HAPPY NEW YEAR!

A little more than a year ago, we had no idea what our lives would be for the holidays 2009. Thanks to biochemists, modern medicine, intelligent researchers and doctors, prayers and more prayers, and the grace of God, we were able to spend a quality Christmas with our families, children, and friends! Tonight we will enjoy our traditional dinner at Angelo's with Jim and Sue and bring in another year! Tomorrow, we will celebrate at my brother's watching football and eating foods that are to bring good fortune! We feel blessed! We are grateful! We have learned to live moment to moment!

http://www.llerrah.com/newyearwishes.htm

We wish you peace within your heart, love from family and friends, and faith to guide your way!

We suspected...

The research study is taking no new patients, so it was revealed that Ralph is taking the maintenance chemo...supposedly a good thing. We must trust in God to advise us through the doctors.

We were suspicious, from day one, that Ralph was receiving low doses of chemo. He immediately needed more bathroom time and his behavior was similar to the way he reacted with strong chemo...but less severe. He can annoyingly chatter...he used to be quiet. His short term memory is lacking...but whose isn't?

We pray that this maintenance chemo is the answer to buying more time...quality time..and that the effects are minimal and not another problem!

2009 Christmas Letter

Greetings!
As always, I hope that this letter finds you and yours safe and well.
Our house has been anything but calm! The first 7 months of 2009 were very challenging for our family. I was not dealing well with the “Empty Nest” and was wondering what I was going to do with my free time. After sending Mallory to Italy to study abroad for 4 months, Ralph and I began to consider all the house projects that were needed, the idea of joining a gym, and the thoughts of bicycling. Well, as the song goes, “If you want to hear God laugh, tell Him your plans”; He had different plans for us. On January 12th, Ralph was diagnosed with multiple myeloma…a treatable, not curable, cancer of the blood plasma. It eats the bones. “If He brings us to it, He will carry us through it”, and He did. On August 12th, after 4 rounds of chemo and a stem-cell transplant, Ralph was cancer free! We pray for the longest remission possible! Now, Ralph is part of the research to “pay it forward”. For his benefit as well as others with myeloma, he seems to be probed and prodded frequently. His work and golf days are fewer and less intense, but he has a new appreciation for other matters. With help, he had a successful deer hunting season. We created a Blog to inform friends and relatives of our plight. ralphchicone.blogspot.com/
In the midst of all that, based on family history and the fact that atypical cells were found during surgery to remove a papiloma, I am considered high risk and am being monitored at the Hillman Breast and Ovarian Cancer Center. As a proactive defense, I am taking Evista to block estrogen from my breasts and am examined every six months with yearly mammograms being diagnostic.
What matters most…all three children are healthy, safe, and happy! No one has moved or changed companies, but Megan is another step closer to agency. Their personal lives are blossoming, and their academic lives have broadened. Mallory hopes to be attending grad school in Pittsburgh, next fall, to become a speech therapist. We picnicked around our new pond and putting green, this summer, and celebrated birthdays! Cirque Du Soliel was entertaining! Thanksgiving was served at our house, and Ralph and I took the girls to see the Rockettes in Pittsburgh. We have enjoyed a few Sundays at Michael’s and Erin’s and our house, as a family and with friends, cheering on the STEELERS!
Yes, our lives were interrupted, and we met many challenges this year, but with the support of family, friends, and our community we are well on our way to recovery. We like to think that we have become better people and that our family ties are stronger because of our quandary. It seems that some things that really mattered are no longer important, and that other things that we took for granted are the most important. Hopefully, 2010 will be happily eventful, and we will be back at the beach for vacation!
From the bottom of my heart, I wish you and yours nothing but good health, safety, and peace! Be content when things seem to stay the same for change is not always welcome. Bask in the sunshine, and if it gets cloudy or storms, may you be given the guidance, courage, and strength needed to endure.
Keep the faith!

a beautiful sentiment to share...

"At the end of the day, may you feel peace, and at the beginning, may you feel loved."

Benign...

As a family, we celebrated our bounty! It was a great 48 hours! On the Wednesday before, Ralph had out-patient surgery to remove a soft lump which was not attached to anything, from his arm. YES, we were nervous. The doctors did not believe that it was anything, but we held our breath until the pathology report...Thank God!!

As Dr. Raptis promised, Ralph is back to golfing and shot 2 deer! He says his golfing is not up to par, and he needed help getting the deer to the butcher. Nevertheless, he is out there!

Golf...

After a day with his dad, Michael says that Ralph is able to play golf. This must be true, because Ralph summoned us to watch him chip from the deck to his golf green...a first!

Happy Thanksgiving to All!

SEASON of turning-
turning homeward,
turning inward,
appreciating the good things in life...
SEASON of gratitude...
for special people like you.

"If the only prayer we ever say is thank-you, that will be enough"

10 Months Later...

It has been 10 months since that shocking day! We are all recovering well. Ralph is part of the myeloma research, is working part time, golfs less frequently and with less intensity, and is enjoying every day life and our children more than ever! His hair has grown in and is not gray! I am working and taking life a lot less seriously. I can honestly say that adversity has strengthened our faith, improved our marriage, and brought our families closer together. We stop to smell the flowers. When we are tired, we rest. Nothing comes before spending time with our children, and we no longer sweat the little things. We are truly blessed!

Results are in....

Bone marrow biopsy....less than 2% which is EXCELLENT!

Pay it forward...

Ralph has agreed to become part of the research to determine if a chemo drug that is used prior to a stem cell transplant is also an effective maintainence drug. To begin, all tests have come back normal, and we are waiting for the tresults of his bone biopsy. He will not know if he is receiving the drug or the sugar pill. He can also quit, at any time, if he becomes uncomfortable or sick.

I'd like to think that we are coffee beans!

http://www.heartwarmingstories.net/carrot.htm

Update...

Ralph seems to be progressing well. He works about 1/4 of the day! Each day brings more strength and more hair!!!! Again, thank you for your support and prayers!

Vertebroplasty...Monday, August 17th

To relieve the discomfort in Ralph's back, he will have a procedure called Vertebroplasty as an out-patient at Shadyside.

http://www.radiologyinfo.org/en/info.cfm?pg=vertebro

What gave me strength...

Beyond the love and support of family, friends, and prayer groups, I frequently remembered and read:

Isaiah 41:10 (New International Version)

So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand.

and...

http://www.footprints-inthe-sand.com/index.php?page=Poem/Poem.php

I also believed that whatever God would bring me to, He'd bring me through. Oddly, the calendar quote for August 12th, the day we got the good news, read:

"God will never, never let us down if we have faith and put our trust in Him." ~ Mother Teresa

I will continue to call upon God for continued patience, strength, courage, understanding, good health, safety, expert guidance, and all that is truly important for myself, my children, Ralph, our family, our friends, and for those who are in the most need, but for now, I am going to thank Him and give Him praise!

