Lymph Journal #60 Happy Birthday Diane!

4/28/2012

For those of you who know my wife Diane you will most probably agree with the following observations of what I see in her and this reflection n the anniversary oh her birth.

Diane is smart and wise – you know that is not always found in combination.

Diane is strong and tender.

She is honest and open.

She is a virtuous woman.

She is capable of great accomplishments and has proven that often.

She has demonstrated great stamina in trying circumstances over the years – now as much as ever.

She is beautiful inside and out and ever increases in this.

She is a most companionable, delightful, complementary wife and friend.

I am so grateful for the over three quarters of my life I have had in relationship with her.

Together we’re not so good in successfully celebrating these markers of life’s progress. On Diane’s birthday last year she was undergoing back surgery.  Granted, we were just back from China and Vietnam but missed any exotic Asian celebration – no it was the Gelenk-Klinik for us.  Our twentieth anniversary was spent at the Hasbro Children’s Hospital eating leftover lasagna by the window of Carl’s room overlooking a parking lot.  The nurses did score some cake for us an offered “candlelight” in the form of two flashlights draped with washcloths.  This year her birthday will consist of visiting me for a few hours here in the Uniklinik.  But she gets to attend “The Great Hallelujah” – a gospel celebration led by Danny Plett tonight for which I may have a Skype hookup.  We’ve had a few other celebration busts I won’t go into today. “Normal days” are usually pretty good.

Maybe someday we’ll do better in this department.  But our philosophy has always been that things like a marriage are way more important than a wedding and one’s living is way more important that celebrating said life.  Those things are milestones along the way but walking the way is how you get there and make any celebration meaningful.

So, Diane, thanks for the life you live with me.  It has always been an adventure and I always prefer the adventure to the slideshow afterwards.

Happy Birthday Sweetie!

Lymph Journal # 59 - A little walk, a little surgery

4/27/2012

I woke this morning after a great night’s sleep.  One truly positive thing to say about how things are done here is that once your nurse has “tucked you in” after last vitals of the day they bid you “gut Nacht” or “gut Schlaf” (Good sleep!) and refrain from interrupting said sleep until it’s time for morning (after the sun has risen) vitals.

I’ve tolerated yesterday’s chemo very well apart from a brief period when I was in no shape to operate heavy equipment.  If that is as bad as this “high dose” stuff gets we’re going to get through this well. 

I had a bit of a floorshow with my breakfast.  My roommate was getting his central line installed while I had my brötchen and coffee.  It seemed to take a little bit of time.  He may have his turn to watch me during lunch as I’m scheduled to get an extra entryway installed soon.

After breakfast the physiotherapist showed up.  He’s an Italian technician who spoke passable English (well beyond either my Deutsch or Italian).  He ran me through a set of exercises for legs, buttocks, hips, back and arms.  I now have my own stretchy ribbon of health that I can use on the hanging bar over my bed (“hanging bar” – maybe I should say, “the bar that hangs over my bed”). 

I also got out for a walk in the dangerous fresh air after I was temporarily disconnected from the IV pole. The grounds are shaping up nicely – daffodils are past it but the tulips are going strong as are the lilacs and pansies.  I found where the seemingly incongruous ducks of my first visit hang out and I made it past the train tracks to the huge cemetery nearby (OK, no smart remarks about good planning)….

(Oops, taking a break here it’s central line time and I just popped some sort of tranquilizer.)

Well, that was something I wouldn’t want to do on a daily basis.  (SPOILER ALERT – the balance of this paragraph is descriptive of a medical procedure that you may or may not wish to read).  Once the bed was reconfigured with my head at the foot (an old-school mechanical bed unlike the pushbutton one my roomie has) I got surgically draped and my head was positioned looking far left.  My Argentinian doc was doing the procedure for about the tenth time (yes, I usually ask) under the supervision of a more senior doc.  I insisted that they talk me through every step.  On the positive side, I’ve got “huge” veins in the neck – hope this bodes well for future stroke avoidance.  They snapped an ultrasound picture to prove it.  On the down side, my soft neck skin apparently has the real consistency of leather.  In a case of, “It’s cruel to be kind”, this made for a tough insertion – even after two Lidocaine shoot-ups.  My Argentinian was too gentle and the other doc stepped in with more brazen aggression to finish off the leatherworking phase.  So, it goes like this: Ultrasound location and inspection of the target, marking the skin for the entry point, needle inserted through leather and into vein (also on the tough side), wire inserted through needle, needle removed from wire, catheter “slipped” in over the wire (here was the aggressive but welcome intervention), wire removal while catheter goes further in (ultimately about 20cm/7.8 inches), sutures to hold things in place, cleanup of the area from blood etc., bandages to cover until needed and finally a trip to X-ray to check if all is OK. The target, by the way, was the interior jugular and the end result is three more hookups available for the upcoming chemo and the return of the stem cells.  All in all (minus the Xray) about an hour.

