This will be brief, or at least as brief as I am able; those who know me well know that brief is a stretch for me! One housekeeping issue: we are getting a bit of spam on the comments, so I have added the "word verification" feature for comments. Sorry about that, and thank you all for your continued written (notes, cards, emails) encouragement.
On to the medicine. I talked to Pappas at Duke yesterday. He had shown Dee Dee's CAT scan and x-rays to about 6-7 docs at Duke. They all agreed that the lymph node must be addressed, but could not reach any consensus on how to get to it. It is adjacent to her aorta, and they simply disagree as to the best physical technique to get it. So, they decided that they will not do anything until she has had the octreatide scan and a PET scan. (For more info on the PET, this is a very good web site: http://www.radiologyinfo.org/en/info.cfm?pg=pet&bhcp=1)
The PET is scheduled at Duke for Monday at 2:30, and will last about 3 hours. The octreatide is at Mayo on the following Monday, 10/16. I don't know if the biopsy will be done at Mayo, or back here at Duke when we return.
This continues to be a tough time for myself and my sweet bride. The issue of the node has weighed heavily on her heart since the day they told us about it, and the extra difficulty getting to it, the number of docs looking at it, as well as the delays in finding out the answer are all contributing to the general sense of unease. Please continue to pray that it is a medical "red herring," and not of any real importance.
More later,
Tony
Thursday, October 05, 2006
Tuesday, October 03, 2006
No wonder it's tough to love doctors!
Well, I wrote a post earlier this evening, and went to officially put it on the blog, and it totally disappeared. It was not a nice post, not upbeat, not encouraging, and I think God wanted me to meditate on Him a bit longer before I wrote anything for public consumption!
Today was, to be blunt, a bad day. The whole point of the day, medically, was to do an endoscopy and obtain a biopsy of the lymph node via the esophagus (we were wrong yesterday when we both thought it was via the trachea). We arrived at Duke at 9:15 this morning, they started at 10:30, called me back at noon. She began coming out of anesthesia at 12:15, doc came in at 12:30 or so. "We did the endoscopy, but despite all our efforts were unable to obtain a biopsy." I was shocked, did not know how to react, decided against anger (barely). They advised going home and waiting for Dr. Pappas to call sometime this week with the next, as yet undetermined, procedure time. So, my heart hurt for my wife who had undergone this procedure that while not painful, is uncomfortable and leaves her feeling pretty lousy for a day or so, to no real benefit.
I insisted that they page Pappas before we left. So, we left Dee Dee's I.V. in, etc., in the hope of doing the next thing while we were already there. He called back, and said to hustle over to try to get the octreatide scan today. We went to that area, waited 2 hours, then were told that it could not be done at all today, and that in fact it couldn't be done for a bit over 2 weeks!
Driving home, there was not a lot of conversation. We were both sort of empty, very disappointed. Dee Dee handled it best, and reminded me several times that our times are His, that the courses of our days are in His hands. I called Pappas, and he returned the call a bit after we arrived home. He said he was not shocked that the procedure did not work, and that the node was just too far from the esophagus to reach it safely via that route. He is going to have the pulmonary specialists look at the CAT scan to determine which route will work, and hopefully get that done this week. The options are an incision in her neck, or a larger incision between two ribs.
He also still wants to get the octreatide scan, and will try to get it scheduled sooner than 10/18. By the way, we found out today that this is a 2-day scan. No hospital stay, but back to Duke two days in a row for scanning.
I then called the doc at Mayo who will actually be taking care of us while in Minnesota. This was the first time I have talked with him (he called me back during Caleb's baseball game, while I was coaching and Caleb was pitching!). His name is Geoff Thompson. He wants us to go ahead with lymph biopsy here, agreeing that a 4 cm lymph is unusual, and must be evaluated. He reiterated that he doubts it is carcinoid, but that the size mandates attention. After talking, we agreed upon travel dates, and I have booked flights and hotel for Rochester, MN. Thank God for many things, including Priceline.com! Tickets were all listing for over $1000 per person, and we got them on priceline for $300 a person. Whew! I had to remind Dee Dee that just like our time is His, so is our money. If He chooses to have us spend it on plane tix and hotels in MN, that is His prerogative.
The other significant news from my conversation with Thompson is that he basically said that he was going to absolutely disagree with Pappas. He said that he NEVER takes out any part of a woman's stomach unless it is completely unavoidable. "There is no possible way that I would allow this procedure to be done on my wife. Period." He said that we would be taking a woman who is essentially without symptoms, and "sentencing her to a life of daily symptoms, where she would never again feel normal and good." He wants to look at everything himself, and repeat a few tests (octreatide scan, endoscopy, remove the larger tumors in their entirety), but if all the info we have been given so far is correct, he will simply advocate lifelong monitoring, choosing to leave the cancer in place.
This, my friends, has been the weirdest day of the whole event. We had things done that produced no knowledge, and now have two docs from the #1 cancer center in the US (Mayo) and #4 cancer center in the US (Duke) completely disagreeing. To be honest, I have no idea what to think, how to process this information. I appreciate your prayers for wisdom and discernment at this point. We will not do the octreatide scan here and at Mayo, so we will just do it at Mayo. We fly to MN on Sunday 10/15, and return on Thursday 10/19. That gives them 3 full days to test/poke/prod and talk. As I learn more about his reasons for non-surgical treatment, I will let you know. Also, when we know the time of the biopsy round #2, I will post that.
Tough day, and not a lot of medical progress. Difficult day emotionally for us both. Certainly it was a day that we were glad to see end. Actually it ends two tough days. Yesterday we had two different families that had memorial services for their sweet boys; one lost their son during pregnancy, and another lost their son one day shy of his 9th birthday. A family member/friend of ours had lumpectomy today. Lots of opportunities for God's grace! The good news? His mercies are new EVERY morning, and tomorrow morning is never more than a few hours away.
Tony
Today was, to be blunt, a bad day. The whole point of the day, medically, was to do an endoscopy and obtain a biopsy of the lymph node via the esophagus (we were wrong yesterday when we both thought it was via the trachea). We arrived at Duke at 9:15 this morning, they started at 10:30, called me back at noon. She began coming out of anesthesia at 12:15, doc came in at 12:30 or so. "We did the endoscopy, but despite all our efforts were unable to obtain a biopsy." I was shocked, did not know how to react, decided against anger (barely). They advised going home and waiting for Dr. Pappas to call sometime this week with the next, as yet undetermined, procedure time. So, my heart hurt for my wife who had undergone this procedure that while not painful, is uncomfortable and leaves her feeling pretty lousy for a day or so, to no real benefit.
I insisted that they page Pappas before we left. So, we left Dee Dee's I.V. in, etc., in the hope of doing the next thing while we were already there. He called back, and said to hustle over to try to get the octreatide scan today. We went to that area, waited 2 hours, then were told that it could not be done at all today, and that in fact it couldn't be done for a bit over 2 weeks!