Celebrate! Exactly 7 months later!

Tests results indicate that, as of this moment, there is no cancer in Ralph's body! The transplant worked! All levels are NORMAL!!!!!

Good thing...I have work for him to do...hehe!

Fixing his back...

Ralph's discomfort will be relieved on August 17th! He has to get an EKG and some blood work, first. The procedure is out patient and will be done at UPMC, Shadyside. I will post the name of the procedure later. I do not have it, handy, right now.

He seems to be doing well. Every day he accomplishes more of an every day normal routine. I think that when he notices progress, he finds some peace of mind. He is at home less and out and about more! BASEBALL WORLD SERIES IS HERE....you know where he is!

Let's be nervous another week...

MRI is done, and Ralph behaved for the 1.5 hours with medicinal help. At the UPMC Sport's Complex, the machine is wider and shorter...fyi

His blood work will hopefully not be misplaced, and we will know how well the stem cell transplant worked.

He has noticed more range of motiom with his shoulder....no therapy, just time!

oops...

Ralph's blood was misplaced at Hillman. They will draw more on Tuesday, before he goes to the South Side for the MRI.

This past week...

After Thursday night’s dinner with Danny, Ralph saw his oncologist, at Hillman, on Friday. Dr. Raptis does not want Ralph golfing, yet. He informed Ralph that his bones are weak and that of a much older person. Hopefully, the quality will improve. Ralph can, however, eat anything that he wants!

On Monday, Ralph goes to the Southside for a CT scan and then, he will have an MRI. The neurologist ordered these before any attempt is made to improve the discomfort in his back.

Next Friday, we may know the results of the transplant.

Sunnier Days

The rest of Sunday was quiet and low key....refueling, perhaps.

The past few days have been okay! Ralph went, with A.J, Lynnie, Paul, and Michael, to a Pirate game and has been running errands and such.

We are all looking forward to A.J.'s wedding on Saturday. It will be a mini-vacation with the kids and old friends!

UPS and DOWNS

The neurologist wants ANOTHER MRI to be clear as to where he is going to cast Ralph's back. This is a 2 hour MRI, and Ralph is not happy. HE HATES THEM!!! His shoulder still bothers him, and when he coughs, his ribs have discomfort. I cannot believe that these discomforts are anything but the effects of the myeloma....fractures in his bones.

We had a nice time at the wedding! Ralph enjoyed talking to old friends and acquaintances. He became emotional when Maggie danced with John to "I Loved Her First". Pain pills kept his back from annoying him, and his anxiety was kept to a minimum.

On Saturday, Mallory, Ralph, and I went to breakfast, then he joined Lynnie, AJ, and Jim at a little league baseball tournament.

This morning, Ralph had a difficult time getting out of bed. He is feeling sorry for himself and, at the same time, guilty because he knows his blessings. We have not ridden the emotional roller-coaster for a long time, it seems. Hopefully, we will ride it out today, and tomorrow we will feel renewed with more strength.

Update...

Although Ralph's counts are not normal, they are good, and he is no longer in a neupogenic state. He has been driving short distances, running errands, seeing a few baseball games, etc. He still cannot work as his back and shoulder still give him some discomfort and his ability to focus for long periods of time is not where he feels it needs to be.

On Friday, he is going to the neurologist to discuss options for his back. We are also going to a wedding!

Blood Results

Ralph's white blood count and platelets were down a little, but he did not require a transfusion. They are expected to still be at these levels and will increase, according to the nurse. He wants to be able to go to a wedding on the 17th. Next Wednesday, he will be told if he can.

Fourth of July

Ralph had his first outing since the transplant. We went to Cataldo's for a small gathering/picnic. Expected to stay only an hour or two, Ralph stayed 7 hours! On Sunday, he went to the Palamino baseball game. Afterwards, we had a family picnic at our house.

Doctor Appointment

At the follow-up examination, Ralph was informed that his white blood count had dropped and the others were rising, as expected. He can go to a restaurant with a mask, but if seated in a booth, he can remove the mask. All food must be well cooked....I doubt that he does this.

The doctor wants him to wait another 3 to 4 weeks to give the stem cells a chance to graph before addressing any should discomfort issues. After the ride to Pittsburgh and sitting in the waiting and examination rooms, he needed pain medication for his back. He sees a neurologist on July 17th about that. He will receive a bone strengthening treatment in 2 weeks, at UPMC in Meadowlands, and have the myeloma parameters determined. He goes back to Hillman on July 23rd.

Ralph has been enjoying our healing garden on sunny days. He has been putting alone and with friends on his green.

Home Sweet Home

Ralph got home today at 8:30 PM. He needs to stay around our house and yard for a few weeks. His diet remains the same until all counts are normal. He has a lot of follow-up appointments. There is nothing that he cannot do for himself. He must wear a mask for doctor appointments, keep shoes or slippers on his feet, wash hands frequently, and bathe daily. He is encouraged to walk and stay “off the couch” to build strength and stamina.

Again, thank you for all your cares, concerns, and prayers. Your cards, calls, and visits were inspirational and gave strength to each of us. We have learned the true meaning of, “If God brings you to it, He’ll carry you through it”. Our journey is not over, but, at least we know what we are up against. Bless you!

Cross all fingers...

Ralph’s counts were near 5000 this morning. The other counts are increasing, and the doctor wants to send him home tomorrow! Before Ralph can come home, he will receive more platelets and his port must be removed. Thus, he would not be discharged until late afternoon or early evening.

His back and shoulder are still bothersome, but I guess those will be addressed at a future time. His responsibilities include nothing but caring for his meals, his hygiene, and keeping a positive attitude. Tomorrow, the complete list of instructions will be reviewed and he will have a printed copy.

TUESDAY and WEDNESDAY

I went home for about 32 hours to do some gardening and trim the jungle in our front yard. Ralph wanted me to take pictures of the healing garden and putting green. It must inspire him to get well soon.

Ralph’s white blood count jumped from 900 to 2700 to 3600. Normal counts are between 5,000-12,000. He is eating better and walking faster. The other counts rise slower. He received two more units of blood to increase those. All vital signs are good.

On Tuesday, Mallory spent the afternoon, and Megan delivered a “Party-in-a-Box” that Ralph’s friend and appraisal typist, Cathy, got together for his birthday. She collected cards, well wishes, and a few presents from all the friends at credit unions, banks, and businesses that Ralph either works for or is associated. He’s already read the book, “Extreme Golf”, that was in the box.

