Memorial Service Invitation

We invite you to celebrate and remember Doug's life with us this Thursday. Below are the details for the memorial service:

Thursday, November 13th

at 7:00 PM

Mulkey-Mason Funeral Home

740 S. Edmonds Lane

Lewisville, TX 75067

In lieu of flowers, the family requests contributions to Gerazim Chrisitan School in Guatemala (hisappointedtime.com).

Monday, Nov. 10 - Doug's Passing

At 1:04 this morning, Doug passed away peacefully with his family around him. We have returned home from the hospital and are at the Ryans' house. Please check back for details about Doug's memorial service and celebration of life.

2 Timothy 4:7 - "I have fought the good fight, I have finished the race, I have kept the faith."

Sunday, Nov. 9 Update

Doug was stable for most of the day and  his O2 was steady in the low 90s. He wasn't as responsive today as yesterday. He only responded to a few of our questions. 

We were waiting for the hospice nurse to come to see if we could take him home, but she didn't arrive until 6pm. She assessed Doug's condition and said that she didn't recommend moving him home in his current condition. She pointed out that he had a slight temperature (100.1) and some blotchy-ness and discoloration in his hands, feet and ears, which are signs that he may pass away soon - in the next few hours/day. 

After she left, his heart rate increased to between 140 to 150 (previously in the 120s) and his O2 dropped to the high 80s. His breathing has been more labored since then and he is sweating slightly (because of the fever). 

Our prayer is that The Lord would miraculously heal him or that he would take him home. 

One of Katie's friends was sharing the news about Doug with her husband and their 5-year-old son overheard. When the husband explained that Katie's daddy may be going to see Jesus soon, his eyes lit up as he cheered, "Yay!!! That's so awesome! I wanna go!" 

Luke 18:17 -"Truly, I say to you, whoever does not receive the kingdom of a God like a child shall not enter it."

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Romans 8:37 - "In all these things we are more than conquerors through him who loved us."

If you would like to help the family by providing a meal, you may sign up at the following website:  https://lotsahelpinghands.com/c/722602/

From the other day:

Saturday, Nov 8 Update

Not a lot of news today. Doug slept well last night and his O2 stayed in the mid-to upper-80s. In the morning, it increased to the low 90s and has remained there all day.

Around 9am, Dr V and the team came in and said to continue making him comfortable. The most recent blood test showed that the leukemia blast cells were increasing exponentially in the blood. It went from hundreds to 2,000 to 6,000. His platelets are also low.

Doug is receiving a small, continuous dose of morphine, which tends to make him sleepy. However, around 10am he woke up and was responsive, nodding yes or no to certain questions: Are you comfortable? Are you in pain? Do you want some Diet Coke? The important things. He has been in and out of sleep all day.

Proverbs 3:24 - "When you lie down, you will not be afraid; when you lie down, your sleep will be sweet."

Friday, Nov. 7 Update

Doug was coherent today, holding conversations and continuing to crack jokes. We started working toward going home on hospice.

Later in the afternoon he had a breathing scare. The doctor was in the room and he complained about feeling short of breath. She hooked him back up to the O2 monitoring machine and saw that his oxygenation levels were quickly dropping. It dropped to the mid 30s (90 is a preferred minimum) before the rapid response team was able to stabilize him on a BiPap machine.

The BiPap pumps air in and out of your lungs and delivers almost twice as much Oxygen than he was receiving through the nose plug. It is also the last resort before going onto a ventilator.

The BiPap mask is somewhat invasive, so he couldn't talk and was getting frustrated. We were finally able to have him communicate by writing in a journal. He said that the lack of Oxygen caused him panic and got his attention. Doctors call this "air hunger." He said he was not afraid of death, but was worried about that transition; he didn't want to experience that again. The doctors agreed and decided to give him increased pain medication and an anti-anxiety med to make him more comfortable.

Because if the episode and need for the BiPap, Doug decided that it would be less of a hassle to stay where he was in the hospital rather than going home.

