This letter was written and sent to Joel & Sue but explains how this came about to all.

After talking to LueAnn last night I realized that I had not talked to you two yet. You have always been a great support to us, but you know that. We love you and appreciate your friendship and support.

A little history. It had to have been on or just after my birthday that I started having pain in my left foot. It was similar to a bruised heel but there was no corresponding injury event. Knowing me I thought it not unusual that I could have done something that would result in hurting myself. Over the next couple of days it got to the point where it really hurt and I was limping on the leg. Then just before my knee scope procedure on the 19th the pain lessened and it began acting the same way in the right foot. After the knee surgery my O2 level would not stay up. Over a couple of hours it began to stay at or just above 90 on 3 liters so they decided that since Mountain View was full and Denise was a nurse that they would send us home on 02 and let us monitor the situation.

There was a bit of a communication breakdown here between Dr. Huntsman and the hospital; there were no follow up instructions in case the situation did not resolve. Two days later, Friday night, we didn't want to go the weekend without some resolution. I called the hospital back and was told they were pretty confident it would get better; this was quite common after surgery. Dr. Huntsman had left town and given call to another doctor unfamiliar with my case. I talked to one of my guys at work who is also an RT; the first thing out of his mouth was "it sounds like a PE". So without much improvement over the weekend I went to Dr. Mckinlay Monday morning. He did a chest X-ray that showed some consolidation in the upper left lobe. I didn't have a fever, no coughing or indications of an infection other than SOB. He gave me an antibiotic for pneumonia and I went on my merry way. The pain in my legs was now in both feet and occasionally in my calves.

I went to the podiatrist thinking maybe this is foot related. He "practiced" his medicine and diagnosed plantar fasciitis even though in retrospect the tests he did were not conclusive that that was really the problem. That brings us forward to last Tuesday the 16th of December. My feet are still killing me and now I have CHF like edema in both legs from the knee down. I got back to Mckinlay and asked to see what he thought was going on. He repeated my chest x-ray which looked the same as it had three weeks earlier. With misgivings he wanted a d-dimmer thinking it would perhaps not be usable due to the recent surgery. His nurse ordered an SOB panel that includes the d-dimmer. They were on the phone an hour later alarmed that the d-dimmer was not only elevated it was above 5000. Mckinlay sent me to the hospital for an ultrasound that showed large clot formation in both legs from the knee down. The clots were at the level of the popliteal biafrication but had not move higher. They guess that there is still blood moving aorund the clots hence the lack of DVT pain?? That finding resulted in a contrast chest CT that showed three small clots, 2 in the right and one in the left lung. It also showed lymph node enlargement around my heart and in my left axila. We're headed downhill fast now. We started the thinning process with warfarin and lovenox. I had an allergic reaction to either the contrast dye or the lovenox, we'll find out which on Monday.

I think that doctors (sorry Joel), just like the rest of us, get used to everyday routine stuff and consequently sometimes miss really serious symptoms. Yet we think it was rather amazing that this whole thing presented in this manner and we were able to get all the ducks moving in the same direction when it became clear this was not simple; not months later when the prognosis would have been much less promising??

The CT resulted in a biopsy late Wednesday of the lymph nodes in the arm and with the super efforts of Ann, Dr. McKinlay’s nurse we were able to get the pathology back Friday night. We were in the office when she finally got the fax. Dr. Mckinlay was on the road returning from a delivery in Idaho Falls (another story). We were in his office on the speaker phone. He told me this was the first time that he remembered his patient reading him the pathology report. So that's where we are. Monday morning I will be in the CT again for abdominal, head and bone scans; from there they are recommending that I go to Dr. Dickson in Rexburg. He is an oncologist who worked at Huntsman’s in SLC. He has done some miraculous things with patient’s in the area. Dr’s Mckinlay and Cardinal both recommended him independently. We have two cases here in our ward that are his with what we think are miracle endings. Maybe it’s the water?

We are thinking we caught this fairly early and the primary source appears to be the lungs. That is likely a result of occupational exposure. We have not gotten any real solid guesses yet as to the prognosis. We think, have seen and have been told that this is manageable, the extent of damage and course of treatment yet to be determined.

A couple of side notes relevant or not?? When I raise my left arm fully extend and rotate it there is a nerve or something that pulls from my wrist to my armpit. About a month before all this (October) I was in to Mckinlay for a sinus infection. I realized at the same time that I had lost my sense of taste and smell. I was thinking that was related to using Zicam on and off most of the summer??

Denise is scared. I am normal... just going through the process. I don't feel really aprehensive but a little emotional on occasion. I'm comfortablegetiing through what ever I am dealt. It's all part of the test.

One of our paramedics, Kim Getsinger, I don't if you remeber him Joel, he retired from Idaho Falls and now has come to work at Blackfoot; he told about a Dr. Rath from the Netherlands. He has, he believes, a nutritional answer to cancer, http://www.drrathresearch.org/. Joel I would live to have your opinion.

More as we find it out, Love you both,

Kurt