Health Update 9 August 2018

This is Bill Chu, my sister Kim and I are visiting to Uncle Franklin. I been invited to share this update with the blog community. Please pray for healing.

Franklin is currently in Virginia Mason Hospital room 1822. He is having severe respiratory distress and a lack of appetite. Franklin is hoping to get on a clinical trial a new oral cancer treatment. The clinical trial board is holding a spot for him; however, given his compromised state he does not presently qualify.

Franklin has been in hospital for several weeks with a variety of compilations including infection, bowel obstruction and respiratory distress.

He has friends and family surrounding him. Jenny, Catherine, David, Matthew and Marco are showering him with love and care.


July proved to be a challenging period. Franklin spent the first week in hospital for an infection. He was released once infection was under control, however he had to return to hospital after only one day at home. This time Franklin was unable to keep anything down, having difficulty breathing and was retaining water.

Radiologic evidence indicated a obstruction in the distal end of the small intestine. Franklin was treated with a nasogastric tube to release pressure from his belly, and medication to promote clearing of the obstruction.

For two weeks Franklin took nothing by mouth. The internal medicine team was at a standstill and the surgical team elected not to take Franklin’s case given the his current cancer status. Dr.  Catherine Chu was on hand to intercede both as a patient advocate and as a medical consultant. She and Franklin suggested that the Gastrointestinal Team might employ a stent to relieve the obstruction.

Under the pressure of persistent requests for consult from the Doctors Chu , the GI team sent Omar the GI Physicians Assistant to make an initial assessment. The PA thought the stent idea might be fruitful and ordered a Cat scan to determine a more precise assessment of the blockage. Was the there a single blockage or multiple sites? Was the blockage due to impaction within the bowel or were metastatic tumors strangulating the gut? These were the salient questions that the cat scan would answer.

It was determined that the blockage was internal to the bowel and located a single site in the ilium or last part of the small intestine. While this is just outside the typical colonoscopic range, Dr Steven  Ross the GI surgeon felt confident that he could reach the site and repurpose a stent for this “Hail Mary” procedure. Dr. Catherine Chu was pleased that Dr. Ross was Mass General Hospital trained. Furthermore Dr. Ross was able to demonstrate that his hands were steady.  Linnea was satisfied that the surgeon was confident and simultaneously realistic.

On Wednesday Aug 1, the stent was successfully placed in Franklin’s ilium. Within two days x-rays showed contrast dye in the sigmoid colon. These findings were consistent with a successful clearing of the obstruction. However, Franklin was still unable to have a bowel movement, had very little appetite and continued to have a distended belly.

Three days later Franklin had a bowel movement. His first in several weeks.  He still needs to get his appetite up before he can go home or begin the trial.

Health Update 28 June 2018

Again, we were on the 7:05 Seattle ferry for the scheduled Chemo session.  We arrived just in time for the 8 AM appointment and were escorted to Short Stay to access the Pic line for the CT Scan.  Blood was also drawn for test.

No other way to say it.  The test results were not good this time.  CT revealed multiple new lesions throughout the liver and belly, including new lesions in the subpleural area.  Dr. Picozzi and we were all obviously disappointed.  Current Chemo regiment has lost control.  Dr. Picozzi stopped the current treatment and entered me into a stage 2 clinical trial of which I am one of the first patients enrolled.  Recruitment is for 99 patients.

Before acceptance, I had to have an eye exam to document my cataract status.  I’ll get an EKG and more blood work, and I am scheduled for a PET scan Tuesday to document the extent for the metastasis.

Since Chemo has been suspended, the daily infusion of antibiotics have been terminated as well.  The visiting nurse removed my Pic line on Friday and today I enjoyed being able to shower for the first time in nearly seven months!

I apologize for feeling down; I have procrastinated in writing this report.  When my daughter Catherine in Boston heard this news, she immediately arranged for her family of five with 3 grandchildren to visit Mon-Thurs.  Son, David and family of four with two granddaughters came over and spent the night of July third.  We enjoyed each other immensely and had a grand time.  The 5 grandchildren, ages 1,2,4,10,11 could raise anyone’s spirits.  Now my step-son Matthew, Kattarina and 5-year-old Ariana are here for the week-end.  I feel well supported.

The doctor placed me on an anti-depressive, hoping to resolve some of my neuropathy as well as elevate my mood.  But it makes me sleepy all the time.  If I sit, I’ll close my eyes and sleep, sometimes for hours.

WE are hopeful that this clinical trial will do some good.  First report will be after four weeks.  I’ll update a report then.

