Usually in a good story, the author doesn't give the ending until, well, the end. (Except in Pulp Fiction, or Reservoir Dogs, but that reference is probably just for a few, like Randy! I actually thought about naming each of the people we met with today Mr. White, Mr. Pink etc....) Well tonight, I'm giving the ending first. Today was a very good day! It was long, but there was nothing terribly painful or miserable about it, and the outcomes were better even than we had hoped.
We started at 10:30 a.m., and finished at 6:00 p.m. We actually spent 5 hours sitting in one exam room! We joked that for us lately, that might qualify as a date. (I then observed that the exam room door had a lock, but Dee Dee didn't think that was terribly funny.) Every 60-90 minutes someone else would come in and ask a bunch of questions, marvel that this young, fit woman had any serious health issues, and assure us that everything was going to be fine. We met with three docs before the end of the day. Dr. Garst was great; she just sat up on the exam table while we sat in the chairs, and talked. She was friendly, warm, and encouraging. She also said pretty quickly that she was the least important "doctor-piece" to the puzzle, because her specialty is lung cancer. She saw herself more as the facilitator/coordinator.
Dr. Garst then went and personally found a doc we had no appointment with whatsoever, but this was the doc that Garst felt would be the best one at Duke to help decide about the stomach, after the node has been dealt with. This was Dr. Johanna Bendell, a medical oncologist specializing in digestive cancer. She just stopped by to meet us, and couldn't really get into the medicine yet, but was also very engaging. Then (well, 60 minutes later) Dr. D'Amico's personal physician's assistant came in. He stayed for at least 45 minutes, and was fantastic. He connected with both of us, and you just felt a trust with him right away. Further in the conversation, he talked about his faith, and asked about ours! Every doc eventually picks up on the fact that we are in a medical profession; every Christian picks up on the fact that we are believers.
Here's where it starts to get medically great. Dr. D'Amico has invented a surgical technique that he is extremely confidant will allow him to get the entire node out with a much less invasive procedure. He will use a video-microscope and two small incisions (1-2 inches each) to get to the tumor. They will deflate her left lung for the surgery, re-inflating afterward. They will leave a drainage tube in her chest until it stops draining any fluid, about a day or so. She will be in the hospital for 1-3 days instead of 4-5 days with thoracotomy (the one we actually thought was the best option) or 2 weeks with the most serious approach. She will be on prescription pain meds for about a week, as opposed to a month the other way. He has done about 2500 of these surgeries, and feels almost certain this will work. Praise God! Finally, he is going to do this surgery at Duke on Monday, 10/30, which is much sooner than we had thought Duke's wheels would spin.
We still have some hurdles to clear. This whole thing is too big to finish all at once. That's the old metaphor, you can't eat an elephant at once, you have to eat a bite at a time. Today was a really good day for progress, for encouragement, and for basic good news. We still have to find out what the node actually is. We have to decide what to do about the stomach. Also, that was a second lesion lower in the chest, and we have to investigate that at some point. Today, they were not terribly worried about this smaller spot. We'll get to all those things, but for tonight we will sleep a bit better, and enjoy the good from today.
Thanks for praying today. "The prayers of a righteous man availeth much." We are grateful that the are hundreds of righteous men and women praying much, availing much, on our behalf. We are aware of people in Peru and Sweden, South Africa, Slovakia, and Germany, and all over the good ol' USA praying for us. Our prayer is that God would richly bless you as you walk this path with us. Thank you! Thank God!
Tony
Thursday, October 26, 2006
Wednesday, October 25, 2006
For His Own Glory
I'm sorry that it has been a few days since the last post. Nothing has happened medically, and normal life has been pretty busy. However, with the time lapse, there's a lot on my mind, so this could spin into a long one (sorry Kim)!
