GIG #3 - The Hickman Catheter

I’m thankful for Dr. Robert O. Hickman and his 1973 invention – the Hickman catheter. (You can read Dr. Hickman’s short bio here.) I have a love/hate relationship with this instrument. But let’s be clear here at the beginning – this is not the kind of catheter you are currently thinking of. That would be a much less complicated relationship (and would prohibit any blog pictures, I'm afraid). Rather, this is an intravenous (IV) catheter, with tubes running into my jugular vein.

It was surgically placed in my chest before chemotherapy began in order to deliver drugs, fluids, and blood transfusions. It will remain there until my treatment is over. Yes, I have tubes hanging from my chest like in the picture above. This is creepy. And although I don’t think anyone else would really notice the tubes under my shirt, I’m sometimes self-conscious about them and feel as if I need to introduce my tubes to friends and strangers alike. But blurting out, “Hi. My name is Aaron and these are my tubes” will only get me weird looks.

My sons think the tubes are kinda cool, though. I’m like some kind of part human--part machine combo now. Tanner wondered if they made me kinda like a superhero and thought maybe one tube could shoot lasers while the other one could shoot lava. I could be (cue big announcer voice) “Super-Laser-Lava-Robo-Daddy!!” But SLLRD is too long for a superhero uniform and sounds badly now matter how you try to pronounce it. So we just left it at Super Daddy.

Despite the creepiness and periodic hassles, I am thankful that I have the Hickman catheter and have avoided countless needle sticks in my arms. You all already know how much I like those.

Radiology Report

Round 3 is over and I’ve been home for a few days. Until today, I’ve felt pretty crummy. But my energy and appetite are returning and I feel much better. I had a CT scan done yesterday and although I have not consulted with the doctor yet, I did sweet talk my way to a hard copy of the results from the radiologist. Here’s an abbreviated version, just for my readers….




RADIOLOGY REPORT

PROCEDURE:
CT Abdomen and Pelvis

DATE: 08/26/08

COMPARISON: 07/03/08

HISTORY: Burkitt lymphoma

TECHNIQUE: Routine with oral and IV contrast.

FINDINGS:
Marked cecal thickening has nearly completely resolved. Appendiceal thickening and distention has significantly decreased though some persistent mucosal thickening of the appendix is seen. Adjacent lymph nodes are also smaller. Organs of the pelvis are otherwise normal in appearance.

IMPRESSION:
Near resolution of cecal thickening. Significant decrease in appendiceal thickening.


I’m sure my doctor will interpret all of this for me when I visit with him in the next couple of days. But here’s my own interpretation: WOO HOO – THE STINKIN’ TUMOR IS ALMOST ALL GONE!! The cecum is where the majority of my tumor was located (where small and large intestines meet). And that “thickening” is nearly completely gone. There is still some of the mass near my appendix. But this is well within what is expected at this point in treatment.

This is great news, especially considering I’m not yet half way done with chemo. It’s early in the game and I’m kicking some Burkitt butt.

Thank you for your thoughts and prayers!!!!

Just in Case...

…you youths were tempted to tease me…

Click here to read 2 Kings 2:23-24. Then think again.

85-90

85-90%…
85-90%…
85-90%…

That’s my projected total recovery rate – meaning my cancer goes away with chemo and never comes back. I sometimes repeat those numbers to myself, like some sort of lucky mantra.

As far as cancer news goes, that is very, very good. And I am very, very thankful. But somewhere in the back of my mind lingers two quiet questions: “Who is in the other 15-10%?” and “Could I be in that group?” But I choose not to let myself dwell on these questions for long. They are too unsettling.

Throughout this entire ordeal, I can honestly say there have been very few times of fear or anxiety for me. What fear and anxiety I have felt has been related in some way to this 10-15% group. So I deal with it by not thinking about it. I just assume I’m going to be in the 85-90%.

I need your help again. Please put on your theological thinking caps to ponder this question – Is it a sin to be afraid? It seems a normal and natural reaction in a situation like this. But is normal and natural the same as being OK and right? Is it a sign of weakness, of failing to trust God?

This is important. Because it is within the realm of possibility that God’s plan for my situation is to allow me to be in the 10-15%. I need to take this possibility into some consideration. If you have followed my posts, you know I don’t worry about myself, but I worry a lot about what would happen to my family – my sons in particular. I always know in my head that God loves them more than I do and will take care of them. I just don’t always feel it in my heart.

