Beware the Ides of March!  March 15^th has come, and unlike Ceaser, I hope to walk out of my encounter with a knife in healing.  My encounter is knowing, and hopeful, if not easy.

Friday, I will undergo surgery to remove cancer in my liver and a lymph node.  Hopefully it will be all robotic, but it could end up being more intense and an open surgery depending on what the doctor actually encounters.  I am asking for prayer for myself, my wife and my children.

Our perspective in the world is sometimes only focused on the threats around us.  At one point in the past year, one cell in my body divided wrong and kept going.  My immune system missed it.  Nevermind that millions of other cells kept functioning correctly.  This little cluster got out of hand.  We forget the daily grace that abounds all around us.  We may have 364 days in a year that are warm sun or nurturing rain, but only one when a tornado shows up.  I am not trying to minimize tragedy or challenge.  Really, my Friday is going to be rough.  But I don’t want to lose perspective that there are a lot of beautiful days in this life, and there is a common, vast amount of grace in this world.

Please pray for us.  My paradigm of faith sees the sovereignty of God at work.  I have prayed for others in my life, but over the past few months, I have newly experienced the emotional and spiritual compassion of faithful people praying for me, and it has changed me.  If God is merciful, of which I am hopefully confident, I have a new trajectory for my life.  One way or another, I am going to have a deeper and richer experience after tomorrow.

We will keep you updated on the results.  Thank you for your prayers during this real challenge.  There is fear in this, but I hold there is a God working mercy – undeserved – but mercy no less.

• 6 Months of Treatment Completed
• Latest Image Results are ‘Remarkable’
• Surgery Date Set
• God is Still Good

We have passed a milestone, and have a new direction, and it comes with some good news, but confirmed one big challenge. 

I have now completed 6 months of chemo- and immunotherapy. It was a long process, and was becoming more and more difficult, but we did it.  So, last week on February 15, we spent the day at Vanderbilt having scans, labs and meeting with the surgeon.  The scan results were very positive.  Compared to the original set of images from last September, the liver tumor (and affected lymph node tumor) has reduced over 60%. He used the term ‘remarkable’ for the results.  I feel remarkably blessed.

With that kind of success, we were able to have an informed discussion about surgery. I am a little leading edge:  The immunotherapy that I have been receiving is a very new treatment for my type of cancer, and it creates two additional challenges. First, it’s inflammatory to the tumor area.  This is why I have been feeling discomfort in my side even as the tumor has been shrinking – it’s a good thing, because it means that my immune system is responding and fighting the cancer.  But the inflammation of the area makes the surgery a little more difficult.  It also has another effect: treatment makes the cancer tissue ‘sticky’, making to more challenging to remove.  (I wanted to suggest spraying my liver with Goo-Be-Gone and rubbing it out, but that felt snarky)

Despite the challenges, my surgeon was still very confident that he could be successful removing the last of the cancer.  It’s going to cost me 15-20% of my liver, my gall bladder, and a lymph node deep inside.  He was also confident that he could do the liver resection and gall bladder removal as a robotic/laparoscopic procedure, which would reduce my recovery time.  The challenge is the lymph node.  It’s deep inside my trunk and surrounded by some core arteries and veins.  He is going to try to do it robotically but will switch to an open surgery approach if necessary to make sure to get all the cancer tissue.  It’s a call he will have to make during the surgery itself depending on what he sees.  All that considered, we think it’s the right approach with the right surgeon. 

We scheduled surgery for Friday, March 15.

So now the preparation begins for that last mountain – God willing it’s the last mountain on this journey.  I will be honest – I am not excited by the prospect of 6 hours of major surgery. I am haunted by the surgery that my own father went through when I was 13.  That was far more invasive and challenging, and he recovered, but I can’t deny the daunting aspects of this solution.  I am on board, and this is a sound decision I am confident in, but it’s not emotionally easy.

I know that it’s not just a challenge for me.  This is hard for Karly and the kids as well.  There are plans to make and preparations.  I am glad to be done with chemo, and I am increasing my exercise for the next couple of weeks to build up my strength.  I am making time to spend with the kids and Karly.  I am trying to focus on the outcome, not just the challenge.

