Sharks, Shooting Stars, and a New Way of Winning

Posted on August 15, 2026 by Mike

Sharks, Shooting Stars, and a New Way of Winning

We were blessed to be at a little beach cottage this week as a family—the one trip this summer, and just before taking Ella to college next week. The boys were boogieboarding amid schools of fish when I saw a large school jump nearby. I called them to the shallows, and they watched a shark casually swim by just feet away.

A day later, we brought our chairs down at midnight to watch the Perseid meteor shower. We set up chairs in the sand, feeling the warm Gulf breeze and listening to the waves on the shore. We talked quietly, looking up and calling out every few minutes when a brief streak of light flashed across the night sky.

On the hottest of afternoons, we retreated to view the blockbuster Odyssey and dove into an animated debate about the changes from the original text and the cinematic techniques, and I smiled at the discovery that my children are starting to surpass me in cultured perceptions.

Another day, we putted our way through a dinosaur-themed mini-golf park, laughing and competing at each hole—right until I bashed my head on a fiberglass velociraptor. I had a huge Band-Aid on my head for a day. Mia thought it looked like a square yarmulke. Shalom.

Memories are being made. Family is together before we let go of Ella into the next step of life as a college student. We are about to change as a family.

Mia is now dual-enrolled at Calhoun, about to start her first in-class experience there. Along with Mia, Mason, Colin, and Brenden are starting a new co-op experience each week—still classical in framing, but in a new environment with different pacing. More change.

Karly is continuing to balance work and homeschooling. It’s challenging. We are working through the changes, helping the kids to become more independent and accountable, but it’s a hard schedule.

As for me, this summer has brought some substantial changes as well. Since June, several events have happened regarding my health:

I had a full round of scans: CT, MRI, and PET. They determined that each of the four tumors—one in each lung and two in my liver—had all grown slightly but significantly and consistently over the last six months.
We discontinued the trial of CUSP-06 at Sarah Cannon due to the continued slow development of cancer in multiple locations.
To treat the two lung tumors, I received a round of SBRT radiation in July to each lung. We will scan again in a couple of months to determine the results.
I met with my surgeon again at Vanderbilt to determine the viability of doing Histotripsy on the two newly developed tumors in my liver. This was successful last year for a tumor in my liver, and an ultrasound prescreen looked good. But we are back to fighting the insurance company to get this procedure approved. It is likely I will have to push hard, contact multiple people, and go through multiple rounds of denials dragging out over weeks before I can convince them again that this treatment is better and cheaper than surgery and that my doctor, a leading specialist in his field, knows what he is talking about. (I am processing my frustration.)
Finally, I am now back to a more aggressive form of chemotherapy called Fluorouracil (5-FU). (Yes, I am taking a chemo that is literally labeled FU. I am deeply amused.) I am on a two-week rotation: I go in on Monday, get pre-med IVs for two hours, and then get hooked up to a mini-pump for 48 hours that I bring home. The fatigue and nausea are back, and a weird sensitivity to cold, and I get the added bonus of dragging Daryl around for two days. (Daryl is what the kids named the mini-pump man-purse that I sling-pack around. We are adding googly eyes to it next week. Laugh or cry, I choose laughter.)
One last prayer request: The benefit of being on a trial is that the treatment and some of the scans are covered by the trial. We were able to manage some of the costs from earlier this year. Now we are picking up the burden again with additional co-pays, scan costs, and doctor visits. Please pray that we continue to manage the financial burden wisely.

All this stuff has happened in the last six weeks. Some of it is genuinely good—it is a multi-treatment strategy to attack tumors using the best specialized methods for the part of the body affected. But it has also reinforced the idea that this is a battle with limited treatment options and limited chances of success.

In the middle of all this, there was a side comment by one of my doctors that haunted me. “If we do nothing, you only have six months.” It was the first time a timeline had been mentioned. And truth be told, this has been three years of battling cancer almost to the day. Not just any cancer—cholangiocarcinoma. I am already beyond the odds by God’s grace.

So here is where I am: Some want to say that winning against cancer is curing the disease. I can’t tell you the number of people who have contacted me to tell me that their natural supplement, their parasite-killing drug, or some organ extract is going to eliminate and CURE my cancer. The Europeans do it one way, and deep in South America is the answer. It’s the government keeping it secret, or a company that killed the competition to keep me on chemo.

But here is one thing I have learned over the past three years: Chasing your fear to find the answer to the wrong question does not lead to a real victory.

Winning is not trying to cure a cancer that currently has no cure. Hoping that the next scan is clear, the next blood test is negative, or the next miracle is coming just sets you up for crashing disappointment. And you miss what God is actually doing in your suffering.

Winning is the victory in Christ that promises eternal life, taking away the sting of death. Winning is getting all the best specialists to do their part and give me more time with my family. Winning is defined by God giving courage like daily bread, knowing that He has entered into my suffering to walk with me in compassion, even when I do not know why I have to walk this road.

Winning is maturity in adversity. Winning is resilience when crushed.

Winning is the memory of the chill I felt when a predator passed my family in the shallows. It’s in the immense wonder of the midnight sky while holding my son’s hand. It’s sharing great stories. And it will be in the tired but bright chatter of my children riding home in a big red van with 212,000 miles, looking forward to our own beds. Winning is in the time granted as a gift, and the attitude of being present in this beautiful world.