On Wednesday, Mallory visited, and Michael spent the late afternoon with Ralph. Megan came after dinner.

HAPPY BIRTHDAY, RALPH!

Ralph celebrated his 55th birthday with visits from Mallory, Megan, Nathan, and Michael! We brought homemade cupcakes for the staff, and Megan brought a huge balloon! He received a lot of calls, as well. For lunch and dinner, the hospital added a small, one serving cake. His counts are going up but are still low. PT thought that he was walking pretty quickly and that the muscles in his shoulder make his arm shake, because they are in the habit of protecting Ralph from pain. He still has an IV for hydration and potassium.

HAPPY FATHER'S DAY!

Ralph had a rough night of vomiting. In the morning, Ralph showered and shaved. He was able to eat some of his breakfast, and then went for a little walk. He ate lunch and is consuming a little more than broth. While he watched the U.S. Open, he chose half of a peanut butter and jelly sandwich as an afternoon snack. He still hates to fill out his own menu and waits for one of us to arrive. Although, he has more interest to choose, and he has the menu pretty well memorized. Megan and Michael visited, and we all played Spades until his dinner arrived. It was encouraging that he would rather eat something than finish the game. Mallory was at work.

Ralph's address...

UPMC Shadyside
Room 750 West Wing
5230 Centre Avenue
Pittsburgh, PA 15232-1381


Some have requested Ralph's address. This is the Internet site address with his room number. We assume that he can receive mail, but if not, they will probably hold it for him until he can. Mallory has been bringing the mail, from home, weekly. We expect him to be in the hospital for the rest of this month.

Thank you for all thoughts, concerns, and prayers!

NO Resistance

Ralph has no resistance, now. Through the night, he had a slight fever, and his mouth became swollen. Both are common. His fever was monitored carefully until it went down on its own. Thus, he did not feel well. He describes it as flu-like without vomiting. He is also urinating a lot. He prefers no visitors, as a precaution, so we will stay in touch through phone conversations.

Hopefully, we were fortunate enough to weather only one storm.

Ralph’s appetite improved, today, and he has been able to keep everything down. He received platelets and walked his laps. Thank goodness the US Open is distracting him! Dr. Raptos predicted that Ralph’s counts will begin to rise on Monday (Ralph’s 55th birthday) and that Ralph would not feel as badly. Megan and Nathan visited. He answered all his calls, as well.

Another patient, named Paula, visited Ralph in the hopes that he could inform as well as comfort her. She has the same type of cancer, but it affected her kidneys. She was diagnosed in January. She described her symptoms as flu-like with nausea that lasted over a month. Paula received her transplant, today, and wanted to know what to expect. Ralph encouraged her.

Email worthy of sharing!

Recently I overheard a Father and daughter in their last moments together at the airport. They had announced the departure. Standing near the security gate, they hugged and the Father said, 'I love you, and I wish you enough.'

The daughter replied, 'Dad, our life together has been more than enough. Your love is all I ever needed. I wish you enough, too, Dad.' They kissed and the daughter left.

The Father walked over to the window where I was seated. Standing there I could see he wanted and needed to cry. I tried not to intrude on his privacy, but he welcomed me in by asking, 'Did you ever say good-bye to someone knowing it would be forever?' 'Yes, I have,' I replied. 'Forgive me for asking, but why is this a for ever good-bye?'. 'I am old, and she lives so far away. I have challenges ahead and the reality is - the next trip back will be for my funeral,' he said.

'When you were saying good-bye, I heard you say, 'I wish you enough.' May I ask what that means?'He began to smile. 'That's a wish that has been handed down from other generations. My parents used to say it to everyone.' He paused a moment and looked up as if trying to remember it in detail, and he smiled even more. 'When we said, 'I wish you enough,' we were wanting the other person to have a life filled with just enough good things to sustain them.' Then turning toward me, he shared the following as if he were reciting it from memory.

I wish you enough sun to keep your attitude bright no matter how gray the day may appear. I wish you enough rain to appreciate the sun even more. I wish you enough happiness to keep your spirit alive and everlasting. I wish you enough pain so that even the smallest of joys in life may appear bigger. I wish you enough gain to satisfy your wanting. I wish you enough loss to appreciate all that you possess. I wish you enough hellos to get you through the final good-bye.

After the first storm passed...

Ralph was given something, in his IV, to alleviate the nausea. Once that took effect, he walked in the hall, twice, ate a Popsicle, and enjoyed some macaroni and cheese. About 2:30pm, he received more potassium, liquids to hydrate, and 2 pints of blood to go with a nap...a sound nap from the Benadryl that was given for relaxation during IV transfusion, hydration, and potassium. By 4:30, he was awake and watching TV...disappointed that the US Open was postponed. He ate some dinner...tried lasagna but said that it was inedible. Megan visited, and they walked a few laps in the hall.

Darkest before the dawn...

Ralph' s period of not being sick was short lived. As expected, he was violently ill through last night and thus far, today. He is unable to keep anything, that is given, down. The medical staff is working on an answer for some ease. Every patient is different and reacts differently to the process of the transplant and medications. We are thinking that his counts have hit rock bottom and after these storms pass, he will begin to see clear skies ahead. Hopefully, we are not too naive.

DAY 9

Well, the shot must have worked! Ralph had no problems holding his food down! Of course, his appetite is minimal, but he slept better. After examining Ralph, the doctor felt he was doing well. As of 11AM, Ralph felt weak and slightly nauseated, but he made a business call! More food was consumed, at lunch and dinner, than any meal over the past few days. At 4pm, Ralph commented that he felt okay and that he had walked in the hall which has filtered air, twice. Michael and Megan visited.

DAY 8

Ralph vomited for about 20 minutes about 10pm, last night, but was able to get some sleep after that. He awoke,this morning, not feeling very well. Around-the-clock medicine is being given for nausea and Ralph needed IV potassium. The Neupogen shots were started today. Those stimulate white blood cell production.

He made the effort to eat, but breakfast and lunch did not stay down. He made one outing into the hall but is significantly weaker today. At about 4pm, he was given a medicine that tells the brain to not be nauseas…it knocked him out until supper which he attempted to eat.

Small world, again…a friend of Megan’s from high school, who is in med school, recognized Ralph’s name and stopped in.

