Lymph Journal #6

1/11/2012

I woke this morning (a fairly productive sleep night) with two main thoughts.  One was the prayer that the words of my mouth and the meditations of my heart would be acceptable unto my God.  I’m not sure where this thought is going to take me yet – we’ll have to see.  The second thought was that the time has arrived to begin the “battle” in earnest.  I am so pleased by all who are standing with us in this battle as they ask for great but perfectly doable things of God.

Here’s the more clinical aspects of the day.  Added to the following was some kind of antihistamine that’s had me in rather a chemical haze. I spent about seven hours at the clinic with this.

Rituximab 

Rituximab belongs to a group of drugs called monoclonal antibodies. These are used to try to destroy some types of cancer cells while causing little harm to normal cells. They are designed to recognise certain proteins that are found on the surface of some cancer cells. The monoclonal antibody recognises the protein and locks onto it like a key in a lock. This then triggers the body’s immune system to attack the cancer cells and can sometimes cause the cells to destroy themselves.

Rituximab is used to treat several different types of B-cell lymphoma. It locks onto a protein called CD20, which is found on the surface of one of the main types of normal white blood cells (B-cell lymphocytes). It is also present on the surface of most of the abnormal B-cell lymphocytes that occur in some types of non-Hodgkin lymphoma. Rituximab acts by attacking both abnormal (malignant) and normal B-cell lymphocytes. The body can quickly replace any normal white blood cells that are damaged.

http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Chemotherapy/Combinationregimen/R-CHOP.aspx

Tomorrow the actual more toxic chemo begins with a 2-3 hour session.

Like I said there was (and remains – maybe why this doesn’t make perfect sense) a certain chemical sleepiness brought on by some of the additional medicine(s).  The first few hours I pretty much slept but then sleep was overcome by the marmalade lady.

One of the band of chemo brothers and sisters in the room today really held the floor for quite a while.  She was knitting constantly, although the object in question never seemed to grow, and had a very projecting, deep, and flat voice – the sort of voice that can fill a room – and did it ever! She was speaking (in German, of course) about marmalade (read this word with no silent vowels and you’ll come closer to the German pronunciation).  For close to an hour she held court on the nuanced differences between Brombeeren marmalade versus Sauerbrombeeren marmalade versus Sauerkirschen marmalade – I felt like I was stuck in a sound loop for a high school German class and the one word we should know by the end of the lesson was marmalade.

Well I finally fired up the iPod and listened to the David Crowder Bands new and last release Give us Rest.  Appropriate to the day were many of the pieces on the album – thank you for the gift Ida-Mae & Jim.

I wish I could offer something more profound for the lessons of the day but I am still a bit foggy.  Thanks all for the encouragements received – they are moving and welcome.

Lymph Journal #5

1/10/2012

Well, thank you God, and my dear Diane and fellow staff and docs who were willing to let me risk it – thank you all for the opportunity to share directly with my Worldviews students about what is unfolding in my life and how it will touch their lives as well.  It was tough each time through (a tiny bit easier with practice) my four classes and the lunchroom crowd but it was so good to be direct, share the story and the facts and allow kids to ask the questions that struck them at this point.  I know that some of my kids have walked through tough variations on this theme so pray for them.

Here’s a couple of things I hope I got out there to each class:

-The facts of what’s going on.

- The sure and certain knowledge and conviction that God is the Potter and I am the clay.  One student asked if I had a positive attitude/assurance that I would get better because “studies show” that attitude makes a difference.  I agreed that it most probably does but also argued that there’s something far beyond attitude here.  God will heal – He always does that for His children but not always on this side of heaven.  God will do what He chooses with me.  I honestly don’t have a conviction either way regarding healing in this life.  Some people have shared what they feel God is showing them and that’s encouraging but I don’t have that yet – hope yes, trust yes, but so far no “answer”.  And that’s OK – I/we’ve walked through enough stuff so far in life to have seen God’s wisdom, strength and peace demonstrated over and over again.

