Timeline

A timeline is a linear projection of directionality that includes the accomplishment of a number of short term goals that move a participant or organization toward the achievement of a larger long term goal [my definition]. We have been working on developing a timeline for my cancer treatment.

After meeting with doctors at the U of M Cancer Center last week and with our own physician today, we’re projecting a timeline for treatment. This is, of course, subject to change. God may intervene at any time. Medical tests and discoveries vary. And, only God knows what is really going on in my body.

Here’s the tentative timeline.

April 20 - 22	Chemo treatment	Holland
May 4 - 6	Chemo treatment	Holland
May 18 - 20	Chemo treatment	Holland
Late May	MRI	Holland
June 4	Surgery consultation for removing spot on liver	Ann Arbor
Late June	Liver Surgery	Ann Arbor
Late July - November	Resume chemo: 8 treatments over a 4 month period	Holland

We know that there will be additional dates for consultations and treatments, but they should all fit within the above timeline.

While I’m thinking about planning and goals, here are a few of my favorite quotes.

It's not hard to decide what you want your life to be about. What's hard . . . is figuring out what you're willing to give up in order to do the things you really care about.

Shauna Niequist

If you don't know where you are going, you'll end up someplace else.

Yogi Berra

What would you attempt to do if you knew you could not fail?

Robert H. Schuller

Cat: Where are you going?

Alice: Which way should I go?

Cat: That depends on where you are going.

Alice: I don’t know.

Cat: Then it doesn’t matter which way you go.

Lewis Carroll

Everybody has their own Mount Everest they were put on this earth to climb.

Seth Godin

Begin with the end in mind.

Stephen Covey

Cancer Center Visit

We would never have anticipated that our first trip to Ann Arhor, Michigan would be for appointments at the University of Michigan Cancer Center. But, that was our journey yesterday, Thursday, April 17. Marlene’s sister and her husband, Jerry and Diane Antoon, provided wonderful support by joining us.

Our consultations were with Surgical Oncologist, Dr. Hari Nathan, and Medical Oncologist, Dr. Christine Veenstra. We were richly encouraged by these gifted physicians, their staffs, and the entire culture of the Cancer Center.

Their recommendations are consistent with those of our current Oncologist, Dr. Eric Batts. However they are suggesting a few modifications that make sense to us. As a result of the appointments, Marlene and I have a better understanding of the current situation and the proposed future direction. The doctors spoke positively about the probability of being “cancer free” as a result of a planned liver surgery and continued chemotherapy.

Many thanks for your continued prayer during coming chemotherapy treatments and for future liver surgery. On Monday I receive my second round of chemo. At that time, we will also meet with Dr. Batts to make decisions about the recommendations from Drs. Nathan and Veenstra.

Marlene and I live on a little lake and have a small sandy beach. Yesterday the landscapers added fresh sand to the beach. This morning I went outside in bare feet and made footprints in the sand while reflecting on the following story.

Footprints in the Sand

One night I dreamed I was walking along the beach with the Lord.

Many scenes from my life flashed across the sky.

In each scene I noticed footprints in the sand.

Sometimes there were two sets of footprints, other times there were one set of footprints.

This bothered me because I noticed that during the low periods of my life, when I was suffering from anguish, sorrow or defeat, I could see only one set of footprints.

So I said to the Lord, "You promised me Lord,

that if I followed you, you would walk with me always.

But I have noticed that during the most trying periods of my life there have only been one set of footprints in the sand.

Why, when I needed you most, you have not been there for me?"

The Lord replied, "The times when you have seen only one set of footprints, is when I carried you."

Mary Stevenson

Second Opinion

Upon receiving the news that the spot on my liver is cancerous, I talked with the Dr. Batts about getting a second opinion.  He agreed and recommended University of Michigan Cancer Center, Ann Arbor. (You've heard the old second opinion crack. Patient to Doctor upon getting news of his/her illness, "I'd like a second opinion." Doctor to patient, "OK, you're not only sick, you're also ugly.")