DAY 7

Ralph did not sleep well but was not vomiting. He was able to eat Cream of Wheat, orange slices, and a 6 oz. chocolate milk shake for breakfast, but that did not stay down. He showered and was given a medicine, before lunch, in an effort to keep his lunch down. He ate beef vegetable soup, mandarin oranges, and crackers after he took a shower. The medicine must have worked! He took it before dinner, as well, and as of 8pm, all is in his stomach! PT walked 11 laps with him…a new audience to hear all about baseball teams that he coached and on which he played. He refused therapy on his shoulder. An orthopedic surgeon is going to evaluate his shoulder.

He took phone calls.

His only expectations are to walk, fill out his own menu (which he hates to do…haha), wear his mask out of the room, shower, do his shoulder exercises, and try to eat.

As of now, everything is going as predicted. He has not hit rock bottom, yet. Once he does, his health will begin to improve! The nurse encouraged him by stating that he will be pleasantly surprised as to how fast he will feel better>>>KEEP ALL FINGERS CROSSED!

DAY 6

Ralph vomited through the night and needed potassium, so an IV was started. His appetite is basically nil. Medicine was given for nausea through the IV, too. Twice, he walked in the hall but mainly watched golf and baseball. He was pretty quiet and didn’t feel like talking on the phone. Small world…Sharon Difilippo’s and Fran Binder’s niece was Ralph’s nurse! She would also be Nathan Voytek’s cousin!

DAY 5

Ralph is only able to eat Popsicles, saltine crackers, and broth, at this time. He showered and walked around the restricted hall area. Staying awake was getting easier. He only napped for about an hour. Michael, Megan, Nathan, and Mallory visited, which always distracts Ralph from his discomfort. Looking at some of the other patients, Ralph realized how lucky he is. He seems inspired to get out of the hospital and realizes that eating and excercising is the key. He needs to push himself to do both.

DAY 4

Ralph started the day with no appetite and the smell of food making him nauseous. He also experienced diarrhea and was treated for both problems His energy level decreased by early morning, as well. The doctor explained that Ralph is experiencing some of the common effects of the Chemo he received. As of 1pm, he still had no motivation to leave his bed. He was able to answer phone calls.

For lunch, Ralph ate some broth and crackers. The PT had him walk and do one shoulder activity. The girls visited in the late afternoon, and Mallory decorated the room with family pictures. Random odors began to nauseate him such as the ink on the newspaper.

For dinner, Ralph ate broth and crackers again. Because his potassium went low, he was hooked back up to an IV.

The Rest of Day 3...

After Ralph settled himself, he dozed off and on for the rest of the day and through the night. He walked a little, but his esophagus burns, and he felt nauseous. For that reason, he only enjoyed Popsicles. He took a few phone calls and watched television.

TRANSPLANT COMPLETE

Ralph has had his new birth! The actual re-infusion lasted 4 minutes! The preparation was one day less than 5 months! His cheeks got red, he asked for peppermints to mask the taste, and mentioned that his ears felt hot. The doctor checked his vital signs and told him that the cells would begin to make their home in 10 to 14 days. That is when they will begin to grow. He has begun to lose his appetite from the Chemo taken this past Tuesday and Wednesday and is expected to feel tired from the Benadryl given prior to the re-infusion. All reactions to the Chemo will begin tomorrow or Saturday.

The experience is quite emotional. No doubt, a plethora of feelings and thoughts are going through Ralph's head. He is anxious and doesn't know what to do with himself. Ralph, Megan, and I received communion. He put on his mask, and then walked a few laps, with Megan, in the area where the air is filtered.

LET THE HEALING BEGIN!!! Again, thank you, family and friends, for your constant support, thoughts, and prayers!

Day Two

Through the very early morning, blood work was drawn. Another doctor introduced Ralph to the “virtual handshake” to prevent the passing of germs. There will be no more skin to skin contact. He ordered, “Walk and eat”. A physical therapist evaluated Ralph and began easy exercises to improve his shoulder’s range of motion. Around noon, Ralph complained of nausea and asked for medication. He was able to eat some soup, a couple crackers, and a little bit of the rice and vegetables. Michael stopped by during his lunch hour. As of 1pm, television still kept Ralph’s attention, and he played along with Family Fued. At 3:15, Ralph was inspired to take a short, quick paced walk, even though he asked for nausea medicine, again. As before, his cheeks and face are very red from Chemo.

Thus far, Megan, Nathan, Michael, and I like Ralph with really short hair. We have not convinced him to keep it, though! Michael likes it well enough to message us later in an effort to impress upon Ralph that he should keep it.

Again, at 5:30pm, Ralph received his second dose of Chemo. He was able to feed himself ice chips, continuously, for the hour. Mallory came in the evening.

Ralph is to get his new stem cells tomorrow between 10am and noon!

No matter what scenario we hear or live, there is always a sadder or one more devastating. We continue to count our blessings and have added new acquaintances to our prayer list.

Day One

Ralph was called into Shadyside at 8:30am. We arrived around 10:30 and were quickly escorted to his room, #750, in the West wing. His vital signs were taken; height and weight were measured; an EKG and a chest XRAY were prearranged; blood was drawn; a tour was given of his area; he did not complain about lunch or dinner; head was shaved; Chemo started at 5:30 and lasted about an hour. As instructed, Ralph chewed his ice chips during Chemo to help prevent too many sores inside his mouth. He also met one doctor who will be working along with the transplant team. Hopefully, everything goes as well as the pretty picture that he painted.

It appears that Ralph will need to build resistance to bacteria, so HE is the only one who will wear a mask when he leaves his room. Of course, no one is to be in his room if they have any sign of an illness or have been around anyone who is sick. His room is private, clean, and comfortable.

In the evening, Megan and Nathan brought Chinese food, and we watched the Penguins in the family room of the hospital!

Last week...

Ralph had anticipated feeling more energy last week. Each day, he felt weaker, short of breath, and even lost his balance a few times. On Thursday, he had a blood transfusion because his hemoglobin count was low. http://www.mayoclinic.com/health/low-hemoglobin/AN01295 http://en.wikipedia.org/wiki/Hemoglobin At Hillman, he received 2 pints. After that, he did find more energy and felt better, in general. We were able to go to Megan's and Nathan's for dinner with Michael and Erin, as well.

Meanwhile, on Wednesday, Ralph had an MRI of his back for the neurologist that he saw on Friday. Since Ralph admitted that he could tolerate his back pain until after the transplant, it was decided that the procedure to heal or ease his pain in his back would wait. We tried Angelo's, again, on Friday night, but Ralph got anxious, and we left after 30 minutes. Jim and he made their Saturday "ride around" and Shorty's lunch! On Sunday, Ralph accompanied me on a few errands. Michael came for "Take-out" dinner and watched golf and a movie. Sam and his son, Steve, visited.