Back to the morning stroll.  It was a pleasure to smell fresh cut grass and hopefully not a health hazard.  The cemetery is enormous and, as most German cemeteries are, quite beautiful to those who enjoy riots of flowering plants and trees.  There’s always something interesting in a cemetery.  One grave with all German names had a Samurai warrior statue – hmm?  The graves of Italians are easy to spot.  They always seem to have, behind a sturdy, impervious glass cover, a photograph of the deceased on the headstone.   This kind of cemetery is not, what we call in the States, perpetual care (meaning official grounds-people see to mowing, trimming and such while frowning on and/or outright prohibiting any creativity from loved ones that make the job more difficult).  These cemeteries are more like perpetual responsibility.  Loved ones tend each plot.  They make the decisions, sometimes quite aesthetic, sometime quite eclectic, regarding what will be planted or placed on each plot.  The cemetery makes available water spigots (free water in Germany, this is a big deal), watering cans, bins in which to place trimmings, etc.  It was interesting to observe one lady biking into the cemetery with her own personal watering can in the front basket (that was sort of sweet) and a shortened twig broom strapped to the rear rack of the bike.

Last night I figured out some inside exercise.  My wing (yes, it’s mine!) runs off of a three-story atrium.  Counting 33cm tiles, I figured out that forty laps equal one kilometer.  Nordic walking is BIG in Germany.  Nordic walking is basically walking with ski poles so as to exercise the upper body at the same congruently with the bottom half.  Well, I’m perfecting the chemo version with my pole as the “Nordic Walker” (I am three-fourth Swedish). 

I did a half k and, by the time I finished it became apparent that, two floors down, a little concert was about to begin.  One guy on the cello and one gal on the accordion and vocals made up the band.  After cooling down and informing roomie of the upcoming festivities I went back and enjoyed the mix of German and French tunes until my IV started ringing and I had to report back to the Krankenschwester (sick sister aka nurse).

Waking up this morning in the light of my own situation, prefiguring a cemetery walk, and remembering the recent passing of our friend Mari Ellen I got to thinking about one truth of life for the believer.  It’s really a sort of dichotomy of what can be spoken into our life each day. 

On the one hand Jesus may say, “Lo” (because that’s how He spoke in 1611), “I am with you always, even unto the ends of the earth”.  In that case we have His presence – what that means is wrapped up in the mystery of the Trinity.  Jesus is with me, Jesus is in me?  I’m convinced that the Incarnation was God’s throwing His lot in with us forever in bodily form so, Jesus was raised in bodily form, ascended in bodily form, is standing and interceding for us in bodily form, and is coming back in bodily form.  I know God is the author of the laws of physics but how can Jesus be with me, in me while in bodily form elsewhere?  Like I said, it’s a mystery wrapped up in the Spirit’s role in the Trinity.

On the other hand He might say, “Today you will be with me in Paradise” as one crucified thief once heard.  Or as Mari Ellen must have heard, “Welcome to Paradise and on, of all days, Easter.” 

So, in Christ, on any given day one of two statements apply (well maybe not the Easter Day part).  They’re both great!

Well, just got hooked up for chemo.  Let’s get this party started.

Lymph Journal #58 - Regimen underway

4/26/2012

It’s noontime and I’m just now plugged in for the first chemical in this round of High Dose Chemo.  They’ve got some glucose running to clear the way and the toxin starts in fifteen minutes.  There will be about six days of the chemicals that make up the BEAM regimen followed by a day of  “Therapiepause” and then the stem cells make their triumphant return.  Looks like an additional hookup will be used for this, a “central line”.

Upon arrival yesterday I was quickly shipped off for another CT scan.  The results were good with only a spot or two of “regressing” lymphoma.  It’s cleared from liver, lungs, bones, etc.  Hopefully this last round blasts away anything that remains.

The doc (a female doc from Argentina whose accent in English is clearly not the usual “Denglish” we’ve come to know from living among Germans and working at English Camps) just popped in with a final warning about today’s med – Carmustin.  It is dissolved in ethanol before infusion so she wanted to let me know that I might be feeling the effects of a few drinks.  Well, it is after noon here so maybe that’s why they waited until now.

