Persistent.

Yesterday was reassessment testing day at Duke.  Blood work and a bone marrow biopsy, followed by a PET scan, filled out our otherwise boring day.  In case you are interested, the bone marrow biopsy is not really all that bad, but if you have a choice between that and getting a tooth filled, I would recommend you should always go with the filling.  I had a biopsy three months ago that showed the marrow was clean.  I thought they might not do another one this time but they needed to confirm that it was still clean.  The results of that biopsy won't be available until early next week.

The main thing we wanted to find out about was the status of the one persistent lymph node in my abdomen.  The PET scan 3 months ago showed that everything else had been resolved (medical jargon for it is gone).  But that one persistent node was essentially unchanged from it's original shape and size back in June.  Yesterday's PET scan confirmed that everything else is still resolved, but there has again been no change in that one persistent node.  It still looks about the same as it did six months ago when we started.

That wasn't the information that we were hoping to hear, but it is still positive.  The chemo treatments have been very successful at eliminating the original cancer, except for that one node, and keeping everything in check.  And while the persistent node is not going away, it isn't getting any worse either.  All of that is good news.  We go in to see Dr. Beaven next Wednesday to review the test results, and hopefully we will find out more about what other options are available.  We will see what she and Dr. Horwitz, from the Bone Marrow Transplant team, think is the best course of action from here.

Until then, we will stay positive and place our trust in the Great Physician.  He has brought us this far and is not going to abandon us now.

Best wishes to all for a happy and prosperous New Year.

A very special Christmas

I already have my Christmas present from Santa this year.  My last chemo treatment was over a week ago and I have no more scheduled.  I have reassessment testing on Dec 27, but that is a walk in the park compared with anything I ever received in the Treatment Center.  So jolly old Saint Nicholas made an early delivery this year at the Davis house.

We have already started our holiday visits and are currently at our daughter's home in western North Carolina.  The house is all decorated for the season, and the three little ones, 5, 2 and 8 months, certainly add lots of excitement and energy to our lives.  Over the coming weekend we will head an hour down the road to South Carolina to be with our son and his family for Christmas.  With 12, 10 and 4 year old grand kids, the excitement and energy are sure to continue.

For someone who, back in June, wasn't even sure he would be alive to see Christmas this year, this is going to be a very special Christmas season.  I was recently asked if having cancer makes you appreciate things more.  The answer is unequivocally YES!  The tragic school shootings in Connecticut were yet another reminder that none of us is guaranteed one more day on this earth.  So please, for even just one moment, stop and think about those around you and how very special they are to you, each and every one.

The lyrics from an Alicia Keys song,"Like You'll Never See Me Again", express it so well:

If I had no more time

No more time left to be here

Would you cherish what we had?

Was it everything that you were looking for?

If I couldn't feel your touch

And no longer were you with me 

I'd be wishing you were here 

To be everything that I'd be looking for 

I don't wanna forget the present is a gift 

And I don't wanna take for granted the time you may have here with me 

'Cause Lord only knows another day is not really guaranteed 

So every time you hold me 

Hold me like this is the last time 

Every time you kiss me 

Kiss me like you'll never see me again 

Every time you touch me 

Touch me like this is the last time 

Promise that you'll love me 

Love me like you'll never see me again 

Joy and sorrow.

I started to write a new post, confirming that last Tuesday was indeed my last chemptherapy treatment at Duke.    My mood up until now has been one of joy and relief, knowing that I would not be having any more toxic drugs pumped into my system.

But as I was starting to write, the news about the school shooting in Connecticut began to unfold.  Words are so inadequate to attempt to describe that situation.  My mind cannot begin to comprehend the shock and the grief that has been experienced by those involved.  The days and weeks that lie ahead will entail emotional trauma beyond that which most of us will ever know.  I can't imagine what it must be like to be the parents of one of the slain children.

My emotional battles and struggles, as I endeavor to understand and cope with my cancer, are very real and very complicated.  But they do not compare to those of the families and friends of those who have lost loved ones in this senseless tragedy.  May our thoughts and prayers lift up all of those in need, and may our Heavenly Father be with them all.

Only one more.

One more treatment remains.  Next Tuesday will be my last regularly scheduled chemo treatment and I can't even begin to tell you how much I am looking forward to having that behind me.  Back when I completed Cycle 2, I went through reassessment testing and found out that most of the cancer had disappeared, except for one persistent lymph node in my abdomen.  I have now completed 2 additional cycles, and will return to Duke on December 27 for another round of reassessment testing.  We will then meet with Dr. Beaven on January 2, to review the test results and determine what the next phase of treatment will be.  I am believing that the remaining persistent node will be completely gone, or at least reduced far enough to be considered almost gone.  Either of those findings will most likely permit me to proceed with the bone marrow transplant process, probably sometime in January.  However, should that one persistent node appear to not be responding, I will probably have to start some additional chemotherapy treatments, until it gets taken care of.

Having the doctor tell us that I am finished with the chemotherapy phase of my treatment will be the best Christmas present I could possibly receive.  It has been 6 months since we started taking our 25 day trips to the Duke Cancer Center, where I have been stuck, poked, tested and poisoned by some of the best in the business.  And while the result of all that abuse, upon my already aging body, has been quite positive, I am ready for it to be over.  Enough is enough already!  Last week Dr. Beaven said l was the most upbeat and positive patient that she has.  But I am tired of being tired.

I have been amazingly fortunate to have been able to avoid most of the side effects of my chemotherapy.  The two main areas where I have been impacted are hair loss (not a real issue to me) and fatigue.  For the last 6 months I have just felt worn out, all the time.  I have read and heard about how chemo can have a cumulative effect, and I believe that I am finally experiencing some evidence of that reality.  In the last 3 or 4 weeks my energy and stamina levels have fallen even further.  Hauling 4 trash bins of yard debris to the curb for pickup leaves me drained.  I am still upbeat and positive, but I am tired of being tired.  My hope is that after next week, I can begin to start recovering and my body can actually have a chance to start the rebuilding process.  Yes, the bone marrow transplant will undoubtedly knock me back down to some degree, but having 6 or 8 weeks to recuperate will be a welcome respite.

Trust and faith.

I read something at church yesterday, and was struck by how very true it is.  "Allow us to be still, in the midst of what our minds cannot fully grasp, and what our lips cannot fully explain."  And that, in turn, reminded me of the scripture:

Be still, and know that I am God.  Psalm 46:10

Only God's knowledge is perfect.  Only He knows what our future holds.  My mind is capable of understanding and comprehending much about my cancer, and it's implications on my life, and the lives of those around me.  But I reach a point where my capacity to grasp and discern are simply inadequate.  I reach a point where I can no longer understand or comprehend.  That is when I have to begin to trust in Him.

Trusting is not easy; in fact it is quite difficult.  One definition of trust is "to give to for safekeeping".  To truly trust in someone else, with something that is very important to you, requires tremendous faith in that someone.  

Now faith is the substance of things hoped for, the evidence of things not seen.  Hebrews 11:1

I have faith that my Heavenly Father loves me, and has His perfect plan for my life.  I have faith that the God who created the heavens and the earth, is the same God that knew me before I was formed in my mother's womb.  And I have faith that He will deliver me from this disease that was discovered in my body 6 months ago.  I don't know exactly how that deliverance will manifest itself, but my faith in Him allows me to trust that He is in control, and will see me through this ordeal.

Can my mind fully grasp this conviction, and can my lips fully explain it?  No!  Do I struggle with it on a daily basis?  Yes!  But fortunately my Lord of Lords, and King of Kings, reigns over heaven and earth for eternity, and He alone is worthy of my total trust and faith.  And a long as I know that in my heart of hearts, I can sleep well at night.

Only 2 more treatments.

Yesterday was spent getting another chemotherapy treatment at Duke. It has been 2 weeks since I had my regular 3 consecutive days of chemo, which will definitely take some of the wind out of your sails. But I have had enough time to recover, and the last part of the cycle only involves one treatment each week, so I don't expect too much difficulty lies ahead. I only have 2 more treatments to complete Cycle 4, which is hopefully the end of my chemo treatments. As I write those words, I almost can't believe it. Two more treatments and my Clinical Trial chemotherapy routine is finished, done, complete, history.