Remedial Chinese at UW: Humble Pie

After her Junior in HS, my daughter Catherine was selected to attend Harvard University Summer School as a regular college student.  Unbeknownst to any of us, she chose to immerse herself in learning Chinese.  She had taken Japanese at Bainbridge High School but had no knowledge of any Chinese.  Because their mother didn’t speak Chinese, I didn’t share any of my language with my children.  (It was almost impolite).  Even when I spoke with my parents or to my cousins, we spoke English, so everyone could understand.  Besides, I was also trying to use these teaching opportunities to ‘force’ my newly immigrated cousins to learn English and not be so self-conscious or embarrassed.

Money spent for that summer school was well worth it.  Not only did Catherine learned to speak almost perfect pinyin conversational Chinese, she also learned enough characters to write a beautiful one-page letter to Grandpa!  Grandpa proudly carried and showed that letter to his friends whenever he had a chance.  All my cousins also agreed that if they could attend a similar program that taught English with such result, they’d all gladly pay the tuition and join the classes!

Well, after the summer, Catherine returned home and wished to continue studying Chinese, so she enrolled at the University of Washington evening school.  The classes were 7-9 pm, Tuesdays and Thursdays.  It was problematic using public transportation, especially coming home really late, so I agreed to drive her.  At first, I was going to transport her and use the waiting time to do my patients’ charts.  Then it dawned on me that why don’t I sign up as well?  Though I have no problem speaking, I could learn to write more characters and improve my written knowledge base as well.  Catherine and I became classmates!!

Dilemma!!  How should I behave in class?  In my old school days, without much effort, I could out shine anyone in class.  Should I hold back a little to just keep up and let Catherine be the ‘star’?

Having researched the prerequisites, I noticed while driving to our first session that Catherine already had her text and her dictionary.  I did not prepare at all, thinking that the teacher would provide or suggest materials at the first gathering.  Wrong!!

At our first session, the teacher went down the rows and asked each one to try to speak ‘as best as possible’ in Chinese what their goal was for this class.  Each student struggled a little but verbalized his/her purposes very adequately.  Most indicated that they’d wanted to be more fluent in Chinese.  When it was my turn, I simply said that I can converse, but I’d like to read and write better.  After the teacher heard me talking, he asked if I spoke other dialects.  I started speaking Sichuan and Cantonese.  I also said I could get by with Henan and some ShanTou.  He then asked about my history.  It was clear from the uneasiness of the rest of the class that they felt I didn’t belong.  At last, the teacher said that since I was a doctor and didn’t need the credit, I should just audit the class and attend as I’d like.  It was a good suggestion.  He then went to the prescribed assigned text and had each one read in order.  I didn’t even have a book!   As it turned out, working full-time and being older, I was having great difficulty keeping up with memorizing about 40 new characters each session.  I would learn the new, but invariably forget half of the old.  My Mom became my tutor and she could not believe how ‘stupid’ I’d become.  Outshining Catherine was no longer an issue, I was fearful I was embarrassing her.  Young brains are certainly more pliable and retentive of new information better than mine now.

Definitely the ‘star’, Catherine finished the class with an A, .  Despite my efforts, if I were to give myself a grade, it would be at best a C-!!

A humbling experience!!

Health Update 14 June 2018

Again, we were on the 7:05 Seattle ferry for the scheduled Chemo session.  We arrived just in time for the 8 AM appointment and was greeted by Dr. Picozzi for the exam before any tests were started!  He found me to be healthy appearing, my weight stable and I have no discomfort or pain; he continued my same regimen of meds.  He said that the paresthesia may take some time to improve and may not resolve completely.  We queried about the Ca marker rise and he tried dodging it by saying one reading does not mean much.  Well today (result came in after his visit) the marker jumped from 2000u/ml to 4000u/ml since two weeks ago!!  He still wanted to wait after the next CT scan scheduled for my next visit in two weeks before making any changes.  This is somewhat of a discouragement.

I am otherwise doing well.  Wish my balance is good enough to at least go on the golf course to hit some chipping and putting but looks like that’ll yet be a while.

Deep heartfelt thanks for visiting and your continued care and concern.  Update after the CT Scan next visit.

Happy Father’s Day to ALL.

Emergency Drop Off

When our eldest son Matthew was to be deplored to Iraq in 2003; we planned a farewell dinner at Harbor Lights in Tacoma before he left.  Unfortunately, that week a dear cousin of mine passed away and subsequently my family scheduled a memorial service planning session for that same evening.  Since I was unable to attend, the least of my responsibility was that we get my parents there.  My father was to be the officiant for the service.   Linnea and I allowed plenty of time to drive around, pick Mom and Dad up in Federal Way and get them to north Seattle.  We would then meet Matthew, his girlfriend, his father/wife in Tacoma before he departed from Ft Lewis later that night.