Driving home, there was not a lot of conversation. We were both sort of empty, very disappointed. Dee Dee handled it best, and reminded me several times that our times are His, that the courses of our days are in His hands. I called Pappas, and he returned the call a bit after we arrived home. He said he was not shocked that the procedure did not work, and that the node was just too far from the esophagus to reach it safely via that route. He is going to have the pulmonary specialists look at the CAT scan to determine which route will work, and hopefully get that done this week. The options are an incision in her neck, or a larger incision between two ribs.
He also still wants to get the octreatide scan, and will try to get it scheduled sooner than 10/18. By the way, we found out today that this is a 2-day scan. No hospital stay, but back to Duke two days in a row for scanning.
I then called the doc at Mayo who will actually be taking care of us while in Minnesota. This was the first time I have talked with him (he called me back during Caleb's baseball game, while I was coaching and Caleb was pitching!). His name is Geoff Thompson. He wants us to go ahead with lymph biopsy here, agreeing that a 4 cm lymph is unusual, and must be evaluated. He reiterated that he doubts it is carcinoid, but that the size mandates attention. After talking, we agreed upon travel dates, and I have booked flights and hotel for Rochester, MN. Thank God for many things, including Priceline.com! Tickets were all listing for over $1000 per person, and we got them on priceline for $300 a person. Whew! I had to remind Dee Dee that just like our time is His, so is our money. If He chooses to have us spend it on plane tix and hotels in MN, that is His prerogative.
The other significant news from my conversation with Thompson is that he basically said that he was going to absolutely disagree with Pappas. He said that he NEVER takes out any part of a woman's stomach unless it is completely unavoidable. "There is no possible way that I would allow this procedure to be done on my wife. Period." He said that we would be taking a woman who is essentially without symptoms, and "sentencing her to a life of daily symptoms, where she would never again feel normal and good." He wants to look at everything himself, and repeat a few tests (octreatide scan, endoscopy, remove the larger tumors in their entirety), but if all the info we have been given so far is correct, he will simply advocate lifelong monitoring, choosing to leave the cancer in place.
This, my friends, has been the weirdest day of the whole event. We had things done that produced no knowledge, and now have two docs from the #1 cancer center in the US (Mayo) and #4 cancer center in the US (Duke) completely disagreeing. To be honest, I have no idea what to think, how to process this information. I appreciate your prayers for wisdom and discernment at this point. We will not do the octreatide scan here and at Mayo, so we will just do it at Mayo. We fly to MN on Sunday 10/15, and return on Thursday 10/19. That gives them 3 full days to test/poke/prod and talk. As I learn more about his reasons for non-surgical treatment, I will let you know. Also, when we know the time of the biopsy round #2, I will post that.
Tough day, and not a lot of medical progress. Difficult day emotionally for us both. Certainly it was a day that we were glad to see end. Actually it ends two tough days. Yesterday we had two different families that had memorial services for their sweet boys; one lost their son during pregnancy, and another lost their son one day shy of his 9th birthday. A family member/friend of ours had lumpectomy today. Lots of opportunities for God's grace! The good news? His mercies are new EVERY morning, and tomorrow morning is never more than a few hours away.
Tony
Monday, October 02, 2006
News from Duke
Well, we had our first visit at Duke today, with Dr. Pappas. He did not really have any surprising news or thoughts, but we do have a clearer picture of the scenario.
First of all, he does not think the lymph node is going to be carcinoid. As he put it, "People either get respiratory carcinoid, or digestive carcinoid, but almost never both." However, that node is significantly larger than normal, so it has to be checked out. As he also said, "This cancer is rare enough that even though I see about as much of it as anyone, I average about one a year." That means you check everything out, no matter how remote the risk.
So, Tuesday we go back to Duke for a lymph node biopsy. This node is directly beside her airway in the left side of her chest, so they are going to do endoscopy with a biopsy probe attached to the scope. When they get to the level of the node, they will punch a hole through the airway wall and gather the biopsy of the node. The airway will self-seal, and that's it. It will take 2-3 days for the result.
If it is not carcinoid, then he wants to proceed with surgery in the next few weeks. If everyone is shocked, and it were to be carcinoid, then we start looking at traditional cancer issues, and chemo/radiation/surgery all come into play.
Bottom line, Pappas believes that these are gastrin-produced carcinoid tumors, and that ultimately the cure is removal of the gastrin. Why does she have so much gastrin? The cells in the stomach that allow someone to absorb B12 through the gut are the same ones that inhibit gastrin. In a patient with pernicious anemia, like Dee Dee, these cells don't work. So the gastrin is produced unchecked. Because the tumors are secondary to the gastrin, if you remove the gastrin the tumors shrivel and go away.
So, the surgery he proposes is to remove the lower third of her stomach, called the antrum. Remember, the tumors are in the upper stomach, so he is saying to simply leave them alone. Gotta tell you, it feels weird to intentionally leave the tumors inside! He also said that because this is so uncommon, there is no single definitive treatment option. He thinks there is a reasonable chance that the folks at Mayo may give different advice, just because there are so few cases of this that there are no real clinical studies for everyone to agree upon.
So please pray for several things:
* Dee Dee as she has this biopsy/endoscopy procedure today
* Healthy lymph node, and that we would learn this quickly
* Continue to pray for the trip to Mayo, and really that the docs there would be in agreement with the docs here
* For our courage and strength. There is something hard about meeting the cancer docs and surgeons that propose to remove part of your stomach. It isn't new revelation, because obviously Dee Dee has known that this was coming. It is just the hard reality of it all coming into plain view.
Thanks to you all, and we'll update later.
Tony
First of all, he does not think the lymph node is going to be carcinoid. As he put it, "People either get respiratory carcinoid, or digestive carcinoid, but almost never both." However, that node is significantly larger than normal, so it has to be checked out. As he also said, "This cancer is rare enough that even though I see about as much of it as anyone, I average about one a year." That means you check everything out, no matter how remote the risk.
So, Tuesday we go back to Duke for a lymph node biopsy. This node is directly beside her airway in the left side of her chest, so they are going to do endoscopy with a biopsy probe attached to the scope. When they get to the level of the node, they will punch a hole through the airway wall and gather the biopsy of the node. The airway will self-seal, and that's it. It will take 2-3 days for the result.
If it is not carcinoid, then he wants to proceed with surgery in the next few weeks. If everyone is shocked, and it were to be carcinoid, then we start looking at traditional cancer issues, and chemo/radiation/surgery all come into play.
Bottom line, Pappas believes that these are gastrin-produced carcinoid tumors, and that ultimately the cure is removal of the gastrin. Why does she have so much gastrin? The cells in the stomach that allow someone to absorb B12 through the gut are the same ones that inhibit gastrin. In a patient with pernicious anemia, like Dee Dee, these cells don't work. So the gastrin is produced unchecked. Because the tumors are secondary to the gastrin, if you remove the gastrin the tumors shrivel and go away.
