Monday, September 28, 2009

Stories about Dave

Friends and family,

Thank you one more time for all of your prayers, love, and support. Thank you, thank you, thank you. I have one last request. Our family has spent time enjoying stories about Dave. However, his children only know some of the stories. If you have a story that you would like to share with us so that our children will have the opportunity to get to know their grandfather, please share them with us through email. Please email as many stories as you want to
Please give them your own clever or reminiscent titles. Thank you again for all of your love and service to our family.

M&K Palfreyman

Wednesday, September 23, 2009

Correction on the location for the Viewing

The Viewing will take place Thursday September 24 from 6 to 8 at the Church of Jesus Christ of Latter-Day Saints building at 50 South 750 West. (That is the building on the West side of Mountain View High School, behind the seminary building.)

The Funeral will take place on Friday September 25 at 11 am at the Church of Jesus Christ of Latter-Day Saints building at 195 West 300 South. (There will be a viewing opportunity on Friday starting at 9:30.)

Tuesday, September 22, 2009

Farewell services

Dear family and friends,

Dad passed away last night. We have appreciated all of the prayers, notes, visits, and support from all of our dear friends and family. His funeral will be this Friday September 25 at 11 a.m. at the Orem Park Stake Center located at 200 W. and 300 S. in Orem, Utah. The viewing will be Thursday evening from 6-8 p.m. also at the stake center. The details of the service will be coming in the Herald and Deseret News newspapers soon. Our sweet father was a fighter until his last breathe. As short as it was we are so grateful that we had time with him, and we were able to say goodbye. We love all of you so very much, and look forward to seeing you all at the service.

The Palfreyman Family

Sunday, September 20, 2009

"Abide with Me"

Dave is asleep most of the time now. He seems very peaceful. He doesn't seem to be in pain, or discomfort. He does have an on-call Hospice nurse who has been here a lot to help get him comfortable and I think he finally is. His children are all here with him now. I think that alone has helped him to relax and be more comfortable.

Dave will not be able to have visitors anymore. His family needs time to be with him. There is a notebook hanging from the front door of his house. Please feel free to leave messages there, on facebook, or on his blog. We read them to him at night before he goes to bed.

We will continue to let all of you know how this progresses as well as funeral information when that time comes.

Thank you again for your love and prayers. Dave's life has been so blessed by the many loved ones he has. Thank you. God Bless!


Friday, September 18, 2009

Thank You!

Dearest family and friends,

We are very grateful for your love and support. Dave has unfortunately taken a turn for the worse. At this point we're unsure just how much time he has left and are doing everything we can to ease his symptoms. Personal visits will be alright if he is feeling well enough to visit. During those times he is unable to visit, we have placed a notebook on our frontdoor for friends and family to leave personal messages on. We'll read these notes to him nightly before bed. Also, if there are any messages that we can pass on to him, please feel free to leave one and we will pass it on.

Again thank you for your continued support, prayers, and understanding at this difficult time.

M. & K.

We need your prayers!

To our friends and family,
Please petition the Lord for blessing for Dave this week. He is holding on as best he can, but it is an uphill battle, and needs all of the help he can get.
M&K Palfreyman

Sunday, September 6, 2009

Another Day

Dave's doctor appointment went well. He had a CT scan and some blood work done. The blood work shows that his elevated liver functions have dropped, which is a good sign. I believe that means that his liver doesn't have to work as hard to keep him alive. The CT scan shows that the main tumor has grown to 16.5 cm. However the lymphnodes haven't grown since they registered in at 8 cm (end to end). Dr. Watson mentioned at his July 1st visit that the first CT scan that they would take would likely show(as it did) that the tumor had grown. I think that is because there was time between the last scan they did and the TheraSphere. (So the tumor had time to grow before the medication was administered.)

Dave is doing alright. He has some ups and some downs. It is hard for me, as it is for many of you, to see him on his bad days. One of Dave's best friends, Matt Packard (the man my husband is named for), helped me put this difficult situation into perspective with something that he said. Matt said, "Our Heavenly Father does not take lives by accident. When someone we love passes away, it is always on purpose." I think that has helped me to realize that my father-in-law is being watched over and protected. No matter how bad it seems to me right now, there is a bigger plan. Dave is destined for greater things than I can imagine, whether it be in this life or the next.

Tonight, I would ask you all to keep him in your prayers. Since his tumor is inoperable, I am praying that he doesn't suffer much more than he already has. I know that our Heavenly Father has the power to work miracles. I know that if it is His will, He will be able to heal Dave.

