Glass half full.

I find that quite often my morning walks are a time of quiet communion with my Lord.  This morning my thoughts centered on how many blessings He has poured out upon me.

"Delight thyself also in the Lord and He shall give thee the desires of thine heart."  "But my God shall supply all your needs according to His riches in glory by Christ Jesus."  (Psalm 37:4 and Phillipians 4:19)

Yes I have cancer.  And some might wonder how it is possible to dwell upon my many blessings when this unwelcome monster has invaded my body.  But that cancer is only a part of my existence - and it will be dealt with in due course.  There are so many other things in my life that are so much more wonderful and marvelous.  Last week we spent several days with our son, our daughter-in-law and 3 grandchildren at the beach in Charleston.  We came home Saturday only to be joined by our daughter and 3 grandchildren, and our son-in-law will join us mid week.  Family time together is one of our greatest blessings.  I am being treated for my cancer at one of the finest medical facilities in the United States, if not the world.  And considering the very lengthy list of possible side effects from chemotherapy, I am fortunate to have only lost what little hair I had, and I feel more fatigued than usual.  How blessed is that.  As I walked, my mind wandered through an almost endless list of physical possessions that surround me and make my life more comfortable and enjoyable.  And even more importantly, I have so many other less tangible blessings, including the love of my marvelous wife and my wonderful family, the comfort afforded me by living in the great U.S.A. (with all of it's imperfections), and the peace and joy of knowing my Lord and Savior Jesus Christ.

Whether I consider my glass half full or half empty is a choice that is mine to make.  And I choose half full.

Off to the beach.

Wednesdays are normally my chemo days, but since I have a 2 week break before starting a new cycle of treatments, this morning we headed out for Charleston.  Our son and his family rented a beach house on Isle of Palms and they are spending the week there.  They invited us to join them and who can pass up several days of sun, sand and fresh seafood.  I may pass on the sun and the sand since I am already fatigued and the heat just melts me like butter.  But I will make up for it in the seafood department.  There is nothing that beats the taste of shrimp or flounder or snapper that was just swimming around in the ocean 12 hours ago.  And since I love to cook, I will get twice the enjoyment out of whatever we have for dinner.  Our two granddaughters, 11 and 9, and our 4 y/o grandson will keep the days busy and the activity level high.  Lots of memories, lots of stories and lots of love.  It just doesn't get any better.

Optimistic outlook.

Battling cancer with an optimistic and upbeat attitude is a challenging task.  I would think that for most people having just been diagnosed with cancer, their initial reaction is probably not one of upbeat optimism.  I know mine wasn't.  As I have mentioned before, I have been doing a lot of reading, trying to gain strength and hope from the experience of others.  And I have found an amazing number of stories, from people just like you and me, who steadfastly refuse to just lay down and die.  Rather, they dig down deep, and muster an inner strength and determination that propels them ever onward and upward.  I read about a woman named Nancy, who has battled cancer in various forms, for over 20 years, starting at age 39.  She says ".. I have had over 14 types of chemotherapy or hormone therapy, 12 surgical procedures, 12 weeks of radiation therapy, and more bone scans, MRI's, PET scans and other scans than I could count."  She also says "We never know how much courage and strength we have until we are put to the test."  And finally "You are unique, and how you face challenges in life and respond to those challenges is unique to you.  You are not a statistic!  I have always taken on the approach that if statistics say there is a one in 100 chance for survival, the other 99 might as well move over, because I am heading for the winning position at the finish line."  Nancy's inspirational story should challenge us all.

Then there is Ethan, a 38 year old who has already battled Hodgkin's Lymphoma twice.  In addition to chemotherapy, he has had 2 different bone marrow transplants, one using his own cells and the other from a donor.  Amazingly, part way through his second series of treatments, Ethan ran in the Disney half-marathon.  Not that I have started training to compete in any road races, but Ethan's spirit of drive and determination has been motivational for me.  He is quoted as saying "I want to debunk the perception that there are winners and losers with cancer - you either win and you beat it or you lose and you die.  The reality is that there's an in between.  There are plenty of people like me who learn that there are drugs that will keep you alive longer.  I realize that I can live with cancer - and still call myself a winner and a survivor."

