Final Zapping

Today was my 20th and final radiation treatment.

Thank you to everyone who has sent cards and gifts to the boys and me -- they love getting mail and  appreciated the encouragement. Thank you to my MIL who sent a "sunshine box" with different gifts for us to open on different days to give them something to look forward to. Thank you to those who have sent texts and messages letting me know you're praying for me. 

Thank you to my friend Georgia who made dinners for us when I was fatiguing and who stayed with the boys when they were off school and to Elizabeth who took the boys for a night of fun at Defy one evening. 

Thank you to Melody and Rick who kept the boys during the eLearning day when I had both a radiation treatment and oncology appointment. 

Thank you to my parents who came up for a week in the middle of October from warm, sunny Florida to stay with the boys during fall break. 

Thank you to my Aunt Karen who dealt with breast cancer herself and who texted me faithfully every day to let me know she was praying for me. 

Thank you to my friend Dan who also sent a note of encouragement each day. 

Today, Kieran wanted to know if they killed all the cancer cells. That's the idea, of course, but in order to further reduce the risk of occurrence, I'll be taking a hormone suppressant pill (Tamoxifen for the curious) for the next 5 to 10 years. I also have a cocktail of supplements that I'll be popping along with the pill (message me if you'd like to know what's on my counter).

As I read through the literature on the options available to minimize the risk of occurrence or the statistics on who gets breast cancer because of which cause, it strikes me how much of this is out my hands--how much seems to be so arbitrary and almost capricious. And I wonder if that's part of the curse God placed on sin--death, ultimately, is the reminder that we aren't in control of our destiny. I drink apple cider vinegar every day, I use natural, organic body and hair products, I try to buy organic when I can, I was off sugar for several years, I've taken immune-boosting supplements . . . and yet . . . and yet here I sit with a divot in my skin from where a cancerous lump was removed and a rash from where the radiation attempted to eradicate any remaining cancer. 

As much as we might like to think we can control what happens to our bodies, ultimately we can't. Yet as I peer through the seeming capriciousness, I choose to recognize the sovereignty of God in all of it--the cancer, the disability, the sickness, the people who cross my path. And I know it's not for nothing--that he's working all of this for my good and for his glory. And I'm driven to remember my dependence on my Creator for even my next breath. So as I lay on the table in the radiation room early in the morning, I chose to give thanks for the gift of another day of life. Another breath. Another new mercy. 

Someone recently posted a quote from Elizabeth Elliot that went along these lines but I can't remember where I saw it. I found these quotes, though, which point me toward that conclusion (from Suffering Is Never for Nothing).

“Just start thanking God in advance because no matter what is about to happen, you already know that God is in charge. You are not adrift in a sea of chaos.”

“You either believe God knows what He's doing or you believe He doesn't. You either believe He's worth trusting or you say He's not. And then, where are you? You're at the mercy of chaos not cosmos. Chaos is the Greek word for disorder. Cosmos is the word for order. We either live in an ordered universe or we are trying to create our own reality.” 

 Even as we work to minimize the risk of the cancer returning or spreading, I rest in God's sovereignty over my life and in the mercies he gives abundantly. He is good, all the time. 

The Wounds of a Friend or the Kisses of a Enemy

I've started and stopped this post several times over the past two weeks. It was a heavy time for me. 

On September 9, I met with the oncologist to go over the next phase of treatment. The mammography center is in the same building as the cancer center at our hospital. The last time I was there was for those initial pictures. At that time, I parked farther away and walked past the "Reserved for Oncology patients" signs, wondering what it was like for those who needed to use those reserved spaces. 

A few weeks later, and I had found out.  

My next treatment phase was based on the oncotype score of the tumor. After the surgeon removed the tumor, she sent it to a lab for analysis. The lab analyzes the genes of the tumor itself and spits out a number that predicts the risk the cancer will reoccur if it's not treated with chemo in addition to hormone therapy. (For those who like to read, this site had more information on the oncotype tests.) On a scale of 1 to 100, my tumor returned a score of 25. Tumors with scores less than 20 didn't typically benefit from chemotherapy and weren't likely to reoccur. Tumors with 26 and higher scores definitely needed to be treated with chemotherapy as they are more aggressive and likely to come back. In addition, there was a small subset of pre-menopausal women under 50 with tumor scores between 20 and 25 who seemed to benefit more from chemotherapy to minimize the risk of recoccurence. So, my tumor sat right there on the border. 

