IRENE'S OBITUARY

Name:

Irene Hall Garn

Date:

January 19th, 1941 - July 2nd, 2013

Obituary:

Irene Hall Garn, 72. After battling cancer for 4 years Irene passed away peacefully at home on July 2, 2013, with her husband of 51 years by her side. Irene was born on January 19, 1941, in Tremonton, Utah. She is preceded in death by her parents, Harold and Vera Hall and brothers Byron (Hazel) and Roland. She is survived by her sister-in-law Norma Hall and her three sisters Jean Stevenson (Evan), Norma Coombs (Theo), and Nadine Woodhead (Robert). She is also survived by her husband Daryl Hodges Garn, her children: Brad Garn (Laura), Dana Garry (Steve), Gayla Peterson (Chuck), Greg Garn (Rebecca), Byron Garn (Michelle), and Kevin Garn (Tara) along with 30 grandchildren and 2 great-grandchildren who all live in the Phoenix area. More than anything else Irene loved being a wife, mother and homemaker. She devoted her life to serving her family and serving in The Church of Jesus Christ of Latter-day Saints in many capacities. She spent 5 years serving with her husband in Hong Kong and an additional year and a half as the Mesa Arizona Temple Matron. She enjoyed writing family histories, documenting them with photos and publishing them. She was a wonderful example to all who knew her. Visitation is Friday, July 5, 2013 from 6-8 PM at Bunker’s Garden Chapel, 33 N. Centennial Way, Mesa 85201. Funeral services will be Saturday, July 6, 2013, at 10 AM, preceded by a visitation at 9 AM at the LDS Stake Center, 5350 E. McLellan, Mesa 85205. In lieu of flowers please consider making a contribution to the general missionary fund of the Church of Jesus Christ of Latter-day Saints at http://www.ldsphilanthropies.org/missionary/.

Visitations:

6:00PM to 8:00PM on Friday, July 5th, 2013 at Bunker's Garden Chapel (map/driving directions)

9:00AM to 9:45AM on Saturday, July 6th, 2013 at LDS Alta Mesa Stake Center (map/driving directions)

Services:

10:00AM at LDS Alta Mesa Stake Center on Saturday, July 6th, 2013 (map/driving directions)

RELIEVED FROM HER SUFFERING

Last Thursday we had another significant setback, if we can really call it that.  We met with Dr. Kelly Tobias, a pain specialist.  We must have been her last patient because we were with her for an hour and a half. She determined that Irene was not healthy enough to proceed with the planned chemotherapy the next day.  For several days Irene has not been able to speak the words that she wants to speak.  Sometimes it is worse than others and has seemed to continually get a little harder for her to communicate.  Near the end of the appointment, kind of out of nowhere, Irene asked Dr. Tobias, "What is the time frame"  As I write this I am not sure those were her exact words, but I looked at her and was wondering what she was asking about.  Dr. Tobias turned to her and in a very kind and professional manner explained that it is often very difficult to discuss this issue, but that she thought Irene may have a month or two left.  It was a sweet moment and I think Irene understood what she was saying.  Dr. Tobias explained that she would consult with Dr. Homsi and she would have Hospice of the Valley contact us. 
 

By Saturday afternoon Irene was resting comfortably in a hospital bed placed at the foot of our bed.  All of our children, many of the grandchildren and dear friends have come to visit.  She was able to recognize everyone and communicate her love, but could not quite get all the words out that she would like to speak.  Even sipping ice water, which she loves, was getting difficult.  The pain meds had been changed to liquids rather than tablets and capsules because she had some difficulty in swallowing the pills. The hospice nurses suspected that her condition may go down rather quickly, but that did not seem to be the case to me.  We have had some sacred moments together when she wanted to talk about her dying.  Neither of us thought that would happen anytime soon. 
 

Sunday night Irene drifted into a coma and continued unresponsive until she quietly passed away this morning at 9:10 a.m.  Dana, Gayla and I spent the last twelve hours at her side.
 

Her funeral will be on Saturday, July 6, 2013 at 10:00 a.m. at the Mesa Alta Mesa Stake Center located at 5250 East McLellan, Mesa, AZ 85205.  A viewing will be held at the Bunker Family Memorial Chapel on Centennial Way in downtown Mesa on Friday, July 5, 2013 from 6:00 to 8:00 p.m. There will also be a viewing at the stake center on Saturday at 9:00 a.m. before the service.
 