The medication they gave him put him to sleep for a while. When he woke up, he took the BiPap mask off and after Respiratory came they were able to switch over to a less invasive Oxygen mask that allowed him to talk. This mask doesn't force air into his lungs and doesn't provide as much O2 as the BiPap, but he seems to be doing fine. They gave him more medication and he fell back asleep.

There were a number of people around after the nurse gave him the meds. She ensured us that he could still hear our conversation and encouraged us to talk to him and share stories. For about an hour, we had a beautiful time as we told our favorite Doug stories: conquering Pompeii with Sherry in a wheelchair, taking her to the top of every castle, Smokey the Cat, movie lines on napkins in Katie's middle school lunches, Drew and the Honey Pot, Ronald capturing Doug on film in mid-throw-up, being a Monopoly cheater, and much more.

Psalm 18:29 -"With your help I can advance against a troop; with my God I can scale a wall."

Thurs., Nov 6, Update

 Doug's lungs are filled with quite a bit of liquid. The pneumonia is getting worse. He is being given the maximum amount of oxygen. He has decided not to go on a ventilator.

Doug's brother Don and long time friend Davy from MS flew in today. We will talk to the social worker and doctor about Doug going home under hospice. At this point, the battle is the Lord's.

Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me; your rod and your staff, they comfort me. (Psalm 23:4 ESV)

Tuesday, Nov 4 ~ Very Bad News

Dr. V came by with several residents and her PA. She told us, based on a blood telimit*#ry (?) test that the aggressive leukemia had returned. The biopsy isn't necessary. This is very bad news.  They might have tried a second transplant if it were 6 months past the first transplant. But it isn't even 100.

The strategy right now is do a strong dose of steroids. Hopefully it will calm done the nerves, keep the leukemia at bay, and help with the pneumonia and bowel infection. The goal is to get rid of these infections. I am dying (no pun intended) for a diet coke. They said maybe tomorrow. It depends on the esophagus and how well I'm swallowing. The pain is in different parts of my body is excruciating.

M.D. Anderson in Houston is doing a clinical trial of some medicine that might help me. I am not strong enough right now to qualify. So, getting rid of the infections is important. 

In a couple of days they may do another round of chemo.  At this point the survival rate is about 10%.

I figure I've got around 10 days to turn this around.

I know that you can do all things; no plan of ever can be thwarted. Job 42:2

Mon, Nov 3

 I moved from ICU to  the 8th floor around 2 PM. I took catnaps consistently from 2 to 5 PM. Last night I battled with pain to get through the night. They would give me morphine interveniously. The morphine would break the pain to help me to sleep, but only for an hour at a time. I would struggle to sleep between the times I couldn't take it.  The morphine made my thinking muddled. I had hallucinations and couldn't determine whether it was reality or not. It was very disorientiing. I thought I called my brother at 9 am but it was really 9pm.

A doctor from ICU listened to my chest. It was a lot better. The neurology doctors dragged a few new med students along when they came by to show them my rare condition. The surgerions also came by. It sounds like that the nerve biopsy may happen tomorrow They are concerned about low platelets. I will have an infusion to increase them probably tomorrow before the surgery. My  platelets are now around 20,000, they want them around 40,000. I asked him about putting the feeding tube in. They said not right now because they want to get in and out quickly for the nerve biopsy. Dr. V my oncologist  is waiting for the nerve biopsy. If it shows leukemia it will help her to determine what chemo drugs to use. If it is HVGD, it will help determine the steroids to use. She wants to load me up with fluids before I start the chemo. If they do the biopsy early in the day and get the results back, chemo should start tomorrow. If it's late in the day I may still get some fluids but the chemo wouldn't start till the next day.

The speech therapist came by and is my new best friend. She said that I could have ice chips 4 times a day. Chewing ice chips felt glorious, after not eating or drinking for five days. Chewing ice chips is better then…well, it's better than a new car. She also gave me exercises to do to improve my swallowing. I had two major bathroom accidents last night and today. The nurses are great.

And if your [lateral nerve on the outside of your left foot] causes you to sin, [have the surgeon] cut it out and throw it away. For it is better that you lose one of your members than that your whole body go into hell. (Matthew 5:30 ESV).

