Monthly Archives: June 2018

by | June 19, 2018 · 11:24 am

Disappointed, joyous and free

I don’t have problems. I have opportunities, and some of my opportunities are insurmountable – heard at a meeting.

It is a character trait of mine that my emotions run ahead of my reason. And the surest outcome of that tendency is to permit circumstances to toss me around. Let a storm cloud appear on the distant horizon, and I am already wet. Let a sliver of sunlight emerge, and the world is a perfect place. I strive to be temperate, I may even boast of it at times, but calm, rational acceptance of circumstances is hardly guaranteed.

Today received news that things actually are just as grim as we first thought. I had embraced the unexpectedly sunny prognosis, and have now made myself worse off than before in some ways. In addition to the fear I already faced, I now carry the additional burden of self-inflicted disappointment (not to mention some embarrassment over having celebrated a bit soon).

When I first had a confirmed cancer diagnosis, I resolved to glory in my infirmity. And God certainly seemed to be providing the grace to stare down this obstacle. But as is often the case, the price of grace can be dear. Thus the question becomes “is grace always sufficient for the trial?” Is the true measure of grace always to be found in the depth of the struggle? My theological self says “yes” emphatically, and my scared inner self says “shut up.”  They are not in conflict.

I will continue to proclaim that God is my fortress and my shield. As in the past, I will affirm that Jesus conquered death and that the grave no longer holds the victory. And I will do this with quivering lips because I am weak, as are we all. It is not bravado I wish to show to the world. Rather, it is the inexplicable peace that overcomes it. Don’t think for a moment that I am not frightened. To face something this dire and not be frightened is either insanity or stupidity. But beneath the fear is a joy that no one can take from me. And that joy is rooted in absolute truths: that I am loved and supported by the best people in the word, that the most spectacular woman in the world is my wife, and that God, in His boundless love, will never leave me desolate.

So be by my side as we navigate these “opportunities.” It’s going to be a hell of a ride.

 

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by | June 7, 2018 · 7:02 pm

What would Thomas say?

Today I went for an MRI at Karmanos Cancer Center and a biopsy at Harper Hospital. Up to this point, we have had nothing but morbid outcomes given to us by all the doctors we have seen. Today, however, Dr. Lin at Wayne State found the tumor to be superficial and easily resected with a reasonable hope for a cure, possibly without radiation, and a return to the status quo.

Were all these doctors (including him) wrong in their initial assessments? Were they just being conservative in their prognoses? Or did something, in fact, happen to that tumor?

Phenomena like this are not uncommon in God’s plan. He reveals Himself in degrees, and often in such a way as to make faith an essential aspect of the experience. Most everyone is familiar with the phrase “doubting Thomas,”  but few non-Christians understand the spiritual significance of the story.

Thomas was not present when the risen Lord appeared to the Apostles, and when told of it, he chose to be skeptical, not an unreasonable attitude given the incredible claim made by the others. Jesus again appeared to them and this time Thomas was present. When the Lord invited Thomas to place his fingers in the nail holes and his hand in His side, Thomas did so and proclaimed “My Lord and my God.”

Jesus’ response is telling.

Have you come to believe because you have seen me? Blessed are those who have not seen and have believed.

What do we make of this? Is blind faith better than faith based in observed phenomena, “signs and wonders?” I don’t think so. God honors our faith however it comes to us. But often it comes to us in the context of what we already believe. Faith in the redemptive work of Christ requires first a faith in the plan of God, a faith that is itself a grace that can only come from God. Paul spoke of this in 1 Corinthians 1:21-23

For since in the wisdom of God the world did not come to know God through wisdom, it was the will of God through the foolishness of the proclamation to save those who have faith. For Jews demand signs and Greeks look for wisdom, but we proclaim Christ crucified, a stumbling block to Jews and foolishness to Gentiles…

The Pharisees demanded signs from Jesus. He was proclaiming himself Messiah, either an utter blasphemy or the very fulfillment of the ultimate aspirations of the Jewish faith. He did not fit into their concept of how Messiah would appear so they sought to ensnare him by demanding something that only a true Messiah could produce. Jesus’ response was harsh and to the point:

Then some of the scribes and Pharisees said to him, “Teacher, we wish to see a sign from you.” He said to them in reply, “An evil and unfaithful generation seeks a sign, but no sign will be given it except the sign of Jonah the prophet.