 

We are eternally grateful for the love and concern expressed by so many dear friends.  We are at peace and know that she is "...encircled eternally in the arms of His love."

LEARNING TO TAKE ONE DAY AT A TIME

We are learning to take one day at a time and be ready to deal with the unexpected. Irene was released from the hospital May 25 after her hip surgery on May 23. She is not to put any weight on her right leg so is using a walker to go the short distances in the house and the wheelchair for the long distance moves. A portable shower chair provided by Karl Watkins is also helpful in rolling her into the shower. Getting in and out of the car is often difficult and painful for her. 

Memorial Day was celebrated with most of our family.  We visited the Mountain View Memorial Cemetery here in Mesa where my parents are buried. Irene and I have looked at grave sites for us at that cemetery and were able to consult with our children regarding the proper location within the cemetery. We just need to act now and secure a resting place for us. 

The home health care nurse and physical therapist came to assist us with the hip fracture recovery process. The radiation for her brain lesions was scheduled for May 30, but was cancelled after we arrived at the facility because one of the computers was not working properly. The procedure was rescheduled for June 3. 

The radiation for the brain tumors ended up being probably the most painful event Irene has experienced. Her head was placed in the mask and then bolted to the table so she could not move during the procedure. The procedure took much longer than was planned (estimated 45 minutes ended up being over two hours) and the pressure from the mask on her face was unbearable. She resolved that day not to do that again. Dr. Chamberlain was very apologetic about the time and pain, but felt the procedure was successful. 

          Irene being positioned on the table for the radiation therapy

 The face part of the mask being positioned to the back half of the mask

          The two halves of the mask bolted together and to the table

                    The final positioning

 

She was examined that day by Dr. Homsi’s nurse practitioner because of the swelling and painful leg. The nurse recommended she be hospitalized and begin IV antibiotic therapy. She was in the hospital from June 3 until June 7, and we continued the oral antibiotics at home. Dr. Homsi had the first infusion of a new chemo drug infused on June 5 while she was in the hospital. 

Ron and Marilyn Cook, dear friends in our ward, had offered the use of their cabin in the mountains to the Garn family for a few days. We had all planned to gather at the Cook’s cabin on June 5 and stay through June 9. Our family had a great time at the cabin without us. Thanks to Ron and Marilyn for their generosity. 

On June 12 she had a hip X-ray, and we met with Dr. DeComas who reported that the surgery looks good.  The bones are positioned properly and appear to be healing nicely.  Dr. DeComas wants Irene to only toe touch the floor with the right foot when using the walker until we see her again July 24.  Irene has so much other pain in that right leg that any pain from the hip surgery has not seemed to bother her much.

The second round of chemotherapy was June 13 with the follow up Nulasta shot to protect the heart the next day. This has been an extremely difficult last four weeks for Irene. She now has sarcoma skin metastases on her right leg, which was confirmed by a biopsy at the time of her hip surgery. We have been advised not to wrap her leg at night or wear the constriction stocking during the day, so her leg is severely swollen with the red raised lesions covering her leg. As a result any movement from the bed to the bathroom or the lounger just kills her. 

              Irene's swollen and painful right leg

     Her left leg looks great compared to the right one

 

The pain meds she takes are generally effective and we have recently added Lorazapam which causes her to want to sleep a lot and makes her a little groggy. She is scheduled to see a doctor who specializes in pain on June 27, and another chemotherapy session is scheduled for June 28. 

We had a consultation with Dr. Korn at the Envita Natural Medical Centers of American in Scottsdale on June 20. We received his recommended treatment plan with the associated costs yesterday and will be evaluating additional treatment with the natural therapy that he has recommended. He noted several times during the consultation that stage four sarcoma cancers are very difficult to treat. 

               Beautiful cake given to us by Verna Perkinson

 

We are so appreciative of dear family and friends who have been so supportive with visits, cards, calls and the wonderful meals they have provided. Irene is in good spirits and we are still hopeful.

Another Bump in the Road (Irene’s Fall)

The week of May 13 started off great with the end of school year presentations and concerts featuring our grandchildren that we were able to attend.  Other than needing to send her hearing aids away for refurbishing it was a looking like a great week. 

On Wednesday she went in for the simulation for the Stereotactic Radiosurgery which, “involves the delivery of a dose of X-ray treatment precisely focused on a target within the brain. The use of stereotactic methods allows delivery of a high target dose with significantly lower dose to the brain tissue in the immediately surrounding region.” 