   "This too shall pass", said Doug from the portable potty.

Sunday, Nov 2- latest news from ICU

I slept ok last night...maybe 4+ hours.

The pain from left rotator cuff moved to left hip and down hamstring.  I felt like it was beginning to tear, so I had nurse wrap it in AC bandage at 2:00 am.  This morning was much worse, so I had ice pack put under bandage.  A little while ago a doctor came and inspected it.  She thought it had weakened, but had not torn.  Just keep ice on it.  They are also going to get me some cough medicin.  

About returning to BMT 8th floor (my latest goal in life)?  First, I must qualify by receiving oxygen in single digits.  Yesterday, they reduced my flow rate per minute from 12 litters per minute down to  8 and were able to maintain same oxygene level of 95%.  BMT wanted to see min of 92%.  They turned down oxygen again and my oxygen level actually increased to 97%.  So, it's beginning to look favorable to my return to 8th floor today!  A very big yea!  This will allow me more freedom to move around and get better than is permitted in ICU.

What about permission to drink?  No such luck till at least Mon or Tuesday.  Docs want to see improvement in my nerve, not just pneumonia...which has no time goal just yet.

Just saw ICU doc.  He listened to my lungs and thought pneumonia sounded much better and noted I was way down on oxygen.  He will recommend to BMT on 8 that I return.

Surgeons may talk with oncologists today to see if they want or really need info that would justify ignoring three risk factors: my level of oxygen, blood clot and high blood pressure.  Head surgeon won't return till Monday to make final call.

I will update this post throughout the day.

Sat. Nov 1

Daily blog info:

ICU doc still hears sounds pneumonia; doesn't think they will release me back to BMT  8th floor today, which is depressing.

Question as to when on nerve biopsy?  According to Paul in Neurology, decision held with pulmanatorty guys, who are afraid of pneumonia, which equals delay.  Bummer!

I have requested a Physical Therapy while in ICU.  I really need to get out of bed.  After hitting the call button and then getting permission, it took ten minutes of unhooking tubes to allow me to walk 12 feet to toilet.  I wobbled a bit, which got the nurse concerned.  If they would allow me to walk 1,200 feet, with shoes on, I'd do better,

I've requested swallow test, which has been delayed because of pneumonia.  I have't ate or drank anything for days...that hasn't gone through a tube.  It doesn't look promising that I will eat or drink until pneumonia cures up.  Bummer!

Met my new oncologist doc for month of November.  They aren't starting chemo in any serious way until they see nerve biopsy, which is on hold (even with local).  They all agree lots of steroids would help.  I can't return to 8 because I'm taking so much oxygen.  They have begun to cut the rate back the flow rate from 12 to 10 liters/minute and see if my oxygen level stays above 92%.  Still no rush on doing swallow X-Ray test .

Well, who can I blame for all my problems?  Doctors, Obama, the Tea Party?  No.   Sadly,
I am responsible for aspirating food particles into my lungs.  I'm the one to blame,

Surgeon walked for a talk.   She will talk to  her  staff and try to schedule nerve biopsy in a few days.

Fri, Oct 31 Late Day Update

The ICU doctor said that I looked bad yesterday and that he expected me to look worse today, but he says I look much better. He says I may be released to the 8th floor and start chemo tomorrow.

The radiologists looked at the MRI and found a nerve to biopsy. It is an enlarged and highlighted nerve in my leg. The biopsy will probably be Monday. It has been delayed because of the pneumonia in my right lung.

This morning they replaced my heavy air mask with a much lighter tube in my nostrils, which is better. And sometime they will remove the feeding tube from my nostrils and put it directly in my stomach. This will not preclude me from eating or drinking on my own. I don't miss eating or drinking, but I dream about milkshakes and warm, chocolate chip cookies.  They're also planning to do another swallow x-ray tomorrow.

It's odd, I fall asleep very quickly these days and sometimes I will talk out loud in my dreams, only to wake up and realize that two people are in the room trying to understand what I said.

Hopefully I will be able to make it out of the hospital by next Tuesday.