So, the surgery he proposes is to remove the lower third of her stomach, called the antrum. Remember, the tumors are in the upper stomach, so he is saying to simply leave them alone. Gotta tell you, it feels weird to intentionally leave the tumors inside! He also said that because this is so uncommon, there is no single definitive treatment option. He thinks there is a reasonable chance that the folks at Mayo may give different advice, just because there are so few cases of this that there are no real clinical studies for everyone to agree upon.
So please pray for several things:
* Dee Dee as she has this biopsy/endoscopy procedure today
* Healthy lymph node, and that we would learn this quickly
* Continue to pray for the trip to Mayo, and really that the docs there would be in agreement with the docs here
* For our courage and strength. There is something hard about meeting the cancer docs and surgeons that propose to remove part of your stomach. It isn't new revelation, because obviously Dee Dee has known that this was coming. It is just the hard reality of it all coming into plain view.
Thanks to you all, and we'll update later.
Tony
Sunday, October 01, 2006
Piper, Powlison, on valuing cancer
Friends,
Here's a quick overview of the last 3 weeks in the Clark house. This is a lead-up to the article that I am going to post at the end of my entry. A bit over three weeks ago, Samara had to be rushed to the E.R. with severe allergic reaction to an unknown airborne allergen, with her airway closing off. She now carries an epi-pen and rescue breather everywhere she goes. Then we found out about the "lumps" in Dee Dee's stomach. Then someone stole my credit card #, and began using it (thankfully a vendor became suspicious and alerted me fairly quickly). Then the biopsies came back as cancer. Then, Thursday, I was told that I needed surgery on my shoulder for several bone spurs and rotator cuff problems. Mercy!
So here's the reason for the synopsis. They are all intentional parts of God's perfect plan for the blessing of His beloved children and the good of His kingdom. There is no accident here, there is no part that falls outside His divine will and decree. So, if that is the case, why? Why us, why now? We may never know all of the answers, but that's okay, we don't need to.
Many of you may have already read John Piper's classic letter that he wrote on the eve of his surgery for prostate cancer earlier this year. For those who don't know Piper, he is a pastor of a large Reformed Baptist church in Minnesota. He is also a wonderful author, and some of his books are Clark favorites. What I had not realized (thanks to Gail O. for pointing this one out to me!) was that shortly after he wrote this letter, a fellow in PA named Dave Powlison was also diagnosed with prostate cancer, and wrote a companion article to Piper's original. Powlison was at New Life church while we were there back in optometry school. This is the approach we should have toward not just the biggees like cancer, but to all the mundane trials and difficulties of life. His letter is entitled "Don't Waste Your Cancer," and you could substitute almost any other word for cancer. Don't waste your shoulder pain; don't waste having your credit card stolen; don't waste the many aspects of raising children, or of dealing with traffic, or anything at all!
Anyhow, Piper and Powlison say it all better than I do, so here ya go. Enjoy! Piper's words are in blue, Powlison's are in red.
Tony
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Don’t Waste Your Cancer
by John Piper
February 15, 2006
I write this on the eve of prostate surgery. I believe in God’s power to heal—by miracle and by medicine. I believe it is right and good to pray for both kinds of healing. Cancer is not wasted when it is healed by God. He gets the glory and that is why cancer exists. So not to pray for healing may waste your cancer. But healing is not God’s plan for everyone. And there are many other ways to waste your cancer. I am praying for myself and for you that we will not waste this pain.
David Powlison’s reflections on John Piper’s words were added on the morning after receiving news that I also have been diagnosed with prostate cancer (March 3, 2006). In each case, the main point and first paragraph is his; the second paragraph under each point is mine.
1. You will waste your cancer if you do not believe it is designed for you by God. It will not do to say that God only uses our cancer but does not design it. What God permits, he permits for a reason. And that reason is his design. If God foresees molecular developments becoming cancer, he can stop it or not. If he does not, he has a purpose. Since he is infinitely wise, it is right to call this purpose a design. Satan is real and causes many pleasures and pains. But he is not ultimate. So when he strikes Job with boils (Job 2:7), Job attributes it ultimately to God (2:10) and the inspired writer agrees: “They . . . comforted him for all the evil that the Lord had brought upon him” (Job 42:11). If you don’t believe your cancer is designed for you by God, you will waste it.
Recognizing his designing hand does not make you stoic or dishonest or artificially buoyant. Instead, the reality of God’s design elicits and channels your honest outcry to your one true Savior. God’s design invites honest speech, rather than silencing us into resignation. Consider the honesty of the Psalms, of King Hezekiah (Isaiah 38), of Habakkuk 3. These people are bluntly, believingly honest because they know that God is God and set their hopes in him. Psalm 28 teaches you passionate, direct prayer to God. He must hear you. He will hear you. He will continue to work in you and your situation. This outcry comes from your sense of need for help (28:1-2). Then name your particular troubles to God (28:3-5). You are free to personalize with your own particulars. Often in life’s ‘various trials’ (James 1:2), what you face does not exactly map on to the particulars that David or Jesus faced – but the dynamic of faith is the same. Having cast your cares on him who cares for you, then voice your joy (28:6-7): the God-given peace that is beyond understanding. Finally, because faith always works out into love, your personal need and joy will branch out into loving concern for others (28:8-9). Illness can sharpen your awareness of how thoroughly God has already and always been at work in every detail of your life.
2. You will waste your cancer if you believe it is a curse and not a gift. “There is therefore now no condemnation for those who are in Christ Jesus” (Romans 8:1). “Christ redeemed us from the curse of the law by becoming a curse for us” (Galatians 3:13). “There is no enchantment against Jacob, no divination against Israel” (Numbers 23:23). “The Lord God is a sun and shield; the Lord bestows favor and honor. No good thing does he withhold from those who walk uprightly” (Psalm 84:11).
The blessing comes in what God does for us, with us, through us. He brings his great and merciful redemption onto the stage of the curse. Your cancer, in itself, is one of those 10,000 ‘shadows of death’ (Psalm 23:4) that come upon each of us: all the threats, losses, pains, incompletion, disappointment, evils. But in his beloved children, our Father works a most kind good through our most grievous losses: sometimes healing and restoring the body (temporarily, until the resurrection of the dead to eternal life), always sustaining and teaching us that we might know and love him more simply. In the testing ground of evils, your faith becomes deep and real, and your love becomes purposeful and wise: James 1:2-5, 1 Peter 1:3-9, Romans 5:1-5, Romans 8:18-39.
3. You will waste your cancer if you seek comfort from your odds rather than from your God.
The design of God in your cancer is not to train you in the rationalistic, human calculation of odds. The world gets comfort from their odds. Not Christians. Some count their chariots (percentages of survival) and some count their horses (side effects of treatment), but we trust in the name of the Lord our God (Psalm 20:7). God’s design is clear from 2 Corinthians 1:9, “We felt that we had received the sentence of death. But that was to make us rely not on ourselves but on God who raises the dead.” The aim of God in your cancer (among a thousand other good things) is to knock props out from under our hearts so that we rely utterly on him.
