Steve's Memorial Website is now available

A new memorial website for Steve Yu is now available. In it you will find photos and transcripts and more. You will also be able to enter your comments and stories into a new blog for Steve. Please click on the following link
http://home.earthlink.net/~helentsang/yufamily

and then click on "Steve Yu's Memorial Page" or "Dad's Memorial Page".

Florist Info

If you are thinking about ordering flowers for the memorial service, please contact 喜相逢 (Carrie's Florist) at 626-839-4008. Please mention 俞贛 (Steve Yu) when you order.

Memorial Service

Memorial Service will be held at

Evangelical Formosan Church of Los Angeles
洛杉磯福音教會
9537 Telstar Ave. #101
El Monte CA 91731
http://efcla.org/

Saturday, August 11, 2007
10:00 am Memorial Service
*reception immediately following

Rose Hills
3888 Workman Mill Rd
Whittier, CA 90601
1:00 -2:00 pm The Wake (Viewing) at the Mortuary Building
*for those who cannot attend the service or official viewing, the mortuary room is open from 9 am on Saturday
03:00 pm Burial Service at the graveside
Location: Lupine Lawn

Please send all mail correspondence to

Mrs. Jeanne Yu
2200 Camino Del Sol
Fullerton, CA 92833
jc_rules@msn.com

Helen Yu at 714-553-0310
James Yu at 714-606-8389
as needed

Memorial Service & Funeral Plans

The Memorial Service is planned for this Saturday, August 11. Please check this blog for location and other announcements.

Tuesday AM Update

Steve passed away 4:45 a.m. Tuesday, August 7, 2007. He spent his last hours surrounded by his family. He experienced no discomfort.

Monday afternoon update

Status Summary:
**Steve's major organs are failing due to massive infection. Both his liver and kidneys are failing. He has inflammation in his brain (meningitis). He has septicemia, a significant presence of bacteria in his blood (or blood poisoning). The vast array of antibiotics prescribed has not been able to stop the infection.
**Steve is having extreme difficulty in breathing, and his blood pressure is maintained only by saline solution, which exacerbates his breathing problems.
We have taken the following course of action:
1. We have stopped the antibiotic drip.
2. We are planning to stop the saline drip after this current bag.
3. We have also stopped the electrolyte drips.
4. After some planning to move Steve home, we decided that it would be more comfortable for him to stay here.
5. Steve is being given morphine when needed.

Sunday Afternoon: Unstable Day So Far

It was a rough night for Steve. Phlegm continues to build up in his lung. His heart rate, blood pressure and oxygen saturation level continue to fluctuate.

Saturday

Result of the CT scan on the brain: Pockets of fluids accumulated in between the brain mass and right temporal area. Due to Steve's poor health condition, the lumbar puncture cannot be performed. MENINGITIS is highly (99%) suspected but cannot be confirmed.
G Tube feeding is now at 25ml/hour.
Steve is less agitated with the help with drugs like codeine and morphine today.
Phlegm continues to build up in his lung. He is now on oxygen mask.
Liver is inflamed.
New strand bacteria at G tube site and herpes on his back has been confirmed.

Late Friday Night

The itch continues to bother Steve all night. At the request of the family, starting 10pm, Benedryl will be given to alleviate the itching. By 11pm Steve finally calmed down and fell into a state of light sleep.
At 6am Saturday morning, transfusion of platelet will be given. Following the transfusion, the guided lumbar puncture will be performed by the radiology department. Please pray for a good night rest for Steve so he will have enough physical strength for the procedures tomorrow morning.

Friday Update

1. Steve's delirium continues. There is suspicion of meningitis. He had CT scan today, and a spinal tap is being performed tomorrow.
2. Steve is on coedine for the pain and the restlessness/uncontrolled scratching

Thursday Update #2

Praise: Today's ultrasound showed normal gastro-intestinal functions.
Prayer:
1. For Steve to regain lucidity. He is confused and not speaking.
2. His skin is very itchy and he is scratching and pulling on the various tubes and PICC line (the doctor has already ordered restraints).

Thursday PM Update

1. Steve's condition has not changed very much.
2. His diarrhea has slowed (which may allow increased feeding).
3. He is becoming irritable, his arms flailing and pulling at various tubes. Restraints are being considered.
4. We are trying a chinese medicinal supplement, lingzhi, with doctors' approval. He took the first dose yesterday.

Wednesday Update

1. Steve continues to be delirious.
2. Steve continues to have digestive problems, unable to get much nutrition. (very slow feeding, 15mL/hr)
3. His TPN drip is causing liver functon problems.
4. He is on antibiotics, but none of his blood/urine/stool culture indicate infection. The doctors are reluctant to stop the antibiotics because everytime the antibiotics stops, Steves goes into sepsis.
** Steve is mal-nutritioned and his organs are gradually failing. **
** We are not sure if there is much more the doctors can do to get him out of this vicious spiral **

Tuesday Update

1. White blood cell count continues to rise, indicating possible infection. The doctors ordered more antibiotics and more tests to determine the source of the infection.
2. Liver enzyme readings are high, indicating possible problems with liver function.

