Lets live with hope....

On Wednesday, Dec. 17, Hap returned to Sloan for an appointment with his main doctor and to receive his monthly ocetreotide injection.
Since his liver tumors have been fully embolized, Hap was anticipating a big appointment with decisions about his next step.
With that in mind, he brought along his ontourage, wife Mary, friend Lisa (angel in the outfield) and sister-in-law, Bonnie. Team member/brother-in-law, Jeff K.
could not be present due to a week long power outage in his hometown in Massachusetts. All came prepared with research and questions.

After thorough discussion, Hap’s doctor decided to scan Hap on Jan. 12 to evaluate the tumors’ response to the embolizations and the ocetreotide injections.
Hap will then meet with his doctor on Jan. 19 to discuss the results and his next plan. Future decisions will include whether to embolize the pelvic mass or begin chemotherapy. Many friends and family members have wondered why Hap hasn’t started chemo yet. Symptoms from carcinoid tumors are generally treated with somatostatin analogues (ocetreotide injections). Chemotherapy is only initiated in patients whose symptoms do not respond to somatostain.

Other concerns at this appointment were Hap’s weight loss, fatigue and finding the primary source. Unfortunately, we may never know the primary source
or possibly, it’s in the liver. Regardless, Hap’s doctor feels very confident in the choice of treatments for Hap’s situation.

Hap, Mary and family wish everyone a Merry Christmas and Happy New Year!

Quote for the Day: By Henri J. M. Nouwen
All the great spiritual leaders in history were people of hope. Abraham, Moses, Ruth, Mary, Jesus, Rumi, Gandhi, and Dorothy Day all lived with a promise in their hearts that guided them toward the future without the need to know exactly what it would look like. Let's live with hope.

Ray and Bonnie brought Hap and Mary home last night after a long week at Sloan. Hap was unable to come home on Thursday due to fevers.
On Friday, he had a chest X-ray and blood work. Both were fine and after being visited by 3 doctors and Mary begging, Hap was allowed to go home,
still with a fever and annoying hiccups. Being home and seeing his three sons should help speed up his recovery.

It takes a HUGE support system to make it possible for Hap to be able to travel into New York for outstanding care at Sloan. Hap and Mary are very grateful for all the support that includes, prayers, cards, grandparents taking care of their boys, arrangements made for Mary in the city, meals for their family back at home, transportation for their boys, text messages, phone calls, friends and family spending time with Mary in the city and I’m sure there’s more. Even through this difficult time, Hap and Mary continue to feel blessed each and every day.

*$#%@ Hiccups!

With the exception of a great visit from a furry friend, Hap has had a pretty tough day. To add to his list of side effects, he is now suffering from hiccups.....yes, hiccups....non-stop hiccups. Apparently, this is a rare side effect that could last up to a week.

If Hap shows improvement and begins to eat some solid food, he may be discharged tomorrow.

The second embolization...

Hap had his second embolization today, which took about 2 1/2 hours to perform.

He is currently battling post embolization syndrome, which includes high blood pressure, pain and nausea.

He will remain in the hospital for a few days to be monitored and manage the pain.

Hap will follow up with his doctor in a few weeks for a scan to measure the progress.

Lean Mean Embolization Machine...

Hap was at Sloan today for his appointment with his interventional radiologist. She is prepared to embolize the second half of the liver.

Hap's lungs sound better and most of the post embolization syndrome effects have subsided.

His blood pressure remains to be a little high.

Hap had bloodwork, an EKG and a chest x-ray. He also had his monthly ocetreotide injection.

His doctor noticed his weight loss and I quote, said,"You're a Lean Mean Embolization Machine".

Physically, Hap is ready for the next embolization...working on mentally being ready. The next procedure is scheduled for December 1.

This week, Hap returns to Sloan for a visit with his interventional radiologist who did the embolization. He also has pre-surgical testing and will receive another ocetreotide injection. On December 1, he will return to the hospital for an embolization to the other half of his liver. Since Hap struggled with the post embolization syndrome, his doctor decided to embolize the pelvic mass at a later time.

Last week, Hap and Mary did not have any appts. and had time to reflect on all the kindness and support surrounding them. They want to thank everyone for their prayers, novenas, rosaries and many acts of kindness. Taking this journey is truly a collaborative effort and they thank you from the bottom of their hearts.

Wow, what a great inning today at Sloan!

Hap returned to Sloan today because he continues to run fevers. It was determined that the fevers are due to fluid in his lungs. In addition his blood pressure is slightly elevated so the doctor will be putting him on medication.

Now for some good news....the CAT scan showed that the embolization is working. The tumors on his liver are showing changes for the better. The pelvic mass has already decreased in size, due to the ocetreotide shots.

Hap will return in two weeks for a follow up and to determine the date of his next embolization.

Hap returned home on Friday evening. He is spending a lot of time resting, since the pain in currently under control.

Next week he will call his doctor to set up a follow up appoinment and an appointment for the scan.

They went into extra innings in NY....

The embolization was more difficult than expected. Half of the liver was embolized. In four weeks a scan will determine how successful the procedure was. At that time, the radiologist will also determine when to embolize the other half.

Hap is currently battling side effects this evening...nausea, high blood pressure, sweats and pain. The doctors and nurses are working hard to get him comfortable. As of 8:30PM, he is still in recovery. After he is stable they will move him to his own room to be monitored.

Thank you all for keeping Hap and his family in your thoughts today.

