Has It Really Been a Year? (Jan. 16, 2006)

One year ago today Laurie was wheeled into the operating room for the first of two surgeries to remove her breast cancer tumor. At the time we were unsure of what God had in store for her or for us as a family. Those who have been through the ordeal of cancer know what it is like to wonder about the future. It wasn't that we weren't trusting God, we just weren't sure what He had planned.

Looking back, we are amazed at how God blessed and cared for us during the last year. So many of you were our constant support and encouragement, and we will always be so very greatful for all of you. Looking back, we thought this would be a good time to reflect and bring everyone up to the present regarding Laurie's treatment and current health.

We last left you on May 23 with Laurie having finished her last chemo treatment and a third of the way through her radiation treatments. It was a week later that we packed our bags and headed to Disney World in Orlando for Memorial Day Weekend. The radiation oncologist gave us a few extra days off from the radiation treatments, and we enjoyed four very relaxing days away from "cancer." The trip seemed too short. When we returned to Dallas, Laurie immediately began the remainder of her once-a-day radiation treatments. The side effects of tenderness and irritation as well as the fatigue continued to become more noticeable, but not intolerable. Laurie knew that all she needed to do was make it through to the end of the month of June.

We had begun Laurie's radiation with the trip to Orlando and our planned vacation to Colorado in mind. The treatments began a little sooner than the doctor would normally have liked so that we could keep our reservations in Rocky Mountain National Park. The accelerated schedule may have resulted in a slight increase in the intensity of the radiation side effects, but not excessively. None-the-less, Laurie was more than ready when she went in for her last treatment at the end of June. The trip to Colorado was never more sweet to her knowing that she would return to a more normal life.

The two weeks in Colorado were wonderful. We spent time with Jim's mom in Grand Junction, and then met our friends, the Joslins, in Rocky Mountain National Park the second week. Laurie's friend, Ann, had been her constant companion and prayer warrior during Laurie's months of treatments, and it was good to spend time with them in a more relaxed environment with no medical schedules. Little did we know what was in store for our families.

We returned from Colorado in late July. Ann had visited the doctor in late spring for an enlarged spleen, but tests to that point had not indicated any problems. The doctors thought it was likely the result of an infection of some kind. She went back to the doctor after we returned. Her spleen was still enlarged, and the doctor thought it best to remove it as a precautionary measure. We found ourselves back at Baylor hospital a couple weeks later, but this time not for Laurie. Ann's surgery revealed that her spleen contained several tumors. A few weeks later and after some confusion in the diagnosis, the doctors determined that Ann had a very rare form of cancer called angio sarcoma of the spleen. Tests futher revealed that it had spread to her liver. We were all devastated. Ann had faithfully walked the road with Laurie during her treatments only to discover that she was afflicted with cancer as well.

So while Laurie was receiving great news from her doctors in August, the Joslins were bracing themselves for an even bigger battle. The shift was hard for Laurie, not wanting her friend to go through what she had just experienced, but at the same time, Laurie was uniquely qualified to stand by her friend. Something we are still doing to this day.

Ann has been travelling to M.D. Anderson Hospital in Houston for treatments for the last several months. She has handled chemo very well, and the leisions appear to be shrinking. The doctors say that her condition isn't curable, but it is treatable. We think God can easily cure her, and if the current results are any indicator, He appears to be doing just that. Time will tell, and we know that Ann is in His mighty grip. I know the Joslins would be blessed by your prayers for them as we were blessed by your prayers for us.

Laurie has had two checkups since her treatments ended. No evidence of any cancer has been found. In fact, Dr. O'Shaughnessy told us that she would be very surprised if Laurie ever dealt with her cancer again. Laurie continues to take her daily tamoxifen tablet, and still has some residual fatigue, especially in the afternoons, but she is doing very well. She even gave up her prized trophy wig over Christmas and now sports what Jim thinks is a very cute, albeit short and curly, hair do. :-)

Of course, cancer still weighs heavily on our hearts and minds as we go through the experience with Ann and the rest of the Joslin family, but for Laurie, at least, the future is bright. We are so thankful that God allowed Laurie's cancer to be diagnosed early and to be so treatable. We know it doesn't work that way in all cases and we don't take the blessing for granted.

One other interesting side note came as a result of Laurie's journey. One of her college friends, Ivey (Harrington) Beckman, is the editor in chief of HOMELIFE magazine. When she heard of Laurie's diagnosis last year, she was among the first to call. As Ivey followed Laurie's journey through this blog, she wanted to include it in an article the magazine wanted to publish on how husbands and wives walk through breast cancer together. That article came out in the October issue of the magazine. It is our hope and prayer that our journey may give hope and courage to others who are walking the same path.

So we look back at what can only be called "quite a year." By God's grace, Laurie appears to have won a life threatening battle. Obviously we can't know for sure what the future holds, and each checkup will be faced with a little uncertainty, but we know who's in control and we are confident that He holds the future, our future, in His loving hands. We are greatful for the prospect of many more years together. The gift is even more meaningful and tender when we think of dear friends who are in the throes of the battle at this moment.

We take nothing for granted. But one thing we know for sure. We are eternal creatures. All of us who have put our faith and trust in the finished work of Jesus Christ on the cross will one day stand in His presence, in perfect health and with unimagineable joy. Some of us will get there sooner than we might expect, but never sooner than God has planned. Jim has often commented over the last several months on what he imagines God might be saying to each of us as we face the challenges of life. He can almost hear God saying, "If you only knew what was in store for you in heaven, you wouldn't worry so about the life you now live nor fret so when it seems to be more tenuous and fleeting. We both pray that we can keep our focus on the hope that is set before us and not discouragement that so easily besets us. We pray the same for you as well.

Till next time, may God be your peace and encouragement in whatever circumstances you find yourself.

Catching Up (May 23, 2006)

Turn around, blink once or twice, and before you know it, almost five weeks have passed since Laurie's last chemo treatment. Jim had good intentions of updating the blog sooner, and he can't say he forgot, since Laurie regularly reminded him that it needed to be done. But with year-end activities, not the least of which was Dallas Seminary's commencement, the blog seemed to play second to life. Fortunately, this has been a case of "no news is good news."

