From: JoAnne Wortman, Michael Wortman
Sent: Wednesday, July 19, 2000 10:09 PM
Subject: Dave Wortman

I am sad to report that David Wortman died this morning, July 19, 2000 at 
10:50AM after a 14 month battle with leukemia. He was unconscious and went 
peacefully.

There will be an open house at David's house in a few weeks. David
requested this to be a party of joy and remembrance and not a sad occasion.
Details to follow.

There will be a Memorial service at the home of Mae Wortman, David's mother.
at 150 Lake Blvd. #124, Buffalo Grove IL.  Again, details to follow.

Rather than sending flowers, please make donations in memory of David to his
favorite charities:

Nature Conservancy, 1244 Pine BOULDER CO 80302-4809 

The Leukemia & Lymphoma Society, 621 17th Street, #320 Denver, CO 80293 

For those of you who are local, please consider donating blood to the 
Presbyterian/St. Luke's Hospital blood bank.  Call 303-839-6910 to make an 
appointment.

Understandably, family members are currently dealing with many things.
Please allow them the time to do this and respect their need for privacy and 
uninterrupted reflection.

Some background:  

David had a Bone Marrow Transplant last October 21st. He came through the 
transplant with ease and seemed to be on his way to a recovery. This was not
to be. He started feeling weak two months ago and it was determined that his
stem cells had reasserted themselves and he had relapsed. There was soon to 
be a clinical trial of a new monoclonal antibody that was specifically 
developed for his disease. David was enrolled in this trial. It was the most
prudent course. The alternative would be another round of Chemotherapy with 
all the risk involved to his system. After a bit of delay, during which, 
David's condition noticeably deteriorated, David was given the drug on June 
30th. 

When he returned for follow on testing, instead of dropping, his white blood
cell count had jumped to more than 140,000. (Normal is 10,000.) The white 
cell count is the best indicator of whether the leukemia is producing 
"crippled" useless blood cells. This number indicated that while the 
transplanted cells were still present, the Leukemia was very aggressively 
reasserting itself. He was removed from the clinical trial.  Dave was then 
admitted to the Bone Marrow Transplant unit at Presbyterian/St. Luke's where
his transplant was originally done. Chemo was started on July 8th. While 
every effort was made, this morning David became one of the 80% who do not 
survive a BMT long term.

(Following is a detailed account of the experience in the BMT unit. Please 
skip it if you are not interested in the gory details)

David was in bad condition when he entered the BMT unit. His liver, kidney 
and spleen were engorged with leukemia cells. His liver and spleen were 
enlarged to twice the normal size. David was an uncooperative patient that 
first night. He tried to get up and use the rest room, nearly pulling
several tubes and wires out of his body. He was disoriented and it took
three nurses to fight him back into bed. He was heavily sedated and
restrained to bed after that and never regained consciousness.
He was put on dialysis to help his kidneys filter the leukemia cells as
well as the dead cells produced by the Chemo. He was having trouble breathing
due to inflammation and swelling in his throat and was sedated and put on a
ventilator His blood pressure was low and he was given a drug to boost it.
Much of his body chemistry was off and he was given drugs and fluids to
bring everything back into normal ranges. This was going well. 

There was trouble with getting his O2 count where they wanted it.  This led 
to a chest x-ray and a MRI that showed fluid in his lungs. The fluid was 
removed and, when cultured, showed a virus. He was given an anti-viral drug 
and a boost of donor white cells to fight the infection. 

David went through several blood pressure "crises". He pressure would drop
to 58/20. This, despite drugs intended to raise his blood pressure.
His dosage was increased to three times the limit and additional drugs tried,
but still his pressure fell. It was down to 30/15 this morning before he
passed on. 

Michael Wortman