Yesterday’s check in also included the, now familiar, octopus like EKG.  I love this innovation.  If all of these tests I’ve had over he past two months had been done with old-school adhesive pickups I’d be worried about getting rid of mounds of lint stuck to my chest and ankles (rather than being continually startled by the lack of hair that characterizes them now).

I traded my first roommate in this morning for a new one.  Both were/are pretty much monolingual German speakers so I’ve had to step up my game at meal times.  Of course, one can convey many nuances of why the food is unappetizing without having to express it linguistically.  My first roommate will be coming back in fifteen days for another round of chemo so I expect we’ll meet again.  He’s also a football fan so he enjoyed watching the Munich-Madrid game last night – we both slept well with the outcome for the “home” team.

Well, “lunch” just arrived and “drinks” are about to be served via IV so I best indulge.

So, lunch was not bad – sort of a veal hamburger with gravy, noodles, broccoli and raspberry yoghurt.  I didn’t have to get out the salt-shaker I smuggled in and I even ate some of my veggies.  I know I’ve been sort of ambivalent regarding the food but this one could be gladly repeated – and that’s not just the IV talking!

Correction on the new roomie – he’s not bad in English as a former IBM software engineer retired at exactly the same time he was diagnosed with the cancer that has him here for a stem cell transplant as well.  We seem to be getting on well.

Time to kick back.

Lymph Journal # 57 - Endgame's Eve

4/24/2012

Tomorrow is, I hope, the beginning of the end.  I’m scheduled to enter the Uniklinik Freiburg for the last step in the autologous stem cell transplant process.  I guess I am as ready as I can be.  I’ve read up on the procedure from both the scientific and experiential points of view.  There’s only so much you really want to read heading into something like this.  The clinical stuff is OK except when your attention is drawn to the failures that can happen in the process and reading the experiences of fellow bloggers that have gone through this has the potential to get you imagining all the tough parts they experienced happening to you.  So, I’ve read enough.  Up to this point in the various phases of treatment the experiences have never been nearly as dire as one would imagine from reading such material so I hope this holds true for this chapter.

I’ve downloaded loads of reading into the Kindle.  If I run out on chemo brain it will either be a miracle of awareness or I won’t really have read well at all – either way I’ve got stuff to read – always important.

Most importantly, I’m still confident and aware of the sheer mass of people that are praying for me and for us.  It means everything.  I know that God has heard and that whatever lies ahead is fully bathed in the prayers of the saints and is ordained in the will of God – so, what’s to fear?

I’ll tell you what’s to fear – 21 days of hospital food!  Strangely, it’s the one fear that I do not have peace over yet – how stupid is that?

For those of you that wish to dig further into the technical aspect of the treatment I’m about to undergo (BEAM chemo, transplant, and recovery of blood cells) here’s a fairly comprehensive website: <http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Chemotherapy/Combinationregimen/BEAM.aspx>

I’ll be hospitalized throughout the chemo and the recovery of blood levels – approximately 21 days.

For my last supper I’ll be grilling steak (a rare treat here in Germany due to high prices for good beef) and we’ll finish the second half of last night’s strawberry-rhubarb pie.  There will be the odd vegetable as well.

So, thank you for your prayers on my behalf.  Please continue to hold up the family in prayer.  Diane has been so wonderful through all this but has a very busy few work weeks ahead and will have to balance out home and hospital with this.  Pray for her strength and physical well being throughout.  Pray for the kids as well, both near and far, pray that they would know God’s peace through all this.

Lymph Journal # 56 - The harvest is in!

4/18/2012

Thanks to the wonders of modern medicine undergirded by the deluge of prayer worldwide directed towards the Great Physician (or is it the other way around?) today turned out to be harvest time.   Two days ago my white count was at 7% of the level it needed to be, this morning’s blood test in Freiburg they stood at 128%.  The decision was made to step into the other room and start the harvest. I called Diane who was as thrilled by the news as I was.  The downside was that I had driven in for a blood test and that she would have to hitch a ride to pick up both the Opel and myself.  (Thanks David!)  The technician said that she had to advise no driving after the procedure.

A few days ago, seemingly out of nowhere, my hips started to really ache.  I had been warned about bone pain in relation to the whole stem cell transplant procedure but I went from zero pain to fairly intense pain in about ten minutes.  It was gone by the next day.  Today, seeing how pleased I was at the results of the blood test, the technician asked if I’d been sore.  I told her of the hips and she said, “That’s what we look for – that is your bone marrow producing these cells.”  I had also passed a night of vague edge of flu-like feelings – also part of the immune system kicking into gear.  It’s actually pretty cool to now know what that feels like.