Laurie finished her last chemo treatment on Thursday, April 20. Those joining her for the climactic event were her mom and dad; her sister, Michelle; her good friend, Ann; and, of course, husband, Jim, the not so up-to-date blog writer. This was the last, and by far the easiest, of Laurie's treatments. She stayed awake and mostly coherent during the entire treatment. Even though she drifted once or twice, she was able to interact much better than previous treatments. At last the final drip of Cytoxan fell from the bag into the IV line. Moments later, Laurie was finished.

What happened next was reminiscent of celebrating a birthday at Don Pablo’s. Just before her nurse unhooked her from the equipment, she and a host of her compatriots surrounded Laurie for the "last-chemo" celebration. The next thing we knew, confetti was flying through the air and all over Laurie. We discovered at that moment the benefit of a wig. Instead of hanging her head upside down to shake the confetti out of her hair, Laurie just took her hair off and shook it! One can find small blessings anywhere!

It's hard to describe the feeling knowing you don't have to go through anymore chemo. Laurie was clearly relieved to have that part of her cancer treatment behind her. The nurses didn't even seem to mind when we told them we hoped not to ever see them again . . . in Christian love of course. So off we went, Laurie home with Ann, her parents and sister to their own homes, and Jim, back to the office, where, by the way, he meant to get started on the blog. Oh well . . . he did remember to pick up the pizza later on the way home. Priorities you know.

The next day saw the last of the Neulasta shots as well. A running tally of the cost for those three shots plus the chemo, revealed that enough money was spent (mostly by insurance), to have bought first a Kia, then a Chevy, then a Honda, and finally a Lexus! And yet, what a blessing to live in a time when medical advancement can do so much! It hasn't escaped our notice that fifty years ago, this disease would likely have killed Laurie. Now we're looking at a ninety-six percent cure rate! We have at times questioned God's plan in all this, but we certainly can't quit thanking Him for providing the medical expertise to give Laurie such a good prognosis.

Eleven days later on May Day, Laurie went in for a consultation with her radiation oncologist and to undergo what is called radiation mapping. This is when the doctor and technicians set Laurie up for the actual radiation treatments she would be starting on May 8. The mapping is designed to ensure that Laurie would be given each of her thirty-three radiation doses in exactly the same way and directed at the same location each time. The plan was to schedule the treatments so that Laurie would be completely finished with her radiation before we left for Colorado on July 1. Everything looked on track for that.

Laurie began her radiation on May 8. So far she has completed twelve of her thirty-three radiation treatments. She goes in at 2:30 each afternoon, Monday through Friday, for about twenty minutes. The actual radiation treatment lasts just a couple minutes. The only side effects so far (besides glowing in the dark :-) ), are some irritation and tenderness from the radiation and a little fatigue. Other than that, she's doing great. Her hair has even started to grow back! Still a little fuzzy, but not nearly as shiny!

On Tuesday, May 9, the day after her first radiation treatment, Laurie went in for a checkup with Dr. O'Shaughnessy. We were pleased that everything checked out OK. Laurie had handled her chemo regimen well. Dr. O' also gave Laurie her first prescription for Tamoxifen. She will take a pill a day for the next three years, but, according to Dr. O', this is probably the best treatment for her type of cancer. Tamoxifen is a hormone blocker, and Laurie's particular cancer is highly receptive to hormones, so this treatment basically starves the cancer cells and kills them. If any do remain after the chemo and radiation, the Tamoxifen should keep them from growing.

Again, we are so thankful for what God has allowed medical science to accomplish. We are reminded of the verse in Genesis 11:6, where God, at the Tower of Babel, made this most astounding comment, "once man has banded together there will be nothing that is impossible for him to do." What a marvelous statement of God's creative design of man! We should not be surprised at the things men and women have been able to accomplish. We are made in God's image, and we have tremendous potential, even though marred by sin. Laurie has been the beneficiary of what God created man to do. It all comes back to Him, doesn't it!

Thanks to all of you for your continued love, prayers, and support. God has used each of you to encourage us in special and needed ways. We are truly blessed!

Three Down! (Mar. 31, 2006)

The next Friday, March 31, found Laurie feeling better than she'd felt at anytime during her chemo treatments. This was probably due to the fact that she got one extra week between treatments because of the last Friday's postponed treatment. Her appointment started early in the morning this time. Jim took her in and after the standard blood draw to check her blood counts, we headed upstairs to see Dr. O'Shaughnessy.

We could tell when Dr. O'Shaughnessy arrived in the exam room that we were going to be able to go ahead with the chemo treatment. The labwork showed perfectly normal bloodcounts and no indication of any infection. It was the shortest appointment we had had up to that time.

We headed down to the infusion lab with Laurie's folks and one of her friends, who had arrived while we were in with Dr. O. The wait was not as long as the last time. Jim had to go back to the Seminary for a meeting, and while he was gone, Laurie and the rest of the crew were called back to the lab.

The only change in Laurie's regimen was a fifty percent reduction in the Benadryl. We hoped Laurie wouldn't be nearly as jittery as her previous treatment and be able to rest more during the actual infusion.

Jim got back about lunchtime. Laurie was much more alert and much less loopy than before. But we still had a couple chuckles. We were just finishing some lunch when the infusion pump alarm went off. Laurie had inadvertantly crimped the IV line and the machine was letting us know that it wasn't working. The alarm must sound a little like one might expect some phone rings to sound. After a few beeps, Laurie, who had dozed a little, perked up and said, "Will someone please answer the phone!" She immediately drifted off again as the nurse fixed the IV. Funny, but she never did ask us who called. :-)

A little later, when the infusion of Taxotere, her first chemo drug, was finished, the alarm again went off, signaling the nurse to come and flush Laurie's system with saline before starting the Cytoxan. Laurie knew this, of course, as demonstrated by her not-so-lucid comment, "The Taxotere is finished, now they're going to flush me." The double entendre was not lost on us as visions of "toilet seat covers" danced through our heads.

The rest of the treatment was uneventful. We got home early that afternoon. Laurie napped a little, but otherwise was feeling great. She had a relaxing evening followed by a good night's rest.

The next morning revealed a Laurie who you'd think had nothing more coursing through her veins than a little glucose. We headed back down to the hospital for another shot of "liquid gold" (I mean Neulasta). It took us longer to walk from the car to the bone marrow lab than it took to get the shot. What a racket! The rest of the day was uneventful.

