Saturday, September 30, 2006

September 30th - October 5th: The Duke of Puke


Parent’s Note:

Keith feels rotten but he’s home again. He returned around mid-day today after spending the night and morning at the hospital. In retrospect the extra time there was important because he was able to stay hydrated with fluids through his IV for the 24 hours needed to clear all of the residual toxics from the chemo. If he had come home with us last night we wouldn’t have been able to get him to drink enough just because he felt so crummy.

He got sick three times during the day today. The first time occurred at the hospital just as the attending physician and resident were working over Keith for the final time before discharge. When Keith let go, the doctors actually dove for cover while Josie grabbed the pink bucket! Poor Keith had been trying so hard not to get sick for fear of having to spend even more time at the hospital and sure enough just like clockwork he barfed at the last moment just as he was being readied to leave. Unlike yesterday though, he was given the green light to go home anyway much to his relief.

At home today he was still was feeling lousy for the most part and spent the afternoon confined to the sofa. There was the occasional smile here and there but he seemed extra fragile. Just trying to get all the scheduled meds into him was impossible because he just wasn’t up to swallowing those big gel-caps (yep, we’re back to having to fill them again) so we felt like we were always behind rather than ahead of his nausea.

On the positive side some good news to report: Keith’s home with Scott and gets to sleep in his own bed tonight; Kirby's meow seems much more cheerful; and add to that the long list of yummy food he has requested (artichokes, beef bourguignon, panini and chocolate cupcakes) and things are looking up for a better day tomorrow.

Lastly, I think it's amazing that he was able to lead Michigan to still another victory given how lousy he felt today!

SUNDAY, OCTOBER 01, 2006 10:45 PM, PDT

“Bllllluuuuuuggggghhhhhhh….. Ok, so now let’s make cupcakes. hic...” Keith

Parent’s Note:

Sometimes all you can do is laugh. Keith, bless his heart, blurted out this gem just after losing his French toast breakfast. So guess what? We made cupcakes. Well actually after thumbing through Alton Brown’s “Just Here for More Food” cookbook we decided on chocolate-chocolate chip muffins instead. We all agreed it was a good choice.


It is amazing his nausea doesn’t seem to dampen his interest in food or his appetite. And even better he didn’t get sick the rest of the day, so maybe we are done with this chapter of this course of chemo for now. He did actually feel better today as evidenced by his interest in playing board games, video games, and “see what I can get my dad to do” games – the latter triggered by watching a special on TV featuring life in China, leading to an interest in Chinese food, leading to “…. we have pot stickers in the freezer…”, leading to orders from the Patient Himself for me not to return home from work without pork buns from Chinatown in San Francisco. Who am I to argue? Sounds good to me too.


Here’s a snapshot of what Keith had to endure on a quite Sunday home from the hospital:

Change the dressing on his Broviac (ouch)

14 pills to swallow

7 injections into his Broviac


He has been having a lot of hiccups recently and of course wanted to know what causes them and what purpose they serve. This led us to search the internet for the ‘answer’ and it would seem that hiccups have been documented to be a side effect of chemo in about a third of patients. That would be Keith it would seem.


MONDAY, OCTOBER 02, 2006 10:05 PM, PDT

Parent’s Note:

We weren’t expecting today to be as rough as it turned out to be for Keith. He woke up feeling fine but soon started to feel very ill to his stomach. After being sick several times and unwilling to allow us to draw his labs or for that matter give him any more antiemetics, the clinic directed us to bring him in so that they could administer IV fluids and get some of the meds in him that he desperately needed.

We were at the clinic from late morning to early afternoon and Keith got all of the necessary meds and fluids. They did the labs there and the results showed that after just 2 doses of G-CSF Keith’s ANC had bounded up to over 23,000 – remember normal range is between 1,500 and 8,000 – so he really overachieved here and we’ve been told to stop the injections for now. Still he continued to get sick several more times at the clinic and after we returned home as well although he seemed in less agony than earlier in the day. His appetite remains strong, he just has a very twitchy stomach that hopefully will calm in the next day or so. All indications point to the Cisplatin as the culprit for all of this. It’s a great cancer fighter, but has so many negative side effects it’s scary.

We’re all a bit tired and it goes without saying Keith is exhausted. Crossing our fingers for a better day tomorrow….

Keith opened a very special gift yesterday. The card inside read as follows:


This Quilt was made for you by about 50 different people.

Most were made by Moms, who know you and your family from Wagner Ranch or Orinda Park Pool, two were from a family in Oregon that you’ve known since you were born, some were made by your classmates, some were made by people you’ve never met, a few were made by people who had never, ever knit before, one was made by a past teacher of yours, a couple of them were made by your Mom’s co-workers.

And all of them…were made…stitch by stitch…to wrap you up in our Love.

Thank you Sara and Karen and everyone who came together and gave their time, and yarn for Keith. It is a beautiful thing but so much more than just a pretty object. He has spent a great bit of time wrapped in it already (although we’re keeping it at a safe distance until his stomach is calmer), and I’m sure he will always hold it as a bright reminder of the many friends who came together to support him on his difficult journey and his ultimate victory against this unbelievably unfair thing, cancer.

TUESDAY, OCTOBER 03, 2006 10:15 PM, PDT

'You should definitely write that I didn't barf at all today.' Keith

Parent’s Note:

If you’ve read the previous couple of journal entries you will recall that Keith hasn’t been feeling so well since he returned home on Saturday, even though he sleeps through the night and wakes up feeling ok. So this morning Keith woke up happy and hungry again and when he asked if I could make a run to Gepetto’s for an apple fritter before heading for the Bay Bridge we relented saying in effect ‘ok, if that would make you happy’ but really thinking to ourselves ‘great, that will be fun to clean up’…

I dutifully made the quick trip and returned with said fritter. Keith wasted no time digging into it. Apparently he soon noticed his mom hovering around him as he ate it with the now notorious pink bucket not far from her reach as though simply awaiting the inevitable eruption.

So to her surprise and relief, the Duke of Puke didn’t live up to his namesake today. Not only did he keep down the apple fritter, during the course of the remainder of the day he consumed two bowls of soup, a ham, cheese and caper panini, two artichokes, another sandwich – this time a ham, mustard and caper sandwich (with extra mustard), most of a half gallon of milk, a couple of slices of Zamboni’s pizza and some mango juice to top it off. We’re still trying to figure out where all this stuff actually went because there seems no possible way for it all to fit into his skinny body. Maybe someday we’ll come upon a food stash under a cushion and that will explain it…

Now this might not be a truly scientific conclusion, but circumstantial evidence points toward this amazing turn-around as the result of consuming that grease-bomb of an apple fritter! So much for eating ‘lite’ foods to control nausea… Next time we’re heading to Gepetto’s right after the next round of chemo! (ok, so maybe all the medications helped a little…)

So needless to say Keith had a good day and his whole, happy personality bubbled to the surface again. When I asked him to rate his day on our 1 to 10 happiness scale he replied “Today was a really good day. I’d give it a 9”.