The girls joined me at the pool which was a nice opportunity to relax, see a few friends, and gain some strength before the trek ahead.

FREEDOM....

Ralph is no longer restricted and can do anything he chooses between now and being admitted into the hospital. To have 2 transplants, one must harvest 5 million good stem cells. After the blood work results, the machine predicted that it could collect 43+million from Ralph! The nurse seemed very pleased, so we are taking this as a sign that Chemo did it's job! He is at Shadyside, today, for approximately 8 hours to collect those 5 million!

Getting ready...

Ralph spent Wednesday night at Michael's and Thursday night at Megan's and Nathan's. We are lucky that between the two taking him to and from the hospital, he had his port surgically placed and received 9 hours of chemo. Mallory held down the fort, at home. She makes every effort to keep things bacteria free.

This particular chemo causes the bladder to bleed. As a proactive measure, Ralph took pills to coat his bladder and needed to drink a glass of water and void every 90 minutes through Friday night into Saturday. He is fortunate that he did not get sick, so the pills worked. He also took anti-nausea pills for a few days, but he seemed to tolerate this chemo, well. He is tired but not bed ridden. He has noticed some hair loss. The anticipation of what is to come is making everyone anxious and emotional.

On Saturday, he and Jim enjoyed their weekly ride and Ralph enjoyed the relaxing sound of the waterfall and fountain in our healing garden. As soon as a St. Jude statue is placed, it will be complete. There are colorful birds that visit and entertain, too. He began his shots to boost white blood cells.

My parents visited on Sunday. We were able to spend the morning outside. I think everyone found peace. The weather, this weekend, was beautiful!

Michael, Erin, Megan, and my mother came for a picnic on Monday. Ralph's request was BBQ chicken, deer burgers, corn-on-the-cob, and baked beans. Again, the weather cooperated and we all had a great Memorial Day! Ralph started antibiotics and hourly temperature taking. He cannot have a reading of over 100.5.

Weekend...

Yesterday, Ralph stayed out of the house until around 2pm. He and Jim took a ride in Jim's new play toy! He pretty much slept the rest of the day and most of today, except for when my parents and Lynnie visited and for watching part of "Taken" with Mallory and Megan.

He seems to have a hard time focusing or gathering thoughts. His skin is very dry and itchy, but he surely enjoys the freedom of no picc line to hinder showering! The anticipation of what's to come, in the next few weeks, and the fear of the unknown can make him emotional as it takes a toll on each one of us, in different ways.

The Healing Garden is nearly complete. It has already brought us some distraction with its beauty and sound!

Test results...

All the tests that Ralph had this week indicate that he is able to have the transplant. His height is now 3 inches shorter than he last remembers. He was able to joke about that! It is obvious that his spine has compressed due to the bone weakness caused by myeloma. Dr. Raptis is already thinking about that issue once the transplant is complete.

Ralph still has a window of energy each day. During that short time, he runs some errands
and goes out and about. He'd like to sit at a restaurant to eat but tires by dinner. Angelo's is his favorite, so he gets take-out. After this Thursday, he will no longer be out in public or able to eat any food from anywhere but home...preferably single serving frozen items to minimize the opportunity to contact any bacteria.

Again, thank you for your cards, calls, email, inquiries, texts, thoughts, and prayers. We have all been humbled by the sincere care and concern you have shown.

One more month...

Preparing emotionally and mentally for the transplant can be very draining, at times, for each of us. We are trying to remember and practice all necessary precautions for keeping the spread of bacteria in our home. Ralph now has his own refrigerator and a lot of single serving food items. He needs to keep slippers on. He uses white towels that can be bleached after a single use; he uses only glass that can be washed in the dishwasher; he uses only paper towels in the kitchen. All counters are wiped with Clorox wipes after each use, and there are hand sanitizer pumps that are easily accessible. Ralph is trying to remember to carry individual hand-sanitizer wipes when he leaves the house. Fortunately, he can have his own bathroom and bedroom where no one can share germs or at least, minimally. The dogs have been shaved and are only allowed on the floor. Soon, we will be covering couches, with sheets, before he sits or lays.

This past Saturday, he sat outside and watched me plant some flowers. Jim took him out for lunch, and Danny took him to watch golfers for a bit. The kids came on Sunday. Megan spent the night because she is taking him to Shadyside, today, for testing.

Ralph took his last oral chemo pill yesterday. It is obvious, by his mental state and his physical appearance, that he does not feel well from all the rounds of chemo. He is weak and tired, feels cold, shaky, swollen, unable to focus, at times, and can become confused. He has emotional lows, as well. No doubt, he is tired of the fight, afraid of what is to come, and is in anticipation of getting this all behind him and having some normalcy back in his life. Hopefully, he will feel a little better over the next 10 days before the chemo and other medicines start again.

The continual flow of cards and well wishes encourage and give strength. Please keep praying in the weeks to come. Your prayers have been heard. God has truly heard and carried us through!

Mallory came home!

On Saturday, we had the duct work cleaned and the upstairs' carpets. The house smelled so fresh! Around midnight, Mallory came home from Italy. Ralph slept most of the late afternoon and evening so that he'd be up when she arrived. Michael, Erin, Megan, and Nathan greeted her at the airport and stayed the night. After a wonderful breakfast, made by Megan, we were left alone to enjoy having Mallory to ourselves. Ralph was very content to have all the kids in the house at one time.

On Monday, Ralph become quite agitated and snippy with everyone after the nurse from Hillman called to give him instructions and his schedule for May and June. Most anger is out of fear, so we are chalking up his angry behavior to fear...understandable.

Timeline...

Ralph seems to have had a better, more energetic week. He feels that he accomplished a lot by getting things organized at his office so that things can run smoothly in his absence.

He finished his 4th round of chemo on Thursday. Hopefully, that was his last round, and the procedures for the transplant can begin. Dr. Raptis, at Hillman, feels that he can go ahead as scheduled, based on the preliminary tests taken over the past 2 weeks. Hillman is VERY pleased with test results and feels that Ralph will fare well during the transplant and his recovery, based on the strong way his body reacted to chemo.

If all goes as planned, the month of May will be consumed with extensive testing to determine if every part of his body will tolerate a transplant, having a port placed in his chest, dental check-up, a 9 hour chemo treatment, the start of antibiotics, and shots to increase white blood cells. From May 23 to June 1 is when he will be extremely susceptible to infection.