Did you know that every time your heart beats, 30% of that flow goes to your liver?  Did you know the liver is one of the few organs that can actually grow back?  I could have 75% of my liver removed before they would start to be concerned about organ failure.  It’s a remarkable organ within a remarkable system.  The interconnectedness, interdependency, and functionality of the human body is miraculous to me.  What is conscience in the brain?  How is cellular mitosis regulated?  It’s all a wonder, and we tend to take it for granted until something goes wrong.  Even when cancer invades, there are billions of other cells still working right. 

I see the hand of a creator and sustainer at work.  I see that designer’s hand in the endless stars above, moving among the uncounted cells of my own body, and His fingerprints further below in the mysterious quantum mechanics of the smallest particles. We are suspended in this life between the astonishing immensity of the cosmos, the surrounding complexity of our own existence, and the mysterious reality of the subatomic. Though a paradigm of faith I can see an order and a balance to existence, and even further, I see purpose.  It’s humbling.  It’s encouraging.  It’s even glorious.  That little pain in my side has reminded me that hurting can be part of the healing process, and that mercy is still something that God expreses.
Please keep praying – there are still mountains to climb and valleys to stumble through.  As we move closer to the next big step on March 15, I’ll keep everyone updated.

First, some updates: I am nearing the end of my 6 months of chemotherapy: February 6th is my last scheduled treatment. We now have new appointments on the board: 2/13 is a CT scan and 2/15 is my next consultation with the surgeon at Vanderbilt.  There are a lot of branching possibilities depending on the scan and tests, but the middle of the road is to expect some kind of surgery 3-4 weeks after my last Chemo treatment.  Maybe.  Unfortunately, we just don’t get to see past the next set of tests to see what the future has in store.   

My treatments have become increasingly challenging.  The fatigue is real and persistent.  I spend a full Tuesday at Clearview Cancer Institute getting my infusions, and the fatigue builds Wednesday and Thursday and peaks on Fridays.  Then over the weekend, I start to get a little more energy.  It’s challenging to keep clear-minded as well.  Karly and the kids all dance to this rhythm, giving me space, encouragement and patience as I work through the process. It’s a new routine, but it’s never normal. 

We have noted a few interesting things about my particular brand of cancer and treatment. For one, I have discovered my own form of cancer-induced male PMS!  I tend to get a little emotional and ‘dramatic’ on my down days. My naturally emotive self really comes out when I am tired and feeling blue.  Karly is both patient and amused at my displays of sensitive manhood. 

There are a few common questions that I can answer.  I have not lost my hair, (Well, at least not any more.  It was thin to begin with.)  I am not supposed to hug small children and pets the first couple of days after a treatment, since I am RADIOACTIVE MAN! (no super-powers yet.) I had a port installed in my chest to be able to take chemo, So I consider myself fully a cyborg now. (I am Locutus of Borg…).   

We have this weird mix of the serious and the absurd.  The shadow of cancer falls over everything.  How do we plan for summer trips? How will I feel this weekend? What do I step back from?  We have been told many times that it’s OK to step back and say no to taking on things. Take time for yourself.  And there is a certain reality where we have changed focus.  I stepped down from being Troopmaster in Trail Life.  But there is also reasons not to give in to a fully self-focused life, even when the struggles are real. 

I look at it this way.  I am glad that Paul didn’t say “I am stuck here in prison, chained to this guard.  Things look bleak.  I should really focus on myself and my situation – The Philippians will be able to take care of themselves for awhile while I practice some self-care.”  Instead, he wrote: “Rejoice in the Lord always. I will say it again: Rejoice! Let your gentleness be evident to all. The Lord is near. Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.”  When you remember the context of where and when Paul was writing, his encouragement is remarkable. 

It’s easy, and even expected that we should curl up and turn inward when hard times come.  I have done some of that.  But it’s also isolating.  Keeping a compassionate eye toward others is a way to keep your own balance.  I think as I roll into the early weeks of a new year, I am less concerned about a personal new resolution or some trendy form of self-improvement, and I am more likely to lean over and offer a hand to someone else. I’m doing ok, God is gracious and has a plan I trust, even if I don’t know it.

How are you? 