Looking back at the calendar, my treatments started on June 20th, and since then I have received 22 chemotherapy infusions, with 2 more waiting in the wings. In many ways it has been a very long and arduous 5 months, not something I would wish on anyone. But by the grace of God, and a decent amount of intestinal fortitude on my part, I have come through the whole ordeal with amazing ease. I have lost most of my hair, and have had a running battle with fatigue, but otherwise I have escaped virtually all of the other symptoms commonly associated with chemotherapy treatments. Nausea and vomiting are the most common and widely feared side effects, and I can safely say I have not had one moment of either. I am well aware that my experience with these toxic drugs is not typical, and I actually feel somewhat guilty when I complain about a minor ache or pain. I could be so much worse. I see many fellow cancer patients in the treatment center that, on their best days, are probably not as good as I am on my worst.

Assuming that my reassessment testing, in late December or early January, indicates that the cancer is gone, I will begin my bone marrow transplant sometime early next year. But we will cross that bridge sometime early next year. In the meantime, I rejoice in how well I am doing. Back in June, there was much that was unknown. How would I react to the drugs? How effective would they be at killing my aggressive cancer? So many questions and so few answers. But here we are, approaching the end of that long dark tunnel, and we are doing just fine. I read something recently, written by another cancer patient, that rang so very true. "We have no idea what we can overcome until we have no choice but to do so." It is my hope, that by relating the details of my journey, I may be of some encouragement to others, who may be standing at the entrance to that same long dark tunnel. Yes, dark tunnels are scary. But it is possible to travel through them and come out the other end, without having to endure pain and sorrow along the way.

I cannot begin to express how important the prayers of so many people have been in helping me on my journey. Without question, the power of prayer has played a key role in the progress I have made, and the many victorious moments I have experienced along the way. As the song says "Our God is an awesome God. He reigns over heaven and earth..."

Thanksgiving day.

Five months ago I was diagnosed with cancer and, for a while, I wondered if I would be alive to see the end of the year 2012.  I am thankful that The Lord has brought a peace to my spirit, and a healing to my body, that allows me to continue to enjoy His many blessings, which are all around me.

Some forty four years ago I met and married the woman that God had selected to be my partner for life.  Holly and I began our journey together with much joy and anticipation.  Some forty four years later, we will celebrate this holiday season, surrounded by the family that has been our extreme joy and fulfillment.  To have this opportunity, to all be together around our table of Thanksgiving, is truly a blessing.

This day will be busy. Young children will scurry about, laughing and crying and just being young children.  And the adults will  spend their time preparing the food, reflecting on times past, and wondering about things that lie ahead.  Later in the day we will all be seated around one large table, to join together in quality time as a family.  Times like this are the embodiment of that joy and anticipation we felt so long ago.  And they are the basis for the joy and anticipation of what still lies ahead.

My cancer diagnosis was not a blessing.  But it has caused me to have a much clearer perspective of the countless blessings that are all around me.  Through the years I have lost my focus many, many times, and assigned far too much importance to people and things that were actually very insignificant and momentary.  But on this day, I plan to dwell on the love and goodness that God has placed all around me.  My life is so rich and full, and I plan to appreciate every moment of this glorious Thanksgiving Day.

And just because I can, I want to list my blessings one by one: Holly, Brent, Adam, Annie, Gracie, Eliza, Owen, Jill, Jeff, Ben, Max and little Rose.  Thank you Jesus.

Attitude is key.

Cancer is an ugly monster, and chemotherapy and radiation are it's twin brothers.  Surgery sucks.  The emotional toll that accompanies a cancer diagnosis is devastating, not only for the patient, but equally so for family members and friends.  I have done a lot of reading since my diagnosis 5 months ago, and I have yet to come across a single person who has felt that cancer was a positive addition to their life.  Certainly, many cancer survivors believe that a positive by product of the cancer process is a whole new perspective on who and what is really important in life.  Cancer will help you sort out the things that are important, from the things that aren't.  But I don't recall anyone indicating that they felt the cancer itself was a positive, in any way, shape or form.  It is, in short, simply a disease that threatens to take your very life.

The initial cancer diagnosis triggers an emotional roller coaster ride of epic proportions.  I know because I have been there.  Back in June, when I was told that I had a rare and very aggressive form of Lymphoma, classified as stage 4, with a 5 year survival rate of 20 to 30%, I can safely say I went into emotional shock.  Over the next several days my mind went wild.  Would I even be alive this Christmas?  How will Holly and the kids deal with my death?  Not the type of thoughts that generally occupy your consciousness.  But they are thoughts that will be present in every cancer patient's mind.  Fortunately, the process of mental adjustment and coping does not stop there.

Over the days and weeks that follow, more information becomes available from various sources, most importantly from medical professionals, that allows things to be put into a better perspective.  A more realistic, and less emotional assessment begins to evolve. That assessment may not be what the patient and family was hoping for, and wanting to hear, but it is a more considered and less emotional set of facts that will form the basis for future decisions and actions.  Every instance of cancer is different, and how it will impact the patient's body will vary from person to person.  So there is certainly no one-size-fits-all answer that will work for everyone.  That is where each individual, whether the patient, the family, or a friend, must work out their own unique method of coping with the situation.

I generally tend to be an upbeat, positive outlook kind of guy.  I am not fond of some of the bumps and bruises that this life can send my way from time to time.  But I can usually just pick myself up, dust myself off, and move on.  I am a big believer that your present circumstances don't determine where you can go, but they merely determine where you will start.  I don't control my circumstances, but I do control how I react to them.  This is where I feel the cancer patient needs to focus most of their thoughts and energies.  My initial reaction to my diagnosis was fear.  But then I got mad.  This damn monster was not going to rob me of my life.  I was going to fight this unwelcome and unwanted invader with every fiber of my being.  I might not win, but I wasn't going down without a fight.

I remembered something said by Lance Armstrong, the cyclist and cancer survivor, after he emerged from his battle with both testicular and brain cancer - "Pain is temporary, quitting lasts forever."  And I more recently read an article, where the author was discussing the prospect of quitting during times of discouragement or slow progress.  She said "It's all about knowing when it's time to quit, and when you're just quitting."  Oh yes, there may come a point when it is time to quit, and recognizing that point in time is important.  But until that point in time, you can't quit fighting.  Because quitting lasts forever.

Winston Churchill was the famous British politician and statesman, and was the UK's Prime Minister during World War II.  His steadfast refusal to consider defeat, surrender, or a compromise peace, helped inspire the British resistance, especially during the difficult early days of the War.  He was particularly noted for his speeches and radio broadcasts, which helped inspire the British people.  On one such occasion, he said

"If you're going through hell, keep going."

Whew - what a week.

This has been one very full and busy week.  On Monday, our granddaughter Eliza had brain surgery at Duke Children's Hospital in Durham.  All indications are that the surgery was very successful, although it may take several months before the long term results are more apparent and more readily evaluated.  We leave those healing adjustments to the Lord, and rejoice in the way her body is healing from the surgery itself.  The doctors released her from the hospital ahead of schedule "because she is doing remarkably well, when compared to most post-op neuro kids".  She and her family will be staying with us here in North Carolina, at least through her followup visit next Wednesday, to minimize the travel time back and forth to Duke (1 1/2 hours from our home versus 4 hours from her home in South Carolina).

This week was also my week to return to Duke for the start of Cycle 4 of my chemotherapy.  Tuesday, Wednesday, and Thursday were spent visiting with Dr. Beaven, getting the inescapable round of blood tests, and spending far too much time with the staff in the treatment center.  The initial phase of each cycle, as specified in the clinical trial protocol, is spread over three days and involves about 8 hours of being tethered to a very impersonal and disinterested IV pump.  Fortunately, the amazing nurses provide a constant stream of TLC as they treat each patient as if they were part of their immediate family.  Over those three days I receive about 2 liters of drugs, none of which was formulated with my comfort and short term sensibility in mind.  Five days of high dose Prednisone tablets, which cause severe insomnia, and a Neulasta shot to boost my white blood cell count, and the beginning of Cycle 4 is complete.  A break of about 10 days will allow me some recovery time, before starting into the second half of the treatment routine.

With Eliza's surgery on Monday, we have made 4 round trips to Duke, which totalled about 12 hours of driving time.  Thank God for National Public Radio.   Obviously, the main focus of our attention was on Eliza and her condition and status.  Fortunately the Cancer Center and the Children's Hospital are only about a 10 minute walk apart.  So when I wasn't receiving treatments, we were with Eliza and her parents, trying to provide whatever support and assistance we could, yet not wanting to get in the way.  We were able to chase mom and dad away a few times to have some dinner, allow them a little break, and some much needed time together.