I pray for a cure. I do. And I am doing hard work for it. But I already won yesterday, and God promised tomorrow, so tonight I will sleep well.

At the end of the day cancer has never had a chance of claiming victory over my family, Christ eliminated that on the cross. When you keep running into broken expectations, or painful circumstances, or an unexpected challenge, remember that God has a path to the solution. It just may not look like what you were hoping for or expecting. It may look like a deep valley with long shadows. But beyond that valley are rich green fields and clear still waters. And maybe a beautiful sunset.

“Winning is the memory of the chill I felt when a predator passed my family in the shallows. It’s in the immense wonder of the midnight sky while holding my son’s hand. It’s sharing great stories. And it will be in the tired but bright chatter of my children riding home in a big red van with 212,000 miles, looking forward to our own beds. Winning is in the time granted as a gift, and the attitude of being present in this beautiful world.”

Brenden at 12!

Posted on July 9, 2026July 9, 2026 by Mike

Brenden at Twelve

Time for a great Birthday!

July 3^rd was Brenden’s 12^th Birthday – I am so proud of this son of mine! He is growing into a thoughtful, kind, vigorous young man! He brings his unique energy and focus to everything he picks up – solving Rubik’s cubes in competition, exploring and building upon his grandfather’s coin collection, learning history and math: his mind is constantly absorbing and taking in the world. He is also one of the most well-spoken people you will encounter even at his age. Still shy around many adults, yet when drawn out, he can captivate with his knowledge and ideas. But perhaps the greatest thing is his desire for integrity. Like many you men his age, he can be captivated by something he wants or wanting events to be fair all the time. This can lead to some frustration. But almost always, when given a moment to consider, he thinks it through and discovers the wisdom for right choice.

There are so many memories that I treasure about Brenden. But for some reason, one of my favorites that often come to mind is when he was about 5 years old and was not feeling very good, running a bit of a fever, and just having a hard time sleeping. I took him downstairs, and he laid with his head on my chest as we watched Ford vs Ferrari. I thought he would fall asleep quickly, but he stuck with it almost all the way through. We were just close, and he just wanted to be with me when he wasn’t feeling good. It was just a night when being close to Dad was enough, and that made me content as well.

He has great enthusiasm but is learning to harness all that passion with wisdom. For his birthday, he wanted to see the movie Young Washington, and to visit a battlefield. We did both over the weekend. I love my son and see the journey he is on, and I am blessed to have some measure to walk with him.

A Hard Shadow on the Family Table

Posted on June 29, 2026 by Mike

May / June Family News

Bad: Cancer is Spreading
Good: Ella Prepping for University
Good: Mia, Mason and Brenden Soccer
Good: Family Dinners are Evolving
Note: The picture is of the kids at the top of Rag Top Mountain in Shenandoah NP in March.

A Hard Shadow on the Family Table

So much to update across the spectrum of our family! Grab a cup of coffee for a quick catch-up around the table. God is building our faith through trials but also opening the doors of opportunity. First, the hard news:

Last week was rough. On Tuesday, I had PET and CT scans, and on Wednesday, the results were disappointing: The tumors in my lungs were slightly bigger by a millimeter, but more concerning was that there were new areas in my liver where cancer was spreading, and both my hip and right 5^th rib were more active. This part about my rib was no surprise – I began having pain in my side some weeks ago. For the past 3 years, while I have felt various levels of discomfort, it was always a result of treatment, or a procedure, or some other side effect. But now, the pain I now feel each day in my side is a direct result of the cancer. It’s mostly manageable, and varies from day to day, but it’s a clear sign of progression. All of this turned out to be not just a read flag, but a stop sign. My Oncologist at Sara Cannon said that with the results of clear progression, it’s likely time to end my trial of CUSP-06 and consider alternative treatments (Radiation, other chemotherapy or immunotherapy.) There is no clear other trial drug that she could recommend.

Further, my iron levels and hemoglobin were so low that we could not proceed with treatment even on this past Wednesday, and I had to be scheduled to receive 2 units of blood on Friday just to get the base level up to avoid organ damage. I am also scheduled to get an iron infusion early Monday morning. I am hoping that I can still get another full treatment of CUSP-06 on this Wednesday, but that needs to be confirmed.

This upcoming week, we are meeting with our chief oncologist to circle the wagons and come up with a new treatment plan. This has been an unsettling week. For the first time in 3 years, we don’t have a clear path forward. There are still several approaches, but none of them are obvious. Please pray for wise choices, good research by our care team to take the right approach, and success in managing the new angle of some continual level of discomfort. The uncertainty has caused no little concern for us all.

This will be financially challenging for the rest of the year as well. While the trial covered many costs of treatment, we are still at the end of my FSA for the year, and a few costly repairs to vehicles earlier this year as well as a repair to the home AC have kept us from creating any real cushion. And even thought BCBS said I was approved, Vanderbilt still insists that I owe $1700 for my Histotripsy 8 months ago. Ugh. I am working on some ideas to come up with some extra income, but – Well please pray for us in this area as well. (GoFundMe)

Now, for the good news, and there is a lot to celebrate. We are preparing for Ella to attend Samford University this fall. We have been navigating all the ways to prepare Ella for the full university experience, and she is signed up for classes and plans to participate in Air Force ROTC as well. We are excited for Ella to start this next stage of her life.