Let's go medical first. If you remember, Dee Dee suffered a seizure in January this year. She awakened me at 4:30 in the morning with the seizure, and we spent the next two weeks getting her head scanned and tested in every imagineable way. Bottom line: no cause found, "pretend like it didn't happen." Well, I got to thinking that maybe this lymph node, because it presses against her phrenic nerve (the one that operates her left diaphragm, the muscle that makes your lungs work correctly), could it have initiated the seizure? I talked to her neurologist today, and he said that the lymph is almost certainly the cause of the seizure. However, my logic was off a bit; he thinks that because it is on the heart, it started an arrythmia that triggered the seizure. Either way, it is more evidence that the thing must be removed! Now, more than ever, we are opposed to the biopsy approach.
More medicine: we start tomorrow at 10:30 at Duke for (yet more) bloodwork. Then we meet with Dr. Jennifer Garst, the pulmonary oncologist. Here is where there is a huge praise! We have a friend at church who works at Duke Med. She knows Garst personally, and affirmed to us that she is a terrific doc, and a very nice person. Unfortunately, she is not a surgeon. She is a cancer doc, and maybe a biopsy doc. We were quite bummed, because that basically would have meant at least another week of waiting. Well, our friend told Garst our story, including Mayo's recommendation to skip the biopsy and just go straight to surgery. Garst responded with a recommendation on her favorite thoracic surgeon at Duke, and took it upon herself to get him to meet with us tomorrow as well. His name is Dr. Thomas D'Amico, and we meet with him whenever we finish with her. It may not seem like a huge deal, but I gotta tell you, for the Clarks right now there's not much that could have been better news. Our heartfelt thanks to Julia P. for helping us here! More, though, is our sincere thankfulness to God for orchestrating the daily events of our lives to accomplish his good purposes.
Last medical update for the day (hopefully many more tomorrow): I'd like to explain the surgery that was proposed at Mayo. If you take your left hand and make a fist, with the thumb pointing up, hold it in front of the middle of your chest. The fist is the heart, and the thumb is the aorta. Her node sits on top of the fist, leaned against the thumb. In front of the node is the phrenic nerve, that controls the diaphragm. To the right of the node (I think I'm correct here) is the nerve that controls her voice box. The danger of trying to biopsy is that one of those nerves could be accidentally damaged. So, the head thoracic surgeon at Mayo proposed to do a sugical procedure in which he makes a ~5 inch incision in her left side, probably breaks 2 ribs to gain access, and goes to the tumor that way. If he can adequately visualize the tumor/heart/aorta/nerves, he would remove the tumor in this fashion. This also would be dependant upon the tumor being "encapsulated" as opposed to a tumor that is "growing roots." If he cannot see well enough, or if it is rooted into the heart and aorta (like ivy growing on a wall), then he would change and make an ~8 inch incision in the center of her chest, saw through her sternum, and split open the ribcage to almost do open-heart surgery. The first surgery would hurt really badly for ~ 3 days, with hospitalization for 4-5 days. If he has to change gears, we are dramatically increasing the length of recovery.
Obviously we are praying for the least-invasive, lowest-risk surgery that will succeed. We pray that that docs at Duke agree with this approach, and that for a change the two sets of medical experts agree on the correct treatment. We pray that the lesser surgery will succeed. We already pray that her surgery would be without complication, that her life would be protected, her heart and aorta safe, and her nerves undamaged. We pray for a fast recovery, and that the pain would be less severe than they anticipate. We pray that we can do it at Duke, but if things just aren't "right" at Duke, we have decided that we would return to Mayo for the surgery. We pray that we leave Duke tomorrow with firm answers and dates.
Now on to non-medical. People have been graciously, wonderfully supportive in prayer, words, notes, and deeds since this started. We are blown away by the goodness and love of the body of Christ! One of the things that folks keep asking is, "I know how her health is, but how are you both doing otherwise?" I can honestly say that we are doing better than anything that makes good sense. I have yet to detect any anger or despair in either of us. There is no lack of faith; we are perfectly content to be in the center of His will and plan for our lives, and for our kids' lives. We are encouraged daily by His word, your prayers, and our love for one another. We are actually excited by the opportunity to parent our children through this time, because we know that it can be a time where God does amazing things in and for them, too. I told Caleb and Samara the other night that while Dee Dee and I don't want to "Waste her cancer" as Piper put it, our kids shouldn't waste their mom's cancer, either. This will be the seminal time in their adolescence that they will remember their parents actually living out their faith. For them, it may be the most visible time in which our faith was not just theoretical, but real. How great is it to be able to recognize that opportunity, not just have it lazily drift by? The heat of this moment forces us to recognize it, and for that we are thankful.