Heart Rate 113 / Blood Pressure 134/97 / Oxygen 94-100 with the tube and steady 87 without

Friday, Oct 31- docs still won't let me eat or drink

I just don't have much breath, so it's hard to talk.  Feeling much better today.  Hope to get swallow x-ray test again today.  As Sherry noted yesterday, I may be moved from ICU back to 8th  floor tomorrow.  I'm going to lobby hard for right to at mleast drink, but may have to rely on feeding tube.  It's weird, I miss estting

so much I dream about eatting.  I  spoke with a couple of ICU doctors about installing the more permanent feeding tube directly through tummy wall, as opposed to the one coming down my nose.  Surgeries may have to wait till pneumonia is resolved.

Word is radiologist reviewed my MRI and found a nerve to cut...ahh biopsy.  The info from biopsy will be used by Patel and Anderson to pick which chemo drugs to use down the road.  I think they are  ready to start me on something tomorrow night.

I still can't eat or drink anything.  I rely totally on feeding tube.

I really like the Neurology staff.  Although the ICU doc gave me a mean look and a lecture for setting off the bed alarm, for the third time..  I just think I will feel much better by Tuesday,

Thurs. Oct 30 - More complications

I was admitted to ICU around 3:00 a.m. early this morning because of insufficient oxygen - They like to have it above 92. Mine was 88. So. I now have to wear an oxygen mask.

 An X-ray of my lungs showed that there are particles in my lungs resulting from food going down the "wrong way into my windpipe." So, I now have pneumonia in my right lung. They are treating it with antibiotics. Another thing they did was to put a temporary feeding tube in. It is a tube that goes through a nostril and all the way down to the intestines. It was very painful and it took 5 tries to get it right. After each time they took an X-ray to see if the long and narrow tube ended up in the right place. Meanwhile, I was without any nutrition or pills all day. I was not allowed to have anything by mouth including ice chips or water.

The various docs, along with their students and residents, came by:  pulmonary, neurology, and oncology. The pulmonary group came first. Based on an X-ray of the chest, they concluded that I have pneumonia.  At this point, the Pneumonia gets priority because I can't go under anesthesia (for the nerve biopsy) with pneumonia.Neurology is still waiting on the interpretation of the MRI of the leg to determine where to do the biopsy. And oncology is waiting on the biopsy.

I've been in a lot pain today despite them doubling the morphine.


Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal. (2 Corinthians 4:16-18 NIV)

4:25 Oct. 30 ICU

Wow!  I sure got the attention of three rapid response teams tonight.  Mark, my nurse, was concerned about my oxygen level: 88 vs accepted low of 92.  He spent an hour hooking me up to more accurate sensors.  Then when he left I thought it would be a good idea to eat some of Pam's delicious, dense cinnamon honey bun that Mark brought for me.  It was great, until it got totally stuck in my throat.  I have serious problelms swallowing.  Honestly, I got scared for five seconds. I ripped out the sensors on my chest and was finally about to cough some up and breathe a little.  A bit more hacking opened up my wind pipe.  An x-Ray showed I had inhaled a good bit of food particles into my lungs.  This aspiration is very is very dangerous for me.  So, I don't get to eat or drink anything without another swallow test.  So, here I am in ICU.

Wed.October 29 - Another MRI

The doctors came in this morning and said that they needed yet another MRI. Yesterday, I was in so much pain in the MRI tube that after about 2 hours I pushed the "panic button"  to get out. The doc said they need another MRI with contrast so that they can make a better decision about the nerve biopsy. So, I went back for another MRI today. Fortunately it went much better than yesterday. They upped the dosage of pain meds before the MRI and also  gave me some afterwards. 

I was pretty blunt with the doctor (imagine that) and said that I didn't want them to do a nerve biopsy, which could leave me with a permanent disability like drop foot, if it was only CYA for the doctors to not    get sued. Dr. Anderson assured me that they would learn something from the biopsy such as what kind of chemo to use. I think the biopsy will be tomorrow. 

My blood pressure has come down. It is now 132/86. My pulse is 105. my weight is down to 169.