Both Ella and Mia had the opportunity to serve on an international mission trip earlier this summer and had an extraordinary experience in a very different culture. They have also continued to work their jobs this summer gaining great experience and some important financial resources. Even Mason has started doing yard work around the neighborhood and is earning his first wages (and bills. He owes me for lawn mower gas!…)

Colin has sprouted up and is helping with more challenging chores. His voice has dropped enough that our dog does not always recognize his voice from another room and barks at him until he sees that it’s just Colin.

Brenden has picked up a couple of new hobbies this summer and thrown his whole self into them: coin collecting and model building. Using my dad’s coin collection, he has learned all about mint marks and different kinds of coins from many different countries. He has also been diligently building a detailed helicopter model.

Mia, Mason, and Brenden are also starting to train for this fall soccer with LK United. Mason and Brenden had a great season this past spring with the team, so much so that Mia was up for jumping back into the sport. LK United has been that great balance of competitive play, character building coaching, and encouraging team camaraderie. It’s very often hard to find sports teams where the schedule is of the hook, or the competitive drive is so fierce that it’s ugly. This team just seems to hit the sweet spot of the best of sports. Looking forward to the fall!

Closer to home, I have noticed something has clicked in many of our dinners together: the conversations are evolving. There is still lots of nonsense and occasional bickering that kids bring to the table in bigger families, but now it’s being layered in with discussions of music, movies, culture, headlines and spiritual perspectives. Francis Schaeffer and Thomas Aquinas are referenced along with Batman, Vader, and Hail Mary. It’s unpredictable, sometimes frustrating, occasionally hilarious, profound, and sweetly richer.

As we continue to live and grow as a family, I find great satisfaction with the people I live with. I have a wife that has worked with great effort to support, love, guide and discipline a set of exceptional, vibrant, unique, creative, opinionated young men and women that are our children. I love them all SO MUCH, and I love that they all have this passion for life as well. Most of all, they all seem to have found a sincere faith in God that is also uniquely their own – each at their own stage with their own questions.

I pray that each of you get to have the experience of sitting around a table with a family that feels secure enough to voice their opinions, but also secure enough to challenge each other’s ideas, but humble enough to still listen even in disagreement, while sharing a foundation of faith and love. If your missing it, keep that cup of coffee and join us at our table. You would find yourself welcome here.

Room in my Heart for Ella

Posted on April 11, 2026 by Mike

Room in my Heart for Ella

In 2008, Ella was born, and I was 37. She arrived in the California spring and lit up our little family and hasn’t stopped since.

In the weeks before her arrival, I spoke with a friend in our small group who was a father of two children about his experience of becoming a parent. He said it was like opening a new room in your heart, one that you never knew was there, only to discover a new capacity for love, wonder and worry. I found his words framed the mental, emotional and spiritual experience when I held Ella for the first time.

Ella is now 18, and a page is turning. I am actually kind of a mess about it. I know there is nothing magical about the days between today and tomorrow, but you can’t deny that when you reach a milestone, something has changed. Just as she has recorded all the measured steps of childhood to young adulthood, so I have walked the steps as a father alongside her. Now we both gradually change the course of our relationship.

Ella is a fierce, fun, bright, bundle of energy, and I love her with all my heart. When she was little and just walking, Karly would be working at the bookstore in the evening, and I would take her to the Americana Mall and watch her clap and smile at the dancing water fountains. Her shining blond curls, blue eyes, and quick smile charmed everyone. Then I would take her home to put her to bed and she would cry; sometimes for hours.

As she grew, her personality emerged as a sweet, vocal, stubborn, kind, compassionate child. She seemed to have boundless energy and creativity, filled with imagination. When she loved a topic, she dove in with both feet and learned everything about it. Everything. Many believe I inspired Ella to get into Star Wars, but she actually did so on her own and soon became knowledgeable about both the story and its behind-the-scenes details. When she started writing, it was with a creative discipline that far exceeded my own at her young age, and I was very proud of what she could do.

Ella acknowledges that growing up comes with challenges, but her outgoing nature has helped her encourage others as she works through her own struggles. Her vulnerability and courage is another commendable trait about her I hold close to my heart.

No father is perfect either. I have regrets I can’t let go of without the gentle embrace of divine grace. I could have spent more time, given more wisdom, soothed the hurts of life better. I could have use my words and actions to better lift, strengthen, heal, prepare, guide and empower her. I am still going to try and do those things for as long as God give me.

But perhaps the most comforting thing I see is her foundation of earnest and curious faith in God. Ella is sincere in both her foundational beliefs, and well as the questions that come with a complex and nuanced world view. Ella has convictions, and they are centered strong ideas of goodness and justice.

As I linger in that space in my heart, I find it is furnished with a great number of wonderful memories of Ella. Manuscripts on a table; swim goggles hanging on a hook; sweet coffee drinks; colorful outfits for an 8-year-old. Jars of tears and flasks of laughter. There are a thousand other things: some scattered about and others displayed with care. Yet for all the treasures, the room is not full. Not by a long shot.

Happy Birthday, my dear Isabella. Looking forward to adding new treasures to my heart.

You have a museum in your mind, a museum of memories.