Normally, the first week of a new cycle is draining, and I feel a sort of heaviness, both physically and emotionally.  It would seem that the added stress and anxiety, associated with Eliza's surgery, would have made things even more taxing.  But in reality, it seems to have had just the opposite effect.  Spending 3 days in a cancer treatment center, being infused with a couple of quarts of toxic chemicals, does tend to make your thoughts focus on yourself and what is going on in your body.  I believe that is a perfectly normal reaction.  But this past week my focus, and prayers, were on someone else.  My time spent hooked to that IV pump was spent thinking about how someone else was doing, and not about my own situation.  So at the end of what is typically my hardest time, I feel better than ever before.  And I believe that is very strong evidence of the role that the mind plays in how we react to the effects of our cancer treatments.  We can't be totally oblivious to what is happening to our physical being, but we also can not allow it to be our sole focus.  Maintaining some reasonable level of mental balance is critical to our longer term well being.

Recap

I have picked up several new readers recently and felt that a recap of my battle with cancer might be in order.  One of the problems with a blog is that going back and reading all of the previous posts can be both cumbersome and time consuming.   So the following is a summary of my diagnosis and treatment progress:

I am a 68 year old retiree living in North Carolina, married for 44 years to a wonderful wife named Holly, and we have 2 children, Adam and Jill, and 6 grandchildren.  In 2000, I was diagnosed with Hodgkin's Lymphoma, received both chemotherapy and radiation, and then was cancer free for 12 years.

Based on a lymph node biopsy, on June 6, 2012 I was diagnosed with Non Hodgkin's Peripheral T-Cell Lymphoma NOS (not otherwise specified).  This particular form of cancer is very rare (340 cases reported worldwide in 2012), very aggressive, difficult to get into remission and very prone to recurrence.  A bone marrow biopsy revealed a 30% involvement and resulted in my cancer being given a Stage 4 designation, the highest (worst) level.  The prognosis was not good, a 5 year survival rate of 20 to 30%, based on the standard treatment protocol.  That was not what I considered to be a good start to my summer.

Based on the poor prognosis, I wanted to pursue and consider other options.  I wound up at Duke Cancer Center, in Durham, North Carolina, under the care of Dr. Ann Beaven, an Oncologist specializing in Lymphoma and Leukemia cancers.  I was accepted as a participant in a clinical trial.  For those with far more medical comprehension than I, the full tile of the clinical trial is A Phase II Study of Cyclophosphamide, Etoposide, Vincristine and Prednisone (CEOP) Alternating With Pralatrexate (P) as Front Line Therapy for Patients With Stage II, III and IV Peripheral T-Cell Non-Hodgkin's Lymphoma.

The trial is based on a 7 week cycle (49 days), with the CEOP drugs being given on days 1,2 and 3, and the Pralatrexate on days, 15, 22 and 29.  Neulasta shots are received on days 4 and 30 to assist in maintaining white blood cell count at an acceptable level.  At the completion of Cycles 2, 4 and 6, the patient is reassessed and progress determined.  In my case, after Cycle 2, I received a another bone marrow biopsy and PET scan.  The bone marrow biopsy showed that my marrow was free of any cancer cells.  The PET scan I received back in June indicated numerous pockets of cancer cells throughout my body (my family doctor indicated that it really 'lit up' the screen).  My subsequent scan showed no indication of cancer cells, other than one persistent lymph node in my abdomen.  In short, after 14 weeks of treatment, my body and my cancer was responding amazingly well.  2 additional Cycles were prescribed, to attempt to impact the one remaining node, with further testing and reassessment in late December.

It is obviously my hope and prayer that when I am reevaluated in December, the remaining lymph node is clear.  At that point I will begin preparations to undergo a autologus bone marrow transplant at the Duke Adult Bone Marrow Transplant Center, sometime in January 2013.  My doctor for this procedure will be Dr. Mitchell Horwitz, and the reason for pursuing this additional step goes back to fact that my particular lymphoma is very prone to recurrence.  The bone marrow transplant will add a level of insurance that there are no remaining cancer cells, lurking in the shadows, that will return at a later time.  You can read more about my transplant in earlier posts by clicking here and clicking here.

This recap covers the most of the clinical aspects of my cancer odyssey thus far.  I am a strong believer that my arsenal contains 4 distinct weapons for battling this unwanted and unwelcome invader, that has taken up temporary residence in my body.  My treatment regimen, my unique body chemistry, my attitude in confronting this monster, and my faith.  Numerous past posts have dealt with these topics, and no doubt more lie ahead.

Just as a little teaser, I recently read a quote attributed to Churchill "When you are going through hell, keep going".

Eliza update

Just got home from Duke and wanted to post a note that Eliza came through the surgery with flying stars.  The surgeon said that everything went very well and it was obvious, once he got in there, that the surgery was definitely needed.  She is in the ICU and the next hurdle is getting through the initial few days of recovery and healing.  If you are interested in following her post-op recovery, she has a blog (maintained by mom and dad) that will keep you informed.

http://www.caringbridge.org/visit/elizadavis

Thank you all for your prayers, and we would appreciate it if you would leave her on your prayer list through the next several days.

Big week ahead.

This coming week marks the beginning of Cycle 4, hopefully my last chemotherapy cycle.  Of course it takes seven weeks to complete each cycle, so I won't finish until the 2nd week of December.  That seems a long ways off, but history says it will go by quickly. Sometime near the end of December, I will go through another round of testing to reassess my status, and that is when the decision will be made whether I proceed on to bone marrow transplant, or start a new round of chemotherapy.  Hopefully Santa will bring me a totally clean cancer report, and give me a gift certificate for one successful bone marrow transplant - the things you wish for !?!?  And yes, the jolly old man is coming to visit all the good little girls and boys in only 44 more days.  Can you believe it?  Have you started your Christmas shopping yet??

This coming Monday is also the day of Eliza's surgery.  She too will be at Duke, just a couple of buildings away from the Cancer Center.  Monday she has her surgery and Tuesday, Wednesday and Thursday I have chemo treatments.  Eliza's parents, Adam and Annie, will be staying in a hotel nearby until she is released from the hospital, hopefully about Friday of next week.  At that point they will bring her here to our home in North Carolina, just 1 1/2 hours from Duke.  That is much closer that the 4 hour drive to their home in South Carolina, and will be much more convenient for followup visits after her release.  Fortunately we are all pretty good at "going with the flow", so much like my cancer, we will take things one day at a time.  The family motto for my cancer is "We're going to beat this", and that seems fitting for Eliza and her situation - we're going to beat this too.

I know that I don't even need to ask, but please keep the Davis family in your thoughts and prayers next week.  We all put our trust in the Lord, but we are human and have been known to worry a time or two.

Prayer for Eliza

On Monday of next week our 10 year old granddaughter Eliza will undergo major brain surgery at Duke Children's Hospital in Durham.  After several years of visiting doctors, and numerous tests, she has been diagnosed with a Chiari Malformation, which is a structural defect in the cerebellum, also involving portions of the skull.  Most children who undergo the surgery do quite well and have improvement of their symptoms.  While the doctors say they are confident this surgery will have a positive effect on her quality of life, the prospect of surgery on the brain and skull, particularly in a child, is scary.  And when it is your child, or grandchild, the worry and anxiety are heightened dramatically.

During my treatment for lymphoma, I have sensed the powerful presence of God Almighty throughout my journey, and felt the undeniable power of prayer.  There is no doubt in my mind that He will be with our sweet Eliza, and her family, during every step of her treatment and recovery.  I ask that everyone who reads this blog, and keeps me in their thoughts and prayers, add Eliza to your prayer list. We know that she will be in the care of a highly skilled and capable medical staff at Duke.  But knowing that we have a team of equally committed prayer warriors, lifting her up to The Great Physician, will mean so very much.  May God bless each and every one of you.

My shadow.

Recently, while taking one of my walks around the neighborhood, the sun was shining, and I noticed my shadow on the pavement.  It was right there with me, whether I walked slow or fast, straight or crooked.  I strolled on for a while and began to think of other things, forgetting about that shadow.  But a short time later I noticed it again.  It had not gone away just because I wasn't conscious of it - it was still there.  And then it occurred to me that my cancer is much like my shadow.  It is always there, even if I am not thinking about it.  It is always in my body, striving to exert it's terrible influence on my cells and my tissues.  It is always seeking to destroy my very being, and my life. 