The oncologist went through the risk analysis with me and seemed to settle on the need for chemotherapy as my next step in order to make sure the cancer didn't come back. That wasn't what I wanted to hear. He brought in a social worker who offered a variety of supports for women with breast cancer. And, after telling me to think about it over the weekend, he set up an appointment to begin chemotherapy two weeks later. It would be one infusion every three weeks, beginning on September 23. 

So, I went home and talked it over with Seth, researched the studies done on the oncotypes, researched chemotherapy, and began freaking out over losing my hair and all the other side effects of chemo. 

If I told you what was happening during that time, I likely said something like, "It seems like I'll need chemotherapy" because I just couldn't bring myself to actually surrender to needing it. How would I be able to mother my kids if I was sick in bed all the time? Who would help them with homework? Get them to sports? How would they react to seeing my hair fall out? ("Most women go ahead and shave their heads before they begin just to get it over with," the oncologist said.) How would I be able to deal with my job and all my other responsibilities? As much as I hated the thought of chemo, I tried to start getting my ducks in a row so that I didn't drop too many balls as I went through it. 

Of course many women, including my aunt who was diagnosed with triple-negative breast cancer, have been through chemo and survived. In fact, my aunt called me during that time to share her journey with me and pray with me. 

I just didn't know how I was going to survive it. I prayed and cried and and looked for a second opinion and tried to rehearse the promises that God's grace is sufficient for every situation and that his power is made perfect in my weakness. And then I also tried to think of other options . . . like having my ovaries taken out. (The tumor had estrogen-positive receptors, which meant it fed on estrogen produced by my body; take the ovaries out and no estrogen was my thinking.) Drastic, I know. Which is what Seth said when I brought it up him. And also the oncologist when I brought it up to him. And also my doctor when I brought it up her. And also my sister-in-law when I brought it up to her. 

In a conversation about my anxiety with my sister-in-law, she also let me know this, "My prayer is that you know the assurance of God's good hand and can always approach Him with confidence and gratitude. That you are always mindful that the One who made the world with His words is still speaking into your life. That you remember He has already worked the greater miracle of bringing you from death to life in your salvation and to know that as hard as it gets, God's work in and through you is not done yet! Our pastor mentioned the other day, "Could it possibly be that God knows what He is doing?" And we know He does, but I pray that you would absolutely be able to trust Him for direction, wisdom, peace and comfort in the midst of a hard road." There's something about praying specifically and also letting that person know how specifically you are praying, isn't there? 

And then she said, after listening to my laments about the toxins that would be dumped into my body, "And just maybe the "poisons" are the wounds of a friend, not the kisses of the enemy?" 

Those words helped shift the way I was thinking about chemo. So, I messaged the nurse and asked about setting up a time to have the port put in that would be used for the infusions (instead of digging in my veins each time). When I did, I mentioned that I was still struggling with the decision. 

Later that day, the doctor called and said he had "run the numbers" again and had discussed my case with other breast cancer specialists at the hospital and based on what they saw, they were comfortable with not doing chemotherapy and proceeding with radiation and, later, hormonal treatments. 

Praise God. 

So, instead of beginning chemotherapy today, I met with the oncologist to talk about treatment options for after I finish radiation. I begin that on Monday morning and will continue every weekday for four weeks. 

There were some bright spots in the middle of the turmoil. My friend Diane sent me this pillow she had made, after talking with another friend of hers who had been through breast cancer and had been blessed with someone making one for her. It has pockets for ice packs and wraps around like a hug. Thank you, friend.  

Melody and Jenny, two friends from church, put together a care package to carry me through both chemo (should I have needed it) and radiation. They found a shirt that would allow easy access to the port for chemo . . . 

A wearable blanket . . . 

Coloring and devotional books for when I'm waiting for treatments or want to journal about the cancer journey . . . lotions to help with radiation . . . fuzzy socks to help with temperature regulation during treatments . . . 

Encouraging blankets . . .

Candles and bath salts . . . 

And so many other blessings such as snacks and head scarves. Things to make a hard journey that much easier and better. Thank you, friends. 

 At church a few Sundays ago, I taught the kids the account where the Israelites are fighting a battle and they win when Moses raises his hands. They lose when his hands fall. It was a long battle and Moses' arms grew tired, so Aaron and Hur stood beside him and held up his arms. Thank you to all of you who have been holding up my hands through prayer and also through other tangible gifts like these. 