Anniversaries. Birthdays. Milestones. Traditions. Each one hangs in its place, firmly fixed in your mind…and in the minds of your children.

You’re the curator. You watch over its treasures and realize its value.

But here’s what Solomon wisely reminds us:

“It is useless for you to work so hard from early morning until late at night, anxiously working for food to eat; for God gives rest to his loved ones.”

— Psalm 127:2

Very few treasures from the office hang in our museums of memories. Overworking ourselves at the expense of our families is useless because, ultimately, it is God who provides for us.

We have a museum to look after, and it needs to be filled with the right treasures.

— Chuck Swindoll

Winter Paths

Posted on February 15, 2026 by Mike

paths

Winter Paths

“There is no real going back. Though I may come to the Shire, it will not seem the same; for I shall not be the same (…) Where shall I find rest?” Gandalf did not answer.

Sometimes there are just no immediate answers. Life does not always happen on your schedule. It’s hard to give a clear update when the results are far from clear.

While I had CT scan two weeks ago, I still don’t have clarity on the results. Scan results are usually run to be compared with the last results to see what has changed. Unfortunately, the comparison of my last results was done with scans from 6 months to a year ago, resulting in some conclusions that don’t compare well. So we are waiting on a new comparison and re-read between the scan from December 4^th and January 26^th.

We have done some ‘back of the napkin’ comparisons, and the results look like a mixed bag: One lung tumor shrunk, one stayed the same. Which is good. But one small liver tumor may have increased, and we don’t have real clarity on what is happing with the metastases on my rib and hip. Maybe we will get some more clarity this week – or maybe the conclusions will still have the shadows of ambiguity. In the meantime, we are continuing to move forward with the treatment plan with the clinical trial of CUSP06.

I am in treatment every three weeks and have had a ton of lab tests for the first three treatment cycles. Now that we are past the first 3 treatments, most of the lab requirements are going away, and the next time I get treatment later this month, I don’t have any extra labs to do. This is a big relief to not have to drive up to Nashville for just a blood draw (2 hours there, 2 hours waiting for results, 2 hours back) once or twice a week.

The treatment has been challenging – lots of nausea and fatigue that is lingering for a week or more. While this is a novel drug that has a complex chemical delivery system, it’s still a chemo-adjacent drug with chemo-like effects. It can be challenging, especially in the immediate days after treatment.

I am well into 3 years on this cancer journey. It’s hard. It’s hard on Karly. It’s hard on my kids. Brenden has been living with this shadow over his dad for years, and it’s still not normal, and still scarry.

Yet there remain moments of simple charm and delight. When I hear the kids laughing and vigorously debating a movie or song. When we have an open discussion and I feel that I can offer a small measure of encouragement. When I curl up next to Karly at night.

I still do not know where the whole thing is going – no one really does. But I try to find the living bread for each day. And a little hope for tomorrow.

