Monday, December 7, 2009

For today

For today, all I can do is be thankful that I don't have to do chemo this week...

Sunday, December 6, 2009

My Lamentation

"I am the man who has seen affliction by the rod of his wrath.
He has driven me away and made me walk in darkness rather than light;

Indeed, he has turned his hand against me again and again, all day long.
He has made my skin and my flesh grow old and has broken my bones.
He has besieged me and surrounded me with bitterness and hardship.
He has made me dwell in darkness like those long dead.
He has walled me in so I cannot escape;
he has weighed me down with chains.
Even when I call out or cry for help, he shuts out my prayer.
He has barred my way with blocks of stone;
He has made my paths crooked.
Like a bear lying in wait, like a lion in hiding,
He dragged me from the path and mangled me and left me without help.
He drew his bow and made me the target for his arrows.
He pierced my heart with arrows from his quiver.
I became the laughingstock of all my people;
They mock me in song all day long.
He has filled me with bitter herbs and sated me with gall.
He has broken my teeth with gravel;
He has trampled me in the dust.
I have been deprived of peace;
I have forgotten what prosperity is.
So I say, “My splendor is gone and all that I had hoped from the Lord.”
I remember my affliction and my wandering, the bitterness and the gall.
I well remember them, and my soul is downcast within me.

Yet this I call to mind and therefore I have hope:
Because of the Lord’s great love we are not consumed,

For his compassions never fail.
They are new every morning;
Great is your faithfulness.
I say to myself, “The Lord is my portion;
Therefore I will wait for him.”
The Lord is good to those whose hope is in him, to the one who seeks him;
It is good to wait quietly for the salvation of the Lord."

~ Lamentations 3:1-26

Saturday, December 5, 2009

Be Strong and Courageous

I woke up this morning very much so still processing the news from my last appointment. Again, it's going to take a while...

Then I got an email from a dear friend, which ended with the exhortation, "be strong and courageous." That immediately drove me to the book of Joshua, chapter one to be exact. After Moses died, Joshua took on the responsibility of leading the Israelites into the Promised Land. It was a big task, way bigger than Joshua was feeling prepared for, I'm sure - but the Lord knew that and yet he still called him to it.

What's encouraging about this story is how many times Joshua was challenged to be strong and courageous. Four different times in his calling he was reminded to be strong and courageous. He must have really needed to hear that, don't you think? The thing that struck me upon my reading of this passage in the context of what I'm facing is the reason why God called him to be strong and courageous... because the Lord his God was going to be with him wherever he went!

That nearly drove me to tears. God encouraged Joshua with the truth that he would be with him throughout his journey, no matter how unprepared he felt... no matter how scary or difficult it might have been. He didn't have to be terrified. He didn't have to be discouraged. Whatever his calling would bring, God would be right there with him to see him through it.

As much as I'd like to opt out of the journey that's ahead of me, I know that I don't have to be terrified and I don't have to be discouraged either... because God will be with me wherever this life may take me.

So with that thought in mind, I put my feet to the floor this morning determined to face at least this set of twenty four hours with faith in the fact that God has a purpose for me in this day and with appreciation for the fact that I even have this day. It doesn't mean that my life has suddenly become all sunshine and roses. I'm still wrestling with some really tough things. I just got the reminder I needed the most this morning... God will be with me through it all!

Joshua 1:9 - "Have I not commanded you? Be strong and courageous. Do not be terrified; do not be discouraged, for the Lord your God will be with you wherever you go."

Friday, December 4, 2009

My Life is a Mist - An Update

I finished my second round of chemo and had another scan recently. I got the results yesterday and as always, it was a mixed bag.

Overall, my doctor is really thrilled with my progress - Let's start with that.

This scan showed that there is still no visible cancer in my abdomen. Even better, it showed that all the nodules in my lungs, with one exception, have completely disappeared! The one nodule that is there is about 8 mm and my doctor thinks that there's a chance it may not even be cancerous. We're going to wait until my next scan and see how it looks at that time. If it's grown, then it's definitely cancer and we'll absolutely have to talk about more chemo after radiation. As it stands now, we may still consider some chemo after radiation anyway. I'll just have to wait and see what my doctor decides when we get to that point.

In addition to that one nodule in my lung, a new abnormal spot showed up in my right groin. My doctor said that it doesn't make any sense that new cancer would show up in that location at this point, so he's thinking that it may not be cancer related at all. Again, we're going to wait until my next scan and see what it looks like at that time to determine if it's anything that we need to address. For now, I'm cleared to start radiation next week.

