Tomorrow

An obvious subject title but one oddly enough just as elusive to us as to all diviners, fortune tellers, soothsayers, and Mayan calendar makers.

We have had a good week, Judy has been gaining in strength, energy, and even weight. Who could have foretold that we happily announce a gain in weight!?

It's been a remarkable turnaround and one that has been such a blessing and encouragement. Our 'Todays' are filled with laughter, calls from loved ones, and the continuing provision of Manna from heaven.

Looking forward is still hard. This isn't news I know. I did call the oncologist this week, behind Judy's back as she refuses to interrupt his busy week. I decided to brave the fallout as I wanted to better understand the treatment plan for Judy. A number of you also have expressed similar concerns.

Basically chemo finished 8 years ago. For 5 years Judy had a hormonal treatment. It is POSSIBLE that that hormonal treatment has been effectively keeping her cancer at bay, maybe even these 3 years since she stopped taking it. Therefore the treatment is to get her back onto hormonal therapy. If it reduces the growth and spread of Judy’s cancer, then we can stay on that treatment for as long as possible. As soon as it is no longer effective they will then try chemo. So we have a weekly check with the oncologist and he will determine if extra tests/scans are required and whether the treatment needs to be changed.

This is aimed at giving Judy the best quality of life possible. There is no medical avenue of curing the disease, only of slowing it down. Nevertheless, I hope you are joining me in praying that the Lord does cure Judy.

So for the next weeks we are hanging on to the results of these progress checks with the oncologist. He says that it may take up to 2 months before a clear view emerges. Therefore part 1 of 'tomorrow' means staying put in Brookfield. We had hoped to do a drive out to some outlying friends - Ohio, North Carolina etc. But that is on hold for now.

As a consolation prize Laura and Mikey have booked tickets and will be here from the 15th for 2 weeks. Helen Nugteren is also popping in on her whirlwind world tour! We hope also to see some other family members between now and December.

What does 'Tomorrow' look like after December? Judy will be able to fly again so if her treatment is still hormonal and going well then we expect to head south for some time with our family in New Zealand. Looking out further I have set one of Judy's passwords to "Rome2013" so every time she logs in to read your lovely messages of support and encouragement she has a reminder of a 'stretch goal' to continue to aim for.

We know however that every 'tomorrow' is the Lords. Our plans and hopes have a place but the Lord's plan takes precedence. As I quoted in the last post, the Lords plans cannot be thwarted.

So we have been enjoying our 'todays' and God gives us the grace to await His tomorrows with a peace that is beyond understanding.

Thanks for the wonderful gifts, hugs, flowers, cards, messages, hugs, and prayers. Yeah I like getting hugs.

Today

When I sent out the first news about Judy's cancer returning a friend of mine said she saw the email arrive from me and was assuming she would get a good chuckle from it. As in that case, I am not sure that I can raise any smiles in this update.

The result of the CT scan of Judy's liver confirmed that the cancer has spread. There are multiple lesions on the liver and this really has over shadowed the other areas of concern. The oncologist explained that the cancer is now spreading through the blood system, so it is possible that it can affect the other organs in the boby. They will be monitoring Judy very closely and may do other tests to check.

Judy is losing weight quite quickly so they want to start her on some appetite enhancing medicine.

At this stage they do not want to start Judy on Chemo. We are not exactly sure of the reasoning as yet but I suspect that they really want to limit the amount of bad news that throw at you in one go.

We did ask today about the prognosis and while they are not able to be very definitive they did indicate it is very poor.

We are now trying to take a day to gather our thoughts. It is a shock when you think that 2 months ago Judy was in seemingly great health.

We have a lot of decisions to make over the next days and weeks but we still need to gather more info, reflect on the situation, pray, speak with our doctors etc. So while today has bought a lot of clarity to our situation it is does not answer all questions and poses many new ones.

I will try to keep this updated when there is news or just reflections we want to share with you all. I hope that Judy will make some entries here as well.

We had a beautiful sermon on Sunday morning and we share with Nebuchadnezzar the assertion that the Lord's will can not be thwarted. We know the road that He maps out for us looks dark and we rely on His strenght to carry us through the days ahead.

Yesterday

Yesterday was an ordinary day.

We didnt go to the hospital or have any doctors visits. There was no testing, no blood work, no results to wait for. We just stayed at home, had time to sit in the sun. Judy felt a lot better, and her cold is well behind her now.

We went shopping for goceries together, even though each morning we see manna spread out for us. I even talked Judy into a cup of coffee at Panera Bread. She beat me in another game of W.E.L.D.E.R. I had admitted that I took it easy on her (just once) so now she is out to prove a point.

