Quite honestly, I don't even know where to start. I thought finding out on July 10 that Travis had a brain tumor was hard. I thought that going through surgery, radiation, and chemotherapy was hard. I thought that watching our list of options for treatment continue to dwindle was hard. I had no idea what hard truly entails.

The positive bump in Travis' symptoms lasted for roughly 12 days after his Avastin infusion on April 23. That was long enough that we felt doing another Avastin infusion was worth it. However, instead of traveling to Iowa City on May 7 (which was the original plan), we were able to get Travis' care transferred to the VA hospital here in Des Moines. I knew the time would come when it would no longer make sense for us to travel back and forth to Iowa City for care, so we scheduled Travis' third Avastin infusion at the VA on May 8. 

Travis had one decent day on Thursday (May 9) and then the wheels fell off the bus. On Friday morning, Travis awoke with a good deal of pain and discomfort. He was unable to tell me exactly where it hurt or how much it hurt, but by midafternoon it was clear from his body language that he was in need of assistance. I was supposed to leave on Friday afternoon for Emma's graduation weekend in Iowa City. Instead, I sent Izzy and Gretta to Iowa City without me, and Travis' dad and I took him to the ER at the VA hospital. 

After over five hours in the ER, suspicions of a bowel obstruction, an X-ray, and a CT scan, the VA gave Travis laxatives, told us he was constipated, and sent us home. We did have a bit of excitement upon returning home late on Friday night. Keith and I were helping Travis up the stairs when he decided halfway up to freeze. And by freeze, I mean he decided he was not going to move one more inch. Not forward, not backward, not anything. Travis has maintained his upper body strength and he knows how to use it. He had a death grip on the railing and there was nothing Keith and I could do. And believe me, we tried everything. Thanks to the four West Des Moines paramedics who were able to get Travis safely removed from the stairs. Another first for us. 

I left for Iowa City early Saturday morning determined to make Emma's graduation. Keith was on duty to take care of Travis. I found out just a few minutes before the 1:00 ceremony that Travis had been taken by ambulance back to the hospital, this time to downtown Methodist. As his pain and discomfort had continued to get worse on Saturday, Keith made the call to get Travis immediate medical attention. Good thing. Right after the graduation ceremony, the girls and I were able to have a conference call with Keith and the Methodist ER doctor. They ran more extensive tests than the VA had the night before. It was determined that Travis had numerous blood clots in his lungs, stress on his heart, and he wasn't getting enough oxygen.

This whole journey has been a practice in making hard decisions. I often feel like every decision is a crappy one, and I'm just trying to choose the least crappiest. Stay home on Friday night and take care of Travis? I feel crappy because I'm not with Emma for one of life's biggest milestones. Leave Saturday and attend graduation? I feel crappy because I'm not with Travis. After the graduation ceremony, I told the ER doctor that I could be back in Des Moines in two hours. She told me that Travis was stable, he was in good care, and that I should stay in Iowa City and finish the weekend with Emma. I think she must be a mom. And I love her for giving me permission to make yet another difficult decision. I was ultimately able to get 24 hours in Iowa City with the girls celebrating Emma.

Travis was officially admitted to Methodist on Saturday night and is currently still there. He's been on a blood thinner to help dissolve the clots in his lungs. He had an echocardiogram to determine what condition his heart is in. Although he has an enlarged right ventricle, the cardiologist believes that will resolve itself as his lungs improve. And he is now on oxygen. The good news, and most important thing, is that Travis is pain free and back to eating and resting comfortably.

Needless to say, the success of this round of Avastin did not meet up to our expectations. Although not everything can be blamed on the Avastin, since Travis' infusion on Wednesday, we've had two ER trips, two 911 calls, and one hospital admittance. The writing is on the wall. We will not be doing another Avastin infusion.

Travis will be going home tomorrow morning and Hospice will be taking over his care. The girls and I have talked about how to best go about this next phase. We plan to keep him at home for now. That may change in the future, but for the time being, it's what we are most comfortable with. He will continue on the blood thinner and oxygen as comfort providing measures. Being on the blood thinner is a risk. Tumors can bleed and the last thing we want is bleeding in Travis' brain. But it's blood thinners or blood clots. The lesser of two evils. 

Izzy went back to NYC on Sunday morning. Another hard decision. She had been here for a whole week. Based on what the doctors have told us, we felt it was best for her to head back, knowing she may need to return home at any time. I know we'll still have lots of hard decisions in the future. And those decisions may make today's decisions look easy. The only thing I know for sure is that we, especially Travis, are loved by our family and friends. 

Fun Fact 1: Travis and I have strong girls. Like crazy strong. Emma walked the stage at Carver Hawkeye Arena on Saturday amidst uncertainty and chaos. She finished her senior year with a Bachelor of Arts in Communications and a Bachelor of Science in Psychology. She had back to back 4.0 semesters. She has landed a job at Beacon Hill Staffing Group here in West Des Moines where she'll do recruiting for tech companies starting in July. Izzy has maintained living and working in NYC balanced with frequent FaceTimes and trips home as much as possible. Gretta celebrated her 20th birthday on April 30. She finished up her sophomore year at Iowa, packed, and moved herself home for the summer. She'll be interning at Berkshire Hathaway Energy in Des Moines.

Fun Fact 2: We have a good friend, Cyndi, who is here at Methodist as well. As in, right next door. Cyndi is recovering from back surgery. After arriving at the hospital on Sunday and seeing her car in the parking lot, I texted Cyndi to find out her room location. I received her response, promptly walked around the corner, and found her in the next room. She and Travis share a wall. Their heads are about four feet apart. And I did get Cyndi's permission to post this. ;)

Love,
Brooke, Travis, Izzy, Emma, and Gretta