-My story as it related to Worldviews.  Our next philosophical unit is Nihilism which is one of the stepchildren of a Naturalistic viewpoint that argues all there is, is the matter and energy of this universe spinning through a cycle of random cause and effect (well – it’s a bit more nuanced than that but you’d have to have taken my class to see what the kids have been taught).  Nihilism is one “logical” possible next step – if the natural universe is ALL that there is does/can anything make sense.  Well, my story – I was a childhood Nihilist.  When I was about ten years of age I asked myself strange questions (well, strange for age ten) – why am I here, what’s the purpose/significance of anything, what difference does it make in life if all you ever do and all anyone else ever does is live then die?  - these sorts of cheery existential questions.  By the grace of God there were people that claimed that He offers answers to those questions so I really feel that God called me to Christ through the valley of the shadow of Nihilism – a term I’d never heard of when I was that age.

Well kids – I wish you the best in this last semester for you at BFA – I’ll be walking with you in the shadows of hygienic distance but my heart is all there.

Physically I was granted a good night’s sleep despite yesterday’s surgery and the physical and emotional strength to face this day. More than I could ask or imagine.

Lymph Journal #4

1/9/2012

Well today Frankenport is installed.  It’ a good things I revisited the pre-op instructions last night because if I missed this instruction “Steppbettlaken mitbringen” I would have failed to bring along my personal fitted sheet for the recovery room bed.  Whew! Saved myself that embarrassment.  Strange to those of us used to the U.S. process but it works.

The anesthesiologist was one of the most personable docs we’ve ever met.  His English was great – his wife’s from Kansas – and he reminded of a cross between my brothers Dick and Don.  The surgeon was also quite accommodating – we’re batting a thousand so far as to great care.

Surgery seems to have gone off without a hitch and I got them to throw in removing stitches from my previous lymph node biopsy and expanding the chest X-ray to a full so as to avoid having another one done for the lung evaluation doc.

Hopefully all will be followed with a good night’s rest and the strength to face tomorrow’s challenge.  Assuming I have the strength the challenge is not medical but quite personal and professional.  I hope to meet with each of my classes and unfold the news for them in a way that I hope will be best and will reinforce some of what I try to communicate in Worldviews.  This is another episode of “transition” that seems to be the stock and trade of this place we call BFA and this community of missionaries but it’s coming awfully early in the new semester.

Lymph Journal #3

1/8/2012

After a poor night’s sleep (don’t know if it was the prednisone, general anxiety, or crazy dreams* - probably all three) the day has felt pretty good.  Sunday service at Black Forest Christian Fellowship (BFCF) is always a pleasure and this might be my last one for a while as I have to go into low immunity mode.  Our worship leader Mike is just a pleasure to participate in praise with and Great is thy Faithfulness was one of the hymns sung.  It’s a wunderbar hymn in its own right and it reminded me of the days when we’d sing it to Sam and Amanda (sorry or thankfully Hannah and Carl – you were spared this) at bedtime.

On occasions in the past I the role of Elder at First Baptist Narragansett and here at BFCF I’ve had the privilege of participating in the James 5 practice of prayer by the Elders.  Today my participation was from the other side of the fence as many of the Elders and some other close friends gathered around Diane, Carl and me for prayer.  Asking God to intercede as He sees fit - powerful stuff!

I’m still feeling good enough for our afternoon walk – not the 5-6 km up and down the hills we were doing four weeks ago but an honest yet level 1km past the local BIO farm with all those fine rural aromas.  The sky was duly dramatic, the vista beautiful and the goats are getting a little shaggier in their coats.

Tomorrow, Lord willing, they’ll install Frankenport – my I-V superhighway.

*Crazy dream: I was accepted into a training program for the police force somewhere in the States and my first day’s training was to begin at 4AM.  However, due to difficulty sleeping I decided to go floating on the nearby lake on a double mattress.  When I woke there in the lake it was already 4:09 – late for my first day! And I decided I must ask for an extension on entering the program, facing up to the fact that cancer just might make it difficult.  Whoo boy! - shades of strange dreams to come.

Lymph Journal #2

1/7/2012

It’s been great to receive emails of encouragement, phone calls, etc. – to see how, as news of what’s going on spreads locally and globally that we have a reservoir of folks who care and pray and encourage.  It’s encouraging to see how not only we seek comfort and strength and guidance in Scripture but others do so on our behalf. 

[For my Worldviews kids I see a chance to reinforce some of the stuff we talked about earlier in the year.  (I’m going to miss the day to day with you guys!).]

A good friend and former colleague here at BFA, Doc Parsons, sent along one such Scriptural encouragement.  Isaiah 41:10:

“So do not fear, for I am with you; 
do not be dismayed, for I am your God. 
I will strengthen you and help you; 
I will uphold you with my righteous right hand.”