Jesus would soon, in fact, show them the sign of Jonah, but even that would not satisfy them. He had been going throughout Galilee performing unmistakable miracles, and those who had eyes to see, saw them. The case can be made that, if God were to appear in His unveiled Glory, we would have no choice but to worship Him. But that was not the plan. We were given free will because only a free creature can love, and to fully reveal Himself would ironically make it impossible to love Him. So He reveals Himself to those who choose to see Him revealed in part.

What, then, is the point of all this? Simply put, what happened to me happened ambiguously, so that those with faith would see and those without faith might choose to see without compulsion. Even I won’t say that this was a verifiable miraculous healing. The evidence is imperfect, the outcome questionable. But I accept it as such by faith, as some of you might. And it may even be that this little “miracle” may make one of you less of a Thomas.

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by | June 6, 2018 · 7:22 pm

Making it easier

To all my friends that had trouble commenting:

I had the blog set to require moderation of comments, but since I am so lazy it meant that your comments weren’t posting until I got around to it. I activated a plug-in that should prevent spam so if it works, there won;t be any restrictions. If I have problems with spam, I may have to tighten things up a little, but I’ll let you know before I do.

 

And thanks for all the response to my last post. More will follow. I have a biopsy tomorrow which will give us a better idea of what we’re dealing with. Pray for Charlotte. She’s having a tough time.

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by | June 5, 2018 · 8:18 pm

I need some input

Normally when I post to this blog, I do so in the role of one offering ideas, explanations, insights and sometimes humor. I don’t get many comments so I don’t think of this as going the other way. But I am at a point where your responses can mean a great deal.

I am nearing the point where decisions will have to be made regarding my choice of treatment, decisions that have major consequences for how I live the rest of my life. In its simplest form, it reduces to this: do I want to take the least invasive approach which will allow me to continue living as I am now, but with the likelihood of a shorter life span, or do I want to take a course that will probably result in a cure but may deprive me of speech?

If you know me at all, and many of you certainly do, talking has always been what I do. I’m a teacher by nature and my greatest joys in life have been those few but precious times when what I say has made a difference in someone else’s life. It’s hard to imagine me still being me if I couldn’t do that. So what would be the point of living longer if that was the condition? What kind of life would it be to not be able to tell people that I love them? How could I deprive my wife of the words “I love you?”

But of course, I would have to be alive to do that. So choosing to keep my speech but possibly die sooner has a similar effect. Do I go for quality or quantity? How does that affect those who love me? Do they get a choice in this?

I have just about worn out the “?” key on my keyboard. So many questions and no real answers. I’m really grappling with a big one here. I’m going for a biopsy on Thursday that will define the parameters of this decision more clearly and, while I want to think that I will know what to do, I fear I won’t.

Prayer is central to this. I believe there is a “God way” through everything and in all honesty I’m really at peace knowing that I’ll get both the guidance and the Grace to live in a way most pleasing and useful to Him. That for me really illuminates the decision. Which choice makes me a more useful tool in His hands? I don’t believe that death is a tragedy. I do believe that a life without purpose is.

Before all else, I am a Christian. Jesus said that there is no greater love than when one lays down one’s life for a friend. But what does it mean to lay down your life? It certainly means dying in one sense. But it could also mean laying aside the life I now have for another one, one that I do not choose, but one that nonetheless fulfills my vocation. Do I lay down my life by shortening it or by sacrificing an aspect of it? Again, more questions than answers.

This has been an unusual post. I always take time to craft my work, write it, set it aside, return to it, refine it, produce the very best I can with the talent I have been given. But this has been more of a stream of thought, musing out loud and not really attending to the craft, because the craft may very well be in my willingness to expose my fear, my confusion; to be something I rarely am, unpolished.

