"Saving the Best for Last"

Pondering the title of Pastor Katrina’s January 18^th sermon, I find myself turning to a personal application of God’s work in my life. He has saved the best for last.

I have several answers to when “the last” began. Moving to Whidbey Island, Washington in June 2008 to help my youngest brother care for our mother was one definite beginning. My world had been rocked by unusually difficult times since 2000. I still was not sure where I would end up in my faith journey. The 5 ½ years that followed my move to the island provided a new beginning, gradually established with a firm foundation. To this day, I do not know all that the Holy Spirit did in my life during that time, save that he removed much of the fear of people that had ruled my childhood, teen years, and adulthood. And how that was done I do not know, just that I was gradually changed.

My move to Bartlesville in 2013 and being involved in my grandchildren’s lives was the start of another “best for last.” (Sadly, my own children did not have that experience, with grandparents hundreds of miles away. Nor did I after age seven when my maternal grandfather died.) I never expected that I would experience the blessing of living in the same community as my daughter, son-in-law, their children, and my son.

Serving as a pastor at Good Shepherd was another unexpected “best for last.”  It was the fulfillment of an almost lifelong call and dream. 

And here comes the shocker: three times with cancer is my final “best for last.” I would rather not have cancer, but the blessings God has given me while enduring it are enormous. Each occurrence has made me draw closer to God, enriching my faith, this third time especially. I always thought that having cancer, especially stage IV cancer, would be terrifying. It is not. I have found, much to my surprise, that I fully trust in Jesus and do not fear the end of life. I am okay with God’s timetable, whatever that is, though I would prefer more rather than less time. He has given me a peace that I could never manufacture. What the apostle Paul wrote in Philippians is true: “For to me, to live is Christ and to die is gain.” What greater gift is there than that?

*To be totally honest, the day after writing this, I was smacked down by a wave of discouragement over my lack of energy even on a “good” day. (Doing two short errands completely depleted me.) Later, scrolling through Google news on my phone, I ran into an October 14, 2022, blog post by Joni Eareckson Tada titled “What Does It Look Like to Persevere in Trials?” She writes, “But if I run to God in my moments of need, he will provide endurance for my trials. Endurance is his gift to me!”

If you need encouragement today, check out Joni’s blog and read Romans 15:5 and James 1:12. God is faithful.

 

Starting Up Again

 Last Thursday (January 8), I received my infusion. I’m continuing Trudolvy, which is a chemotherapy wrapped in antibodies that target the protein on cancer cells.

Soon after I arrived for my 9 am appointment, everyone was herded down to the basement due to a tornado warning. There we sat for the next 40 minutes or so until the danger passed. Even with the delayed start, I was done with my treatment by 1:30 pm.

The strange brain fog feeling plus fatigue stayed for a good part of the day, making it hard to think clearly. More fatigue followed on Friday and Saturday, then shakiness on Sunday. Yesterday (Monday) and today have been better. I hope I can drive tomorrow to have my labs done locally, then stop by Hopestone to pick up my meals for the week and visit with a friend who volunteers there. Thankfully, my son is always available to chauffeur me around town as needed. Thursday will be another infusion, and we’ll start the side effects again.

Acceptance, I find, goes a long way towards dealing with the side effects from my treatment regimen. Bemoaning the fact that I’m not up to par only makes things worse. I’m grateful that the side effects I’ve experienced since beginning treatment in October have been much milder than the first two times I had cancer. I’ve learned to adjust my activities (or lack thereof!) each day and am getting a clearer sense of when I can be up and around, when I need to relax in my recliner, and when I need to go lie down for an hour or so.

The one thing I can count on is starting each day with prayer and meditating on a few verses. Right now, I am slowly working my way through Ephesians. That time grounds me and reminds me that God is in control. I don’t need to worry because whether in life or in death, Jesus is my outcome!

What I Learned

 I spoke too soon.

These past few weeks since my PET scan, I’ve been happily cruising along and gaining a little more energy each day. But yesterday, I learned firsthand how a lack of knowledge can mislead you into thinking you know it all.

Calling in to Hopestone Cancer Support Center yesterday, I spoke with the director about my good news. She rejoiced with me but then filled me in with details I did not want to hear. They boil down to this: treatments must continue to keep the cancer at bay. Obviously, the Trudolvy is working very well, but metastatic triple negative breast cancer is aggressive and sneaky. Without treatments, it will come back even harder. Debbie has had years of experience with helping cancer patients, and maintenance chemotherapy is what prolongs the lives of those with stage IV cancer. As happened after my first and second rounds of cancer, stray cancer cells hung around and eventually got active again. (No one know what triggers that activity.) I was blessed to have eight years of remission after the first cancer. After the second cancer, I had a mere 8-9 months before it returned. Ouch.