Please pray that Steve would be able to digest his food properly so that the G-tube feeding can speed up. Also, please pray that the doctors will be able to identify the infection and find the right antibiotics.

Monday Evening Update

1. Steve is back on G-tube feeding, but a very slow rate (10 mL/hr) because of the problem he is having with digestion.
2. His bedsores on his lower back has advanced to stage 3 (maximum = 4) and is causing him a lot of pain.
3. He is not entirely lucid today, but did seem better toward the end of the day.

Sunday

Steve's coughing spell has finally stopped.
Early Sunday afternoon he received one unit of blood transfusion to help decrease his heart rate. His heart rate is holding steady in the110's, praise God!
After the transfusion, he started to have some minor skin irritation. After a dose of Benedryl, Steve finally slept well for the first time in two days.
The reading of the CT Scan of the abdomen indicated no significant change since the last examination on July 16, 2007. Pockets of scattered air filled loops in the small intestines may be the cause his colic-like pain. The underlying cause is not known. But what the report suggests is a dysfunctional small intestine. Please pray earnestly for the doctors to have wisdom in their diagnosis and treatment. Without the small intestine performing its function to absorb the nutrients, the chance for Steve to fight the disease diminishes greatly.

Saturday Morning

Even though it was light and sporadic, Steve's cough persisted through out the night. He is tired from lack of sleep. His lung is slightly congested right now. Intravenous fluid input was reduced to see if it would alleviate the situation.
The glucose level is in the 60's despite a higher dose of dextrose. Possible cause is the insulin level in his TPN being too high. A new order with a lower dosage of insulin is being formulated.
At 9:00am, Steve was wheeled to be examined with the CT Scan.

Friday Evening

With the help of the respiratory therapist, Steve was able to cough up some phlegm this evening.
The discomfort has decreased with the help of an empty stomach. He is receiving a new anti-fungal medicine and a boost in amino acid intravenously. After an examination by the GI specialist who felt Steve's abdomen is distended, a CT Scan was ordered for the abdominal cavity to check for infection, obstruction or other possible cause.
There will be no chemotherapy this weekend. The oncologist has decided to wait for another week to re-evaluate. He is considering to only administer the mildest drug in order to maintain the progress made so far with lymphoma.
The air bed arrived at around 8:30pm tonight. New medication was ordered to enhance the healing.

Friday 7/27 AM Update

Although the G-tube feeding had resumed last night at a slower rate, Steve's stomach is still not quite well. He complains of regurgitation. At the moment the feeding is stopped. He is off the oxygen, primarily because he does not like the nasal cannula.

At the moment, he is lucid but is uncomfortable without being able to pinpoint the source.

Thursday PM Update

1. Steve is out of ICU and is now in Room 151.
2. He still has bowel problems. The doctors are checking to see whether there are toxins or bacteria in his stool. If his stool is clear, they will resume the G-tube feeding.
3. The doctors have ordered a new bed designed to alleviate his severe bed sores. They have also consulted with a wound specialist to examine the sores.

Thursday PM: Update from CCU

This afternoon Steve is much better. He is able to speak and is quite clear-headed. All his vitals are normal. Much of what happened last night is probably due to an unintentional stoppage of his TPN drip, which, after the G-tube stoppage in the morning, was his only source of nourishment. Being diabetic, this immediately resulted in a dangerous dive of his blood sugar. The doctors have agreed to make sure Steve's blood sugar level will be monitored more frequently. Furthermore, the removal of the stent may have caused a minor infection.

Frequent diarrhea indicates that Steve's digestion is not as good as it should be. Therefore, when G-tube feeding resumes today, it will begin at a lower rate, and will be maintained at a slower pace.

Tomorrow marks the three-full-week term since the previous chemotherapy (the 2nd installment in a plan of 6) began. It is also the date, then, for the 3rd installment of chemotherapy, if everything had gone according to plan. However, as everything has not gone according to plan, and Steve's recovery has yet to begin, it is doubtful whether any chemotherapy should be contemplated at this point or at any point in the near future. Please pray for guidance for the doctors and the family so that we will make the best plan of care for Steve.

Thursday Early Morning

12:30 am
Admitted to CCU (Critical Care Unit)
Blood Pressure 90's / 50's
Heart Rate 140's

06:00 am
Blood Pressure 90's / 50's
Heart Rate 110's

08:00 am
Blood Pressure 115/55
Heart Rate 109
Glucose 57

Wednesday 11:15pm Back in ICU

Steve's blood pressure is down again. It was at 82/43. His blood sugar plummetted again--this time too low for a reading, after having had a dextrose injection at 6pm. He will be going back to the ICU again, possibly for sepsis.