In June, they will collect 5 million stem cells over a 1 or 2 day period. On June 9th, he will be admitted into the hospital for the replacement and will stay there from 3 to 4 weeks. On the first two days, Ralph will be given an amount of chemo that is equivalent to what some people take over a year to kill any myeloma cells that might be left. Right now, June 11th is predicted to be Ralph’s new birthday; the day they transplant all the healthy stem-cells!

Because Ralph is his own donor, we do not need to have as sterile an environment as we first feared. The dogs are allowed to stay, but Ralph is not to care for them or allow them on his lap. He needs to be very cautious about washing his hands, keeping his feet covered with slippers, keeping his food off of the counters, using a glass and his towels only once, not bleeding, no fever, a certain diet, and a whole list of stuff. He will need to stay around the house and our yard. He will be allowed visitors who are not sick. Our goal is to be able to be out in public by the end of July!

We need to be careful not to touch anything that he might eat. He has a special diet to follow. For that reason, everything will be single serving and in his own refrigerator. No take out food or food prepared in other kitchens. The areas that Ralph frequents, in the house, must be cleaned well, before he comes home, in an effort to minimize contact with bacteria. We are having the air ducts cleaned and sanitized so that he can breathe cleaner air. We have a list of other precautions that do not seem as overwhelming as the initial literature.

As always, thank you for your constant care, concern, and support!

Great News!

Ralph's bone biopsy was PERFECT...not a thing wrong with it!!!!!

Getting closer

Ralph really has not felt well since Thursday. We are not sure if it is the effects of chemo or the withdraw from pain medication, which he no longer takes for the first time in 3 months! It's probably both. At any rate, his appetite and energy level have decreased. He struggled to sit with us at the table when Megan and Nathan came on Thursday then again on Friday with Michael and Erin. On Saturday, he went to Denny's with me for breakfast but could not get out of the car at a few errand stops. He went with Jim Blue for a bit and was pretty quiet when Danny visited, later. Today started out very emotional. His appetite and energy level was poor.

Soon, Hillman will tell us when his transplant will start. They have sent us all the information. Stem-cell replacement appears to be very brutal. From what we understand, Ralph will come home with no immunities. Slowly, his body will begin to rebuild. He will need to be immunized, again. We will need to be very careful. Once we meet at Hillman, we'll have a clearer picture.

All bacteria will need to be removed from our house. Megan and my friend, Geri, are project engineers. We started buying what we need, this weekend, and scrubbed the front porch and deck with Clorox. So many people have offered to help. Please email Megan at meganchicone@yahoo.com Thank you!

As always, your prayers are most important.

POSITIVE NEWS

http://www.webmd.com/a-to-z-guides/immunoglobulins

Dr. Kane called and said that normal IGG levels are 700-1600. When Ralph was first tested, his count was 5500. The results, this week, are 1200. THIS MEANS THAT HE IS RESPONDING WELL TO CHEMO! His skeleton survey is stable; they expect to still see lesions. The important thing is IGG levels. Dr. Kane suspects that Dr. Raptos will transplant Ralph without another round of chemo.

This site is very similar to what UPMC sent us for preparing for Ralph's recovery after the stem-cell transplant...no set date.

http://pfrc.med.nyu.edu/handouts/pdf/all/pfrc07-000004.pdf

Round Four...

Round # 4 starts tomorrow. Ralph will receive IV chemo for the next 2 weeks on Mondays and Thursdays, as well as his every day dose of Thalomid and steroids on the day of and the day after IV. Ralph is very fortunate that the UPMC Cancer Center opened at Meadowlands where he receives treatment. He has decreased his pain medicines from 9/day to 4/day with hopes of eliminating them all together very soon. This past weekend he was able to accompany me to Sam's to purchase a new grill and to Angelo's for take-out. He stayed outside for a while and did a few small jobs of getting out the lawn furniture and cleaning off the deck. Our friends, Cheryl and Tom, from Pittsburgh, visited on Saturday evening. On Sunday, Megan came for the afternoon and thought that Ralph was more alert and seemed more like himself. He has started on the Neutropenic Diet which basically is well cooked foods and no fresh vegetables or fruits, because his immune system will not fight bacteria as well.
http://www.upmc.com/HealthAtoZ/patienteducation/Documents/NeutropenicDiet.pdf

It wears on a person...

Ralph has been rather cranky, so far, this week. His emotions are, again, like a roller coaster. He does not like the fact that he is tired or sleeping most of the time. He still has a pain in his side. Nothing about life seems normal when one is disabled. His patience is short, and he can take out the frustrations of his health issues on others. It is understandable, but the really tough part is still ahead. Please pray that he will find more strength to endure what is needed to beat his disease.

Easter Blessings!

It has been 3 months since Ralph was diagnosed. We had a great Easter weekend with family and friends! Ralph finished his third round of chemo on Thursday which made him pretty tired by Saturday and Sunday, but he was able to go out for an afternoon with Jim, help hide Easter eggs, and fill his belly with good food and jelly beans (his new habit). Mallory called from Italy, and Michael came on Sunday! Having Megan home all weekend brings such joy!

Ralph has this week off from IV chemo. After Round #4, we will meet with the doctors at Hillman to discuss the stem-cell transplant. He has started physical therapy for his shoulder.

Same old, same old...

The weekend was pretty much “as usual”. By 2pm, Ralph was ready to relax and sleep, each day. He did anything he needed to do, away from the house, before then. He sat on the deck, while I raked, holding his golf club. He said he wasn’t ready to swing it, yet. My friend, Donna, provided us with lasagna, so he enjoyed that for dinner, today, and treated himself with the Easter candy that I made! Megan visited yesterday and my parents, today.

Family and friends, enjoy your Easter week and Easter Sunday. God...no brighter promise...no greater love!

Bless each of you!

Happy Anniversary!

This past week, Ralph received 4 of the 5 radiation treatments for his rib. Typically, it takes 15 days after the last treatment (Monday) to feel the full effect, which would be no pain, hopefully. The goal is to no longer need the pain medication. His chemo makes him very anxious, so Xanax was prescribed, this week, to help him relax enough to get a complete night’s rest. His stomach is very swollen from the steroids which can make him uncomfortable, but his appetite is still good. According to the doctors, Ralph is tolerating very high dosages of chemo and steroids, and they do not want to decrease the dosage.

Our 29th anniversary is today. My parents visited and Michael, Erin, Megan, and Nathan came which went much better than last night when we attempted to eat at Angelo’s. Ralph was unable to take off his coat; not because it was physically difficult. It was obvious that he was not comfortable. He ate very little of the appetizer, but could finish his salad. Once our meal arrived, he needed to leave, so it was packed to-go, and he was able to enjoy it at home. He was touched by a dessert surprise left on our porch by Monika, one of Mallory’s friends. How sweet! Mallory called from Italy!