By Sunday afternoon, Laurie was starting to feel like she expected to feel after a round of chemo. By Monday, she described it as feeling like she'd been run over by a truck. By Tuesday, although a little tired, she managed to get back to the classroom at Scofield. Each day since has been an improvement over the day before. We've decided that we are actually going to get through this!

Three down, one to go! Thanks, again, Lord, for the strength to meet each day!

No "Chemo" Sabe (Mar. 24, 2006)

Before Laurie began her chemo treatments, her sister, Michelle, gave her a cute little stuffed monkey (no, not Jim!) she had named Key-Mo-Sabbi. The little fella has sat on the kitchen counter reminding Laurie of Michelle's love and support.

With apologies to Tonto and the Loan Ranger, I thought of that monkey the other day when Laurie found out she couldn't have her regularly scheduled chemo treatment on Friday, March 24. "No chemo today," Dr. O'Shaughnessy said. "No chemo," I thought, and "sabe" just kind of popped out. That was the last thing we wanted to hear.

You may recall from the last post that Laurie took a short trip to the emergency room the previous Monday because of a fever. The doctor found nothing suspicious and Laurie dutifully took the prescribed antibiotics. As we sat in the exam room, Dr. O'Shaughnessy listened as we described the fever events on Monday. She looked concerned and after a brief exam, thought she noticed some slight swelling. Not wanting to risk the possibility of a worse infection, Dr. O. decided postponing chemo was in Laurie's best interest. She also wanted Laurie to have a sonogram to check the swelling.

So, while Jim rushed off to the airport to catch a flight to Tampa to teach a course for the Seminary, Laurie, two of her friends, and her parents headed down to the breast imaging center to get the swelling checked out. By the time Jim landed in Tampa, the imaging department had discovered and aspirated a seroma about the size of a golf ball. A seroma is clear-fluid build-up in the area of the lumpectomy. We would later find out that the seroma was the likely source of Laurie's fever on Monday, but the antibiotics had eliminated whatever infection had been involved. Dr. O'Shaugnessy's concerns turned out to be well-founded.

Laurie went home that evening, continued on a new antibiotic, and we began to wait for the next Friday to try the chemo again.

Things sometimes don't go as we plan we discovered, but thankfully we know God's plan for us never fails. We take great comfort in that truth everyday we go through this ordeal.

Fever! (Monday, Mar. 20, 2006)

Ten days after Laurie's second chemo treatment and all appeared well. The entire family had spring break at the same time this year (a first in recent memory), and we spent the first few days of it at Laurie's parents' lake house. Laurie was starting to feel better from her treatments, although she was still a little achey.

We arrived back home early Monday evening and Jim started fixing dinner (well, anyone can open a can of baked beans, grill hamburbers, and throw a Marie Calendar cobbler in the oven). Laurie was feeling a little warm and tired so she took her temperature. The thermometer read 99.6 degrees, a little high, but nothing to be concerned about. Jim kept cooking. A few minutes later, Laurie checked her temperature again. This time it was about 100.3. We both perked up, remembering we'd been told that if her temperature ever hit 100.5, we'd need to call the doctor and probably high-tail it for the hospital.

Jim kept cooking. Laurie kept heating up. She checked her temperature again a few minutes later--101.3 degrees. She really wasn't feeling that bad, but Jim went to get the number to call the doctor. In the meantime, Laurie changed from the digital thermometer to a regular mercury thermometer. She took her temperature again--101.7. Jim called the doctor but got the anwering service. The lady who answered took our number. "The doctor on call will get right back to you," she said.

Laurie checked her temperature again. This time it read 101.9 degrees. Her temperature had risen from 99.6 to 101.9 in less than thirty minutes. The phone rang. While Jim talked to the doctor on call, Laurie got a few things together in case her visit to the hopital turned into a stay. She and the girls grabbed a hamburger (Jim had managed to get those cooked).

Fortunately the doctor did not seem overly concerned, but confirmed we needed to head to the emergency room. "Any one will do," she said. "Just make sure you tell them your wife is undergoing chemotherapy. They will draw some blood and check her blood counts. Depending on her vitals, they might keep her overnight. Have the ER doctor call if necessary."

Jim managed to grab a quick bite and put the food away after he got off the phone. Meanwhile Laurie checked her temp again. It was holding at 101.9, a good sign if only because it hadn't gone up any higher. Finally all of us piled into the car and headed down to Baylor. It was a little after 8:00.

When we got to the emergency room and told them why we were there, they immediately handed Laurie a surgical mask to protect her from all the wheezing and coughing going on in the waiting room. A nurse then escorted Laurie and Jim into a small triage room where she checked Laurie's vitals. Her temp was still over 101, but everthing else seemed OK. The nurse asked if Laurie had taken anything for her fever. "Not yet," we said, so they gave her some Tylenol. We then sat down to wait. It was a little after 8:30.

We found out later that Laurie was waiting for a bed in the ER to clear. The hospital staff kept her in triage rather than have her sit out in the main waiting area. They wanted to avoid exposure to whatever illnesses and bacteria lurked out there.

During the time Jim and Laurie were in the triage room, Steffi and Abby were sitting out in the main waiting area reading. Policy allowed only one guest per patient in the back. Jim went out to register Laurie and let each of the girls go in and see Mom one at a time. When Jim went back to sit with Laurie, her temperature had already dropped a little, but she was still waiting for a bed to clear so she could get her blood drawn. We both tried to read a little, but mostly just sat and waited. Jim let the girls rotate in one more time to sit with Laurie before going back in to sit with her himself.

We were still waiting at 10:30. Steff and Abby had finished all their reading for school (small blessings occur in the least expected places), but they were getting tired. We decided they'd be better off at home so Jim drove the girls back to the house, thinking that at the rate things were progressing, Laurie would still be waiting by the time he got back. But, just as it rains when you wash your car, so also the minute you leave your wife, she gets taken back to a bed. By the time Jim got back from taking the girls home, Laurie had had a chest x-ray and her blood drawn. The x-ray was negative. They were just finishing a second draw of blood for a culture when Jim finally found them. We started waiting again.