Here’s to apple fritters…

11:25 pm. Late update: Keith is having even more apple fritter. He simply can't be stopped...


Parent’s Note:

A non-event day really. Keith spent a quiet day at home engaged in research and study. Now before you get all impressed and what-not, the subject matter was not scholarly and instead involved a Sonic Hedgehog video game…


This might be a good time to update everyone on some of the recent responses to treatment that we have both observed and learned from Keith’s doctors over the past couple of weeks. Just as a reminder his initial diagnosis of stage 4 neuroblastoma indicated he has a primary tumor in his lower abdomen involving the adrenal gland and some other nearby structures that is typical for this disease and staging. When diagnosed the cancer had metastasized to his bone marrow and lymph nodes. Tumors behind both eyes had caused one eye to become visibly pronounced to the point where during his first stay in the hospital he began to actually see double.

The latest CT scan from two weeks ago after 2 courses of chemo clearly indicated that the primary abdominal tumor had begun to recede significantly and of course that is great news. It means that the chemo is working and he is responding to the treatment just as the oncologists had expected. When surgery is performed later on, it should be much smaller and less complicated to remove. Also, his right eye has almost fully receded and he looks normal again.

We will be delaying the stem cell harvest three weeks from what we had originally planned as the last bone marrow aspiration indicated that while one of the two samples came back ‘clean’ the other still showed evidence of contamination. His first bone marrow samples both showed cancer so it’s still a big improvement. The stem cell harvest can’t happen until both samples are clean.

Of course since these encouraging reports, he has endured another round of chemo so the expectation is that he will continue to show even more improvement when the next round of tests and imaging are completed.

Sorry for the mostly humorless narrative. It just didn’t seem appropriate to deliver this information with my usual irreverence. Still we thought you would all appreciate knowing where we stand.

Besides I can only get so editorial much mileage out of Keith’s odd culinary escapades…

THURSDAY, OCTOBER 05, 2006 10:02 PM, PDT

Parent’s Note:

Keith had a good day and we seem to be over the hump with his nausea for now. On the other hand his latest lab results were returned today showing that his blood counts have dropped precipitously but not unexpectedly. We’re scratching our heads over this, but he slipped from an ANC of 23,000 (super-human) to an ANC of 1,000 (sub-human) in just the past 3 days (could it have been the fritter?). So word came back from the clinic to rev up the G-CSF pump and get those white blood cell counts back up. So for the next several days he’ll be in that vulnerable stage where he probably couldn’t win an arm-wrestling contest with a single-celled pathogen. That may be why he seemed to be a bit more tired today and even Kirby with his reverberating 6:30 am meows couldn’t roust him out of bed.

Scott has a big science test on Friday and has been studying all of those physics formulas that most of us (except maybe Sue and Kris) have long forgotten like F=MA and 1 Newton =1kg x 1m/s2. This is all great, but the only formula we seem to be using on a regular basis is ANC = (WBCx10)(neuts+bands).

Maybe it’s just me but judging from some of the recent guestbook entries we seemed to have touched a somewhat sensitive (competitive? territorial?) nerve out there…..Keith certainly didn’t intend to start a Hatfield vs. McCoy type feud between rival northern Michigan clans and he certainly wouldn’t want to be the catalyst that caused life-long friendships to sour other over such a trivial thing like bragging rights to the absolute best whitefish spread in the entire galaxy (John Cross Fisheries of course). I suppose the only fair way to settle this would be to have a friendly little ‘taste-off’; a competition of sorts. John Cross vs. Toskey Sands vs. all other challengers judged by, hmmmm, let’s see... someone who has a very discriminating palette, like…Keith!

But I don’t suppose there is any way this could possibly happen…

Sunday, September 24, 2006

September 24th - 29th: Chemo Course #3

SUNDAY, SEPTEMBER 24, 2006 10:13 PM, PDT

Parent’s Note:

Keith is back at Children’s for round 3. We packed up mid morning much to the chagrin of Keith – he thought it would be later in the day. The checklist included the usual overnight necessities plus his Gameboy & strategy guide as well as some photos of Kirby for the wall.

Once there and registered, we made our way back up to the 5th floor and the room where Keith will bunk for the rest of the week. The doctors and nurses went through their usual bedside diagnostics and pronounced Keith quite fit (except for his neuroblastoma) and they all seemed happy to see him again. Keith returned a few forced smiles, not quite as happy to see them again I imagine.

The primary reason for checking in today was to place Keith on a 24 hour creatinine clearance test to measure kidney function before blasting him again with more chemo. All of these chemo drugs are effective cancer fighters but they can take a real toll on the rest of the body. So the day involves sitting around and peeing into the plastic jugs they conveniently provide. No tubes and no pokes which is great, but hey, we could have done this at home!

He will need to stop eating or drinking at midnight and won't be able to resume until after the bone marrow procedure is completed tomorrow midday-ish. We spoke briefly to the doctor who will perform the operation and asked him if he could restrain himself from covering Keith’s backside with bandages and tape as was done the last time – to remove them was much more traumatic for Keith than the procedure itself. He winked and said sure…. Keith’s holding him to it.

So that’s where we are, getting ready for bungee leap #3.

MONDAY, SEPTEMBER 25, 2006 09:11 PM, PDT

“I am awake. I am thinking. I can process information” Keith’s first words after waking up in the recovery room.

Parent’s Note:

It’s about 9 pm as I write this and Keith has been watching Food Network intermixed with endless Steve Irwin reruns ever since the batteries on his Gameboy ran dry. When I asked Keith how his day was on a scale of 1-10 he responded it was a 6. He went on to explain it was actually a good day and the only thing that kept him from rating it an 8 was the bone marrow procedure earlier in the day.

Around noon Keith walked under his own power and completely unplugged to the day surgery center across the street. The anesthesiologist and surgeon both talked to Keith and answered his questions. He was particularly interested in how he was going to wake up. Then he bravely walked with them into the OR and about a half an hour later he was in recovery. When he did come to we were amazed how quickly he regained command all of his senses. He opened his eyes and blurted out the I-can-process-information quote. Josie and I both laughed. He sounded like some sort of android or maybe HAL from Kubrik's 2001: A Space Odyssey.