It is so, so hard to think of being weak and fatigued now that I’ve had a taste of energy and hope of being cancer free. I’m glad she explained the need for maintenance chemo to me, though: otherwise, I would have been completely devastated when I see Dr. Moussa later today. . . .

Dr. Moussa was very pleased with the PET scan as well as today’s bloodwork. Though my cancer is in remission, treatments must continue to prevent any stray cancer cells from multiplying and spreading. We will follow the same treatment plan: infusion two Thursdays in a row followed by a week off. Tomorrow will be my fourth infusion. He says that after I have completed six infusions, he will look at a possible dose reduction and/or longer times between infusions.

Early this morning, I felt defeated and depressed, so I prayed, telling God all about my disappointment and asking for his strength to endure. Then, as I often do, I went back to bed for a few hours. I rested, maybe dozed on and off, and found myself thanking God for his help. By the time I woke up, the sense of defeat and depression were gone. You see, our Triune God is ever faithful. He will see me through.

My Report

 My brain is still trying to process something I read yesterday. I seem to be in a state of shock. What I read was my PET scan report. I spent a lot of time looking up definitions. The phrase, “Interval marrow activation,” gave me some pause, so I looked it up and discovered it can be caused by chemotherapy. I believe I understand the report. But it still doesn’t feel real.

If you have ever had a PET scan, you may know that the last section, titled “Impression,” summarizes the findings. Mine says this: “No evidence of metabolically active malignancy. Resolution of previous right pleural effusion.” What does that mean? There are no tumors, and the pleural effusion (which contained cancer cells) is gone.

I should be jumping up and down with joy. But I am still stunned. This is the best news I could ever get. I’ve been asking God for more time, and it appears I am receiving it. When I see my oncologist on January 7^th, perhaps that is when this most excellent news will fully sink in.

An Update

Sometimes, like this past week, I just don’t know what to write.

But I can start here: thankfully, the sensory overload I experienced a week ago Thursday faded out during the evening. And then I had a good week with a bit more energy than usual.

Yesterday was treatment day, and the nurses tried something different: giving the Trudolvy infusion in one hour rather than two. The day was one of delays, but finally the pre-meds IVs started in late morning: Pepcid, anti-nausea, steroids, Benadryl, and then the Trudolvy (the chemo) at the end.

It turns out that the one-hour version was not a good choice. Once I got home. I was hit with intense upper back muscle pain. Fortunately, I had the presence of mind to immediately take one Tylenol #3, which wiped out the pain in 20 minutes or so. I was thankful for that!

I used up all my energy this morning, though. Feeling rather good, I spent an hour doing little bits of this and that (none of it strenuous) around the house. Then, all at once, my body said, “no more! It’s time to rest! So, I did. Early this afternoon I went in for the injection to boost my white blood cell count and then spent the afternoon resting but unable to sleep, probably due to yesterday’s steroids.  Unfortunately, I was still too fatigued to go hang out with the Hemmingers (you know, my daughter, son-in-law, and the six young-uns) as I do a few evenings a week.

I have a good break before my next medical appointments. On December 23, I will have a PET scan. January 7 will be my labs and visit with my oncologist in Tulsa, and January 8 will be my next treatment day.

On a perhaps unrelated note, each day I wake up early (sometime between 4 and 6 am), have a light breakfast, and spend some time in the Scriptures. I have a set of the New Testament (ESV) with journaling space. My practice is haphazard: so far, I’ve gone through several of Paul’s epistles, and now am almost through 1^st and 2^nd Peter. Normally, I cover just a few verses, ponder them, and write. And then, I go back to bed and usually can sleep for an hour or more.

It is a lovely way to start the day. But I have discovered that I need to spend more time in the Word, which I’m currently doing by reading Dallas Willard’s Renovation of the Heart: Putting on the Character of Christ. He quotes the Bible throughout each chapter. When I leave out that longer reading time, I feel bereft! I much rather end each day with God’s peace within.

 

Sensory Overload

When I got home from my treatment today, I was so sleepy that I lay down to take a nap. After an hour, I got up, and that’s when sensory overload struck.

Sounds assaulted me: my son’s voice, his cough, a loud engine in the neighborhood. It was almost like they smacked into my brain, making me cringe. They were almost unbearable. I had to have silence. I couldn’t even risk a cough jolting me, so I eventually went back to my room, closed the door, and turned off the lights.

But I could not turn off my thoughts, which also were almost physically uncomfortable. I could not listen to music; that would be another assault on my brain. I needed absolute quiet, which was not available. The faint sound of Joseph’s voice as he tutored a math student online came through. And my tinnitus, of course, continued its high-pitched buzz. After another hour lying down, it seemed like things weren’t quite so intense, so I got up again.