A nurse is holding both the front and back parts of the mask

 

A two piece mask of her face and the back of her head was formed.  This will be used to attach her head to a table and will keep her head from moving at all during the procedure.  When the mask is completed it is hard plastic as seen in the photo.  A new more refined MRI with one millimeter images rather than the normal five millimeter space between in the images was taken to aid in the precise radiation treatment to destroy the tumors in her brain. 

On Thursday Irene attended the sealing of Zack Zaharis and Lauren Reynolds who are children of families we have known and loved since our move to Mesa.  She was not feeling great, but planned to attend the reception up until the last minute when she did not feel well enough to go.

A routine blood draw was scheduled for Friday morning at 9:00 a.m. at Banner MD Anderson.  Two hours later we received a call that she needed to come back in for two units of blood.  With new blood and IV nutrients, we left the infusion center at 6:00 p.m. that night, and she felt better than she has felt for several days.  We have learned that chemotherapy can present all kinds of issues. 

 

Saturday, May 18 we attended the baptism of our beautiful granddaughter, Nicole Garn, who is Kevin and Tara’s daughter. That evening was spent with most of our Garn Family. It was so nice to also have Tara’s dad and mom, Craig and Mary Lynne Wilson and her brother and his wife Travis and Teresa and their boys with us. Irene attended all the meetings on Sunday and we had dinner back at Kevin and Tara’s that evening. Craig Wilson likes to cook and is a chef (dentist/periodontist) extraordinaire.
 

                                                            Irene and Nicole

                           Nicole Garn (looking pretty prior to her baptism)

                                              Nicole and her mother Tara Wilson Garn

                                                   Grandpa Craig Wilson

                                Yang Yang Crispy Beef (this was delicious)

            Ashley, Alison and Grandma Mary Lynne Wilson

 

Wednesday, May 22 will be a night to remember.  As were going to attend our granddaughter Amy's seminary graduation when Irene's toe, on her good leg, caught the leg of a chair and she fell into the doorway of the chapel.  We lifted her into a chair and her right hip, her bad one, was really hurting.  Carl Watkins brought a wheel chair from his car, and she was able to enjoy the graduation.  After the graduation we wheeled her across the street to Chuck and Gayla's where Chuck examined her and recommended we take her to the ER.  X-rays confirmed that her right hip was broken.  She has a Subcapital Fracture which is defined as "an intracapsular fracture of the neck of the femur, at the point where the neck of the femur joins the head."  
 

          Amy Garry and Grandma Irene after Seminary Graduation

                       Amy Garry - Mountain View High School Graduate

 Gayla Garn Peterson, Irene, Dana Garn Garry (our daughters)

      Irene and Amy (pictures taken after Irene had broken her hip)
 

She was admitted to the hospital, and had surgery Thursday at 6:30 p.m.  Three screws were placed to stabilize the head of the femur.  Dr. Amalia De Comas, who was trained by Dr. Valerie Lewis at MD Anderson CC in Houston, is the surgeon who is caring for her.  Dr. Lewis is the doctor whom we had determined was to do the planned amputation in Houston in December of 2012.  Dr. De Comas advised that it was not wise to try and remove any of the sarcoma tissue during this operation.

 

Her time in the recovery room was very difficult because she was experiencing severe pain for more than an hour.  I know it was bad because she has never admitted to pain, on a scale of 1-10, above about a 6.  She freely admitted that it was at least a ten for that hour.  One of the nurses later commented that on a scale of 1-10 it may have been 100, and Irene agreed that is exactly what it was.  The pain was eventually contained and she had a restful night.  She is not to put any weight on that leg for six to eight weeks to allow for healing of the bone.  We expect to bring her home from the hospital on Saturday.  We did get her home today.
 

 She has been so cautious getting around and has commented many times that she does not want to fall.  We were walking together and as we approached the chapel door she stepped ahead of me and tripped on the chair.  There was nothing to cushion her fall and her swollen right leg was little help in getting her balance.  She has a great attitude and as I left the hospital last night her were words were, "I am going to be big about this."  She is a good one.
 

The radiation treatment is tentatively scheduled for Tuesday, May 28.  Additional chemotherapy is scheduled for June 11.  She has had wonderful priesthood blessings along this path, and we are confident that she is in the Lord’s hands.  Thanks to all for your faith and prayers.

Neurological Side Effects of Ifosfamide Chemotherapy

The first series of Ifosfamide chemotherapy was completed on April 18 and in addition to a little more nausea than usual, Irene was having severe pain in her leg. Dr. Homsi saw her in the infusion center suffering from pain and admitted her into the hospital.    IV anti nausea and new pain meds had her feeling better and she was released the next day.