Wait for the Lord; be strong and take heart and wait for the Lord. – Psalm 27:14

Down a New Road

Posted on November 18, 2025November 18, 2025 by Mike

Down a New Road

The last couple months have been a roller-coaster of changing plans, much of this coming from an extended engagement between Insurance, hospital, and me to get a treatment scheduled and completed.
The good news was that I DID ultimately have a new procedure called Histotripsy to treat one of my liver tumors successfully. The road to getting that treatment was anything but easy. I won’t go into the details – because it’s exhausting – but it took 6 weeks, nearly 40 hours of work, going through multiple channels, including the state insurance board, state representatives, lobbyists, review boards, all working to explain how this procedure was no longer ‘investigative’. I ultimately wrote a 5-page report on the procedure – ask me about Histotripsy some time for the details. Oddly, once the insurance was approved, it took the hospital a couple of weeks to figure out how to process the approval and get me scheduled for the procedure. In the end, it was God’s grace and provision that allowed for the procedure to take place.
In the days before the Histotripsy, I had an updated CT scan, which showed some unfortunate developments. My bone metastasis in my right rib and in my left hip showed renewed activity. In addition, they discovered a set of 1.5 cm tumors, one in each lung. However, both liver tumors appeared smaller, which was the only good news. I also recently had a blood test return results with a dramatic increase in trace cancer markers. With all that, and working with my care team, and some remarkable providential timing, we came up with a new treatment plan.
Step one is done – the Histotripsy took care of one of the two liver tumors. The remaining tumor is still small, and we are going to monitor it.
Step two – For the bone metastasis, we brought in a radiation oncologist and determined that a two-week course of targeted radiation on the two locations should knock them down. After a few days of wrangling with insurance complications – again- we were able to work out the details, and I started my two weeks of treatment Monday 11/17. This should be straightforward with only minor side effects, like some extra fatigue, but it should also reduce some of the occasional discomfort I feel.
Step three is the real turn. 18 months ago, I met with an oncologist at the Sarah Cannon Institute in Nashville, and they ran tests on the original tumor that was removed back in 2024 and noted that I had a few key markers that would have qualified me for a clinical trial, but there were no openings at that time. After the last scan, we asked again. As providential timing would have it, one slot had opened!
It’s a very targeted treatment, and the chemistry is fascinating. The treatment involves an infusion of antibodies that have been modified to seek out and attach to cancer cells that have a particular protein marker. Once attached, the cancer cell draws in the antibody and starts to disassemble it. The sequence has been modified so that the first part disassembled releases a powerful chemotherapy drug that kills the cancer cell, and usually some nearby cancer cells as well. The kids and I have taken to calling it Project Trojan Horse. The trick with a clinical trial is that I must discontinue all other treatments while on the trial (no more chemo- or immuno-therapy), and I have a short wash-out period from the radiation before starting. I must go to Nashville on December 3rd for an enrollment process and a series of baseline tests, then I will start the clinical trial mid-December.
So here are the prayer requests:
Pray that the various treatments are effective. I have pushed for an aggressive, multi-treatment approach that knocks everything down as hard as it can before starting the trial, because once on it, I must stick with it alone for a while. If it’s not effective, I have other choices, but the reality is that chemo and Immunotherapy are not as effective as they were in the past. Pray that the radiation and trial are truly effective.
Pray for logistics and funding. I now have to go up to Nashville for all of my treatments, scans, doctors etc. Many of the costs appear to be covered by the trial, but we are continuing to pay numerous co-pays and there is simply the additional time Karly will have to take off from work to be with me. In addition, we have had several critical hits the last couple months beyond the ordinary budget: The downstairs heat went out for a couple of weeks and was a costly repair to an old unit we could not fully replace. Our cars have both been extra expensive this year with repairs that drew from savings.
Finally, pray for the family. This continuing fight takes energy, time and resources that we just don’t always feel that we have. And family life needs to continue as well – Ella is deep in college applications. It’s challenging to keep the homeschool structure going with all that’s going on and Karly working. Trying to effectively give everyone fair and heathy family time is difficult.
I am grateful for how God continues to provide, but the path ahead is only visible a short distance. I have no idea what 6 months from now will look like and today that uncertainty is hard. I feel like one of the disciples still in the boat. I can see Jesus on the water, but the boat is creaking under me, and I am holding to the mast. Peter can get out and walk on the waves, but man, how do I do that? Where does that faith come from?
That being said, I have seen a collective string of ‘circumstances’ over the past two years that together add up to more than just coincidence. I have hope, and I know not to trust any one plan or treatment. We are waling a long road with many ups and downs, and now we are managing many different choices and options as we try to find the most effective treatments. Ultimately, God is really in control, and I am ok with that.
I have recently taken to reading the Lord of the Rings again, since it’s been more than 25 years since I last read it. There was a short verse that Bilbo sang when he left the shire for the last time:

The Road goes ever on and on
Down from the door where it began.
Now far ahead the Road has gone,
And I must follow, if I can,
Pursuing it with eager feet,
Until it joins some larger way,
Where many paths and errands meet.

So I am still walking this road to a far county, one of healing and comfort, even if this path is rocky and difficult.

“The Road goes ever on and on
Down from the door where it began.
Now far ahead the Road has gone,
And I must follow, if I can,
Pursuing it with eager feet,
Until it joins some larger way,
Where many paths and errands meet.”
— J.R.R. Tolkien

Cheers and Fears

Posted on August 23, 2025October 31, 2025 by Mike

Updates

New Diagnosis, New treatment
Insurance Challenges
Facing Anxiety

Cheers and Fears

One of my favorite shows in the 80’s was Cheers. Funny, sharp and endearing, you just wanted to go visit a place ‘where everybody knows your name’ just like one of the verses of the theme song. I was reminded of the show when I noticed that there are now two places in my life where, when I walk in, I am welcomed by name by multiple people: Decatur Presbyterian Church and Clearview Cancer Institute. The first is a joy to be known by my church family. The second, well; there is a kind of comfort to be known and well-tended to by the professionals at CCI.

The receptionist recognizes me and starts my check-in as I am walking up as he greets me “Mr. Bailey”. My Oncologist will tease me in the hall for being a troublemaker. The scheduling nurse and I have an ongoing Dad Joke marathon. My treatment nurse will often offer me a premium seat by the window knowing that I spend most of my day in the infusion center working remotely while I receive my treatment. I know that I am blessed to have made the connections with a care team that communicates well and works together – not just CCI, but at Vanderbilt and with my wholistic oncologist as well. All these people know me and have been working for the past two years to keep me alive, and I don’t feel like a number to them. But at the same time, I would rather not know them at all. I know them because I have cancer. I would never have encountered them if it weren’t for this life-threatening illness. I am glad to have them in my life, but the circumstances were not my choice.

And we are in a new stage now. The good news is that from that the diagnosis from January (the three small masses in my liver and the metastasis in my rib and hip) have all resolved. Which was a great result considering how many areas of concern had developed. However, in the last scan, two new small tumors have appeared in my liver. While they are small, the big concern I have is they developed while I was in therapy. That may mean that the current treatments are becoming less effective. I have also reached a point where my care team decided that after a combined 18 months of aggressive chemotherapy, my body needs a break. It was just getting very hard to handle that treatment regime. So, we have discontinued chemo for now, and are just focusing on immunotherapy, which has a much lower side-effect burden. Last week I had only an hour of treatment, down from 7 hours with chemo, and I only need to go in once every three weeks. There was nausea and fatigue, but it only lasted a day, not five days with chemo. That leaves the two new tumors to deal with, and we have an option for that.

