11/3/15 It was the best of times, it was the worst of times...

Dear Family and Friends,

Dickens was right.  Life sometimes takes you swiftly from good times to bad, and sometimes you experience both at the same time.

On September 26, Steve and I flew from Seattle to Istanbul, where we spent the next nine days experiencing the thrill of touring in Turkey and the Greek Islands.  Almost immediately on arriving in Turkey, however, my stomach began to hurt.  It wasn't just pain, but also a feeling of indigestion, heartburn, and extreme fullness after eating even small meals.  We hoped I had picked up a bug or was having some simple gastritis (inflamed stomach lining), so we bought some Prilosec at a Greek pharmacy to reduce the acid production in my stomach.  While it didn't stop my symptoms, it calmed them enough that I was able to notice them, but also keep my concerns on the back burner as we left Greece for Spain, where Daniel would join us.  

During two beautiful weeks in sunny Spain, the symptoms continued, and I began to worry that my cancer might be back.  Despite my worries, with God's help, I fully immersed myself into the joy of walks, hikes, Mediterranean swims, and drives around the Costa Blanca region of Spain.  When Steve returned to Seattle, Daniel and I continued in Spain and then ended our trip with five days in London.  While exploring British museums and parks and seeing plays at night, I began to realize my stomach symptoms were ever present and were most likely cancer.  Upon arriving home, a CT scan confirmed my suspicions.  My ovarian cancer is back for the third time.

The good news is, the cancer is not in my internal organs.  My liver, kidneys, pancreas, gallbladder, and upper colon look pretty amazing for a 55-year-old!  Unfortunately though, it is in some abdominal lymph nodes which have significantly grown since March.  One of these enlarged lymph nodes presses on my pancreas and one presses on my aorta and vena cava.  The presence of these cancerous lymph nodes taking up space in my abdominal cavity seems to be causing my stomach symptoms.  And of course, you don't want the cancer to travel from your lymph nodes to any other part of the body!

Thus, I begin my third chemo regimen on Monday.  We will be using a time release chemo drug called Doxil this time, administered through the port in my chest once every four weeks.  We will re-scan in three to four months to see how it is working.  The potential side effects are nausea, hair loss, heart damage (no thanks!), and a thing where your hands, feet, and armpits get sore rashes and peeling skin.  Please pray that the Doxil will kill the cancer and that I will experience minimal side effects.  Thank you!

Additional good news is that to avoid the armpit skin symptoms, I am to avoid anything that will make my arm rub against my armpit, including VACUUMING, SWEEPING, AND DOING DISHES!  Woo hoo!  I've got a "get out of housework free" card for the foreseeable future!  :-)  Poor Steve, Renee, and Daniel...

I enter this "hat trick" round of chemo with a lot of gratitude.  I'm thankful for the wonderful time in Europe that preceded my new diagnosis and shored me up for what lies ahead.  I'm thankful for an expert gynecological oncologist who always knows exactly what to do when I have a recurrence.  I am thankful for good strength going into the chemo from all the exercise I had in Europe.  I'm blessed with great friends from so many sectors of my life who are faithful in praying for me, and who have offered to help us with whatever we may need, such as meals or a little housecleaning now and then.  I have the world's best husband and kids in Steve, Renee, and Daniel, who love me fiercely and will care for me with the utmost devotion and compassion.  And last, but most important of all, I have a 40-year strong faith in God, Who will never leave me or forsake me and Who will continue to help and sustain us through the unwelcome journey of cancer just as He has in the last two years.

I close with the song that keeps playing in my head, and the joy in knowing that despite my health challenges, it is well with my soul.

