David A. Lemmink

Just a short note to fill you in.

David had his second round of chemo this week. Monday, his mom Carol and I were with him. Tuesday it was Angela and Wednesday, Elisabeth and John. All in all things went well. He didn’t feel too bad those days, but Thursday wasn’t a good day. He got up, got ready and went to work in the morning…and thought on the way….”what the heck am I doing? I should just turn around and go home.” He continued on to work and lasted the morning, but came home at lunchtime. Following a light lunch, he got right into bed and took a long nap. As previously written, sleep seems to be a great healer (and maybe a great “forgetter”, too), when you are sleeping you don’t realize how bad you are feeling. Today, Friday, he can look forward to a quiet, restful weekend at home, recuperating, and sleeping, not doing too much.

Also, I ask your prayers for Jerry’s family. Sadly, I have to write that he passed away July 24, so please think of them, and keep them in your prayers.

Not much else to report ….. I guess, that is a blessing!

Thank you for your prayers and support!

Love, Connie

PS: Monday is David’s birthday! We are making plans to have fun and do some CELEBRATING!!!

Today is the beginning of week three in the 21-day (3 week) schedule that David is on, and things are going fairly well. He is feeling pretty good with not too many noticeable symptoms at this moment. His symptoms have been on and off since he began chemotherapy. One day is good, the next, not so good. In all this time, he has only missed one day of work due to the symptoms. EXCELLENT! Even on his not so good days, he has gone to work. I appreciate the effort it has taken, but it has been worth it … a GREAT feeling of accomplishment! He does come home from work and slip into bed and take a nap almost every day. I think he has only missed one day, last Friday, where he came home from work, felt good, and didn’t nap. Sleep is great medicine.

This morning, he did notice the effects of one symptom they told him to expect. Following his shower, he looked down at the drain and noticed large clumps of hair piled there. Even though we have expected this, it is a bit disconcerting when it actually happens.

The expectation is that this will be a pretty good week. Next Monday begins the second round of chemo. All in all, it seems not to have been as horrible as expected. Not great, not fun, not something to want, but not so bad. Hopefully the next round will be more of the same. Good days, not so good days, lots of naps, and getting through.

Also, please keep Jerry and his family in your prayers.  He is still in the ICU in a drug-induced coma.  The surgery he had was successful, but he is still struggling.  We are praying that he will recover and be able to go home very soon.

Thanks so much for all your prayers and support.

Love, Connie

David is done with his first three days of treatment. Thank God.

As I stated before, Monday was long. Tuesday and Wednesday were about 2 1/2 to 3 hours each. His mom, Carol spent both Tuesday and Wednesday with him, and they played cribbage. Tuesday was David’s day — Wednesday was Carol’s. It appears they have a rubber match to play!

Tuesday, Carol came to pick David up at around 9:30, and off they went. Again, they had to wait for over half an hour. When they were finally called in, they got a private room, which seems to make things much more comfortable. The treatment, which consisted only of the etoposide, then took a couple of hours, and when they finished up, they decided to come over to church to see if there was any food left from the Tuesday group. There was, and we got to enjoy their company while they had their lunch.

Tuesday evening, David decided he would go to work Wednesday morning. He got up and went to work for 3 hours before he had to leave at 10:00 for his 10:30 appointment. He met his mom there, and again they requested and got a private room…so they could have privacy and play their rousing game of cribbage! Again, he was only given the etoposide, so it didn’t take too long. Today, Carol brought lunch, so they were able to sit and play cribbage and enjoy their lunch. They got done about 1:00 and were on their way.

David stopped by Meijer on his way home to pick up a few things and ran into Tom where they proceeded to talk for an hour. Tom is a fun and entertaining guy and the perfect person for David to run into..thanks, Tom! ♥

…as an aside…in the meantime, sometime during the day, Brian came over with his lawnmower and mowed our lawn. While he was visiting David on Monday, we had a conversation about the lawn and how I want to purchase a new lawn mower, something that would be easier for me to use. We discussed how expensive lawn service is and that a new lawnmower would be more practical. Brian, being the thoughtful person he is, heard that and took it upon himself to come over and take care of our lawn for us. ♥ THANKS A TON, BRIAN! ♥

When David got home, he ate something and headed right to bed to take a nap. I got home from work (late) and he was still sleeping.

All in all, the first 3 days have been long and tiring but not awful. David asked the nurse, and she told him most of the symptoms kick in at about 6 days, so that is something to think about. His plan is to go to work when he is able and stay home when he isn’t.