I can only speculate on how many times each day I consciously think about my cancer.  It may be just a fleeting thought, or it may occupy my mind for a more extended period.  That feeling of fatigue may elicit a momentary thought about it's cause.  Or taking a pill in the morning can cause me to consider why that tablet is  necessary.  And at still other times, for no particular reason, my mind will begin to consider my current situation and my longer term prospects.  I can safely say that, since my diagnosis, my cancer has occupied far more than it's fair share of my attention.  It is for this reason that cancer patients desperately need to find other things to get involved in, that will keep their minds busy, and away from their disease and it's implications. 

But even when my mind is absorbed by other thoughts, just like my shadow, my cancer is still there.  I have said to Holly that I have this sense that there is always something lurking just over my shoulder, as if a dark cloud is hanging above my head.  It is very difficult to put into words, but the sensation is very real.  And regardless of the focus of my thoughts and emotions, my cancer is always with me.  It is currently as much a part of me as my right leg, my lungs or my liver.

As I considered the similarity between my cancer and my shadow, and their ever present nature, it dawned on me that God Almighty, my Redeemer and Healer, is also omnipresent and with me at all times.  Whether I think about Him or not, He is with me.  He was with me before I was formed in my mother's womb, and He has been with me for every second of my existence in this life.  Just like my shadow, He is always there.  So in the future, when I see my shadow, it will be my reminder of God's constant presence in my life.  And that is a far more comforting perspective.

Send the rain.

This year at church, when the choir started up again after their summer break, Holly and I both decided to join.  It has been a long, long time since either of us sang in a choir and we are really enjoying it, even though the voices aren't quite what they used to be.  We are hoping that with some time and some practice, the voices may respond and improve.

This morning the anthem was a song titled "Hiding in the Shadow of God (Send the Rain)".  Even though we have been rehearsing it for several weeks, today the words just came alive for me.  I could see the mighty wings of God covering me as the rains come down. Towards the end it says "And in this test I know that I am blessed, I can rest, my God is here!"


There's a safety on this journey;
there are wings to break my fall.
And when there's harm
I'm folded in God's arms,
I am held before I call.

There is shelter from the evil,
there's still light on days of gray.
And in the storm God's presence keeps me warm,
giving faith so I can say,

"Send the rain, let the wind blow.
I am covered by the mighty wings of love.
I will not fear, I've stopped running.
I'm hiding in the shadow of God."

Walk before me in the darkness,
and hold me up when others fall.
Give me the grace to seek and know Your face
and to recognize your call.

Send the rain, let the wind blow.
I am covered by the mighty wings of love.
I will not fear, I've stopped running
I'm hiding in the shadow of God.

In the shadow there is refuge, 
I will not be conquered by my fear.
And in this test I know that I am blessed.
I can rest, my God is here!

Send the rain, let the wind blow.
I am covered by the mighty wings of love.
I will not fear, I've stopped running.
I'm hiding in the shadow; there's peace within the shadow.
I'm hiding in the shadow of God.

There's a safety on this journey
hiding in the shadow of God.


I had to lip sync most of the song.  Because when I opened my mouth to sing, my voice broke so badly it was pointless to continue to try.  So the rains may come, and the winds may blow, but I know that I am covered by the mighty wings of love.

One cycle left.

Yesterday, we were at Duke for the final treatment in my 3rd Cycle.  And this morning I went to my local Oncologist to get a Neulasta shot to help boost my white cell count.  Thank God for medical insurance - that Neulasta shot costs somewhere between $ 8,000 and $ 9,000 each.  Unbelievable.

Now I have a break for 2 weeks before starting Cycle 4, which hopefully is my last chemotherapy cycle.  I will get tested and reassessed in the latter part of December, and assuming the tests show the one persistent lymph node in my abdomen has disappeared, I should be ready to start the bone marrow transplant sometime in January.  As I was singing to Holly the other day, "All I want for Christmas is a clean PET scan, a clean PET scan, yes a clean PET scan."

We have been traveling to Duke for treatments for about the last 20 weeks.  Add to that 2 or 3 more weeks waiting for the biopsy and the pathology results, and we have been living with this cancer thing for the last 5 1/2 or 6 months.  In some respects the time seems to have gone by quickly.  But in other ways we are ready to get this phase behind us.  Even though I am extremely fortunate and blessed to not be reacting badly to the treatments, it is none the less beginning to wear thin.  It is time to move on.

Sun and fun.

We spent this past weekend down on the coast at Ocean Isle with some friends.  We have attended the annual Oyster Festival there for several years and it is always such great fun (and I don't even like oysters).  That makes our third trip to the beach this summer.  Considering that I started my chemotherapy treatments on June 20, and have had 16 infusions so far, I think being able to make 3 trips to the beach along with several others to visit the kids and grand kids (4 hours each way) is pretty darn good for an old dog with cancer.  The Lord has blessed me in so many ways and enabled me to stay active and busy.  What a mighty God we serve.

Back when I was first starting treatments, daughter Jill said she was picturing the chemo like lots of little pacman heads running around gobbling up those cancer cells.  And that must be just about the way it worked, since my interim test results a few weeks ago were just excellent.  The main object now is that one, large, more persistent lymph node in my abdomen, and I am picturing those same pacman heads crowded around that one node and munching away, sort of like ants gathered around a piece of food dropped on the ground.

Won't you join me in a little mental imagery?

Pray for Eliza

Yesterday was another treatment day at Duke, and things went very smoothly.  Without question, the prayers of many, many people have played a big role in my amazing ability to avoid the side effects normally associated with chemotherapy.  My recent test results indicated a very significant reduction in the amount of cancer present throughout my body, an almost unbelievable achievement after only 14 weeks of treatment.  A couple of Dr. Beaven's comments yesterday indicated that she too is impressed.  The power of prayer has been evident since the beginning of this battle with lymphoma.  And I thank all of you for lifting me up to our Heavenly Father.

I would ask that you continue your prayers on my behalf.  But I have another prayer request that I am asking be added to your list.  Our 10 year old granddaughter, Eliza Davis, is scheduled to undergo brain surgery at Duke Children's Hospital on November 12.  After several years of testing and evaluation, the doctors have determined that she has a Chiari Malformation, and major surgery is needed to correct the problem.  We all have a high degree of faith and confidence that the surgery will go well, and Eliza will come through it just fine.  All of our thoughts and prayers will place her in the powerful and loving care of The Great Physician.

A shining beacon.

Yesterday was another Duke day, an opportunity to spend a few hours in those impressive facilities, meet with my equally impressive medical team, and then go have someone infuse some poison into my bloodstream.  It was indeed and lovely Tuesday.  This begins the second phase of my Cycle 3 treatments, and if past history is any indication, I do not expect to have any adverse reaction to the drug that I am receiving, which is called Pralatrexate.  The main possible side effect of this particular tonic is sores in the mouth and/or throat.  It takes 4 or 5 days for any sores to begin to show up, so we won't know for sure until about this time next week.  But good oral care has kept me pretty clear of any past problems and hopefully will work again this time.

I have commented in the past about some of the people that we see in and around the cancer center, and how their cancer, and the related treatments, has caused them such obvious pain and suffering.  But yesterday my attention was drawn to a woman seated in a wheel chair, waiting to have some blood drawn.  She was probably in her 50's, a petite lady, and her hair was completely gone.  In my reading I have learned that while most women have significant difficulty dealing with the loss of their hair, and immediately begin wearing wigs or some other head covering, some women reject such measures and proudly display their bald heads.  This was one such woman.  She was neatly and comfortably dressed and her smile just lit up the room.  She was chatting with her companion about various topics, none of which had anything to do with her cancer or her resultant condition.  It was a joy to observe how she able to be such a positive beacon to all those around her.

Being treated for cancer does not have to be a physically debilitating process.  In recent years, the advancements in treatment medications and techniques have been significant.  And those advances have enabled patients to better withstand the rigors of those lifesaving procedures.  So while our eyes may naturally be drawn to those who are struggling so greatly to get through, there are also many who are able to live fairly full and active lives while contesting their disease.  I am blessed to be included in that latter group and I praise the Lord for it.