1. When peace, like a river, attendeth my way,
   When sorrows like sea billows roll;
   Whatever my lot, Thou hast taught me to say,
   It is well, it is well with my soul.
   • Refrain:
     It is well with my soul,
     It is well, it is well with my soul.
2. Though Satan should buffet, though trials should come,
   Let this blest assurance control,
   That Christ hath regarded my helpless estate,
   And hath shed His own blood for my soul.
3. My sin—oh, the bliss of this glorious thought!—
   My sin, not in part but the whole,
   Is nailed to the cross, and I bear it no more,
   Praise the Lord, praise the Lord, O my soul!
4. For me, be it Christ, be it Christ hence to live:
   If Jordan above me shall roll,
   No pang shall be mine, for in death as in life
   Thou wilt whisper Thy peace to my soul.
5. But, Lord, ’tis for Thee, for Thy coming we wait,
   The sky, not the grave, is our goal;
   Oh, trump of the angel! Oh, voice of the Lord!
   Blessed hope, blessed rest of my soul!
6. And Lord, haste the day when the faith shall be sight,
   The clouds be rolled back as a scroll;
   The trump shall resound, and the Lord shall descend,
   Even so, it is well with my soul.

Love,

Gabrielle

P.S.  Let's end with some Europe photos!

Philippi, Turkey. The Apostle Paul was imprisoned in this spot.

Virgin Mary's House near Ephesus

Colosseum at Ephesus where Apostle Paul spoke

Colossus of Rhodes

Our Regent Seven Seas Mariner cruise ship!

Altea, Spain vegetable market with my aunt Julianne!

The colorful town of Villajoyosa, Spain

Eating fresh, hot churros y chocolate at the famous Valor Chocolate shop

Walking around Altea, my aunt and uncle's Spanish town, at night

Hiking to a lighthouse in Albir, Spain

Alhambra in Granada, Spain

Uncle Oliver, Aunt Julianne, and me on my favorite beach at Villajoyosa

Pretty fall scene with fat pigeons at Regent's Park, London

Curtsey for the Queen at Buckingham Palace

Heaven on earth--the bakery at Harrods!

World's second largest Chihuly at Victoria and Albert Museum, London

Dressing to go into the Hagia Sophia Mosque in Istanbul

Mykonos, Greece

Ceiling of the Hagia Sophia Mosque

Kids in Istanbul having their "coming of age" celebrations dress like princes and princesses. Hagia Sophia in background.

A pretty mosque with gorgeous blue tiles everywhere

Spice Market in Istanbul

Our spacious room on the cruise ship!

Swimming on island of Crete. Visibility to 30 feet!

Everyone's favorite Greek Island--Santorini!

We hiked along the coast from town to town in Santorini!

Foxy husband on Island of Mykonos with it's red roofed windmills

Daniel and me on beach at Villajoyosa

Daniel on a hike in Spain

Every year we go to Altea we climb the spiderweb on Altea Beach!

Daniel and me on the beach promenade between Altea and Albir

Hiking I Fach in Calpe, Spain

Daniel with I Fach rock in background, Calpe

This is the life. Villajoyosa.

Along the waterfront in Altea

One of many views from the Altea Old Town hilltop where my aunt and uncle live

Apparently this is my deli in London!

Daniel didn't know what a phone booth was until he saw one in London

Our final London meal--world's best Indian food!

Last night in London we happened upon a red carpet movie premiere. Pictured here is movie actor Vin Diesel!

9/2/15 Enjoying Life!

Dear friends and family,

Happy September!  I hope you had a wonderful summer and are living life with gusto--treasuring the gift of each day.

In August, my family and I celebrated my one full year of remission from Stage 3C Ovarian Cancer!  Hallelujah, and praise the God in whom we live and move and have our being.  (Acts 17:28)

When I visited my oncologist in August, my CA-125 ovarian cancer blood tumor marker was normal, at 18 (normal is 0 to 30), and my physical exam was perfect.  I have felt well this summer, with about 80% of my strength and energy restored.  So the doctor said I didn't even need a CT scan!  I am cleared to continue enjoying life for the next three months, then I will see her again.  Yippee!  

We celebrated the good news of that exam with a week at our favorite beach--our peaceful place, where our bodies and souls get refreshed--Cannon Beach, Oregon.  At the end of this post you will find some trip photos.  As I look at these photos, my eyes well up with tears of joy at the blessing of this past healthy year spent enjoying the gift of my loving family and friends.  To have the strength to hike mountain trails, walk the beach, ride my bike, and play with babies this summer has been exhilarating! And to be able to eat anything I want without nausea--well that's pretty awesome too!