Don't get me wrong! There is certainly fear (of the surgery, of the pain, of the outcome, of all sorts of things); this is scary stuff. There are many sleepless nights; I haven't slept more than about 4 hours in a night since we found out she had cancer 6 weeks ago. There are more stress-related headaches than we usually have in a year. We wrestle with patience with our kids more, and I wrestle with patience with work issues more than usual. It is just that these things exist inside an over-arching awareness of the sovereignty of almighty God.
So why are we doing well? Why aren't we falling apart at the seams? How are we getting out of bed each day, instead of simply lying there holding each other? This is a living definition of faith. As Dee Dee told our small group Sunday night, faith is choosing to live as if the God of the Bible is real and His word is actually true, even when our emotions don't feel like it. When we do this, our hearts will follow our heads. What do our heads know to be true here? It is just this. God planned from before time that Dee Dee would have cancer in 2006 A.D. This has always been in His design for us, it is under His control, and it is not surprising Him nor stretching His ability to govern it. And because our Lord is also our Father, He loves us too much to let us get to this place unprepared! He not only planned the cancer, but He planned every event, every encounter, every relationship and conversation, even our childhood enjoyment of science which led to medical training, so that when we got here we would not drown. Not only will we get through it, we will triumph, because this is the God we serve.
Why is this so? FOR HIS OWN GLORY. Not for our own praise, but for His. Several have mentioned how amazed they are at our attitudes, or how proud they are of our strength. This is kind, and I thank you. I know the intent of the words, which is to encourage; it does! But remember, I will not boast in anything, save Christ at work in me. Trust me, Tony Clark is not man enough nor Christian warrior enough to handle Dee Dee having cancer and be anything but a babbling idiot. BUT, through Christ we are victorious; through Him we don't just get by, we excel. In Him we live, and move, and have our being. Not for our own glory, but for His.
This cancer was ordained by our Father for our good and His glory. And that is true, no matter the medical outcome from this whole thing. We pray that He will allow this cup to pass, that her health will be restored quickly, and that we soon we are looking back on this time as a closed chapter. But no matter what cup He has for us, we will drink deeply. To do otherwise would be to deny that He is good, to deny that His promises to perfectly love and to always do the best thing for His children are false, to call Him a liar. Our God is true, and trustworthy, and gracious to His chosen people. Never let us doubt the goodness of God!
Finally, I just wanted to mention one of the ways that God has sustained us. Exactly ten years ago our infant son was lying in a hospital bed, desperately ill. The medical team told us that he had about 24 hours before he would slip into a coma, and another 24-36 hours before he would die. He was the third patient in medical literature to have his specific diagnosis, and the first to recover. Today, our faith is strengthened every time we look at 10-year-old Gabe. He is healthy, and sweet, and kind, and bright. He is insightful, loves deeply, trusts God, and thinks the world of his siblings. He is funny, plays drums, is easily distracted, and hates clowns and pigs. In short, Gabe is your classic boy. Every time we look at him, we are confronted with living, breathing proof that our God is able to do whatever he chooses, whenever He chooses, however He chooses. How could I doubt this same God now? If I look at Dee Dee and begin to lose faith, all I have to do is look at Gabe and my heart rejoices.
So, thank you God for being miraculous. Thank you friends and family for being earnest and faithful in your prayers and support. We look forward to seeing the miracles that He works in this time, and to rejoicing with you as He does. I will update everyone tomorrow after we find out more.