Not a bad promise, I’d say.  But how can I appropriate this for my situation?  I’ve got to ask some basic questions about the text because, boys and girls, we don’t want to play fast and loose with the Word of God and we don’t want to lose the real meaning (exegetically speaking) in the quest to find some preferred but not really there comfort (eisegetically speaking).  So we ask some basics – what are the concentric contexts (paragraph, section, book, body of literature)?, authorship and audience and historical setting, figures of speech?, etc.

What do we get? (I’m not going to do a lot of heavy hermeneutic lifting here).  We get the words of the prophet Isaiah speaking out against idolatry and urging Judah to live right under the rising threat of Babylon over 700 years before the time of Christ.  We know prophetic writing tends to speak on many levels of time – the now, the soon, the later and the distant future.  Isaiah’s full of this sort of stuff.  He’ll address the present sins of Israel or Judah, warn of soon coming judgment, promise redemption from that and speak at length about the Suffering Servant, the Messiah, the Wonderful Counselor, the Mighty King, the Everlasting Father, the Prince of Peace.  This figure is the ultimate Redeemer whose birth we recently celebrated and whose life lived out the amazing and specific prophecies found in Isaiah. (When you see this happening you know you’re into a pretty spectacular story grounded in truth). We get the figure of speech of God’s righteous right hand when we know God is spirit.  There’s a lot more we could explore but it boils down to an ancient Near Eastern prophet talking about some pretty cosmic stuff.

Is he talking to me, to us?  Can we claim, “So do not fear, for I am with you; 
do not be dismayed, for I am your God. 
I will strengthen you and help you; 
I will uphold you with my righteous right hand.”, for ourselves?  Is it really all about us?

Nope and Yup. 

It’s probably not all about us and our present specific situation. 

But I do know it’s all about Him. 

And what does it reveal, who does it reveal?  It reveals the Redeemer of Israel, of Judah, of the universe.  It reveals that the Suffering Servant is with the Israelites and with His Church, His people who He has called by His Name for He is our God.  That he is the source of courage and strength.  And if we’re going to be held up by anything it’s going to be by Him.

And guess what, He has enlisted His people to help out.  So thanks Doc Parsons and all the many others who are part of the righteous right hand of God in motion.

On the day to day front – feeling pretty good today, did a few errands, ironed (a strange passion I’ve developed late in life), took a walk by the local farm, and finished my last year project of reading the Bible in big chunks (Revelation 5-22 today).  How will I approach it next?

Diane’s cooking up some chicken ala king and it smells (the mushroom stage) pretty good.  I continue to rejoice in what we have together and I’m pretty impressed with our kids as well.

Lymph Journal Entry 1

1/5/2012

Today brought full realization that this is a deadly deal.  I felt like I was dying.  The walk from the parking lot to the office just about did me in on the streets of Lörrach. Turns out my red cells ad dropped from 9.3 (already badly low) to 7.2.  Today we got the authentic name of the disease T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) stage IV intermediate (of four stages).  Today we saw the pictures from the PET CT scan illuminating all the areas of involvement in the spleen, liver, spine, muscles and various regions of bone mass.  This would explain the excruciating hip pain I’ve been wrestling with for a few weeks time. (Good call on not following up on physical therapy appointments – it just didn’t feel like that kind of pain).  

Today I asked the time frame question, “How long have I had it and how long would I last without treatment?”  From a few years to a couple of months I’ve had it for the first question – One month for the second – but the way I felt that seemed a tad optimistic.

Today, meteorologically we experienced rain, wind, sunshine, a rainbow, lightning, thunder and hail – in January – felt almost Shakespearian or maybe just another funky day in Germany.

Today we picked up our prescriptions for a course of therapy (these are the ones I take at home) – just shy of 1000 euro.

Today we started therapy – exactly 3 weeks from my first visit to the oncologist for blood testing.  In between I’ve had the PET CT scan, bone marrow testing, a surgical snip of lymph node for analysis, and echocardiogram, lung function testing (fairly comical experience asking me to run up and down stairs in my condition while a big blue plastic clamp was hanging from my right earlobe and also for my almost complete inability to follow direction about inhaling and exhaling at various speeds or giving the technician the English name for a “booth”, “Oh a boose” and later, “You must return to the broose”),  numerous other blood draws – and all through the holiday season.  I must say I’m impressed.  The first drugs of the R CHOP therapy: prednisone and Vincristine by IV.  In addition and later in the day I received two units of blood.

