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flatscreen TV dishes so that we could prepare food if needed. The cost was very<br />
reasonable at $79 per night <strong>with</strong>out any hotel tax being charged.<br />
Wednesday was a very busy day. First appointment was <strong>with</strong> Dr. Nghiem. I was first<br />
examined by a visiting physician from Japan. Then Dr. Nghiem came in. He gave me a<br />
complete examination. We had a long discussion about the options. He felt that there<br />
was no recurrence of tumor mass in the region of recent resection. Because of this, he<br />
felt that it would be inappropriate to start injections in the area where the tumor had been<br />
removed. We had a frank discussion about what my chances are <strong>with</strong> Judy present.<br />
Basically, radiation treatment is expected to control local disease at least 80% of cases.<br />
However there is a 50-50 chance of having distant disease. At that time, chemotherapy<br />
may be an option for palliation. Injection of beta interferon may be an option if a mass<br />
appears, but this treatment is too untested to inject this material at the original tumor<br />
section site.<br />
We then went for our appointment <strong>with</strong> Dr. Parvathaneni. We take a shuttle to the<br />
University Hospital which is about two or 3 miles away. We first met <strong>with</strong> a resident<br />
named dr Ralph Ermoian who is from Fresno. He examined me. We had long<br />
discussions about radiation treatment. Then Dr. P. arrived and he gave me a thorough<br />
examination including palpation of my tonsils causing me to gag. He felt that my tonsils<br />
were not involved. He is going to have discussions <strong>with</strong> Dr. John to organize my radiation<br />
treatments in Fresno. It looks like he will recommend only six weeks of radiation<br />
treatment.<br />
Following this, we returned to the lab at Dr. Nghiem's location where they draw nine<br />
tubes of blood. We then returned to SCCA house, picking up bagels on the way back to<br />
have a late lunch. I checked my e-mail and discover that they want me to return for one<br />
more blood sample. That takes less than an hour as I take the shuttle in both directions.<br />
We decided it would be best returned to Fresno immediately. The SCCA house is very<br />
good about this. They allow us to check out and credit us for the three days we did not<br />
spend there. Delta Air Lines, however, is not so cooperative. They want more money for<br />
the return flight to Fresno then they would charge if I just booked a one-way flight to<br />
Fresno. Instead, we book a direct flight from Seattle to Fresno on Alaska airlines. We<br />
arrived back in Fresno late Wednesday.<br />
I will work half a day on Thursday and half a day on Friday which will more than pay for<br />
the additional cost of the flight.<br />
It looks like the timetable is now as follows:<br />
Monday, June 28: I have an appointment for the setup for radiation treatment at 9 AM. I<br />
plan to work Monday afternoon.<br />
Tuesday, June 29: I plan to work all day.<br />
Wednesday, June 30: I have an appointment <strong>with</strong> Dr. Person for a complete teeth<br />
cleaning, and consultation regarding keeping my teeth healthy during radiation treatment.<br />
At 11 AM, I have an appointment for follow up <strong>with</strong> Dr. Flam.<br />
Thursday, July 1: I plan to work all day.<br />
<strong>My</strong> <strong>Battle</strong> <strong>with</strong> <strong>Merkel</strong> <strong>Cell</strong> <strong>Cancer</strong>
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