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Sent: Friday, February 27, 2004 5:00 AM
Subject: [friends_of_melanie] Letter from Mr Mudan!!

Hello again,

I didn't think I would send out a note so soon.....but when the post
came this morning, I was super surprised to see a letter from Mr
Mudan himself!  I literally broke down (in a good way) as I am just
so thrilled to have him as my main surgeon.  He is the bomb!!  I am
not sure he would appreciate/understand that term, but so be it.  So,
I thought I would just type in his letter. 

Here it is:

Dear Ms Woiwode

It was a pleasure to meet you and your aunts at my Surgical Oncology
Clinic of 6th February 2004.  Thank you for letting me know that you
have written a note of thanks to Ms Jahangiri.  (She is the cardiac
surgeon).  It was wonderful to have her there at the operation and
certainly we could not have achieved what we did without the help of
her and her team.

The key points from today were that the inferior resection margin
shows that at the microscopic level the resection is very close. 
This begs the question of whether there may still be some tumour
cells on the other side of where we divided the inferior vena cava,
that is in the vena cava that still remains in your pelvis.

I would hope that this is unlikely, but nonetheless it is possible. 
I think two options could be deployed.  We could either wait and see
if there are any changes on CT suggesting that there was tumour re-
growth at the lower end of the graft and then take some action to
remove that part of the remaining inferior cava.  However, this
commits us to a policy of regular surveillance and will induce a
degree of anxiety in your mind and mine.  Moreover, in the event that
you wish to travel or reside in another country it would mean setting
up an elaborate programme of surveillance with appropriate surgeons
who may or may not be willing to comply with taking over your care.

I understand from Professor Thompson that the problem with the
inferior vena cava graft which he so skillfully placed, will
eventually thrombose as is the way with these grafts. 

On balance, my feeling would be that we allow some time to pass for
you to recover from the operation and for the tissues inside the
abdomen to heal and settle.  This will also allow us some time for
collateral circulation to build.  Then I propose elective resection
of the remaining inferior vena cava.  This may require some fancy
vascular grafting, but I am sure that this is well within the
abilities of the vascular surgeons and do not anticipate that they
will have any problems in complying.

I will talk with Professor Thompson as to what sort of time he would
like to leave for further collateral circulation to become
established, but I would have thought that we should re-operate
towards the end of 2004.

In any event, I would like to see you again with some further imaging
in April.

Yours sincerely,

******************************************************************

So, there you have it! 

On a side note, I swam yesterday (2200 meters) and today (2000
meters) and am thinking Donner Lake anyone??  HA!  Just a joke for
the swimmers on this list.  Yesterday, I did swim in an outdoor pool.
It was awesome to see the steam rising from the pool....it was
probably about 38-40 degrees outside. 

Well, better get cracking as I am at work.

Ciao,
Melanie

Date: 09 Dec 2003 17:45 MST

The operation was a total success. 

And it took less time than originally anticipated since they did not have to auto-transplant

 the kidneys nor the liver.  What they did to is break her sternum so that they could clamp the

vena cave further up.  But they did cut out the entire tumor and replaced the affected part of the

vena cava with an artificial one. 

Melanie is in ICU recovering.  Her sisters and brother were/are there
and even spoke with her briefly.  Her color looks good and she is expected to make a full recovery. 

She will be in the hospital for about 1-2 weeks and then home to her apartment in London to continue the healing.  Tom will stay with her until the end of the month.

Thanks so much for your concern and love. You are so very much appreciated! 

And thanks for continuing to keep Mel in your hearts and thoughts during her recovery.

With love and thanksgiving,
Gus & Cam
 

Date: 25 Nov 2003 10:15 MST

Melanie's Surgery has been scheduled for December 9

Date: 24 Nov 2003 7:01 MST

For all of you who do not know

Hermann Buffel in Reifenberg, Deutschland passed away Friday night November 21, 2003. 

More info will be forthcoming

Lieber Gustel,

wir haben deine traurige Nachricht erhalten, es ist ja furchtbar, dass Melanie diese schreckliche Krankheit hat. Sie hat keine Eltern, die ihr in dieser schweren Zeit beistehen. Wir hoffen und beten, dass die Chemotherapie anschlägt und sie erfolgreich operiert werden kann.

Die Bilder werden wir Daniel zukommen lassen. Wir haben uns letztes Jahr alle Familienbilder machen lassen, die werden wir ihm  schicken.

Nun auch noch eine traurige Nachricht von uns. In der Nacht von Freitag auf Samstag ist  Papa verstorben. Er hat vermutlich einen Hirnschlag erhalten. Mutti war bei ihm als er starb. Es hat uns alle unerwartet getroffen, da es ihm nach seiner Krankheit nun allmählich etwas besser ging.
Am Dienstag wird er beerdigt. Es war sein Wunsch, dass er vor Mutti stirbt und er hätte sich einen solchen Tod gewünscht, das tröstet uns ein wenig. Ich werde mich später noch mal bei dir melden.

Alles Liebe,
Ulrike

Date: 21 Nov 2003 22:01 MST

In other Family News: - The Fires of Southern California

San Diego Area:

Sabine and Jack's property near Julian, CA burnt but their house and their business were spared.  Their barn, storage facility, fencing, and trash area were all consumed by the flames but due to their business having been a staging area for the firefighters, they were able to save it and their home.  We are all very grateful that Hanni, Harry, Jack and Sabine plus pets escaped the inferno and were able to return to their home and business unscathed by the flames.

LA Area:

The fires in the LA area came within a mile of Bjorn and Gabi's house; however, they are safe as is their property.