Early Christmas Present

I received an early Christmas gift from Dr. Prystas' office this morning when they called to tell me that my CA-125 levels have dropped from 1191 to 412. This time around, before they started dropping, it was as high as over 2000--so this is really terrific news! I'm only going every other week for chemo now, & they are only doing the blood test once a month. It's always wonderful to get such good news when the side effects from the chemo are really kicking in & I'm starting to feel crummy. I was worried that not being able to do 3 treatments a month with this medication wasn't going to work very well, but am pleased that they have found a pretty good dosage & schedule. Mom is still coming up each week I do chemo (she's busy cleaning bathrooms & dusting as I write!), & I've been having different friends take me down for my treatments once a month. It has been such a pleasure to share this experience with these good friends.

Thanksgiving was marvelous! My entire family spent it at my Mom & Dad's this year, & it was just a great day! I was grateful to have the week off of chemo & be able to really enjoy the experience. Kali & Jarett were both home during the holiday & had friends over several times. It was just a wonderful weekend! As we sat around the table at Mom & Dad's & shared what we were most thankful for on Thanksgiving, I said that although I'm not quite sure I can say that I'm thankful for cancer (that's pushing it a bit!), I am so very grateful for the blessing cancer has given me of drawing closer to my Heavenly Father & Savior, Jesus Christ. I am also thankful for the blessing of being so loved & having my love also grow deeper for my family, relatives, friends, ward members, people in this beautiful valley, doctors & even strangers I've met through this experience. These past 14 months have given me such a profound appreciation for the power of love, compassion & charity in our lives. Wouldn't it be wonderful if we could all experience this each & every day of our lives? Thank you again for your love, prayers & faith--it means everything to me. Love always, Kim

Just plugging along

It's been awhile since I last wrote, but I'm just plugging along. I went in for chemo on Oct 24th, but my white blood counts were too low & they weren't able to do it--so I ended up having that week off. My chest cavity has stayed pretty clear & I've been able to continue breathing easily--yea! I went in this last Monday, & my blood counts were good so I was able to go ahead with the chemo treatment. Apparently the chemo, Gemzar, is pretty hard on the bone marrow, so Dr. Prystas is "tweaking" the dosage so that I will be able to continue with the 2 weeks on/1 off schedule. The side effects this week haven't been as bad as they were the first three times. It's Friday, & other than extreme fatigue hitting me periodically throughout the day, I'm doing good. Mom was with me for most of the week--taking care of loads of laundry, cleaning the house & running boys to and fro. We've also had some wonderful meals brought in, & with having my lungs working better, it's easier to eat--I'm sure I'll be putting on weight again with all this good food! Here are some pictures we took when I went to my chemo appointment Monday. I want everyone to see these wonderful ladies who take such great care of me.

Dr. Prystas, Me & Kathy(the most fabulous nurse!)

Jeri, Val & Amy (what fun gals--always smiling & laughing)

Enjoying my "chemo cocktail" in the party room

It's not always a fun process, but I am so incredibly grateful for these wonderful ladies in my life. They are so compassionate and show their love for me and my family in so many ways.

Life is pretty good right now. I started my 2nd "round" of chemo last Monday, & am feeling almost normal this morning. This time around, a "round" of chemo consists of 2 treatments spaced 7 days apart, & then a week off--so it's 3 weeks total. After my treatment on Monday, they sent me over to LDS Hospital to have my right chest cavity drained again--2.5 liters this time! I still have a cough, but the fluids seem to not be building up so far--I am able to still breathe easily & even walked around my block yesterday (albeit slowly!) The third & fourth day after the treatments seem to be the worst. I am just really headachy, nauseaous & my torso, abdomen, kidneys, etc. just hurt. When that happens, I just tell myself that the chemo must be working & killing all those nasty cancer cells. Other than that, I'm just incredibly tired--much more tired than I remember being last year. I end up falling asleep often during the day & take a few cat naps, which is totally unusual for me! They did my CA-125 test this last Monday, & although the numbers didn't go down (in fact, they went up a bit) they didn't go up as much as they had in the two weeks previous to my starting chemo. Dr. Prystas is hoping that the first round of chemo has just stabilized things, & that we'll see the numbers start to go down in the coming weeks. If they don't begin going down, she may consider changing the chemo drug that I'm receiving.

I am--once again--amazed at the love & support of such good people. This has been such a long year, & I am sure that everyone must be tired of thinking of me, praying for me, & serving me & my family. I know that I have days where I'm sooo sick of myself--of being sick, & feeling like I'm the center of attention. There are times when I wish so much that I could just go back to being the "old" me. But, that's not possible--our entire purpose in being here is to learn, grow & progress--to change & develop a "new" heart that is more like our Heavenly Father & Savior's. I am grateful for the opportunities I've had this past year to grow & stretch spiritually. I just hope that I am becoming what They see I can become, & that I can in some way serve others as I have been so lovingly served by you.

Here are some of the pictures from a couple of weeks ago. Camille Garrison did the photos--I think she's awesome!! She was wonderful to work with, & I'm glad they've turned out so well. Love always, Kim

Feeling Like I've Turned a Corner

Last week was a pretty tough one, but I feel like I've turned the corner & things are looking better. I am so thankful...once again...for the many prayers being offered on my behalf. I went in, still fevering, for my 2nd chemo treatment this Tuesday. My white & red blood counts were okay, so Dr. Prystas gave me the option of going ahead with the treatment or waiting until I felt better. I decided to go ahead--I couldn't imagine feeling much worse than I had for the past 5 days! She wasn't sure why I was fevering--there wasn't any sign of infection--& it would just come & go. After my chemo tx, they sent me over to LDS Hospital to have them drain my right chest cavity so I could breathe. They were able to drain 2 liters of fluid from it. There probably was more, but they don't like taking more than that because it can kind of "rebound" on you if you take too much. It's amazing how much better I felt after having it removed! Mom has been here with me throughout the week, & I've pretty much stayed in my jammies until today. My breathing has become a little more difficult--I think the fluid is beginning to build up again--but it's not gotten too bad. It seems to be taking a little bit longer for these drugs to begin working on it.
Two blessings that I'm most thankful for are the opportunity to do our family pictures, & the blessing of being able to attend General Conference for the first time in my life on Sunday afternoon. When I was so sick, I just prayed that at least I would be able to participate in those two activities with my family. My prayers were answered abundantly! I was even able to attend Braedon's football game Saturday before I started feeling lousy again. When I get the pictures back, I'll have to post one...my dear friend (& hairdresser), Heather Holbrook, showed up at my house Saturday morning & did my hair & make-up. I wish I'd taken a "before" picture so you could see the miracle she performed on me that morning. My brother, Paul, told me that morning that I have the best friends...I totally agree! How could one person have such great family & friends? I am especially thankful for my best friend, the Savior, who is always there during my darkest hours--I know that I am never alone and that I matter to Him. Love always, Kim