It was an ordinary day. As we prayed together at the end of the day I said to the Lord that we often say 'thank you for this day'. How much more so now Lord when you have shown us to treasure each moment with renewed awareness.

I'm not saying we won't have more days like yesterday we do expect to, but treasure them, each of you, as the blessing from the Lord that they are.

People have been asking how they can help - apart from the heavenly food (and the pristine house that 2 angels cleaned for us last night). All that is much appreciated, as are your cards, notes, calls, and prayers. To those who live nearby (or who have a spare 1,000,000 frequent flier points) - feel free to visit, for me any excuse for a cup of coffee is well received.

.

Tuesday Part 2

Judy's cold is feeling better. She has actually been off teaching piano lessons this afternoon. The strenght of character of this woman is incredible.

Today we met the oncologist. He is known by his staff as Pezz so that is what I will call him here as well.

Firstly he was able to confirm that the biopsy report shows that this is the same  disease and it has not mutated. A mutation would have caused a change in treatment options.

The PET scan from yesterday shows cancer in the right plueral sac - the bag surrounding the lungs. This was something we already knew. It also showed some cancer in the sac around the heart, this we also knew. There was also clear involvement of Judys spine at T12 and L1. While this isn't good news there are some positive elements to bear in mind here.

1. Each of these 3 confirmed sites respond to hormonal treatment. Judy will continue the treatment she started which is just a daily tablet, and also start a treatment of monthly injections to strenghten her bones.
2. Both of these treatments are well tolerated
3. The actual lungs and heart are themselves free of disease. Indeed Judy's breathing is so much more comfortable after the fluid was removed from her lungs and heart.

There is also uncertainly in the PET scan results as they suspect it may also have spread to the liver. Judy will have a CT Scan of the liver on Thursday to try to work this out. When breast cancer spreads to the liver it is still breast cancer, so the treatments are different than if this would be a primary cancer. Pezz thinks that if it has spread there then we would look at doing chemo.

I don't want to get into conjecture, we will wait and see what the CT scan has to say.

Pezz asked Judy a lot of questions about other areas of her body, pain or changes can indicate further spread of the diseasr. Judy calmly said no to all those - she doesn't have any particular back pain yet either. Then he asked us if we were OK emotionally? We looked at each other and she just said "yes".

IS 26:3 Thou wilt keep him in perfect peace, whose mind is stayed on thee: because he trusteth in thee.

 to an inheritance that is imperishable, undefiled, and unfading, kept in heaven for you, who by God's power are being guarded through faith for a salvation ready to be revealed in the last time. In this you rejoice, though now for a little while, if necessary, you have been grieved by various trials, so that the tested genuineness of your faith—more precious than gold that perishes though it is tested by fire—may be found to result in praise and glory and honor at the revelation of Jesus Christ.
(1 Peter 1:4-7 ESV)

 Now who is there to harm you if you are zealous for what is good? But even if you should suffer for righteousness' sake, you will be blessed. Have no fear of them, nor be troubled, but in your hearts honor Christ the Lord as holy, always being prepared to make a defense to anyone who asks you for a reason for the hope that is in you;
(1 Peter 3:13-15 ESV)

Tuesday Part 1

There is little to report today folks.

Judy had a scan yesterday - it takes 2 hours so I hope they had a really good look!

Today we meet with the oncologist to get the results of the scan and hopefully the results of the biopsy that the surgeon took last week. Eight years ago I remember waiting with bated breath for a similar appointment and we really heard nothing, so I'm trying to temper my impatience and expectations.

What do I want to hear? "It's all gone!" would be nice. Please Lord.

What might we hear? "The cytology report is conclusive we need more tests", "The scan didn't really show enough to make a judgement on your treatment", "Congratulations you're pregnant". (that would be a mixup in lab results!)

Now I find my old programming days coming back to me. If ... then .. else is a classic structure in programming. You can 'nest ' these structures. So when you get to the else part you can insert another if ... then .... else...

IFCancer is gone
     THEN sacrifice 40% of Erics herd of cows and do other happy things
      ELSE IF then we get all the different mutations of the disease, the different treatments etc.

the range of possible nested IF clauses are running through my head at light speed. Yes Laura. Light only travels at that speed in a vacuum so I know what I'm saying about the contents of my head.

Enough about me and physics. Judy has picked up Troys cold. A nasty nasal cold that he had last Thursday/Friday. So Judy has a truely miserable combination of coughing and sneezing, all tugging away at her sutures. This morning it does seem to be passing, thankfully.