Current status.

It has been 2 weeks since I had the PET scan and the bone marrow biopsy.  As reported earlier, the test results were most encouraging and uplifting.  Since the time we received those results, we have been exchanging a few emails with one of the main nurses at Dr. Beaven's office, trying to get a better handle on what the phrase "significant resolution" really means.  Based on what we have heard, I believe it would be safe to characterize my current condition as follows.  The bone marrow, which initially indicated a 30% cancer involvement, is now clear and cancer free.  No evidence of cancer in the marrow was found.  As for the PET scan, which can detect cancer throughout the body, her phrase was "From the capability of the scan, it appears the cancer is not detectable.  It is the microscopic piece that is not evaluable."  In my terms that means there is no detectable evidence of cancer in either the marrow or the lymphatic system throughout the body.  The lone exception to all of this is one large lymph node in my abdomen, that thus far has seemingly resisted the effects of treatment and has remained somewhat stable in size.

So in a period of just 14 weeks, I have gone from Stage 4 lymphoma (4 being the highest or worst stage) to being essentially cancer free, with the one exception.  That is pretty impressive and those chemotherapy treatments, unpleasant as they may be, are really working well.  Praise the Lord!!!  I have gone from a prognosis that was alarming and decidedly negative, to a situation where things are looking quite bright and positive.  All in all it has been a pretty darn good 14 weeks.

But I 'm not completely out of the woods yet.  That remaining node has to start responding, and I am confident that it is only a matter of time before it also disappears.  Then there is the issue of "microscopic pieces".  Certain cancers, mine included, can be almost completely eliminated through treatment, but still have a few cells remain to come back later and start the cancer growing all over again.  You can be 99.99999% cured, but that last .00001% can come back to haunt you.  And that small of an amount is totally undetectable with current testing technology.  It is for that reason that I will undergo a bone marrow transplant, probably starting sometime in January.  The transplant, which is like going after the last fly in the house with a guided missile, will hopefully destroy the few remaining cancer cells, or at least get us up to 99.99999999999999999999%.  It is not a procedure I am particularly looking forward to but it is necessary to improving my longer term prognosis.

I was reading something this week, which indicated that the initial response to a cancer diagnosis is often shock and disbelief, followed by a period of distress.......  Been there, done that.  We have come so far in such a short period.  Many thanks to all of those who have been so supportive in so many ways.  Your many expressions of love and caring have meant so much, and we especially appreciate the many prayers that have been lifted up on our behalf.  The Lord is good, and His presence in this situation has been so evident and so obvious.  We just ask that you continue to keep us on your prayer lists.  When measured in days or weeks, most of our journey still lies ahead.  But we will continue on, with confidence and joy, knowing that our every step is being watched by our Heavenly Father.

Pretty good.

Last week was what I have come to refer to as my "heavy week".  Three consecutive days of chemotherapy could probably be called a lot of things, but when I finish the week I just feel beat.  In addition to the chemo, I take very large doses of Prednisone for 4 straight days.  I think it is the Prednisone, but something that I get during that period keeps me from getting much more than about 3 or 4 hours of sleep at night.  That will get your tail dragging in no time.  We have also found that towards the end of that week, my voice gets very weak and strained.  The doctor says it is just one of the ways my body expresses fatigue.  Add in some long drives, and the week just doesn't rank up there very high in my idea of what is ideal.

As I have said many times before, I am so blessed to be experiencing only a few side effects, and those are quite mild.  I know that there are many, many people out there who go through great pain and suffering while receiving chemo, and it remains with them for days if not weeks.  I saw a lady last week in a wheelchair, being pushed into the waiting area for the treatment center.  She was all hunched over a dish pan sitting in her lap, and I'm sure it was not there to hold dishes.  I am so fortunate.

The weekend and the first few days of this week have been just heavenly.  Aside from going to church on Sunday, there was no place we had to go to.  No appointments, no doctors' visits, no chemo treatments this week, so all we had to do was stay home and rest.  And we have been getting a lot of practice at our resting.  It is Tuesday evening now and I think I am getting pretty close back to "normal".  The voice is still a little weak and I'm not ready to start painting the house, but I am feeling pretty good.  Feeling pretty good is nice, when you haven't been there for a while.  Praise the Lord, for feeling good!

Busy, busy.

While taking my walk today, I kept thinking about an incident that took place as we were leaving the Duke Cancer Center last Thursday.  I had just finished my 3rd day of chemotherapy and was looking forward, with much anticipation, to getting home and just relaxing for a few days.  We got on the 4th floor elevator with another couple, and got all the way to the 3rd floor before we stopped and the doors opened.  A woman in a wheel chair, probably about my age, came through the doors being pushed by her husband. The elevator was not overly spacious and conditions started getting a little crowded as we all moved back to make room.  She was obviously in the wheelchair for a reason, and though she did seem a bit weak and feeble in some ways, she was also reasonably alert and aware.  She smiled and make a comment about causing everyone else to have to get all squeezed and crunched.  We all tried to reassure her that it was perfectly all right and not to worry about it.  We made it all the way down to the 2nd floor before it was time to stop again and let her off.  As her husband began to pull her out, I think Holly said something like "...and have a nice day".  As she was backing away she looked up with a big smile on her face and said "I will.  I found out I'm going to live."  And the doors closed shut.

Forgetting her husband, the other four people on that elevator were thinking about other things.  Planning their weekend, trying to remember where they had parked the car, wondering whether they had called someone back.  Based on the way in which that woman said those words, I got the distinct impression that, at some point, there had been some serious doubts raised about her longer term prognosis.  And I sensed that she had just, a short time earlier, learned the results of additional tests that removed those doubts.  She was going to live!!  She didn't care where her husband had parked the car - she was going to live!!  She didn't even care if they had a car - she was going to live!!

All of us have our lives to live.  There are many details that we need to plan for and deal with.  We get busy with our families, and our jobs, and our bad hair days, and sometimes we forget about the simple fact that we have been granted more days in our lives.  There is no guarantee that any of us will see the sun rise tomorrow.  So while it is still necessary to pay attention to the many facets of life that pass us by each day, let us not forget to be thankful for just being alive.  That lady in the elevator is undoubtedly having a simply glorious weekend.  Take a moment to sit back, draw in a deep breath, and just think about it.

Drip, drip, drip.

Today I just finished up my third consecutive day of chemotherapy, the usual start to a new treatment cycle.  That involved about 8 total hours hooked up to an IV pump, actually 3 pumps to be precise, and infusing about 2 liters (+/- 2 quarts) of several poisionous chemicals.  Those drugs are designed to kill very active fast growing cells.  Those cells are cancer cells, but they are also include hair and beard type cells so there is some collateral damage, some seen and some unseen.  I sometimes wonder about what might be included in that unseen category, but I don't get too worked up about what I can't see or feel.  I'll just leave that aspect to the Lord, and let Him deal with it.

So that's 8 hours of chair time, plus 3 trips to Duke at 3 hours per trip, an appointment with the doctor, and a few hours in waiting rooms.  That adds up to 3 perfectly good days that could have been spent in far more interesting and pleaurable pursuits.  But we are where we are and we do what we have to do.  Or as they say, we just go with the flow.  The good news is that we now have 11 days with no further medical visits, a vacation of sorts.  So we will rest up from sitting in chairs, and sitting in doctors offices, and sitting in waiting rooms, and we will consider what other pursuits we might undertake to fill all our spare time.  Oh, the stresses and strains of being retired.

And the doctor said...

Our appointment with Dr. Beaven was at 12:00 noon today, but we had to feed the vampires in the lab at 11:00 so we left home at 9:45.  By the time we saw the doctor and completed the treatment, and then drove back home, we arrived at our little castle at 7:30.  A ten hour day.  But we have learned that when we have to head north to Duke, we just block off the whole day to allow for traffic, schedule changes, etc.  However long it may have taken today it was worth it to hear her say that the bone marrow biopsy came back clean and the official PET scan report indicated significant recovery, with the exception of one lymph node.  Good news to be sure. Back when I was diagnosed on June 6th, there was a bone marrow biopsy performed and the results indicated a 30% involvement of the marrow - not good.  But today's results, just 16 weeks later, indicate that the bone marrow is clean, indicating no evidence of cancer.  That is major!!  The PET scan, when compared to the one taken back in late May, shows significant improvement.  It does, however, show that one lymph node in my abdomen has not responded to any noticeable degree.  The doctor said that she sometimes sees this with T-Cell Lymphoma, and if it does not respond after 2 more cycles, we will consider other options.  I asked if that would be radiation and she said that it would most likely involve another chemo drug.  So we just need to concentrate our prayers on that stubborn node.  No need to drag this process out any longer than needed, and that remaining lymph node just has to go.  Our daughter Jill said some time back that in her mind she was picturing all of these little pacman heads scurrying around eating up all of the cancer cells.  Well, we still need some of them continuing their reconnaissance and attack operations, but our main force needs to be squarely focused on that remaining stronghold.  No time now to let down our guard.  We have the enemy on the run, and we're going to beat this.