God himself is your comfort. He gives himself. The hymn “Be Still My Soul” (by Katerina von Schlegel) reckons the odds the right way: we are 100% certain to suffer, and Christ is 100% certain to meet us, to come for us, comfort us, and restore love’s purest joys. The hymn “How Firm a Foundation” reckons the odds the same way: you are 100% certain to pass through grave distresses, and your Savior is 100% certain to “be with you, your troubles to bless, and sanctify to you your deepest distress.” With God, you aren’t playing percentages, but living within certainties.
4. You will waste your cancer if you refuse to think about death. We will all die, if Jesus postpones his return. Not to think about what it will be like to leave this life and meet God is folly. Ecclesiastes 7:2 says, “It is better to go to the house of mourning [a funeral] than to go to the house of feasting, for this is the end of all mankind, and the living will lay it to heart.” How can you lay it to heart if you won’t think about it? Psalm 90:12 says, “Teach us to number our days that we may get a heart of wisdom.” Numbering your days means thinking about how few there are and that they will end. How will you get a heart of wisdom if you refuse to think about this? What a waste, if we do not think about death.
Paul describes the Holy Spirit is the unseen, inner ‘downpayment’ on the certainty of life. By faith, the Lord gives a sweet taste of the face-to-face reality of eternal life in the presence of our God and Christ. We might also say that cancer is one ‘downpayment’ on inevitable death, giving one bad taste of the reality of of our mortality. Cancer is a signpost pointing to something far bigger: the last enemy that you must face. But Christ has defeated this last enemy: 1 Corinthians 15. Death is swallowed up in victory. Cancer is merely one of the enemy’s scouting parties, out on patrol. It has no final power if you are a child of the resurrection, so you can look it in the eye.
5. You will waste your cancer if you think that “beating” cancer means staying alive rather than cherishing Christ. Satan’s and God’s designs in your cancer are not the same. Satan designs to destroy your love for Christ. God designs to deepen your love for Christ. Cancer does not win if you die. It wins if you fail to cherish Christ. God’s design is to wean you off the breast of the world and feast you on the sufficiency of Christ. It is meant to help you say and feel, “I count everything as loss because of the surpassing worth of knowing Christ Jesus my Lord.” And to know that therefore, “To live is Christ, and to die is gain” (Philippians 3:8; 1:21).
Cherishing Christ expresses the two core activities of faith: dire need and utter joy. Many psalms cry out in a ‘minor key’: we cherish our Savior by needing him to save us from real troubles, real sins, real sufferings, real anguish. Many psalms sing out in a ‘major key’: we cherish our Savior by delighting in him, loving him, thanking him for all his benefits to us, rejoicing that his salvation is the weightiest thing in the world and that he gets last say. And many psalms start out in one key and end up in the other. Cherishing Christ is not monochromatic; you live the whole spectrum of human experience with him. To ‘beat’ cancer is to live knowing how your Father has compassion on his beloved child, because he knows your frame, that you are but dust. Jesus Christ is the way, the truth, and the life. To live is to know him, whom to know is to love.
6. You will waste your cancer if you spend too much time reading about cancer and not enough time reading about God. It is not wrong to know about cancer. Ignorance is not a virtue. But the lure to know more and more and the lack of zeal to know God more and more is symptomatic of unbelief. Cancer is meant to waken us to the reality of God. It is meant to put feeling and force behind the command, “Let us know; let us press on to know the Lord” (Hosea 6:3). It is meant to waken us to the truth of Daniel 11:32, “The people who know their God shall stand firm and take action.” It is meant to make unshakable, indestructible oak trees out of us: “His delight is in the law of the Lord, and on his law he meditates day and night. He is like a tree planted by streams of water that yields its fruit in its season, and its leaf does not wither. In all that he does, he prospers” (Psalm 1:2). What a waste of cancer if we read day and night about cancer and not about God.
What is so for your reading is also true for your conversations with others. Other people will often express their care and concern by inquiring about your health. That’s good, but the conversation easily gets stuck there. So tell them openly about your sickness, seeking their prayers and counsel, but then change the direction of the conversation by telling them what your God is doing to faithfully sustain you with 10,000 mercies. Robert Murray McCheyne wisely said, “For every one look at your sins, take ten looks at Christ.” He was countering our tendency to reverse that 10:1 ratio by brooding over our failings and forgetting the Lord of mercy. What McCheyne says about our sins we can also apply to our sufferings. For every one sentence you say to others about your cancer, say ten sentences about your God, and your hope, and what he is teaching you, and the small blessings of each day. For every hour you spend researching or discussing your cancer, spend 10 hours researching and discussing and serving your Lord. Relate all that you are learning about cancer back to him and his purposes, and you won’t become obsessed.
7. You will waste your cancer if you let it drive you into solitude instead of deepen your relationships with manifest affection. When Epaphroditus brought the gifts to Paul sent by the Philippian church he became ill and almost died. Paul tells the Philippians, “He has been longing for you all and has been distressed because you heard that he was ill” (Philippians 2:26-27). What an amazing response! It does not say they were distressed that he was ill, but that he was distressed because they heard he was ill. That is the kind of heart God is aiming to create with cancer: a deeply affectionate, caring heart for people. Don’t waste your cancer by retreating into yourself.
Our culture is terrified of facing death. It is obsessed with medicine. It idolizes youth, health and energy. It tries to hide any signs of weakness or imperfection. You will bring huge blessing to others by living openly, believingly and lovingly within your weaknesses. Paradoxically, moving out into relationships when you are hurting and weak will actually strengthen others. ‘One anothering’ is a two-way street of generous giving and grateful receiving. Your need gives others an opportunity to love. And since love is always God’s highest purpose in you, too, you will learn his finest and most joyous lessons as you find small ways to express concern for others even when you are most weak. A great, life-threatening weakness can prove amazingly freeing. Nothing is left for you to do except to be loved by God and others, and to love God and others.
8. You will waste your cancer if you grieve as those who have no hope. Paul used this phrase in relation to those whose loved ones had died: “We do not want you to be uninformed, brothers, about those who are asleep, that you may not grieve as others do who have no hope” (1 Thessalonians 4:13). There is a grief at death. Even for the believer who dies, there is temporary loss—loss of body, and loss of loved ones here, and loss of earthly ministry. But the grief is different—it is permeated with hope. “We would rather be away from the body and at home with the Lord” (2 Corinthians 5:8). Don’t waste your cancer grieving as those who don’t have this hope.