The room, once I was hooked up, contained three bald guys undergoing stem cell harvest and one hirsute gentleman undergoing what I think is something called photoluminescence therapy.  This procedure pulls blood out of the body, exposes it to UV light and returns it back.  I have no idea why this was being done but it’s a pre-antibiotic era treatment that seems to be undergoing new applications for a wide variety of medical conditions.

The harvesting requires both arms be hooked up.  My left arm had the big steel needle for pulling out the blood supply.  This arm had to remain fairly immobile throughout the five hours spent in the lounger.  There was a bit of pain after about an hour but I got past that soon enough.  The right hand became the return line hook-up as well as the all purpose Kindle grasping, lunch delivery and head scratching implement. 

By the way – I don’t mean to give any commercial endorsement but thank you to the “B’s” who sent me a Kindle.  I have few fears in life but one major one is being stranded somewhere without a book to read.  Now that I’m of a certain age that fear is joined by the fear that I’ll forget my reading glasses and the presence of a book will be a moot point.  That lovely little e-book is always stocked with material and you can adjust the font size (particularly important today as I did, indeed, forget my reading glasses).  I know there are those that swear they could never adopt this technology but I am firmly in the fan column.  I’ll still consume paper versions.  I ordered, after hearing of it from one of the Freiburg docs, the Pulitzer winning The Emperor of All Maladies, A Biography of Cancer by Siddartha Mukherjee.  It’s touted as one of those blends of historical and scientific writings that, when done well, are highly entertaining in a way that feels like it’s more than entertainment.  It’s also way bigger than my Kindle.  Oddly enough, I look forward to reading it but I’m not sure I should right now.

Vitals taken, hook-ups in and the machine began its work.  I had been told that this could take more than one session but I though that I’d be more than satisfied with just the one round.  The time passed fairly quickly by most accounts.  The one account that wouldn’t agree was my lower back due to having to remain in pretty much the same position for the whole five hours.  Lunch included something I know I must have experienced before but of which I have no active memory – someone had to cut up my schweinefleisch (pork cutlet) that was served courtesy of the hospital kitchen.

As various test results came in the news was more and more encouraging.  The best news was that one session would be sufficient to achieve the goal of an adequate harvest.  And it was.  I became strangely prideful when I finished before the two other guys who had started before me.  It’s a guy thing apparently still latent despite the ability of cancer to strip away most of your usual pride.

At the end of the session the result was two bags of product.  One contained pure blood plasma – sort of a clear yellowish fluid.  The other contained approximately eight million stem cells produced by my aching hips and other bone marrow repositories.  These would be mixed together and then frozen – really frozen in some sort of liquefied gas (couldn’t get the proper one across the language barrier) for later “consumption” during the next hospital stay after one, hopefully, LAST chemo (high dose) session.

Speaking of consumption, time to pop lasagna in the oven.  Back in late December we put together and froze three.  We were making one but why go to all that trouble for just one lasagna.  We intended one for the ill-fated mini-break to a self-catering apartment in the Swiss Alps a few days before Christmas.  That was when all of this lymphoma stuff made itself known.  I felt awful, there was little snow and I received the ominous email from my local physician that I needed to see an oncologist ASAP.  Who ever wants to hear that they need to see an oncologist?  We came home a day early and the one of our pre-prepared meals traveled back with us (I don’t think it was the lasagna but I could be wrong).  Anyway, what we’ll eat tonight was prepared when I had stage IV intermediate HRLBC lymphoma.  Well, I don’t know what stage I’m at now – if any – but one thing I do know – I’ll enjoy tonight’s lasagna a whole lot more than that first one.

Thank you for all who pray.  Thank you.

Lymph Journal # 55 - A note from the oncologist

4/17/2012

Here it is in its entirety:

Do you already know that there is no more bone marrow infiltration?

Initially it was packed! Congratulations.

Nuff said!

Lymph Journal # 54 - And so, we wait

4/16/2012

And so we play the waiting game.  Here’s the thing.  My blood levels, particularly my white count, needs to rise to a certain level in order for the “harvest” of stem cells from my blood supply to be successful.  It should happen but we wait and check by blood test every few days.  Friday’s test put them at about 7% of where they need to be.  This morning’s (Monday) no change seen.  This is not worrisome, as the lab tech explained through vivid swooping motions, the levels drop far and then rise as I continue to inject myself each morning with the leukocyte stimulant.  It’s not worrisome but it is waiting and, humanly speaking, honestly speaking, I’m a bit tired of waiting. 