Praise be to God for His faithfullness and His loving kindness.  He has heard our prayers and answered the petitions of our hearts. Praise His holy name.

Here we go again.

Tomorrow (Tuesday) we have an appointment with Dr. Beaven and will get the "official" results of my testing last Thursday.  At this point we don't have any feed back on the bone marrow biopsy but the preliminary report on the PET scan was favorable, so overall things look encouraging and hearing anything negative will be a great surprise.

Based on what we have heard so far, I expect to leave her office and go down to the treatment center to begin Cycle 3.  That means Tuesday, Wednesday and Thursday will be treatment days and I will get to bring home about 2 more quarts of chemo drugs, all sloshing around together in my bloodstream.  The beginning of Cycle 2, seven weeks ago, was harder on me than usual and I am a bit apprehensive about how I will react this time.  I may have been a little more run down when I started Cycle 2, and that could have contributed to my feeling it more.  But Holly has said recently that I seem to be as good as she has seen me in a while so maybe this time will be better.  Regardless, I don't really have anything to complain about.  My overall reaction to my treatments has been far better than what most people experience.  Just hair loss and some fatigue, and when you compare that to how bad things could be, I am a very blessed man.  But like someone said the other day, no one likes to feel poorly, even if it is just a little poorly, so I am entitled to some apprehension and maybe even a little complaining.  So far my spirits are very good, and I guess I can handle a little worry without going all to pieces.  The first 2 cycles (14 weeks) have gone well and the results have been encouraging, so 2 more cycles shouldn't be too much to handle in the overall scheme of things.  The ultimate goal is to be cancer free, and if the journey to achieve that goal includes a few bumps and bruises, so be it.  Praise the Lord, we're going to beat this.

Especially Heather

I was reading on the Internet today and I came across a blog, written by a young lady named Heather, who I am guessing is somewhere in her late 30's.  A wife and mother, Heather was diagnosed with a malignant brain tumor in 2007.  Her blog was started in 2006 and, though she is now cancer free, she continues with periodic postings.  As I read through Heather's blog, I came across one of her posts that just captivated me.  I have cancer living inside of me right now, and when I read her words, I immediately could relate to how she was feeling when she wrote what follows:

 "You have invaded my body without invitation.  You have robbed me of emotion, energy, and most of all time.  Time with my family.  Time wasted worrying over you and what you will do next, when will you strike next.  Time wasted worrying about the next scan, the next oncology appointment, the next .......  

I will not let you steal my joy and my self confidence (even though you stole my hair).  I will not let you touch my heart.  I will not let you steal the smile from my face or the beat in my step, though it has become weaker over the time I have known you.  You have taken too much from me, so much from me.  You are a shadow in my children's faces, they worry about their mom and it shows.  You are a shadow in my husband's eyes, he wonders how he can live alone, raise three kids alone.  In those quiet moments, when he and I are alone, I see fear in his eyes.  You are a shadow in my parents heart, wondering if/when they will have to bury their only child.

You are a shadow in my heart, whispering in my ear.  "I am still here." and quietly I whisper back "Not for long".  That whisper is getting louder and louder day by day, moment by moment.  And sometime, soon I hope, it will drown out your voice."

Heather is an amazing young lady and she has been through a lot.  But her faith and her strength shine through loud and clear. If you would like to read more of Heather's story, her blog is titled Especially Heather  -  it's not about the hair, it's about the heart and you can read it by clicking here.

Really good progress.

The unofficial report we got today from Dr. Beaven, after completing my testing, was that I am making really good progress. The bone marrow biopsy report won't be available until probably Monday, and the "official" PET scan report has not yet been received, but based on what she had received thus far she said things looked really good.  Since there is still definitive evidence of the cancer on the PET scan, I will probably continue with 2 more cycles of chemotherapy before proceeding to bone marrow transplant.  We will find out for sure next Tuesday.  That means that my last chemo treatment will probably be sometime in the middle of December and what a Christmas present that will be.  I suppose if I was having a bad time with the chemo, and dreading every time I had to get a treatment, the news that I will have 2 more cycles (12 treatments) would not be greeted as welcome news.  But since I am having almost no side effects thus far from the chemo drugs, I did not mind hearing about the additional treatments.  If that will get rid of the remaining cancer cells, lets get on with it.

All the way home, Holly and I kept saying "Praise the Lord.  Praise the Lord."  He is good and has answered our prayers by showing us that the cancer is responding.  To the many prayer warriors out there who have been lifting up both Holly and me, we say thank you.  We so appreciate your faithfulness and ask that you continue to keep us on your prayer lists.  We have made really good progress but we still have a lot of ground to cover before this is over.  But we are standing by our family motto "We're going to beat this".

Based on the good news we received the day could not have gone much better.  But shortly after we arrived at Duke we found there was a scheduling problem and we wound up with some extra time on our hands.  So since it was an absolutely gorgeous day, we took a walk through the Doris Duke Gardens, adjacent to the cancer center.  What a beautiful place and what a lovely start to a marvelous day.

Praise the Lord!!

Anxious times.

The next week will be a very significant period in my battle with Non Hodgkins Lymphoma.  On Thursday of this week I go to Duke for blood tests, a PET scan and a bone marrow biopsy.  The results of those tests will determine whether I continue with more chemotherapy cycles or if I begin preparations for a bone marrow transplant.  I believe it would be safe to say that represents a rather major fork in the road.  But aside from deciding whether I take the right fork or the left fork, it will also represent my first indication of how effective my treatments have been at impacting my cancer.  The tests will be completed on Thursday and I have an appointment with Dr. Beaven on Tuesday to discuss the results.  There is a chance that I may get some of the results before Tuesday, but the official review and the decision on the fork in the road won't happen until Tuesday.

So the 5 days from Thursday until Tuesday will probably seem more like a lifetime.  Has the cancer been profoundly diminished?  Will the bone marrow show no signs of the disease, given that the initial test showed both bone and bone marrow involvement?  Will I be re-staged from Stage 4 down to maybe a 2?  Or will she tell me that there is very little evidence of any improvement?  Do you remember waiting to get your first test back in Chemistry, or in Calculus, or maybe in that extra tough Political Science course?  You were confident that you had done everything you could to prepare for that first test.  Maybe you had even stayed up all night studying.  But until you saw that grade, written on the top of the exam paper or blue book, you just couldn't be sure.  While the stakes between that test and my test this week are quite a bit different, the principal is much the same.

My faith that God is in control is still as strong as ever.  I know that He is aware of the desires of my heart, and hears the many prayers that are lifted to Him on my behalf.  But my mind is still anxious about hearing the final report.  I don't believe that reflects a weakness in my faith.  It simply reflects the fact that I am human.  And in my mind it is OK to be a little anxious about things like this.  The key is not letting it get out of hand and having it begin to consume you.  So I'm going to be a LITTLE nervous until about next Tuesday :-).

A rubber raft.

I have never been much of a reader.  Aside from college text books, you could probably stack all of the books I have read since then on the dash board of your car and still have a clear view to drive.  Holly, on the other hand, has an insatiable appetite for books of all kinds and is never far from her Kindle.  But since I was diagnosed, I have spent a significant amount of time online reading about Non-Hodgkins Lymphoma and searching out blogs written by others going through their own battles with cancer, or survivors who no longer battle the disease but struggle with their thoughts about recurrence.  Since May we have also spent a lot of time sitting in doctors' waiting rooms, and I have actually been reading a hardback book (proof that cancer does cause significant changes in your life).