Admirably, Ralph has maintained poise and dignity throughout his ordeal. If this has been a judge of character, Ralph’s is exemplary. He rarely complains, and when he does, it is justifiable. He asks for very little, and tries to be self-sufficient. He has put his faith in God and his trust in his doctors, family, and friends. Ralph makes sure he gets dressed and goes out of the house every day. He has been able to help Megan shop for a new car and has made me take him to Dick’s just to look at golf gear! Ralph has read and reread his cards and appreciates visitors.

After Round 3, which starts tomorrow, Ralph will be seen at Hillman to discuss the stem-cell transplant and harvesting cells.

The weekend...

On Friday, Ralph's pain made it impossible for him to lay flat for the radiologist to mark him for radiation to his rib. He went to bed at 6pm, that night. Saturday morning, he found more energy and came to breakfast with me, the Cataldo's, and Jan. Afterwards, we met Megan at my parents', and went to Dick's. The outing must have really worn him out because he went to bed at 4PM and didn't come downstairs until 7AM. He was told to start taking his break-through pain medication on Sunday, and he did. Perhaps that was the reason he was so antsy all day. He found it difficult to sit still or stop talking when Megan and Nathan came for dinner and when Jim and Sue stopped by. PITT probably heard him coaching! Hopefully, tomorrow brings him relief with radiation.

A Glitch...

All considered, Ralph had a pretty good week with two chemo treatments. His stomach swells, but he was given more pills to remedy that. The glitch is that last week’s CT scan revealed nothing new in his lower back, and Ralph said, today, that his back did not hurt much this morning. Meanwhile, his rib began to hurt this week (he had 2 broken ribs when he was diagnosed), and the oncology radiologist says that there is myeloma there. Ralph will begin radiation on Monday, for 5 days. He had not had a CT scan since January 12, 2009, when he was diagnosed. Five and one half weeks passed before his first chemo treatment. The time without treatment was a concern. What was the cancer doing? We are not clear as to whether the cancer is eating bones even with chemo, because we have not had the nerve to ask. Please pray that it is not. His next chemo treatment is scheduled for March 30th.

Archangel Raphael

Last summer, we started a tranquility garden in our back yard. Only a few months later, we need to also add a healing and more obvious religious aspect. For the religious aspect, a statue is needed. I Googled "Saint of Healing". Ironically, he is the Archangel Raphael which also means "God has healed". Everyone in our family needs to heal and find peace, and we believe that this garden will be one way to begin that process.


http://www.angelfire.com/biz3/danielkudra/healing_with_archangel_raphael.html

http://scholar.lib.vt.edu/theses/available/etd-05132002-115528/unrestricted/Healing_Gardens_Thesis_Vapaa.PDF

Happy Saint Patrick's Day!

At today's chemo treatment, Ralph was bandaged with festive green gauze. No one mentioned the results of his CT scan from last Wednesday. When he made an inquiry, Ralph was told that the doctor had not read it, yet. We are hoping that is a good sign that there is no urgency. At last week's visit, the doctor thought that Ralph was looking better. The only pattern seen is that Ralph has lots of energy the day of and the day after chemo on Mondays. He then seems to sleep a lot from Wednesdays through Sundays. His taste buds prefer spicy foods with tomatoes or tomato sauce. He seems to have more flexibility when he is not swollen from the steroids. He gets sore spots that seem to move from one area to another then go away. When the kids come, he makes more of an effort to be alert. Megan sees her dad at least 3 times each week. Michael is busy with tax season. Megan, Nathan, Michael, and Erin spent all day, yesterday, at our house. He is weak, but Ralph will venture out with his brother or me for a few hours each day. His emotions are unpredictable, but he realizes that it is going to get a lot worse before he gets better. We have a couple outdoor Spring projects to begin. Hopefully, Ralph will enjoy supervising.

8 Weeks gone by...

For whatever reason, Ralph’s stomach and legs became very swollen last Sunday through Tuesday. It appeared to be water retention. The heart doctor gave him a water pill and changed his heart medication. An EKG revealed nothing was wrong with his heart, thankfully, but his heart was beating too fast. The only change he had made, other than chemo, was that he had started taking Flexoral, again, for back pain, so he stopped taking that. It appears that his stomach has gone down, but his ankles are still a little swollen. On Thursday, he enjoyed Megan and Nathan coming for dinner and celebrating Nathan’s birthday. He was able to sit at the table without discomfort, and his appetite was good. Friday evening, after friends left, he wanted take-out from Angelo's and enjoyed the ride across town. He went out each day but admitted that being away from home for too long makes him anxious and sick. He slept a lot on Friday, Saturday, and Sunday, but he appears to be walking better, and it does not seem as difficult, for him, to stand up from sitting on the couch. He complains of being stiff more than pain. He sat on the garage steps to watch Albeno, his friend and plumber, fix a leak. He could not have done that a week ago. Megan visited on Sunday and they ventured to the store. He is able to talk to Mallory, face-to-face on Skype which always brings him joy. It has been 8 weeks since the original diagnosis. Ralph had never been sick or missed work for illness. This is taking a toll on his emotions. Visitors seem to distract him and make him feel more normal. Hopefully, spring weather will be here soon, and he will enjoy sitting outdoors. He is very cold and needs layers of clothing or a blanket. Round # 2 starts tomorrow! Please pray that it goes as well as Round #1!

It's March 1st!

There doesn't seem to be a pattern for the ill effects. Ralph received his last chemo treatment on Monday and did not feel terrible until Thursday evening, when Megan came for dinner. From Thursday to Saturday, he was either very cold or sweating with pain, mainly, in his hips and down his legs. He dosed off but still managed to get dressed, every day, and left the house for a few hours, with an escort. He is not driving, It is obvious that he struggles to walk or move, and he tires easily. He rides an emotional roller coaster, and, as predicted, he has lost feeling in his finger tips making some tasks difficult and frustrating. He was better, today, but believed that was because he didn't go anywhere and just watched sports with Michael. His appetite is good, and he still welcomes visitors, calls, and cards. Hopefully, he will feel better with each day until Round #2 starts.

Ralph's back...

Ralph's plan to go to the store on Sunday was ruined by his lower back pain. He spent most of the day in pain, but at around 6PM, he seemed to find some relief, and then, he couldn't sit still. He had visitors which was a welcomed distraction. He seemed to walk better on Monday morning. In the afternoon, he completed his first round of chemo. The side effects that Ralph experiences is anxiousness, tingling in his face and fingers, diarrhea or constipation, and tiredness. Today, he saw the oncology radiologist who told him that he did have a crack in his lower back, as well, from weakened bones (evident from the original diagnosis, but no one remembered hearing that). The doctor suggested that Ralph wait because mixing radiation with chemo is not favored. Possibly the chemo will take care of it.