Another surprise - the recovery room nurse was his friend Wylie’s grandmother Judy who Keith had met on his previous visit. She apparently saw that Keith was having his procedure today and asked if she could be staffed for the day. Keith sure has a lot of great people watching out for him.

The next thing he was interested in was the size of the bandages on his back. Boy was he relieved to find out that there were only two little round ‘dot’ bandages. I guess he must have made his position crystal clear to the doctor yesterday - no large, sticky bandages! He wanted to walk back to his room on his own, but we finally talked him into taking the VIP wheelchair service.

Still no chemo yet but it is scheduled to start as soon as the doctors say ‘go’ which could be any minute now. They are just waiting for him to be well hydrated. Keith is in his usual ‘let’s do it’ mode. The sooner he gets started the sooner it’s over.


Parent’s Note:

Course 3 officially started at 12:30am on Tuesday after Keith’s hydration levels finally hit ‘spec’ and after the 11pm nursing shift had settled in for the night. This means that for the next 3 nights the same routine will prevail so that each of the four doses of Cisplatin and Etoposide are separated by 24 hours. It made for a restless night and will continue to be for the rest of the week because so much nursing activity needs to happen to set up the IVs and administer the anti-nausea drugs. There are also lots of hourly runs to the bathroom for Keith to get rid of the all the fluids that the four IV lines deliver. Now here is something a parent can actually be useful for. Keith weathered the night fine but by morning had a few run-ins with the barf bucket. A little more on that in a bit.

Later in the morning after Josie arrived he was taken down to have another routine echo scan of his heart to make sure all was in order and once back in his room he took part in some arts & crafts activities that were going on in the unit. The rest of the day and into the evening he was fairly comfortable thanks to Zofran, Ativan, Decadron, Benadryl and probably one or two other medications. He slept through much of the remaining afternoon (one of the effects of Benadryl) and we were absolutely fine with it. It’s probably the easiest way for him to tough-it-out over the next few days.

Ok, now I will reluctantly share one my more memorable and pathetic attempts to help Keith in a moment of need. When he first got sick to his stomach around 6 am I rushed to his aide but could not locate the large pink bucket anywhere near, around or under his bed (the room was very dark after all). This is where we usually stow it for just such emergencies. After scrambling around the room for way too long and mumbling some carefully chosen words, and while Keith lay groaning in agony in his bed, I finally found the vessel in the bathroom next to the toilet (again very dark). The race was on to get to a now-gagging Keith in time and so I grabbed the bucket and shot out of the bathroom only to realize too late it was half full of some sort of liquid that had completely sloshed out and was now pretty well distributed all over the floors of both rooms. What if it was….. yuck…. too late now…. (more well chosen words). Finally I made it to his bed just in time for Keith to let go. It’s one of those slo-mo ‘instant replay’ moments that life occasionally affords.

When the lights were finally turned on the liquid appeared to be nothing more than just melted ice water. So disaster was narrowly averted thanks in part to Keith’s stellar marksmanship. The friendly 5th floor mop crew soon paid us a visit, grinning and shaking their heads. Somehow I sensed this was a scene that they had been witness to many times over. Look, I’m sure there was a much better way to handle the situation, but waking up in the fog of sleep deprivation does dull one’s decision-making abilities a bit.

Maybe Keith will smile someday when this is all over as he is reminded of how clumsy his dad was on that morning.

I would be completely ok with that.

I think he has an amazing attitude.


Parent’s Note:

Day two of chemo almost complete and Keith has been feeling pretty good ever since our little pink bucket incidents yesterday. It would be great if we could sneak through the remainder of this week without any more nausea. Not much news – a quiet day for Keith. Of course the night is young and I am on watch tonight so anything could happen.

Here is an observation that I’ve been stewing over for some time now. As you can imagine in a hospital there’s a tendency to want to quantify everything. Everything. Questions like “How much did you drink?”; “How much did you eat?”; “How much did you pee?” are quite common. Weight, blood pressure, temperature, phosphate levels, blood counts and on and on – measure ‘em and record ‘em. Keith’s medical record has enough raw data in it to make any serious number cruncher envious. Everything comes into Keith’s room in nice little measured packages. The nurses like to use the 1-10 scale for things like asking a child ‘how bad is the pain?’ and the like. I could go on but you get the picture. Everything gets recorded. Well, almost everything…

I noticed that they don’t have devices to measure his happiness; or how many smiles he had when he talked with his brother; or how good the Indian food tasted or how good it feels to beat his mom in his favorite card game (again). There is a qualitative component that just goes undocumented amidst the need to capture so many other absolutely necessary clinical things. It may be as simple as there just aren’t any boxes on their forms for these vignettes of happiness.

So I’ve decided to take it upon myself to ask Keith how he would measure his day on a happiness scale. And just to be consistent with hospital standards, we decided to use the 1-10 scale as well.

“So Keith, how was your day today?”

“Well I’d probably give it a 7”

“Wow, that’s pretty good!”


Seven! There must be some sort of grade inflation going on here. I’m amazed that a 10 year old kid, stuck in a hospital room, plugged into four IV lines receiving chemo would consider anything above zero. After he fell asleep tonight I tried to rationalize this wonderful optimism as best as I could and here’s my theory. As parents and friends who have not experienced cancer directly we probably tend to associate cancer therapy with pain and discomfort – a big negative. Keith sees it the other way around. He sees it as a necessary step toward making him well again. Every day the chemo drips, the cancer is beat further into submission.

Ok, so maybe I’m being a little idealistic…we’ll see if when he returns home to Kirby and his friends, he rates those days higher or lower…

One humorous note about Keith’s hospital room décor that’s worth mentioning. First of all it’s actually a nice room and has a window facing west toward the bay with an appropriate boy-themed decorative wall band featuring all sorts of creatures of the sea wrapping around the entire room (funny, it looks a lot like the sidebar of this web page). However, there is a clock on the wall that Josie and I decided had to go the minute we walked in the door. It’s pink. And it’s decorated with Snow White and three other Disney princesses. As if this wasn’t bad enough, it was really loud too, clanking away like some cheap grandfather clock wannabe.