James 1:5 NIV says: If any of you lacks wisdom, you should ask God, who gives generously to all without finding fault, and it will be given to you. Please pray that God will give the doctors wisdom.

Wed, Oct 29- New Normal?

Wow!  Here's a scary thought.  What if my current condition is the new normal: very little extension of left arm and hand, very weak right hand, move around like I'm 100.  If that's my new reality,  I have a role model to show me how to do it in my darling wife, Sherry. I don't think you guys appreciate what she puts up with or how tough she is.  I just got to figure out the chronic pain and swallowing.  I think I am very close to needing a food tube to get a decent diet.  The tube would be a an embarrassment, but would not prevent me from eating when I could.

What about my story?  You know I wanted to be that guy.  The guy that was cured from two 'incurable' cancers. It looked like I was on my path to a cure three weeks ago, but it now sounds like I will have 1-2 years.  Please understand that I am not waiving a white flag.  I just have to accept my physical condition.  I also accept God doesn't care if my leukemia came back.  God isn't the house at Vegas.  He doesn't survive by controlling the odds.  He can do anything he wants.

Tuesday, Oct 28-

I spent the last hour writing a blog that didn't get saved. Bummer!

My day started out well. They adjusted my pain meds so I slept better. Apparrently all the doctors , the oncologist, neurologist, and radiologist met and they decided that they wanted to find a nerve to biopsy.  So they sent me to the MRI to get it back and leg image.  I knew it would be painful to be in the machine for two and half hours so I took two pain pills and morphine shot before I went in to the MRI.  Being still and locked into the MRI machine is just a very unpleasant experience.  Plus, today I got the hot, loud machine and I came out drenched in sweat.  During the second session my pain got worse, my hands became paralyzed and I had trouble hitting the panic button.  I would like to say it felt better to raise my arms and stretch but it really didn't.  I also get dark bruises from trying to be so still.  I agreed to go back into the machine for the last half hour.  I just couldn't take it so I quit the session. It felt like dopping out of the hundred miler.  However, I think it was the right thing to do.  

Since getting back to my room, I took two Norco pain pills and three morphine injections. The pain is just beginning to ease, although it's becoming hard to think strait.   

So where do we go from here?  Hopefully, the doctors have enough MRI images to find a nerve to biopsy.  The doctors are convinced leukemia has returned and is hiding in my nerves. They just want the evidence before they give me more chemo.  However, if they don't find a nerve with leukemia, they plan to give me chemo anyways, probably tomorrow night.  I expect to in the hospital for several days.  

Three weeks ago everything was going great and I was on a path to a cure, now it looks like the cancer is back.  It's just a sad, painful situation.  God doesn't need the odds to be in his favor; however, it's closel too

Ii got to sleep now.

Monday, Oct 27- My Condition is Just So a Rare

Pain, pain, pain is just what I'm dealing with right now.  I had another lousy night sleep, which means I was up till about 330 in the morning.  This morning I talked to the oncologist and I neurologist about adjusting my pain meds.  I now have two morphine pills,  one of which is time released.  I am also still having trouble with swallowing and choking and coughing.

I just met with Dr. Williams and his neurology staff.  The preliminary reading of the MRI of my leg did not show any suspicious, inflamed, or enlarged nerves.  A previous MRI of my chest showed a very suspicious nerve under my right arm.  It was highlighted with intensity and enlarged; however, it was located in a position that was very high risk and no surgeon wanted to cut in that area.  So what do we do?  There is no nerve to biopsy.  Dr. Anderson, my oncologist, and his staff just came by.  The neurologist, the oncologist and the radiologist are trying to arrange a meeting this afternoon to figure out what to do.  Because they all seem to agree that leukemia is in the nerve one course of action is to do blind chemotherapy. If they do that it might take place tonight in the hospital.  It is odd to do chemo if you don't know what the problem is and can't measure the effectiveness of the drug.  However, if they do chemo and leukemia is actually in the nerve, much of my neuropathy symptoms, such as pain, swallowing, hoarseness, and motor skills might improve.