But, on that particular November day, the Seattle traffic was incredibly heavy.  Having left with lots of time to do the pickup, we found ourselves barely creeping towards Seattle.  Finally, with less than an hour left to meet Matthew who was flying out that night, we were merely approaching China Town.  In desperation, I contacted one of the cousins who was already at the north end and have him come back and pick up my parents at the barber salon near Auntie Grace’s apartment.  This arrangement was done quickly and apparently without my parents (hard of hearing) knowing anything.  The salon was lit and warm, so we left them there saying that one of the cousins will be there soon.  (They were fighting traffic as well.)  Linnea and I left headed towards Tacoma.

Unbeknown to any of us, the salon closed at 7 pm and left my parents outside on the street waiting for over one hour!  It was dark, and they were cold.

To this day, my Mom still tells stories of me ‘dumping’ them on the street in the middle of nowhere in Seattle on a cold November night!!

Greek Fraternity

After graduation from The Ohio State University in 1966, I was attending the School of Medicine at Johns Hopkins.  Everyone there was diligently ‘hitting the books.’  Studying 24/7 was a new and exhausting experience, yet I felt I was always behind.  There was so much to learn and so little time!

One day in October I got a phone call from Mom asking me if I had joined a fraternity while I was at The OSU.  I answered her “No.”  She said, we received a letter from some fraternity asking for $50.  I told her I didn’t owe anyone anything so go ahead and throw that letter in the garbage.

Later in mid-November Mom reported that another letter had arrived; but this one was certified, requiring a signature as receipt.  It again requested $50 for the price of a key to some Greek fraternity.  I told Mom that I’d come home for Thanksgiving and I’d get that straightened out.

The letter was from Phi Beta Kappa.  I was now placed in the class of 1967 since I had not remitted the required $50 for the ‘key’ in time for the 1966 class.  If I wish not to accept the membership, (though they’ve not had refusals before,) I should notify Phi Beta Kappa personally and my name could be removed.  If the $50 fee posed a hardship, they had scholarship to help and I can/should apply.

I explained to Mom that this was not a Greek fraternity at The OSU.  This was a national honored scholarship organization.  It was renowned and deemed a privilege to be selected.  For example, everyone in my Hopkins’s class was a member.

We remitted the $50 promptly.

p.s.  my step-son Marco Simons is Phi Beta Kappa 1997 from Harvard and my daughter Catherine Chu (Kramer) is Phi Beta Kappa 1998 from the University of Washington.

1950 Chevy

After Uncle David completed his divinity studies at Lutheran School of Theology in Chicago, he was ordained and received his first Call at Adams Lutheran Church in Batesville, IN, and served from 1961-1963.  Prior, as a student, he drove a 1950 Chevy and kept it running in relatively good shape.  Now that he had contracted a full-time call, he offered to sell his car to William and me for $50.  We accepted his offer and took over ownership.  Since William was of and had the engineering mind-set and already worked the previous summer at a ‘body shop’, we thought that we’d be able to spiff this car up ourselves and learn some auto mechanics in the process.  First, we ‘gapped’ and replaced all the spark plugs.  Finding that a few wires appeared too worn, we went to a junk yard and towed home an identical car model to use as replacement parts.  That worked well because we could choose and use the better parts from either car.  Next, we borrowed Uncle David’s timing gun and adjusted the engine fly wheel to specification.  Then we cleaned the carburetor.  During the summer, we fixed all the dents and spray-painted the car from olive green to a light sky blue.  We also exchanged the front driver’s seat but kept the passenger and back bench seat because David’s car seats felt more comfortable.  We always noticed that the ‘plastic’ steering wheel of the car was cracked, and the junk car had a leather lined one.  We loosened all the nuts and bolts visible on the steering column but simply could not ‘budge’ the steering wheel more than ¼ inch.  (Of course, we had no manual to follow).  Cocky Smart as I was, I suggested that we use the tire jack and position that to ‘jack’ the wheel out.  Accordingly, we tried.  But the wheel moved slightly and only ‘crookedly’ not symmetrically as expected.  Both William and I pushed the jack handle together once more, but the jagged tip of the jack suddenly popped out and glanced past William’ arm and hit me squarely on the right side of my nose, tearing off a flap of tissue ½” by ¾ inches, along my nose just under my right eye.  Of course, this was accompanied with much bleeding and pain.  We ran into the house and had Mom wash the wound.  After the bleeding stopped, l noted that the torn tissue seated very well back in its original position.  Mom wanted to take me to the ER.  I argued that they cannot sew me better than if I kept it clean and protected it with a band aid.  If it got worse, we’ll go later.  Self-care healed it in 7 days.  We put all the nuts and bolts back and kept driving the car with the even more cracked and disfigured steering wheel.