Recent medical advances in the treatment of cancer are numerous, and many more lie just ahead.  Monoclonal antibodies are one exciting new approach that allows the targeting of specific cancer cells, rather than the more generalized and destructive nature of chemotherapy.  Each year brings new and better ways to treat and potentially cure cancer.  And it may not be that long before they find a way to more effectively treat and cure my rare and aggressive form of the disease.  The current treatments may be able to cure my Lymphoma, and that is our fervent prayer.  But if not, there is definitely hope on the horizon.

I am optimistic that one day I will again be cancer free.  Between the diligent work of medical professionals, and the power of prayer to my Almighty God, I am confident that better days lie ahead.  The path that I walk today is not one that I welcome, but it is what it is.  My life may be somewhat harder, but it will keep going.  My faith has been strengthened in the past when I encountered difficulties and trials, and I have no doubt it will grow stronger in the days ahead as I learn to cast my burdens upon Him.  So I will take things one day at a time, knowing in my heart that we're going to beat this.  Anything less simply isn't an option.

Quote for the day.

A book I am reading contains the following statement, which I wanted to share:

"No one gets the luxury of selecting life's problems, but how you deal with them makes all the difference."

Digging down deep.

Yesterday I had my last treatment (Pralatrexate) which completed my 1st cycle of chemotherapy.  I was diagnosed on June 6 and in some ways that seems so long ago and yet in others it seems like just yesterday.  Much has happened in that 6 1/2 week period.  Locating doctors, enrolling in clinical trials, starting chemo treatments, trying to digest and understand a whole new world of medical terminology and procedures, attempting to comprehend the implications of having a rare and aggressive form of cancer, and discerning it's likely impact on the coming months and years.  Add to that the emotional struggles of trying to come to terms with various possibly life-changing outcomes, and you have what can safely be termed a very stressful situation.  Fortunately we are surrounded by a tremendous support group of family, friends and first class medical care personnel.  The phone calls, cards and letters and expressions of support and caring have meant so much.  And last, but by no means least, is our faith in  a loving and all powerful God Almighty.  Without that faith, I know that all of the rest would not have been sufficient to meet our needs.  Our journey has just begun, and there is a long and winding road that lies ahead, but we have every confidence that we will be able to navigate the bumps and turns along the way.  Remember, our family motto is: We're going to beat this!

If you are ever feeling down, or feeling that life has taken a recent turn for the worse, just go spend a couple of hours sitting in the waiting area outside a chemotherapy treatment center.  It won't take long for you to see that things could be a lot worse, a whole lot worse.  There I sit looking more like someone who is waiting to pickup a patient, rather than someone who is an actual patient waiting for treatment.  Look around and some of the people just make your heart cry out.  For some of them it took every ounce of strength they had just to get there.  But then you think about the courage that surrounds you.  These people have been through so much, so much pain and suffering, so much heartache and turmoil, and yet they keep coming back.  Their return may be based on sheer will and determination to not let this monster win.  Or it may be based on the fact that the alternative is so much worse.  But however they find it, they dig down deep and muster enough courage to fight through another day.  

Some of them will not win their battle.  But many will.  Six months, or a year from now, they may well look and act just as normal as ever.  Their outside appearance will not distinguish them from all of the others around them.  But inside they will never be the same.  They will remember the difficult times, the fear and the sorrow.  Then they will remember that they fought a great fight and they won.  They are cancer survivors.  Their view of life will never be quite the same.  Twelve years ago I fought a battle with Lymphoma and I won.  That fight and that victory will forever be part of me.  By no choice of my own, I am now in another fight with a different form of Lymphoma.  And just like I did before, I will dig down deep and muster enough courage to fight through another day.  Because once again, we're going to beat this!

Home sweet home.

We got back yesterday from the visit with our daughter and her family.  It was a very enjoyable visit and gave us lots of things to occupy our minds.  Four days in the western Carolina mountains were a welcome respite from the grueling heat wave that has gripped most of the rest of the southeast lately.  But as we arrived back home we thought of the young girl from Kansas saying "There's no place like home".  I have another chemo treatment tomorrow and then, in the middle of next week, we are heading to the beach at Charleston SC, where our son and his family have rented a beach house.  Don't know that I will be spending much time on the beach itself, but having more time with family and eating lots of fresh seafood will no doubt provide plenty of fun and memories.  Not a bad schedule for someone in their 2nd month of chemotherapy treatments.  I am still feeling just fine, although I must admit to feeling a bit more fatigued lately and I do have a few sores in my mouth from the new Pralatrexate drug treatment, although nothing bad.  Things could certainly be far far worst and I praise the Lord for allowing me to stay as healthy and active as I am.