Wednesday 9:30pm

The cardiologist says that Steve's high heart rate is due to some other cause, e.g., infection, and is therefore not to be treated directly. Blood samples will be cultured for infection. Meanwhile, Steve got some Codeine for his pain (Demerol is no longer the pain medication of choice as it makes him delusional). Our night nurse suspects the pain is still due to stomach regurgitation. She will give him a course of Carafate (an ulcer medicine).

Wednesday 8:30pm

Steve is suffering from acute pain in the chest area. He has a mild fever of 100.4. His heart beat is still around 150. He is awake but is in distress. We are waiting for a cardiologist to call or come by.

Wednesday 7/25 PM Update

After the shot of Demerol today around 12:30pm, Steve fell into a fitful sleep, in which he would open his eyes and even wave his arms, but he could not be wakened. The doctor believed this is due to the Demerol. However, compared to previous times, this semi-conscious state lasted far longer.

At 6pm, his blood sugar was measured at 40. Some dextrose was injected. Slowly Steve came out of his sleep. However, the coughs that plagued him this morning returned. Again, his heart rate is at 160, though his blood pressure looks normal. Currently we are looking for his primary physician. Steve is very weak and unable to communicate. His whole body is trembling due to the coughing fit. Please pray for relief and knowledge for the doctors to understand the cause.

Wednesday 7/25 AM Update

The G-tube feeding can result in problems such as acid reflux and aspiration, etc. Last night, as he was routinely turned to one side, some reflux occurred, causing heart burn and pain at the back of his throat. Since his pain medication (Demerol) has expired, it took hours to finally find a doctor who would prescribe Demerol for his pain relief. The doctor upped his Protonix medication to reduce the chance of stomach regurgitation. G-tube feeding was altogether terminated due to diarrhea last night.

This morning, further complications erupted when Steve began coughing incessantly. Though some mucus was coughed up, things continued to worsen. His heart rate jumped up to 168. The doctor ordered X-ray and breathing treatment. Suction through his nasal passage and throat was done, and Demerol was given. At the moment, coughing has stopped, and his heart rate is down to 120. However, he is still very uncomfortable. The breathing therapist believes the present troubles arise from his inability to cough up phlegm from his chest. She may need to perform another suction later. This ordeal has left Steve exhausted.

Tuesday Update

The procedure to remove the ureter stent was successful. Steve is pretty alert for most of the day, although he has trouble speaking. G-tube feeding resumed today around noon. Tomorrow a speech therapist is coming to help Steve eat his first bite of food orally in days. Steve suffers from short-term as well as long-term amnesia. However, it is not an immediate concern.

Right now Stever urgently needs to become mobile, as his bed sores are very serious. Please pray for recovery. Thanks.

Monday Update

Not much happened today. Steve's electrolytes remain unstable. He was very low in potassium this morning. On a happy note, his white blood cell and platelet counts are both good.

Tomorrow a procedure is scheduled for removing the stent in his ureter. This will eliminate one possibility of infection. After the procedure, he may resume feeding through the G-tube and possibly try to eat.

His bed sores continue to be at level 2, which is pretty severe. Please pray for recovery.

If all goes well this week, Steve may need to move to a skilled nursing facility or an acute care center. Please pray for wisdom and guidance as we decide how to proceed.

Recent photos

Here are some photos of Steve and family from a week ago, thanks to David and Bafee Lu.

Good Day, Steve's Out of ICU

It is 5:24pm. Lots of progress today. Steve has been transferred back to the general medical floor at Los Alamitos Medical Center. The new room has a nice garden view. He is still weak physically.

His vital signs are steady and stable. If this condition holds, the doctors will remove the stent placed in his ureter on Monday.

Due to the likelihood of aspiration pneumonia, feeding has stopped since Thursday afternoon. Meanwhile, he will be given TPN (total parenteral nutrition) starting 9pm to boost up his nutritional level.

So far, the culture on his blood, stool and urine has been negative of bacteria.

He is back on Lasix to help drain the fluids.

This afternoon, the speech therapist evaluated and determined Steve does not have a full functional swallowing ability. Please pray for a full recovery. His ability to eat well is pertinent in nursing him back to health.

8:00am

Dad is fully awake this morning. He is able to speak, coherent and weak at the same time. He did not have much recollection about the past week. Charles and Mom gave him a quick rundown this morning.
The nurse has slowly weaned him off the vasopressor (medication to raise blood pressure) through out the night and his blood pressure is holding up. He is on a much smaller dosage compare to last night.