As some of you know, my oncologist had me take early retirement from my 30-year career in nonprofit fund raising last year.  She said that a "low stress" life is one of my best hopes for living longer.  Thus, I finally have time to volunteer.  Today was my volunteer day this week at Seattle Children's Hospital where my "assignment" was to rock, play with, and sing to two tiny baby girls with so many tubes coming out of them I couldn't count them all.  Of course, as I read, sang, dangled toys, and rocked these sweet girls, I prayed silently that the Lord will heal them and give them a chance to grow up and lead full and healthy lives.  What a privilege it is to spend time with these babies while their parents need to work or just have a break from round-the-clock weeks spent in the hospital.  If you live in Seattle and want to volunteer, the Child Life Program I volunteer for needs more help!  Go online to Seattle Children's Volunteer Program and check it out.  You have to commit to three hours each week for a year.

I read a very encouraging article about ovarian cancer life expectancy research today.  After being told I might have just two to three years to live, here is what I read in a UC Davis cancer research article:

"Of the 11,541 patients in the registry database, 3,582 (31 percent) survived more than 10 years, Cress and her colleagues discovered. It was the first time that research has looked at 10-year trajectories for patients; most survival studies have looked only at 5-year survival or less. What struck the researchers was that of the long-term survivors, 954 of them had been considered to be at high risk of dying from their disease, either because of their tumor stage, grade or older age at diagnosis. 

Reading this research is really the first time I've even considered that I "could, potentially, maybe, if God wills it"--live more than 10 years!!  Will you join me in praying that I be in that 31% group that  lives longer than expected?  Thank you, and here's to the 31%!

Meanwhile, I just treasure each day as it comes.  Even this past week, when wind storms in Seattle left us without power on two different days and without internet or TV for three full days.  That first night, we lit about 30 candles and played scrabble while eating up ALL the melting ice cream in the too warm freezer!  Then the second day of no power, everyone was off to work except me, and I bundled up with a blanket and a great novel, sitting near the window for as much light as possible on a gray day.  I tell you--EVERY day--even days that contain some level of hardship, pain, or loss, is still a good day for me--for I am here to experience life in all it's joys and sorrows.  

Speaking of loss, I may have already mentioned that I lost my beloved cancer buddy, Jeanie, this summer.  She lost her battle with pancreatic cancer.  As I began to grieve her loss, I read a book on grief that said that grief is the "tax" we pay for loving.  When we love someone, we will one day grieve for them, for love and loss are two sides of the same coin.  You can't have one without the other.  I am trying to lean fully into the grief while remembering that it is the price I must pay for the precious gift of so much love and friendship. 

In closing, I have been studying the book of Philippians this summer.  There is a verse I aspire to.  It is something the Apostle Paul said when he was suffering in chains in prison for sharing the good news of Jesus.  This is my prayer too, as I continue in this ovarian cancer journey.  And it was Jeanie's.  

"I eagerly expect and hope that I will in no way be ashamed, but will have sufficient courage so that now as always Christ will be exalted in my body, whether by life or by death.  For to me, to live is Christ and to die is gain."  Phil. 1:20-21

Love, grace, and peace to you all,

Gabrielle

Selfie at Haystack Rock where my Mom's and Grandma's and Steve's Dad's ashes were scattered.  Very special place for us.

Renee, Daniel, and Steve hiking from Seaside to Ecola State Park.

After a long day at the beach, go to Nonni's in Seaside for their monster meatballs and spaghetti!

With Steve, my one true love of 33 years, and my rock through cancer.

Oh how I love hanging out with these three!

Steve, working on his tan in the sand dunes, where he is out of the wind.

It doesn't matter if your daughter is 27 and your son is 25.  He will still want to bury her in the sand!

Renee Dudley--the daughter I always dreamed of and love so very much!