Thank you all for the love, support, and prayers. God Bless.

Sunday, August 23, 2009

Ready, Set, Go!

Tonight our fingers are crossed for Dave.
He will be making another trip to the doctor's office for some tests tomorrow. I believe he will have a CT scan, ultrasound, and blood work done tomorrow to see what the TheraSphere treatment and lymphnode radiation has done.

Here is a picture of Dave from tonight. We also have some video footage that Kaylene's son Trevor took. I will upload it as soon as I get it.
This picture shows how skinny he has gotten!

Wednesday, August 5, 2009

Just keep on keepin' on!

Dave had the TheraSphere treatment last Monday July 27. As far as we can tell, everything went well. He has been very tired and dizzy. After the treatment, Dave was given steriods because of the high level of radiation in his body. (I think the steriods were intended to help his energy level and keep him from feeling too much of the effects of the TheraSphere.) Because of the steriods, however, Dave's blood sugar is way too high and that is making him dizzy. His doctor told him that he should take the medication he had been taking for diabetes but that he should double to dose. He should be feeling better soon.

As for the TheraSphere, the doctors would like for him to have another dose but they aren't sure that will be possible. During the first dose 13% of the radiation went into his lungs (due to some blood vessel damage) and while this one didn't harm him, 13% is borderline. By the time they are ready to do the second dose they would have to do another mapping procedure to see how much of the radiation would get into his lungs and they don't think that the percentage will be low enough. (They think too much will leak into his lungs.)

Dave has an appointment to have a CT scan, ultrasound, and blood work done on August 24. The CT scan may actually show that the tumor hasn't changed. (That's normal for the first scan.) But hopefully the blood work will show some positive signs.

As for Dave he just keeps on keepin' on.
Thanks for your love, support, and prayers.
God Bless

Monday, July 13, 2009

May I have the Envelope Please?!

"And the winner is....Dave Palfreyman."

After so many weeks of more and more bad news, we have heard back from the insurance company. They have agreed to pay for the TheraSphere treatment. We just found this out this morning. Dave is fortunate to have some very close friends in just the right places. Fortunately, one of those friends made a call and pushed this through for us. I don't know that I can express how much of a relief this is. We have been more and more concerned about Dave's quality of life. So this is especially good news given that the alternative treatment often has very horrible side effects. We are so grateful that this treatment is available for Dave. We are hopeful that it will lengthen and improve his quality of life.

Timeline for Treatments:
Dave will finish radiation next Wednesday July 22 and will start TheraSphere treatment on Wednesday July 29. I believe he just has to go in the one time for this. If they opt to do more treatments, (they may do 2 or 3) they will be space out a few weeks to months apart.

Thursday, July 9, 2009

Ready or not, here it comes!

Dave's first radiation treatment was yesterday. It didn't take very long. He was only there for about 15 minutes. He came home and just laid on the couch for most of the night. He had another treatment today and will continue this 9 more times. Dave is feeling alright after the treatments. He is really nauseated and a little tired after the radiation. His spirits are high and tonight he actually looks better today than he has in a few days. At the moment, he is visiting with friends and is very alert.

Tuesday, July 7, 2009

Dave's Golf Tournament

As you can tell, I am a little slow about getting things done lately. I apologize for that. I should have put these pictures up last Friday. At any rate, Dave’s golf tournament was a huge success . The weather was beautiful and participants were able to enjoy the quiet calm of Utah Lake views all morning. Talon’s Cove in Saratoga Springs hosted the event. It is a beautiful course and our family is grateful for their help and would encourage all of you Golfers to go out and enjoy that course.
Many of Dave’s friends and family came to show their support. More than 100 people played yesterday. Dave was able to attend the luncheon, catered by Talon’s Cove, and shared a few touching stories about old friends and his recent experiences with his family since the news of the cancer. He was full of energy and grateful to be with so many loved ones. He expressed his deep appreciation for the support of the players and donators, and expressed his firm commitment to give this cancer the best fight he has. Thank you to all of our friends, family, and members of the community who have shown their support! We also send a HUGE thank you to Steve Watts and the Talon’s Cove Golf Course crew for hosting the tournament.

These are pictures of the luncheon after the golf tournament.

Dave and Kaylene

Matt and Kelly Palfreyman, and Kris Coles

More of Dave's Family

On the left is his sister Annette, her grandson, daughter, son-in-law and his dad. On the right is Dave's father Kent, and his wife Janet.