Tony
Let's go medical first. If you remember, Dee Dee suffered a seizure in January this year. She awakened me at 4:30 in the morning with the seizure, and we spent the next two weeks getting her head scanned and tested in every imagineable way. Bottom line: no cause found, "pretend like it didn't happen." Well, I got to thinking that maybe this lymph node, because it presses against her phrenic nerve (the one that operates her left diaphragm, the muscle that makes your lungs work correctly), could it have initiated the seizure? I talked to her neurologist today, and he said that the lymph is almost certainly the cause of the seizure. However, my logic was off a bit; he thinks that because it is on the heart, it started an arrythmia that triggered the seizure. Either way, it is more evidence that the thing must be removed! Now, more than ever, we are opposed to the biopsy approach.
More medicine: we start tomorrow at 10:30 at Duke for (yet more) bloodwork. Then we meet with Dr. Jennifer Garst, the pulmonary oncologist. Here is where there is a huge praise! We have a friend at church who works at Duke Med. She knows Garst personally, and affirmed to us that she is a terrific doc, and a very nice person. Unfortunately, she is not a surgeon. She is a cancer doc, and maybe a biopsy doc. We were quite bummed, because that basically would have meant at least another week of waiting. Well, our friend told Garst our story, including Mayo's recommendation to skip the biopsy and just go straight to surgery. Garst responded with a recommendation on her favorite thoracic surgeon at Duke, and took it upon herself to get him to meet with us tomorrow as well. His name is Dr. Thomas D'Amico, and we meet with him whenever we finish with her. It may not seem like a huge deal, but I gotta tell you, for the Clarks right now there's not much that could have been better news. Our heartfelt thanks to Julia P. for helping us here! More, though, is our sincere thankfulness to God for orchestrating the daily events of our lives to accomplish his good purposes.
Last medical update for the day (hopefully many more tomorrow): I'd like to explain the surgery that was proposed at Mayo. If you take your left hand and make a fist, with the thumb pointing up, hold it in front of the middle of your chest. The fist is the heart, and the thumb is the aorta. Her node sits on top of the fist, leaned against the thumb. In front of the node is the phrenic nerve, that controls the diaphragm. To the right of the node (I think I'm correct here) is the nerve that controls her voice box. The danger of trying to biopsy is that one of those nerves could be accidentally damaged. So, the head thoracic surgeon at Mayo proposed to do a sugical procedure in which he makes a ~5 inch incision in her left side, probably breaks 2 ribs to gain access, and goes to the tumor that way. If he can adequately visualize the tumor/heart/aorta/nerves, he would remove the tumor in this fashion. This also would be dependant upon the tumor being "encapsulated" as opposed to a tumor that is "growing roots." If he cannot see well enough, or if it is rooted into the heart and aorta (like ivy growing on a wall), then he would change and make an ~8 inch incision in the center of her chest, saw through her sternum, and split open the ribcage to almost do open-heart surgery. The first surgery would hurt really badly for ~ 3 days, with hospitalization for 4-5 days. If he has to change gears, we are dramatically increasing the length of recovery.
Obviously we are praying for the least-invasive, lowest-risk surgery that will succeed. We pray that that docs at Duke agree with this approach, and that for a change the two sets of medical experts agree on the correct treatment. We pray that the lesser surgery will succeed. We already pray that her surgery would be without complication, that her life would be protected, her heart and aorta safe, and her nerves undamaged. We pray for a fast recovery, and that the pain would be less severe than they anticipate. We pray that we can do it at Duke, but if things just aren't "right" at Duke, we have decided that we would return to Mayo for the surgery. We pray that we leave Duke tomorrow with firm answers and dates.