So help me. (This is my plea for reader participation.) What do I do with the fear and anxiety that will come if I consider being in the 10-15%? Ignore it? Deny it? Accept it as normal and natural? Work though it? (If so, how?)

Whoa. I just realized how heavy my past few posts have been. I’ll try to lighten it up a bit soon by writing about poop or something.

Hootie and the Blowfish and Me

Do you remember Hootie and the Blowfish? They were a phenomenon of the mid-1990s. Every college student (including me) owned Cracked Rear View. We belted out with Darius Rucker the lyrics to songs like “Hold My Hand,” “I Only Wanna Be With You,” and “Let Her Cry.” That album went platinum 16 times and still ranks as the 12th best selling album in music business history. Most people don’t know that Hootie and the Blowfish have continued to crank out albums. But none of them have reached anything close to the heights of Cracked Rear View. I don’t know if we can classify them as a one-hit wonder since they had several hits from that album. But they definitely have only had one album achieve worldwide success of any magnitude.

I saw Darius Rucker interviewed on Vh1 of something like that not long ago. He was reviewing the history of the band, and discussing the success of Cracked Rear View compared to other albums. He said that they enjoyed the wild success of that album and all the big venues and recognition it provided. But he also said they have been content with their subsequent albums, too. They are playing smaller venues, receiving less recognition, and making less money. But they are satisfied. They are not bent on trying to relive or recreate the glory days.

I would much rather be like Hootie and the Blowfish than some other bands always trying to achieve their previous success.

If, and this is a monumental “if,” this time in my life turns out to be part of a plan of profound importance, I am much more comfortable being a one-hit wonder. I don’t think I can sustain prolonged profoundness. I am amazed, even bewildered, but extremely honored that people read my blog and have found a little bit of encouragement, hope, and inspiration. Thank you for your kind words to me. Please know it’s all about God, not me.

But I have to tell you, I am looking forward to the day when my life isn’t, well, profound. I enjoy prolonged periods of normal and quiet stability. Is that wrong? A friend of mine a church mentioned in our Sunday School class this week that he desperately wanted to do big things for God. Just for one example, he wants to be like the missionary to cannibals who accomplished great things before being martyred. He wants to be a part of a profound plan.

And I caught myself thinking, “Man, I’m not so sure I want to sign up for that.” I want to have a solid Christian walk, but I’m not sure I want a life of magnitude. I don’t think I’m up to that challenge. I want a quiet life again. I like the idea of being a one-hit wonder. Seriously, is that wrong?

Why? (part 3)

I’ve mentioned a couple of times already (here and here) that I am not wrestling with the “why” question like I thought I might. Even in the middle of round 3 of chemotherapy that continues to be true. But I’ve decided that I might want to distinguish between at least two different kinds of “why” questions. First, there is the “why” question that is laden with anger, bitterness, sadness, or most of all, entitlement. This question has the person as the center of attention: “God, of all the people in the world, why did this have to happen to ME?” Whether by denial, self-righteousness, or God’s grace, I have not been struggling with this question. Compared to a perfectly holy, righteous, and just God, I actually deserve worse than a fight with cancer. I am a blessed man.

Second, there is the “why” question that is an honest, non-blaming search for God’s design. This question has God as the center of attention: “God, what are you trying to accomplish through and in me during this time? How would you have me live my life in the midst of this situation?” (Perhaps, then, this is actually a “what” or a “how” question.) I think I should be giving THIS question more thought.

There is a story in the Bible of a man with his own major life crisis – he was blind from birth: John 9:1-3: As he went along, he saw a man blind from birth. His disciples asked him, "Rabbi, who sinned, this man or his parents, that he was born blind?" "Neither this man nor his parents sinned," said Jesus, "but this happened so that the work of God might be displayed in his life.”

Jesus’ disciples approach him and ask the first kind of “why” question. Why is THIS man blind? Is it his own fault or that of his parents?

But Jesus answers the second kind of question. God intends to use this man’s situation to demonstrate something about how He works.

I suppose the same could be said of my situation (and yours someday). God wants to use it to demonstrate to, both to me and to others, something about how He works. And even as I type these words, I feel the gravity of responsibility. I need to be thoughtful and diligent. This is serious business. There could be a plan of profound importance at stake.