These are some of Dave's friends and coworkers from Bank of Utah.

We are pleased to announce that Dave's still up for a good time!

More of Dave's friends

More of Dave's friends!

Thursday, July 2, 2009

Dave's Visit to the Doctor

I will post pictures and information about Dave's golf tournament tomorrow.

Dave had an appointment with Dr. Watson yesterday. He is the oncologist/radiologist that Dave will be seeing for treatment. At Dr. Watson’s request, our family went with Dave to his appointment. We met with the doctor so he could explain some things to us and answer any questions we had. This is, as I heard it, from the doctor. I hope you will forgive the frankness of this post. The nurse told us that most families find it easier to deal with this kind of a difficult situation if they are honest and talk about the hard stuff together. She said this includes talking about the treatments, side affects, and even how much longer he has on this earth.

First, let me say that the transplant is not an option as of right now but it is the only cure for Dave. Without a transplant he will have to battle the cancer for the rest of his life. According to Dr. Watson, his tumor would have to be no more than 5 or 6 cm for a transplant. (This is contrary to the 8 cm that we were told by Dr. Walentyne.) Dave’s tumor was 12 cm last time he was scanned. (Today the scan indicated that it has probably grown. That will be explained below.) Dr. Watson is confident that he can shrink the tumor. He said that it will be difficult to shrink it enough for Dave to have a transplant. He said, “Shrinking a tumor that much is a remote possibility. His chances are not zero, but not great.”

They did a CT scan today to pinpoint exactly where the lymph node tumors are so that they are ready for the radiation treatments to start next week. The CT did NOT show that the cancer is spreading to any of the organs near his liver. (YAY!) There are two lymph nodes that each have a tumor. The tumors are right next to each other and were measuring (last time they were checked) at 6 cm total. However, within the last month they have grown to a total of 8 cm. That is a VERY fast growing tumor, which also leads us to believe that the main tumor has grown as well.

So the radiation on the lymph nodes will begin next Wednesday at noon. He is scheduled to have the treatments every day for 11 days (business days) in a row. The side effects from that include nausea, cramps, and fatigue. He will take a pill every day about an hour before the treatment to help with the nausea.

Dave asked the doctor if it looked like the Nexavar (the pill to stop the growth) was working at all. The doctor said no and that he wants Dave to stop taking it. He is concerned about it affecting the blood vessels in the liver. If the medication weakens the blood vessels then he won’t be able to have the Therasphere treatment. So the Nexavar is out for now.

Dave’s mapping procedure showed that most of the dye went where it should have. About 9% ended up in his lungs. Usually they only see 2-3% in the lungs. They can do the procedure at 9%, but we need to pray that his blood vessels will stay as intact as they are. Unfortunately, Dave’s insurance has said that they will not cover the Therasphere treatment. It is a very expensive thousand treatment. Dave’s doctors are working tirelessly to explain to the insurance that Dave needs this procedure. They feel confident that the insurance will have to pay for this because it is medically necessary for Dave to have. It seems like it will take some work to educate the people at the insurance company. We are going to do everything we can to get our needs heard and addressed by the insurance company.

Until we have a ‘yes’ from the insurance company, Dr. Watson doesn’t feel comfortable with putting that financial burden on our family since there is another option. A treatment called TACE, Transarterial Chemoembolization. “TACE, a procedure in which the blood supply to a tumor is blocked (embolized) and chemotherapy is administered into the tumor.”

Dr. Watson would rather fight the insurance for Therasphere because the side affects are easier to deal with. Since TACE uses a form of chemotherapy, the side affects can be ugly. However, Dr. Watson did say that some patients react with very few side affects because every one is different. When I asked Dr. Watson how long we would wait for the insurance company before we decided to go on with the TACE procedure he said, that the radiation will start next week and he doesn’t want to start the other procedure until the radiation is done. We will want to know by the end of the radiation if the insurance will pay for it. Otherwise, he will start TACE procedure. (Dr. Watson said that the TACE procedure is more easily covered by the insurance since it isn’t as new.)

With either of those procedures, it is likely that he would have the treatment done a couple of times. They will be done 2-3 months apart. (If his liver function stays where it needs to be for the procedure.) The first scan they do after the procedure will not be useful. It will likely show that the tumor is worse than before. That is normal though. They will do a second scan later and it should show that the tumor is shrinking.