Speaking of hoarseness and swallowing I just met with the physical therapist and reviewed the video of the x-ray of me swallowing liquids.  We don't need to do anything now; however, I may need a feeding tube soon.  When I swallow, I often choke and food goes down my windpipe.  However, I'm currently strong enough to cough it up.  A feeding tube would ensure that I got sufficient nutrients on the hospital for an extended period of time.  It would not preclude me from eating food separately on the side.  I can eat some foods better than others.  Bread and rice, things that expand when exposed to liquid are problematic.  I need to focus on the foods that I can handle and drop some of the foods that make me choke and throw up.

I'm just doing stuff right now, plus I'm very tired. 

Sunday, Oct ,26

Amazing how much my physical condition has deteriorated; although I was able to walk ten 200 yard laps around the hospital wing this morning.  Sherry brought me a Which Which sandwich by for lunch today, which I butchered with a swallowing attacked. Certain foods just cause me to choke, aspirate food into windpipe and have to rush to the bathroom to throw up.  My terrible horse voice and trouble swallowing is just another part of my nerve damage that may soon lead to a feeding tube or pneumonia.  When I started this process in May, I was very sick, but very strong; now the wheels are just coming off.

While I am in the hospital this month, I am under the care of Dr. Anderson; rather than, Dr Patel. This makes sense because he sees all the tests real time and can coordinate with the neurology department.
Trouble is I don't like him very much.  It's almost painful for him to communicate with me.  Today he recited a list of platitudes, received an email that was more interesting than our conversation and just walked out.  Oh well...

I pushed this morning about getting the MRI of my leg completed today.  I was told at 3 o'clock that it would be done tomorrow; however, one of my doctors stepped in and said that was unacceptable and started making phone calls. I received the MRI, which took two hours. This means I will get the nerve biopsy tomorrow an move the process along.  I have been told the nerve biopsy may have consequences, such as a droop foot.  I'm very pragmatic.  I may only have a year or so to live.  I already rode my bike across the country and don't need to do it again. However, we simply must know what is going on in the nerves.  I should find out within a day or two if the leukemia is back.  All the doctors think it is.

Speaking spiritually, I no longer have the ability to rely on my own strength.

2 Corinthians 12:19 'My grace is sufficient for you.  For my power is made perfect in weakness.  Therefore I will boast all the more about my weakness, so that Christ's power may rest on me.'  

Galatians 3:3  'Are you so foolish? After beginning by means of the Spirit, you are now trying to finish by means of the flesh?'

Well, God has me where he wants me, dependent only on him.

Life is good!

11:30 am- took 2 pain pills 40 minutes ago. Just took sleeping pill and shot of morphine to try to knock me out.

10:00 Sat Night, Oct 25th

First, some medical news.  I never got the MRI of my left leg; guess we'll get it tomorrow. The MRI will highlight which never will get biopsied and answer the all important question:  did the cancer come back?  The docs think the leukemia is hiding in the nerve and causing all my neuropathy issues.     If not cancer, then maybe my pain and movement issues are caused by HVGD, which would also be pretty bad news.

I've had lots of trouble swallowing lately and had a swallowing x-ray, which showed problems.  The doc was close to putting me on a feeding tube, but relented.  I now have strict rules: tuck chin, multiple swallows, and must clear throat loudly to prevent food going down windpipe.  Aspirating food particles could increase risk of pneumonia, which is already high.  Tonight, we ate steak from Saltgrass, which was wonderful.  I handled the food slowly and without incident.

My neurologist changed my medications to better reflect my nerve pain.  I plan to have a restful night's sleep, which will be a blessing compared to last night's up-all-night pain fest.

I had a wonderful visit from my Nigerian friends:  Arit P Eke-Ude, Teresa Agada and her son Chine.  They were great and reminded me of Hezekiah, who was told by God to get his house in order; he was going to die, which is what the doctors are suggesting to me.  Hezekiah turned his face to the wall and prayed, 'Remember, Lord, how I have walked before you faithfully and with wholehearted devotion done what is good in your eyes.'...Then the word of The Lord came...'I have heard your prayers and seen your tears; I will add fifteen years to your life.'  Well, that's what I want: 15 more years.

Love.