Thursday PM Update

1. Steve was not responsive all day. He had mild fever in the morning and he began to cough. A CT scan to the brain was done in the morning. The coughing continued throughout the morning. He appeared to have a lot of flem in his chest. At one point, he exhibited signs of nausea and actually threw up a bit of his food fed through the G-tube. Steve's heart rate began to rise. The nurse attributed it to his coughing. An EKG was ordered.
2. His blood Pressure was normal in the morning, but dipped a bit at around noon time. The fever picked up a bit to 99.6 at noon. The nurse gave him some medicine for his nausea and it seemed to have suppressed the cough as well. The EKG was taken around this time. The pulmonary specialist came and checkout Steve's condition and said his current mental state may be due to the severity of his illness and his long stay in the hospital. Other than that, Steve looked fine. There's definitely some sort of congestion in his chest may be pneumonia.
3. At around 3 pm, Steve fever reached 101. That's when his blood pressure dropped to 89 over 50 something, from 129 in the morning. Frantically, the nurse tried to reach every doctor on the chart. The infectious disease doctor came first and declared Steve at a critical state and ordered steroid and antibiotic for his treatment. She also spoke to the Primary physician and gave order for Steve to relocate back to ICU for special care. During this time the cardiologist came and evaluated the EKG. Nothing was unusual from the result. During this time, Steve's breathing became very slow and quite shallow.
4. By 7 pm, Steve finally moved back to ICU in room#162, still in isolation. His vitals are stabilizing but his breathing is still weak. The CT scan of the brain came back negative for any fluid build up. In other words, no stroke. YEAH. Please continue to pray Steve and his family.

Thursday Update: Steve back in ICU

Today Steve's blood pressure plummeted again. At one point, his heart was racing at 150ppm. He also had a fever of 101. He is back in ICU, being treated for low blood pressure. Currently, his vital signs are holding steady.

The doctors attribute this episode to possible sepsis or pneumonia. More diagnostics are being done, including chest X-rays and blood tests.

Earlier today, a brain scan showed no signs of stroke (a very good thing).

Please also pray for Jeanne and Charles, both of whom will be staying in the ICU tonight.

Wednesday Update

A CT scan reveals that Steve's pelvic tumor is no longer visible. Another scan also confirms that there are no tumors in the lungs. However, some fluids continue to accumulate in the chest area. At the moment, Steve is not experiencing any breathing problems. All the vital signs are normal, except his heart rate (120 ppm).

Battle with infections continues. Steve is still severely malnutritioned. He is now back on G-tube feeding around the clock.

A growing concern: Steve has not been very responsive today. His mental ability seems to have deteriorated over the last few days. He cannot chew or swallow. A CT scan of his brain is scheduled for tomorrow to check if he has a stroke.

Tuesday Update

1. Steve's white blood cell count is 11.1 this morning, slightly above normal.
2. The Gastro-Intestinal Specialist decided to not pull out the G-tube. He is now back on the feeding tube.
3. the speech specialist came to try to get him to swallow and eat. He ate a few ice cubes and about quarter cup of puree.
4. A bit of water in his throat has allowed to speak with a bit more volume, but he is still very tired.

*** Spoke with Dr. Reddy, the uncologist during lunch. The CT scan from yesterday showed that the pelvic tumor previously around 3.8 cm in length is no longer visible. ***

Monday PM Update

1. Praise the Lord, Steve is out of ICU. He's now in a regular room by himself, still in isolation. Thanks to your prayers and the hardwork of all the doctors, nurses and staffs at Los Alamitos Medical Center.
2. Steve's WBC count is up to 6.6 and climbing; blood pressure is stable but a little on the high side; oxygenation is at 98% level; no more traces of fever; he's no longer bloated from water retention as he was couple days ago.
3. The G-tube and infection is still our biggest concern at this time. the GI doctor suggests a removal of the G-tube tomorrow and replace it with a nasogastric tube. The Primary doctor however seems to feel G-tube is the best choice at this time despite Steve's current high level of bacterial and fungal infection. They need to talk and decide by tomorrow.
4. The oncologist suggests a alteration to our current treatment. He wants to discontinue chemo but maintain the use of rutaxin in our next treatment. This will keep the cancer growth at bay while allow Steve to recover his physical strength, due to malnourishment.
5. Steve will have to go through a swallow test before drinking and eating again. Physical therapy will follow soon after his energy returns.

Sunday AM Update

Steve's condition remains stable this morning. His blood pressure is now in the 120/60 range. The nurses occasionally replenish him with potassium and other needed nutrients, as he frequently loses these.

The big news this morning is that his white blood cell count went up! It is now at 1.9--a significant rise from yesterday. After the blood transfusion, there was also a nice rise in his hemoglobin (at 11.7) and platelet count (50+).

The primary physician now expects to release Steve from the ICU today or tomorrow.

Steve still suffers from acute pain at the G-tube site and the chest-tube site. Please pray for healing in those areas.

Saturday PM Update

Steve continues to improve this afternoon. His heart rate is down to 105. Breathing rate is under 20. The best thing of all is that he is able to speak in phrases for the first time in two days! Today's chest X-ray indicates that there is some improvement in his lung congestion. He is weaned off the oxygen mask and is using a nasal cannula instead. In spite of all the injections that might lower his blood pressure, including Lasix (a diuretic) and Demerol (a pain medicine), his blood pressure has held steady (now at 122/54). God is working wonders in a medically desparate situation!