Show the world this different way of grieving. Paul said that he would have had “grief upon grief” if his friend Epaphroditus had died. He had been grieving, feeling the painful weight of his friend’s illness. He would have doubly grieved if his friend had died. But this loving, honest, God-oriented grief coexisted with “rejoice always” and “the peace of God that passes understanding” and “showing a genuine concern for your welfare.” How on earth can heartache coexist with love, joy, peace, and an indestructible sense of life purpose? In the inner logic of faith, this makes perfect sense. In fact, because you have hope, you may feel the sufferings of this life more keenly: grief upon grief. In contrast, the grieving that has no hope often chooses denial or escape or busyness because it can’t face reality without becoming distraught. In Christ, you know what’s at stake, and so you keenly feel the wrong of this fallen world. You don’t take pain and death for granted. You love what is good, and hate what is evil. After all, you follow in the image of “a man of sorrows, acquainted with grief.” But this Jesus chose his cross willingly “for the joy set before him.” He lived and died in hopes that all come true. His pain was not muted by denial or medication, nor was it tainted with despair, fear, or thrashing about for any straw of hope that might change his circumstances. Jesus’ final promises overflow with the gladness of solid hope amid sorrows: “My joy will be in you, and your joy will be made full. Your grief will be turned to joy. No one will take your joy away from you. Ask, and you will receive, so that your joy will be made full. These things I speak in the world, so that they may have my joy made full in themselves” (selection from John 15-17).
9. You will waste your cancer if you treat sin as casually as before. Are your besetting sins as attractive as they were before you had cancer? If so you are wasting your cancer. Cancer is designed to destroy the appetite for sin. Pride, greed, lust, hatred, unforgiveness, impatience, laziness, procrastination—all these are the adversaries that cancer is meant to attack. Don’t just think of battling against cancer. Also think of battling with cancer. All these things are worse enemies than cancer. Don’t waste the power of cancer to crush these foes. Let the presence of eternity make the sins of time look as futile as they really are. “What does it profit a man if he gains the whole world and loses or forfeits himself?” (Luke 9:25).
Suffering really is meant to wean you from sin and strengthen your faith. If you are God-less, then suffering magnifies sin. Will you become more bitter, despairing, addictive, fearful, frenzied, avoidant, sentimental, godless in how you go about life? Will you pretend it’s business as usual? Will you come to terms with death, on your terms? But if you are God’s, then suffering in Christ’s hands will change you, always slowly, sometimes quickly. You come to terms with life and death on his terms. He will gentle you, purify you, cleanse you of vanities. He will make you need him and love him. He rearranges your priorities, so first things come first more often. He will walk with you. Of course you’ll fail at times, perhaps seized by irritability or brooding, escapism or fears. But he will always pick you up when you stumble. Your inner enemy – a moral cancer 10,000 times more deadly than your physical cancer – will be dying as you continue seeking and finding your Savior: “For your name’s sake, O Lord, pardon my iniquity, for it is very great. Who is the man who fears the Lord? He will instruct him in the way he should choose” (Psalm 25).
10. You will waste your cancer if you fail to use it as a means of witness to the truth and glory of Christ. Christians are never anywhere by divine accident. There are reasons for why we wind up where we do. Consider what Jesus said about painful, unplanned circumstances: “They will lay their hands on you and persecute you, delivering you up to the synagogues and prisons, and you will be brought before kings and governors for my name’s sake. This will be your opportunity to bear witness” (Luke 21:12 -13). So it is with cancer. This will be an opportunity to bear witness. Christ is infinitely worthy. Here is a golden opportunity to show that he is worth more than life. Don’t waste it.
Jesus is your life. He is the man before whom every knee will bow. He has defeated death once for all. He will finish what he has begun. Let your light so shine as you live in him, by him, through him, for him. One of the church’s ancient hymns puts it this way: “Christ be with me, Christ within me, Christ behind me, Christ before me, Christ beside me, Christ to win me, Christ to comfort and restore me, Christ beneath me, Christ above me, Christ in quiet, Christ in danger, Christ in hearts of all that love me, Christ in mouth of friend and stranger” (from “I bind unto myself the name”). In your cancer, you will need your brothers and sisters to witness to the truth and glory of Christ, to walk with you, to live out their faith beside you, to love you. And you can do same with them and with all others, becoming the heart that loves with the love of Christ, the mouth filled with hope to both friends and strangers.
Remember you are not left alone. You will have the help you need. “My God will supply every need of yours according to his riches in glory in Christ Jesus” (Philippians 4:19).
Pastor John
www.desiringGod.org.
Here's a quick overview of the last 3 weeks in the Clark house. This is a lead-up to the article that I am going to post at the end of my entry. A bit over three weeks ago, Samara had to be rushed to the E.R. with severe allergic reaction to an unknown airborne allergen, with her airway closing off. She now carries an epi-pen and rescue breather everywhere she goes. Then we found out about the "lumps" in Dee Dee's stomach. Then someone stole my credit card #, and began using it (thankfully a vendor became suspicious and alerted me fairly quickly). Then the biopsies came back as cancer. Then, Thursday, I was told that I needed surgery on my shoulder for several bone spurs and rotator cuff problems. Mercy!
So here's the reason for the synopsis. They are all intentional parts of God's perfect plan for the blessing of His beloved children and the good of His kingdom. There is no accident here, there is no part that falls outside His divine will and decree. So, if that is the case, why? Why us, why now? We may never know all of the answers, but that's okay, we don't need to.
Many of you may have already read John Piper's classic letter that he wrote on the eve of his surgery for prostate cancer earlier this year. For those who don't know Piper, he is a pastor of a large Reformed Baptist church in Minnesota. He is also a wonderful author, and some of his books are Clark favorites. What I had not realized (thanks to Gail O. for pointing this one out to me!) was that shortly after he wrote this letter, a fellow in PA named Dave Powlison was also diagnosed with prostate cancer, and wrote a companion article to Piper's original. Powlison was at New Life church while we were there back in optometry school. This is the approach we should have toward not just the biggees like cancer, but to all the mundane trials and difficulties of life. His letter is entitled "Don't Waste Your Cancer," and you could substitute almost any other word for cancer. Don't waste your shoulder pain; don't waste having your credit card stolen; don't waste the many aspects of raising children, or of dealing with traffic, or anything at all!
Anyhow, Piper and Powlison say it all better than I do, so here ya go. Enjoy! Piper's words are in blue, Powlison's are in red.
Tony
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Don’t Waste Your Cancer
by John Piper
February 15, 2006
I write this on the eve of prostate surgery. I believe in God’s power to heal—by miracle and by medicine. I believe it is right and good to pray for both kinds of healing. Cancer is not wasted when it is healed by God. He gets the glory and that is why cancer exists. So not to pray for healing may waste your cancer. But healing is not God’s plan for everyone. And there are many other ways to waste your cancer. I am praying for myself and for you that we will not waste this pain.
David Powlison’s reflections on John Piper’s words were added on the morning after receiving news that I also have been diagnosed with prostate cancer (March 3, 2006). In each case, the main point and first paragraph is his; the second paragraph under each point is mine.
1. You will waste your cancer if you do not believe it is designed for you by God. It will not do to say that God only uses our cancer but does not design it. What God permits, he permits for a reason. And that reason is his design. If God foresees molecular developments becoming cancer, he can stop it or not. If he does not, he has a purpose. Since he is infinitely wise, it is right to call this purpose a design. Satan is real and causes many pleasures and pains. But he is not ultimate. So when he strikes Job with boils (Job 2:7), Job attributes it ultimately to God (2:10) and the inspired writer agrees: “They . . . comforted him for all the evil that the Lord had brought upon him” (Job 42:11). If you don’t believe your cancer is designed for you by God, you will waste it.