I am not asking for answers, though I will certainly accept them. As for pity, I can produce enough of that for both of us if I give in to that impulse, so none is needed. I’m not saying that I don’t need anything. I just don’t know what I need. All I know is that whatever I need, it will come from you whom I love. I would appreciate comments just to know you have read this. Maybe you are as baffled as I am. That would be good to know. Maybe you have some insight. Also, good to know. Maybe you feel compelled to offer advice because you feel obligated. I won’t object.

I hope that this hasn’t been to much of a downer for anyone. These are the kinds of decisions each of us will likely have to make. So the real irony of all this is that you may be answering these questions as much for yourselves as for my benefit. So let’s be joyful, and let’s be grateful for the love we’ve shared.

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by | June 1, 2018 · 9:13 pm

Tempus

My initial consult with Dr. Steven Chang at Henry Ford Hospital was very thorough and opened my eyes to how difficult my case is and how many different approaches could be taken in resolving it. Everything is at once risky and beneficial, and choosing a treatment strategy involves a pretty daunting set of permutations.

The options break down into three major classes, well known to anyone who has ever approached cancer treatment.

Surgery

The tumor is deep in the base of the tongue, just to the right of the midline. It has not involved any bone and does not appear to have metastasized. However, due to my narrow mouth opening (trismus) Dr. Chang did not feel that he could properly visualize and clear the margins robotically via the mouth. His only choice would be excision from under the chin, possibly involving a separation of the mandible, followed by flap reconstruction (from thigh or calf) to replace the missing tongue tissue. Due to the amount of tissue lost and the pre-existing damage to the left side of my neck, there would not be enough structure intact to support the larynx, so a laryngectomy (removal of the voice box) and a tracheostomy would be indicated.

At first I was a bit aghast at this, but he explained that it would be advantageous even if there were no cancer involved. First, it would actually improve my speech since I am operating on one vocal cord now and am breathy and unable to complete sentences in one breath. Many patients do quite well on laryngeal prostheses and he would expect a good outcome in my case. Secondly, it would completely separate my breathing from my esophagus thereby eliminating the possibility of aspiration pneumonia, a primary cause of death for people in my condition. (It almost got me once already.) Thirdly, and most exciting, I would recover some swallowing and be able to get off the feeding tube. This would be a major improvement in the quality of my life. He even advised that I might consider having this done even if we don’t do cancer surgery. I contacted Dr. Peter Belafsky at UC Davis with whom I had been working on the Swallow Expansion Device, and asked for his opinion if the procedure for its own sake. His reply: “Yes. I agree that laryngectomy is a very reasonable option and the one I would choose for myself.” That was quite an unexpected endorsement so, we may be looking at that as a separate issue at a later date if we don’t do the resection of the tumor.

Chemotherapy

Conventional chemo might be an option. But I am being evaluated for a clinical trial for what is termed “targeted therapy.” Here’s a really good fact sheet explaining it. My “Nurse Navigator” at Henry Ford Health Services (HFHS) is currently arranging to have my tissue biopsy sent for testing at Tempus, the primary company developing this treatment modality. If all goes well, I may be enrolled in a clinical trial or, if I qualify, for one of the treatments already approved by the FDA. This is no sure thing, Not every cancer is treatable this way, but we are hoping. This form of treatment is much less debilitating than conventional chemotherapy but does have side effects and risks, Still, I am eagerly hoping that I am a candidate. If this turns out to be the case, we would try this first with surgery as a fall-back plan.

Radiation

I will be seen by a radiation oncologist at my next set of appointments. There is already significant damege to my neck from the first cancer, so radiation may not be an option. That wouldn’t break my heart.

So I am now scheduled to return to Detroit in a couple of weeks to go over the Tempus results and be seen by both the medical and radiation oncologists. I am also scheduled on Monday to see Dr. Ho-Sheng Lin, chairman of the Otolaryngology Department at Wayne State University School of Medicine/Karmanos Cancer Institute. We hope to have additional light shed on our situation.

I am probably happier than I should be, but I feel that I have that “peace that passes all understanding.” My faith is strong and I know God is in the midst of it all. Thanks for all the prayers and support from all my friends. I literally could not make it without the love I have been shown.

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