Honestly, I’m not sure I like that. I don’t know that God can rely on me for that. I’m not sure that I’ve ever done much that is “profound” in my life.

Pray for me through the rest of my treatment that I will be more purposeful in my behavior. Pray that I’ll have good conversations with my nurses and nurse’s aides. Pray that I’ll make sense in my blog posts. Pray that I’ll have a positive influence on my students and any others who are watching what I say and do these days. But through all of that, pray that I won’t try to do it all on my own power – pray that I’ll allow God to do His work in me.

Good News, Bad News

The good news – I’m not a wimp for passing out (more than once) at the oncology clinic. I remembered something about a reflex that works in some people from my Abnormal Psychology textbook. So I looked it up. There is a case study of a woman named Judy, who fainted during a movie with graphic scenes of blood in it. Here's an excerpt from the book:

“We now know that more is involved in [this reaction] than just [wimpiness and early childhood experiences]. Physiologically, Judy experienced a vasovagal syncope, which is a common cause of fainting. When she saw the film she became mildly distressed, as many people would, and her heart rate and blood pressure increased accordingly, which she probably did not notice. Then her body took over, immediately compensating by decreasing her vascular resistance, lowering her heart rate and, eventually, lowering her blood pressure. The amount of blood reaching her brain diminished until she lost consciousness. Syncope means “sinking feeling” or ‘swoon’ because of low blood pressure in the head….

A possible cause of the vasovagal syncope is an overreaction of a mechanism called the sinoaortic baroreflex arc, which compensates for sudden increases in blood pressure by lowering it. Interestingly, the tendency to overcompensate seems to be inherited, a trait that may account for the high rate of [wimpiness at needles and blood] in families.”

If you made it through that material, you learned two things. (1) I’m not really a wimp, and (2) It’s my dad’s fault.

The bad news – I did not get to have a CT scan on Wednesday as planned. This would have let us know how well the chemotherapy was working at shrinking my tumor. Unfortunately, my kidneys are getting overworked right now and since CT scans can be hard on kidneys, too, they decided to postpone the CT scan for a couple of weeks. I’m a little disappointed. It would have been nice to get some concrete data on my progress.

The good-or-bad-depending-on-how-you-look-at-it news – I start round 3 of my chemo on Monday. I will probably be in the hospital that afternoon.

Why? (part 2)

Back on July 9th (and before I started chemotherapy), I shared some of my thoughts about the “why” question. I wrote then that I had not been struggling with asking it. I didn’t figure that there was any good reason why I should not get cancer.

Since that time, I think I’ve read a dozen or so articles and a couple of books – and it seems like all of them have addressed this “why” question that haunts many people. Each one of these articles and books described how everyone with cancer (or in some other crisis) eventually asks why. Everyone wants to know why they have to suffer, why they have to experience some particular hardship, why they have to endure disappointment, pain, or loss.

In fact, one article explained that even Jesus asked the “why” question on the cross. In Mark 15:34 we read this: And at the ninth hour Jesus cried out in a loud voice, "Eloi, Eloi, lama sabachthani?"—which means, "My God, my God, why have you forsaken me?"

Dang. So everyone asks the "why" question? Even Jesus??

I began to feel uneasy. Several questions started to swirl in my head. Am I just in denial? Am I burying my head in the sand? Am I being genuine and authentic? Am I faking some sort of self-righteousness? Do I think I’m better than Jesus?

I don’t know. But I still don’t think much about the “why” question. I’m not angry or bitter that I have cancer. Don’t get me wrong, I don’t like it. I don’t like the fatigue, the medicines, the strain it is putting on the rest of my family, the interference it is having on my friendships, work, and hobbies. I don’t like it at all. But I figure this is just a part of life – it is part of what it means to live in a world that is tainted with sin.

And I figure Jesus is the only person who ever deserved to have an answer.

The author of last article I read made me feel better. After describing his own struggle with several crises and the “why” question, here was his conclusion:

“If I knew why each of those events happened, I still wouldn’t be satisfied. Comfort doesn’t come with explanations; it comes from the promises of God. And not once did God answer the why’s of Job. Nor did He answer the why of Jesus. What both of them realized at the end of their lives was that compared to the presence of God, the why didn’t matter.”