Faith and Prayers

Today I have been asked by Kim to update her blog.  Since her chemo treatment last Tuesday, she has been struggling a bit with the side affects - they were not able to use the same drugs that were used during her first series of treatments because they began to cause an allergic reaction.  So heading into her first treatment this week - she was not sure what to expect.  Wednesday she was able to be up a bit in between resting and was even able to get a walk in around the block of her subdivision.  Then Thursday was not a good day - she was continuing to feel week, head achey with no energy.  Saturday their family was able to get together for an extended family picture - which was something that they had been planning for months.   Then by Saturday afternoon she was experiencing fever, chills, and aching all over.  In contacting Dr. Prystas, she thought that Kim had either a bacterial or viral infection and prescribed a strong antibiotic for her.  This morning Kim was feeling a little better!

As Kim's family and friends she has requested our faith and prayers in her behalf.  She is scheduled for another chemo treatment this coming Tuesday and really wants to get some strength back going into that second treatment.  We are asking that each of us combine our faith and prayers to match Kim's great faith and please keep her in your thoughts and prayers this week as we prepare to fast on Sunday.  We have definitely been blessed to see miracles in her life this past year - and we know there are more to come for her.

 For those of us who have been able to listen to Conference this weekend - we have definitely been reminded of how each of us are loved and known by our Heavenly Father and Savior Jesus Christ.  How blessed we are to have a Prophet - President Monson - that reminded us today in his beautiful talk of the Savior's words - "Fear thou not; for I am with thee; be not dismayed; for I am thy God: I will strengthen thee; yea, I will help thee; yea, I will uphold thee with the right hand of my righteousness."

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Well....at least it's not "rip-roaring" cancer

The bad news is...the cancer is back. The good news is it's not "rip-roaring" cancer according to Dr. Prystas. I had my CA-125 blood test done last week in preparation for a 4-month follow-up with the surgeon. I'd been having some stomach aches & shortness of breath for the couple of weeks leading up to this appointment, but I was hoping that it was just the anxiety leading up to the appointment. Unfortunately, Dr. Dodson told us that my numbers had gone fromo 67 to over 1300--obviously something was going on. I had a CT scan two days ago that showed no tumors--yea!--that means no surgery. All my vital organs appear to be normal, but I do have fluid in my chest cavity & abdomen again (darn!) and there are several enlarged lymph nodes in my abdomen & pelvis. Soooo...according to Dr. Prystas, there are definitely signs of cancer, but it's not "rip-roaring" cancer. It sounds like I'll be doing another few rounds of chemo again. I go see Dr. Prystas next Tuesday to hear what the game plan will be. Because it's only been 6 months since my last chemo treatment, they can't use the same drugs. She'll have to figure out what new medications to use, & she's going to try again to have my insurance company pay for a new drug that hasn't been FDA approved for ovarian cancer, but is showing some promise. It's been a little rough this past week--I've shed a few tears--but it's going to be all right. I've known this was extremely likely to happen, I was just hoping it wouldn't be quite so soon.
Last night, our Stake Relief Society held a special meeting & had Sister Virginia Pearce speak to us. I think she was there just for me--it was wonderful! She spoke about living "abundantly" & that is what my goal is--to live my life abundantly as long as I can. When we were heading down to S.L. to the Dr.'s last week, Kali & I were texting about how it had been a year to the day since my diagnosis. I wrote something about it being a wild year, and Kali responded: "Yeah, it's been quite a year...but Mom, it's been a YEAR!" That put everything into perspective for me. A year ago I could never imagine still being here to see & experience another beautiful fall day. We have had so many wonderful experiences this past year as a family--especially these past 6 months. I have been blessed so abundantly, & have felt the love of the Lord in my life more this past year than at any other time. I am once again feeling the prayers of many of you who have known of my circumstances this past week, & I am grateful! Love always, Kim

Summer Update

A few people have reminded me that I haven't updated since my last visit with the oncologist--I'm sorry--I've been busy enjoying my summer & I keep forgetting to sit down & write! Things are going really well right now. I'm feeling well physically & almost have the same level of energy I did a year ago. Most of the time I feel normal physically, then I'll have a day where I get super tired, & I can't figure out why, until I remember, "Duh, you've had two major surgeries & 8 rounds of chemo--you should be tired!" About a week before I went to see Dr. Prystas I began to have stomachaches & weird pains all over in my abdomen. I'm realizing that when you've been diagnosed with cancer, you're entire mindset experiences a big shift. Instead of logically thinking, "Oh, my stomach hurts--I shouldn't have eaten those 3 pieces of Costco chocolate cake today!" (I know--so bad!), you begin to think that the cancer is back & then the worries all kick in. I ran into a friend, who's also done chemo, a few days into this crazy thinking & she told me that the same thing would happen to her every time she had to go into see the oncologist. Then, when she'd get the report that everything was fine, the symptoms would disappear until her next appointment. Listening to her helped ease my mind for those few days until I could get the results back from my tests--what a tender mercy it was to run into her!
Anyway, my CA-125 levels came back and were 67--yeaaa! That is the lowest it's gone down since I was diagnosed. Dr. Prystas did another very thorough exam & said that so far things are looking good. My stomachaches have pretty much disappeared, but I still have to be somewhat careful about what I eat. I know that 3 pieces of chocolate cake in a day isn't the best diet (& really--it's not normally that bad! It had been a stressful week & I was eating for comfort). The sad news I have to report is that my sweet dog, Maggie, passed away while we were at a family reunion in Bear Lake. The vet thinks it was an auto-immune disorder that hit her pretty quickly & she was only sick for less than 48 hours--she doesn't think Maggie suffered much. I have felt so badly about her death. She was kind of a handful for everyone else in the family, but she absolutely loved me & I loved her in return. She spent most of this winter on her pillow, keeping me company while I was going through chemo. She was one of my angels, & I am really missing her--it's hard to go walking & work outside without her right next to me.
I get two more months "off" from the Dr.'s (unless something else crops up) & will go to see Dr. Dodson, the gynecological surgeon, in mid-September. Unfortunately, I've had to visit the hospital the last couple of days because my younger brother, Matt, was in a mountain biking accident in Cedar City on Saturday. He's going to be okay, but had surgery this morning to repair a broken hip & also has a torn ligament in his shoulder & a fracture in his wrist. He's going to be hurting for a while. :-( With four members of my immediate family having spent some time in the new IMC in Murray since it opened, I'm thinking of asking them to give us a family discount or at least name a wing of the hospital for us! Seriously, though, I am once again grateful for the blessings of good medical care, wonderful family & friends, & the knowledge that Heavenly Father & our Savior are always mindful of our needs & are right there to bless & comfort us. Thank you for your continued prayers & kind thoughts. Love always, Kim