Thank you for all your support, prayers, and love. It is amazing to see God at work through the loving, caring people in our lives.

Love, Connie

So, we’re home!

Today began in the middle of the night when neither David nor I could get much restful sleep. As I tossed and turned, I noticed that he was doing the same. Sleep. Wake. Sleep. Wake. … etc. Annoying when I knew a good night’s sleep was what we most needed.

We headed down to Lack’s around 10:00 or so and got there in plenty of time for his 10:30 appointment. We checked in at approximately 10:15 and proceeded to wait. When they called David’s name at 10:50, we followed Linda, David’s nurse back to the chemo area. She was going to put David in the main area, and I asked if there were any private rooms available. She checked and sure enough there was. We were thankful for that. We could spread all our stuff out and not feel that we had to whisper. In the main area, there were lots of people in treatment with some trying to sleep the time away. That would make it uncomfortable to have any type of conversation.

So, we settled in and Linda came in with the first, large bag. This was mainly saline, with some anti-nausea medications in it, but it was given mainly to slightly overload his kidneys. This is to protect them from the cisplatin which is hard on kidneys. Because there was so much, it took a couple of hours to drip through.

In the meantime, I left the room to go find some hot water to make us some tea. In my travels, I passed the gift shop in the Lack’s center, and who did I see, but Brian. He had come down to see David on his first day of chemo and to spend some time with him. He had a lot to talk about, because he and Marianne had just gotten back from their vacation. It was fun to hear all about their travels in the Upper Peninsula. That was a nice surprise for David and a fantastic way to pass some time.

While Brian was visiting, I went back to the gift shop to get us a couple of sandwiches. (Dumb me, I thought, because we would be spending so much time in a hospital, they would provide us food. I never thought about the fact that we were in an outpatient area, and that amenities were not included, that was information that would have been good to have earlier.)

When the saline was done, Linda came in with the cisplatin which was another large bag. She hooked it up and again it took a couple of hours to drip through. And while that began, we ate our sandwiches. Also, I set up the portable DVD player and put a movie in and David enjoyed having a good laugh on Chris Farley while he ate his lunch!

Time was passing.

Following the completion of the cisplatin, Linda came in with etoposide. This bag was smaller, and we were hopeful that we would be going home soon.

Through all of this, David felt great. There were no ill effects to anything that Linda administered. We are thankful for that and pray that he will continue to have an easy time with side effects. I am not blind to the fact that it is early, but everyone who has talked to us about side effects, prefaces their conversation with the fact that each person is different and the drugs metabolize differently in each. So that is what I pray. It doesn’t HAVE to be difficult and hopefully it will not.

We arrived home around 5:30 and wow…did that feel good.

Because it is Monday, and because David was feeling pretty good, he decided to play cards. Monday is pinochle night with the guys and they all hate to miss it. My dad came at 6:15 and picked him up and off they went. I told him to call if he started to feel bad and we would go and pick him up and bring him home.

So, day one is finished. I hope and pray that each day could go as well and be as easy as today.

Thank you for your love, prayers and support.

Love, Connie

Today was our appointment with Dr. Brinker, at the Lack’s Cancer Center. This appointment was scheduled to fill us in on David’s upcoming treatment plan. With the information gleaned from Dr. O’Dorisio, along with the information from Dr. Brinker, they put together the treatment protocol for David.

David started on Sandostatin (Octreotide) on the way home last Friday. He started on the short-acting type, 3 times daily for 2 weeks. Dr, O’Dorisio suggested he start with this to see how he will tolerate it. He will then follow with the long-acting type given after 1 week. Because of the 4^th of July, he will be given that long-acting shot on Monday. This long-acting type Sandostatin will be something he will most likely be having monthly for some time, or possibly forever. The Sandostatin is what helps maintain the Carcinoid and keeps the Carcinoid syndrome at bay.

Next Monday is when David will begin chemotherapy. He will be on a 21-day rotation. 3 days at Lack’s being given the chemo and then 18 days off. Dr. Brinker said we will do 2 cycles and then a CT scan to see what the tumors look like, if they have changed, or gotten smaller, he will be given 2 more cycles. Following the 2nd cycle, Dr. Brinker will assess David to determine if he needs the 3rd cycle.