Recognizing his designing hand does not make you stoic or dishonest or artificially buoyant. Instead, the reality of God’s design elicits and channels your honest outcry to your one true Savior. God’s design invites honest speech, rather than silencing us into resignation. Consider the honesty of the Psalms, of King Hezekiah (Isaiah 38), of Habakkuk 3. These people are bluntly, believingly honest because they know that God is God and set their hopes in him. Psalm 28 teaches you passionate, direct prayer to God. He must hear you. He will hear you. He will continue to work in you and your situation. This outcry comes from your sense of need for help (28:1-2). Then name your particular troubles to God (28:3-5). You are free to personalize with your own particulars. Often in life’s ‘various trials’ (James 1:2), what you face does not exactly map on to the particulars that David or Jesus faced – but the dynamic of faith is the same. Having cast your cares on him who cares for you, then voice your joy (28:6-7): the God-given peace that is beyond understanding. Finally, because faith always works out into love, your personal need and joy will branch out into loving concern for others (28:8-9). Illness can sharpen your awareness of how thoroughly God has already and always been at work in every detail of your life.
2. You will waste your cancer if you believe it is a curse and not a gift. “There is therefore now no condemnation for those who are in Christ Jesus” (Romans 8:1). “Christ redeemed us from the curse of the law by becoming a curse for us” (Galatians 3:13). “There is no enchantment against Jacob, no divination against Israel” (Numbers 23:23). “The Lord God is a sun and shield; the Lord bestows favor and honor. No good thing does he withhold from those who walk uprightly” (Psalm 84:11).
The blessing comes in what God does for us, with us, through us. He brings his great and merciful redemption onto the stage of the curse. Your cancer, in itself, is one of those 10,000 ‘shadows of death’ (Psalm 23:4) that come upon each of us: all the threats, losses, pains, incompletion, disappointment, evils. But in his beloved children, our Father works a most kind good through our most grievous losses: sometimes healing and restoring the body (temporarily, until the resurrection of the dead to eternal life), always sustaining and teaching us that we might know and love him more simply. In the testing ground of evils, your faith becomes deep and real, and your love becomes purposeful and wise: James 1:2-5, 1 Peter 1:3-9, Romans 5:1-5, Romans 8:18-39.
3. You will waste your cancer if you seek comfort from your odds rather than from your God.
The design of God in your cancer is not to train you in the rationalistic, human calculation of odds. The world gets comfort from their odds. Not Christians. Some count their chariots (percentages of survival) and some count their horses (side effects of treatment), but we trust in the name of the Lord our God (Psalm 20:7). God’s design is clear from 2 Corinthians 1:9, “We felt that we had received the sentence of death. But that was to make us rely not on ourselves but on God who raises the dead.” The aim of God in your cancer (among a thousand other good things) is to knock props out from under our hearts so that we rely utterly on him.
God himself is your comfort. He gives himself. The hymn “Be Still My Soul” (by Katerina von Schlegel) reckons the odds the right way: we are 100% certain to suffer, and Christ is 100% certain to meet us, to come for us, comfort us, and restore love’s purest joys. The hymn “How Firm a Foundation” reckons the odds the same way: you are 100% certain to pass through grave distresses, and your Savior is 100% certain to “be with you, your troubles to bless, and sanctify to you your deepest distress.” With God, you aren’t playing percentages, but living within certainties.
4. You will waste your cancer if you refuse to think about death. We will all die, if Jesus postpones his return. Not to think about what it will be like to leave this life and meet God is folly. Ecclesiastes 7:2 says, “It is better to go to the house of mourning [a funeral] than to go to the house of feasting, for this is the end of all mankind, and the living will lay it to heart.” How can you lay it to heart if you won’t think about it? Psalm 90:12 says, “Teach us to number our days that we may get a heart of wisdom.” Numbering your days means thinking about how few there are and that they will end. How will you get a heart of wisdom if you refuse to think about this? What a waste, if we do not think about death.
Paul describes the Holy Spirit is the unseen, inner ‘downpayment’ on the certainty of life. By faith, the Lord gives a sweet taste of the face-to-face reality of eternal life in the presence of our God and Christ. We might also say that cancer is one ‘downpayment’ on inevitable death, giving one bad taste of the reality of of our mortality. Cancer is a signpost pointing to something far bigger: the last enemy that you must face. But Christ has defeated this last enemy: 1 Corinthians 15. Death is swallowed up in victory. Cancer is merely one of the enemy’s scouting parties, out on patrol. It has no final power if you are a child of the resurrection, so you can look it in the eye.
5. You will waste your cancer if you think that “beating” cancer means staying alive rather than cherishing Christ. Satan’s and God’s designs in your cancer are not the same. Satan designs to destroy your love for Christ. God designs to deepen your love for Christ. Cancer does not win if you die. It wins if you fail to cherish Christ. God’s design is to wean you off the breast of the world and feast you on the sufficiency of Christ. It is meant to help you say and feel, “I count everything as loss because of the surpassing worth of knowing Christ Jesus my Lord.” And to know that therefore, “To live is Christ, and to die is gain” (Philippians 3:8; 1:21).
Cherishing Christ expresses the two core activities of faith: dire need and utter joy. Many psalms cry out in a ‘minor key’: we cherish our Savior by needing him to save us from real troubles, real sins, real sufferings, real anguish. Many psalms sing out in a ‘major key’: we cherish our Savior by delighting in him, loving him, thanking him for all his benefits to us, rejoicing that his salvation is the weightiest thing in the world and that he gets last say. And many psalms start out in one key and end up in the other. Cherishing Christ is not monochromatic; you live the whole spectrum of human experience with him. To ‘beat’ cancer is to live knowing how your Father has compassion on his beloved child, because he knows your frame, that you are but dust. Jesus Christ is the way, the truth, and the life. To live is to know him, whom to know is to love.
6. You will waste your cancer if you spend too much time reading about cancer and not enough time reading about God. It is not wrong to know about cancer. Ignorance is not a virtue. But the lure to know more and more and the lack of zeal to know God more and more is symptomatic of unbelief. Cancer is meant to waken us to the reality of God. It is meant to put feeling and force behind the command, “Let us know; let us press on to know the Lord” (Hosea 6:3). It is meant to waken us to the truth of Daniel 11:32, “The people who know their God shall stand firm and take action.” It is meant to make unshakable, indestructible oak trees out of us: “His delight is in the law of the Lord, and on his law he meditates day and night. He is like a tree planted by streams of water that yields its fruit in its season, and its leaf does not wither. In all that he does, he prospers” (Psalm 1:2). What a waste of cancer if we read day and night about cancer and not about God.