Last week....

Ralph had a better week after a horrific Valentine's weekend. He still is troubled by lower back pain, but the doctors did not seemed too concerned. If it does not subside, they will order an X-Ray, but they seem to think it is an effect of the shots given to boost his white blood cell count.

This week, Ralph was able to, briefly, go out of the house, with his brother, to get fresh air and to finish a little paperwork. He feels best when he is moving. After his third IV chemo treatment on Thursday, he was quite anxious. He had a difficult time sitting still and talked unceasingly. On Friday, he found more peace. Ralph ventured out on Saturday afternoon alone. He drove to the mall and to a friend's house for lunch. That pretty much wore him out for the rest of the afternoon and evening. Hopefully, he will find more energy and less pain, today. Tomorrow, he finishes his first round of IV chemo and will have 2 weeks off.

Again, prayers and good thoughts are much appreciated. Thank you for caring and for your support!

What is a Round?

Ralph has chemo on Mondays and Thursdays for 2 weeks. Each day that he has IV chemo (Velcade) and the day after, he also takes 40 mg of Decadron, a steroid. Beginning on the first day of chemo and for 21 days, he takes 200mg of Thalidomide. Another round begins after 2 weeks off. We heard 4 to 5 rounds before stem-cell replacement.

Ralph has experienced anxiousness, tingling in his face and fingers, and tiredness, but he has had no nausea, diarrhea, or constipation, which are other possibilities. Hair loss is not a side effect of this particular treatment.

Valentine's Weekend...

Ralph's lower back is hurting and he has an obvious limp. We are hoping that it is from the bone strengthening medicine. We were able to eat at Angelo's on Friday night. Ralph had every intention of going into the office on Saturday afternoon, but as the day progressed, so did his back pain and pain from constipation. Saturday was a very uncomfortable day for Ralph, and he had a horrific night. At 6:00AM, the doctor recommended an enema and magnesium citrate. Fortunately, Ralph found some relief, and we did not need to go to the hospital. Tomorrow, he gets blood work and has another chemo treatment. Hopefully, he will get answers to why his back hurts and a prescription for relief. Michael, Erin, Megan, and Nathan came for dinner (They cooked.). Ralph was not able to join us for dinner but enjoyed the kids visiting. After they left, he ventured downstairs and wanted to eat. His back pain seemed less, and he no longer felt constipated from medications.

Treatments...

Ralph was unable to receive chemo on Monday because his white blood cell count was low. Apparently, this is not uncommon. To boost the level, he was given a shot on Monday and Tuesday in preparation for chemo on Thursday. Hopefully, all conditions will be optimal, and he'll begin Round #1. He did, however, receive a 2 hour IV treatment to strengthen his bones.

Monday was also 14 days after his last radiation. Supposedly, the full effect of radiation is not seen until day 14 or 15 afterwards. We have noticed better movement and usage of his right arm! Maybe the bone strengthening and radiation, combined, helped.

He is achy from the bone treatment and injections to boost his white blood count but is still managing to go into the office for a few hours or travels to do an appraisal. He cannot drive because of the pain medications, but his brother is retired and willingly chauffeurs! Hopefully, he will be off pain meds soon and will be independent, once again.

The Plan...

On Friday, Ralph will have a pick line placed at the Washington Hospital in preparation for his chemo treatments that will begin on Monday. A pick line is an IV that stays in your vein so that the patient does not have to be stuck with a needle each time. Later, he will have a port placed for the stem-cell replacement. The catheter for that procedure needs to be thicker and the diameter larger than a regular port for chemo.

Ralph will have up to 4 rounds of chemo, which is understood as up to 4 months, in preparation for a stem-cell transplant. (That part was a little confusing, but as time passes, it will be better understood.) The chemo treatments, fortunately, will be given at UPMC in Meadowlands. He does not go back to Hillman until there is a 3 hour intake meeting to discuss how well the multiple myeloma has responded to chemo and to explain the stem-cell transplant. That date has not been given. He will also receive a drug to strengthen his bones.

The only restrictions Ralph has been given is to be careful because his bones are weak. He is not to do heavy lifting or bend over, too much, to protect his spine. He hopes to be able to find more relief in his shoulder without pain medication and to be able to work part time, at least. Ralph seemed relieved that aggressive treatment would begin. He is anxious to get started, be able to golf again, and have this all behind him. The doctor assured him that he would golf and that Hillman would take care of him.

The past weeks have been a fog for Ralph. Yesterday, he read over his visitor list and through his cards. He was touched by so many who care and became quite emotional. Your visits, cards, phone calls, emails, etc. give him motivation to fight. Thank you!

Those who have reached out to our family in sincere concern and support give us strength, as well. Kind words and generous offers and actions will never be forgotten and are greatly appreciated. Bless you!

Please continue your prayers for Ralph's strength and courage and for the guidance for doctors and researchers to find the cure.

To date...

Ralph has been diagnosed with multiple myeloma....it causes the body to produce more plasma than needed, then the plasma eats the bones. It is treatable but has no cure, as of this date.

In September, his shoulder began to hurt...2 Advil and he was still hitting golf balls. At Thanksgiving, it worsened, and he lost most of his mobility. Everyone, including his orthopedic doctor, thought he had bursitis or maybe something was torn. An x-ray showed everything as normal. The doctor gave him a shot and advised Ralph to return if it was not better in 10 days.

On January 7th, he had an MRI. On January 8th, he got a severe pain in his back. On January 9th, the ER thought that he was having severe muscle spasms from overcompensating for his right shoulder. On January 12th, the MRI revealed a mass on his shoulder (we have since heard a hole in the bone) and from that day on, his pain became excruciating. He was in the hospital for 2 weeks....had a compressed fracture in his spine and 2 broken ribs (possibly from the chiropractor when Ralph tried that option for relief in the shoulder.)

We have heard many positive stories about people who have this disease. Ralph's is not the worst or the most rare type of myeloma, and it is not seen in any of his major organs. He has had 5 radiation treatments. His pain is manageable.

Sloan Kettering, in NYC, reviewed his records and agreed that UPMC would treat him as they would. On February 4, 2009, he meets with the doctor at the Hillman Center, in Shadyside, to discuss a plan of treatment.

Ralph is at home trying to build his stamina and maintain some normalcy. He enjoys phone calls, visits, and cards. Your continued prayers and thoughts are always appreciated.