Gloomy weather doesn’t help and it has decidedly gone back into the fairly common cold wet spring mode here in Germany’s southwest corner after a spell of fairly glorious weeks.

Physically I haven’t bounced back quite as far energy wise as after the first hospital stay.  I suppose that makes sense.  Two rounds of this more potent chemotherapy should logically impact me more than one.

I can’t put my finger on why this waiting seems harder than what I’ve waited through before.  Maybe it’s easier to wait in the winter when we’d all like to hibernate anyway.  Maybe it’s because things have moved at a predictably appropriate pace until now.  Maybe it’s because I’m sort of at the brink of the endgame – a, hopefully, fully successful procedure that could just put this thing behind me.

Maybe I’m tired of betrayal.  It came to me a day or so ago that cancer is just that – a betrayal of yourself by your body.  One day something so basic and unconsidered as your T-cells and/or (in my case) your B-cells “decide” to run off the deep end and put the entirety of your existence here on earth at grave risk.  Surviving that risk requires a wholesale change in circumstances and medical procedures that no well person would think of undertaking voluntarily.  You haven’t been “hit by a bus”, you haven’t chosen to bungee jump with too long a cord, you haven’t wittingly exposed yourself to environmental hazards, your enemies have not fiddled with your drink – what’s happened is that your own body, in contravention of common sense, has turned upon itself. 

But that is just that way it is in this broken world of ours.  We’re our own worst enemies sometime deliberately (a thought I entertain when I enter a hospital portal through the clouds emitted by smoking medical personnel) and sometimes just because that’s the way it is in this Creation that groans for redemption.

So, it’s not my finest moment in the whole lymphoma chapter of life.  But truth always helps.  A few weeks ago I was reading II Corinthians and the following verses were powerfully refreshing so I set them aside to be included in future musings.  I think now is a good time.  And the sun just broke through.

II Corinthians 4: 16 Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. 17 For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. 18 So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal.

5: 1 For we know that if the earthly tent we live in is destroyed, we have a building from God, an eternal house in heaven, not built by human hands. 2 Meanwhile we groan, longing to be clothed instead with our heavenly dwelling, 3 because when we are clothed, we will not be found naked. 4 For while we are in this tent, we groan and are burdened, because we do not wish to be unclothed but to be clothed instead with our heavenly dwelling, so that what is mortal may be swallowed up by life. 5 Now the one who has fashioned us for this very purpose is God, who has given us the Spirit as a deposit, guaranteeing what is to come.

 6 Therefore we are always confident and know that as long as we are at home in the body we are away from the Lord. 7 For we live by faith, not by sight. 8 We are confident, I say, and would prefer to be away from the body and at home with the Lord. 9 So we make it our goal to please him, whether we are at home in the body or away from it. 10 For we must all appear before the judgment seat of Christ, so that each of us may receive what is due us for the things done while in the body, whether good or bad.

Lymph Journal # 53 The next steps

4/11/2012

It’s time for some information updating for those who are curious. 

I spent last Wednesday through Saturday back at the Uniklinik Freiburg for the second round of chemotherapy aimed at preparing my system for the harvesting of stem cells from my own blood supply.  All things considered I tolerated it well with no overt (actually losing lunch) nausea.  Here’s a shot of the chemo cocktails hanging on my IV pole.

Cocktail Time!

This week I began self-injections of meds to boost my white blood counts in preparation for a “good harvest”.  Blood tests are scheduled to monitor levels and optimize the harvest schedule.  Timing is fairly crucial on this – the aim is to harvest when the stem cells are being “pushed” by the bone marrow into the blood supply but before they actually do all their differentiation and become what they will morph into.  Harvesting (aka apheresis) is done through running the blood out one arm through the device that selects out the stem cells and then running what’s left back into the other arm.  The good stuff is further treated to optimize it and then frozen for later transplantation.

Not actually me.

April 25 is my tentative entry date for the three-week stay at the Uniklinik.  Here the high dose chemo will be applied and I will hopefully say my last farewell to lymphoma lurking in my body.  I hope that my success in tolerating chemo so far bodes well for minimal side effects here but this stuff will be pretty heavy duty.  (BEAM is the protocol for those in the chemo know). A few days later the stem cells are given back and we wait out the aftereffects of chemo and look for the blood supply to recover health as reds, whites and platelets morph from the stem cell boost.  When levels are healthy I should be eligible for release. 