Lucky me--a huge bowl of "nuts for coconut" ice cream with not one, but TWO fresh waffle cones!

One of life's best blessings--my dear friend Sally.  We met up for a beach walk in Lincoln City.

Never dreamed I would have a son this great.  Daniel--I love you!

And lastly, note my "Enjoy Life" t-shirt at a deserted beach in Ecola State Park.  Your assignment for the month of September:  Enjoy Life!  

7/11/15 Happy news!

Dear friends and family,

   I apologize for taking so long to blog.  I was having technical difficulties with my new computer and today, Daniel fixed them for me!     Let me bring you up to date.
  When I had my two-month visit to the oncologist in May, I learned that my ovarian cancer tumor marker, the CA-125, had DROPPED from 24 to 16.5! Normal is 0 to 30, so I am right in the middle of normal. Hallelujah, praise the Lord, and THANK YOU for praying for me!!!  My physical exam was also good and I have had no cancer symptoms, so the doc told me I don't need to see her again until late August!  Thus commenced a wonderful summer.
   First, Steve and I went on one of our "life list" trips.  I don't like to call it my bucket list, because I don't like the association with kicking the bucket!  I want to focus on living life to the fullest.  So off we went to southern Utah for nine days in the national parks there.
   Our favorite park was Zion, though we also loved Bryce Canyon and Arches. Thanks to no cancer, I was able to do a lot of hiking on this trip. Everyone had told us that the "must do" hike was Angel's Landing in Zion.  It was 1,500' up, with many steep switchbacks and the last part you have to climb the ridgeline of a peak while holding onto chains so you won't fall off the mountain on either side of the ridge!  Steve remarked to me after that he had no idea I was so fearless.  I hadn't noticed that the hike hadn't scared me.  But my only conclusion is that after battling ovarian cancer twice, my courage meter has increased!
  In other news, Daniel just finished part one of his national physician board exam on 6/30.  We are so proud of him!  He will be taking a year off before his two clerkship years to do research on babies receiving cochlear implants for hearing loss.  I wish the NIH would pay me to hang out with babies all day!
   Renee is shining in her job as a trust and estate administrator, and tries not to rub it in too much that "I" never had a window office on the 60th floor of the Columbia Tower building!  Who knew that a theology major would be setting up complex trusts, doing trust tax returns, depositing $1.7 million in the bank and sending out $46 million trust distribution checks.  She also officiates weddings on the side.  We are very proud of our daughter of many talents!
   Filling in the rest of our summer, we have been boating, crabbing, swimming in lakes, hiking, and eating ice cream.  All bets are off for me when Ben & Jerry's goes on sale.  At last count, we had 15 tubs of ice cream in our freezer.  Come on over and have a bowl!
   I want to close with sharing with you how I start my prayers each morning.  The first words out of my mouth are "Thank you, God, for the gift of life today."  I next ask the Lord to let me not be an ovarian cancer statistic (as in having 2-3 years left to live), but to let me be an outlier--a miracle of His hands.  Then I ask Him to let me live to see Daniel graduate from med school and residency, to see both the kids get married (not to each other, of course), to kiss my future grandbabies' cheeks and tell them that I love them and God loves them, and to be there for the love of my life, Steve, as he ages.  Will you join me in this prayer?  :-)
   I wish you the very best summer, and a feeling of wonder as you wake up each morning to the gift of another day.  And in even your toughest days, may you find a glimmer of joy.  

Grace and peace,
Gabrielle

Steve and Gabrielle at Arches National Park, Utah

Gabrielle on top of Angel's Landing at Zion National Park--a hard hike!

One of the sweet babies I babysit each week!

Renee playing in "our pool" with our other sweet baby--my great-nephew Jericho!

OK--so I know perms are "out."  I just did this to help a friend in salon school!  I'm so lucky to have hair to perm!!

Hike to Talapus Lake with friend, Laura (and Steve, the photographer).  Great swimming!

Daniel, Steve, and I caught 10 crabs on opening day!  Best crab cakes ever that night!

Gabrielle at Butchart Gardens, Victoria, B.C.