We received word that her sister-in-law, Hazel Hall, (who was married to her brother Byron who just passed away in January) had passed away on Friday, April 19.  Her funeral was scheduled for Saturday, April 27, and Irene wanted very much to travel to Washington DC to attend the funeral.

That is until April 23 when Irene’s nose started bleeding and we could not stop the bleeding.  Finally we took her to the ER where they put a nose clip on her nose and got the bleeding stopped.  She was also experiencing quite severe nausea at that time.  Blood and urine tests revealed that she was low on platelets and potassium.  With the infusion of platelets, potassium, anti nausea meds and a change in the pain meds, she was released the next evening feeling pretty good.

Our grandson Joshua Peterson, son of Gayla and Chuck, gave his farewell talk on Sunday, April 28 and we enjoyed a day with our family.  He has been called to the Dominican Republic Santo Domingo West Mission and left May 8.  He will go directly to the MTC in the Dominican Republic.

 

          Josh Peterson with his Happy Grandparents ready to go to the MTC 

            Josh pointing to his mission on the map in the Peterson home

     Josh with his grandparents and his mom and dad Gayla & Chuck Peterson

                                           Josh and several of his cousins

For some time we have planned to go to Nauvoo with Robert and Diane Latyon to visit President Russell and Sister Karen Gilliland.  The Laytons and the Gillilands served with us in the Mesa Arizona Temple presidency.  The trip was scheduled for April 29 – May 4 with a flight into St. Louis and a three hour drive to Nauvoo.  That trip was on and off again depending on how Irene was feeling until late Sunday afternoon, when the decision was made that we were going.

 

      President Russell & Sister Karen Gilliland, Irene, Dianne & Robert Layton

                                Sister Gilliland with the team of horses

     Attending the senior couple's production of Rendeveau in the Cultural Hall

               President Gilliland at the Browning Home and Gunsmith Shop

        Sister Gilliland, Irene and Dianne in the living room of the mission home

 Robert, Daryl and Pres. Gilliland waiting for 40 young performing missionaries

                                                      Nauvoo Temple

We had a wonderful reunion with our dear friends in Nauvoo and Irene did well in that she could rest as needed and do as much or little as she felt like doing.  President and Sister Gilliland do an amazing work in presiding over seventy plus senior couples, twenty single sisters, twenty young single sisters and about forty young performing missionaries.  We met many of these wonderful missionaries and appreciate their service.  We also had dessert in the mission home with our friends President and Sister Spencer Condie who are the president and matron of the Nauvoo Temple on an evening prior to attending the temple the next morning.

The second series of the Ifosfamide chemotherapy was started on May 8 with a full day in the infusion center at Banner MD Anderson in Mesa.  As with the first session, Irene came home with a back pack with a pump and two liters of medicine that was pumped into her body through her port.  When I brought her home after the second day of chemo, there was a noticeable change in her behavior.

Some of the neurological side effects of the chemo drug (Ifosfamide) that she was taking in this series may be confusion, slurred speech and difficulty in speaking.  Wednesday when I got her home it was obvious she was having those neurological side effects.  After about three hours, I looked up the management for that situation, and it was to call her doctor IMMEDIATELY.  I called Dr. Chuck, Gayla's husband, and he recommended we take her the ER. 

The ER doctor ordered several tests (blood, urine, CT scan of her head, chest x-ray and an EKG) and decided to hospitalize her.  They treated her the next day in the hospital with various medications and IV fluids.  For about 36 hours she was not able to answer questions, track a conversation or speak very coherently until about 10:00 p.m. Thursday night.  Dr. Homsi was checking her throughout the day and was pretty sure the symptoms were a result of the chemo and it appears that he was right. Several additional tests were administered.  It sure felt good to be able to carry on a pretty good conversation with her Thursday night.   Some of her responses were pretty funny.

 

The CT scan taken in the ER indicated there may be some swelling in her brain, but it was not a very definitive scan so an MRI of her head was taken the next day. Dr. Homsi came in and gave us the report on the MRI which was that she has two lesions (cancer tumors) in her brain. One is the size of a marble and the other is smaller.  Dr. Homsi and Dr. Callister, radiology oncologist, consulted and are recommending radiation to destroy the lesions.  Dr. Callister explained that they have radiation technology today that they can specifically and precisely radiate the tumors without full brain radiation or damage to surrounding tissue.  We will see Dr. Chamberlain, who specializes in these procedures, next week and the radiation will be done the following week.  A more refined MRI of her head will be needed to pin point the radiation.  After the radiation, Dr. Homsi will consider another chemotherapy drug that we can try to destroy the other tumors in her body.