What is so for your reading is also true for your conversations with others. Other people will often express their care and concern by inquiring about your health. That’s good, but the conversation easily gets stuck there. So tell them openly about your sickness, seeking their prayers and counsel, but then change the direction of the conversation by telling them what your God is doing to faithfully sustain you with 10,000 mercies. Robert Murray McCheyne wisely said, “For every one look at your sins, take ten looks at Christ.” He was countering our tendency to reverse that 10:1 ratio by brooding over our failings and forgetting the Lord of mercy. What McCheyne says about our sins we can also apply to our sufferings. For every one sentence you say to others about your cancer, say ten sentences about your God, and your hope, and what he is teaching you, and the small blessings of each day. For every hour you spend researching or discussing your cancer, spend 10 hours researching and discussing and serving your Lord. Relate all that you are learning about cancer back to him and his purposes, and you won’t become obsessed.
7. You will waste your cancer if you let it drive you into solitude instead of deepen your relationships with manifest affection. When Epaphroditus brought the gifts to Paul sent by the Philippian church he became ill and almost died. Paul tells the Philippians, “He has been longing for you all and has been distressed because you heard that he was ill” (Philippians 2:26-27). What an amazing response! It does not say they were distressed that he was ill, but that he was distressed because they heard he was ill. That is the kind of heart God is aiming to create with cancer: a deeply affectionate, caring heart for people. Don’t waste your cancer by retreating into yourself.
Our culture is terrified of facing death. It is obsessed with medicine. It idolizes youth, health and energy. It tries to hide any signs of weakness or imperfection. You will bring huge blessing to others by living openly, believingly and lovingly within your weaknesses. Paradoxically, moving out into relationships when you are hurting and weak will actually strengthen others. ‘One anothering’ is a two-way street of generous giving and grateful receiving. Your need gives others an opportunity to love. And since love is always God’s highest purpose in you, too, you will learn his finest and most joyous lessons as you find small ways to express concern for others even when you are most weak. A great, life-threatening weakness can prove amazingly freeing. Nothing is left for you to do except to be loved by God and others, and to love God and others.
8. You will waste your cancer if you grieve as those who have no hope. Paul used this phrase in relation to those whose loved ones had died: “We do not want you to be uninformed, brothers, about those who are asleep, that you may not grieve as others do who have no hope” (1 Thessalonians 4:13). There is a grief at death. Even for the believer who dies, there is temporary loss—loss of body, and loss of loved ones here, and loss of earthly ministry. But the grief is different—it is permeated with hope. “We would rather be away from the body and at home with the Lord” (2 Corinthians 5:8). Don’t waste your cancer grieving as those who don’t have this hope.
Show the world this different way of grieving. Paul said that he would have had “grief upon grief” if his friend Epaphroditus had died. He had been grieving, feeling the painful weight of his friend’s illness. He would have doubly grieved if his friend had died. But this loving, honest, God-oriented grief coexisted with “rejoice always” and “the peace of God that passes understanding” and “showing a genuine concern for your welfare.” How on earth can heartache coexist with love, joy, peace, and an indestructible sense of life purpose? In the inner logic of faith, this makes perfect sense. In fact, because you have hope, you may feel the sufferings of this life more keenly: grief upon grief. In contrast, the grieving that has no hope often chooses denial or escape or busyness because it can’t face reality without becoming distraught. In Christ, you know what’s at stake, and so you keenly feel the wrong of this fallen world. You don’t take pain and death for granted. You love what is good, and hate what is evil. After all, you follow in the image of “a man of sorrows, acquainted with grief.” But this Jesus chose his cross willingly “for the joy set before him.” He lived and died in hopes that all come true. His pain was not muted by denial or medication, nor was it tainted with despair, fear, or thrashing about for any straw of hope that might change his circumstances. Jesus’ final promises overflow with the gladness of solid hope amid sorrows: “My joy will be in you, and your joy will be made full. Your grief will be turned to joy. No one will take your joy away from you. Ask, and you will receive, so that your joy will be made full. These things I speak in the world, so that they may have my joy made full in themselves” (selection from John 15-17).
9. You will waste your cancer if you treat sin as casually as before. Are your besetting sins as attractive as they were before you had cancer? If so you are wasting your cancer. Cancer is designed to destroy the appetite for sin. Pride, greed, lust, hatred, unforgiveness, impatience, laziness, procrastination—all these are the adversaries that cancer is meant to attack. Don’t just think of battling against cancer. Also think of battling with cancer. All these things are worse enemies than cancer. Don’t waste the power of cancer to crush these foes. Let the presence of eternity make the sins of time look as futile as they really are. “What does it profit a man if he gains the whole world and loses or forfeits himself?” (Luke 9:25).
Suffering really is meant to wean you from sin and strengthen your faith. If you are God-less, then suffering magnifies sin. Will you become more bitter, despairing, addictive, fearful, frenzied, avoidant, sentimental, godless in how you go about life? Will you pretend it’s business as usual? Will you come to terms with death, on your terms? But if you are God’s, then suffering in Christ’s hands will change you, always slowly, sometimes quickly. You come to terms with life and death on his terms. He will gentle you, purify you, cleanse you of vanities. He will make you need him and love him. He rearranges your priorities, so first things come first more often. He will walk with you. Of course you’ll fail at times, perhaps seized by irritability or brooding, escapism or fears. But he will always pick you up when you stumble. Your inner enemy – a moral cancer 10,000 times more deadly than your physical cancer – will be dying as you continue seeking and finding your Savior: “For your name’s sake, O Lord, pardon my iniquity, for it is very great. Who is the man who fears the Lord? He will instruct him in the way he should choose” (Psalm 25).
10. You will waste your cancer if you fail to use it as a means of witness to the truth and glory of Christ. Christians are never anywhere by divine accident. There are reasons for why we wind up where we do. Consider what Jesus said about painful, unplanned circumstances: “They will lay their hands on you and persecute you, delivering you up to the synagogues and prisons, and you will be brought before kings and governors for my name’s sake. This will be your opportunity to bear witness” (Luke 21:12 -13). So it is with cancer. This will be an opportunity to bear witness. Christ is infinitely worthy. Here is a golden opportunity to show that he is worth more than life. Don’t waste it.
Jesus is your life. He is the man before whom every knee will bow. He has defeated death once for all. He will finish what he has begun. Let your light so shine as you live in him, by him, through him, for him. One of the church’s ancient hymns puts it this way: “Christ be with me, Christ within me, Christ behind me, Christ before me, Christ beside me, Christ to win me, Christ to comfort and restore me, Christ beneath me, Christ above me, Christ in quiet, Christ in danger, Christ in hearts of all that love me, Christ in mouth of friend and stranger” (from “I bind unto myself the name”). In your cancer, you will need your brothers and sisters to witness to the truth and glory of Christ, to walk with you, to live out their faith beside you, to love you. And you can do same with them and with all others, becoming the heart that loves with the love of Christ, the mouth filled with hope to both friends and strangers.