The impact of these two things has been fairly dramatic so far – I feel much stronger than this morning – nothing like a few more red blood cells and a bit of prednisone. 

Today I experienced the camaraderie of the chemo infusion room.  It’s a quiet, busy and lethargic place.  Eight lounge chairs, usually full with all ages of patients, each with their hanging cords for the IVs. It is customary for a Germany exiting a dining room of a restaurant or a waiting room in a doc’s office to say “Auf Wiedersehn” but when you’ve sat with these folks for a couple of hours sharing a very elemental experience that goodbye takes on a whole new feeling.

Today Diane has been my precious wife – this is both above and beyond and as usual.  Thank you my love.

Today we continued to experience the power of encouragement and prayer by the community of God.  The response to our monthly prayer letter revealing this has been phenomenal!  Keep sending these prayers aloft!

The next big event is the installation of a “port” (Frankenport I think I’ll call it) on Monday morning and then the big guns start to fire Wednesday with 6 hours of IV chemo.

12/6/2012

The improvements experienced by the close of business yesterday are hanging on.  The hip pain is almost non-existent (that really means the odd ibuprofen now and then keep it at bay).  I was able to do things today that I would have just sat back and put off a few days ago.  Laundry loads, the tedium of running back and forth to the printer to photocopy bills for faxing to the insurance company, vacuuming, tossing the Christmas tree off the balcony to the street edge and attaching the euro coin to it for the fire department’s pickup tomorrow – all the typical things one might do on Three Kings Day, celebrated here in our corner of Europe.

Screwed up my courage to read up more on the disease.  It is mistaken 85% of the time for Hodgkin’s – something we experienced for the space of only half a day.  That period, however, led us to share the hopeful 90+% cure rate for Hodgkin’s before we had to retreat to the 60-70% rate for THRLBCL – that way many email and other contacts got to experience a bit of our roller coaster ride.  The disease is not usually picked up on until stage 3 or 4 – that makes pretty good sense based on my experience with it.

The whole family got haircuts today – just regular haircuts – it’ll be a few weeks before I might have to go for the more radical look. Diane’s been cutting my hair since I was 18 – I should have invested all I saved.  She also made some traditional Swedish rice pudding in an effort to employ comfort food in the quest for health and harmony.  These are only two tiny reasons among so many huge ones that I realize that I well and truly married the right woman!

Our dinner-time devotional tonight (from Jesus Calling) challenged us that the more extreme the circumstance the more opportunity to see His power and glory.  Writing about this stuff can sound awfully me-me centered and I don’t want to come across that way.  I want it to be about His glory and the cool thing is – that’s what everything is ultimately about anyway.

Tough News

It was a crazy Christmas break.  After a whirlwind semester we looked forward to three weeks of relaxation and a bit of fun in the mountains.  Carl and Hannah awaiting the sled train  Snow in the mountains Our little tree I was looking forward also to enjoying the foodstuffs of Christmas time after having lost much weight over the fall by changes in my diet and much walking - or so I thought. It turns out something else gets to take credit for my "success". I had some routine blood work done the last week of school but the results came back troubling.  While we were on our three night vacation I received an email urging me to return ASAP.  We left that day - here's the upshot: I have been diagnosed with non-Hodgkin's Lymphoma in a process that has taken the last two weeks.  I will probably begin a course of chemotherapy a week from tomorrow.  The cure rate for this sort of lymphoma is in the 60-70% range but if non responsive after the first treatment or two there are further measures that will be undertaken.  The medical care in Germany is excellent and we are quite confident that we are in a good place in that regard. It has been amazing to see the speed and efficiency of the run from routine test to scheduled treatment. Pray for us - for me that the treatment will be effective and pray for Diane as she drives me to my appointments, takes on whatever extra organizational chores associated with managing this, figures out her work load, and continues to be the most excellent helpmeet I can imagine. Pray also for a good solution to teaching my classes - I'll only have them for the first day of the semester to "unfold" this news and I will miss the classroom deeply. I have always preached and taught that God knows what He's doing and allowing.  We know it's true. We have to live it now. Russ for both