And now I sit at my computer trying to explain what sensory overload feels like, for me, at least. It gives me a better idea of what it may be like for my 10-year-old grandson, Josiah, who has autism. Sometimes he sits or walks around the house with a finger in each ear. Or he yells or cries and runs off to his room. I even get the yelling or crying part. My own voice does not disturb me, though I am so tired and sluggish that speaking is a chore. Listening and comprehending are much harder.

Just now, the furnace kicked on. It is annoying. My tinnitus continues. I hear Joseph and his student talking about math concepts. I usually prefer bright light. However, right now, the light feels too bright—but if I turn off the overhead light, the computer screen’s brightness will be too much in the dark.

For whatever reason, I can write. It could be due to the writing getting my thoughts that won’t stop out of my head and onto the screen! But reading or even playing Kindle games seems like too much stimuli.

I’m not sure where I can find relief. My sense is that this disturbance is temporary. I expect to wake up in the morning with it gone, even though the fatigue will remain.

When I say “fatigue,” it is more than the feeling of not having had enough sleep. There is exhaustion mixed in, difficulty concentrating, and general malaise. Those are the days when I must be gentle with myself and refuse to feel guilty when I get nothing done.

But there are several silver linings: my labs from yesterday show that the tumor marker test has dipped down even more, from 34 to 28. Those numbers are well within a normal range. When I told Dr Moussa that I wondered if the pleural effusion was coming back, he had me get a chest X-ray, which showed that the effusion was gone! Very good news, indeed. Before the end of the year, he will order a PET scan to see if any solid tumors have developed.

Next Thursday, I will have another treatment followed by an injection the next day to help my white blood cell count to stay up. And then, due to Christmas and New Year's Day falling on Thursdays, my next treatment won’t be until January 8. What that means to me is my energy level will very gradually increase! Last week (with just one extra week between treatments), I was able to read two novels, drive the car a several times for a couple short errands, and do a few things around the house. Plus, visit the grandkids, of course.

Elijah’s fourth birthday was yesterday, December 2. It was so much fun to see his excitement!

 

 

Thanksgiving Week

 This morning, Wednesday, I treated myself to driving across town to pick up a prescription. I know it doesn’t seem like anything worthy of being called a treat, but it was. I usually don’t drive anymore because it uses up so much energy. But it was a crisp, sunny fall day just perfect for a little drive, and I felt well enough to do it. On the way, I even stopped at the library to pick up a book on hold (Louise Penny’s latest novel, The Black Wolf). At Walgreen’s I looked around for a bit before picking up nystatin mouth rinse. From there, thoroughly worn out, I drove home.

Yesterday afternoon I took a walk . . . across the street to visit my neighbor. And that was after the morning ride to Aldi with my son to pick up a few groceries. He drives, I go in the store with him to make selections, and when we are done, I leave him at the line to the cashier while I go out to sit in the car.

Monday, my daughter picked me up to come over for supper and time with the grandkids. As always, that was fun!

And on Sunday, my son drove me to church. I stayed seated for the entire service, but I was quite happy to be able to sing a verse or more of each of the four hymns, something I have been unable to do since September when I thought I had bronchitis, but it turned out to be a pleural effusion. Singing takes energy, too.

So now you have the rundown of a week in which I feel a little stronger than usual because of the treatment cycle which, after two weeks in a row of my Thursday infusions, gives me the third Thursday off. I also get this week off due to Thanksgiving, so who knows what I’ll be up to next week!

People talk about quality of life when you are receiving palliative care. The infusions keep the cancer somewhat controlled to give me some quantity of life. They also drain me. However, I still find quality in each day. That quality is in being able to spend time with family. It is in being able to write and concentrate enough to read. It is in listening to music and praying. It is in being able to worship with my church family. And next week I get to preach.

Not every cancer patient experiences the level of weakness and fatigue that I do. But you must remember that when I started treatment this time, it was only nine months after finishing treatment for the first recurrence, and my energy had not returned to what used to be normal for me.

So, no, I won’t be traveling or going to special events or completing a bucket list (which, by the way, I don’t have). I’ll be here at home with my son Joseph or over at Dana and Shawn’s with them and their delightful brood of six. I’ll do the bits I can, rest as much as needed, and appreciate every little detail of my beautiful life.

It’s been a hard year, yes, but it has also been a year full of God’s blessings and His provision. Tomorrow is Thanksgiving, and there is much for which to be thankful.

Praise the Lord, my soul; all my inmost being, praise his holy name.

Praise the Lord, my soul, and forget not all his benefits (Psalm 103:1-2)