Steve is currently getting 2 units of blood for transfusion. He is also receiving a drug called Neupogen, which should stimulate white blood cell production.

Steve still cannot take in any food. Though feeding through the G-tube resumed today, his digestive system seems to reject everything through diarrhea.

Prayer requests: Please continue to pray for improvement in his G-tube infection and other potential infections, white blood cell count, platelet count, internal hemorrhaging, and his nutritional needs. With inadequate protein in his blood, he will continue to leak fluids through his blood vessels. Also pray that all the congestions in his lungs will clear up. Thanks for your prayers.

Saturday AM Update

Steve's condition remains steady. His blood pressure hovers around 105/50. Blood sugar level has been normal (~130). The doctor gave him some medication since yesterday to drain out some fluids in his body, hoping to clear his lungs of an accumulation of fluids. Steve's breathing has been good. Yesterday he was using 100% oxygen; today the mask is adjusted to 40%. His blood oxygenation is still good. The nurses will gradually wean Steve off the oxygen if he is able to breathe well.

X-rays of his lungs reveal that there is much congestion in both lungs, though no one could say for sure what it is: fluid, infection, or lymphoma. Without CT scan, it cannot be determined for certain. A good sign is that the draining of the fluids is helping Steve's breathing. We will know more from today's chest X-ray.

Steve blood test results remain problematic. Platelet counts continue to drop (30+). Hemoglobin and hematocrit both down. So a blood transfusion is ordered for today. White blood cell count remains low (0.4).

Friday 7AM

Over the course of the night, Steve's blood pressure began to inch back up. Right now it's about 104/44. With the help of a 100% oxygen mask, his blood oxygenation level slowly climbed back to normal. Currently his vital signs look steady, and the fever he had yesterday is gone. His blood sugar level is still variable and occasionally low. He is being monitored for possible heartattack, pneumonia, etc. The doctors call Steve's condition sepsis (Wikipedia: serious medical condition characterised by a whole-body inflammatory state caused by infection). For the most part, Steve remains asleep, though he does seem to understand when we speak to him.

Thursday PM: Steve back in ICU

Steve's vital signs are very unstable. His blood pressure dropped to 74/40 recently. The doctor ordered to transfer him to ICU. Steve will be in room 168. Currently, he is in a critical state. Because he has almost no white blood cells, he has no resistence to the infections. The doctor ordered a drug to stimulate his bone marrow to create more white blood cells, but this can take 2-3 days to take effect. Meanwhile, the infections can take over and threaten his life. Please pray that he'll pull through this critical period. Thanks.

Thursday AM

Steve was mostly unconcious this morning. A blood sugar test just now revealed that his sugar level plunged from 150 down to 33 within a few hours. The nurse quickly administered some dextrose into his PICC line. He woke up, albeit very shaken and hungry. His heart beat is at 130, oxygen level at 89. His blood pressure is low (94/40). Today's blood works showed that his white blood cell level is down to 0.2. He has a slight fever at 101.2. His immune system is very weak right now.

Improvement at the G-tube site

The infectious disease specialist examined Steve's G-tube infection and declared it an improvement. We've been playing nurses by dunning gloves and cleaning the infection as often as possible. All the work is paying off! The doctor said that it may not be necessary to remove the tube if the improvement continues.

Steve had some rice and chicken broth for lunch. He did some arm and leg raises during the physical therapy. Overall, he is feeling slightly better than yesterday.

Wednesday AM Update

Steve remains lethargic this morning. He did, however, have a better-than-usual breakfast, consuming some eggs, jam w/ a smear of English muffin, corn flakes with milk -- thanks to Jeanne's persuative powers and persistence. He was unable to get up for the occupational therapy, finding arm-raising too difficult.

Biggest issue at the moment: infection at the G-tube site. No improvement yet.

Tuesday PM

1. Though Steve is currently on a whole host of new antibiotics, the MRSA infection continues to be a problem. The GI specialist is considering removal of the feeding tube in a couple of days if the situation does not improve. Unfortunately, Steve has had little appetite lately and is dependent on the feeding tube for his nutrition.

2. Today Steve has been very lethargic, with no energy to eat or to move very much. Bedsores are developing and his skin lesions are not healing.

3. The uncologist tells us that this lack of energy is normal for the few days after a chemo treatment. He should be feeling better in a few more days.