I liked that.

Why? (part 3) – coming soon.

GIG #2 - Meet the Staff

Since day 1 of this ordeal, every single person – every doctor, every nurse, every receptionist – has been pleasant to work with. There’s not been one person that I’ve had issues with. Now, there are some people that I enjoy more than others due to personality, similar interests, etc. But there’s not been anyone that I’ve thought to myself, “ooh, I don’t really like them,” Of all the things I am thankful for, this is at or near the top of the list. I’m not sure it would be for everyone else, but for a people person like me, this is extremely important.

There’s Dr. Thomas Reid, who shoots straight in his discussions and is accessible, confident, and honest. He makes me feel like we are on a team together, battling this cancer. He credentials are outstanding – like being the Chief of Oncology at Walter Reed Hospital before coming to Conway. And anybody who has both and MD and PhD has got to be pretty smart, right?

You can read an article about him here – http://www.thecabin.net/stories/062908/loc_0629080015.shtml
Or visit his hospital staff page here – http://www.conwayregional.org/body.cfm?xyzpdqabc=0&id=50&action=detail&ref=284

And there’s all the nursing staff at the clinic, too. It is hard to describe how good they are. They all have found the ability to show compassion without showing pity. They are empathetic without being sympathetic. They take cancer and treatment seriously, but don’t take the rest of life too seriously.

There’s Cathy, who was with us when we got the news of the kind of cancer and its staging and who has gone out of her way to educate us on all sorts of things related to cancer and quality of life. There’s Lesa, who says if she were in charge of all my neupogen shots in the belly, she would have done them in a pattern – the tiny bruises giving me a temporary tattoo. There’s Dena, who I know has struggled with cancer in her own immediate family. There’s Laura and Amanda, who usually do my labwork and tease me about passing out while keeping one eye on me just in case I do it again. There’s Sonja, who I found holding my feet up once I regained consciousness from passing out. Next time I’ll see if she’ll massage them while she’s at it. There’s Maria, who I’ve called Marilyn maybe more than once but she doesn’t hold it against me. There’s Darla, Tammy, Amy, and Diane, all who have made me feel welcome and cared for.

Any time you name names like this, you run the risk of leaving someone out. I don’t think any of the nurses know about this blog. But knowing Conway, somebody somewhere will point it out to one of them someday. So I should say, with all honesty and sincerity, that I appreciate every single one of the nurses there. And some day later, I’ll highlight the staff at the hospital, too.

If/when you think of it, remember Dr. Reid and all the nurses by name in your prayers. Thank God for such competent compassionate folks

Status update: My white blood cell counts and anc counts are up (this is a good sign that my immune system is rebounding from round 2). But my red blood cells were getting pretty low. So I am – as I blog right now – getting a transfusion. I haven’t had any trouble with it so far. I have a CT scan scheduled for tomorrow.

By the Numbers

45 – Days we’ve known that I have cancer.

2 – Rounds of chemo down, 6 more to go. For the statistically challenged, that means I’m 25% finished.

13 – Pill bottles in my pill bottle basket

18 – Pills I take every day.

14 – Neupogen shots I’ve gotten in my belly.

3 – CT Scans after next Wednesday when we’ll find out to what extent my tumor has been reduced.

4 – Spinal taps, 12 more to go. They aren’t extremely painful, but I hate those.

4 – Episodes of throwing up. Shanda feels very sorry for me when I do, but I just keep repeating my mantra to her: “It’s just vomit.”

3 – Fingers that have been left a little numb from the chemotherapy. We don’t know if that will go away or not.

0 – Eyebrows I have lost so far. But it’s just a matter of time and it’s gonna be weird.

2 – Episodes of passing out at the oncology clinic.

7 – Approximate number of nurses staring at me when I regained consciousness.

14 – Meals we have had good friends make and deliver to our house.

2 – Grandmas that have come for extended stays to help take care of our boys.

12 – Approximate number of times each day that Shanda asks me, “Are you OK?”

12 – Inches long for each tile on the oncology floor at the hospital.

250 – Number of tiles a person travels if they make a lap around the oncology floor.

21 – Laps around the oncology floor to make 1 mile.

3 – Miles I walked during my last hospitalization.

7 – References to Kojak or Mr. Clean when people hear about or see my bald head.