Josie figured it belonged to a previous patient and conspired with a willing nurse to remove the offending device. They eventually pulled it off the wall (along with the paint and some plaster) and dislodged the batteries solving the noise problem. However, fearing that we might be liable for damage to the room, the clock was gingerly replaced, covering the offending holes again. But what to do about the pink Disney princesses? No problem. Josie reached into her bag and pulled out a large picture of Kirby and affixed it to the face of the clock, completely obscuring it. Problem solved.

Are we good or what?


“John Cross Fish Market makes the best smoked whitefish pâté” Keith

Parent’s Note:

Day three of chemo and again Keith has been feeling ok. No big appetite and not much physical activity but no nausea either. Probably the best we could hope for given Cisplatin ( is notoriously nasty stuff. It is still to be determined when he will be discharged. It’s possible it could be Friday night but more likely on Saturday sometime.

We thought Keith might partake in the ‘make-a-video’ activity planned today for the kids on the floor. He seemed interested in it when the volunteers described it to him the day before and we thought it might be a way he could share with his friends his hospital experience. But when the activity time slot actually arrived today he was zonked out in what turned out to be a 3-hour Benadryl induced nap. Maybe we can arm him with a video camera sometime and let him have run of the oncology unit. Not to put any ideas into his head but I’m thinking he could film some kind of role-reversal vengeance scene where Keith gets to rip a sticky Tegaderm patch from one of the male nurse’s hairy arms.

Heather the social worker dropped in to say hi again and hand Keith some more courage beads for all of his procedures over the past three weeks. He enjoyed threading his new acquisitions on his ever-growing strand and it currently hangs from his IV tower next to his bed.

Regarding the pâté comment above, Keith had been looking forward to receiving the four small tubs of smoked whitefish pâté that his Annie and Grandpa Don had shipped from Charlevoix earlier in the week. For those of you who have not had the privilege of experiencing this fine morsel, it is a local northern Michigan specialty that is outstanding spread on crackers and Keith has been a huge fan of it for several years now. On our visit to Charlevoix this past summer Keith asked if he could go to the Cross Fish Market to pick up some for the week we were there. It’s become one of those look-forward-to traditions associated with visiting his grandparent’s cottage. Mrs. Cross was so impressed that a kid would make this a highlight of their day that she gave him a tub of it gratis – he was very pleased. So as soon as the pâté arrived in California Josie brought it to the hospital. Keith couldn’t wait to dive into it even though his appetite was somewhat dulled by the chemo and declared it essentially the best-thing-on-the-earth-at-this-moment, rolling his eyes in enjoyment. We all dug in like a bunch starved dogs and then laughed that Keith was almost surely the only one in the hospital with smoked whitefish pâté in his room.

No offense to the hospital food staff, but Keith has refused to order anything from the menu this past week. He much prefers food from the local Taquerías or the small plastic containers we bring from home that often contain samplers from the great meals that friends have prepared for us. In fact for the second time this week a member of the kitchen staff visited Keith’s room to ask him why he wasn’t ordering anything from the kitchen. Diplomat that he is, he declined to give her the real reason simply saying he wasn’t feeling that hungry. She looked around the room, saw the whitefish pâté and containers from home and nodded her head in complete understanding.

I suppose we should have offered her some pâté.

FRIDAY, SEPTEMBER 29, 2006 11:10 PM, PDT

“When can we get out of here? I want to go home now!” Keith

Parent’s Note:

Day four of chemo complete and Keith is spending the night at the hospital and will most likely head home in the morning. He had been doing so well tolerating the chemo that by late morning the doctors were giving him the green light to be discharged in the middle of the afternoon. So he really got his hopes up. Unfortunately it wasn’t to be. Events conspired against him and what was a day of looking forward to getting back home ended in disappointment.

Things started to veer off course a bit around 4 pm as the nurses were preparing to take him off the IV to discharge him. They found one of the two lumens that make up his Broviac central line was partially obstructed. Keith impatiently asked how much longer this would take to fix – he really needed to go home now! As it turned out clearing it required about an hour and a half. Once this was finished all seemed back on track again, so we packed up our belongings and dragged most of the stuff out to the car in the garage across the street. Unfortunately, soon after that Keith became sick to his stomach. We cleaned him up and while he felt much better afterwards, the doctors felt this was a sign that he wasn’t ready to go home quite yet. Hearing this little bit of news set the low point of the week for Keith and he was quite upset. Maybe in another 2 hours he could go home the resident said hopefully. But soon after that he was given the one-two punch of meds that always seems to knock him out – Benadryl with Reglan - and by the time sleep effect wore off it was too late in the day. It was clear he wasn’t coming home tonight.

Keith later conceded that it was probably better that he stayed the night, because as he put it he “wasn’t feeling 100% - more like 85%.” On the positive side the clogged Broviac line probably saved us from having to deal with Keith getting sick in the car half way through the Caldecott Tunnel. Keeping him overnight was ultimately the right decision, and validates our trust in Keith's caregivers. I just regret putting him through the emotional roller coaster.

Even more alarming, the picture of Kirby that we plastered onto the wall clock in his room was peeled off, packed away and is now home, meaning that the four pink Disney princesses are staring down at Keith once again.

I hope his stomach can handle it…

Sunday, September 17, 2006

September 17th - 23rd: Make-a-Wish Pays a Visit

SUNDAY, SEPTEMBER 17, 2006 09:56 PM, PDT

Parent’s Note:

No big news today but that’s ok with us – mostly just time at home highlighted by a couple of activities that Keith engaged in. He played a little ping-pong on the back patio (actually he whipped his mom, commenting that she had to amp up her serve a little if she really wanted to have a chance against him in the future). The other highlights consisted of him helping to bake (and eat) a chocolate Texas sheet cake and us dragging his drum set out of the garage and into our living room (of all places) where he promptly serenaded the neighborhood with an improvisational percussion jam session. While not specifically on his list of physical therapy exercises, we figured this had to be good for him.

Scott’s cold seems to have waned and he has been enjoying water polo at Park Pool. So far we seem to have escaped handing Keith an infection while he has been at home (knock on secondary xylem of trees and shrubs, lying beneath the bark and consisting largely of cellulose and lignin). We fully expect he will continue to feel well for the duration, and expect that his blood counts will rise back to acceptable levels sometime soon.

The real news will come later this week. We have several activities planned in addition to the usual lab drop-offs. This will be Keith’s last full week at home before being re-admitted to the hospital for his third round of chemo. We have an initial consultation meeting to go over Keith’s upcoming stem cell transplant procedure currently planned between his 3rd and 4th courses of chemo. Also, we are all scheduled to get flu shots and Keith is scheduled for another CT scan later in the week before we finally report for duty at Children's Hospital next Sunday.