There is a new treatment called Histotripsy which uses an ultrasonic pulse directed at a liver tumor, causing cavitation that breaks down the tumor tissue. It’s a non-invasive way of destroying cancer tissue and has been shown to be very effective (90% + success). But there is a hitch. While Histotripsy has been approved by the FDA and is not considered experimental, Blue Cross of Alabama considers it ‘investigative’ and does not cover it. United Health in Alabama covers it. Blue Cross of Tennessee covers it. I have Blue Cross of Alabama. We are gearing up anticipating a denial and getting ready for a fight through an appeal process.

This is frustrating on a number of levels. Histotripsy is not a new technology, but an evolution of an existing technology applied in a new way. For decades, ultrasonic waves have been used to breakup kidney stones – Lithotripsy. It’s effective and safe – I have had it done twice to crush kidney stones, and it’s worked. Applying it to liver tumors is a natural and proven extension of the technology, even though it’s a radically different target and disease. It very much seems like a better option than surgery – less risk of complications, faster recovery, less discomfort, shorter procedure, shorter anesthesia, reduced hospital stay. Honestly, it seems like a less expensive procedure as well, which I think would be to Blue Cross’s advantage. I don’t get the math on their side, and I am frustrated because it’s my body – and life – we are pressing through somebody’s spreadsheet. If it was an experimental procedure with unproven outcomes, or low statistical samples, I would get it. It’s been approved by the FDA since 2023 – it’s new, but over 800 patients were treated in 2024, and hundreds more already this year, all with almost immediate, measurable successful results.

So, here we go. For the first time in two years of fighting liver cancer, we are facing a potential delay in treatment, or a second-choice treatment (Surgery), due to an insurance dispute that goes against a qualified medical recommendation by multiple physicians. For the most part, I have been incredibly blessed with an excellent care team that I have come to trust through experience. I have even had a very positive experience with Blue Cross with quick coverage determinations and good support and service. I just hope that will continue.

Even if approved, we are going to face a challenge. We have already expended our FSA long ago, and will be paying co-pays and fees out of pocket – and there are many with multiple scans and treatments ongoing. Cost will continue to be an issue for us.

There is one other reality I am facing: emotional fatigue. It’s been two years since my initial diagnosis, and I am tired. Just really tired of the toll this is taking on my family, my children, my financial wellbeing, my mental health and spiritual strength. Since hearing that I have two small tumors that have developed while in treatment, my anxiety has greatly increased. I had a pretty good ability to pray through fear and reach a moment of calm and peace, but that has become much harder now. I still trust God, believe in Him and His plan – I don’t need to see it all, but walking forward in the dark with even more concerns now is simply harder. I have seen God provide my daily bread of hope, comfort, and provision so many times since – I have more evidence of His gracious providence in the last two years than in the past 40 years. But cancer weakens you, humbles you, hurts you, and keeps whispering to you how you have every reason to be afraid.

A couple of weeks ago, I was able to be at a Zach Williams concert. One of his best songs is “Fear is a Liar” Here is the chorus:

Fear, he is a liar

He will take your breath

Stop you in your steps

Fear, he is a liar

He will rob your rest

Steal your happiness

Cast your fear in the fire

Cause fear, he is a liar

I have had that song on my playlist throughout this experience, and its powerful message is an important check in broken thinking. Another quote that I have often thought of through this experience comes from one of my favorite novels: Dune by Frank Herbert. Recited by a couple of the characters at key intense moments, it’s used as a mantra to gain focus.

“I must not fear. Fear is the mind-killer. Fear is the little-death that brings total obliteration. I will face my fear. I will permit it to pass over me and through me. And when it has gone past I will turn the inner eye to see its path. Where the fear has gone there will be nothing. Only I will remain.”

But the best and most empowering message comes from Living Word In Psalm 23:

The Lord is my shepherd; I shall not want.

He makes me lie down in green pastures.

He leads me beside still waters.

He restores my soul.

He leads me in paths of righteousness

for his name’s sake.

Even though I walk through the valley of the shadow of death,

I will fear no evil,

for you are with me;

your rod and your staff,

they comfort me.

You prepare a table before me

in the presence of my enemies;

you anoint my head with oil;

my cup overflows.

Surely goodness and mercy shall follow me

all the days of my life,

and I shall dwell in the house of the Lord forever.

I would note a couple things here. Unlike the thoughtful but self-help motivation of the Dune quote, in Psalm 23, the help and rest and blessing comes from God himself. It’s not even the idea of having faith – faith is just the pipeline through which the living water of hope comes – but it comes from God. Faith is not an end source of hope, but the connection to the true source of strength and encouragement, which is God himself. When I am weak, tired, angry, lonely, and frightened, I can’t even find the strength to motivate myself to hope. It’s then that I receive hope as a gift, I just need to open my hand to receive it.

It’s God who knows my name. It’s God who is glad to see me, welcome me, give me a cool drink and is ready to hear all about my day, good or bad. Or just sit with me in companionable silence. And in those times when I recognize his presence, it’s then that fear falls to the comfort and peace of God.

Note: Mia took the picture of Mason this summer at a lake in Ohio, and it just seemed close to perfect.