The median survival rate for a positive (meaning good) response to the TACE procedure is 16-19 months. (Meaning that on average patients live that much longer. 50% live less than that and 50% live longer than that.) The positive thing about Dave’s situation is that he is actually pretty healthy (other than those pesky tumors). Also, the Doctor said that the healthier a patient is going into the treatments, the better the patient will handle the effects, and the healthier the patient will be coming out of the treatments. Right now, tumor and its effects aside, Dave is reasonably healthy. He eats surprisingly well and keeps his food down, which is good because it will keep his body strong. His diabetes is mostly under control due to the major weight loss he has experienced and his liver is functioning very well for a tumor that size. Also, Dr. Watson says that the healthier a person is going into these procedures the better their chances are. In other words the procedures work better on healthier people.

This last month has been difficult, with the news, the waiting, etc. But, I know God loves us and will bring us comfort and support, come what may. Our family has decided to help Dave live the rest of his life with joy, love, and passion for life. If he eventually gets a transplant and lives a long life, then he will be able to look back on this difficult time and remember his family, his friends, and having the time of his life.

Dave would like to mention that his darling wife Kaylene has been such a blessing and support to him. She has worked so hard to take care of Dave and their home. Kaylene has also been a great blessing to Dave’s kids and family as well. We are very grateful for her strength, support, and wisdom during this experience. We are so blessed to have her in our family.

God Bless

Matt and Kelly

Sunday, June 21, 2009

Happy Fathers Day!

We just want to wish everyone a Happy Father's Day. Dave wants to thank everyone for taking the time to visit, help out, call, and pray for him throughout the last few weeks. Please continue to pray for him to be able to receive his treatments this week and that his tumor will respond to those treatments. It has been a very good Father's Day for him today and he hopes that all of you have also had a great one as well.
Remember, we can do all things through Christ who Strengthens us.
Much Love.

Thursday, June 18, 2009

Additional Information about the Golf Tournament

New number for Steve Watts at the golf course. 801.407.3030

Also, donation accounts have been set up at Central Bank and Bank of Utah in the name of "David K Palfreyman Cancer Donation Account".

Tuesday, June 16, 2009

Dave's Treatments --

1. Nexavar – a pill to stop the growth of the tumor
2. Radiation – the typical radiation treatment
3. Therasphere – a new form of direct radiation (it will be concentrated in the tumor)

Dave started the Nexavar last Thursday. He has had only a few side affects. He has had some itching and a dry throat and mouth. He also has been very tired from this medication. He goes in and out of phases where he feels really energized and phases where he feels really tired. I feel like it’s a good sign that some days he has a lot of energy.

When they start the radiation treatment, it will be full blast. They will use the highest dose that they can to attack the tumors on the lymph nodes. I will let you know more about this soon.

Dave will hopefully start the Therasphere next Tuesday. First, it is necessary to find out if his blood vessels in and around the liver are in tact or if they are damaged. Today he went in for a mapping procedure to find that out. This procedure is much like the treatment itself except that the doctor injected a dye (rather than the radiation) today. (Details about this treatment are listed on the posting “Therasphere Treatment Postponed”) The doctor can see where the dye goes and that will let him know if it will be safe for Dave to have the Therasphere treatment. If the blood vessels are damaged, the dye will go into his lungs and GI Tract. If that happens, the dye won’t hurt him, but the radiation from the Therasphere would so they won’t do the procedure. The nurse told Kaylene that if he is not a candidate for the Therasphere treatment the doctor would call with another treatment plan. It will be a week or two before we know the results from the mapping procedure. However, he will be scheduled for treatment as soon as the results come in.The mapping went well. I thought he would be tired and ‘out of it’ tonight, but he is awake and alert. The doctor told him that he needs to be up and walking around more. They want to make sure he doesn’t end up with a blood clot. He went for a brief walk around the house and out onto the porch this evening with his sweetheart.

Thursday, June 11, 2009

Golf Tournament for Dave

Dave has helped so many people throughout his life. He is very blessed to have so many close friends who have offered their prayers and support.

Dave’s type of cancer is rare, and the procedures he will require are expensive and they will affect him so that he will be unable to work. To help ease the financial burden brought about by his circumstances, there will be a golf tournament fundraiser on July 1st. The details are below.

Date: July 1
Registration Check in: 7-8 am
Tee Off: 8 am
Location: Talon’s Cove

Please contact Steve Watts to sign-up.
Phone: 801.472.0965

We will have a catered luncheon with entertainment following the tournament.

Donations of $75 are encouraged to participate. However, donations of any amount to participate will be received with gratitude. All proceeds will go to Dave.