The doctor then went over all the side effects David can expect and ways to combat those side effects. This was not a long appointment. Understandably it was an upsetting and depressing day. Anyone who has experienced chemotherapy will most probably understand what is to come, and we are guessing by all the talk and information about the numerous side effects, that it is not something to look forward to.

Following our short time with Dr. Brinker, he took us to the area where they administer the chemo. It’s a nice area, with “lazy boy” type chairs and tables and such, although there isn’t much privacy if that is what you desire or need. A bit impersonal and assembly line-like. That is where he will spend those 3 days of each 21 day cycle.

After waiting a short while, a nurse, Yolanda, came to talk more about chemotherapy and its effects, and also ways to combat those effects. She gave us a packet to take home with us and then we were on our way.

That’s it. We now enjoy the week and 4^th of July weekend (with a fun party to look forward to) and then buckle down and get through the next 2-3 months.

Happy 4th of July to all!

Thank you again for all your prayers and support.

Love, Connie

Wow, what a day!

Last night, it rained………more than rained. Thunder and lightning …… and rain. The people of Iowa don’t need more rain. It must be a sad and difficult feeling to have so many problems with flooding and then have MORE rain. Fortunately, this morning, when we woke, it had stopped. When we got out around 7:40, we noted that the night’s rain didn’t seem to have any ill effects. Thank God!

We woke at 6:00, and immediately got moving. Our first appointment of the day was at 8:00. There was a breakfast of sorts downstairs, and mediocre coffee, but we had to share it with all the workers here to help with the flood damage. We didn’t begrudge them their breakfast, but it made it difficult. They had a long day ahead of them, and needed lots of food to sustain them through their hard labors. In speaking with one gentleman as he prepared his breakfast, I asked him about the upcoming day. He responded in a Southern accent “Well, darlin’, when we get to a site, all we see are sad faces, and when we leave, there are smiles all around.” Even though the work is hard, it is obviously satisfying.

In driving down “the strip” all the businesses were closed. We could see indications of how high the water rose, by the lines on the buildings, apx. 5 feet up. Many of the plants were dead up to the water line, and alive above …… all in a straight line. Wet sandbags all around. The soccer field was completely covered with water. We saw many people busy cleaning up, hurrying to get everything back up and running in as little time as possible.

When we got to the hospital we went directly to the 4^th floor for our appointment with Dr. Iannettoni, Head of the Dept. of Cardiothoracic Surgery. Upon getting turned around, we luckily had the help of a man who was here for his one year check-up following heart transplant surgery. He obviously has spent many days and weeks in this hospital and knew his way around. Of course there were lots of forms to fill out, and David got busy. We sat and waited, and finally got called in to see Dr. Iannettoni at 8:30 or so. And then we waited some more. I thought it would get easier to wait, not so. Eventually, another doctor came in to talk to us and ask David some preliminary questions. Following this, Dr. Iannettoni came in and gave his assessment. He told us after analyzing all the test results he was uncomfortable trying to debulk the tumor (to remove all or most of the substance of a tumor or lesion). Because of the location and size, he wasn’t sure he would be able to do what we had expected. He drew us a picture on the examination table paper showing that it is located in the center with lots of blood vessels around and apparently attached to it. He had never done one that was this large and located in this particular area, and just wasn’t sure if he wanted to attempt something he had never done before. WOW, this was not at all what we were expecting to hear. I personally was prepared to stay here in Iowa City for surgery and recovery. If we didn’t get home for 3 weeks, then so be it.

Here we were again twisting and turning through this Carcinoid disease. I don’t know if it is the same with other diseases, but we have found that any time we have preconceived ideas of how things are going to go, they don’t go that way and we are disappointed. And the disappointments are HUGE! I admire Dr. Iannettoni for being honest with us and not playing God. He knows his limitations and feared that the surgery would be difficult for David and in the end would not be successful. He knew we were going to see Dr. O’Dorisio later that afternoon, and suggested to us that we see first what Dr. O’Dorisio had to say. We left that appointment discouraged and scared.

With time to kill, we headed back into the shopping area near the University. It was nearing lunch time and although we weren’t feeling hungry we wandered around and found the New Pioneer Co-op where they had a deli with delicious choices. We looked around the co-op first and then ordered our food and ate. Nothing tasted as good as expected, and I don’t think it was the food. Following lunch we wandered around the little mall (where we found a cute little yarn store called The Crazy Girl Yarn Shop) and then did some more wandering around town. Finally it was time to head back to the hospital to see Dr. O’Dorisio.