Monday afternoon we received a flurry of calls from Ann Arbor. W are scheduled for two appointments for this coming Thursday: one with a chemo doctor and one with a liver surgeon. We are thankful to get the ball rolling before the next chemo treatment, which is scheduled for this coming Monday.

I am apprehensive about the next chemo treatment. The side effects from the first have been significant: fatigue, mouth sores, sensitivity to hot foods and drinks, decreased appetite, a bit of nausea, both constipation and diarrhea. We may need to modify the mix or dosage.

As I reflect on the coming days and making connection with new individuals in the medical community, the prayer of St. Francis comes to mind.

Lord, make me an instrument of thy peace.
Where there is hatred, let me sow love;
Where there is injury, pardon;
Where there is doubt, faith;
Where there is despair, hope;
Where there is darkness, light;
Where there is sadness, joy.
O divine Master, grant that I may not so much seek
To be consoled as to console,
To be understood as to understand,
To be loved as to love;
For it is in giving that we receive;
It is in pardoning that we are pardoned;
It is in dying to self that we are born to eternal life.

Further Developments

Over the Easter weekend, we were waiting for results from the liver biopsy that I had on Good Friday. Dr. Batts called with the news this noon that the small spot that had showed up on the CT scan and the MRI is cancerous. 

This moves us into a new area of discussion, testing, and treatment. The situation now includes the following.

Yesterday, Monday, I was hooked up to a chemotherapy pump. After a four-hour infusion in the cancer center, I went home with a continual infusion of the chemotherapy for the next 46 hours. The infusion pump will be removed tomorrow, Wednesday. It's a portable thing that can be fit in a sport jacket pocket. It just means that I'm dressed better than most when I'm out and about. We are currently planning on this for the next three months--or possibly six months.

At the three month point, liver surgery will likely be recommended to remove the spot. At that time. we will also be able to see how the spot has responded to the chemo, or if there are other spots in other places.

Because the liver has become involved, we will be working with our local oncologist in getting a second opinion. This will be as soon as possible through the University of Michigan, Ann Arbor, where we will seek recommendations on treatment options.

As we look at the developments of these past months, we are surprised at how rapidly the situation has escalated. From a routine colonoscopy at the end of January, to colon surgery on March 3, to multiple tests (CT scan, MRI, ultrasound, fine needle biopsy), to the first chemotherapy treatment this week, and now toward possible liver surgery. 

We remain grateful for the fine medical and spiritual support we are receiving. In going through this journey, we find help in Scripture, prayer, music, and the support of family and friends. The following quote about attitude has been on my mind today.

“The longer I live, the more I realize the impact of attitude on life. Attitude, to me, is more important than facts. It is more important than the past, the education, the money, than circumstances, than failure, than successes, than what other people think or say or do. It is more important than appearance, giftedness or skill. It will make or break a company... a church... a home. The remarkable thing is we have a choice everyday regarding the attitude we will embrace for that day. We cannot change our past... we cannot change the fact that people will act in a certain way. We cannot change the inevitable. The only thing we can do is play on the one string we have, and that is our attitude. I am convinced that life is 10% what happens to me and 90% of how I react to it. And so it is with you... we are in charge of our Attitudes.” 
Charles R. Swindoll


  

A Quick Update

A quick update:

Monday's MRI did show the "spot" that the CT scan had originally revealed; however, it was impossible from the MRI to indicate whether that spot is merely a benign cyst or cancerous. The next step is a fine needle liver biopsy, which is today, Friday, at 11:30 AM.

We're assuming that it will be Monday or Tuesday before we find out the results. Meanwhile, you thoughts and prayers are appreciated.

Bible passages on which I have been reflecting lately are:

Consider it pure joy, my brothers and sisters, whenever you face trials of many kinds,  because you know that the testing of your faith produces perseverance. (James 1:2-3)

Rejoice in the Lord always. I will say it again: Rejoice! (Philippians 4:4)