Home Again

Thanks so much once again for the prayers and support given to me and my family while I was in the hospital last week. It was such a blessing to be able to come home on Wednesday afternoon--my doctors and the nursing staff at LDS Hospital were just wonderful to me, but home is always best! On Tuesday night, my new gynological oncologist/surgeon (Dr. Dodson) came to see me. At that point I had gone 72 hours without anything to eat or drink (except for a few ice chips) and I was pretty miserable because things weren't progressing. I'd had an NG tube going into my nose & down my throat for two days, but they'd taken that out Tuesday morning (Thank heavens--you don't ever want to know what that's like!) He decided to go ahead and let me start on a few clear liquids with the hope that it might get things working in my stomach, and cause the intestines to unkink themselves. He said it would either work or else he'd see me in the OR. Then he went on to explain what all the possibilities would be if they had to operate. Needless to say, I was pretty discouraged after he left my room, and I began praying in earnest again. Within a couple of hours after having some liquids, things did start to turn around and progressed quickly enough that I could come home the next day.
They're not sure if the problems are caused by scarring of all my innards from the cancer, surgery & chemo treatments, or if there might be some cancer still in the abdomen that is causing the problem. The CT scan didn't show any signs of tumors, but it also only shows cancerous areas that are 1cm in size or larger. Sooo...I am now on a low-fiber diet--I can't have alot of fresh fruits & veggies, nuts and whole grains. (or, as Vern says, basically my same old diet!) Darn! I'd just got so I was really liking all the fresh veggies & could make a pretty good green salad! I had been reading this "anti-cancer" book that listed all sorts of changes we could make in our lives & diets, and had been trying to follow it's recommendations--Dr. Dodson told me to stop--that may have been one of the things that landed me in the hospital! So we're back to white bread & cooked veggies. The plan is for me to still follow up with my oncologist, Dr. Prystas, in mid-July and then see Dr. Dodson in September--unless something else comes up before then. Summer feels like it might finally be here, and I am so wanting to just enjoy it with my family! I pray each day for more time to be here with my family & friends, and am trying to follow Julie B. Beck's counsel to be sure that we take care of the "essential & necessary" things in our day before we get to the "nice-to-do" stuff.
Thank you again for your prayers, love & support--I know those prayers have allowed me to come home instead of going to the OR again this week. Once again, there were many tender mercies that occurred during my week that let me see the Lord's hand in my life--He is awesome!! Love always, Kim

Just a Kink

Kim was admitted to LDS hospital today with what turns out to be a kinked bowel due to scar tissue. Good news - the tests showed no sign of a tumor! The doctors are hoping the kink will remedy itself in the next three days....until then Kim will be forced to take a leisurely break from her abundant activities to get caught up on reading and television while enjoying gourmet ice chips. Things at the Iverson home are completely taken care of, but she says we can all help by keeping her in our prayers.

The Last Update...for Now

Last week I finally got all my drains out--yea! It has been wonderful to sleep at night without laying on them, & feeling them tug and pull on my irritated skin. I was also able to see Dr. Prystas on Friday to get the game plan. It was kind of a difficult appointment for me. I think I was hoping that I'd go in & she'd tell me all the things they were going to do that would control the cancer & guarantee that I'd stay healthy--& that's not how the appointment went. Basically, we're just going into a holding pattern. She has put me on Tamoxifen, which is an anti-estrogen, & has been shown to inhibit growth for both breast & ovarian cancer. She's not sure why the CA-125 levels went up--it could be due to the surgery. I'm learning that the CA-125 tests can be somewhat fickle, but it's the best thing they have at this point for helping to diagnose & track ovarian cancer & it's treatment. It's difficult to determine what is "normal" for a person. Some people may have a CA-125 level that's in the "normal" range & can be full of cancer. Others may have a higher level, and be doing fine. We're not really sure where I am cancer-wise at this point--we just have to wait. I'll either remain fairly healthy & do well, or the cancer will return in the same place, or somewhere else. They're not going to go "looking" for cancer by doing all sorts of tests--it's unnecessary, the tests also have certain risks & it can make me even crazier than I sometimes am at this point. Dr. Prystas said that if the cancer returns, I'll know it--the symptoms will come back. If it does return, then we'll deal with that particular problem at that time. We asked about doing a "maintenance" chemo every 4-6 weeks, as that had been mentioned at one point. She said she'd rather not do that at this time. If you do that, at some point your body just has enough of it, & you also develop allergies to the medication and/or it just doesn't work as effectively the more you have it. She'd rather wait & use the chemo meds if they're needed again. Soooo...I've started the Tamoxifen & will wait 2 months before going in to have my CA-125 levels checked again--I think it might be a difficult 2 months. Thankfully, summer is almost here & the boys will be home and busy & time might fly by really fast.