One last picture of my sweet Jericho.  His favorite bath toy is the plug!

  

Yep, I love ice cream!

4/21/15 I'm still here!

Dear friends and family,

Gabrielle here.  I'm sorry it has taken me so long to do a blog post!  Our computer was dying and I finally have a new one!  

Let's start right off with the wonderful news.  My March 6th ovarian cancer scan was CLEAR!  Thanks be to God for the gift of more cancer-free days ahead.  I will be seeing my oncologist every two months and my next scan will be in July.

However, the past few months have not been without some health challenges.  Since January I have been treated for near daily migraine headaches that began after my mom died October.  I am on a drug called Topamax that has stopped the headaches completely!  Next week I see the neurologist and we will discuss weaning off the drug now and seeing if the headaches will stay away.  Please pray that they will.

Next, after that great cancer scan, I headed off to Palm Springs with my childhood best friend, Renee, to celebrate.  Our daughter Renee is named after Palm Springs Renee!  Well, we were three days into our trip and off exploring Joshua Tree National Park when I experienced severe pain in my lower left abdomen.  It intensified until the next morning at which time I could barely move without crying.  I called Steve and he sent us off to the ER, where we spent eight hours learning that I had diverticulitis with a micro perforation in my colon where the infection was.  I was put on two strong antibiotics and a clear liquid diet.  But that night, I popped a pain pill and off we went to watch a professional tennis tournament we had tickets for.  I got to be chauffeured around in a wheelchair!  If there is one thing I've learned through cancer it is to keep living your life through it and squeeze out as much joy from each day as possible.  On my plane flight home, I noticed that one of my three diamonds was missing from my wedding ring.  So if you are going to Palm Springs in the near future, keep an eye out and you might find a treasure!

I tell you about the diverticulitis because it had a very serious consequence on my future cancer treatment.  My oncologist told us that now that I've had a micro perforation, I am no longer a candidate for the cancer prevention drug, Avastin, that I had been taking every three weeks.  Avastin can cause horrible, life-threatening perforations in 1.7% of the patients who take it so I am now off the list.  The Scripture verse God brought immediately to my mind when I got this scary news is Psalm 20:7 "Some trust in chariots and some in horses but we trust in the name of the Lord our God."  When you are in a battle, you can either trust your equipment or the One who is stronger than all the equipment and your foes combined.  We are trusting God to keep my cancer from growing back without Avastin.  Please pray and trust Him with us.

Once the diverticulitis was gone, along came a little urinary tract infection.  I had gotten to day 7 of the antibiotic, my last pill, when the doctor's office called and said "Oops--we forgot to get back to you to say the strain of your infection that the lab cultured needs a different antibiotic, so now you need another week's worth." Every morning I'm drinking yogurt smoothies to replenish my poor stomach's probiotics!

Lastly, over the last month my legs were aching like crazy.  And not only aching, they were shaking a bit and unsteady on stairs.  I saw my rheumatologist and my Lupus is back.  So he just finished a  mercifully short, three-day high dose steroid pulse and I am feeling SO much better!  In fact, I have had four mile walks each of the last three days!  

All of the minor health issues I've suffered in the last few months pale in comparison to cancer, but when you experience pain for any reason (physical, emotional, etc.) it's still suffering and it's hard.  Whatever ways, large or small, that you might be suffering right now, I am going to pause and say a prayer for you as soon as I hit "post" on this blog post.  Because I get it.  And I wish you relief, joy, peace, and hope ASAP! 

Love and blessings,

Gabrielle

P.S.  Steve and I are in Cannon Beach right now watching the wind, rain, and waves pound the sand.  Beautiful.  Here are a couple photos of us from this morning's walk!  The little blue jellyfish are called velellas.  They are like little sailboats that float on top of the ocean and land all over the beach.  Gorgeous.