So, again, my doctor is really pleased with these latest results overall.

Now with the end of treatment becoming more and more of a possibility for me in the coming months, I had some additional questions that needed some answering. Those answers brought some sobering truths to light.

Allow me to let you in on the conversation that ensued yesterday between me and my doctor. The following are the questions I asked and a summary of the answers I received:

1) How many women diagnosed with uterine cancer are stage 4?

A very low percentage... less than 10%.

2) Of that number of women diagnosed with stage 4 uterine cancer, how many go into remission?

Almost none.

3) Early in my treatment plan, we had discussed the statistics that I'm facing with this diagnosis. I have a 15-20% chance of surviving past five years. Does that statistic change if I go into remission?

No. So few women with stage 4 uterine cancer go into remission that there simply aren't statistics out there for that... so the reality remains the same - a 15-20% five year survival rate. However, I don't like to consider statistics that much because each individual case is so unique.

4) If I go into remission and then my cancer returns, is it true that it will be even more aggressive than before?

No, that's a misnomer. When cancer returns, in time it becomes more and more resilient to treatment. That's what makes people think it's more "aggressive". It's not really that, it's just that it eventually doesn't respond to treatment as well.

5) If I go into remission and then my cancer returns, does that automatically mean more surgery for me?

No. For you, in fact, it most likely won't mean surgery unless we find a mass that is particularly resectable. In your case, you'll most likely be looking at more chemotherapy.

Then the conversation got really... let's say, interesting. My doctor began to explain something to me that I wasn't altogether prepared to hear. It seems that my cancer is so aggressive and advanced that I should expect it to return in the future. It may be ten months or it may be ten years - there's no way of knowing. That's why we'll be doing regular check-ups all the time. The reality I have to accept is that I have a chronic disease that I'll be dealing with for the rest of my life - however long that may be. He said I'll be in and out of treatment from here forward. Our goal will be to keep me out of treatment more than I'm in treatment. However, the reality is that at some point, the cancer will return and be resilient to treatment and we'll eventually have to cross that bridge when we come to it.

Sigh... I've often joked that I have to remember that there is a light at the end of this tunnel... I just hope that it's not an oncoming freight train! As I sat looking into the confident and comforting eyes of my doctor trying to absorb all this new news, I still couldn't shake the feeling that for now the light seems much more like a freight train than ever before. I mean, what a paradigm shift! It seems far too often that I have to wrap my head around a little more of the reality of just how severe my cancer is. I knew that I'd have to learn to live with the "what if" questions for the rest of my life. I just wasn't expecting to be told in so many words that I can expect to die from this disease barring some other odd thing happening.

To be honest, In some small way I'm glad to have a framework with which to face the future. In a strange way, it's easier than facing the unknowns and questions. I'm also glad that I can feel secure in my eternity! It's such a comfort to know that I'm facing something better than this life after I die. It's all the stuff in between that I've still got to sort out. For now, I'm trying to push another reality to the front of my mind. You see, as much as it's true that I can expect my cancer to come back, it's just as true that I have beaten the odds in spectacular fashion so far! I attribute that unequivocally to the prayer of God's people and the power of his hand in my life. God has done a miraculous work in my body through the wisdom of my doctor and the advances of medical technology. It is in the face of the bleakest of circumstances that God has always worked the most amazingly, so there's no reason to lose hope that he will continue to work wonders in my future.

I know that, either way, my life is merely "a mist that appears for a little while and then vanishes" (James 4:14). In fact, this is true of all our lives. Each day is a gift, not a guarantee. Tomorrow is promised to none of us. It's just that we do such a good job of pushing that reality aside. For me, there can no longer be any more pushing aside. From here on in, I have to find a way to live comfortably in the reality of my mortality and the fragility of my life. Psalm 139:16 says, "All the days ordained for me were written in your book before one of them came to be." I know God has a plan for my life, no matter how long or difficult it may be. He knows the number of my days and he has a purpose for each of them. Here's the thing, though... some days, God's truths, like this one, are a tremendous comfort to me; some days, I still have to convince myself of them. Today is definitely a convincing sort of day.

I know one thing for sure: It's going to take some time for me to process all this and shift into a new framework of thinking. For now, I'm just trying to breathe...