Years ago, I read Lance Armstrong's book about his battle with cancer. I remember him writing that the chemo/radiation treatments weren't nearly as hard as the waiting he did for the year after he was finished. When you're doing your chemo treatments you're so focused & feel as if you're actually "working" on killing the cancer cells. I can see that just waiting & watching for symptoms is going to be pretty tough mentally & emotionally. But I've decided that in most ways, nothing has really changed...I am still entirely dependent on my Heavenly Father. He is in charge--He has always been in charge--I've just deluded myself into thinking that I've been in charge for the last 46 years. That doesn't mean that I'm not doing everything I can to get and stay healthy--I'm trying to make changes in my diet, my environment, my attitude, how I spend my time & energy. But I have to not waste my mental & emotional energy by worrying & giving in to my fears of "what if". I'm going to try to just go forward & enjoy this summer as much as possible. Jarett is graduating from Weber this week & will be heading off to BYU-Provo this fall. Kali is staying in Logan & working for the summer, but not too much...I'm hoping to be seeing quite a bit of her. She has promised to come & help me with the spring yardwork in the next few weeks. Hunter & Braedon will be busy with camps, soccer, basketball & baseball...& we have a few family reunions to attend. Vern and Kali are heading to Alaska on a road trip in June. It promises to be a busy summer & I'm excited about it, & looking forward to feeling well. I've decided that I'm not going to worry about updating this blog each week. If anything happens before my appointment with Dr. Prystas the middle of July, I'll write about it..but I'm hoping that I won't be writing before then.
The scriptural reference I'm trying to engrave in my brain for the next couple of months is this from John 14:27: "Peace I leave with you, my peace I give unto you...Let not your heart be troubled, neither let it be afraid." Elder Holland once said that this may be one of the Savior's commandments that is almost universally disobeyed. I know that faith & fear cannot coexist together, & that my Savior wants me to be happy & joyful--this is my goal for the summer (and for whatever time He continues to grant me!). I am so thankful to Vern & our children, Mom & Dad, my brothers & sister, Vern's family & all our extended family members, my ward family, my Ogden Valley family and all my dear, dear friends throughout the world who have supported and sustained me with their fasting & prayers, their letters & gifts, their kind words and acts of service throughout the last 8 months. How can I ever repay what you have given me? You truly are "angels" who have been sent to watch over & minister to my needs. I love you, & I also pray for you--I know that I'm not the only one who has gone through challenges this past year-- we've all had them--mine have just been more visible than yours. Thank you for being there for me. My love & prayers are always with you.--Kim

Just a Quick Update

This is just a quick update--it's Saturday--the sun has been shining--I've been in the house paying bills and I am ready to turn off the computer and enjoy the rest of the day. I am feeling pretty good since the surgery. Each day the tenderness seems to be getting better. I still have all 3 drains in--aaarrgghh! My sister told me hers were in for 2 weeks--I was so hoping that they'd be gone by now--it's difficult to find anything decent to wear so I can go out comfortably, and they get to itching and being sore at times. But, I have left the house a few times the last 2 days because I can't stand being cooped up anymore--this spring weather is glorious!!
I also got the pathology report this week from Dr. Reading. They found absolutely no cancer cells in the right breast anymore--yea!!! They removed 9 lymph nodes from the right arm, and two of them still had residual tumor cells in them. She said that I have responded very well to the chemotherapy for the breast cancer. It's difficult for me to believe that there were no cancer cells at all in the right breast, considering how large and extensive the tumor was 7 1/2 months ago--that is just an amazing miracle to me. I'm still not sure where we go from here. Four weeks ago, the CA-125 levels were 79, which leads my oncologist to believe that there is still cancer in me--they're just not sure yet where it is. I was kind of hoping that they would find cancer cells in the breast, so we would know where they were, and I could feel good about getting them removed. I am so grateful that the chemo has worked so well--I just need to wait (again & always!) until I speak to Dr. Prystas next week to see what the game plan is at this point. Thank you again for the prayers and support during this recovery--it has been much easier so far! Love always, Kim

Mother's Day

I am doing really well & am so grateful for the prayers & well wishes I have received. The surgery was not near as bad as the one to remove the ovarian cancer, & I feel that the recovery has been easy in comparison. If I didn't have 3 drains coming out of my chest area, I'd probably be out & about by now. Hopefully the drains will only have to be in for a few more days. My chest & arms are still fairly numb, but I do get hot, shooting pains in my right arm periodically when I move it. Dr. Reading didn't have to remove any muscle (thank heaven!), but the lymph nodes they removed on the right side were entangled with nerves, & she said that I would have pain in that area for a few weeks.

I have been so tenderly cared for by Dr. Reading, the nurses at LDS Hospital &, of course, my mom these past few days. Vern--as always--has been keeping things moving smoothly on the frontlines with our children & home. My friend, Melanie, gave me the new book of quotes by Elder Holland, and I just devoured it the day I got home from the hospital--I love how he expresses things. One of the quotes that just resonated with me this week was this one:

"When we speak of those who are instruments in the hand of God, we are reminded that not all angels are from the other side of the veil. Some of them we walk with and talk with--here, now, every day. Some of them reside in our own neighborhoods. Some of them gave birth to us, and in my case, one of them consented to marry me. Indeed heaven never seems closer than when we see the love of God manifested in the kindness and devotion of people so good and so pure that angelic is the only word that comes to mind."--Elder Jeffrey R. Holland

There are so many "angels" who have ministered--& continue to minister to me. On this special day, I want to express my love to that sweet angel who gave birth to me, raised me well, & continues to attend to my every want & need. I know that she has touched not just my life, but the lives of all those who know her & observe her Christlike devotion & example. I also express my love to my children--they are beautiful people in every way, & are much better than I deserve to have. I am grateful for their forgiveness of my weaknesses & faults. I have learned more from being their mother than I'm sure I've ever taught them. I think one of the greatest blessings Heavenly Father has given me, has been the opportunity to be their mother. I am so grateful that I am still here, & can continue to love them & take joy in all that they do. I am so thankful that families can be together forever! Love always, Kim

P.S. Thanks to LoriAnn Hogge and all my friends for the cute running shirts they wore at the Snowcrest Ragnar Relay yesterday--you are all amazing!! I can't wait to see the pics!

Kim is Home and Doing Well

Kim had her surgery on Wednesday!  It was originally scheduled for noon - but it was finally around 1:30 p.m. when she went in for the operation.  It was a three hour surgery and by 5:00 p.m. she was back up to her room getting settled for the night.  According to Kim's Mom Fern, the doctor said that there were "no surprises", that they were able to perform the surgery without any complications, and are now waiting on lab results to determine just exactly what the next plan or step will be for Kim.  She was released from the hospital yesterday and arrived home about 6:00 p.m. last night.  She has come home with three drains which allow the fluid to be released from the incisions, but Fern indicated that the liquid is already beginning to be clear and so hopefully she will not have to have them be apart of her for long.  In usual Kim style she is positive, grateful and appreciative of each of you and your kind thoughts and prayers in her and her families behalf.  We will all wait anxiously for Kim to add the next post!  We love you Kim and continue to learn from you through each step of this journey!  You Are Amazing!!