God is good. All the time. 

An update. God is still good.

First, a very large and heart-felt thank you to everyone who has sent a card, brought a meal, offered to help with the boys, and called, texted, or messaged to find out how I'm doing. I'm so very grateful for praying, caring friends and family. 

Second, I know it's been awhile since I've updated so I'm doing that now. When last I left off, we were waiting for the pathology report, which finally arrived. The surgery was successful and the tumor was completely removed (the margins were clear) and the seven lymph nodes they took out were negative for cancer, which is a mercy. The scars are healing well and I'm recovering some feeling in my arm. I'll need to see a physical therapist to help get back the full range of motion, however. 

Today, the oncotype report on the tumor came back. The oncotype (genetic makeup of the tumor itself) helps to predict the chance of metastasis. Although my personal genetic makeup came back negative for all 84 cancer-associated genes (thanks, mom and dad!), this tumor apparently had a mind of its own. It registered a 26, which is on the very upper end of "intermediate"--not really the place we wanted to be. Because the tumor was positive for estrogen receptors, after radiation, I will likely need to take estrogen-blocking pills for several years in order to help prevent a recurrence. This oncotype indicates that chemotherapy may be helpful in making sure the cells haven't/won't metastasize elsewhere. So, I will meet with a medical oncologist to determine the next steps. I was hoping to avoid chemotherapy so we will see what the doctor suggests. 

Currently, I'm scheduled to meet with the radiologist on September 17 and then will have radiation treatments every weekday for four weeks. That could change depending on what the oncologist says. 

Third, since I know most of you haven't recently taken a tour of the new St. Elizabeth center, I thought I'd share some of the items that are given to those going through the cancer journey. They have a boutique in the cancer center that caters to women dealing with breast cancer. There are quite a few Christian ministries that help in various ways, including Chicks and Chucks. 

One of the first items they gave me was a small pillow to fit around my seat belt on the way home from surgery.  

There was also a Hope Scarf. 

When I showed it to Cael, he asked why they were providing these things. I told him they helped to encourage women who have cancer. And he asked, "But who will encourage me?" 

We've given them the information we think they should know and can handle at this point without hiding from them what is happening. Kieran is upset that I will have a laser pointed at me. He doesn't want me to be zapped (I may have used that word). He will likely also tell you, "My mom had surgery to get the cancer out" and he wonders if all the cancer really is out. Cael asks some deeper questions. We continue to talk with them, pray with them, and let them know that God is still good and he is still sovereign. 

And fourth, this verse has popped up several times since I was diagnosed. I've been meditating on it as the days wear on. 

"It is good for me that I was afflicted, that I might learn your statutes." (Psalm 119:71)

I don't enjoy pain and don't feel the need to "push myself" to "find out my limits." Unlike, say, Seth, who jumps at the chance to do a Tough Mudder whenever one is near and works out in between them to stay in shape for the next one, pushing himself to lift heavier weights and do more reps and bike more miles. Not me. My biggest "push" in the past few years has been running a 5K. Which I didn't enjoy, for the record. I like my comfortable life with my comfortable people. 

Apparently, however, God has other plans for my comfort and other things for me to learn. And I think of this from a favorite woman of faith, "God permits what he hates to accomplish what he loves." 

As you pray for me and my family, please do pray that the Great Physician would grant healing (he is, after all, Jehovah Rapha--the Lord who heals). But pray, too, that we learn and grow through this and discover more of him as we walk yet another path that doesn't have a known destination. 

God is good. All the time. And whatever he does is good. 

Cancer Sucks. God is good.

Before Kieran was born, I wrote a book called, Why Is Keiko Sick?. A few weeks ago, someone asked me what my motivation was for writing the book. It does seem an odd concept for a children's book. And yet, I wrote it because I wanted to provide a way for parents to have conversations, based on biblical truth, with their kids about why bad things happen. Too often we focus on the "wonderful world" we live in -- skies of blue, clouds of white, trees of green, red roses, too -- and forget about the thorns in the roses, the poison ivy growing up the trees, the hawk that swoops down from the skies to grab a chicken, the hurricanes that bring violent clouds. If we don't continually talk with our kids about the ultimate reason behind the bad things that happen and point them to the solution, we risk building a faith in our kids that falls apart at the first sign of trouble. 

