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Tuesday, October 5, 2004 6:01 PM CDT

We met with Dr. Sacks today. According to his interpretation of the films, Dave's MRI was not what we had hoped. The scan shows what Dr. Sacks and Dr. Moraldo think is new growth in the lower part of the frontal lobe. This is growth since the scan in July. It's too early to tell if the gamma knife is really working on the spots that were treated in August, but these findings indicate new growth beyond what was treated with gamma knife. It's diffuse growth that enhances, the word they used was "speckled" so the growths are not large, but there are many spread around. The enhancement means that these areas are composed of fast-growing cells. This is not good news.

There was one part of Dr. M's report that offered an alternative point of view, saying that it could be radiation necrosis (proliferation of dead cells from the gamma knife), but that it is much too soon for that. Dr. Sacks says that it's too soon to see results from gamma knife and that the findings represent disease progression. Well, perhaps all the prayers accelerated the gamma knife? That's what we'll keep praying for. We all know Dave is not typical in any way!!

We start BCNU on Thursday afternoon. Chemo is really the only way to attack this diffuse growth. Dave will take off Thursday and Friday, and hope to be well enough to go back to work on Monday. They said that this particular chemo causes a lot of nausea and vomiting, even with an anti-emetic like Zofran. Please pray that he will be able to tolerate the BCNU and that it will completely obliterate those tumor cells. Pray also for protection for his lungs, as BCNU causes pulmonary toxicity. Also for his veins, Dave has good veins, but BCNU causes hardening of the veins, and it's likely they'll have to put in a port at some point. Also for his blood counts, as BCNU is very hard on the bone marrow....we have to watch his white and red counts, and his immunity will be compromised. Lastly, BCNU causes leukemia to develop in years after treatment. Pray Dave will be spared this effect.

Thank you to all who have rallied around us. Dave is continuing with his very positive attitude, certain that the BCNU will be the thing to do the trick. I keep saying he's amazing, I just don't know another word that describes him so well. He truly is.

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