Hap met with the radiologist today who will perform the liver embolization on October 28. The liver tumors are throughout the liver; therefore
the embolization will be in two parts. On October 28, half the liver will be embolized where, as the doctor said she will get “the biggest bang for the buck”.

The progress will be monitored with scans. In 1-2 months, she will embolize the other half. This is a long term management plan that hopes to starve the tumors.

The radiologist will also get a better image of the pelvic mass to determine if an embolization can be done there in the future. She needs to check the vessels, blood supply going to this mass and how close nerves are to this mass.

Hap received a long term ocetreotide injection today to suppress the symptoms he is having from the release of hormones from the carcinoid tumors.

Hap will be in the hospital for 3 days to be monitored and to manage the pain (thank goodness for pain management pumps!)

Please continue to pray for Hap as he begins this difficult journey.

Top of the second....game plan

It was a long first inning, but Hap has reviewed the plays with his team and he's ready to swing for the fences.

The treotide scan showed no additional tumors, so Hap received confirmation that the carcinoid is only in the liver, pelvic mass and some lymph nodes.

After weighing all the options, the team decided to start with an embolization to the liver tumors and chemo to target the pelvic mass in order to avoid the risks involved with surgery at this time.

In preparation, today Hap received a short term treotide injection to make sure he would not have any allergic reactions.

Next week, Hap will receive a long term treotide injection to suppress the release of hormones from the carcinoid tumors.

The embolization will take place on October 28th.

Chemo treatments will begin soon after and last approximately two months.

Following that, Hap will receive another scan to evaluate the changes and progress made.

"The difference between the impossible and the possible lies in a person's determination." ....Tommy Lasorda

Hap had the rectal ultrasound and it was determined that the pelvic mass is not attached to the rectal wall; therefore, a biopsy was not needed.

The latest CAT scan showed that there’s been no change in the pelvic mass since the scan 7 weeks ago.

Hap is scheduled for a treotide (nuclear) scan on Monday and Tuesday to see if there are any other carcinoid tumors.

Then Hap and Mary will return to Sloan on Wednesday for the results. Hap’s doctor will also give her decision about the surgery
to remove the pelvic mass and lymph nodes, as well as the procedure for the liver.

Hap was thrown a curve ball today...

Hap's doctor called in a colon and rectal surgeon to evaluate the pelvic mass, which has been identified as a carcinoid.

The surgeon determined that the carcinoid has spread to some lymph nodes above the pelvic tumor.

Hap had another CAT scan today to find out if the liver tumors and the pelvic tumor have changed in the past 7 weeks. (results to follow next week)

Hap will have a rectal ultrasound and a biopsy of the rectal wall tomorrow back at Sloan.

Based on those results and the CAT scan from today, both doctors will collaborate on the best procedures for Hap. The ideas shared today include:

• the doctors remove the pelvic mass in conjunction with the determined liver procedure
• or they shrink the pelvic tumor first before surgery along with a procedure on the liver

The doctors anticipate having a decision by early next week...it is truly a "team" effort.

Hap will meet with the doctor on Wednesday to get the biopsy results. In the meantime, Jeff and Rick are in town to spend some quality time with Hap. ....the state police are on standby

A long day....

Hap spent an exhausting eight hour day at Sloan today. They biopsied the pelvic mass and hope to have results by this weekend.

Hap returned to Sloan on September 25th for pre biopsy and pre chemo tests, which included EKG, Xray and additional blood work. He is scheduled to re-biopsy the pelvic mass on Tuesday, September 30th at Sloan. Hopefully, this will provide the doctors with the answers they're still looking for.

The Mystery Continues...

I guess you could say the appointment went well today... Hap had an endoscopy procedure done, which ruled out cancer in the stomach and esophagus.

The primary remains unclear, so Hap is scheduled to receive another biopsy of the pelvic mass next week at Sloan.

The doctor called today and Hap will be returning to Sloan tomorrow the 19th, for the endoscopy procedure. Updates to follow...

Hap and Mary just returned from Sloan this evening. In the doctor's words...."this is a very unusual case". The top pathologist reviewed Hap's results and still they are not able to identify the primary source. They have; however, ruled out colon and prostate cancer.

The doctor originally mentioned that Hap would begin chemo today. After the results from his blood work, (which was very good) she decided to hold off until further testing.

Hap will return to Sloan next week for an endoscopy procedure and an additional biopsy.

Unfortunately, not all of the pathology reports were available today, as originally expected. Hap will be returning to Sloan this Wednesday, September 17th. The doctor did mention Hap should be prepared to start chemo on Wednesday during his appointment. I will post an update on Wednesday evening with the outcome of all his tests and biopsy.

Please keep praying.

The Angel in the Outfield

Thank you to Lisa Healy for taking Hap and Mary to the first appointment at Sloan. You were truly The Angel in the Outfield today.

Hap had more blood work done today in addition to a MRI of the pelvic area. The doctor from Sloan has ordered the slides from his second biopsy at Newton Hospital to be sent overnight in order to conduct her own pathology tests.

On Monday, September 15th, Hap is scheduled to return to Sloan to review all of their findings from these test.

Top of the first....

Hap is recovering from another biopsy today and preparing for his first appointment at Sloan-Kettering tomorrow morning.

You can't sit on a lead and run a few plays into the line and just kill the clock. You've got to throw the ball over the *** plate and give the other man his chance. That's why baseball is the greatest game of them all.

-- Earl Weaver