On the more pleasant side, a representative from the Make-A-Wish Foundation will stop by to talk to Keith about what he might like to look forward to when his doctors say he is able. "If you could wish for anything . . .what would it be?" is the question that begins the conversation. I hope he wishes

for something that makes him very happy and that looking forward to it makes his journey more tolerable.

I have a wish as well, but I don’t think they have anything in their bag that will fix it…

MONDAY, SEPTEMBER 18, 2006 09:01 PM, PDT

Parent’s Note:

I’m struggling to come up with any real information to fill this journal entry tonight, but I also feel compelled to keep up with daily updates for now. I could weave a long yarn or two but I think I’ll keep it short.

Keith continues to feel well and is in no apparent discomfort now. The chemo is still having lingering effects on his digestive track but nothing a little laxative can’t handle. Because he is naturally skinny I find myself compelled to ‘fatten’ him up while he does feel good so a large chocolate malt is headed his way after I finish this entry.

More substantive news should be on tap for tomorrow after we speak with the transplant doctors. Apologies for the lame space filler tonight.

Due to severe space problems associated with the unexpectedly large quantities of mayonnaise bottles that have accumulated on our porch in recent days in response to the ANC quiz from a few days back, management will consider answers submitted in spice bottles as well.



“Oh great, let’s see….I want to go to Gepetto’s for breakfast.”

Keith's response, when asked what he would like to do now that he could leave the house without a mask

Parent’s Note:

Later, while enjoying that apple turnover at Gepetto’s, our favorite local cafe, Keith asked if he could come back later in the day for lunch…..Of course there was only one possible answer – yes!

The main theme of this journal entry is that we received a great lab report today. Keith passed with flying colors as his ANC skyrocketed from zip to ‘man of steel’ levels in only the past few days. The doctors gave him that coveted carte blanche wink to go out and enjoy life without covering up his nice little smile with a mask.

I’ll spare you having to calculate his ANC as you are all experts by now. So to cut right to the data his ANC was an enviable 7,810 (remember, he was 50 last Thursday)! His WBC improved just ever-so-slightly from 200 to 11,000! Hemoglobin up from 6.8 to 9.6 (ok, so he had a transfusion but who’s looking). Platelets more than doubled from 66,000 to 130,000. You get the picture. He’s standing on top of the Millau Viaduct again. He could enter the X-games now if he just could perfect that backside double kickflip. Short of that, he can at least get on BART.

Of course this news made him quite happy and of course as parents if he’s happy, it goes without saying we’re ecstatic. We really admire how maturely he has been able to understand the rhythms of his therapy and to do what he needs to do when he needs to do it without fighting the treatment every step of the way. He knows he is an important part of his own cure and has to work with the doctors – pretty impressive for a ten year old it seems to me. Ok, so maybe he doesn’t like bad tasting medicine…

Later in the day Josie and I met with Dr. Walters of Keith’s oncology team. He will lead the stem cell harvest and later on the actual transplant procedure. Many details will still reveal themselves only as we get closer to each procedure but we now have a clearer picture of the overall sequence of events and risk factors. Keith is scheduled to have another bone marrow aspiration next Monday just prior to his next course of chemo. If the results show the marrow is clean, ie: not contaminated with cancer cells, then the stem cell harvest procedure will likely follow this next round of chemo, after his counts have rebounded again with double doses of G-CSF. He will be given a new cocktail of chemotherapy drugs for this next course that the cancer hasn’t ‘seen’ yet. It’s one of those sneaky techniques employed to minimize the chance of the cancer becoming resistant to the drugs it has ‘seen’ before.

Later in the day, Keith stopped by Park Pool with Scott to watch swim practice and say hi to anyone who wanted to say hi. It was the first time back by the side of the pool since he swam in OMPA in early August and he felt good to be there again. Another first – Josie and I were able to go out for a nice dinner together for the first time (excluding the hospital cafeteria) since Keith’s diagnosis. Thanks Judy for spotting us!

Here’s to good lab reports!


“Well today for breakfast I had a cinnamon roll. For lunch we went out to Quiznos. For dinner we had pasta. Oh yeah, the Make-A-Wish people came to our house. For my wish I decided that I would like to go scuba diving at the Great Barrier Reef because I want to swim with moray eels and octopuses.” Keith

Parent’s Note:

Tonight Keith met with two very nice volunteers from the Make-A-Wish Foundation who interviewed him to find out what it was that he really, really wanted as a wish to look forward to. He’s been thinking about his wish for some time now and for those of you who might have ever had the privilege to see Keith’s collection of stuffed animals, you would have at first been impressed by the sheer quantity of them and then would have been struck by the unusually high percentage of them that are members of the cephalopod family. His most treasured ‘stuffies’ are five octopuses (very well-worn) and one cuttlefish, each of which can usually be found in, around or under his pillow. Swimming with octopi may seem like an odd thing to do for you or me but given his love for animals in general and especially his interest in creatures of the sea his wish request makes perfect sense and is so uniquely Keith-like.

It is worth pointing out that Make-A-Wish no longer just serves kids that can’t be cured but is there for all kids that face extremely difficult medical challenges. While the wish can’t be promised, there is a pretty good chance of it happening they say. Still, Keith is going to think of a back up wish in case he can’t do his first choice. The other unknown is that we have no idea when he might be physically or medically up to such an adventure. In any event it will be a great reward incentive to help him push through the tough times ahead and the many treatment procedures still to come. We are thankful such a noble organization exists. We also never, ever thought they would be ringing our doorbell.

It goes without saying that we would trade all the make-a-wishes in the world for a healthy Keith.

Another milestone: over 10,000 visits to Keith's site. That's almost one visit for every white blood cell!


Parent’s Note:

Today was one of those days where a lot needed to get done, and needed to get done early in the day.

Keith was scheduled for a CT scan that required fasting for several hours beforehand. So everyone got out of bed extra early today so that Keith could get some breakfast into him before the 7am “food curfew”. Later, after ingesting a cinnamon roll and some strawberries Keith yanked up his shirt for his standard blood draw that is routinely required on Mondays and Thursdays. He has become so nonchalant about this procedure that he now plays his Gameboy while we fiddle with all the tubes and syringes. He only breaks his game concentration to snap close the clamps on his Broviac lumens when we are finished flushing them with Heparin.

Soon afterwards we split up into several directions…Scott trudged off to the school bus stop with his 40 pound backpack (uphill and into the wind…), I left for the office stopping by the lab to drop off the little vials Keith so kindly produced while Josie, Judy and Keith piled in the car and headed for the hospital.