Please feel free to forward this to anyone who knows and loves Dave.

Dave’s family would like to express our deepest gratitude to all of our friends and family members who have been and will continue to be so supportive to Dave. Thank you! You are in our prayers daily.

Therasphere Treatment Postponed

With the Therasphere treatment, comes a risk. (That is the treatment where the doctor places a catheter in his leg and runs it up the Femoral Artery and into the Hepatic Artery. Once that takes place, the radioactive material, encased in tiny glass spheres, will flow in through the blood vessels and into the tumor and start to attack it.) If Dave’s blood vessels in the liver are damaged, it is possible that the radiation spheres will travel into his lungs and GI Tract. That would create a very dangerous situation for Dave. However, if his blood vessels are all in tact and healthy, the procedure will work just fine. Fortunately, there is a procedure called ‘mapping’ that will enable the doctor to know if the blood vessels are damaged or not. They will not do the Therasphere treatment until they get the results from the mapping and know that it is safe to do. Dave’s mapping appointment is on Tuesday June 16. It will take one week before they can actually do the Therasphere treatment. It won’t start until at least Tuesday June 23.

Dave’s medication(Nexavar) came today. He started it this afternoon.

On another note, the surgeon, Dr. Ott called Tuesday afternoon and said that if it hadn’t been for the cancer in the lymph nodes, he would have operated on Dave this week and pulled the tumor on the liver out. He said he is confident that he could do it and although it would be a long procedure and long recovery, Dave would have been fine. Dr. Ott also said that if the radiation cleans out the cancer in the lymph nodes, he will go ahead and operate. That is really positive news for our family! Dave really needs the operation. The doctors have told us it is the only way to cure this type of cancer. Keep praying that the radiation will go well on the lymph nodes and that the main tumor on the liver will be able to come out! Thanks for your love and support.

Monday, June 8, 2009

Treatments! ... Finally

Dave had a biopsy done on the swollen lymph nodes this morning. Then he met with Dr. Watson who specializes in Liver Therapy. Kaylene says that the first appointment was very grim. One of the lymph nodes has a cancerous tumor that is 6 cm on one side. (That is half the size of the tumor on his liver.) The doctor that gave the results of the biopsy was very matter-of-fact. Kaylene said that it was horrible to sit through that explanation. On the flip side, Dr. Watson was very positive. He came in and said that he will treat this cancer very aggressively and that they will get started right away. There are three different treatments that they will use. One is a pill called Nexavar. That will help keep the tumor from growing. With the tumor being so big, the Nexavar won’t shrink the tumor. The second treatment will be radiation on the lymph nodes. They have ordered the stuff to start radiation within the next week. The third treatment will be a new type of radiation therapy that is more concentrated on a specific spot. This is called Therasphere. Dr. Watson is the only doctor in Utah who uses Theraspehere. We are very fortunate to have been able to meet with him. Dr. Watson wants to start treatment within a week from today. (Hopefully Wed/Thurs) Here is the website that explains this new treatment option.

Brief Explanation of Therasphere:
The doctor will make a small incision into Dave’s leg (I believe in his thigh) and place a catheter into the Femoral Artery. He will use fluoroscopy which is the technology that allows the doctor to see the images as he guides the catheter up the Femoral Artery and into the Hepatic Artery. The liver has two main arteries. One of them, the Hepatic Artery, supplies blood to this type of tumor. Once the catheter is in the Hepatic Artery, the doctor will inject millions of tiny glass spheres filled with radioactive material. Those spheres will travel along the blood stream and attack the tumor from the inside. There will be minimal (if any) damage done to the healthy tissue near the tumor. The half-life of this material is approximately 64 hours. This means that after 64 hours only half of the original amount of material will be left in his system. After 4 half lives of this material (256 hours or 10.5 days) the radiation levels will be undetectable (basically out of his system).

The Side Affects:
Each of these treatments will be done outpatient. For the radiation and Therasphere, Dave will go in to the hospital for a few hours and then come home and likely go right to bed. There are side affects to these treatments but right now it seems the biggest one is fatigue. He will be very tired. With the Nexavar he may get a rash and his feet may swell up. Fortunately, increased nausea, pain, and discomfort are not likely.

Friday, June 5, 2009

"An apple a day keeps the doctor away."

If only it were that easy. Actually Dave is very blessed to have scheduled appointments with some VERY good doctors.