 Irene believes that the neurological side effects are a blessing in that the brain tumors may not have been identified without the CT scan in the ER.  The fact that they are small, they are more easily treated with radiation. She was released from the hospital on Saturday, May 11.

 Friday night as I was leaving the hospital she started to cry, which I have rarely seen in the four plus years she has been suffering from this cancer treatment.  When I inquired about the tears she expressed that she was just so sad that her children and her sisters and I had to worry about her.  That is typical Irene.

Today, Sunday, May 12, 2013, was Mother’s Day and she spent it with a trip to the hospital for a Nulasta shot and then dinner with Dana and Steve’s family.  We were invited to attend the Mother’s Day call from Elder Jason Garry from Mexico and Elder Joshua Peterson from the Dominican Republic.  This evening the Garn Family got together at Kevin and Tara’s to honor all the mothers.  Her favorite gift was a video put together by Byron highlighting each of the 46 members of our family.

NEW CHEMOTHERAPY TREATMENT PLAN

Irene had been on the oral medication for about six weeks when it became apparent that it was not  effective in reducing the growth of the tumors in her thigh.  The swelling in the surgical site in her thigh and the fact that we could not control the swelling in her leg with the wrapping at night and the constriction stocking during the day as well as increased pain were the first indications that the tumors were growing.  Dr. Homsi ordered a new MRI and CT scans two weeks earlier than planned and confirmed that the tumors were growing.

 

Today she started a new chemotherapy treatment plan with a drug named Ifosfamide which is a chemotherapy agent that has been used for some time in treating sarcomas.  As with most cancer treatment, the side effects of this treatment are pretty scary.  The treatment consists of three days in a row (five hours per day) of infusion through her port.  We were actually at the infusion center today from 9:00 a.m. until 4:00 p.m.  She comes home with a back pack filled with a pump and two liters of fluid that will continually deliver medication through her port until she goes back tomorrow for a refill and more chemotherapy.  She will even sleep with this. This process goes on for three days, and then on the fourth day she receives a nulasta shot to protect her heart and a couple of hours of infusion for anti-nausea.  This process will be repeated every three weeks if her symptoms improve, and the tumors are reduced.

 The swelling in her leg is comparable to how it was when we went to the MD Anderson Cancer Center in Houston for the planned amputation of her leg.  As you will recall, the cancer had metastasized to her lungs and the amputation was abandoned.  Surgery does not appear to be an option at this time.  Irene is experiencing severe pain at times, and the pain medications are being adjusted on what seems like a weekly basis to try and keep her comfortable.

 

She is still as wonderful as ever and continues to do most of the things she loves to do.  We are so grateful for your faith and prayers.

 

CANCER UPDATE

As you might remember from one month ago, Dr. Homsi discontinued my chemotherapy treatments, since they were not controlling the cancer.  We met with Dr. Callister, a radiation oncologist at MD Anderson, and after reviewing my records from Mayo Clinic, he did not feel that more radiation would be wise, since I have had quite a bit.  He said that whenever they have gone that route, they have usually been disappointed with the results. 

 

That left the oral medication called Votrient as the option that Dr. Homsi felt was the best, and which we agreed to.  It is called a targeted medicine which attacks the blood vessels that are necessary for cancer tumors to survive.  I take four pills a day all at the same time and have taken them for one month.  I feel blessed that I haven’t had any side effects from this drug.

 

As to how it is working, we do not know.  I had an appointment with Dr. Homsi on Wednesday, of this week, March 27, and he wants me to continue for another month then have an MRI and CT scan.  To be truthful, I have been discouraged, because I feel the tumors are increasing in size and I have had more pain.  However, Dr. Homsi was very positive and encouraging, so I feel much better.  He said that additional chemotherapy with different drugs could be an option and that new treatments are continually being discovered.  He also tweaked my pain medication a little. 

In addition to that, I have been reading Elder Holland’s new book “For Times of Trouble” which has been a great help.  I just need to trust in the Lord and be grateful for the things that I can do and for all the love and support that blesses our lives.   As always, Daryl is here to do anything and everything that I need with a total positive and willing attitude.  What more could I ask for?