First, we are still in the race.  While we were very encouraged to hear that the tumor has been reduced after three months of therapy, the team has decided to keep up the full regimen for the full 6 months. Basically, don’t take your foot off the throttle if it’s working.  The downside is that I never get quite a chance to fully recover, so the fatigue and side effects are somewhat cumulative.  Each time is taking a little more time to bounce back, a little longer in the fog.  But the reality is this is a marathon, and I am in it to win it, so by God’s grace, I’ll keep running.  The new milestone is February 6 – A full six months of therapy. Then a new CT Scan and likely a liver resection surgery.

I am thankful for cancer.  I have been dancing around that statement for sometime, but I think I can finally state it honestly.

It’s going to take some explanation, right?  How can I possibly be grateful a life-threatening illness whose treatment is taking poison just enough to kill the cancer but not quite kill you?  What about the fear it’s introduced to my wife, my kids, and myself? Being confronted with Cancer with a capital C means you are going to have to face your world in a hard way. 

Some foundations were tested and revealed to be sure.  My faith in God as a Christian gave me real strength and perspective.  More on that in a moment.  My wife was a real blessing: Karly expressed her love for me in real ways for my mental, emotional and spiritual health, and it has allowed our relationship to grow into new, more open ways.  My children have all grown in ways that has given them a more mature perspective as they have processed our family situation.  No one is perfect, and we have all had our moments of frustration.  But we are doing this together.

I am grateful because the cancer has made me more vulnerable.  I am less self-reliant and more dependent on God, my family, my church and my friends.  It’s healthier to be more interdependent in a community.  Some of the old American ideas of self-reliance go too far into isolation and alienation.  Yes, we should be responsible and capable adults able to take care of our basic needs, but we should also be humbly open to share experiences and burdens.  It’s the model of the most ancient church, and the best still for thriving modern faith communities.

One other complex idea that I have been meditating on is that this cancer is actually a gift and challenge from God.  I have never bought into the prosperity gospel messages.  God is not a shallow gift-giver only looking to give material Gifts.  He is not Santa Clause.  The Scriptures reveal a far more compelling, meaningful, and real perspective.  God allows hard and harrowing events to happen to his faithful people all the time.  From the fates of the disciples (None of whom ended healthy or wealthy) to the martyrs of the early church, it’s clear that God has a purpose in working through suffering.  It builds faith, reveals character, validates sincerity, instills compassion, and nurtures empathy.

Thanksgiving was a time of deeper gratitude than I have known for many years.  It was richer because of the circumstances.  And Christmas has always been about hope fulfilled.  So I find myself standing between those grand ideals, not with a shallow faith, but reaching into something more robust and enduring. Through the gates of thanksgiving, I can embrace the reality of hope that Christmas offers.

So Merry Blessed Christmas!

A new reality.  A paradigm change.  A different world.  Whatever metaphor you want to use, cancer has changed our lives in a very real way, and we are starting to see the world from a new perspective.

In the last few weeks, we have had a few updates and confirmed a schedule moving ahead. 

Biggest news is that we met with a surgeon at Vanderbilt. We appreciated his approach and patience with our questions, and  confirmed that 6 months of chemotherapy and immunotherapy are the best approach and then re-evaluate with an eye to surgical recission.  Apparently 10 years ago, they would have taken me straight to surgery and taken out the tumor and considered that a success, but the best practice now is to do the 6 months of therapies to reduce the chances of re-occurrence.  And the immunotherapy is less than a year on the approved list, and in a small but significant set of patients, it has been very successful. So, six months. 

I will have a CT scan in November or early December, then another sometime around late February.  I do know I am not a candidate for a transplant because of cancer in my lymph node near my liver.  Based on the tumor size and location, he would likely take 30-40% of my liver.  That sounded like a lot, but he reassured me that they don’t start to worry about liver failure until you start looking at a 70-80% recission, and we are not going to let it get to that stage.  Apparently, you can take 70 percent of your liver and not really have any long-term issues.  Huh.  Kind of amazing the durability of some organs.

So, we have a course ahead and a general plan.  Now I just need my body to cooperate.  I came in this morning for my 4^th round and found out that my white blood cell count had dropped far enough that I could only take 75% of my scheduled dose.  We are balancing knocking out the cancer with knocking out my immune system. It’s a game of chess with the variety of risks I face.