When the clock struck 1:00, the emergency room doctor walked in. Laurie's blood counts were fine and no bacterial infection was evident. Laurie's temperature had dropped back down to 99.3 and the doctor concluded that the reason for the spike was likely a virus. Laur had been given an injection of antibiotics earlier, so he saw no reason for us to stay, but he did confirm that we'd done the right thing by coming in.

We were on the way home by 1:30 a.m. and found two sleeping girls lying on couches in the living room, with a movie droning on in the background.

With the girls, Laurie, and Jim finally in bed, the clock read 2:30 a.m. We were really glad we were still on spring break!

Laurie's temperature fluctuated a little for the next couple days, but without the same excitement. The temperature culprit was likely a virus after all. Once again God protected Laurie in a situation that might have been much worse. Thank you Father!

I Didn't Know Gold Came in a Syringe! (Mar. 4, 2006)

Because Laurie's blood counts had dropped so low after her first round of chemo, Dr. O'Shaughnessy decided to give her a shot of Neulasta today, the day after her second round. Neulasta is a wonder drug that stimulates the bone morrow to produce more blood cells. Even though the chemo is killing cells, so many new ones are being produced that it overwhelms the effects of the chemo. Basically the chemo can't keep up and the blood counts stay up, helping the body fight off infection.

When her blood counts fell as a result of the first round of chemo, Laurie was given an antibiotic. It helped her fight off infections in the interim and helped rebuild the blood counts, but the antibiotics spawned a few other problems we wanted to avoid, thus the Neulasta.

So we headed back down to Baylor. Laurie was feeling much better, even if only a little chagrinned when I told her about her behavior the day before. Of course, she was able to explain exactly what she meant about the toilet seat lids. . . . Yeah, right!

The bone-marrow lab seemed deserted when we arrived for the miracle shot. We finally found where to go, but still hadn't seen anyone yet. We'd just finished signing in when we noticed a young lady exit one of the lab rooms. She pleasantly asked if she could help us. We explained why we were there.

"Oh," she said with a smile, "you must be Laurie." (they are just so smart down there!).

She led us back into the lab, sat Laurie down, and picked up a small box not much bigger than two packs of cigarettes end to end (don't ask how I know that!). In the box was a small syringe with a few milliliters of clear liquid inside.

"I hear that stuff is pretty expensive," I said as the tech put on her gloves and picked up the syringe.

"I think it's the most expensive drug on the market," she replied.

I tried to pay attention, but kept wondering who would pay for the stuff if she accidently dropped it on the floor! I snapped back to reality as she continued.

"I sure hope they funnel the money they get for this back into research," she quipped as she finished the injection. We all chuckled.

From start to finish we were in the building for barely ten minutes. I was trying to think how much that one shot cost us per hour! :-) In case you're wondering, with the shot she'd just taken and the chemotherapy from the day before, we figured Laurie was walking around with enough money coursing through her veins to buy a nice new car! I decided then and there that pharmaceuticals is the ticket if I ever want to get rich! Thank the Lord for insurance!

Now if we could only find a way to get to that money. I wonder if I could sell her . . .

Just kidding, Hon! :-)

Toilet Seat Lids! (Mar. 3, 2006)

Morning

Laurie received her second chemo treatment today. She began the day with a professional massage from her good friend, Carol Cromartie, who is in her fourth year of treatment for breast cancer herself. Carol has trained to become a professional masseuse, and she wanted to give Laurie a massage before treatment to help her relax. After the massage, Carol accompanied Laurie to Baylor and stayed with us the rest of the day. By the time Jim saw them, Laurie was definitely relaxed. (But not as relaxed as she was going to get!)

The first stop was the lab to get Laurie's blood drawn. We had prayed that her counts would go up so she could have her treatment today. God really answered that prayer, because her counts were sky high, mostly from the antibiotic she'd been on! She was chemo-ready! Next stop was Dr. O'Shaughnessy's office. Dr. O.' was very pleased with how Laurie handled the first round of chemo and planned to change her "cocktail" (prechemo IV for nausea, allergic reactions, etc.) a little.

After our meeting with Dr. O.', we went down to the Infusion Lab. Must have been a run on chemo, because the waiting room was packed. We got to the lab about noonish, and didn't begin the chemo treatments until a little after 2:00. Our chemo nurse this time was Pam R. We had asked for her the last time because we heard she was a believer and very good at her job, but she was unavailable. We got her this time. She was a hoot! She ushered us into the lab and parked us in one of the partitioned cubicles. While Laurie was away for a moment taking care of personal business, Jim noticed one of the private rooms a few feet away.

"Why not," he thought, so he asked Pam how one could get a room. It turns out that all one does is ask! When Laurie got back, Jim and Carol had already moved everything into a nice private room. Laurie got the bed. Jim got the recliner. Carol grabbed the other chair (I did offer!). Jim got the Apple iPod up and running (some friends from Scofield had given it to Laurie to use during her treatments). The afternoon looked to be on the fast track to going well.

You will recall I mentioned that Dr. O.' had changed Laurie's prechemo "cocktail." The biggest change was the 50-milligram IV injection of Benadryl, designed to prevent the same allergic reaction to the Taxotere Laurie had had the first time. Fifty milligrams is a lot it turns out! Pam started the IV, injected the Benadryl, and we waited. It wasn't long before Laurie's speech started sounding a little lazy. The Benadryl almost immediately made her legs jumpy. That was the most annoying part of the treatment, because it kept her from sleeping as much as the first time. Laurie began talking almost nonstop. I'm kind of glad, too, because we would never have enjoyed the following little discussion on toilet seat lids.

We're about an hour into the treatment. The cocktail is finished and the Taxotere is flowing. Carol is massaging Laurie's feet (what a treat for my wife, since I'm not so good at it!). Laurie has been rambling on about whatever pops into her head, and believe me lots of "popping" was going on. Unfortunately for Laurie, she's in the twilight zone, and what she says seems to be smattered with conscious and unconscious streams of thought. The most memorable conversation went something like this.

Jim (as Carol moves to rub Laurie's back): "How you feeling, Hon?"

Laur (rather sleepily): "OK." She pauses. "We can't forget to get the toilet seat lids."

Jim looks at Carol: "What about the toilet seat lids?"