We don’t know anything new just yet. We anticipate a lot of new information and progress over the next few days. Dave has an appointment today at 4 pm with Dr. Wallentine, who is an Oncologist at Utah Valley Regional Medical Center. I believe is the best that they have. Dave also has an appointment on Monday with Dr. Watson who does “Liver Treatment” in relation to cancer and diseases. I am not sure what that means, but I will find out. Prior to that appointment Dave will have a biopsy done to find out what is going on with the swollen lymph nodes. Tuesday they have an appointment with Dr. Ott who is a surgeon. He should tell us what specifically needs to happen for Dave to have surgery. We are hoping that these doctors will get him started on some sort of treatment plan right away. Please help us by praying for this. Please also know that you are all in our prayers of gratitude for the many loving friends and family members that Dave is blessed to know.

Dave had a rough day yesterday. He had a high fever, was nauseated, exhausted, and had difficulty eating. (This is different from earlier this week when he was feeling alert and comfortable. His wife Kaylene, and daughters Amber and Julia, are taking really good care of him. He is in good hands. Dave says he feels much better today and has much more energy.

After speaking with some close friends this morning, his spirits are higher. Dave spoke with Ellen Matthiais Porter who was in the Young Ambassador’s with him at BYU many years ago. He also spoke with Mike Westfall who is a former mission companion in the Germany, Central mission which is in Dusseldorff. Dave expressed to me that his spirits were really low this morning but after speaking with those good friends, he feels a great deal better. Dave really appreciates all of the comments and phone calls. They have helped keep him hopeful.

Wednesday, June 3, 2009

Larry King and Seagulls

When I started typing this, we were patiently awaiting a phone call from the Utah Valley Region Medical Center’s Tumor Board. We just received a call from them. They met today but did not discuss Dave’s case. Evidently his surgeon thought the oncologist would be taking the records to the board, and the oncologist thought the surgeon was taking care of that. It fell through the cracks. Since the Huntsman Board already looked through his case, we aren’t as concerned as we may have been otherwise. At any rate, we don’t have any more news than that. So,I thought I would share some of the positive experiences that our family has had during this trial.

Dave is long-time friends with Shawn Engemann King. Shawn is married to Larry King. Shawn’s dad called her and talked to her about Dave’s illness. Shawn was so upset, as are many of our family and friends, and she called Dave. Shawn and Larry were at Wrigley Field in Chicago for the Dodger’s/Cub’s game. Shawn called right before Larry was to sing during the seventh inning stretch. She told Dave that they were praying for him and that Larry was going to dedicate the song (for the seventh inning stretch) to Dave. As Larry got to the end of his song and was about to dedicate the song to Dave, the cameras switched to center field where a flock of seagulls had landed right in the middle of the game. They landed for just a moment and then took off in one entire flock. Dave and his oldest son Matt were watching this game. Just as the seagulls flew in, Matt said, “That’s the sign of a Utah miracle.”

For those of you who may not know, the pioneers who crossed the plains and settled in Utah experienced miracle with seagulls. This is the story according to
“The seagull is Utah's state bird. This is because of a miracle that occurred in 1848. That spring the crops were invaded by crickets.
After numerous prayers and pleadings to God, the sky was darkened by thousands of seagulls. They came, they ate the crickets, they vomited them up, then they gobbled up more, and the crops were saved. The birds' intention was to kill crickets rather than to feed them selves.
The Seagull Monument in Salt Lake City is an ever lasing reminder of these days of darkness and light.”
Dave notes that, “The interesting thing about this is that there is no food for the seagulls in the middle of the field. They didn’t land to eat, they just landed and then rose up in the sky.”
Our family looks at this as a reminder that God can perform great miracles. But we must remember the scripture in Ether 12:12. “For if there be no faith among the children of men God can do no miracle among them; wherefore, he showed not himself until after their faith.”
Thank you for your faith and prayers. It has helped us to continue to have faith.

Tuesday, June 2, 2009

Cain and Abel

One of Dave’s doctors or nurses has referred to Dave’s liver as Cain versus Abel. One side of his liver is healthy and strong and the other side has this ugly tumor that is trying so hard to kill off the other side. And the battle continues.

The Huntsman Cancer Institute has a Tumor Board that meets every Tuesday. (An explanation of the Tumor Board is given on the posting Dave’s Story.) Dr. Sorenson from the Tumor Board called today with the results. Keep in mind, there will be bad news, but there will also be good news. Our family is clinging to the good news! It keeps us fighting and keeps Dave strong!

