Now, I don't mean that we are jet-setters traveling to all corners of the world or camping in the American wilderness or winning awards for new discoveries.
No, no. For us, adventures and trials and excitement tend to appear on our own doorstep.
This year marked 10 years since Dan's diagnosis of Stage 4 pancreatic cancer. The simple fact that he is still alive is nothing short of a miracle, one for which we give thanks daily. However, the years of treatment have left scars--both visible and invisible.
Dan has gotten imaging (CT scans or MRIs) every few months for years. Last year, we had a relapse scare involving a new spot on his liver, but the biopsy was inconclusive. We entered another "watch and wait" phase, which perhaps lulled us into some blissful forgetfulness.
A few weeks ago, another routine screening MRI showed 2 new spots on the liver. Very small, but similar in appearance to the one from last year. A biopsy was scheduled and then cancelled once the interventional radiologist determined that he could not safely or accurately hit the spots due to their size. Dan's case was presented to the tumor board, who recommended that the radiologist instead biopsy the larger tumor from last year again. Regardless of biopsy result, the tumor board and the oncologist felt confident that the spots represented new metastases.
As of right now, we still do not know what those spots are, as the second biopsy has not been scheduled yet. Dan was given permission to wait until Christmas break for the biopsy to avoid having to take time off of work. The masses (malignant or not) are growing very slowly, deeming their treatment non-urgent.
So, we come to this week. Dan texted me on Monday from work to let me know that he wasn't feeling right. Chills, back pain, low appetite. By the time he got home, he had a fever of 102.6. He crashed on the couch under the assumption that he had picked up a virus from his students. When he awoke, he had a distinctive yellow cast to his skin and told me that he had now had a yellow tint to his vision.
We went to his primary physician on Tuesday, who ordered a full work-up: blood-work, chest x-ray, kidney x-ray, urine analysis, etc. We knew his liver was angry since he had woken up more yellow, and his fever was staying high. What we didn't expect was a phone call from his physician later that afternoon sending him to the emergency room. His bilirubin (the substance that is responsible for jaundice) was 10 times higher than his normal. Several other labs were frighteningly high, so off to the hospital he went.
Unfortunately, the source of the infection or cause of the problematic liver function was not easy to find. Scans showed no blockages in the liver. The spots that needed to be biopsied were not big enough to be causing this kind of problem. His septic work-up wasn't showing any clear sign of infection. Specialists were consulted, new tests ordered, antibiotics administered, IV fluids given to flush out the excess bilirubin. Still, there were more questions than answers.
Because it is cold and flu season, the kids could not visit Dan. Additionally, since I am still nursing Silas frequently, I couldn't leave him for an extended visit to the hospital, which was an hour away. Dan's mom was incredible helpful and took him to the ER and spent time at the hospital with him.
It was frustrating not being present with Dan through all the tests and conversations with the doctors. However, he eventually started calling me and putting me on speaker phone whenever a physician came in to see him. Plus, Jamie could be another pair of nursing eyes and ears.
It seemed as though Dan was making the medical team nervous because of his history, and no one wanted to commit to a plan or diagnosis. More than once we commented that it felt like they were dragging their heels, leading me to light a fire under some medical tushes.
Finally, yesterday, the GI specialist actually came in to see Dan, rather than just consult over the phone. He determined that one of the tests that the team was considering (an ERCP), would be more risk than benefit and probably unnecessary. Though a cause for all of the symptoms was not clear, this doctor felt comfortable with Dan going home so long as he stayed fever-free for at least 24 hours and his lab values were trending down.
We were cautiously optimistic and fairly impatient, as Dan actually felt pretty good by this point and was frustrated about missing work and being away from his family. (I was also ready for my partner in parenting to be home! These kids are nuts!)
As of this morning, the main doctor has decided that Dan can be discharged. He'll be on new medications, he'll be missing more work until cleared next week, and there are a variety of tests and labs he'll need to have done in the near future. He's also still yellow, so there's a constant visual reminder of how much is going on internally.
The kids are making pictures and welcome home signs as I write this.
God-willing, Dan will be home and healthy for a long while.
Hopefully, we won't have to explain to the kids about worsening health issues or relapsed cancer.
Even so, there is still the quiet voice of his first oncologist telling us that we should reconsider having children, as it "wouldn't be fair to them".There is still the thought of one of my nursing classmates leaving behind his wife and 5 children after he succumbed to cancer.
There is the overwhelming task of meeting the needs of all 3 kids at once alone and imagining this being the new normal.
Only God knows the measure of Dan's days.
Only God knows the measure of all of our days!
For now, I'm going to let the glorious busyness of parenting distract me from the fears that suffocate me if I allow them.
For now, I will help the kids make their signs and be excited about having my husband home.
Please pray with us that Dan continues to normalize, that his biopsy reveals benign masses, that the new medications will be able to control troublesome symptoms, and that Dan can annoy us with his brilliance and ridiculous love of stupid puns for many years to come.