Small & Simple Things

Well, I can give a big sigh of relief--the bone scan results came back clear and we're all set to go this week with my surgery. I was more worried about it than I would have liked to admit--I have been achy all over, but the pain in my left upper arm was so consistent and intense each day that I was sure the cancer had spread. Of course, since I received the news, it's not bothered me near as much as it did before! I can see that having cancer kind of messes with your head, and changes your outlook in ways that aren't always positive.
I received the news in Provo where I was attending BYU Women's Conference with Mom, Julie and Heidi. It was a wonderful conference, and just the place I needed to be with my worrying. All of the classes I attended offered some good insights and the Spirit was strong there. It was wonderful to get away with these wonderful women whom I love so much, and just enjoy being with them. Elder & Sister Bednar's messages were especially inspiring to me. The theme of the conference was from Alma 37: 6-7: "By small and simple things are great things brought to pass." I spent alot of time those two days thinking about all the "small & simple things" that have consistently been done for me and my family by so many of you. These "small & simple things" have lessened my burdens and have greatly affected my outlook & attitude--thank you. I am also very thankful for the many "small & simple things" my Heavenly Father & Savior have done for me. I've been trying to write in a gratitude journal each day since my diagnosis--it has been a very small thing for me to do, but has helped me to really see all the great things that have occurred in my life. I am grateful that I have the gift of sight so I can write and read the about the small & simple things that happen each day in my life. It is so interesting to me that as we recognize our blessings and express gratitude to our Maker for giving them, He pours out even greater blessings upon us. I love you all and thank you for your prayers for me this week. Love always, Kim

Just Enjoying the Wait

Once again, the other day I spoke with someone who told me they wished I would post more often on the blog--and I honestly don't know what to write most days. Right now my life is incredibly boring. I am back to cooking for my family, cleaning my house & doing laundry, trying to grow hair and eyelashes, organizing photos and closets, and driving kids to and from activities. Can I say that I am absolutely loving life right now?

Vern and I met with the surgeon again today to find out a little bit more detail about the surgery next week. I've had a weird ache in my left arm for the past couple of weeks, and they're going to scan it on Wednesday, just to put my mind at ease; but honestly, I ache everywhere most days. I am trying to stay active because if I sit or lay for too long I'm like an 80- year old trying to get moving again. I am getting a little anxious about the surgery, but have been assured that it probably won't be as bad as my last one was. I am just trying to enjoy every day that I feel good and am able to be somewhat "normal" again (although I'm not sure if I've ever been completely normal!).

I was quite emotional all day yesterday--I don't know why I bothered putting any make-up on my 17 eyelashes because I had it all cried off within an hour. It was just that Easter day was a wonderful opportunity for me to read about and ponder on the priceless gift of the Atonement and Resurrection of the Savior. This Easter was more meaningful for me than I can remember. I'm sure it's because of all that my family and I have experienced these past 7 months. I have been so thankful that I have not had to suffer through this alone. I know that my Savior knows exactly what I am going through, and how best to comfort and help me, because He went through it--and so much more--in the garden of Gethsemane. The love that He has for me is at times almost incomprehensible, but I know that it is real. I am thankful also for His Resurrection. It gives me hope during my darkest hours that this life is not all there is--that our relationships are eternal, and our bodies will one day be gloriously reunited with our spirits. I know that none of this would be possible without His love & His perfect sacrifice--I would be utterly & completely lost without Him.

I wish I were more articulate and could better express my thoughts, love & gratitude to all who have fasted and prayed for me, and have given service to my family and me. Please know how grateful I am for you, how much I love you, and that I know our Heavenly Father sees all these wonderful things and will bless you for them.

Back Home

We got home from our trip Tuesday morning around 2am, and I've been trying all week to catch up. It was a fabulous trip! We took the red-eye to Orlando on April 1st and then met up with Vern's sister, Rosie, and her family later that afternoon. My sister, Julie, and her family arrived in the early morning hours on Sunday. There were 20 of us altogether--with 13 kids--and we rented a house for the first 6 nights of our trip. We spent each day either playing in Universal Studios or the Wet'nWild water park. The weather was around 90 degrees each day, and the parks were crowded, but we had a great time! The majority of us were most excited to spend time in "Harry Potter World" at Universal Studios, and we spent quite alot of time there wandering the street & shops, drinking butterbeer and riding the rides. If you're a Harry Potter fan, you'll feel like you've just been transported to Hogsmeade & Hogwarts--Jarett & Braedon especially loved it! Then, we went to Port Canaveral and got on a little 3-night cruise to the Bahamas. That was the perfect way to end the trip. I was pretty exhausted by that time, and it was good to have the opportunity to just relax on the ship and let the kids just go. The boys loved having the freedom to come and go, and eat whenever and whatever they wanted without having me nagging at them. I think they ate at least 6 ice cream cones a day and countless pieces of pizza (even in their beds at midnight!) We have all marveled at how good the kids were! They rarely got enough sleep, and as my brother-in-law, Jeff, put it: "Trying to get this many people any place is like trying to herd cats!", but they all got along the entire trip! They never fought with each other, got whiny, or hurt each other's feelings at any time. This trip was just what my family and I needed at this time, and we are so grateful to Nana, the Leishman's and the Hatch's for making it all work and giving us such a wonderful time!

On Tuesday, I had to go into McKay-Dee for a chest x-ray to check the fluid in my chest cavity and have blood taken for the CA-125 test. I was so surprised to hear from Dr. Prystas' office on Wednesday that my levels had gone from 91 to 79. Since they had only been able to give me the one chemo medication on that last treatment instead of the two I normally received, I was not expecting it to go down at all. In fact, I was kind of worried that it might have even gone up--I was so relieved to hear that the chemo was still working. While I have loved not feeling sick the last couple of weeks, and am feeling my strength coming back and some hair growing back in (holy cow--there is so much gray!), I can see that I might have kind of a hard time when the Dr.'s finally tell me we're done with treatments. As long as they're giving you the drugs, you feel like you're actively doing something to kill the cancer cells. I think the waiting is going to be hard. I'm already kind of nervous that I'm four weeks out from my last treatment. My surgery is scheduled for May 4th, and in the back of my mind is this fear that somehow the cancer cells are going to get active and do something crazy while we're waiting for my body to heal. This is where I really get to exercise my faith in the fact that Heavenly Father definitely does have a plan and a purpose in all this for me. I am not in control--He is. And I know that He has something better in store for me than I would ever choose for myself. I certainly would never have chosen to have cancer and go through what I'm going through, but each day I see blessings that I would have missed out on without this experience. I keep telling myself--it's all about perspective! Thank you again for your continued prayers and support. Love, Kim

