July 16, 2010

Ricky Update:

Written by Dr. Jeffrey G. Rogers


Ricky was diagnosed on Thursday July 8th with a brain tumor. He was fortunate to get right in to one of the top neurosurgeons in the State that very weekend. Surgery was performed by Dr. Mark V. Reichman on Saturday July 10th. Ricky is very strong and although he couldn't walk the first day by Monday morning he was walking on his own and taking the stairs. Dr Reichman feels that even though this is obviously a very serious diagnosis we have great reason to be realistically optimistic about the future. The pathology returned the next week which suggests now a course of chemotherapy and radiation but we are still at this moment unsure of the details and the time course.

Ricky has a meeting on Monday the 19th with the Oncologist from SLC at which time they will outline the plan for the next several weeks. Rick is strongly desirous to be able to finish his last didactic session at Touro University despite his treatment schedule. The usual protocol is to allow time for patients to heal from the surgery before further treatment. This will hopefully allow Ricky to get through much of this last session before the treatments begin.

Touro University Graduation

Sunday Nov 6, 2011 was a huge day for Ricky, Erika and their little family. After 2 and 1/2 years and an extreme amount of effort Ricky has completed all classwork, passed all tests and requirements and was presented for his Masters in Physcian Assistant studies by the faculity at Touro Univeristy. Ricky was honored with a special award before the official excercises in front of his classmates with the first "Richard C Tebbs" award which will now be awarded by Touro each year to a student who shows outstanding grit and determination as Ricky has done. He recieved a special placque for this and great recognition by his classmates.

Moving on to the actual Commencement ceremony Ricky was one of just 4 classmates out of his entire class of 53 to recieve election to the Pi Alpha Honor Society for outstanding scholarship and recogniton in the PA School national arena. This was a surprise to Rick but not to us and we are so proud that he recieved this award in the Commencement program.

The most touching moment came when his name was announced and he walked across the stage and recieved his Diploma. Dr. Padgett gave him a hug instead of the usual handshake and his entire class gave him a standing ovation. Most in the audience also rose to their feet which told me his classmates had told his story to their families. All of us there were very touched and there were many wet eyes in that room. Ricky had many family members and friends there and it was just a very tender moment. After the ceremonies his family gathered round for pictures including his three little ones. Erika and the kids were so proud of their Dad and it was great to see their happiness. Hallee in particular was so glad to see her Dad "get done with PA School".

I would like to comment on how far Rick has come and how hard he has worked. PA school is not easy for anyone and his classmates in their talks mentioned the difficulties, stress, commitment, and struggle they had to get through this rigorous program. (The class President even mentioned Rick as her idol as she struggled to get through PA School and watched him achieve it as well.) For Ricky to do it with the family issues, his cancer, two surgeries, chemotherapy and all that he has been through is beyond remarkable. I would have to say it is and was a heroic effort in the face of extreme adversity. I have watched him study in our little extra bedroom night after night when everyone else was relaxing, going to movies, etc. and his family had all gone to bed. He has written and rewritten his required history and physical write-ups, sometimes many times to get them up to par. He has read, and studied, and struggled, and practiced, and just put his whole heart and soul into these studies. I have also seen a transformation as he now has gained the knowledge that a Masters in PA studies needs to be able to go out and serve in the medical arena. He has earned it and having worked with him during this process I can truely say he is ready and prepared to serve in this chosen profession. I have been so impressed with Rick and his desires and his efforts. I have also observed that he has a great love for medicine and I believe he will serve well in the field.

He has just one more step to take which he has been working extremely hard to prepare for. He takes his PA Boards exam on Nov 15. When he passes that, which he will, he will then be eligble for complete licensure as a PA. Then comes the fun part.......finding a job and earning some bucks. He and Erika are both looking forward to that. After all these years of school he is prepared and ready to join the work force. What a wonderful story this all is. This closes another chapter in the book of Rick's life and we now look forward to see what life holds for the Tebbs family as the next chapter begins. Rick we are all so pleased for you and so proud of you. Congratulations!!!!!!!

Ricky Finishes Chemo !!!!!!

It has been a long winter for Ricky, Erika and the kids. Now after 12 full treatments of chemotherapy Dr Haslem has called it good. The protocol was to treat for 12 full months and then follow closely. So far the CT scans show no recurrance of disease. With this tumor you can never say it is fully cured so you just go on with life. We are so proud of Ricky as he has been able to finish 2 months of Family Practice, 1 Month of Ob-Gyn, 2 months of Internal Medicine, 1 month of Surgery, one month of ER and 1 month of Pediatrics all while taking his chemo during one full week of each month. He has been very sick at times, and each month loses weight durning the chemo week yet he keeps on plugging away. He is currently taking a Psychology rotation followed by a Community Health month. After that it is a couple of electives and he is done in October! The end is in site. We are all so pleased to be at this point. It is really quite an accomplishment to be able to stay in school and take chemotherapy every 28 days.

The family is all so proud of Ricky. He has shown great courage and persistant determination to be able to stay in school while continuing his chemo. All of us that have been close, have been able to watch and relate, and yet have not been able to help him much. We are just so happy for this milestone now to be passed. It is going to be wonderful to see Rick enjoy life and not have a terrible week each month. It really has been an ordeal yet I have never really heard a complaint. Ricky you are the man.