After reporting to Children’s Hospital Keith was more than relieved to find out that he didn’t have to drink the two glasses of contrast fluid after all that we were led to believe would be required before the scan. When he was given the nod by the nurse that he would get a ‘pass’ today he was so happy and almost jumped into the CT scanner saying “great, this is going to be so easy”. And it was. He seems to have a way of sweet-talking the nurses…

Later Keith and his entourage returned home stopping by Gepetto’s again for lunch, hanging around the house for the afternoon and then stopping by Park Pool again to watch swim practice – there seems to be a pattern developing here…While at the pool, Keith learned from one of his school friends that the science test was really hard and that he would probably need to make it up sometime so better start studying soon…

Lastly, many of you may have read Jeannie Fitch’s entry from yesterday regarding a blood drive at Wagner Ranch School that she has organized on Keith’s behalf, but for those of you who may have missed it I am copying it below just to make sure you see it. It is another amazing show of support for Keith and our family and we are so thankful to be a part of such a caring community.

Attention Friends of Keith & the Kelley’s:

Tuesday Oct. 10th, 7am-1pm
at Wagner Ranch Elementary in Orinda
in the Multi-Purpose Room
There will be a blood drive in Keith’s honor.
Please participate if you are able.

Save the date. Blood donors must be at least 17 years old, in general good health, weigh at least 110 pounds, and must not have donated blood in the last 56 days. Please sign up in advance by logging on to We need a minimum of 90 pre- registered donors. Click "find a drive" at the top of the page and type in wagnerranch as the sponsor code or contact me, Jeannie Fitch at 925-253-1097 with any questions. This is a great way to support the Kelley family and a wonderful gift to give Keith and countless others that are in desperate need of blood. Please participate if you are able.

Jeannie Fitch

Obviously, any blood donated will not be specifically dedicated to Keith, but we now realize how important it is that our local blood banks have reliable supplies available when needed. Keith was the beneficiary of more than several anonymous donors so far and literally owes his life to this precious resource being available when he needed it. Sadly, he will likely need many more blood transfusions to support his treatment and before he can eventually be cured. Even if you are not in the Orinda area, and I know many of you aren’t (Uncles Chris and John!), consider giving blood to your local chapter of the American Red Cross.

Thanks in advance to all who are considering and participate in this noble gesture.

FRIDAY, SEPTEMBER 22, 2006 09:48 PM, PDT

Due to the lack of significant news today, the editorial staff has decided to take the night off. We apologize for any inconvenience this may cause.

Oh, yeah, Keith still feels great today.


Parent’s Note:

It has been such a treat having Keith home since way back on September 7th. Life has seemed almost normal for the past two weeks and Kirby has enjoyed the company of his best buddy. Keith’s strength, weight and blood counts have all recovered nicely since his last round of chemo.

Saturday morning started out with Keith’s “I’ll-get-out-of-bed-if-you-make-waffles” breakfast request and, yep, pretty soon that waffle / coffee aroma was swirling around the whole house…mmmmm. We are such doting parents.

Later, with a full carbo-load in his tummy Keith led Michigan to another convincing win – this time over Wisconsin to remain undefeated. They did have a so-so first half and we had a stern talk about how he needed to be more attentive to wearing his ‘chemo-telepathic’ cap throughout the entire game so that the Badgers wouldn’t score any more points. He worked his magic in the second half. I suppose he still has time to refine his ‘powers’ so that the Wolverines shut out their remaining opponents on their way to the national championship. (Hum Michigan fight song here)

After the game he went to a neighbor’s house and spent most of the afternoon just having fun with a friend and for dinner we picked up that great barbeque brisket from Bo’s in Lafayette. Really good! So a great day and indeed a good week for all of us, especially Keith.

Alas, it is time for the man-o’-steel to report for duty again. Everybody at Children’s Hospital is eager to see him again and we are expected to check in sometime on Sunday. He will be re-admitted for his third course of chemotherapy. The standard pre-chemo tests will be performed as well as a second bone marrow aspiration preceding the start of chemo sometime in the day on Monday. We are told this course will take 4 days of continuous IV to administer instead of the previous 3 days and it consists of a new combination of drugs. Hopefully he will tolerate this version as well as the last. If all goes according to plan we should be back home by the end of the week – maybe even Friday the 29th where he can again recover for a couple of weeks and resume Kirbying.

Judy, Keith’s aunt who has been staying with us for the past week, headed back to Boston on the red eye tonight. She has been the easiest houseguest and our home hasn’t looked so spic-n’-span since, well…. ever. She found and eliminated cobwebs that we had no idea existed. I’ll bet that even the spiders that made them had no idea they were there… No speck remained unturned. Plus she was just plain fun to be with. Thanks Judy! Your family surely will be happy to see you again…. the spiders in our house will breathe a sigh of relief as well…..

And yes, since it is the Autumnal Equinox, it is time to announce the winners of the ANC quiz from a while back. Well, actually a forensic lab will be required to determine whether the answers were typed on an IBM Selectric, so the winner is still in doubt, but the correct answer was ANC = 50. I think most of you got it right… congratulations!

Monday, September 11, 2006

September 11th - 16th: Neuts and Bands

MONDAY, SEPTEMBER 11, 2006 10:20 PM, PDT

Parent’s Note:

We made it to the clinic at Children's Hospital without incident. Keith had all of the customary vitals taken and had his blood labs drawn. He weighed in at 25.6kg which is .3kg less than when he was discharged last week, but Josie recalled that the staff at the hospital forewarned us that the outpatient scale registered .3kg less than the hospital scale, meaning Keith had actually retained his weight despite losing his feeding tube. Phew, we didn’t want to see that tube stuck back in again… and we’ve really been enjoying seeing his smiling face again unobstructed with tape and tubes.

Stacy, the outpatient center nurse who met with us today turns out to be the same nurse who Josie finally connected with a few days back when Keith had his little feeding tube incident. She congratulated Josie and Keith for a job well done. She shook her head and confided that those weighted NJ tubes are really hard to get out which I interpreted to mean “I can’t believe you actually did it!”

Later in the morning we received Keith’s lab results. His counts are as follows:

Hemoglobin: 8.5 - a bit low, but ok

Platelets: 182,000 – normal range

WBC: 0.1 – oops, normal is 5,000 to 10,000

ANC: I’ll tell you more about his ANC in a bit.