My Mom’s older sister by 16 years, Auntie from New York, came for a visit.  We proudly showed her our car.  She was gracious and gave us some money to buy new seat coverings to make the car look even better.

The car serviced us well from high school through two years of college.  And we learned a lot about car repair and maintenance; very useful lessons.

Health Update: 2 June 2018

My apologies for the slight delayed reporting.  I had my scheduled Chemo session on the 31 May without any glitches and I tolerated the treatment well.  All my usual lab tests were acceptable.  Physically I feel well, and I look like a picture of health.  I deferred writing this report because I was a little disappointed and felt a little depressed that my Ca 19-9 went the wrong direction, from 966 to >1700 u/ml.  It seems my current regimen is not ‘winning.”  Hoping to participate in an appropriate clinical trial soon.

My only morbidity is approximately 90% paresthesia of both of my feet; but I am managing well with my walking sticks.  The PT gave and taught me helpful hints and exercises on how to fall to minimize the possibilities of breaking any bony structures.  We also developed a program to attempt to increase the blood flow to the extremities.  Furthermore, these exercises will strengthen the body mass.

Good news is that on May 26th, Linnea, Brother Dan/Sue (wife) and I took a little vacation and flew to Phoenix, AZ.  We spent one day visiting Sedona, another day at the Painted Desert and Petrified Forest, and our last day at the magnificent Grand Canyon.  A most wonderful change of scenery and weather.  Much gratitude and appreciation to Dan for driving and making all the arrangements.  We all had a wonderful time.

Thanks Friends and Relatives for visiting this site.  Keep up your Prayers and your Good Karma coming my way.

6 May 2018, Health Update

p.s  I have been searching my mind for the proper description of the paresthesia of my feet for I knew I had experienced these symptoms before.  Finally it dawned on me.  We all have had ‘numbed’ feeling in one or the other foot sometimes after sitting crossing our legs for a period of time.  Upon rising, not only do we have a heavy ‘dead weight’ leg, but also sensations of pins-and-needles tingling in the toes, accompanied often with a loss of balance.  This describes the way my lower extremities have been for at least three weeks, much more prevalent today.  Although able, I walk very unsteadily today.  Hopefully having stopped the Abraxane last Thursday, these paresthesia symptoms will slowly improve.

Health Update: 4 May 2018

Thursday, May 3, early rise for boat trip to Seattle on the 7:55.  We arrived at the terminal 12 minutes early, but the car capacity was at overload.  For once in a very few times we used our medical priority boarding pass and were placed in the carpool lane, at the bow of the boat, first in line.  Thus, behind the motorcyclists, we had front row seats watching the glorious Seattle morning skyline as we sailed.  Greatly appreciated the Good beginning of our day.

Again, we experienced an efficient staff and technicians at VM as they all performed their tests efficiently and uneventfully by 11:00.

Dr. Picozzi examined me around 12:30.

Blood works were unremarkable.

CA 19-9 rose slightly (996) but most likely still within normal limits. (WNL) of test variation.

CT Scan was a little puzzling.  The ‘older’ lesions seemed to be receding, but there may be suggestion of a few suspicious new one developing!  (though non-specific).  Dr. Picozzi commented that the result and report were conflicting.  The areas of ‘abscess’ monitored by Dr. Woolston showed slight shrinkage.  (I dose myself with IV antibiotic daily and she concurred to continue the current regimen since it causes me minimal inconvenience.)

Symptomatically, I continue to have less stamina and am more aware of losing muscle strength.  The lower extremities paresthesia is slowly and steadily getting more pronounced and more intolerable.  I have very little feelings at the bottom of both my feet.  From sitting to standing, I often lose my balance, having a sensation of falling mostly forwards.  I also stumble some when walking because I don’t feel my toes as I walk.  Sometimes, while walking, the bottom of both feet feels ‘pins-and-needles’ awareness.  Linnea is insisting that I start trial using a walking pole.  We requested a referral to have a physical therapy evaluation and that was promptly arranged today with the New Motion Rx on Bainbridge.  For this time, we also stopped the Abraxane agent as a trial to see if the paresthesia symptoms lessened.

As to the thinning of the mucosa membrane and development of ulcers in the mouth, it was better these last two weeks, but not completely resolved.  Because Dr. Picozzi eliminated Abraxane, he full-dosed my Irinotecan regimen.  (This agent most likely plays a greater role with my mouth sores!)  Oh, Well, although I’ve been on this med in the past and had not had problems.

Bottom Line:  I feel well, I don’t feel sick, my appetite is good, and I am maintaining my weight.  I mostly accomplish trying to exercise by (walk a mile day with Linnea’s urging).  Now with PT regimen onboard perhaps I’ll have more assistance in building more strength.

Again,  Deeply-Felt THANKS to all visitors.  Update in two weeks.