I am reading a book titled Unbroken by Laura Hillenbrand.  If you enjoy reading and have not read this one, I highly recommend you add it to your list, acknowledging that my recommendation does not come with a lot of credibility.  It is the true story of a WWII air force bombardier, Louis Zamperini, whose plane was shot down over the Pacific in 1943.  Louie and two of his crew mates, Phil and Mac, survived the crash and spent 46 days drifting in a life raft before eventually being rescued.  It is an amazing and captivating story of their determination to survive, and their physical, mental and emotional struggles along the way.  As I sat in my local oncologist's waiting room last week, waiting to get my Neulasta shot, I read a description of these three soldiers, who were probably at about day 30 of their ordeal, and how they were coping, both individually and collectively.  As I read, I was struck by the similarities between their struggles and those of someone faced with a cancer diagnosis, and their subsequent ordeal as they strive to confront and deal with their situation.  The book's author is far more talented than I, in her ability to describe what is going on in the bodies and minds of these young men.  And what follows is an excerpt from her excellent writings:

Given the dismal record of raft-bound men, Mac's despair was reasonable.  What is remarkable is that the two men who shared Mac's plight didn't share his hopelessness.  Though Phil was constantly wondering how long this would go on, it had not yet occurred to him that he might die.  The same was true for Louie.  Though they both knew that they were in an extremely serious situation, they both had the ability to warn fear away from their thoughts, focusing instead on how to survive and reassuring themselves that things would work out.

It remains a mystery why these three young men, veterans of the same training and the same crash, differed so radically in their perceptions of their plight.  Maybe the difference was biological: some men may be wired for optimism, others for doubt.  As a toddler, Louie had leaped from a train and watched it bear his family away, yet had remained cheerfully unconcerned about his safety, suggesting that he may have been born an optimist.  Perhaps the men's histories had given them opposing convictions about their capacity to overcome adversity.

For Phil there was another source of strength, one of which even Louie was unaware.  According to his family, in his quiet, private way, Phil was a deeply religious man, carrying his faith instilled in him by his parents.  "I had told Phil several times before to always do his best as he knew how to do it," Phil's father once wrote, "and when things get beyond his skill and ability to ask the Lord to step in and help out."  Phil never spoke of his faith, but as he sang hymns over the ocean, conjuring up a protective God, perhaps rescue felt closer, despair more distant.

From earliest childhood, Louie had regarded every limitation placed on him as a challenge to his wits, his resourcefulness, and his determination to rebel.  The result had been a mutinous youth.  As maddening as his exploits had been for his parents and his town, Louie's success in carrying them off had given him the conviction that he could think his way around any boundary.  Now, as he was cast into extremity, despair and death became the focus of his defiance.  The same attributes that had made him the boy terror of Torrance were keeping him alive in the greatest struggle of his life.

Though all three men faced the same hardship, their differing perceptions of it appeared to be shaping their fates.  Louie and Phil's hope displaced their fear and inspired them to work toward their survival, and each success renewed their physical and emotional vigor.  Mac's resignation seemed to paralyze him, and the less he participated in their efforts to survive, the more he slipped.  Though he did the least, as the days passed, it was he who faded the most.  Louie and Phil's optimism, and Mac's hopelessness, were becoming self-fulfilling.

Much like Louie and his two comrades, we are all faced at times with uncertain and sometimes perilous journeys.  And almost always these journeys involve some members of our family and/or our circle of friends, so our little rubber raft may include several other passengers.  Each of us will weather the storms and turmoil in our own unique and individual way.  No two of us will respond in quite the same manner.  Some will be strong and resilient while others will require more care and support.  As I read the above account, I couldn't help but see a parallel to my own unwanted voyage on the sea of lymphoma.  Louie and Phil had the attitude and outlook of survivors and I hope to emulate them as my journey continues to unfold.

My diagnosis.

For some time now I have been thinking that I needed to do a post on how I found out that I had cancer in the first place.  As I read through many other blogs, written by cancer patients or survivors, they almost all start off by saying that they found a lump in their breast, or had a swollen lymph node in their neck, or had pain here or there, or bad headaches, or some other type of symptom that led them to go see their doctor.  In my case there was nothing.  Absolutely nothing.  I was feeling as "normal" as ever.  But God, in His infinite wisdom, knew that it was time for me to get my unknown problem identified and dealt with.

Keeping in mind that I was diagnosed June 6th, Holly and I had spent much of April and early May with our daughter and her family in western North Carolina.  Jill was expecting her third child, and with very active 2 and 5 year boys already around the house, we figured she could use the help getting ready for the delivery and for a week or two after the baby came home.  All went according to plan.  We returned home on May 5th and began settling back into our routine at home.  The next morning I got up and took a shower and Holly started some ironing.  After my shower I sat down in a chair and started talking to her, but she noticed I was acting strangely.  There was a period of about an hour there where I don't really have any recall of what was said or what I did.  So how does all of this relate to my cancer diagnosis?  It was just God tapping me on the shoulder.

Being somewhat concerned about the possibility that I had experienced a stroke, we went to the emergency room for a checkup.  After answering a seemingly endless list of questions, I began getting various tests - CAT scans, MRI's, ultrasounds of my neck and chest x-rays.  Knowing that they were looking for any evidence of possible damage in my brain, I was a bit puzzled by the chest x-ray.  In fact the first x-ray was not quite right so they had to take another one.  The tests were then followed by a long period of waiting, while the results were evaluated.  Finally, the doctor came in and indicated that they could find no evidence of any type of stroke or brain damage, and indicated that I could have experienced a TIA (Transient Ischemic Attack) or mini stroke.  I needed to check with my family doctor to discuss this further.  And, OH BY THE WAY, the chest x-ray showed some evidence of enlarged lymph nodes in my chest/abdomen so they sent me back for still another test, a full chest and abdominal CAT scan.  Then more waiting until the doctor returned and confirmed there was evidence of enlarged lymph nodes and that I needed to followup with my family doctor.  Tap tap.

Two days later my family doctor referred me to a neurologist for further TIA evaluation, and also scheduled me for a full body PET scan and an appointment with an oncologist.  After further tests and studies, the neurologist indicated he could find no evidence of any brain or circulatory abnormalities, nor any evidence of brain damage.  He said that no further followup was needed and that I should call him if I ever experienced any future problems.  So the reason that I went to the hospital in the first place was totally unexplainable.  But, OH BY THE WAY, look what else we found.  Tap tap.

The PET scan showed an enlarged lymph node in my neck, so it was decided that would be the source for the biopsy.  After the biopsy was taken, but before the results were available, my local oncologist indicated that he suspected that the results would show some type of early stage non aggressive low grade lymphoma, which would be easily treatable.  His reasoning: I was totally asymptomatic, not showing any signs or symptoms of any type of cancer.  You can imagine how surprised we all were when the diagnosis indicated stage 4 (very advanced) Non-Hodgkins Peripheral T-Cell Lymphoma, a very aggressive and rare form of cancer.  It was the fact that it is so rare (only 340 cases reported world wide in 2011) that caused us to pursue treatment at Duke as part of a clinical trial.  How we wound up at Duke with Dr. Beaven is still another story about God's guiding hand.

Some might say that the whole episode that led to my diagnosis is just coincidence.  I choose to view it as just another example of how God can and will guide and direct our steps and the events that surround our everyday lives.  He is not a distant God, sitting way up in heaven looking down at us like a spectator at a football game.  Rather, He is actively involved in every aspect of our comings and our goings and has a perfect plan for each of us.  We may not understand the how's and the why's, but all He asks is that we trust Him and surrender to His will.  It is my sincere belief that if God had not sent us to the emergency room that morning, and my very aggressive cancer had stayed undetected, it would not have been found until it was so far advanced that any treatment would have been pointless.

PRAISE GOD!

Bye bye beard.

Back in the middle of July, after the first 4 or 5 chemo treatments, I began to lose some of my hair and my beard started to thin. Since I didn't have a lot of hair to start with, I didn't view this development as being all that significant.  But then it stopped about as fast as it started.  I figured that if I lost half my hair towards the end of Cycle 1, it was reasonable to expect that the other half would probably disappear sometime during Cycle 2.  Well I was partially right.  About 10 days ago I noticed that I was starting to shed more hair and my beard was getting even thinner.  I had been pretty much shaving my head after the first phase but the beard was just trimmed short.  Then the beard finally reached the point where it got so thin that it started looking scraggly, so out came the razor and shave cream.  Now there is just a little stubble on both my head and my chin.

