Charlie and I just returned from Costa Rica on Monday morning.   We spent 2 glorious weeks there.   The weather couldn't be beat.   Our friends Robert and Bryan joined us for a week and it was non-stop laughter from the moment they arrived until we saw them off.

We tried to see as many friends in CR as possible.   We had some wonderful dinners out, a day out of painting with the local CR Artist Group and Charlie and I even hosted a piano concert consisting of Chopin, Debussy and Mozart for just over 30 people at our home.   I began 3 new paintings in CR which I plan on finishing in St Louis when the time allows.

Our very last night in Costa Rica, this past Saturday started very uneventful and ended up with me being seen in a clinic about 11:30p.   I had some very severe symptoms.   As it turned out, even with all my symptoms, my heart and lungs were normal as was the EKG.   Knowing that I had a CT scan scheduled in St Louis on Tuesday morning, we were satisfied to wait for further testing when I returned home.

Sunday morning we left CR and I was feeling just fine, as nothing had happened.   We had to overnight in Charlotte, NC on Sunday night.   While in the lobby of the hotel, my symptoms reoccurred and I stayed bedridden until all pain and fever passed and I knew I was better.   My thoughts at the time was that my heart was throwing more fluid into my lungs causing an inflammation (Pleurisy), so I took my regimen of pain killers and fell asleep, waking up Monday morning feeling once again as if nothing had happened.

Tuesday morning my CT scan took place in St Louis from 8:15a to 8:20a.   I had blood work scheduled for 10:00a, so we went for breakfast.   During breakfast I received a call that radiology read my scans and that I was to return to the hospital immediately.   The scans showed serious changes and I needed to be admitted into cardiac/thoracic intensive care ASAP.   I had a procedure in which they put a tube down my throat and did a trans-esophageal echo.   They looked at my heart.   It turns out I have a new lesion within the pericardial sac about the size of a softball.   This is almost completely blocking the right Atrium.   This was not there in November and it is in a place that "of course" is non-operational.   I left the hospital Wednesday morning.   My oncologist worked all day to get me into the Mayo Clinical Study with Avastin which is currently taking place at Northwestern University in Downtown Chicago.   By 4:30p on Wednesday we knew we had an appointment at 7:30a on Thursday.   We packed and left St Louis at 5:30p.   Charlie drove the entire way as I was too tired, weak and short of breath from the procedures the day before.   We arrived Wednesday night at 11:15p.   Given my heart, we all felt it was unsafe to fly to Chicago.

I woke up this morning feeling much better, and my appointment went very well.   The doctor here, Dr Andrew Evens was very encouraged.   He feels in spite of all the troubles I've had, my heart sounds completely normal as do my lungs.   We did blood work and chest x-rays.   We will return to Chicago for a PET scan and Heart MRI on Tuesday morning, and hopefully begin Avastin on Thursday.   Avastin is a new anti-angiogenesis drug which concentrates on the blood vessels and on fast growing tumors.   It is a vascular endothelial growth inhibitor.   Cancer feeds on new blood vessel growth and this will inhibit the growth.   My cancer, Angiosarcoma, is a cancer of the blood vessels.   This should be a perfect match.   Avastin is much less toxic than chemo therapy and I should have little side effects.

I am feeling perfectly fine now.   We will drive back to St Louis tomorrow afternoon.   I am excited about this new study and I feel that I will do very well.   The infusion is every 21 days.   After two treatments, we will repeat CT Scans and see how effective the medication is.   As our dear friend Sandy Mountford has told me repeatedly, this is part of the process.   I accept that and am ready to begin a new stage and a new chapter.   I will continue to have some aches and pains and will continue to grow stronger into a cancer-free individual.   As I have learned from your letters, many of you are cancer survivors.   I plan to join you soon.

My best to all,

Randy