Exceeds Expectations

Posted on May 3, 2025October 31, 2025 by Mike

Exceeds Expectations

“Exceeds Expectations” Those were the first words out of Dr Miriovsky’s mouth when he walked in the room. I needed a moment to take it in. What did that mean? “It means there is no more detectable signs of cancer” Karly and I looked at each other stunned. The three spots in my liver? Resolved. The fifth-right rib? The left pelvis? Both showed no sign of cancer tissue, only remaining sclerosis (Increased bone density). “This is everything we wanted but were afraid to hope for.” Monday was a good day.

So, what does this really mean?

First, we are just enjoying the good news that treatment appears to be effective. We once again get to praise God for His merciful hand and listening to so many of the prayers of family and friends. Thank You! We are grateful for the wisdom of my care team and their coordinated effort. I am blessed to have Karly and my kids being so supportive and encouraging even in the midst of their own fears. We have also been blessed by our church family in so many ways over the past nearly two years. This is a good place for a marker in the timeline to show our gratitude.

Second, it’s easy to say that God showed up in a big way, but Karly and I want to be clear that He was already showing up each day in a thousand ways. There have been so many times when we were walking in anxiety, God was holding us together. We were expecting a different outcome – I don’t trust the signals my body is sending me. Is that pain in my side indicating that the cancer is spreading, or dying? I just could not tell, other than there was a pain in my side. If the circumstances were different, the same God was working, and we are working to trust in his timing.

Third, we need to be real about what this means in context. It appears that my body has accepted 3 months of Chemo- and Immunotherapy successfully. While undetectable to a PET scan now, it does not mean that I am cancer free. This is a remission, but too soon to determine whether partial or complete. Because we had several months last year where cancer was undetectable, then it came back in 5 different places fully metastasized, we need to still be aggressive in treatment, and cautious when backing off. Dr Miriovsky said that I may never be off maintenance immunotherapy. The reoccurrence rate for Cholangiocarcinoma is still high. There is a cost to every victory. So we are planning to continue another 4 rounds of therapy over the next 3 months. We are also going to try and get my case before the Vanderbilt Tumor Board again to see what they recommend.

This week has been like one long exhale. I didn’t even know I was holding my breath, but psychologically, that was what we were doing. There was this tightening, shrinking feeling in my mind. Now, I am drawing sweet, deep breath into my mind and heart. Even though therapy will be continuing, I know it’s still working, and that makes it easier to push through it.

When peace like a river attendeth my way,
when sorrows like sea billows roll;
whatever my lot, thou hast taught me to say,
“It is well, it is well with my soul.”

The Call of Real Faith

Posted on April 23, 2025October 31, 2025 by Mike

“And behold, a lawyer stood up to put him to the test, saying, “Teacher, what shall I do to inherit eternal life?” He said to him, “What is written in the Law? How do you read it?” And he answered, “You shall love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind, and your neighbor as yourself.” And he said to him, “You have answered correctly; do this, and you will live.” – Luke 10:25-28

The Call of Real Faith

Going back to treatment has been hard. It was a hard day back in January to hear that the cancer had returned and spread. Now after 3 months of renewed treatment, I go on Thursday morning for a new PET scan that will reveal what the next steps will be.

It’s lead me to think about how I have both struggled and grown in my faith over the last 2 years. I have been considering what is real faith; such a core tenet of the Christian paradigm, but often confused and elusive to even strong adherents. I think a real Christian faith Is wrapped up in the core of the greatest commandment: Love the Lord God with all your heart, soul, mind and strength. Jesus calls this the greatest commandment, and it’s found in three places in the bible: Matthew 22:34–40, Mark 12:28–34, Luke 10:25–28.

Faith is more than an intellectual assessment or opinion, but it starts with a considered assessment of hopefully clear thinking. From the heart, It’s more than a flash of emotion or momentary inspiration. There is something powerful when it’s connected with a genuine spiritual experience, and a Christian faith has durability and consistency as it’s true strength.

I was listening to an old Tim Keller sermon and had some great notes about how faith starts with intelligent questions. Contrary to the common presumption that faith is just accepting an idea without evidence, actual faith in an investigation of an idea until you are satisfied that the evidence fits the reality that you need to act on. Pastor Keller gave an example that was remarkably close to my actual experience last year. Soon after my initial diagnosis, I met my surgeon to discuss the potential of removing the tumor from my liver. I asked a bunch of questions, and he assured me of his qualifications to do the work, that he had done this type of surgery before, he could do multiple approaches, etcetera. I became convinced that this was the right approach and scheduled a day for the procedure. I had faith that he could do what he claimed he could do. But the day came, and I had to actually show up and walk into pre-op and start getting ready. The nurse started describing everything she was doing, and my anxiety just went right through the roof, and I passed out. I woke up 30 seconds later and really wanted to just go home – my faith was wavering based on what I was seeing. This is the opposite of what many people expect from faith – Seeing something is supposed to build your faith, right? I had to stop and think – to consider – to renew my thoughts about why I was there. The surgery plan was still the right plan, despite my doubts and anxiety. My faith became real when I laid down and let them put the mask on me and started to count backwards. Real faith has a foundation in intelligent pursuit, and my mind had to oversee my circumstances. Faith needs to be struggled with and investigated. It does not need to be a complete understanding – It just needs to make more sense than any other set of proposed conclusions.