Monday Afternoon

1. Steve didn't sleep well last night, complaining about being too cold and patient next door making too much noise. He was slightly disoriented this morning. Steve mentioned having two recurring dreams. One has to do with Big Helen coming down to LA. What freeway is she taking? Another one has to do with...I forgot.
2. Steve's lack of appetite continued. He ate 3/4 of a large sesame ball for breakfast, 1/3 of a fruit plate and 1/4 of a bread bun for lunch.
3. PT came around 11, Steve sat up and did some punching in the air. Afterwards, he had normal BM and was exhausted.
4. PT came around 3 pm, Steve stood with the aid of a walker for 20 seconds 3 times. He needs to do three exercises every 2 hours or so. a) toe lift, b) leg slide, c) butt lift.
5. The bloodwork result came this morning. BUN is high and the platelet is low, but hemoglobin is holding at 13.7. The oncologist came to discuss the bloodwork in the afternoon and said everything looked as expected. The high BUN is a result of cancer cells breaking down resulting in high protein and amino acid in the blood stream. The kidney unable to process the excess, hence such high number. The low platelet count is a natural result of chemo therapy and one should not be alarmed until it gets to around the 40s.

Sunday Evening 07/08/2007

• Steve is being seen by a specialist in Infectious Disease and a new antibiotics and topical ointment was prescribed to combat his MRSA infection. His white blood cell counts continues to climb.
• Steve did not have much of an appetite today. He ate considerably less compare to the past couple days.
• His calcium is still at critical level.

Saturday Evening

• For the most part of this day, Steve was in good spirit and rested comfortably.
• His electrolytes are off balance. Particularly, Calcium, Potassium and Magnesium which are being given intravenously as we speak.
• MRSA infection has not been eradicated. Pus was observed at the feeding tube incision site late last night. Samples were collected to be cultured and the result will be available in 72 hours.
• Steve experienced some heaviness and soreness on both of his legs late this afternoon. This could be a side effect of the chemotherapy.
• His abdomen is still extended. Edemas are prevalent in the abdomen and lower extremity.

1. Chemo finished this morning a little past 12 am. Steve looked fatigued since chemo began yesterday afternoon, but had good rest through the night with no notable reaction to the chemo.
2. This morning Steve woke up around 5:30 am and by 7:50 he was famished.
3. He looked energetic and alert, slight bit disorientation until he ate some breakfast at 8:30 am: 1.5 Sausage, 1/2 muffin, some scramble eggs, hash brown. Later he ate a bit Chinese OILY stick and Hot Pocket.
4. According to the oncologist, Steve is doing great (referencing his blood work this morning). The 2nd round of chemo will affect his blood work a bit for the next 10 days.
5. Steve should sit up today and began a more rigorous physical therapy. By Monday he should try to walk.

Friday Afternoon

1. The Pulmonary specialist came and told us the good new that Steve's chest xray looked good.
2. The Oncologist told the nurses to speed up the chemo. We're now set at 42 ml/hr.
3. Please pray for Steve's physical therapy. He needs to be more mobile before they could release him for home.

Friday Noon

1. Steve had great appetite this morning. He ate more than anytime since his admittance to the hospital.
2. The PICC was installed successfully this morning by Radiology, all the other prior IVs are removed.
3. The nurses began administering Prednisone, an orally taken steroid, since last night.
4. They have just started the 2nd Chemo w/Rituxan half rate at 21ML/Hr, a total of 600 MG. The dosage will increase if Steve react well to the medication. Other medication will be applied at a later time today.
5. The chemo were mixed by pharmacy yesterday and has an expiration at 4 pm today.

Thursday Evening

1. We are now in Room 141B.
2. The room is still considered an isolation room due to the MRSA infection.
3. Steve is scheduled to receive a PICC line tomorrow morning (a more convenient and permanent way of injecting drugs into the body than IV).
4. After the PICC line is inserted, Steve will receive his second round of chemo (Rituxin, Cytoxan, Vincristine, and prednisone).

7/5/07 1:10 pm

1. We are awaiting transfer to Medical 1 (Rm 131A is part of Medical 2) for the chemo treatment. Medical 1 currently has no rooms available and we are waiting for a bed to open up some time this afternoon or evening.
2. Steve's electrolyte numbers are erratic with deficiencies in postassium, calcium and phosphorous.
3. Steve's appetite continues to improve but his energy level is still low.

7/4/07 1:20 PM

1. Steve is out of ICU. He is now in Rm 131A
2. After the transfusion, his hemoglobin and red blood cell count is near normal.
3. There is still some liquid accumulating in his lungs
4. He is slowly regaining his appetite. He has more energy (and is now eagerly anticipating the Brazil match in today's America Cup tournament).

Prayer:
1. Chemotherapy is set for tomorrow. Please pray for its effectiveness and no additional complications.
2. Steve may be out of the hospital as early as Saturday. Please pray for wisdom in arranging home care or skilled nursing home care.

Thank you for your prayers.

Monday 5:30 PM Update

1. Steve is still in the ICU.
2. The doctor has removed the chest tube from Steve believing that the pleurodesis has been effective.
3. He is currently receiving blood transfusion to deal with his anemia and antibiotics to fight an infection at the site of his feeding tube (MRAS--a penicillin resistant strain of the staph bacteria).
4. The uncologist, Dr. Reddy, plans to begin the next round of chemotherapy on Thursday.