Maybe if you are like me you might have Googled a few of the medical terms that have been thrown around in these journal entries, but for those of you who haven’t, here’s your chance for a little course in oncology blood chemistry. And just because I like the term so much, let’s call it

Neuts + Bands 101

(Neuts + Bands)(WBC x 10) = ANC (please be careful not to confuse Neuts + Bands with the

Newts Band rock group from London)

ANC = Absolute Nutrophil Count – really an overall measure of how well your body is capable to ward off disease.

WBC = white blood count.

Neuts = the short name for neutrophils which are a specific classification of white cells having special inclusion of granules, which puts them in the group of granulocytes (cells with grains).

Bands = immature neutrophils.

A normal range of ANC for a healthy person is somewhere between 1500 and 8000 cells per cubic millimeter with anything above 1000 providing a good ability to fight infection.

I’m sure no one has ever used this analogy before … Imagine the ANC levels in a chemotherapy patient like someone bungee jumping from the Millau Viaduct (here’s a link to Sir

Norman Foster’s great bridge design in southern France:

Let’s begin with a patient who hasn’t started chemo yet or has just recovered from a previous round of chemo and his (or her) ANC level is more-or-less in the normal ANC range – say 8,000. This corresponds with our bungee jumper being strapped in, standing on the edge of the bridge – ready or not - at the apogee of his imminent transit. Now let’s imagine the patient has endured an initial round (or subsequent round) of chemo. This would correspond to our jumper having just leapt (or more likely having been pushed) from the edge of the bridge and is in a state of free-fall; screaming downward. Likewise, the patient’s ANC is heading south as well, at some point crossing the magic ANC 1000 marker where one is considered immunologically compromised or even below ANC 500 where it is very difficult to fight off infection. For the next comparison, assuming our jumper hasn’t had cardiac arrest (although I suppose this doesn’t really matter…), the elastic bands tighten and our jumper snaps to a stop a few feet from the bottom of the gorge. This would correspond to our patient’s ANC reaching its nadir, ie: ZERO. Ok, so this is where Keith is today. He has absolutely no white blood cells and no immune system to speak of meaning no ability to ward off infection.

So we have an action plan. Australian rules football, kick boxing, X-games type skateboarding tricks, traveling on overcrowded MUNI busses and being sloppy about washing your hands are no longer on Keith’s do list for the time being.

The good news is that the daily infusions of G-CSF are designed to force Keith’s own body to produce new, healthy white blood cells and neutrophils. As with his first course of chemo his ANC should rebound within a few days to a week. Then he gets to climb back up to the top of the Millau Viaduct and do it all over again! You’ve got to be a kind of daredevil to fully experience cancer or bungee jumping. I admire the courage of both.

That’s it for class although there might be a pop quiz tomorrow.

And just to make sure that you read all of the journal entry I’ve saved this for last. Keith actually felt really good again today.

Remarkable despite striking out in the white blood cell test.


“It was not at all exciting. Because what we had to do was we went there and it took an hour just to get there. Then we sat in the waiting room for half an hour. And then we waited for them to give me some dumb drops. I had to wear my mask the whole time and it was hard to breathe. And then after the drops we finally got the injection and then we could leave. So it took another hour to get back. The best part was the Subway sandwich place on the way back to the car – I had a meatball sub.” Keith’s account of his visit to UCSF today

Parent’s Note:

All-in-all another feel-good day for Keith despite the less than enthusiastic recall of his trip to UCSF. He's been flirting with a slightly elevated temperature but nothing that would qualify as a true fever yet – fingers still crossed on that one.

Keith’s scheduled visit to UCSF was to have the isotope injection for the MIBG scan that will be performed when he returns again on Wednesday. Josie and Jennifer intrepidly navigated the Bay Bridge, the surface streets of San Francisco and perhaps most stressful of all - the parking garage at UCSF - to get Keith to his appointment on time. Josie described the hospital as a sea of humanity swarming inside a lot of identical, generic white hallways. (It’s a great institution, but hey, sounds like they could use a good decorator). The drops Keith referred to were some form of potassium solution intended to block the thyroid gland from absorbing the isotope so that the isotope finds its way to the cancer hot spots, allowing tomorrow’s scan to image these areas. He vomited up the first round of potassium but somehow managed to keep the second attempt down. When will they ever learn that he hates liquid medication…

Because the isotope is slightly radioactive we’re really looking forward to turning the lights off to see if he glows in the dark….

Gel-cap update: We’ve at least temporarily solved the dilemma of filling gel-caps for Keith. For all of you who jumped to our rescue and provided us with funnels (thanks Kris), Slurpee spoons (thanks Liz) and advice we are grateful. Sorry, but the best solution came from the Keith’s doctors when they decided he no longer needed to be on his oral meds (at least for now…). I have a feeling all of this paraphernalia will still come in handy in the future.

Finally a message from the interim IT manager of this website: Keith loved the video of the scuba diving cat sent by Randi several days ago. And he really enjoys pictures of fat cats – thanks Jill for sharing you picture of Talulah. He asked me to put the word out that if any of you have a great picture of a fat cat or bizarre animal to share with him he would really love it. If you like you can email to him at the address on his “My Story” page or to me at or you can provide a link in your guestbook entries to Keith like Randi did. Since we are limited to 12 pictures on this site I will try to set up an external website linked through this one to display more pictures. That way we can share more pics of Keith and he can view others you want to share with him. If it turns out to be too difficult to manage I may give it up or beg for help…


“The scan wasn’t too bad. I had to lie still for an hour but I got to watch a movie. We stopped by the Subway shop again and I had a spicy Italian sub after we were done with the scan” Keith

Parent’s Note: Keith did great a great job. He is an amazingly patient patient. I figured he would wiggle or sneeze or do something that would require the scan to be redone, but no, he was solid as a rock even though he was grimacing toward the end when his backside became numb. This time I drove Keith and his mom to UCSF. I was looking forward to navigating the dreaded parking garage only to be directed away by the parking police as there was not a spot to be had inside the zillion space structure. I wound up parking near Kezar Stadium several blocks away and a hundred feet lower in elevation than the hospital lobby. This trip really requires two parents (adults). We really appreciated how much more convenient and child-friendly Children’s Hospital Oakland is after the experience of the last two days.

On the way back toward the East Bay, we stopped by Pier 35 so Keith could marvel at the Regal Princess which at 811 feet long makes quite a statement along the waterfront.

Tomorrow (Thursday) we draw blood labs at home and should know what Keith’s ANC is by mid-afternoon. He told us he felt better today than yesterday so we are assuming that his white blood count is climbing up nicely thanks to the G-CSF injections.

