bad news, but it is not fatal. It will be treated like an incurable chronic disease. Robin will likely be closely monitored for the rest of her life, and when cancer shows its ugly head, the oncologist will bop it with a mallet. We will deal with it as we have before --- with the support and prayers of our friends and families, and with our God.

Please continue to pray for us, especially Robin, as we enter this new phase. We continue to pray for each of you, and to pray for all those afflicted with cancer.

Love from both of us,
Larry and Robin