Laur (a little more emphatically): "We can't forget them!"

Jim (looks again at Carol. She shrugs and smiles): "I don't understand. Do you want us to change the cloth covers for the toilets?"

Laur (this time definitely revealing her exasperation): "No! The lid that covers the part you sit on! (She drifts off for a moment while Jim and Carol try hard not to laugh out loud.)

Jim: "OK. I still don't understand. Why do we need to get new ones?"

Laur: "Because they're broken!"

Jim (in his most placating manner): "OK, Hon. Why don't we talk about it later."

Fortunately at this point, Laurie drifted off to sleep for a few minutes. Carol and I chuckled, wondering what topic the next conversation might be about and whether or not I could share it with anyone!

Evening

The rest of the afternoon was pretty uneventful. We took a couple walks around the lab to help Laur's legs, stopping only for a potty break (the IV fluids have to go somewhere!). We finished the chemo at about 6:15 p.m. and headed home. Because Laurie had not really slept during the treatment, mainly due to the Benadryl, she was pretty tired when we got home. I helped her into her recliner and got her a blanket. She managed to stay awake for a few minutes, but soon fell fast asleep. She didn't wake up until 10:00, even with the phone calls and friends dropping by. (I wonder if I should tell her that she has a really cute little snore? Nah! Somethings are best left alone.)

Thus went the second round of chemo. Only two more to go! Thanks, Lord, for making this day so interesting!

G.I. Laurie (Mar. 1, 2006)

Last Saturday Laurie noticed more hair than usual in her brush. We both knew what lurked around the corner. Dr. O'Shaughnessy had told us Laurie would lose her hair 17 to 18 days after the first round of chemo. The wig she had successfully hunted was mounted in the bathroom, waiting for its appointed task. We waited as well.

You'd be amazed how difficult it is to decide how you are going to handle the loss of your hair. Do you anticipate it and just shave your head before your hair starts coming out? Do you wait until you can't bear to look at yourself in the mirror? When is the best time? Well for Laurie, it was complicated by the fact that her kindergarten class pictures at Scofield were scheduled for today, March 1. She desperately wanted to have those pictures taken with her real hair. So our decision was to wait.

Each morning this week has been a test of wills. Laurie was not going to let her hair go until picture day. She babied it and tenderly handled it each day, and though it thinned a little more each time, she made it! Only a few of us could really notice the change.

But . . . pictures were done this morning. The reckoning had come and the deed could no longer be delayed. This afternoon, with two of her friends, Anne and Joan, in tow, Laurie headed up to see Lynn, her hair dresser for the last several years. Jim, as the dutiful husband, asked Laurie if she wanted him to go as well. Her answer took only a split second, "No!" She actually repented a little later, not having meant to be so abrupt, but Jim understood. No woman likes to have her hair cut off, especially in front of her husband.

Anyway, just before lunch, Laurie got her first-ever G.I. buzz cut. Jim has it on good authority that more than a few tears were shed by all involved. Even Lynn had a tough time.

Once that was done, and the wig dutifully in place, the girls went out for lunch. Undoubtedly no one noticed the change except Laurie and her friends. In fact, Jim hasn't even seen it yet. And if he doesn't quit writing this and get himself home quick, he's going to be in big trouble. So . . .

Later all! We love you!

Between Chemo Treatments (Feb. 24, 2006)

We often wondered those first few days following Laurie's first chemo treatment what side-effects to expect. We were so grateful for the absence of any nausea (well at least for Laurie, both girls had a nasty stomach virus last week; they made up for it in spades!). Except for some aches and pains, the loss of a lot of her taste, and some digestive problems, Laurie has done remarkably well. She has been more tired each day, and often needs to rest after getting home from teaching.

Yes, Laurie was able to resume teaching at Scofield near the end of that first week. Her kids were ecstatic, and could not quit clinging to her. Most of them probably don't really understand what is going on, but as long as Mrs. Thames is back, everything for them is OK. Laurie has had to miss a couple days since going back, but for the most part, has done well and is happy to be back in her routine.

Ten days after her first chemo treatment, Laurie went in for a check of her blood counts. This is a normal check after that first treatment to see how her blood cells are fairing under the assault of the chemo drugs. Laurie's original blood counts before her treatment began were above normal, indicating a strong immune system, and leading her doctor to think that she might not experience a big drop. That turned out not to be the case. When her counts came back, they were actually well below what the Dr. expected, prompting some concerns about infection. Laurie was put on antibiotics and given strict instructions to keep an eye on her temperature. An increase up to 100 degrees was to be immediately followed by a trip to the hospital. We appreciate that they don't want to take any chances with an infection getting out of hand. It was not a good day for Laurie, and unfortunately Jim was on a marathon accreditation visit in Florida that week and was not home to help.

Our prayer has been that Laurie's counts will go back up in time for her next treatment on Friday, March 3. If they don't, the treatment will be delayed until they do. Assuming no delay, one thing will happen; Laurie will be given an injection of one of the new drugs designed to help rebuild the blood counts quickly. On Saturday after her next treatment (assuming no delays), she will return for her injection. This should give her the boost she needs to get her counts up quickly and avoid the big decline she experienced this time.

All in all, it has been a good few weeks. The side-effects Laurie has experienced have been pretty normal and not too severe. God has blessed us with answered prayer and we are thankful.

Hunting

Laurie stepped out quietly into the cool crisp forest morning. The sky hinted at the sun's arrival as feathery wisps of light, first violet then gradually red, streaked the eastern horizon. As the forest brightened, the vapory mist that hovered at the ground began to sway as it rose in the morning light, almost like fairies adorned in pink taffeta dancing a greeting to the new day. It was so peaceful, quiet, the sounds of a frantic mechanical world fading from memory and only the sweet songs of birds waking to a new dawn greeting her ears. She almost forgot in that moment, her two worlds drifting further apart, why she was here.

The images caressing her thoughts, she crept quietly through the stillness, aware that she was not alone in the forest. She sensed her quarry, but could not see it. She passed through a grove of trees and stopped next to an outcropping of rocks. Not far from where she stood, just beyond a subtle rise, she thought she saw movement. She froze in her tracks.