As I mentioned I have another treatment tomorrow and that will complete all of the treatments (6 in total) for the 1st cycle.  I will have a 2 week break and then I start a 2nd cycle during the first week in August.  After completing the 2nd cycle in mid September, I will have a series of tests to assess my progress, and then most likely begin the 3rd cycle of treatments.  That assessment will be key in telling us how well the treatments are impacting the Lymphoma.  At the present time only God himself knows how we are doing.  But since I put my trust in Him, I feel that my progress is in good hands.  In the meantime we are taking it one day at a time and today is going quite well thus far.

Change of scenery.

Yesterday was another trip back to Duke, hopeful that my white blood cell count was back close to normal so I could get another treatment.  The blood test results indicated that the Neupogen shot I got last week to help boost my count was very succesful and my count was well into the normal range.  That was good news so the next chemo treament could proceed as scheduled (obviously I have a very distorted view of what constitutes "good news").  This is my first time for this new drug called Pralatrexate, which is  fairly new, and targeted primarliy at T-Cell Lymphoma.  My normal treatment with this drug is once per week for 3 weeks, although I missed last week because of my low white cell count.  As I have mentioned before, the primary side effect is mouth sores, which normally appear in about 7 to 10 days after treatment, so good oral care and lots of prayers between now and then are definitely in order.  Everything went smoothly with the treatement except that they "lost" my drugs for about an hour, but the search party finally arrived with IV bag in hand.

After leaving Duke we headed 4 hours west to visit our daughter and her family for a few days.  As I have said in an earlier post, my cancer will not be allowed to rule my life.  So even though yeterday was my first time for that drug, and I am not totally sure that I won't have a bad reaction, we are planning 3 or 4 days with family.  The safe bet would have been to return home, but then we would miss the excitement and wonder seen in the eyes of a 5 year old and 2 year old, and the joy of holding a 3 month old.  Now that is what life is all about.  And we will grab every opportunity to take advantage of the beauty and joy the Lord has given us.  Besides that, our son-in-law has promised to slow cook several racks of ribs on the grill, and the boy knows how to cook ribs.

Bye bye beard.

12 years ago, when I was getting chemo for my Hodgkins Lymphoma, I had almost no side effects from the treatments.  In addition to looking and feeling pretty normal, I never lost any of my hair.  My hair style has never been something I spent much time thinking about.  It was there, it grew, you washed it at shower time and got it cut periodically.  Several years ago I added a beard, which I keep trimmed short.  Today I was wearing a black shirt and noticed several short grey hairs clinging randomly across my chest.  Not thinking anything about it I just brushed them off and went on my way.  But a short time later I noticed that they were back.  And sure enough, if I rub my hand back and forth across my face, the collection grows in number.  So it appears that I am destined to appear clean shaven and bald for the forseeable future.  Given all the other possible side effects that I could develop, I'll take this one hands down.  And just think how much money I will save on razor blades :-)

My morning walk.

Something I have been told, and have seen in various articles, is that exercise is a very good thing that I can do for myself (of course that applied even before my diagnosis).  Since I still feel very good, I don't have any excuse for not getting some form of physical activity everyday.  So I have been walking for about 30 minutes every morning and, since we live on a lake, we have been taking a swim each afternoon.  Both are enjoyable and will hopefully assist in keeping my body strong and more resilient.

This morning, as I walked around our neighborhood, the 23rd Psalm started runnung through my mind.  And the 4th verse just kept repeating over and over.

Yea, though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me; thy rod and thy staff they comfort me.

The Lord is so special in the many ways that He lets us know He hears our prayers and knows the desires of our hearts.  He is with us all the time and pours out His comfort upon us.  And He speaks to us if we will just take the time to listen.

Something new to consider.