Remember you are not left alone. You will have the help you need. “My God will supply every need of yours according to his riches in glory in Christ Jesus” (Philippians 4:19).
Pastor John
www.desiringGod.org.
Where we are tonight
Hello all, and I'm sorry I haven't updated in the last few days. Part of that was that our internet was down for two days, and part was that not much was really happening. So, thank you for your prayers and cards and emails despite the lack of new information. Many of the cards and emails have been amazingly encouraging and uplifting, affirming my wife's heart. Thank you!
Our first official appointment at Duke is tomorrow at 11:30, with the surgeon (Dr. Pappas). I am assuming that he will review the test results that we have so far, order the remaining ones, and that will be about it. I don't know how much opportunity we will have to discuss the overall plan, timing, etc. I doubt we meet the oncologist in charge, Dr. Morse. We are eager to finish "defining the beast," so to speak. Will there be chemo or radiation? We don't think so, but it will be good to know for certain. When are they looking at surgery? When should we make travel plans to Minnesota for the Mayo Clinic? Those are the questions that keep circulating for both of us.
The other thing that folks have asked about is how we are doing, emotionally and relationally. It has been interesting to see the progression from the time of first diagnosis to now. It seems as if the initial shock is gone, the subsequent adrenaline rush has also gone, and our tanks are a bit on empty. We are just a little less patient with each other and the kids, a little harsher in our words, a little less on our knees than we were several days ago. At least this is true for me; I suspect that Dee Dee is not quite as impatient and that kind of thing as am I. The problem, or more accurately seen, the opportunity for God's glory here, is that all of regular life keeps going on. Homeschooling still needs to take place. Eyeballs still need to be seen. Parenting issues still come up and need to be dealt with. Our friends and families have difficulties of their own, that we hurt for. All this goes on, and yet there is this underlying current of the THING that is this tension-producing stresser. It just builds, and sometimes it bursts through. My friend Dave called it the dead rat laying on the table that no one mentions. It's always there, but dinner still must be served.
So the focus for us right now, as we are faced with the absurdity of continuing life as usual when nothing about it is really usual at all right now, is that God is glorified and exalted when He accomplishes through frail vessels His mighty works. When we parent with grace, during a time when we don't feel graceful, He is honored. If we care for others, when we don't feel any reserve ability to do so, He is praised. As two ordinarily sinfully strong, sinfully self-sufficient people accept some weakness and humility, He is glorified. For all this, we are thankful and praise Him.
One of the things that I began for Dee Dee today is to print out all the emails, and we are going to put them, with the cards and notes and everything else, into a keepsake book of some type. This will become a treasured part of our remembrance of this time, as in the years to come we can look back and re-read the love that is being poured out from all of you to us. We wish we had done this when Gabe was ill; there is value in chronicling God's goodness, and these expressions of His love, shown through you, are evidence of His grace to us.
So, as I wrap up a fairly scattered entry tonight, some specific prayer requests:
* Pray for a refilling of our physical, emotional, and at least my spiritual tanks.
* Pray for continued grace on our kids.
* Pray for our appointment tomorrow at 11:30, that we would have opportunity to talk at length with Dr. Pappas, that we would have the final tests scheduled ASAP, and that we would leave with a fairly complete understanding of the overall plan.
* Pray that we can go ahead and coordinate the Mayo trip, and that our talks with them would be excellent. Continue to pray that the medical advice from the Mayo docs matches that of the Duke docs.
We know that we are not the only ones with scary things, hurtful things right now. We have dear friends who lost their baby this weekend at about 22 weeks pregnant; another with health tests being done of her own. There's lots of stuff for us all to be praying over. As you send us your notes, please know that we are taking each one of them as an opportunity and a reminder to thank God for you and to pray for you as well. You are a blessing to us!
Tony
Our first official appointment at Duke is tomorrow at 11:30, with the surgeon (Dr. Pappas). I am assuming that he will review the test results that we have so far, order the remaining ones, and that will be about it. I don't know how much opportunity we will have to discuss the overall plan, timing, etc. I doubt we meet the oncologist in charge, Dr. Morse. We are eager to finish "defining the beast," so to speak. Will there be chemo or radiation? We don't think so, but it will be good to know for certain. When are they looking at surgery? When should we make travel plans to Minnesota for the Mayo Clinic? Those are the questions that keep circulating for both of us.
The other thing that folks have asked about is how we are doing, emotionally and relationally. It has been interesting to see the progression from the time of first diagnosis to now. It seems as if the initial shock is gone, the subsequent adrenaline rush has also gone, and our tanks are a bit on empty. We are just a little less patient with each other and the kids, a little harsher in our words, a little less on our knees than we were several days ago. At least this is true for me; I suspect that Dee Dee is not quite as impatient and that kind of thing as am I. The problem, or more accurately seen, the opportunity for God's glory here, is that all of regular life keeps going on. Homeschooling still needs to take place. Eyeballs still need to be seen. Parenting issues still come up and need to be dealt with. Our friends and families have difficulties of their own, that we hurt for. All this goes on, and yet there is this underlying current of the THING that is this tension-producing stresser. It just builds, and sometimes it bursts through. My friend Dave called it the dead rat laying on the table that no one mentions. It's always there, but dinner still must be served.
So the focus for us right now, as we are faced with the absurdity of continuing life as usual when nothing about it is really usual at all right now, is that God is glorified and exalted when He accomplishes through frail vessels His mighty works. When we parent with grace, during a time when we don't feel graceful, He is honored. If we care for others, when we don't feel any reserve ability to do so, He is praised. As two ordinarily sinfully strong, sinfully self-sufficient people accept some weakness and humility, He is glorified. For all this, we are thankful and praise Him.
One of the things that I began for Dee Dee today is to print out all the emails, and we are going to put them, with the cards and notes and everything else, into a keepsake book of some type. This will become a treasured part of our remembrance of this time, as in the years to come we can look back and re-read the love that is being poured out from all of you to us. We wish we had done this when Gabe was ill; there is value in chronicling God's goodness, and these expressions of His love, shown through you, are evidence of His grace to us.
So, as I wrap up a fairly scattered entry tonight, some specific prayer requests:
* Pray for a refilling of our physical, emotional, and at least my spiritual tanks.
* Pray for continued grace on our kids.
* Pray for our appointment tomorrow at 11:30, that we would have opportunity to talk at length with Dr. Pappas, that we would have the final tests scheduled ASAP, and that we would leave with a fairly complete understanding of the overall plan.
* Pray that we can go ahead and coordinate the Mayo trip, and that our talks with them would be excellent. Continue to pray that the medical advice from the Mayo docs matches that of the Duke docs.
We know that we are not the only ones with scary things, hurtful things right now. We have dear friends who lost their baby this weekend at about 22 weeks pregnant; another with health tests being done of her own. There's lots of stuff for us all to be praying over. As you send us your notes, please know that we are taking each one of them as an opportunity and a reminder to thank God for you and to pray for you as well. You are a blessing to us!
Tony
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