Flying Out Tonight

Well, it's been 6 months now since my diagnosis and surgery. Tonight we are flying out to Orlando to take a family vacation that had been planned for October and had to be rescheduled because of my illness. I have been in tears for much of this morning--not tears of sadness--tears of joy. For much of the first couple of months, there were so many days where I could never imagine that I would even still be here this spring. I was so ill and weak that I couldn't imagine ever feeling well again, let alone being able to take a trip like this with my family. I feel absolutely blessed!!! It is a blessing to be alive each day--it's a blessing to have physical strength and energy--and it's a blessing to have a peaceful heart. I am thankful to each and every one of you who have exercised your faith, and have directed your prayers on behalf of my recovery, and have given of your sweet service to me and my family. I wish I could take all of you with me! Know that I will be thinking of you each day, and expressing gratitude to our Lord for your influence in my life. This time in my life would not be possible without Him, and without you. Thank you, thank you. All my love--Kim

Results

Well, the results came back and things are looking fairly good. The radioactive glucose will light up any cancer that is just less than 1cm or larger on the PT scan. Fortunately, nothing really lit up--even in my breast where the large tumor originally was. My CA-125 number also went from 100 to 91. The scans also showed some fluid still in my chest cavity. The PT scans are not 100% accurate, and because my CA-125 levels are still over 35, it does indicate that there are still cancer cells somewhere in my body, they're just not sure where at this point. I was also able to go yesterday to see Dr. Reading, the breast surgeon, for a consultation. Both she and my oncologist feel that a mastectomy is a good direction to go at this stage. I am scheduled for this on May 4th, and, at this point, am thinking it will be a double--although this could possibly change. Dr. Prystas was only able to give me the one chemo drug last Friday, because the risk of a severe allergic reaction to the other was just too high. So, the side effects haven't been too awful the past 5 days--I am just extremely tired and sleepy most days. They also didn't send me home with the Neulasta shot (that's the one that causes the severe body aches) because they are giving me a "chemo vacation" for a bit. I'll go in a few weeks for a chest x-ray and a CA-125 blood test, then possibly have them "tap" the chest cavity again to drain the fluid and test it for cancer cells; then we head in for surgery at the beginning of May. Chemo has been suspended for the time being, and we'll see whether I will need more after the surgery. It's a little scary to think that they won't be putting any cancer-killing drugs into me for a while, but both Dr.'s assured me that it's okay to take a "chemo vacation" at this point. Dr. Prystas would have made me take it regardless of whether or not I was able to have the surgery. The fact that I have both ovarian and breast cancer has (and will) really complicate treatment, and I was quite nervous that Dr. Reading wouldn't agree to do the mastectomy with the ovarian cancer possibly still being there, but was so relieved when she didn't hesitate to say she thought it was the right thing at this point in time. I feel very blessed to have these two remarkable women as my physicians. They are both mothers themselves, and completely understand my desire to be here for my children. They don't sugarcoat things, but also express hope & confidence in my future. I feel every day that my being here 6 months later is the direct result of the faith and prayers that have been offered on my behalf. I am grateful to my Heavenly Father for allowing me to still be here--and to be feeling pretty good most days. Life is wonderful--my heart is full of thanksgiving! Love to you always, Kim

Waiting on Results

Last week was just great! I was able to attend some of the state dental convention in Salt Lake, & then had my sister come spend the weekend with me. I also had a CT scan last week of my chest, & it showed that the tumor in my breast has shrunk quite a bit. Yea! Today I had a CT & PT scan done from my head down to my knees. They put some radioactive sugar into my blood stream, & then did a special scan. They bring the solution into the room in a titanium syringe, and then I had to stay by myself for 45 minutes because of the radiation. Apparently, cancer cells really like the radioactive sugar & take it in, so then they show up on the scan. My oncologist & breast surgeon ordered the test to see whether there is cancer in any other areas of my body besides the breast. I guess this will help them determine whether they will go in & remove the tumor or not. I go in for my 8th chemo treatment this Friday, so hopefully I'll hear the results from Dr. Prystas at that time. As always, I am so very grateful for the blessing of prayers & healing. And can I just say that I am loving this spring weather? It is a wonderful time of hope & renewal, & I am feeling that in my heart. Love always, Kim

This One is for Sue

My friend, Sue Owens, stopped in to see me last week & told me that she wanted me to write more often (perhaps not such long epistles--my words, not hers!) letting her & others who don't see me very often know how I'm doing more regularly. Well, I am doing better this week. I'm feeling pretty good physically, other than being bone tired by about 11 am. I'm doing better emotionally this week, also. I have to remember that this is a journey, & it's going to have it's ups & downs. Five months ago, I wasn't even sure if I'd ever be able to leave my house or do anything normal again, so every day I'm alive & feel well is a bonus.
Kali is home from spring break this week, & it's always a delight to have her here! I was able to teach the lesson in Relief Society on Sunday, & I have a full week of activities planned with the family. I continue to be grateful to my parents, all those who bring in meals three times a week, & my cousin, Karen, who comes each week & helps with housework. I know it may seem like a small thing to those of you who are serving our family, but it helps our family immensely for me to have the energy to spend with them when they arrive home from work & school. It has been a long 6 months since things started going crazy for us, & I think the kids are holding up pretty well. We've been able to keep things fairly normal for everyone thanks to all these sweet "angels". I am also very thankful for all my dear friends who call to talk & listen, and those who write such sweet notes. I don't think you'll ever know how much it means to me--thank you. Love always, Kim