 The shaver.

The shaved.

Maybe I should see if I can find a nice wig to wear, with a beard attached that would hang down around my jaw.  Sounds scary doesn't it.  Maybe I will just stick with the close shaved look.

Bye bye beach.

Yesterday morning we had to get up early to leave Emerald Isle and drive up to Duke for another treatment.  It seems like no matter where we are we need to drive to Duke for something, and the beach was no exception.  It was sad having to leave the beach and our family but 4 days of fun in the ocean and eating lots of fresh seafood gave us some memories that we can take home with us.

Emerald Isle at sunset.

The appointment at Duke was my last treatment for Cycle 2.  I now have 2 weeks off and then return to Duke again on Sept 20 for some testing; bloodwork, a PET scan and a bone marrow biopsy.  Then on Sept 25 we have an appointment to see the doctor and review the test results, which will determine whether we continue with more treatment cycles or proceed with preparing for a bone marrow transplant.  My gut feeling is that we will find there has been good progress in treating and reducing the cancer but more treatment time is needed, so we will start Cycle 3 and check back with more tests later on.  But maybe that feeling in my gut is just yesterday's chemo doing it's thing.  One suprise from yesterday's visit was the finding that my blood is quite thin.  I have taken coumadin, a blood thinner, for years and never had any real problems maintaining a proper clotting level.  But all of a sudden it has spiked way up, most likely the interaction with another drug I have started taking as part of my treatments. So the next few weeks will be spent trying to get things stabalized and back to normal.  My regular family doctor said I was not allowed to ride my skateboard for the next 3 weeks.  Bummer.

Beautiful morning.

I woke up this morning and looked out at the Atlantic ocean, the waves washing up on shore with that wonderful crashing sound and the sea gulls soaring above the blue seas looking for some breakfast.   We are at Emerald Isle on the North Carolina coast.  Our daughter Jill and her family rented an ocean front condo for 4 days and asked us to join them, and we just couldn't disappoint the grandkids now could we.  The sunset last night was absolutely gorgeous, with an orange moon sitting high above the deep blue waters, against a fading pale blue sky.  Holly and I took a walk along the beach and marveled at all of God's beauty and grandeur.  Today should be lots of fun looking for shells, swimming and building sand castles.  I still don't do very well in the heat of the day and will probably stay indoors with the 4 month old, but everyone else will surely get lots more sun and sand today.  I was reading a blog the other day and the writer said "I truly believe that life is a gift.  As cancer survivors and patients we simply see it more clearly than many others".  Well said.

Emerald Isle at sunrise.

I'm doing well.

Yesterday was a treatment day at Duke, so I had some blood drawn, saw the doctor and took on another charge of Pralatrexate.  This is the drug that has a strong tendency to cause sores in the mouth, throat or esophagus, usually after about 4 to 5 days.  It is a condition known as mucositis and can be quite severe.  Sometimes the patient is suffering such pain and discomfort that it is the basis for delaying further treatment until it subsides.  During Cycle 1, I received two consecutive weekly infusions of Pralatrexate and had only minor throat irritation that lasted only 2 or 3 days.  With Cycle 2, I received one treatment last week, another yesterday and my third is scheduled next Tuesday.  The doctor asked how my mouth was after last week's treatment and I was pleased to report that I have had absolutely no reaction at all, not one hint of a sore anywhere.  She said she was glad to hear that.  I responded that I was elated.

Numerous times I have commented here about how well I am responding to these treatments and how, with the exception of some fatigue, I have been able to avoid most of the side effects normally associated with chemotherapy.  I marvel each day at how well I feel.  I'm certainly not feeling "normal" but I'm not that awfully far away from the old me.  To be honest, I have often thought that perhaps I should not be discussing how well things are going here on my blog.  I was concerned that another cancer patient might read about it and feel even worse because they are struggling and not doing as well as I am.  But then I decided that I might actually be an encouragement to others and be able to give them hope.  No where is it written that everyone being treated for cancer with chemotherapy and/or radiation must suffer and endure a poor quality of life.  That simply is not the case and I am living proof.  So why am I able to avoid the perils that are experienced by so many?  No one really knows the answer to that.  The drugs administered in chemotherapy effect different people in different ways.  I know of people who have had terrible reactions to Pralatrexate and Vincristine, two of the drugs that I receive.  I have had seemingly no reactions at all to either of them.  Part of it is body chemistry and how your particular body responds to various foreign substances.  Beyond that I believe that your psychological makeup plays a big role.  I am a fighter by nature (not literally) and tend to confront most things head on.  I am also an optimist and am inclined to look for the positive side of things.  And last, but by no means least, a am a man of great faith.  I know that my Heavenly Father loves me and will be with me through any of the trials and tribulations that this life can throw at me.  So if you add all of that together, the strength of my body, the strength of my outlook and the strength of my faith in my Lord and Savior, I believe you have most of the answer as to why I am doing so well. It is my hope that I may be an encouragement to others who are facing their own trials or struggles, whether it be cancer or some other very troublesome situation.

Certainly there is no guarantee that the future will be the same as the past, but I definitely like the way the trend line is going :-)

Family.

This morning in church the sermon was about family, and over the past several days my family has been on my mind more often than usual.  A diagnosis of cancer initiates a dizzying emotional odyssey of ups and downs, highs and lows and everywhere in between.  It impacts not only the patient but the rest of the family too.  Husband, wife, brother, sister, father, mother, grandfather, grandmother.  For most of us our immediate family is the source of our most cherished and intimate emotional bonds.  Our  joys and our sorrows, our highs and our lows, our sickness and our health; all these are shared and felt by the other members of our family.  What hurts one hurts all.

Back on June 6th of this year I was diagnosed with Stage 4 Non-Hodgkin's T-Cell Lymphoma,  an aggressive and rare form of cancer, with a lousy prognosis.  It was like getting hit hard in the gut.  It knocked all of the wind out of me and I went down hard.  My emotions were immediately consumed with fear and apprehension, and my mind was filled with questions and the possible implications of what I had just heard.  My world had been instantly turned upside down.  Somehow I retained my outward composure, in spite of what was going on inside.  Sitting right next to me, and hearing those same words, was my wife and soul mate of 44 years, Holly.  Unquestionably, her thoughts and emotions were on a similar trajectory to mine.  That evening we called our son Adam and daughter Jill with the news.  Their daddy was in serious trouble, although we did word it somewhat more tactfully than that.  They in turn told their spouses, and by bedtime, 6 lives had been shoved way off course.  And then there are also 6 grandchildren ranging in age from 2 months to 11 years.

I am the patient and it is my body that has been invaded by an unwelcome and threatening intruder.  I am the one blogging about my experience as a form of therapy.  I am the one who gets put on prayer lists and asked how I am doing physically and emotionally.  I am the one getting most of the cards and letters in the mail.  But Holly and Adam and Annie and Jill and Jeff are also having to go through their own process of emotional and spiritual adjustment, and work out their individual coping mechanisms. One significant factor in their adjusting is how I am dealing with the situation.  In all honesty and sincerity and can say that I am doing very well, retaining my usual optimistic view, and believing strongly that my medical team and God Almighty will give me victory over my cancer.  Having completed almost 2 seven week cycles of chemotherapy, I can safely say that I am enduring the therapy with almost no side effects other than fatigue.  So what my family sees is a pretty positive outlook from a 6'6" 250# man, who looks more like the doctor than the patient.  I just tire more quickly and sneak away for a nap more often.

But I worry about each of my family members and pray for them often.  They can only draw so much strength and confidence from my demeanor.  So I can only trust that God will be with each of them and give them peace with where we are and where we are going.  I especially pray for Holly, as she is the primary caregiver, and is having to shoulder an increasing load.  During the initial phase of my stem cell transplant, when we will be living in Durham, I pray that God will give her the strength and ability to handle all that will be required of her.  My reading tells me that she will need help and support from others, and I pray that the Lord will provide all that is required.  I also pray that the Lord will continue to bless me with an amazing ability to withstand the rigors of my treatments.  I accept that there are probably some difficult and unpleasant days ahead, but with God's help I know that they will pass and I will be on the road to recovery in His time.

For those prayer warriors that I know I have out there, you should now have a good list of specific needs to work with.  And thank you for your faithfulness.  For those of you who may doubt the power of prayer, pray for belief.