Both camera pills are out and Bob is moving today to Cleveland Clinic today

Family and Friends,

I'm sorry I didn't have a chance to update the blog yesterday but I had to work and make a million phone calls to help set up Bob's move to the Cleveland Clinic. Basically we are on standby until we get a phone call from the Cleveland Clinic letting us know a bed has opened in their ICU. They said once the doctor's make their rounds this am they will probably downgrade someone and Bob will be able to go. He wants me to ride in the ambulance with him, so as soon as I get the call I'm going to leave work and head over to Bethesda.

As you can see from the picture, Bob has finally passed the 2 camera pills that were hanging out in his stomach for the past week. They had given him some stool softeners and milk of magnesia and they came out. The bad thing was that stuff, compiled with the fact that Bob has just started to eat regular food, has caused Bob to go from slowly oozing blood to bleeding again. His platlets dropped last night down to 77,000. (Remember 2 weeks ago they were at 350,000).

Now for some great news. Bob was able to see his son Christopher yesterday, sit right next to him and talk. He was with Bob for about 30 minutes according to his grandmother. I went over to her house and ate dinner with Chris and asked him about seeing his dad. He said "it was good. Dad looks the same just skinnier". So it was great that he wasn't afraid, and I think that was the best motivation to get better that Bob could have gotten.

Also last night I was able to speak to the new GI doctor that will be taking care of Bob's intestinal bleeding. He called me at about 6:45 last night and we spoke for about 30 mintues. He was very open minded and honest with me about Bob's condition and we talked about options for Bob. They hope to evaluate him today and possibly do the double balloon enteroscopy tomorrow or surgery.

If you want me to be detailed, here it is: our first option is the double balloon enteroscopy. It does not require Bob to be cut open. It involves a balloon that is inflated and pushes against the wall of the intestine as it slinks itself downward. The problem is that Bob just had the first surgery only 3 weeks ago and if the balloon passes through that part where they cut and sewed there is a chance that it's not completely healed and he could rupture the area with the balloon. They usually want to wait 6-8 weeks before they would do this. The other option is to do surgery. What is sounded like is that they would open him back up, cut him where they did before, stick the camera directly into the intestine, look all the way down to the bottom this time (unlike his last surgery) fix and cut whatever they need to and then sew him back up and he'd stop bleeding for good. A little bit about Bob's new doctor: Subsequent to his current appointment, he was Regional Chief of Gastroenterology at Kaiser Permanente Ohio. After receiving his Bachelor of Medicine/Bachelor of Surgery in 1990, he completed his residency at Cleveland Clinic. His research and clinical interests include general gastroenterology, capsule endoscopy, double balloon enteroscopy, obscure GI bleeding, diagnostic and therapeutic endoscopy and diseases of the small bowel. He is the recipient of an array of academic awards, including the Dr. Sidney Garfield Physician of Excellence Award, a teaching award presented by the internal medicine residents at Case Western Reserve University Hospital in Cleveland, Ohio, and an Outstanding Senior Medical Resident Award from Cleveland Clinic. So it sounds like Bob's in good hands.

Okay back to him being transferred. The only way Bob was willing to go to the Cleveland Clinic was if he could go back to Bethesda for chemo. He wanted to be close to home and I can understand that. So yesterday Bethesda signed a letter of reciprocity (which I made sure to get a copy of) stating that Bob is going to the Cleveland Clinic to be treated for GI issues only and that once he is stable Bethesda will have 48 hours to take him back provided they have a bed for him.

That's all the news that's fit to print right now. Just waiting.

If I could say thank you to anyone today, it would be to Bob's nurse Emily. I really don't know how both myself or Bob would have pulled through without her kindness. Let me tell you I had to pull some strings to have her put on Bob's case full time, but she has made all the difference. It's amazing how going the extra mile can change someone's life for the better. Saying thank you doesn't even begin to cover it.

Please keep Bob in your prayers and thanks to everyone for their opinions they've been posting. I read them all!!

Lots of love and thanks,

Michele