Thank you for your continued prayers and concern. We are working hard to manage our family schedule with a new schedule of medical appointments and treatments. We do have a very short list of meal nights for treatment days that our close church family has taken care of.  Once we get further along down the road, other needs may arise that we will ask of our extended community, but so far, we are blessed and provided for.  I appreciate the kindness of prayers offered for me.  I do believe that God hears our prayers, and that he acts according to his wisdom and plan in people’s lives.

As a family, we continue to adapt to the new patterns of this reality.  The basic pattern means that I just don’t have the energy and endurance I used to have for the few days after a treatment.  I don’t sleep very well for 3-4 days, and I must fight the occasional nausea, but all in all, it’s been manageable.  I eat a lot more fruit and nuts; and I drink a lot more tea and water.  There are random moments of sadness and fear and even lamenting, but there are also moments of strength, encouragement and perspective.  When I walk through the park, I treasure the trees and sky even more than before. 

And there are blessings even in the treatment.  Mia came and spent the day with me in treatment.  We both got work done, but we also had an epic Uno tournament that had us both laughing and laughing.  It was a good day.

I had a well-meaning friend ask me out of concern how long I had.  I don’t honestly know.  I don’t think any of us know, either.  I have cancer, so the question seems closer, but we are all on a narrow sliver of habitable reality. We are all on thin ice. Go five miles up and you can’t breathe.  Heck, go 5 feet down and you can’t breathe either.  You can’t drink ocean water, or live in it, so that’s 70% of the surface there. Mountains and deserts make nearly ½ the land area uninhabitable.  That leaves only 15% of the Earth’s surface habitable. Go 10 days without food, 3 days without drink, and 10 min without air. We have all had close calls with accidents or illness. 

The treasure of life is the remarkable miracle of experiencing it, and how unlikely it all is. It makes me grateful to God for making me, the beautiful world outside, and my wife and children, my family and friends.  My prayer for you today is no matter your current situation, you can have a moment of awareness of this astonishing world. And then, maybe a one extra moment beyond that where you see the hand of a creative and sustaining God working in ways we are too busy and too small to imagine.

Ready for the Next Round

Thanks to all of you who have been praying and sending encouraging notes – I have been overwhelmed by the number of prayers and encouraging messages I have received. I feel very blessed to have had so many family and friends reach out.  If I have not personally thanked you, please know that I am reading everything, and will reply in time as I can on our journey.

Last Wednesday, (11/6/23) was my first Chemo treatment, and it went smoothly.  It was a long day – a full 8 hours of transfusions (2 chemo medications and Immunotherapy, along with supporting medications).  I left feeling a little strange, a sensation that was hard to describe, but I knew they had pumped a lot of SOMETHING in my system.  Then came the waiting for exactly how my body would react.

Thankfully, I felt pretty good the next few days.  One thing they gave me was a steroid, which made me feel a little jumpy on Thursday.  Nasua was very mild on Thursday and Friday, and I certainly felt fatigue on Friday and Saturday, but by Sunday I was feeling on the upswing, and by Monday, I felt pretty normal, which is a great response, all things considered.

So today, I start the cycle all over again.  I hope that the pattern continues, and while the fatigue was real and I needed some extra rest, it was manageable.  Honestly, the most consistently uncomfortable has been the port in my shoulder.  I am getting used to the feeling of an object under my skin, but it still makes my skin crawl sometimes.  At this moment, I am hooked up and receiving round 2.

I continue to ask for prayer for this process.  Healing, bills, time, work.  There are so many changes making life different, and we are trying to find a new ‘normal’ to this new reality.  I was touched by something one of my pastors said a couple weeks ago – when we pray for others, our faith is lifting them when their faith may by weak.  This communal effort in upholding the concerns of others before God and sharing in the work of recovery is something that God acknowledges and blesses.  This is easy to understand as basic Christian principle.  We pray for ourselves and are instructed to pray for each other.  But as we experience sincere prayer out of concern for others, we open a stream of compassion that changes us for the better.  Karly and I discussed this week how it really is not a burden to pray for others or be involved in their heartache or burdens – It’s often a blessing to able to share the weight.  So if we ask how you are – or how we can pray for you – it’s a sincere question that you don’t need to dodge.  Life is going on for all of us, and life has plenty of trouble for each day.  Keep living it and sharing it as you go.

Thanks again for caring and reading.  I hope you find a beautiful moment today, even if it’s just a glance out the window.