February 26, 2011

Heidi has told me that sometimes people have asked her if I'm really doing as well as I seem to be--they've wondered if I'm perhaps "whitewashing" my experiences for this blog. I don't think I've done that. I've tried to be as honest as I can about what I'm going through--it's hard for me to write this knowing that so many others may be reading it. I just try to think of it as a way for me to journal my experience for myself and my children, and I am choosing to focus on the positive aspects of it as much as I can. Believe me, though, there are some difficult days and yesterday was one of them. I had my chemo tx on Wednesday, and as of yesterday & today, am feeling the worst part of the side effects. I called Dr. Prystas' office yesterday to find out what my CA-125 numbers had gone to, and they had only dropped from 107 to 100. This was a huge disappointment, and I threw myself a "pity party" for alot of the day. I called back to the office to talk to Kathy, Dr. Prystas' nurse, and she helped me put things into perspective a bit. She's more than a nurse--she has to be part therapist also. It's hard thinking of how awful the last chemo tx was, and then to know that despite all that, my counts only went down 7 points. It makes it tougher going through this treatment. I had a bad allergic reaction to one of the chemo meds during my transfusion Wednesday, so they won't be able to use that drug anymore. It sounds like I will maybe only have one or two more chemo treatments left to do--I'm kind of getting to the limit of what they'll do with this regimen & they are scheduling me for a CT scan of the breast to see if surgery is an option at this point. I am still hoping & praying to be completely cured, but realize that I had alot of disease--tumors in two places of my body--and that this may be more of a chronic condition that I will need to deal with long-term. Kathy says that sometimes patients numbers go up during chemo tx, and then may drop again significantly--everybody is different and they just can't predict it. But I may also have to accept the possibility that my numbers may never go under 35, & it may just be that I'll have to deal with having maintenance chemotherapy and/or surgeries every so often & make the best of all the times in between that I feel good.
There is so much that I don't know about all that's going on, and where things are headed in my life. I've spent most of my life deluding myself that I'm in complete control--I've always had structure & a plan! Realizing that I don't have control over everything is a huge challenge for me. But, one thing I do know for sure is that I have a Father in Heaven and a Savior who love me. Because They can see with an eternal perspective--past, present, future--I always have Their attention. They know what I'm going through; what I am, and am not capable of, and what is best for me and my family--in this life and for eternity. I know that in the Garden of Gesthemane and on the cross, my Savior has already suffered all that I am going through, and because of this, He is the one person I turn to for strength & comfort. I know also that He daily inspires all the good people in my life. Every day I am loved and receive Christ-like service. Every day there are tender mercies to get me through the day, and yesterday was no exception. I love you all. I am grateful for your faith & prayers. Love always, Kim

Valentine's Greetings

It's been awhile since I've written. Last week was kind of rough--I wasn't feeling well physically, and my spirits were also a little down. It's challenging waiting for the CA-125 numbers to come back after my chemo treatments. I feel like there's a "fine line" between staying positive & optimistic about the results, and also being realistic. I was really hoping to have my numbers in the double-digits this last time, and to be only 8 points away from achieving that was kind of hard. I knew realistically that things were going to slow down the lower the numbers got, but because they had gone down so significantly each time it was hard to not have it go down alot this last time. But...this week I'm feeling so much better physically and emotionally. Throughout this entire experience, I feel more keenly the strong link between the physical & the spiritual. I am grateful to be continually learning things about myself and my purpose in this life. I was speaking to a wonderful lady earlier in the week, who has also gone through some pretty difficult challenges in her life. We were reflecting on the fact that these experiences we've had have been absolutely necessary for our spiritual growth and progression. If our lives had just gone on as they were, there would have been no other way we could have grown spiritually as we were meant to. I just hope that I can keep these things in mind as other "bumps in the road" occur that are difficult to deal with.
One thing I am especially grateful for this week is the faith and prayers of little children. This last month I've had the opportunity to meet with several young children who have been praying daily for me. I can't begin to describe how touched my heart has been to learn of, and meet with, these precious children of our Heavenly Father. Their faith is so pure and strong, and I am so thankful for their prayers--I know that He especially listens to, and answers their prayers. Thank you, parents, for teaching these young ones to pray and exercise their faith on my behalf.
Yesterday, I also had the great blessing of having my mom's sisters (otherwise known as the "sisty uglers") come to visit me. We had a wonderful visit (albeit short!), and they tied a new quilt to fit on my bed. They, and their families, have been such a support to my family and especially to my Mom, as she serves us all.
I was really hoping to be done with the chemo by this point--I feel like I have been one of the longest running service projects--and am continually thankful for the many acts of kindness & service still being given to us. I can't believe that 5 months into this, everyone is still so thoughtful and generous--you are wonderful and I love you! Happy Valentines's Day! Love always, Kim

February 2, post from "the Mom"

Kim asked me to update her blog today. As you read on the last blog, Kim wasn't feeling too well. She had an infection at the incision site that caused her some grief (and anxiety on my part) for quite a few days. In fact, she usually has about 12 'good' days between her chemo treatments. Not so this last time! She only had about 4 of the 'good' days...so this time, she's not bouncing back as fast. Of course, as the treatments continue, she seems to get a little more tired and it's taking a bit longer for her to get back to her perky self. We're hoping the "little abscess pocket" will correct itself but she knows now what to do if it recurs. Anyway, the numbers came back today...107 from 150. She was hoping it would be in the double digits but we'll take 107. They are continuing to drop! She is going to have more than the 6 treatments originally scheduled...possibly 7, 8 or 9...however many her body can tolerate the toxicity and the numbers are decreasing. We are so grateful for all of your prayers...we know that our Father in Heaven is hearing every one of them, that He knows Kim and each one of us personally. We are grateful for the good medical care that is available for her. The advancements just in the past 2-5 years are amazing.

Kim is the most amazing gal I know....she teaches me every day that I'm with her by her Christlike example! What an honor to be her Mom As her Mom (and Dad and siblings) we thank everyone of you that have been and continue to be Angels...for all of the meals, help with the kids, help with the house and everything else that you do....especially the prayers.
We dearly love every one of you! Fern