One more "Little Note". In reviewing all of this it turns out I never reported on Ricky's surgery. A few months ago Rick noticed some upper abdomnal pain which was hard to explain with just the chemo. A long story made short, we sent him to the good Dr Wintch who removed his gall bladder complete with stones. Dr Wintch did that in between his chemo schedule so he would have maximum protection and healing time. It was a tough surgery but Rick came home quickly and healed very well. He is now back doing all his normal activities. What a story this all is. Any good screen writers out there? This would make for a powerful movie.

Rick it is the movie and story of your life. We know you are looking to finishing your rotations in October and then taking and passing your Boards. It is upward and onward from there. We are grateful to you for the fine example you are to all of us. We all wish you luck and blessings over the next few weeks and months.

Chemo and PA School

Well I have been told it is time for a little update on Ricky's Blog. As you have already heard, the game plan is to take chemotherapy for one year. Ricky took his first dose of medicine on August 19th and then every night for a total of 5 nights  This date was chosen because it was just inside the 6 week mark since his surgery yet it allows him to take only two treatments while he finishes his last section of classwork. His third round will start just after the end of his quarter exams. He has to take the medicine every 28 days. He takes it for 5 days and then has 23 days off. It is an oral mediciation that he takes but it is still chemotherapy with all of the side effects.

His first dose was Aug 19 (Thursday) which allowed him to take most of the doses over the weekend. He still had to take the last dose on Monday and each night he took it the side effects were worse. By Tuesday morning he was very sick yet he continued his program at Touro University. The week of Aug 23 -Aug 27 was a very rough week at Touro including 4 tests. Ricky was able to take all 4 tests and pass 3 of them. The 4th one he did well enough to pass the course. He said he was a little embarrassed because he sat in the back of the room to take the tests with a trash can next to his desk. Each time he would puke it was a little disruptive to the rest of his classmates......but hey what is a guy suppose to do? If you are on chemo and nauseated and need to upchuck what's a little test or two. Especially if you are in your last section of classwork and passing it means you move on. Fortunately one of the teachers had a little compassion and allowed Ricky to finish the test in her office where he could make a little noise in private.

He starts his next series of chemo this Thursday the 16th of Sept and again he will take it for 5 nights. He met with Dr Haslem and they have increased the dose another 25% to bring him into the most effective range. He had a MRI on Aug 20 and again everything is looking real good. Dr Reichman is letting him get back to some exercise and his fitness routine for which Rick is grateful. He feels tired all the time from the chemo but he feels good.

Ricky is bound and determined to finish this last five weeks of classwork and move on to his rotations with clinical instructors starting in November. Rick we are so proud of you. We had a FHE a while back in which we were talking about role models and heros in our lives. Each family member had the opportunity to mention someone they felt was a real hero in their live. When it was Mitzie's turn she quietly yet with significant emotion said that Rick was her hero...............I agree completely.

Jeff

Chemotherapy it is

After discussing all possible treatment regiments and protocols with Dr Ray Richards it looks like the best option for this tumor would be chemotherapy. Ray has worked very hard on this and was even able to talk with Dr Jackle at the Mayo Clinic who wrote the current protocol for Oligodendromas in the United States. He indicated that chemo only is "done all the time" in their clinic because it works so well on these types of tumors and because they can spare the patient the long term side effects of radiation therapy. They still can hold radiation therapy in reserve if it is needed.

Ricky now has an appointment Monday the 9th in the morning to meet with Dr Haslem. He has accepted Ricky as a patient and is ready to help him with the chemo side of this process. He and Ray have discussed everything and Dr Haslem is ready to begin the treatments that will help Ricky with this next step. The chemotherapy is given 5 days out of every 28 days and would probably be given for one year. It is still a hard regiment but patients under age 40 usually do well with this type of treatment. It is still chemo with all of the side effects of nausea, vomiting, fatigue, body aches, etc. but Ricky says he is up for the challenge. He is going to try to stay in school and work through it. What a great attitude. We just don't know when exactly he will start it. We'll keep everyone posted.

Jeff

Ricky back in school July 20 2010

Good News!

Today July 26 we finally received the results of the test Ricky has been waiting for. It is complicated but the short version is that the tissue shows a gene deletion at the p1 and q19 sites. When these types of tumors show this deletion it is a good prognostic factor. In other words this is the good type of tumor to have if you have a brain tumor. Doctors know that this type of tumor is much more sensitive to chemo and radiation and many studies show a much better clinical course for people with this marker.

We are very pleased about this. In the big studies many patients lived for "extra years" when they had this type of tumor marker. Ricky has an appointment now with Dr Ray Richards on Friday to see what the next step is. There is still a lot to understand and decisions to be made about how to treat this tumor. Much thought, study, prayer and listening to the doctors will go into this next step. Dr Richards will be able to answer some of our big questions and help with the next step. We are lucky to have him as he has now accepted Ricky as a patient.

It is a big important day. This is huge!!!! For Ricky's sake this test today is very encouraging and very needed. He needed a break in all of this. His prognosis has just taken a big step in the right direction. We are all so grateful. I will post a report after our big meeting with Dr Richards on Friday.

Jeff