Laurie had anticipated this hunt for weeks. She was apprehensive. The fact that she was hunting today meant that things had changed in her life. She knew the change was inevitable, and this morning's hunt only confirmed that she, herself, was caught, much like the illusive thing she hunted. She breathed deeply and waited.

Moments later she saw movement again. There it was! Quietly, imperceptibly, she raised her weapon. More clearly now as the sky brightened, she saw the long brown hair swaying rhythmically in the morning breeze. Laurie ever-so-slowly shifted her position until her adversary was clearly in sight. She took a deep breath, held it, and squeezed the trigger. . . .

Thus ended the hunt for Laurie's first wig.

She found it and shot it dead.
Now she wears it on her head!


P.S. I was getting tired of the same old dry reporting. This seemed like a good way to describe the search for a wig for my dear wife, who would much prefer to keep her own hair, but has begun her "hunt" for a temporary substitute.

The Morning After (Feb. 11, 2006)

Laurie had a good night's sleep, waking only once! We weren't sure how she would feel in the morning, but are pleasantly surprised. The major concern was nausea. Thankfully, she has none, probably due to the extensive array of medicines on the kitchen counter. :-) We have been told to expect that the second day might be tougher, but that's tomorrow. We are grateful for today!

We want to take this time to thank the many of you who have prayed, sent cards, provided meals, and just been there when we needed a word of encouragement or a hug. We have been overwhelmed by God's love through each and everyone of you. THANK YOU!

We also covet your continued prayer. God's blessing through your prayers is obvious to us and encouraging beyond measure. Specifically, please pray for the following as the Lord brings Laurie to mind.

* That Laurie will continue to tolerate the chemo well with minimal side effects.
* That the chemo would have its intended result and any stray cancer cells would be destroyed.
* That Laurie would be able to resume her teaching schedule at Scofield and have the strength to handle 13 eager kindergarteners.
* That Laurie's immune system would stay strong enough to help her ward off any infections.

Again, thanks for your care and concern. We love you all!

First Day of Chemo (Feb. 10, 2006)

Today was the day Laurie had hoped to avoid when we first learned of her cancer--the beginning of chemotherapy. We were pretty well resigned to the need for this part of her treatment, but were still apprehensive about the effects of chemo on her body. Our good friend Joan Kanne, who had gone through chemotherapy for breast cancer a little over three years earlier, drove Laurie down to the Sammons Breast Cancer Center at Baylor Hospital. Jim joined them from the Seminary.

We met with Dr. O'Shaughnessy at 11:15 a.m. What an encouragement she is! We discovered that she was not yet sure what our decision was going to be regarding chemo and she was delighted that we had agreed to proceed with the chemo regimen she had proposed. Her demeanor revealed that she believed that chemo was a necessary part of the treatment to give Laurie the best chance of a complete cure of her cancer. We were encouraged that her initial proposal on the specific combination of chemotherapy drugs was still her best recommendation for Laurie's particular cancer. She was very encouraging about Laurie's long-term prognosis. After a brief exam and consult, we headed downstairs to the infusion lab.

We had visited the infusion lab on Wednesday. Today we were prepared for a four- to five-hour stay. Laurie had a light snack while we sat in the waiting area. At about 12:30, the chemo nurse called Laurie's name. We took the short walk back to the infusion lab. A number of small cubicles lined the walls. We were surprised to see a woman named Miki receiving a chemo infusion in the same room. Earlier in the fall, Miki sold us a small used car at the Saturn of Mesquite auto dealership. We had no idea at the time that she was undergoing treatments for breast cancer. It is indeed a small world.

Our chemo nurse's name was Lee. Lee was almost eight months pregnant, but still overseeing several chemo infusions in the lab. She worked with us to finalize some paperwork (you'd think we were buying a house!), and spent several minutes going over the various drugs Laurie would receive throughout the afternoon. She reviewed the side effects of each and the ways that the staff planned to help Laurie manage those side-effects. Later, while Laurie was receiving her infusion, Lee went over each of the prescription we had received to manage potential side effects. She did a wonderful job clearly explaining the use and indications for each drug--in plain English!

The IV pump was set up with four bags of drugs. The first contained supporting medications that would help Laurie deal with the actual chemotherapy drugs themselves. One of those drugs was designed to help her relax while at the same time providing antinausea help. The second bag contained a saline solution designed to flush the system and Laurie's veins between each infusion of drugs. The last two bags contained the actual chemo drugs themselves, Taxotere and Cytoxan. Taxotere is administered first and Cytoxan last. Ideally the infusion process lasts about 2-1/2 hours. Once the IV pump was set, the process began. It was about 1:30 p.m.

The process went smoothly. The only hitch was an allergic reaction Laurie had to the Taxotere. She became immediately flushed and short of breath. Fortunately this is not an uncommon reaction to the drug the first time it is administered and the nurse is well-schooled in dealing with such a reaction. A brief suspension of the infusion was followed by an injection of benadryl. Once the allergic reaction subsided, the infusion of Taxotere was resumed and Laurie had no further problems. However, the process was slowed down and consequently, it was 4:30 p.m before the infusion of Taxotere was complete and the Cytoxan infusion began. Laurie had no further problems and in fact slept for about 1-1/2 hours (one of the side effects of the antinausea drugs :-) ). We were finished by 5:00 p.m. and headed home.

As Jim wrote this, Laurie fell asleep in the living room. She wanted to watch the Winter Olympics and managed to stay awake for most of the evening. We prayed for a good night's sleep for her and a good day on Saturday. We were armed with a host of prescription medications to alleviate any of the potential side effects and will use them as necessary.

One down, three more to go! Thank you Lord for getting us through this day!

Laurie's New Radiation Oncologist (Feb. 9, 2006)

After learning that Laurie's cancer had spread, even if only microscopically, plans for the type of radiation she would undergo changed. Dr. Knox's office suggested a radiation oncologist at the Texas Cancer Center in Mesquite, just a couple minutes from our home.

Today was the day that we met our new radiation oncologist, Dr. Michela Caruso. We had been told that Dr. Caruso was the most requested radiation oncologist in the Dallas area. Born and raised in Rome, she received much of her training in radiation oncology at the Mayo Clinic in Minnesota. It was obvious that she knew her craft well. A brief exam and consult confirmed that Laurie would receive External Beam Radiation Therapy about three weeks after her last chemo treatment. The anticipated first day was May 8. We were glad to have this part of the treatment plan set in place.