I have no sure idea of how I’ll feel after release.  The likelihood is that I’ll be pretty weak and need to work on rebuilding energy, mass and overall health.  We’re trusting that part of that time will be spent back in Rhode Island.  We know so many family and folk from there that have supported us through this and we want to see them albeit in a relaxed way.  We don’t anticipate the “usual” Home Assignment of formal speaking engagements and frequent appointments – I really don’t know what my strength level will be - but we’ve got kids, grandchildren, Moms and other kith and kin to catch up with face to face. 

Yesterday broke fair and lovely and, despite hearty rains by evening, the morning was beautiful.  I was not up to extended physical activity but morning errands gave us a chance to drive to the top of the hill nearby and enjoy again the beauty of this region magnified by the newness of spring.  It was even clear enough for an elusive Alpenblick (view of the distant – 2-3 hours by car - Swiss Alps visible under certain clear atmospheric conditions).  

Alps visible!

Taking turns on the Alpenblick bench - Diane with cherry tress and France in the background, me suffering from post chemo bloat.

 

Lymph Journa # 52 - Sretan Uskrs!

4/9/2012

This was to be posted on Easter but I’ve waited a day in light of an unfolded event that will be obvious as you read.

A few mornings ago I woke thinking of exploration.

I love to explore. 

I love not fully knowing where I am, recognizing that the answers may appear as I proceed through the peculiar challenges of being slightly lost.

I enjoy teaching units on the Age of Exploration (in the fashion of the day I should call it the Age of Exploitation – often with good, if culturally anachronistic, reasons). 

Have you ever been in one of those getting to know you sessions with a new group and were asked,  “When would you most liked to live in the past?”  I don’t answer with the spiritual answer of “I’d like to have walked with Jesus” or some such.  I always answer – “I’d go with Lewis and Clarke and the Corps of Discovery”.  Imagine being the first of your cultural experience and heritage to see the wonders of the Rockies, meet a grizzly bear and canoe to the Pacific.

When I take a walk I don’t like to return the same way I went.  When I’m in a new place I’m tempted to get up early and wander and discover.  This stuff feeds some yearning in my being. 

Following God certainly offers opportunities to feel a bit lost and to explore strange regions both literal and metaphoric.  We’d all like to know just where God is taking us but when we get there it’s often a relief that we were kept in the dark along the way.

M-trips are a concrete example of watching this work.  One of my happiest memory snippets in life happened on an M-trip to Croatia.  The group had traveled to Croatia on Good Friday of Spring break to provide lots of manual labor for a camp that would open in the summer.   

The student portion of the team.

The camp cabins newly stained by our labors

Our first nights were to be spent in an apartment in Zadar, an old coastal city.  We had been left with instructions to call our host (whose house across town we’d already visited) in the morning when we were ready to start the day’s activities.  Simple right?  Here’s my card, call me in the morning.

Simple.  The apartment’s phone was not connected.  OK, must find a pay phone. In a residential zone there were none to be found.  This meant getting in the van and negotiating the ridiculously narrow roads of an old Croatian city – off I set on my own – I am not complaining about this – my joy level is rising with each new impediment because it’s an adventure that requires exploration into the unfamiliar.  I find a pay phone.  That was easy.  But, the pay phone requires a special sort of card.  The card is not available at the small “convenience” market next to the phone.  I must find another type of store, on Easter weekend, early in the morning, in a language I do not begin to get.  (Well, I knew what “Happy Easter” was “Sretan Uskrs” – it was plastered all over the Zagreb airport when we arrived.)

Sretan Uskrs!  Happy Easter! @ Zagreb Airport

Off I set on the road again.  I’m following the coastal road and can feel my smile growing with the challenge.  Two or three stops later I find an outlet for these cards and now head back to the pay phone (there’s not one by the place that sells the cards.)  I scrape off the security cover to reveal the magic code and begin the process of making the call.  Many incomprehensible sounds from the earpiece later I figure out that the phone number on our host’s card was in error – just plain wrong or out of date.  I can’t make the call.  It turns out we’ll have to set out as a group and drive across a city we whisked through under jet lag to find a home we’d visited the night before – no problem and we did.  It was in those moments not knowing where I was going or how it would turn out but confident that it would turn out that I experienced great joy. 

This trip had a few more moments like this including solving our “last night in Zagreb/no place to stay problem” at the hands of an opera singer.  That’s another entry.

In thinking about this on Easter morning (and reminded through the Easter sermon) I realized that we have an advantage over the followers of Jesus so shattered, bereaved and disappointed the way things had worked out on Good Friday.  We know how the story turned out.  We know that God had the perfect plan in what had happened – perfect for His glory, perfect for our peace.  His followers didn’t know on Friday or Saturday but how a resurrection changes things.  And that is the greatest reversal and hope for our lostness and grief we can ever count on.  I knew God had a plan in my not “solving” the phone quandary – real small beans in comparison to the followers of Christ on Easter weekend but we, on this side of Easter, can be confident in confusion.