First, Dave’s insurance doesn’t cover the Huntsman Cancer Institute and so he will not be receiving treatment from them but they did meet to discuss his case. They are not suggesting surgery at this point. (For anyone unaware, we have been fasting and praying for surgery. That would have been the best option.) He can’t have surgery because the tumor is so big. If they remove the tumor, his liver might not sustain his body. The national standard for liver transplants states that the tumor must be less than 8 cm. Dave’s is 12 cm on one side. They can not remove the tumor or do a liver transplant at this point.

Since Dave will not be receiving treatment from (HCI), Dr. Sorenson has referred Dave to some doctors in Salt Lake City that we have already heard great things about. Dr. Watson is an Oncologist who specializes in “Liver Directed Therapy”. At this point I am not entirely sure what that means. (As we understand it, they will be trying to strengthen the healthy side of his liver and attempt to shrink the tumor on the right side. When I find out what exactly that is, I will put more information.) Dr. Mark Ott is a surgeon who we have heard wonderful things about.

Dr. Sorenson(from Huntsman) sent Dave’s medical records to both Dr. Ott and Dr. Watson and requested that they call Kaylene within the hour to set up an appointment with Dave. Both called quickly and Dave has an appointment with Dr. Watson(the Oncologist) on Monday afternoon and one with Dr. Ott(the Surgeon) on Tuesday afternoon. Both appointments are next week. Dr. Ott has already reviewed his records and wants a biopsy done on the lymph nodes. (As it turns out he has two that are swollen.) Dave will go in for a biopsy on Monday morning.

Monday- Biopsy on the lymph nodes and appointment with Dr. Watson(Oncologist)
Tuesday- Appointment with Dr. Ott(Surgeon)

Also: There is a Tumor Board that will meet tomorrow (Wednesday) at Utah Valley Regional Medical Center (where Dave was last week). Dave will also get an appointment with his Oncologist from that Tumor Board. His name is Dr. Wallentine.

The Good News:
1. There is something to be said about not getting into the Huntsman Cancer Institute. Since they are a research facility, they don’t allow their patients to have any outside treatment options because they need to have controlled situations for their research. Since we won’t be taking Dave there, he has a lot of treatment options to look at.
2. The tumor is growing very fast. Since the cells are dividing so quickly, they are not very strong and should be easy to kill. We are hoping that the liver therapy will kill enough cells and that they will be able to shrink the tumor enough to operate. I have to think that is the reason that Dr. Sorenson said they were not going to recommend surgery and yet he still referred us to a surgeon.
Keep praying and sending him your love. He’s a fighter and we will fight our way through this. Thanks again for the love and support.

Monday, June 1, 2009

Dave's Story

This contains details about how Dave found out about his cancer. If you have any questions about anything in here, please message Kelly Palfreyman(Dave's daughter-in-law) on facebook. We will continue to post updates as we get them! Thanks for your love and support!

Before the Hospital

Dave has been sick for a few months. He has had respiratory problems (including pneumonia last year) and stomach problems (including vomiting). For a few weeks prior to being admitted to the hospital, Dave’s vomiting had gotten worse but was not in any kind of pain.

Dave had gone in to see his dermatologist, Dr. Jensen, about a lesion on his arm on Wednesday May 20. Dr. Jensen noticed that Dave had lost a significant amount of weight and wasn’t looking healthy so they started talking about it. (On a side note, Dr. Jensen is a long time personal friend who used to work in the ER.) So Dr. Jensen started making calls to get Dave in to have an ultrasound that afternoon.

They called Thursday with the results from the ultrasound. They showed that his gallbladder was not functioning properly and there was a mass the size of a baseball on the right lower lobe of his liver. That same day, Dave went in with Dr. Jensen to have his lungs x-rayed to see if the tumor had spread to his lungs.

Dave went in for a CT scan on Friday which confirmed the mass on the liver and that his gallbladder was not functioning. Then he scheduled a liver biopsy for Tuesday morning (due to Monday being Memorial Day). At this point Dave was still not feeling any pain just discomfort and nausea. Dr. Jensen had given Dave medication to help with the discomfort and to help him sleep.

By Sunday Dave was in a lot of pain (in the ribs next to his liver) and experienced severe vomiting. Dave also had a high fever so he was taken into the ER that night at 8 pm.

At Utah Valley Regional Medical Center (Sunday May 24-Monday June 1)

Dave’s wife Kaylene took him to the emergency room on Sunday night at 8 pm. They started I.V. fluids and gave him Dilloted for the pain. When the doctor came in he felt around Dave’s abdomen to find the location of the pain. For some reason Dave was feeling more pain in the lower part of his abdomen. As a result, the ER doctor was concerned about Dave’s appendix bursting. Another CT scan showed that Dave’s appendix had not burst and we were back to square one.