2/21/15 Good week, bad week

Dear family and friends,

Steve here.  Somewhere in the recesses of my mind, I seem to recall a famous novel begins "It was the best of times, it was the worst of times."  It's not as great a novel as the one that begins "Call me Ishmael," or "He was an old man who fished alone in a skiff..." but that's beside the point.  Well, that's what this week has been like for us in the Dudley house--not the Ishmael part, the other one about good times, bad times, that is.  It's probably best to end on the positive stuff, so here's the "bad week" part.  And, I need to say that it's not like the novel "the worst of times."  We've definitely had worse (see entries from January, 2013, for example.) 
Gabrielle went in for her blood test and Avastin infusion on February 17 (Tuesday) and things went fairly well, except the CA-125 blood tumor marker had risen to 23.  Previously it was in the mid teens.  It is a little concerning, but nurse Janelle said not to worry too much as lots of things can cause a bump in the number, including inflammation and other things like that.  With how achy Gabrielle has been, perhaps that's it.  Still, we didn't like the news and are eager for the next appointment with Dr. M in 3 weeks to hear her spin on things.  Right after the infusion, Gabrielle went on a walk with Daniel and next thing you know, this horrible yip yip dog rushes up to her and takes a chunk out of her thigh.  The nit wit owner was unapologetic and said that he was "just being friendly."  Yeah right.  In a way, I am glad that I wasn't there, as I would have been more than happy to show Ms. Nit Wit some "friendliness" in return to her little "poochie woochie."  The Olympic event hammer throw comes to mind.  I would be willing to bet that I could have gotten that dog all the way to the mid-channel buoy in Puget Sound with just the right spin and release from the leash.  Of course, it would have put my good standing as veterinarian emeritus in jeopardy as we are supposed to be kind to animals (which is why I trap spiders and let them go outside rather than squashing them like everyone else in this house).  Gabrielle finishes her walk and limps into Rite Aid where the kindly pharmacist gives her a tetanus booster (don't they have "distemper" shots for dogs??).  I got home about the time she and Daniel did and I helped dress the wound (fortunately, no stitches).  I finished the job by patching her up with a very special bandage that the kids bought which was adorned with a certain word that I ought not relate in this family oriented blog.  It was a fitting word, though.  Rhymes with...well never mind.  So that's Tuesday. 
Next day, it's her birthday.  Happy ____th, Gabrielle.  Being a gentleman, I cannot tell you how old she is other than to mention that three big things are open to her: the senior discount at IHOP, the senior discount at Fred Meyer, and eligibility in those "55 and over" communities.  She's already got the brochures out for Sun City!  But it didn't get off to a great start: sore leg from the dog bite, sore arm from the tetanus shot, and sore all over from just being achy (Avastin does that).  Her energy was at a low point, but she still managed to walk around Green Lake with Aunt Julianne and go on a second walk with Anna from SPU...7 miles in all. 
And since then, energy has remained at an ebb.  Then, out of the blue yesterday, she gets a "stomach bug" and it wasn't due to my cooking.  I could go into more details as to the exact nature of what that entails, but I will leave it to your imagination. 
So that's the bad news, got it?  Now the good news...
We had a delightful birthday week celebration for Gabrielle.  Ever since the cancer diagnosis, birthdays are never things to be dreaded, but rather embraced, as they represent life and living and moving ahead.  We've certainly embraced Gabrielle's umpteen years with us so far and are excited for many more birthday celebrations to come.  We had a wonderful dinner at the Melting Pot, though were too full for cake afterwards.  One of our traditions at birthdays is to go around the table and say three things we like about the birthday person.  It wasn't hard to come up with a few nice things to say about her and it reminded all of us how special she is not only to us, but to many others as well. 

A little side story here (if I knew how to make italics, that's what this would be)...
When I was a kid, we used to do this "fun" tradition of giving the birthday boy the "bumps."  It's a lot of fun.  You grab your victim by all fours and then bump him up and down on the floor...one bump for each year of age.  Don't know how it started, but in a family of four boys, we all sustained a lot of bumps over the years.  Gabrielle was able to take a pass this year, owing to her achiness.  Next year, perhaps?  Sadly, I missed brother Mark's birthday bumps yesterday (53), but Paul is coming up soon (I forget how many), then the big Kahuna John himself who hits 60 this summer (won't those bumps be fun?). 