This particular Easter Day in 2012 the resurrection’s vitality was driven home real hard.  A friend and fellow worker in the Kandern community, Mari Ellen Reeser, passed away following unexpected complications related to a hip replacement surgery.  Diane was visiting with her when Mari Ellen suffered whatever it was that brought on her death.  It was tough for Diane please pray for her.  Pray for this community as Mari Ellen has faithfully poured her heart and soul into the ministry of counseling here.  She is and will continue to be deeply missed.  But Diane was able to tell the docs that Mari Ellen was with the Lord.  Others later affirmed that sure hope to hospital personnel. The power and the promise of the resurrection are just about everything at this time we’ll all face.

Anyway, as I began, I woke up thinking about exploring.  I was born out of time to experience the great moments (for the explorers at least) of discovery and I’ve had to be content with the little moments.  Maybe it’s a good thing to have missed he unfortunate episodes where exploration went too far and turned into ugliness.  But I realized that the story really isn’t over yet.  I live in a community of missionaries and work with the children of missionaries.  I get to hear a great deal about how frontier, exploratory missions gets done creatively and respectfully.  For here and now there are new areas to explore and a great reason to do so.

But what I really started thinking about was someday.  There are delightful biblical indications that when all is said and done the people of God will be established on a New Earth joined by the presence of God in the New Heaven.  Will these people God has redeemed for forever then have the privilege and joy of exploring this new earth?  If so, won’t it be without the mistakes and mixed motives of the past – won’t it just be good?  Won’t it just be an absolute pleasure offered to us by the Giver of all good things?  To wander, to discover, to delight. Sign me up for those expeditions.

Mark Buchanan, in his book, Things Unseen accurately describes the basic human longing to seek and find what is refreshingly new.  He also speaks of our longing for the familiar, for the sense of wholeness that comes with being “at home”.  Both are deep desires of the heart.  My students who are kids raised apart from their passport countries in all kinds of unique situations generally like exploration and are generally confused about “home” but both are valued and important.

But someday both longings will be totally fulfilled. 

When we first came to Germany our family lived across a narrow bend in a side street of downtown Kandern from Mari Ellen and her apartment mate. Sound traveled well in that narrow canyon way of a street.  Mari Ellen had a particularly distinctive laugh – come to think of it so did her apartment mate.  We always knew when they were entertaining and I dare say they must have known much about our then six people in a small apartment.  Mari Ellen loved the hills nearby and the mountains not too much farther from here but degeneration in her hips had come to greatly inhibit her ability to walk those hills and mountains.  There will be that day when those children of God who have embraced and trusted in Christ’s death and resurrection celebrated over this past weekend will have their heads turned at the sound of Mari Ellen’s signature laugh as she delights in painlessly walking the hills of the New Earth.  Yup, the resurrection means everything.

Sretan Uskrs!

Lymph Journal # 51 I've got bone marrow in my bone marrow!

4/4/2012

Well, I’m checked into the Uniklinik for phase 2 of the autologous (my own) stem cell treatment.  This consists of another round of chemo (probably tomorrow) and some preliminaries today.  The first was more blood drawing – 6 vials – through my Frankenport.  The pros here love it when I bare my upper right chest and demonstrate that I’m a fully equipped cancer patient with the chest port option.  I know the drill pretty well and come prepared with the right sorts of shirts to facilitate access.  I know you’re supposed to swell out your chest as they drive the needle straight into the lump formed by the subcutaneous bubble that is the port.  The gal today demonstrated the chest puffing technique for me and instructed me to pose like – you gotta love this – Stalin!  (I no longer have “hair like Stalin” for all you Seinfeld fans – Kruhschev might have been the better comparison or, the non-communist chest-sweller lookalike might be old Il Duce himself) She went on to explain that she’s from the GDR (former East Germany), home of many a Communist monument.  I’ve always wished, as a card-carrying historian, that I could have picked up a smallish genuine Lenin bust after the Wall fell – not out of admiration for the monster man but as an interesting artifact and possible rotten fruit target.