On Monday, Dave had a Hyda -test done on his gallbladder. This is a test where they inject the gallbladder with a dye and watch what the gallbladder does with it. This shows them how high the gallbladder is functioning. They continued to give him medication for pain and nausea. The liver biopsy was still scheduled for Tuesday when the doctors were back in town.

Typically when patients are in the hospital for an extended period of time, they are given blood thinners since they lay in bed all day. However, the liver is an organ that bleeds a lot. So doing a biopsy after he’d had blood thinners was not an option. The biopsy was postponed until Wednesday morning. (As a side note, his nurse was in tears and very apologetic.)
Wednesday morning, Dave had the biopsy done. The results general take 1-3 days to come back. Dave’s took two days. Wednesday at 4 pm, Dave’s doctor started him on antibiotics. Over the next few days his fever went down and his strength started to return.

The results came back on Friday. Dave had been prepped for surgery before the results came back. At that point the best option was to remove the gallbladder and the tumor. The right lower lobe of the liver could be taken out because that part of the liver will regenerate itself. The results came back that the tumor was cancerous and a better look at the tumor showed that it was actually the size of a softball. The doctors were concerned that the mass might be too big for them to take it out. If they take out too much of his liver it won’t be able to sustain his body. At this point on Friday the doctors explained the options were to operate and take out the mass (if they can without killing him) or to do a full liver transplant. They came in Friday evening and said that a transplant would no longer be an option. The national standard for a transplant includes a qualifier. The tumor on the liver can’t be larger than 8 cm. Dave’s tumor is 12 cm on one side. On another note, Dave has a swollen lymph node in or around the portal vein (the vein that leads to his liver). The doctors aren’t sure why it is swollen but they say it is most likely cancer. We aren’t sure what that means for Dave just yet, but that is a low priority compared to the tumor.

Dave stayed at the hospital until he could tolerate and keep his food down and his oxygen level went back up to the mid 90’s. They transitioned him onto oral antibiotics and oral pain medication. Dave came home this afternoon Monday June 1.

Options for Dave as of Monday June 1

At this point Dave has a few options. The best option is for him to have surgery. However, at this time he is not eligible for surgery because of the size of his tumor. There are medications that can shrink the tumor or freeze it so it won’t grow. If they can shrink it enough, they could take the tumor out. Or, if they can shrink it down to 8 cm then he would be eligible for a transplant. Shrinking the tumor to 8 cm is not impossible, but not likely. However, every person’s body is different.

The Huntsman Cancer Institute at the University of Utah has a Tumor Board that meets every Tuesday morning at 12:30. The Tumor Board is composed of a number of expert Oncologists and Cancer Surgeons who spend time looking through rare cases and try to come up with treatment options. Thanks to some of Dave’s close friends, the Tumor Board has agreed to review Dave’s medical records. Kaylene and Matt (Dave’s son) will be taking Dave’s medical records up first thing tomorrow morning and the board will meet at 12:30.

Dave has a rare form of liver cancer. Generally liver cancer is secondary which means that it starts somewhere else and spreads to the liver. Dave’s liver cancer is primary which means that it started in his liver. Fortunately it doesn’t seem to have spread. His organs (except the gallbladder) are fully functional. The doctors are surprised that the rest of Dave’s liver is also functioning at full capacity given the size of his tumor. They are also surprised that he has this kind of cancer at all. Generally this kind of cancer is found in third world countries in drug abusers, alcoholics, and people infected with hepatitis. They have no idea why he has it or where it came from. For those of you who live out of state or may be otherwise unaware, the University of Utah Huntsman Cancer Institute is a research school and is dedicated to making life saving discoveries. While they don’t know much about this type of cancer, we are confident that getting Dave in at the Huntsman Cancer Institute will be his best option. We are very interested to see what they do with the information.

If you have any questions please message Kelly Palfreyman on facebook. Also, Dave has a facebook group "Friends and Family for Dave Palfreyman". If you are not a member of that group and would like to be, please search and join or message Kelly Palfreyman and she will invite you.

Dave wants to express his thanks to the many friends and visitors who have helped out in any way, and he is happy to report that his spirits are high, most in part because of the great love and many prayers of you, his close friends and our incredible family.

Thanks for your continued prayers and support. We need our Utah miracle, and we can’t do it without all of you.