It may sound macabre, but we've talked about the reason we don't live in a very good world with the boys from the time they were young. We want them to know that God is good and that abundant life was his original intent for his creation. The junk we experience is a result of the just punishment God gave Adam after he sinned in the garden. Death is an ugly enemy that has intruded itself into that once perfectly beautiful creation. And it has brought so much with it -- sickness, addiction, disease, genetic conditions, relational problems, and the list goes on. In fact,  Kieran has taken to saying, "Thanks a lot, Adam," whenever we deal with sicknesses or chicken deaths or the like. 

And yet, we can't just blame Adam for the ugliness--each of us has chosen the path of death away from God when we choose to follow our own way, instead of his. I'm just as complicit in the groaning of this world, weighed down as it is from the curse, as Adam is. I hate what my sin has done--I hate death, I hate sickness, I hate cancer. But sometimes I wonder what I hate more--the sin itself or its consequences . . . . 

We've tried to be honest with the boys in all the "little" effects of the curse--chickens dying, dealing with pink eye or strep throat--so that they have a foundation for understanding when larger effects of the curse infiltrate theirs lives . . . like when their mom is diagnosed with breast cancer. 

Even typing those words seems surreal. Cancer is out there--it's circulating among my extended family and other friends--but you never expect it to land in your lap . . . or breast, as the case may be. 

In early July, I felt a lump. I called and scheduled a mammogram, which was followed by an ultrasound. After looking at the films, the radiologist came into the exam room, sat down, looked at me carefully, and said, "I'm concerned. This looks like cancer." 

When Kieran was diagnosed with Williams syndrome, it felt like we had been punched in the gut. That same feeling came back at the word cancer. A slow exhale of breath . . . a mad rushing of thoughts as you process what's being said . . . a quick, unintended, peek into the future -- am I still there where I thought I would be even next year? And the tears . . . . The fear of the unknown, of what might be, of being thrown onto yet another path that we hadn't anticipated. 

The ultrasound was followed by a core biopsy of the lump and then a phone call, "You have invasive ductal carcinoma, grade 2. You're scheduled to meet with the surgeon." An MRI happened and then last Tuesday the surgeon said, "We'll do a lumpectomy and radiation. I'm available this Friday for the surgery, how about you?" 

So, this past Friday I went under the knife. When I'm healed, I'll be visiting the radiologist for daily sessions for four weeks. Depending on the results of the pathology report of the tumor and the genetics testing, I may need chemo, although that's not on the horizon right now. From what the surgeon has said, we found it early, it's a common type of cancer that they know a lot about, and they are encouraging that we can move on from this. 

Cancer sucks. I don't have to ask the "why me?" questions because I know why -- it's part of the world we live in, part of the world we told God we wanted when we turned our backs on his good plans for us. Although this particular cancer isn't the result of a specific sin, it's still the result of the punishment for sin that we're all living under. 

God is still good. If he weren't, I wouldn't be able to hate death and cancer and call it an enemy (1 Corinthians 15:26). At VBS this past summer, we taught the kids a few of the attributes of God and this was one of the sayings I wanted to impress on them, "God is good, all the time. All the time, God is good." Because it's true. 

And God is also sovereign. This diagnosis whacks us upside the head--it's unwelcome and unexpected. And yet, it's not a surprise to God. He's in control and in his omnipresence, he is here with us--he has gone before us and he is present with us as we experience it. The dark thoughts crowd closer especially at night and I've had to repeatedly take those thoughts captive and focus on what we know is true, rather than wandering down the paths of "what ifs?" We fight to rest in his goodness and sovereignty and to live with his peace rather than drown in anxiety.

We rest, too, on the salvation that Jesus has purchased for us, securing our eternal destiny with him. We know that our sin separates us from God and we are thankful that Jesus has paid that death penalty on our behalf, dying on the cross--the perfect sinless Son of God suffering the ugliness of death, the very curse he placed on his creation--and rising from the dead, showing that he accomplished what he set out to do. We've received the gift of eternal life that he offers through repentance and faith in him and, although we hate death, we look beyond it to eternal life with God. 

We've seen God's mercy in the prognosis--this seems to be a treatable cancer--and in the discovery at an early stage. We're thankful for his grace in giving us good doctors and family and friends who pray for us and offer help. 

Cancer sucks. But it has an end. "He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things have passed away" (Revelation 21:4). God is good.