No big tests or procedures scheduled for the rest of the week, so if Keith continues to feel good we will begin to catch him up on some of the schoolwork he has missed. He also commented that he was a bit put out that his drum set had been relegated to the garage. Josie and I looked at each other and agreed that if he wanted to jam away on the drums again we would be happy to put them wherever he wants them. The sacrifices we make as parents…

Oh, he didn’t glow in the dark last night…


“School started today for me - sort of… Mrs. Morris came to our house and helped me with math and reading today. Also I just want to say thanks for sending all of the fat cat pictures.” Keith

Parent’s Note:

Keith kindly produced several more vials for the lab today that we drew around 8am. He has become so accustom to people poking and prodding that he rarely complains – just pulls up his shirt and produces the little white tubes dangling from his chest. The idea was to get the samples to the lab early in the day in hopes of getting the results later in the afternoon. As it turns out the lab sends the samples to a processing center in San Jose that runs the labs after midnight. So we won’t know Keith’s ANC until Friday morning. If his white blood count turns out to be low – although we don’t expect it will - we will still be able to get more G-CSF ordered before he runs out of the current supply on Saturday.

Keith enjoyed meeting with Jill Morris for the first day of home tutoring and we are so happy and fortunate she offered to do this for Keith. A bit of a refresher in multiplication and division are on our to-do list after his ‘extended’ summer vacation. For some reason Keith’s hair has stopped falling out, and while it is very thin he still is hanging on to a few ragged locks. Even better, his eyelashes and eyebrows seem to be pretty much intact now (…hey Trevor, Keith might have more hair than you now – so sorry!….)

Lastly, there are some great ‘fat cat’ and fun animal pictures and links coming in from all of you which always produce a smile from Keith, so thanks for continuing to cheer him up. After looking at some of them in amazement, it seems Kirby has a whole lot of munching to do to be in the same league with some of your ‘fat cats’..…

FRIDAY, SEPTEMBER 15, 2006 09:33 PM, PDT

Parent’s Note:

We are starting to realize just how unpredictable our days are now. We had expected the lab results to indicate that Keith would have bounced back to healthy blood count levels by now but cancer doesn’t seem to play by the rules. In fact his results were still very low in several areas triggering a call from the oncology clinic requesting Keith to kindly rearrange his busy schedule and make an appearance at Children’s Hospital for a blood transfusion pronto.

It seems his hemoglobin had fallen below the magic number of 7 where transfusion is usually performed. This might partially explain why Keith seemed to have a bit less energy the last couple of days. The lab report also indicated his platelet count was low and he was still severely neutropenic . His Absolute Neutrophil Count (ANC) was about 1,450 units short of a passing grade. Remember that pop quiz I threatened a while back? Sharpen your pencils…there’s a quiz at the bottom of this entry.

Keith drew up his courage once again and we piled into the car. At the outpatient center Keith was shown to an isolation room. Another blood draw was taken to verify the previous lab results. The results were quickly confirmed so word went out for some nice grade-A hemoglobin in a bag. He received the transfusion, was given more G-CSF and just before leaving had another lab draw to determine his phosphate levels. He was comfortable during all of this, the staff was kind and friendly as usual and yes he could watch the Food Network to while away the time. All-said it was about a six-hour unplanned errand door-to-door. And yep, he’s earned another bead or two to add to his growing string of Courage Beads.

Actually we are relieved that this situation was taken care of today so that Keith can continue to recover his energy level, eat lots and put on some weight, and just enjoy a regular weekend with Kirby… plus he looks all nice and rosy again to boot. His next lab draw isn’t until Monday so it will be Tuesday before we know whether Keith’s blood counts have bungeed to the point where he can jump on that crowded BART train without a mask.

Poor Scott has been fighting a mild cold for most of the week and despite not feeling all that great he has been very conscientious of Keith’s needs. He even volunteered to give up his bed in the room he shares with Keith and sleep on the floor in another room so that Keith wouldn’t catch anything from him. Maybe as some sort of cosmic reward, Scott’s ‘Egg Launch’ experiment, where he had to design a container to protect a raw egg launched from a catapult, flying 40-60 yards onto hard blacktop was a success on the first attempt. No yolking…. if only NASA could boast such a record.

And now to separate the wannabe medical students from the rest of us here's the promised QUIZ:

What was Keith’s ANC today if his white blood count was 0.2 and his neuts + bands were 25? The first 100 correct answers will be entered into a drawing for a mint-in-bag orange ‘neuroblastoma’ jelly bracelet (fine print: answers must be neatly typed on an IBM Selectric typewriter and placed in relatively clean mayonnaise jar on our front porch no later than the Autumnal Equinox).

(Spoiler 1: review the formula from the 9/11 journal entry. Spoiler 2: a passing ANC grade is 1500. Spoiler 3: the number is the same as the answer to the following question: On what yard line is the center of the large block M at mid-field in Michigan's 'The Big House' football stadium?)


“I had something I really wanted to say, but I forgot what it was…” Keith

Parent’s Note:

The transfusion really worked wonders and today Keith popped out of bed cheerful and ready to take on the day. His appetite was back on track and he really seemed to be more like his usual old self again. Amazing what having enough red blood cells can do for one’s outlook not to mention one’s complexion.

It was a great day for Michigan fans like us as we tuned in to watch Michigan spank No. 2 ranked Notre Dame in South Bend. What you probably don’t know is that Keith played a pivotal role in their win. He unfurled his recently autographed Michigan player banner, tuned into the game broadcast and sent winning play calls to the field through a seldom-used technique called chemo-telepathy where positive energy waves generated by the massive breakdown of cancer cells in his body are transmitted through the brim of his Michigan cap into the television and cable infrastructure, eventually finding their way into Lloyd Carr’s headset. As proof, there were a couple of times where Keith simply removed his cap and bad stuff happened; Chad Henne was picked off for a score by Notre Dame and on another occasion the Fighting Irish scored on a long pass play. He quickly realized his mistake and kept his cap on for the rest of the game, assuring the Michigan win.

Keith’s Grandpa Jim & Helene drove all the way down from Oregon to visit us today. Keith really enjoyed seeing both of them again and we recalled the fun times when we visited them at their home in Sarasota, catching lizards, canoeing with manatees and enjoying the nearby white sandy beach.

We also picked up Judy, Keith’s aunt from North Andover, Mass., from SFO later in the evening. She will stay with us for the next week to help out in any way she can which is so much appreciated.

I’m sure there is something else I really want to say, but for the life of me I forget what it is…