Interestingly, we got home too late for presents, so we vowed to do them the next night.  That didn't work out either, nor the next, so she still has yet to open her birthday presents (today perhaps).  Not to worry...I think she has already guessed what I got her...it is just too tough to disguise a mop and bucket no matter how creatively you wrap them.  On her birthday, Gabrielle came home to wonderful flowers on the porch and a gift bag from someone else.  She had an extra long massage and then was treated to some home baked bread from her massage therapist.  Cards and letters keep coming in, wishing her birthday greetings, and she's been taken to numerous b-day movies and lunches.  In short, many have reached out to her to tell her how much she means to them, and that is indeed a blessing as well. 
So today is Saturday.  We really need to get those presents opened, especially the mop...floors are getting a little dusty.  So we better hop to it.  Pardon me...there's a spider on the ceiling.  I will have to excuse myself while I gently relocate him to the great outdoors.  Oh, and there goes a yip yip dog out front...let the games begin!  I will end with another first line from a book "I am a sick man..." (Notes from Underground).  Cheers.

1/9/15 It's been two years today.

Hi, folks.  Steve here again.
We had a delightfully restful time over Christmas which I don't need to bore you with.  We'll just leave it at "aloha" and you can fill in the blanks.  Though, I am sure that Gabrielle plans to upload a few pics of me in my Speedo on some sandy beach, so that's definitely something you'll want to skip (fair warning). 
On a more immediate note, Gabrielle went in for her latest Avastin infusion yesterday.  In the process, they checked the CA-125 (the tumor marker), and it had gone up from 14.1 to 16.5.  It is still well within the normal range, but it is inching up and I don't like the trajectory.  Goal is to keep it under 20.  As a reminder, it was around 135 when she was diagnosed two years ago today.
In spite of our wonderful time in Hawaii, it hasn't been easy for Gabrielle lately.  Starting in October, shortly after her mother passed away, she started getting daily migraines which have persisted till now.  We don't know why, though theories abound.  Is it a drug side effect?  Persistent stress?  Just the way it is?  Anyhow, they are pretty debilitating and that's just not good.  In addition, her blood pressure, which has always been rock bottom, has gone up to the point where she is now on blood pressure medication.  That last problem is a side effect of the Avastin.  And the back pain continues.  But she is a trooper and is still maintaining a cheerful and upbeat attitude through it all.
I will finish by telling you that today is an anniversary, if you will, albeit a dubious one at that.  As I mentioned above, it was two years ago today that Gabrielle was diagnosed with ovarian cancer.  It was a day that forever changed our lives.  It has been quite a journey since then...many sorrows, tears, fears, but also a lot of delights and joys as well.  We have been the recipients of an outpouring of grace, love and many acts of kindness and are humbled by your kindness to us.  I wrote a note to a patient yesterday who had just shared news of her sister's ovarian cancer diagnosis in November.  In the note, I mentioned the word "journey" as well.  It seems that's a good metaphor as journeys have their ups and downs, waysides, pleasant vistas, storms, etc.  However, I also told her that perhaps another word to use would be "Shanghaied".  I don't know if that's a politically correct term or not, but it alludes to the fact that people would go into bars on the waterfront, and then either get conked on the head or have something slipped into their drinks to knock them out.  Next thing you know, they'd be at sea hundreds of miles from port, impressed into service, unwilling sailors to say the least.  Talk about recruiting strategies!  Well, that's what this feels like.  Nobody ever asks to get cancer.  It is thrust upon them.  But it's here and we need to deal with it.  And Gabrielle has weathered the problem of being Shanghaied oh so well and I am proud of her.  She is my hero. 
Next month (dare I say it?), she turns 55.  Our mantra for the year will be: "55, it's great to be alive!".  Yes, cancer, makes you aware of the blessing of life and it is indeed a blessing to have her with us and we are spending time living in the present and wringing as much as we can out of it.  Blessings to you too.