Update on Vicki

Dr. Marshall from the Lombardi Cancer Center at Georgetown called today with Vicki's test results. The blood tests were more consistent with a blocked bile duct than liver failure. However, the sonogram showed no clear evidence of an obstruction in the common bile duct. Rather, the test showed a partial blockage further up the biliary tract which has been evident in previous CT scans. Unfortunately, the net result of these inconclusive tests yields no obvious choice. We believe the best course for Vicki will be to place stents into the bile ducts in an attempt to improved the drainage and alleviate some of her symptoms of disorientation. By tomorrow we hope to complete the arrangements for conducting this procedure at either Fairfax or Georgetown University Hospital, depending on the doctor's recommendations.

The combination of the reduced liver function, cancer, and radiation treatments has dealt Vicki such a tremendous blow that she can now barely function on her own. On Tuesday night we began round-the-clock observation in our home, with close friends staying in her room at night to be sure she has ready help. She can only communicate with short words or phrases. She rarely has the strength to open her eyes and when she does she cannot hold them open for very long. When I look at Vicki I wonder how long she can survive in this condition. We try to make her as comfortable as we can.

With the help of some close friends and Vicki's parents, we have begun to make a variety of arrangements. This morning we met with a representative from Capital Hospice. After the doctors perform this next procedure (or if they perform it) we will begin Hospice care for Vicki and our family. Our close friend Jim has helped us contact a local funeral home (Adams-Green) and cemetery (Chestnut Grove), which is only 100 yards from our house. This afternoon Jim, Olin (Vicki's father), and I walked through the cemetery to review the various options. We also discussed Vicki's funeral and began preparing. I suppose I always knew I would have to deal with these issues, but I had not given them any thought over the past three years. I spent my energy and time on finding the best treatment. Even now I am grateful for the friends who carry me because I find all of these so difficult to think about.

I spoke to both Kelly and Lauren very directly over the past two days. I believe they understand but they also process grief differently. I think we adults know what to expect and anticipate the grief so we feel much more pain before a tragic event. I am not sure if children realize what might arise when a parent dies. So they may not feel the full force of the blow until Vicki actually dies or even some time later - when the sense of loss manifests itself in their lives. Kelly just came into the office while I wrote this note to say goodnight and give me a hug. She said "dad, you're doing a great job with all of this, I love you." That's a great way to end a very difficult, emotional day.