Now on to non-medical. People have been graciously, wonderfully supportive in prayer, words, notes, and deeds since this started. We are blown away by the goodness and love of the body of Christ! One of the things that folks keep asking is, "I know how her health is, but how are you both doing otherwise?" I can honestly say that we are doing better than anything that makes good sense. I have yet to detect any anger or despair in either of us. There is no lack of faith; we are perfectly content to be in the center of His will and plan for our lives, and for our kids' lives. We are encouraged daily by His word, your prayers, and our love for one another. We are actually excited by the opportunity to parent our children through this time, because we know that it can be a time where God does amazing things in and for them, too. I told Caleb and Samara the other night that while Dee Dee and I don't want to "Waste her cancer" as Piper put it, our kids shouldn't waste their mom's cancer, either. This will be the seminal time in their adolescence that they will remember their parents actually living out their faith. For them, it may be the most visible time in which our faith was not just theoretical, but real. How great is it to be able to recognize that opportunity, not just have it lazily drift by? The heat of this moment forces us to recognize it, and for that we are thankful.
Don't get me wrong! There is certainly fear (of the surgery, of the pain, of the outcome, of all sorts of things); this is scary stuff. There are many sleepless nights; I haven't slept more than about 4 hours in a night since we found out she had cancer 6 weeks ago. There are more stress-related headaches than we usually have in a year. We wrestle with patience with our kids more, and I wrestle with patience with work issues more than usual. It is just that these things exist inside an over-arching awareness of the sovereignty of almighty God.
So why are we doing well? Why aren't we falling apart at the seams? How are we getting out of bed each day, instead of simply lying there holding each other? This is a living definition of faith. As Dee Dee told our small group Sunday night, faith is choosing to live as if the God of the Bible is real and His word is actually true, even when our emotions don't feel like it. When we do this, our hearts will follow our heads. What do our heads know to be true here? It is just this. God planned from before time that Dee Dee would have cancer in 2006 A.D. This has always been in His design for us, it is under His control, and it is not surprising Him nor stretching His ability to govern it. And because our Lord is also our Father, He loves us too much to let us get to this place unprepared! He not only planned the cancer, but He planned every event, every encounter, every relationship and conversation, even our childhood enjoyment of science which led to medical training, so that when we got here we would not drown. Not only will we get through it, we will triumph, because this is the God we serve.
Why is this so? FOR HIS OWN GLORY. Not for our own praise, but for His. Several have mentioned how amazed they are at our attitudes, or how proud they are of our strength. This is kind, and I thank you. I know the intent of the words, which is to encourage; it does! But remember, I will not boast in anything, save Christ at work in me. Trust me, Tony Clark is not man enough nor Christian warrior enough to handle Dee Dee having cancer and be anything but a babbling idiot. BUT, through Christ we are victorious; through Him we don't just get by, we excel. In Him we live, and move, and have our being. Not for our own glory, but for His.
This cancer was ordained by our Father for our good and His glory. And that is true, no matter the medical outcome from this whole thing. We pray that He will allow this cup to pass, that her health will be restored quickly, and that we soon we are looking back on this time as a closed chapter. But no matter what cup He has for us, we will drink deeply. To do otherwise would be to deny that He is good, to deny that His promises to perfectly love and to always do the best thing for His children are false, to call Him a liar. Our God is true, and trustworthy, and gracious to His chosen people. Never let us doubt the goodness of God!
Finally, I just wanted to mention one of the ways that God has sustained us. Exactly ten years ago our infant son was lying in a hospital bed, desperately ill. The medical team told us that he had about 24 hours before he would slip into a coma, and another 24-36 hours before he would die. He was the third patient in medical literature to have his specific diagnosis, and the first to recover. Today, our faith is strengthened every time we look at 10-year-old Gabe. He is healthy, and sweet, and kind, and bright. He is insightful, loves deeply, trusts God, and thinks the world of his siblings. He is funny, plays drums, is easily distracted, and hates clowns and pigs. In short, Gabe is your classic boy. Every time we look at him, we are confronted with living, breathing proof that our God is able to do whatever he chooses, whenever He chooses, however He chooses. How could I doubt this same God now? If I look at Dee Dee and begin to lose faith, all I have to do is look at Gabe and my heart rejoices.
So, thank you God for being miraculous. Thank you friends and family for being earnest and faithful in your prayers and support. We look forward to seeing the miracles that He works in this time, and to rejoicing with you as He does. I will update everyone tomorrow after we find out more.
Tony
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