From blood draws I went on to the EKG octopus.  I guess it’s fairly routine but until Germany I’d never had an EKG that used suction sensors – kinda freaky and, yes, there were eight tentacles clinging to me until release.  From there, Diane and I walked across campus to the center where stem cells are harvested to fill out forms, sign waivers and learn the drill.  Somewhere around ten days after this chemo I’ll be hooked up to a sort of dialysis machine that pulls the required bits from my blood.  This five-hour process could fulfill the target amount in on go round or I may require a second and even a third filtering – I’m in favor of the one-time deal.

Then it was back to the main hospital where I was sent up to Station Thannhauser, my home away from home.  We were shown to a private room – the excitement built – but we were quickly disabused of this hope when the nurse came in and said she didn’t think it would last.  In fact, it lasted long enough for the next step, the bone marrow biopsy.  I wimpishly (but really, who likes bone pain?) stated my preference for a drug induced nap for this and they obliged and an hour later I woke up with no pain, slightly less bone marrow and a transportation team that shifted me next door to one of my rooms from the last stay.  Not the balcony room but I scored the window bed.  I also scored a late lunch – tortellini, not bad.

Once fed and barely settled it was off to a lung function test. This is a three-stage process that begins with a daub of goop on the left earlobe.  The technician said it might get to feeling hot – it didn’t.  Following a few minutes of having the goop on the lobe another techie came out and pricked the ear (with a suspiciously high degree of vigor) and secured a pipette of blood.  I should have asked for a gold ring for that ear while they were at it.  Then it was into the glass booth for breathing into the snorkel followed by more snorkeling on/into a device outside the booth.  I passed with flying colors and was sent on my way.  I did not pass the find your way back to the room test with flying colors however – I took a few wrong turns (I hadn’t paid close attention on the way there) until I found a few land marks outside the windows that set my personal GPS back into the right mode.

So, back in room 5 and finally unpacked there was another flurry of personnel doing vitals, asking questions, giving me information I already had, etc. when another Transporter (person, not a device from Star Trek) showed up to escort me back to the zone where I’d had my EKG, this time for an echocardiogram (sonogram of the heart).  This was to be my third in three months.  Apart from jelly all over the belly it’s a pretty easy test and you get to see your heart valves flap on the screen and who wouldn’t want to see that.  Alles gut! (nothing has changed through all rounds of chemo – all is good).

Back again to the room – no wandering this time, the route was familiar.

Somewhere in the middle of all this I met the roomie.  He’s an electrical engineering student who had a successful bone marrow treatment but is in for a “graft versus host” infection – something I won’t face with my transplant because I’ll be both graft and host. 

When I first got to the room I “kipped” the window (for you Auslanders, most German windows are casements that swing in or can be tipped diagonally inward hinged at the bottom or “kipped”) to let in some nice fresh cool spring air.  The window was closed when I returned from testing – hmm.  This can be a point of tension. Many Germans, including highly educated and experienced medical personnel, believe the root cause of many ailments is a breeze.  Literally, a breeze, meaning moving air.  Air conditioning is a close second as a chief suspect behind ill health – after all it’s just artificially cooled MOVING AIR!!!  I remember back when we were in Germany before and our daughter Amanda needed an evaluation for some breathing difficulties she was having, the first questions asked by Professor Klein (Dr. Little) were, “Have you been sitting near an open window?  Have you been riding in the car with an open window?  Does your car have air conditioning?”  I suppose that would have made us bad parents if any of those were answered in the affirmative but, being wintertime, we passed the test.

Now, the bathroom window is open and it’s nice and cool in there but the door to it remains shut.  Here we see the principle of “lufting” (airing) in action.  Daily lufting is part of the German haushalt routine. You see one wants to change the air in a room but one doesn’t want to be there when it’s happening – too dangerous!  If you don’t luft for at least fifteen minutes a day you’re considered a slacker in the home maintenance department.  There is some degree of sensibility in this especially in newer German houses that are built especially “tight”.  Lufting can prevent molds from building up.

Dinner was a less than appetizing cold chicken schenkel (leg&thigh) but the evening meal is usually not too big a thrill in the hospital.  European custom puts the big meal at midday so some cold something is usually the supper star.

After dinner the attending doc and his entourage came in with some good news – No lymphoma in my bone marrow.  When I was first diagnosed I had nothing but lymphoma where my bone marrow was supposed to be.  So this is very good news – actual data (in addition to the CT scan of a few weeks ago) that reinforces the conviction that I’m responding well to the therapy.  This is also a good sign for the transplant to go forward.  What we don’t want to see happen is a transplantation of lymphoma back into my system and this test increases the likelihood of a good stem cell harvest.

The sky has cleared and it looks like we’re setting up for a sweet sunset.  I close this awaiting an infusion of saline to prime the pumps for tomorrow.