Judy is losing weight pretty rapidly, she has very little appetite. This deepens our gratitude to all the wonderful women who have been preparing meals for us. Last night we had this like totally awesome chicken and chips dish and Judy had a good sized serving of it. Troy and I showed our solidarity and support by making sure there was nothing wasted.

I could rave about the other dishes we've been enjoying but I have to take Troy to school. Then we head to the doctors appointment. Please keep us in prayer for a full set of results. More later today.

Judy is home

Well it was a huge surprise but when I came in for my morning visit yesterday the surgeon popped in and said that Judy was "going home today".

It would be a lie to say I was overjoyed. Frankly the fact that I had run from the shower and direct to the car meant that the house was a mess. It wasn't utter chaos, but close enough. However the last 18 hours at Danbury had been a bit of a challenge, and Judy really really wanted to be home!

Judy had been moved from her private room to a shared one, and her new room mate made a lot of use of the call button, the TV, or just plain yelling. The hospital is a good place to have life saving stuff done, but sleep is not one of the important things in their book. Even when Judy was in her own room the nurses would come in to change dressings at 3am, surgerical rounds sometimes started at 5:30am, there was just a constant series of interuptions.

Some interuptions were really very welcome - e.g. visitors! However Judy has slept most of the time since she came home. Hopefully she can do a lot more of that over the weekend as well. Monday is the start of phase 2 of this and I hope we can have a quiet time of rest together before all the tests and (hopefully) treatments start up again.

Judy will not be able to do much for a few weeks - she cant lift anything over 10 pounds on her right side, she cant swim for a few weeks, nor can she fly for 3 months :-(

Speaking of pounds, Judy lost approx. 12 pounds last week. Partially because it's been hard to eat but mostly because of what they drained out of her.

Just a quick update. Please feel free to add comments to this blog. They dont charge for it!

I will try to do regular posts on here, probably without the nice photos that Judy always added. To try to make up for it I'll add spelling and grammatical errors.

So status today is;

- Judy had her heart drain out by the surgeon this morning. I was in attendance to offer support and direction if he needed it. Apart from needing some help with taping up the insertion point the surgeon did pretty well.
- So now there are drains to the lungs still in place and the amount of fluid draining is reducing quite steadily. Part of the struggle this week was getting the drain rate to decrease, while also keeping her hydrated. The more fluid she had in the IV or via driniking, the more fluid works its way out of the drain as well. Add the management of blood pressure, pulse rate, and lung and it really was a pretty complicated process.
- Since all her key systems (blood pressure, heart rate, private biological functions etc.) are working they moved her from the Step Down unit today. It's called Step Down cause it's a step down in management and monitoring from ICU. Judy had a very high level of care while there!
- The surgeon also said this morning that Judy should be home 'by the weekend'. I have reason to doubt the clarity of his verbal communication skills (which i won't go into here) so this means somewhere between Friday and Sunday. Friday would be nice but I still need to dust the vegetables and iron the mail. Important that everything is ready for her return home.
-Judy still has significant pain at times. Coughing is good for her lungs but really painfull. She has been walking pretty well although today although after the heart drain was removed I could see things were more painful.
- We have had a lot of visitors, each have been a great encouragement and blessing. We are very grateful for all those who have taken the time out during busy schedules to come and show their concern and love to Judy. Knowing that it's not fair to highlight anyone in particular, the best boost for Judy came from 2 young people who weren't even in the hospital. They are her piano students and had recorded a message of encouragement and a recital for Judy. A very special memory! Not everyone has been able to come visit, some kiwis have pretty good escuses I guess, but we have also been overrun by offers and deliveries of food as well as other practical demonstrations of support and care. I can't really keep up with the emails, calls, and texts. I do read them all and share them with Judy. Just because you might not get a reply please be assured they are warmly received and a big part of how the Lord has his hands wrapped tightly around us.
- Next steps. The scan has had to be delayed until Monday. Most things drive from the results of that scan and the biopsy results from her op on Saturday. The scan will show other possible areas of spread and the biopsy will show the nature of the disease. According to the oncologist yesterday the nature of the disease can mutate so all the characteristics such as estrogen receptor postive, or HER2/neu receptor status might have changed. This has direct bearing on the treatment options. So at this stage we are resting in the Lord and working through each day and the blessings and challenges that come with them.
- For anyone still reading  - Congratulations! You are determined indeed! Final item is about me - My right eye is doing very well. My surgeon is very pleased with progress and I can currently see at 20/25. Slight improvements still expected.