Chemo Class (Feb. 8, 2006)

Our doctor encouraged Laurie and Jim to attend a chemotherapy class before beginning her treatments. They attended the one-hour class on Wednesday, two days before Laurie's chemotherapy treatments were to begin. The class was helpful in giving Laurie an idea of what to expect by way of common side-effects. She also received some helpful information on ways to minimize those effects. We were reminded as we observed others in the class that Laurie's situation is much better than most. Having cancer is never one's choice, but at least Laurie's is very treatable with an excellent possibility that she will be completely cured. We recognized that some of the people in this particular class would very likely not survive another year. We were reminded that our hope and strength for the future comes from God. We aren't sure how those without that hope and without the loving support of God our Father handle such uncertainty. Our prayer is that we might be a positive testimony to God's love and grace as we walk this road.

After the class, we were given a tour of the infusion lab where Laurie would receive her chemo treatments. The next phase of her fight against her cancer would begin here on Friday. Our prayers for strength continued.

Trip to Tulsa (Jan. 30-31, 2006)

Early Monday morning on Jan. 30 found Jim and Laurie winging their way to Tulsa, Oklahoma, to visit the Cancer Treatment Centers of America. We anticipated a three-day visit for consultations and testing. Our purpose in going was to get a second opinion on Laurie's medical treatment. We also were interested in exploring more natural approaches to helping Laurie fight her cancer. CTCA is known for their integrative approach that complements the medical treatments with nutritional and naturopathic methods of cancer treatment. We felt this was an important step, having observed for years the value of such an approach in the health of Laurie's parents.

We spent the first day getting settled in and then in meetings with a radiation oncologist and medical oncologist. Both basically confirmed the course of treatment that had been prescribed by Laurie's team in Dallas. Interestingly, we discovered that Dr. O'Shaughnessy, Laurie's medical oncologist at Baylor, is very well known indeed. The oncologist in Tulsa had not only heard of her, but indicated that Dr. O. had an international reputation and produced much of the research on which medical oncologists across the country based their decisions. In fact the oncologist in Tulsa was pleased that her recommendations were very similar to Dr. O's! This gave us another opportunity to praise God for leading us to some of the best breast cancer doctors in the U.S.

Tuesday morning we met with the nutritionist and the naturopatic doctors. Our meeting with the nutritionist was phenomenal. She walked us through many of the things that Laurie could do to support her body during and after her treatment. She also gave us some good recommendations of things to avoid because of the characteristics of Laurie's cancer. One of the things Laurie needs to avoid is soy. You would be amazed at how many food products contain soy--besides soy sauce that is! :-) She also gave us some suggestions on how to prepare meals and where to buy inexpensive natural and organic foods. We almost felt that the meeting with the nutritionist was worth the trip to Tulsa.

The naturopathic doctors were also very helpful in giving us information on certain foods and supplements to avoid as well as things we could take to support the medical treatments. Their recommendations also confirmed recommendations from Dr. O'Shaughnessy in Dallas, especially in regard to taking natural alternative herbal supplements. Basically they affirmed that avoiding a lot of supplements during chemotherapy was a safe course of action. The rational was to not create an environment in Laurie's body that might make the chemotherapy less effective. They affirmed that Laurie could begin a naturopathic regimen subsequent to her medical treatments that would help her rebuild her body's health and strengthen her immune system to help ward off a return of her cancer in the future.

As it turned out, our consultation with the naturopathic doctors was the last appointment of our visit to CTCA. Since most of Laurie's medical tests from Dallas were so current, we were not required to stay the extra day, and in fact, were allowed to go home early, much to Jim's delight, since he preferred to spend his birthday with Steffi and Abby in Dallas!

In retrospect, we were very glad to have made the trip to Tulsa. To have the medical options for Laurie's treatment confirmed was encouraging, and to get a good handle on the natural things Laurie could do to support herself through those treatments and rebuild her body's defenses after the chemo and radiation was very helpful. With the trip behind us, we were more confident of the next steps Laurie would face in Dallas in the treatment of her cancer.

First Consult with Dr. O'Shaughnessy (Jan 24, 2006)

Today was the long awaited (and somewhat dreaded) day to meet with Dr. Joyce O'Shaughnessy, our medical oncologist (Jim refers to her as the drug doctor). Our hope all along has been that Laurie might be able to avoid chemotherapy, recent pathology reports not-with-standing. So we were not anticipating the best of news in that regard. Actually the appointment went very well. Dr. O'Shaughnessy was very attentive and patient and spent over 2-1/2 hours with us answering our questions. The bottom line is that she considers Laurie to be in the best of all situations considering the fact that she has cancer. When all the treatments are added together, along with certain life-style changes (low-fat, healthy diet and exercise), she has every confidence that Laurie has a 98 to 99 percent chance of being totally cured. In fact, she came just short of guaranteeing that Laurie would beat this cancer! We certainly couldn't fault her for her optimism or encouragement! :-)

On a positive note, Laurie's cancer is extremely hormone receptive, which makes her an excellent candidate for oral hormonal therapies. Hormonal therapies, it turns out, give her the best chance of curing her particular type of cancer. We were also encouraged by Dr. O'Shaugnessy's affirmation of some complementary approaches to Laurie's treatment, including a focus on eating healthy foods, good nutrition, vitamins, and exercise. The downside is that in Dr. O'Shaughnessy's medical opinion, Laurie will also need some chemotherapy to get the best percentages.

We spent at least an hour talking about the various chemo drugs, combinations, and side effects. When the dust cleared, Dr. O'Shaughnessy recommended the shortest, least toxic combination of drugs we could have hoped for, with the confidence that they would accomplish the same positive results as the stronger and longer regimen. Of course, chemo is chemo, and that prospect is not pleasant, especially the losing-your-hair part, but the long-term, permanent side-effects appear to be minimal to nonexistent with the proposed regimen. In a case like this, we are happy to take the bitter with the sweet.

Now it's down to decision time. We will consider all the factors, ask a few more questions, and make a decision. If we decide to go the chemo route as recommended, the regimen would be four treatments three weeks apart (about 12 weeks total). Three weeks following that, we would begin Laurie's six weeks of radiation treatments. Lord willing, the process would be completely done by early summer.