Cancer Shmancer

I feel like I should apologize for not posting anything in several days. I know some of you check often for updates. But something happened a couple of nights ago that put my cancer in perspective (and even made me forget it for a while).

This is cooler than cool. My words won’t come anywhere close to communicating just how incredible this is.

Parker (my oldest son) gave his heart to Jesus Tuesday night.

And I thought I was gonna bust at the seams.

He began a conversation with Shanda that evening – about his naptime of all things. “I think Jesus was tugging at my heart” he said. Shanda asked him what he did and he said, “Well, I prayed and asked him if he would please go away.”

Not only is that funny, but I took it to be an authentic sign of conviction. How many of us, if we were honest enough, would pray the same thing?

I noticed the conversation going on so I joined in. The next 20 minutes or so were spent talking to Parker and answering questions about sin, heaven, and Jesus being the boss.

Then he said, “I think maybe Jesus is tugging at my heart again right now. Can I pray and ask him into my heart?”

It’s a good thing my wife was rock solid as these events unfolded, because by now I was nearly a blubbering idiot.

Parker prayed the most sincere prayer you could expect from any 6 year old. Among a few other things, he prayed, “Jesus, I love you and I want you to come into my heart. I know it’s junky and I want you to clean it up. Thank you for dying on the cross for our sins. I love you and want you to be my boss.”

He was beaming afterwards. So was Shanda and I – maybe just not as openly. I was so proud of him that I felt guilty about it.

Cancer? What cancer? When your son gives his life to Jesus, nothing else matters as much. Give me another day and I’ll post some updates, though.

GIG #1

I'm thankful for my home and my own bed.

This is not the GIG I had in mind for my first entry. But I'm tired. Really tired. This happened after round 1, too. It looks like the first few days home are after my hospitalizations are going to be marked by some serious fatigue. I'm fighting nausea, too, but they make good meds for that.

I might best explain my fatigue like the kind you might get with the flu - just without the aches and chills. I'm worn out and tired. The littlest things seem to zap whatever reserves of strength I have. So I sleep a lot.

Be thankful with me that I have a comfortable home and cozy bed.

GIG Notes

God is good.

Shanda and I talk often about how much we have to be thankful for, even in the midst of this evil cancer and nasty chemotherapy. And it has been good spiritual exercise for me to focus on God’s goodness during these times. In Philippians 4:8, Paul reminds us, “Finally, brethren, whatever is true, whatever is honorable, whatever is right, whatever is pure, whatever is lovely, whatever is of good repute, if there is any excellence and if anything worthy of praise, dwell on these things.”

So I have decided to write “GIG” notes relatively often. Your other suggestions for titles were very good. (Andy, I almost went with “Doxologies” or “Dox Notes” because I thought it would make me sound like I knew some theology or something.) But “GIG” is a simple and practical reminder (mostly to myself) that I have so much to be thankful for. God is indeed good.

However, when I declare that God is good, I am making a declaration, not an argument. It is a statement of fact, not of logical analysis. It is proclamation of faith, not an evaluation of character. Is that confusing?

If each of my GIG notes was nothing but blank space, God would still be good. If I my faith in Jesus brought nothing but earthly pain and misery, God would still be good. If I was completely blind to all things true, honorable, right, pure, lovely, good, and excellent, God would still be good. So my GIG notes are not to be read as lawyer’s arguments. God’s goodness evidence #1, God’s goodness evidence #2, God’s goodness evidence #3….. see, we conclude from the evidence that God actually is good. Rather, my GIG notes are like my field notes on a journey. I want to document evidence of God’s goodness that I already know is there.

That may not make a lick of sense to anyone else but me. But that’s OK – God is still good.

My first GIG note is already half-written in my head. I wish I could share it with you now, actually. But I’ve gotten good news today – I am being discharged home from round 2 this evening. So I am getting my things together and waiting for the doctor to stop by. Yes, yes, I know getting to go home counts as a GIG. It just wasn’t the GIG I had planned on writing. These 5 days at the hospital have been uneventful – and let me tell you that’s exactly what you hope for during chemo. I’m looking forward to time with my family, seeing my boys reaction to my shiny bald head, eating some regular (non-hospital) food, and sleeping in my own bed. I can’t express enough my gratitude for your support and prayers!!

God is good!