We got to the hospital and again headed up to the 4^th floor, this time to Papajohn Cancer Center. Again there were forms to fill out and we waited. This wait was even more difficult. Following the morning appointment, we were disheartened and discouraged. Maybe even hopeless. Difficult to think about going into another appointment. This time, I will tell you, we had NO preconceived ideas of how things would go. Eventually, we were called in. Dr. O’Dorisio came in and we were blown away! He is an upbeat, kind and caring person. In less than one minute of our visit, I already had more hope. Hard to explain, but that’s how it was. He then proceeded to spend the next 1½ to 2 hours with us. He talked to us about the surgery, and we told him what Dr. Iannettoni had told us. He had not yet spoken to Dr. I. We showed him Dr. I’s drawing and tried as best we could to explain what he had said. He then proceeded to talk to us about the tumors, what they were like, and how because they are faster-growing than normal, it would most likely respond well to chemotherapy. He explained to us about the disease, how it is different from other cancers, and did his best to make us understand. He also wanted to start David on Sandostatin right away as he thought that would also give a good response. It felt so good to finally be feeling positive! Finally feeling positive. It’s not just because he is an excellent doctor, but also such a great person with an infectious personality.

Dr. O’Dorisio left and the nurse took David for a blood test and then came in with supplies for us to take home with us. In all, we spent over 4 hours in the Cancer Center, and left with the most hope we have had in the last 6 weeks. It was a positive experience and even though the next few months will be difficult, and I’m sure no fun, at least we have hope.

We left the hospital and came back to the hotel for a while. We then headed out to the Texas Roadhouse for dinner. We ate too much, and enjoyed ourselves and then came back to the hotel where we decided to relax, and make our plans to head home on Friday. It will feel good to be home and finally begin treatment and look forward to David returning to good health

Thank you so much for your support, best wishes and prayers. It is greatly appreciated!

Much love, Connie

Hi all,

We are here in Iowa City.  We left home 9:15 and arrived 4:30 (3:30 central time).  It is an easy trip.  Iowa really IS flat!  Lots of farmland and crops.  Now we are looking for something to occupy our time and then on to dinner.

Our appointment tomorrow is at 8:00 am, so it will be early to bed.

On the way into Iowa, we did see some flooding, but nothing drastic.  The waters have subsided and so far we have not seen too much damage or flooding.  Thank God!

Well, this is it for now.  Just wanted to let you know we are here and it is warm and sunny.

I will update when we have more news and information

Thank you for all your kind words, support and prayers.

Love, Connie

So, here we go again.

Monday, June 16, we had a call from Dr. Brinker. He was calling about the kidney biopsy David had last week Thursday. The reason they wanted a biopsy on that tumor was because it was not lighting up the same in the earlier scans he had. The PET scan and Octreotide scan both use nuclear medicine. They inject the nuclear meds before the scan and then the Carcinoid tumors “glow” or light up. That is how they determine that it is Carcinoid. Because the one tumor in the kidney didn’t light up the same, they weren’t sure what that meant, hence the biopsy. Dr. Brinker said the pathology report showed that this particular tumor is an oncocytic neoplasm. This is a tumor of the ducts of the kidney. There are a few different types, and Dr. Brinker told us that it is probably an:

1. oncocytoma, which generally just grows bigger but does not spread, or a
2. chromophobe renal cell carcinoma, which he explained is more likely to spread, but also more favorable.

As tumors go, it is one that is not fast growing or necessarily dangerous. Generally, it can be removed and all that is left is to monitor it with scans to make sure it does not return. Also oncocytic neoplasms are not common, and are usually found like this one was found, while looking for something else. Maybe symptoms of abdominal pain might prompt looking for kidney stones or something else. Tests would be run, and then they would find an oncocytic neoplasm.

Dr. Brinker will be sending the reports and tissue to Iowa, and then consulting with Dr. O’Dorisio. What we are hoping and praying for is that when David has surgery for the tumor in his lungs, they will also be able to remove this tumor. One surgery would be preferable to two, which of course would mean that he would only have one period of recovery.

Please pray that it will be favorable for David to only have ONE surgery. Please pray for the doctor’s wisdom in treating this tumor along with the Carcinoid.

Also, please pray for the people in Iowa. They are going through and will continue to go through so much with the flooding. When the waters recede, they will have much work cleaning up. It is devastating for them and heart breaking to think about.

Thank you for all your prayers and good wishes,

Love, Connie