We cannot express adequately our appreciation for all the support, encouragement, and especially prayer we have received from so many of you. Our hope is in the Lord, but it is much easier to walk this path with so many of you walking with us, encouraging us on the journey. Please keep praying, especially in the next few days as we rehash all we have heard and make our final decisions. We will keep you posted as those decisions are made.

Laurie's Second Surgery (Jan. 20, 2006)

Laurie's second surgery to remove additional tissue surrounding the tumor site began at 7:20 a.m. She was finished by 8:00 a.m. Dr. Knox said the procedure went well. Laurie was not fully anesthetized this morning. Instead she was put in "twilight sleep". Her recovery from the procedure was much quicker, and she followed her trip home with a take-out breakfast from Cracker Barrel provided by her parents. Laurie is feeling much better and appears eager to take on the day, although Jim is probably going to require a nap. :-)

The next step in the process takes place on Tuesday afternoon, Jan. 24, when Laurie and Jim will meet with her medical oncologist (drug doctor), Dr. Joyce O'Shaughnesy. That's when more information will be presented on the possibilities of chemotherapy.

Surgery Follow-Up and Pathology Report (Jan. 18, 2006)

This was the day that Jim and Laurie went back to meet with Dr. Knox for Laurie's follow-up visit. It was also the day we got the pathology report from Monday's surgery.

Up to this point we had been praying, as were many others, that the tumor would have been completely removed with clear margins and that none of the lymph nodes would be involved. The hope was that such a result would minimize the chances that Laurie would have to go through chemotherapy, something we did not want to do. The results were not exactly what we'd hoped for, but Dr. Knox assured us that the report was a good one. The pathology report revealed that a very small, almost microscopic tumor had started growing a few millimeters away from the first. This tumor did not show up on any of the tests to that point. Fortunately Dr. Knox removed it in the first excision, but because it wasn't visible, it was closer to the edge of the incision than expected. The result is that a few cancer cells were close to the edge of the removed tissue, indicating the possibility that additional cancer cells still remained in the breast. Dr. Knox informed us that a re-excision would be needed to get the remaining cells and get clear margins.

The pathology of the lymph nodes was also a mixed bag. The sentinel node revealed two small clusters of cancer cells in the node, one of 10 cells the other of 40, these were not visible to the naked eye. They were very lowgrade with an extremely low rate of mitosis (cell division). The second node was completely clear. Dr. Knox said this was almost as good as having no nodes involved. The cancer was trapped in the first node and had not migrated further. That node was no longer in her body and those cells weren't going anywhere.

The report, however, did make the possibility of chemotherapy more of a reality. That decision will come later in meetings with the medical oncologist next week.

Because of the small secondary tumor, a second re-excision surgery was scheduled for early Friday morning to remove the additional tissue.

This was probably the gloomiest day of the journey so far. We have a great deal of confidence in God's goodness and sovereignty, but we had prayed so hard for a clear report that the news was a little discouraging. At the same time, we know whose Hand holds ours and He will give the strength to get through each step of the process.

Laurie's First Surgery (Jan. 16, 2006)

The Sunday evening before Laurie's surgery to remove her tumor, the elders from their church, North Highlands Bible Church in Dallas, met with Laurie and Jim for a special time of prayer on Sunday evening before surgery. Several friends from their Life Group also came. The time of prayer was sweet and very encouraging for Laurie as she anticipated the next day's surgery.

Early Monday morning, January 16, Laurie and Jim headed down to Baylor University Medical Center near downtown Dallas. Her first stop was in the Breast Imaging Center where a wire was inserted into the tumor site to guide the surgeon. That was followed by a visit to the nuclear medicine department for a Sentinel Node Injection. This injection of a radioactive dye was designed to create a map of the lymph nodes and indicate which node was the sentinel node (the first node that drains the breast). This information allowed Dr. Knox to remove for testing only the first few lymph nodes that might be involved.

Laurie actually went in to surgery at the Texas Surgery Center at 11:15 a.m. for her breast "excisional biopsy" (i.e., lumpectomy). Jim, along with 32 of her family and close friends pretty well overwhelmed the surgery center waiting area. We almost felt guilty. . . . but not quite. :-)

The surgery lasted for about 90 minutes. Dr. Knox was pleased with the outcome and wasn't surprised by anything, nor did she see anything that would give her cause for concern.

Laurie was at home by 4:00 p.m. that same day. The only side effect was some groginess from the anesthesia and some tenderness. Laurie's biggest emotional day was over.

The First Doctor's Appointment (Jan. 3, 2006)

Laurie and husband, Jim, met with surgical oncologist, Dr. Sally Knox, on Monday, January 3, for their first consultation. Dr. Knox is highly regarded in the Dallas area. She is not only an excellent surgeon, but knows and loves the Lord, and has served in medical missions as well as developing a foundation to provide breast cancer care for women otherwise unable to afford the costs.

When we went in, we had no idea what to expect from the process. The pathologist who had called us with the initial diagnosis before Christmas had indicated that Laurie would likely need only a lumpectomy, probably with chemo, and that her prognosis was extremely good. That certainly had eased some of the stress over the holidays. This appointment with Dr. Knox, however, would provide the detail that we would need to move forward.

Dr. Knox affirmed that Laurie's tumor was very treatable, requiring only a lumpectomy and sentinel node biopsy. A mastectomy was not necessary. However, a lumpectomy does require radiation treatments.

Two types of radiation were presented as possibilities for Laurie's treatment. The standard radiation treatment protocal requires 33 days of external-beam radiation once a day over a six-and-a-half week period. A new procedure, called Mammosite, required only five days of treatment twice a day. This procedure would irradiate the tumor cavity from within the breast with a more intensely radioactive pellet. This procedures delivers the radiation only to the immediate vicinity of the tumor cavity, which is less invasive. This treatment is preferred if no nodes are involved and if the tumor cavity is small and not close to the surface.

The hope was that the tumor would be completely contained and no lymph nodes would be involved, because the Mammosite procedure seemed to be the preferrable option for us. We wouldn't have all the answers until after the lumpectomy and the pathology report.

Laurie's first surgery was scheduled for Monday, Jan. 16.