Day 3___Posted on the morning of day 4

Dear friends and family, co-workers and patients,

I wanted to clarify that this blog site is open to anyone who wants to send Bob a message. This, of course, includes all the wonderful people he works with at the office, but his patients as well. I specifically asked Bobs' partners to share this site with you. Bob cares very deeply about his patients.And I know, from all the get-well messages, he has received over the past 2 1/2 years how much you all care for him. He would be thrilled to hear from you. Provided of course, you are not requesting medical advice. So please feel free to write a note, and pass this site on.

Now, I will apologize for not posting last night. My niece Meg and I went to a friends' house to share a pizza and cheesesteaks, and the night went a little longer than I expected. That is why this post is titled day 3. So, here is what happened yesterday. Bob had to fast again after midnight Thursday, b/c someone decided he needed an upper endoscopy, since he never had one after his 2 episodes of GI bleeding in Feb. Never mind that our GI drs. knew it wasn't indicated...they had to see for themselves(are we sure it's not " HUP 2, 3, 4 " ). Guess what...the upper endo was normal!!! After a yummy fish lunch, we spent the entire afternoon at the dental clinic. The resident(another 12 yr. old girl) who took him down said I didn't have to go along b/c it was just for x-rays and she would bring him back....yeah, right. She doesn't know I'm already wise to the ways of " HUP World", as my friend Joe calls it. Three hours later, we arrived back on 7 Rhoads with the assistance of a transporter, the resident having effectively disappeared an hour before that. Now, some of you may already know that Bob has had previous infections in his mouth. These have required extractions, gum and bone surgeries, and bridge implants. About 4 weeks prior to admission, Bob noticed his gums were sore and his mouth was dry. He went to see his endodontist who gave him special rinses etc. and told Bob he needed to see an oral surgeon. Well, than we found out Bob needed the Bone marrow bx. and we went to HUP for that. We told our hem/onc about Bobs' mouth at that time, and were told to put a hold on the oral surgeon. When we were given the diagnosis of leukemia, we again questioned our hematologist about Bobs' open sore in his mouth, and were told it was most likely from the leukemia and would go away after the first few days of chemo. My specific question on Wednesday morning was "is it okay for Bob to have chemotherapy with this gum sore", and we were given the same answer. Now after multiple x-rays, a CT scan of the jaw, probing Bobs' mouth to take tissue and bone samples, it seems there is the question of whether or not it is safe to give Bob chemotherapy with an open wound in his mouth. And this is probably osteomyelitis or osteonecrosis....bone infection with dying bone tissue, which may or may not be related to the leukemia. Mind you, I am not trying to place blame. I know things change in medicine when you're dealing with the human body. There will be a conferring today of the oral surgeons, infectious disease md.s and the hem/onc dr. on call. Bob was started on antibiotics(abx.) last night, and that may be the course of treatment for 2-4 weeks before the chemo may be started. That is what has to be decided today. Is the leukemia acute enough, that the risks of severe infection in Bobs' mouth outweigh the benefits of waiting until the infection is cleared up? The degree of infection in the bone will play a large factor in this decision, and that will be revealed on the CT scan( for which the poor guy missed dinner again b/c he had to fast for an 8pm scan w/ contrast). I can happily report that his birthday is off to a good start this morning. He had a huge breakfast of eggs, sausage, 2 bowls of cereal, a blueberry muffin(remember Deb eating those every am.) and juice. He requested an Inquirer and some home-brewed coffee, and since it's his birthday I guess we can manage to come through w/ that.


We are going to have lots of goodies to share w/ the staff, as Meg ordered a sour cream pound cake, an Italian rum cake and cannolis for her Uncle Bob, since she wasn't sure what he would feel like. This really frosted Deb T. who actually stamped her feet and said she wanted to get the cake. The woman never stops giving. Oh and I must also tell you that a patient/guest relations rep. visited yesterday and wanted to hear our whole sorry tale of admissions woe. She gave me a few free-parking passes and said she will definitely be looking into the whole fiasco, and get back to us.

Well, I better get rolling. Gotta get to the bakery, and brew some fresh coffee for my sweet April (nobodys')Fool. Bob enjoys reading the blogs, and sends along his thanks for everyones' prayers and get-well wishes. I will keep you posted. Please continue to remember us in your prayers.

All our love,
Bob and Mo

PS to Hatfield Girl, I always wear my seat belt, and I only do 70mph on the turnpike where the speed limit is 65mph. Believe me, I am very careful on the Schuylkil. Although, I must say I'm getting more and more used to it. Not that I'll ever love it!