Monday 2PM Update

An update from the ICU: Steve is recovering well. The doctor okay'ed a transfer out of the ICU. However, it may take a day before this happens. The chest drain is working well. Since little liquid is draining from Steve's chest today, the chest tube will probably be removed soon, giving him more freedom of movement. He is eating soft solid food. However, he needs to eat more, or the direct-feeding through a feeding tube will have to resume.

Praise: Thank God for Steve's current condition. He is happy and requires almost no pain medication. Thank God also for the nurses in the ICU, who are attentive and capable.
Prayer: Please pray that Steve can breathe completely without the help of oxygen tube. Pray also that he can eat more so he can be stronger. Pray that his bed sores will heal. The oncologist mentioned that he may move up the next chemotherapy date to 7/5. Please pray for Steve to get well enough to be ready for the next treatment. Thank you!

Sunday 3pm Update

This morning Steve greeted us with a big smile. He no longer wears an oxygen mask. His breathing is much better. Praise the Lord! We gave him a bedside worship. He was delighted to join us in singing a few lines from old beloved hymns. Mentally, he also seems very alert. As a result, the neurologist cancelled the Lombar Puncture (spinal tap) scheduled for tomorrow. Currently, Steve is on a clear liquid diet. As the day progresses, he may be able to move on to thicker liquid. The doctors are not ready to release him from ICU just yet. However, this is in some ways a blessing, as the heightened attention from ICU nurses does give us the needed break.

Prayer request: Please pray for continued recovery. Steve needs to work his lungs to increase their capacity. Please pray that no further complications occur to weaken his body. We praise the Lord for your faithfulness in remembering us always in prayers. He is our strength in our times of weakness.

Steve out of the operating room and in ICU

It's 7:08pm. The surgery is over. The doctor was able to insert the chest tube, as well as perform pleurodesis on him. After the surgery, Steve's lungs are not recovering their functions as quickly as expected. Therefore, he is staying in the ICU for over-night observation. Please pray for his recovery. Thanks for your prayers and love. Meanwhile, it is not possible for anyone to visit him. We will keep you posted.

Saturday PM update

Steve is finally in the operating room after waiting all day. He hasn't had anything to eat since midnight. However, under the oxygen mask, he rested and waited peacefully. At present, the thorasic surgeon is operating on Steve to insert a chest tube. Steve is under general anesthesia and will be breathing through a machine during the surgery. The doctor said that there's a 5% chance he may need to open up Steve's chest.

Prayer request: Please pray for the surgery itself. Pray for Steve's strength and the strength of his lungs that they may resume functioning after the surgery.

Friday PM update: Urgent prayer request

Steve's difficulty in breathing became worse this afternoon. The pulmonary specialist has ordered a surgery to drain the fluid in his chest this evening, as well as a pleuradesis (removing the space where liquid can accumulate near the lungs). Meanwhile, his heart beat is getting faster and his breathing more labored, in spite of the oxygen mask. A blood test will determine if he needs to be moved into an ICU right away.

Please pray for him that he can breathe again and that the surgery will go well.

Friday PM update

This morning, the GI doctor performed an endoscopy. The photos reveal that the tumor has shrunken significantly from the chemotherapy, causing lesions in the stomach. In other words, Steve now has ulcer, as the oncologist had predicted. The good news is that there does not seem to be significant bleeding in the stomach. His most recent blood test confirms that internal hemorrhage has slowed down but not entired ceased.

Results from his thoracentesis show that there is no lymphoma in the chest fluid. That's very good news. However, more fluids are building up again in his chest cavity, causing breathing to be difficult. Another draining may be necessary soon. The oncologist ordered albumin for him, which will maybe help the tissues to retain liquid and hopefully reduce the pleural effusion.

He is still mentally confused somewhat. The neurologist said that the CT scan and various blood tests came back normal. He attempted to perform spinal tap but was unsuccessful due to too much edema buildup in his back. Another spinal tap is scheduled for tomorrow morning in the radiology department. Since 8pm yesterday, Steve has been off the duragesic pain medication (fentanyl), a drug that is linked to nervous side effects including confusion. We need to see if things improve tomorrow morning once the drug wears off.

The biggest challenge today is Steve's difficulty in breathing. He needs an oxygen mask to relieve the strain.

Prayer request: Please pray that his breathing will become easier and that the doctors can determine how to help him breathe better. Pray also for the spinal tap in the morning to be successful and that his mental faculties will be restored once the duragesic medication wears off. Thank you so very much for checking in.

Thursday PM Update

The stool samples confirm that there is hemorrhage inside the stomach. The GI doctor said that she will perform an endoscopy tomorrow to see where and why the bleeding occurs and if a treatment is possible. The neurologist said that Steve's confusion may be due to medication. He is going to lower the pain medication to see if Steve gets better. If the confusion persists, then MRI or some other diagnostics may be necessary to determine other causes.