Going Slightly Stir Crazy

Things have been a little rough this week. It took about 9 days to get over all the effects from this last chemo treatment--and I was really looking forward to getting up and out and enjoying the next 12 days before my 6th treatment. Unfortunately, I haven't gone anywhere (unless you count driving the car in my jammies to the end of the road and the valley schools for my kids) because I came down with either some type of cold/flu bug and/or an infection in my incision site--I'm not sure if it's one or both. I have been fevering, chilling and having body aches on and off since last Wednesday. I started an antibiotic on Thursday afternoon, and the redness and swelling on my incision has been slowly decreasing, but I've pretty much stayed at home and laid around all week long. This has been kind of a common occurence with each chemo treatment, and Dr. Prystas is not sure why it's occuring, but this has been by far the worst it's gotten. I am so hoping that I'll turn the corner today and have one good week to go before my next treatment--I am tired of being sick. I am very grateful for the lovely ladies who have brought meals in this week. They each brought fabulous "comfort" food--just what you want when you're not feeling well--and I especially needed it this week! I am also thankful for my darling friends, Sue, Jeni and Corrina. By yesterday, I had hit my low of the week--tired of being cooped up in the house, wanting to feel better and get out, but not feeling well enough to do so. They came over about 6:30 last night, dressed in their jammies, with dinner, treats and some "chick flicks" to watch together--I had a great time! I also received phone calls several times each day from my parents, siblings and cousin checking in on me and breaking the monotony of the day. I've been doing so well during my nearly "two weeks off" after each treatment, that this kind of threw me for a loop. I'm continually reminded that we have to have "opposition in all things"--if we don't experience sickness, then we can never fully appreciate how good it is to feel well and have our bodies function properly. We don't always appreciate the good days until we have some that aren't quite as good. Things had been going so well lately, that I was bound to have a little setback at some point--I'm sure there will be more to come. I am continually grateful for a testimony of Heavenly Father and His Son, Jesus Christ and Their plan for me, and for the blessings of a wonderful family and friends. Love always, Kim

5th Chemo Treatment Update

This will be short today--I'm still feeling the effects of the chemo tx on Monday, but want to share my good news. The CA-125 levels went from 282 down to 150 after the 4th treatment. It's not quite as large a jump as the past 3 treatments, but the numbers are getting lower and this was almost a 50% drop again. Mom and I asked Dr. Prystas about how many more treatments I might be receiving, and although she wouldn't commit to an actual number, it looks as if it will be more than the 6 originally planned and that's just a-okay with me. She said that as long as my numbers kept going down, and my body was handling the toxicity well (which it seems to be doing) then she would hate to stop too soon. Because my case is so unusual (with there being a tumor in the breast also) it's difficult for them to predict what's going to happen--plus the fact that everyone responds to treatment differently.
On Monday, I felt again an overwhelming sense of gratitude for Dr. Prystas and her staff--I have so much confidence in her and her abilities. We pray daily that she, and the other physicians treating me, will be guided and directed in the treatment they are providing for me, and I feel a sense of peace that all is going according to plan. What a blessing it is to have such good medical care! I think that because we are so used to having the advantages of good medical treatment, that we take it for granted and don't realize that miracles are performed daily by the good people in the medical field. I do believe that along with their hard work and diligence, our Heavenly Father inspires and blesses them with the knowledge to use the resources He has given us on this earth, and the knowledge of the human body which He has created, to heal our bodies and minds. My prayer is that all of His children could have the same advantages which I have in receiving these miracles. I guess that is part of the the work He has given us--to figure out how to share His blessings with all our brothers and sisters throughout the world. I hope that I can be an instrument in His hands in doing this. Love always, Kim

January Update

Just a quick note today--my brother, Paul, said that when too much time goes by without my posting, then some people get worried that I'm not doing very well. I am doing well--and looking forward to my 5th chemo treatment on Monday. Vern and I celebrated our 25th Wedding Anniversary yesterday. We went to a darling Bed & Breakfast in Logan last night, had a wonderful dinner, and then just relaxed and slept in while Kali came down to stay with the boys and get them off to school this morning. My Mom and Kali helped Vern pick out a mother's ring that he gave me last night with all my kid's birthstones--it is beautiful and just exactly what I would have chosen myself! Later this afternoon, we were able to go to the Ogden Temple with a group from our ward and perform sealings. This was the first time in over 4 months that we've been able to do this, and it was really special for me to be able to listen to those wonderful promises and remember that they apply to our marriage. I am especially grateful these past few months to be married to Vern--he has been so kind and good to me--this challenge has helped me to see him in a different light and has made our marriage stronger. I am thankful for Priesthood power, and the blessing of being sealed together as a family for eternity. Love always, Kim

It's a New Year

I've had a couple of people tell me this week that they wanted me to update the blog more regularly. My answer to them was that I wasn't sure what to write about--the only news was that I'm feeling pretty good and I'm happy! The side effects from the last chemo treatment weren't too awful. By Christmas Day, I was over the worst stuff and was able to really enjoy the day with my family. We spent a wonderful Christmas Eve with the Hansen's, and then spent the next day at home with just our family. Nana, Grandpa, and Uncle Matt and his friend, Stacie, visited for a little bit, but we all stayed in our jammies and just enjoyed our time with each other. I was just so happy to still be here this Christmas, and to feel well enough to enjoy it. I've started taking all the decorations down earlier than I normally do, but I've needed the help of the kids before they start back to school this Monday.

Waking up on the morning of this new year, the sun is shining and this valley is beautiful!! I've been reflecting on how much I love living here--it's not just about the beauties of nature that we enjoy so much. I really think the reason why I love it so much here is because of the beauty in the hearts of the people surrounding me. Twenty-three years ago, Vern was finishing up dental school and we were trying to figure out where we wanted to practice and live for the rest of our lives. Vern was kind of thinking somewhere in southern California or Nevada, where there was more of an opportunity to make a better living--Utah was (and still is!) full of dentists--there were better opportunities elsewhere. Having grown up being close to all four of my grandparents, and four of my great-grandparents, I was pretty adamant about trying to be as close to our families as possible. When the opportunity arose to purchase a practice in Huntsville, halfway between both of our families in S.L. and Brigham City, we jumped at it. I think this has been one of the very best decisions we've made in our married life! It was quite a struggle financially for about the first 7 years, but as I think especially about the last 3 1/2 months, I realize what a "tender mercy" it has been to live here. We are blessed to have close relationships with our parents and siblings, and the relationships we've developed with our friends and neighbors in this valley are a treasure. A friend remarked to me the other day how blessed I've been, because not many people in this life get to know and feel how very loved they are--too often these feelings and sentiments aren't expressed until an individual is gone. I have felt that love in abundance and do feel so blessed!

My next chemo treatment is scheduled for January 10th--this will be my fifth treatment. My body has been responding so well, and hopefully I will only have to have the six treatments originally planned. After that, they will have to do some imaging to determine how much the tumor in my breast has shrunk and if they can then do surgery to remove it. I think I am one of the few women who is hoping for, and looking forward to, a mastectomy. I'm not sure what this new year has in store for me and my family, but I do know that our Heavenly Father and the Savior continue to love us and are very aware of our needs--They constantly inspire the wonderful acts of love and service which we daily receive. Happy New Year to all!
Love always, Kim