Yesterday included another trip to Duke (the car just knows where to go by now).  This time we went to the Adult Bone Marrow Transplant Clinic.  My oncologist referred me there to have an initial evaluation and assessment, concerning the future possibility of a bone marrow transplant.  Since my particular type of cancer is difficult to get into remission, and often difficult to keep from recurring, a BMT is a method utilized to assist in preventing recurrance.  Our daughter worked as an RN in the Pediatric Bone Marrow Transplant unit at Duke several years ago and has been a great source of information and understanding.  To say that it is complex and amazing is an understatement.  We asked a lot of questions and struggled to absorb the answers.  I am definitely a candidate for an autologous  transplant, which is a procedure using my own stem cells (versus donor cells), and is much easier on my body since the cells will not be considered "foreign".  My oncologist will talk with the doctor from BMT and then with us about whether this approach will be right for me and if it is something we should pursue.  It could happen as soon as October, or it could be sometime early next year.

It seems that just as I start coming to grips with my life as a cancer patient, something new pops up and rattles things back up a bit.  In this instance we might wind up living in Durham for a couple of months, close to the BMT Clinic, while I recover.  Never a dull moment.  But that is where it helps to know that God is in charge, and He will provide for all of our needs.  We may not be able to clearly see our way through the maze of details and arrangements, but then we don't really have to.  If that is the path that the Lord has for me, He will open all the necessary doors, calm the raging seas and provide a way for us to follow.  Our objective must be to stay focused on Him, and not on our circumstances.

Appearances can be deceiving.

As I have said here previously, even before starting my chemo treatments I have felt just great.  And after the treatments started I have not had any of the side effects that everyone hears so much about.  I have felt so good that I wondered if the drugs were actually having any effect.  Part of that is just my proactive personality - let's just get on with it is the way I approach most things.  So I had three day of chemo, followed by 10 days without treatments, and then yesterday I was scheduled for another treatment.  Since I had been feeling so great, by the time I arrived at Duke I was actually excited to be able to get another treatment started, and hit that cancer with another salvo of artillery.  So you can imagine how shocked I was when they told me that I would not be able to have the treatment because my white blood cell count was so awfully low (.7 for those who understand such things).  My immune system is practically non existent.  I had thought that the chemo had run it's course and not a lot was going on, but in truth the battle inside was ragging on in high gear.  I was given a shot to help rebuild my white cell count and now I just need to wait while my bone marrow reestablishes my white blood cells.  Hopefully by next Wednesday, which is my next appointment, my white count will be suficiently high that they can resume treatments.

I have now decided that I will be more patient in the future.  Some very smart people have invested a lot of time and effort in developing those treatment protocols and those periods of days, in between treatments, are there for good reason.  And the frequent blood tests are designed to pick up situations like mine where an even longer break is required.  The doctor indicated that my low count is not alarming or cause for undue concern, although I do need to be careful about exposure to germs or bacteria.  So for the next week I think I am going to act like a hermit and stay out of sight.

Outlook is key.

Since being diagnosed I have done lots and lots of reading.  I have learned a great deal about Non Hodgkins T-Cell Lymphoma and just wonder how we ever got along without the internet.  In today's local paper there was an article about a man that lives nearby who was recently diagnosed with pancreatic cancer.  A different form of the disease but equally devastating.  A few of the things he said sounded very silimar to my own feelings and were encouragements to my spirit.  "I want you to understand that I sincerely understand the severity of my diagnosis.  But... I want to tell you I feel healed.  I don't feel any pain.  I don't feel anything that would make you characterize me as being sick."  And the article goes on to say "He told his doctor he didn't want to hear his prognosis.  And he doesn't read websites that could have negative statistics.  "That's irrelevant to me because there's only one statistic that matters to me and that's mine.""  Substitute my name and my form of cancer and that article could have been about me.

I have read many many blogs/journals/articles written by people just like me, who are in the midst of their own personal battle, or who have survived their ordeal and are now cancer free.  Unfortunately there are some stories that had to be finished by a family member or are no longer being updated.  But they all help me understand that by no means am I alone with my thoughts and fears and doubts and apprehensions.  Like many other things in life, it is difficult to totally comprehend the true depths of the struggles of other people if you have not been through it yourself.  That does not imply that your compassion, your support and your concern is any less important or any less appreciated.  But there is some sort of common bond that exists in the writings of other cancer patients.

The article mentioned above also includes a quote from the man's wife.  "The family has a "we're going to beat this" attitude.  It has become our family motto.  We are going to live, laugh and love.  That's what we are going to do now, and in the future."  Who could possibly argue with that kind of mindset.