This afternoon, Steve had an incident where, after getting up for a BM, he returned to bed and immediately had the chills. His heart rate went up to 130 again, and he complained of pain. Some Demerol was given to him, and, after an hour, he was back to normal. Maybe the exersion of getting out of bed was too much for his present anemic condition. It was quite a scare! He's probably not ready to get out of bed any time soon.

Prayer requests: Please pray for his mental ability to get back to normal. Pray for tomorrow's endoscopy to be effective in reducing his hemorrhage. Pray for the restoration of his strength.

Thursday AM Update

The big news this morning is that Steve's heart rate has been slowly down steadily since 5am this morning. Right now it is at 107ppm. Praise the Lord for this miraculous change! His respiration rate is normal (at 18). Around 9am, the doctors inserted a Vena Cava Filter into his right thigh to prevent the blood clot in his leg from causing pulmonary embolism (a condition in which the clot breaks loose and travels into the lungs). He is currently lying flat and resting. All his vital signs are looking good.

Both his primary doctor and the oncologist came by. Currently, it looks as if Steve's internal hemorrhage is slowing down, though no hemoglobin reading was available today. His breathing is normal (Great news!) However, the fluids in his chest cavity are building back up. A more permanent procedure (pleurodesis) may be necessary to prevent the fluids from building up altogether, but this is not urgent at the moment.

A new concern: Steve, though conversing well and feeling better than ever, is confused. He doesn't know where he is. He speaks about crossing the border to Canada and about soldiers and border patrols. A neurologist is scheduled to come in to determine if some of the medications are interacting to cause these effects on his brain.

Praise: That his vital signs are becoming more and more normal. He is no longer breathless and is able to speak.
Prayer request: Pray that he can become coherent and that the neurologist may be able to determine the cause of his mental confusions. Pray also that the fluids in his chest will not confinue to build up. Pray for the consultation with the GI doctor later in the day to see if an endoscopy is necessary. Thank you so much for your love. God bless you for your blessings to us.

6/27 Update

This morning, Steve woke up in very good spirits. He was more alert and energetic than these past few days. He was able to converse, albeit with some strain. He even managed to eat a few bites. The big news this morning is that he did manage a bowel movement, thereby producing some sample for diagnostics--hooray! His blood test indicated that his internal hemorrhage has abated somewhat (hemoglobin level at 10.3--a drop of 0.3 in one day, as compared to >1 in the previous days). In fact, he felt so well and uplifted that he actually declared, "I'm leaving the hospital!" However, his pulse rate did not improve, as we had hoped. The occupational therapist came by to help him sit up. Steve managed to sit at the bedside for 10 minutes. However, it was a big challenge.

In the afternoon, Steve did become more lethargic. The cardiologist came and, with EKG and chest X-ray, diagnosed Sinustachycardia (high heart rate with normal rhythm). This means that his heart is normal, but there are unknown causes for the rapid rate. The mystery continues...

Praise: Steve had not asked for any supplemental pain medication today. Also, he was very alert for much of the day.
Prayer requests: Please pray that the doctors will be able to determine the cause of his high heart rate. Pray also for his internal hemorrhage to stop altogether so that there will be no need for endoscopy. Pray for the examinations and consultations tomorrow: gastro-urologist (for the kidney), the gastro-interstinal (for the stomach). Pray for the IVP filter procedure which will prevent a known blood clot in his right thigh from moving into his upper body. Thank you so very much for your love and support.

Thoracentesis finished

The draining of fluids from areas near his left lung was completed this afternoon. A total of 1.2L was extracted. The swelling in the middle of his abdomen was visibly smaller. However, the procedure seemed to have exhausted him. Also, the acute abdomenal pain came back. So he received another doze of Demerol. His heart rate came down just a tiny bit (133 ppm) so far. It's 6:17pm. No sign of any doctor yet.

Today's update

After last night blood transfusion, Steve was much more alert this morning. He was able to eat a piece of canned fruit this morning. For lunch he had a couple of nibbles of Chinese food. Because of his high pulse rate (138 ppm), he still has a hard time talking. Right now, he is getting a thoracentesis (a draining of fluids in areas near his lungs). The doctors hope that this procedure will allow more oxygen to flow into his lungs, and thereby slow down his heart rate.

Another important diagnosistics that we are waiting for is a sample of his stools. This can tell us if his blood loss is due to hemorrhaging in the stomach (which, according to the encologist, can happen when the tumor in the stomach shrinks too fast and leaves a lesion). Once this is confirmed, then procedures can be done to treat the lesion. However, we are waiting for him to pass stools. Until then, his hemoglobin level still seems to drop at an alarming rate.

Prayer requests: Please pray that the draining of fluids really makes a difference in his heart rate. Pray for him to pass stools so that the doctors can make a prognosis about the cause of his blood loss. Thank you so very much for your love and prayers.