Faith is connected to the soul. There is a mysterious connection to the presence of the Holy Spirit in generating faith. As a Christian, I believe in the presence of the indwelling of the spirit of God in every true believer. It’s not like being plugged in to a power line – It’s not an impersonal force. I think of my home when I was a kid and a relative would come and stay for the weekend. The house would be cleaned up, a menu of good food prepared. The life of the home would be more vibrant with loud, with sparking conversations and an occasional board game. The house had a fullness to it, a rounded presence of trusted family, stories, food and memories. It’s out of this type of fullness that faith can spring up out of grace and peace, not fearful or reactionary, but grounded and complete. We can love God with our soul when we recognize that faith is nurtured by God himself reaching into us with his goodness and lifting us, warming us with his presence, allowing our thoughts to be clear and strong.

Faith also needs to come from the heart. Now the ancient understanding of the heart was where the center of the will was located. We tend to think of heart, in metaphor, as where our emotions and passions originate from, but an ancient reader would understand that Jesus was saying that to love God with your heart was to choose to act on your love. You willfully choose an action based on what the mind has qualified, and the soul has enabled. It is raising your hand to be counted among the fellowship. It’s actually doing something for that struggling friend. It’s the show-me part of saying you’re a believer. When you engage in devotional activities, with a church family, serving in a compassionate manner, or any of a thousand other ways we can take the inner life of faith and find expression in the physical world. This is faith that comes from the heart and loves God.

The strength part of the greatest commandment is where it’s enduring and vibrant. You’re not just acting on your faith, you’re acting on it consistently and creatively, improving the way you walk. It’s not about being perfect, but it is about a consistent trajectory of striving, a willingness to set a direction and keep going.

Real faith is a thoughtful, spiritually full, willful, and enduring expression of loving God, one who first loved us through promises and patience, through Christ, and now day by day as He provides for us.

That leads to my simple prayer request. Yesterday was not a chemo treatment day, but I do have a PET scan scheduled for Thursday. It’s an important one that comes after 3 months of renewed treatment, so it will determine how effective the chemotherapy and immunotherapy has been – or not. If you ask me how I feel, I can’t give you a clear answer. I feel the effects from the treatment, and I feel my ribs occasionally twinge, but is that cancer spreading or dying, I can’t tell. Please pray for healing and a positive mental health as we feel the anxiety of the coming test and results next Monday.

Whatever the results of the scan – and the next scan after that – I have faith – real faith – that a good God will be leading every step.

What Comes First

Posted on March 9, 2025October 31, 2025 by Mike

What Comes First

“But seek first the kingdom of God and his righteousness, and all these things will be added to you.” This has been buzzing in the back of my head for the last week. It’s from Matthew 6, from the middle of the Sermon on the Mount, right after the Lord’s prayer. The next verse starts with “Therefore, do not be anxious about tomorrow…” It’s part of a compelling passage about anxiety and how it can control your life, and Jesus utters this phrase as the solution to managing our anxious lives.

First, the cancer news. I am back in treatment and it’s an old pattern of Tuesdays at the infusion center for most of the day. Then hanging in there Wednesday and Thursday to start to feel better on Friday and into the weekend. Stay hydrated. Get some extra rest. It’s not fun, but it is a familiar track to race on.

The two main updates are that I have had a new biopsy that confirmed my diagnosis of Cholangiocarcinoma, and I met with a new doctor at the Sara Cannon Institute (SCI) in Nashville. While everyone agrees that the current treatment is the best course for now, SCI may be able to help find trial drugs that might help if the current approach fails. It’s always good to have a plan B. or Plan C. The biopsy I had will provide current tissue to test and look for markers that can confirm my eligibility for new treatments.

Please pray that my current treatment is effective. I am also experiencing a little PTSD-like anxiety reaction with needles and injections lately. I still have a port that works for injecting, but has become a little difficult when drawing for lab tests. Last week was fine, but I have passed out several times recently when doing basic draws for labs and scans. It’s challenging to try and ‘think your way through’ the moment, but just can’t quite keep from blanking out for 30 seconds. It’s nothing serious but just embarrassing.

On the happier side of family life, Ella, Mia and Mason were on the robotics team that won the state championship and qualified to go to the World Championships in Houston. We are still working on getting together the plans to see if we can make it for the trip.

Otherwise, life has a normal pattern while living under a rather abnormal set of circumstances. Mason and Colin recently spent time with their Trail Life friends playing Airsoft wars. Mia had a couple of friends over to spend the night, and Ella when out with a friend to go dress shopping and came home with half a dozen books. That’s our girl! I got to spend a little time with Colin and Brenden tossing the ball and batting at the park this last weekend. Ella and Mia spent the last week at an event called TeenPact in Montgomery where they practiced the legislative process and meet state and national leaders.

Seeking first God’s Kingdom is hard when you have your own daily responsibilities. How do I give attention to the kingdom business when I have my own affairs to manage? Yet, the truth I experience is that when I put the perspective and priorities of Christ’s kingdom first: Loving God and loving my neighbor, I find that I have less stress and a better perspective. I can see how God has provided for me and my family above and beyond my own effort. Jesus connected the idea of actively engaging in establishing his kingdom with prayer and communication with God with the command to not be anxious. I am still contemplating how all this interacts and relates, but It’s clear there is a real progression here that is worth considering.