Dan's got a brand new hip!

The day finally came for Dan's hip replacement on Thursday. Dan was super excited, enough to scrub himself with chlorhexidine and stick medicine up his nose for a week in preparation. We came into the hospital at about 0530 since he needed platelets (the clotting part of your blood) before going to the OR. A couple minor ordering snafus later, the orders finally got placed for the transfusion and the surgeon said, "run it fast!" Turns out that wasn't a fantastic plan as it resulted in a minor transfusion reaction. Thankfully, things got done in time and Dan was taken to the OR at 0910 with a fat lip and no worries.

(So, I realized that after 3 days in the hospital, I have only been updating people on Facebook. Oops. I'll recap the last few days by just copying over my status updates. Hey, work smarter not harder!)

6/28/12 1220:
Surgery is done and went well. He bled quite a bit more than the surgeon was expecting, but he has low platelets...so, not entirely unexpected. He will not be getting prophylactic blood thinners, that's for sure! The surgeon tried to test out the hip and said it's firm and hard to dislocate. Good! The doc said that Dan is awake and in recovery. He may even be up and walking around by this afternoon. We'll meet him up in his room in about an hour or so! Keep praying for no complications (blood clots, infection, etc.)!

6/28/12 1421:
Dan's back in his room still trying to get his pain under control. Munching on ice chips and chatting with us. Not quite as happy as normal, but that'll change when he eats!

6/28/12 2200:

Dan got a real dinner. I went home and got a real shower and a real nap. We watched some Cheers ("Norm!"). Dan got some Vicodin. Sleepy time before he runs a marathon tomorrow with PT!

6/29/12 1300:

First Physical Therapy session went well after almost passing out. After laying down for a couple minutes, he got right back up and walked on his new hip a little. PT will be back this afternoon to hopefully walk with him a little further. Dan is very antsy to get moving already!

6/29/12 1730:

Second PT and first OT (occupational therapy) done for the day. Both therapists said he is doing very well and better than they normally see. Dan feels good, only needs Vicodin for pain and is eating a lot. As a side note, his blood counts are a little low, but oncologist said we can hold off on transfusions for today. His immune system is a little battered and bruised from all the chemo, so it's taking a while to catch up. Prayers for no infections, no bleeding and no blood clots would be appreciated. Thanks for keeping Dan in your thoughts and prayers!

6/30/12 1025: (most recent)

Alright, so the fevers are still sticking around. Low but persistent and pesky. Labs have all been drawn, chest x-ray, etc. On-call surgeon said that it could just be post-op inflammation, but if that's the case, the fevers should be subsiding by today.
Dan is cleared by physical therapy to go home whenever the other docs give the go ahead. They say he's doing great! Walking a lot further than expected.
Blood counts still low (WBC 2.2, Hgb 8.6). Oncologist will hopefully order Dan a little blood to boost his energy and defenses...at least that's what I'm hoping. I'm sure his nurse will not be thrilled!
Case manager came in to start prepping for discharge, so when we do get everybody signing off we'll get outta here lickity-split!
Dan's favorite part of the day: wearing shorts and a t-shirt instead of his typical "evening gown".

So, that's it for right now. Dan is attempting to let the Vicodin help him take a nap and take care of his temp. We're frustrated that every time he has surgery (he challenges me on this, but trust me, it's every time), he ends up with a fever and/or infection. His incision looks good per the surgeon, his catheter is out and he's walking a lot...hopefully, those things will chase away infection. However, it will also be very frustrating for Dan (and me) if he is completely cleared to go but his body can't figure out to stop having fevers just because it's angry at being beaten up.

Please pray that we are here the shortest amount of time that is safe for Dan. Also, that the MDs have wisdom regarding when a fever is just a fever and when it indicates something else. Prayers for energy for both of us would be good, too!

Love, Marriage and Babies (and a cat)

This just a quick update on life to let everyone know we're still alive and kicking.

You'll notice that cancer isn't mentioned in the title. This is simply because we have nothing new to share on that front. Dan had a couple weeks in which he wasn't feeling good, but it looks like that may have been related to a new medication that has since been stopped. Now, we just keep watching and waiting until the next CT in June.

In the "love" news, our best friends Lisa and Andrew recently got engaged with a wedding set for November in the Wine Country. Lisa and I have been friends since the 3rd grade, so it feels like my sister is getting married! We've also known Andrew since our freshman year at Biola, and he was in our wedding. My goodness, are we excited!
And, our friends Laura and Brian got engaged, too. They'll be getting hitched this summer. This will certainly be a memorable year!

In the "marriage" news, Dan's sister Jessica just became Jessica McBride. Jes and Josh got married this past weekend up in Lodi at a very unique and beautiful wedding. The entire event screamed "Jes and Josh" and they looked fantastically happy. They are headed off to Iceland for their honeymoon today. Now, Dan and I can start bothering them for a baby...well, we'll give them a few months ;)

Also, my family was invited to the wedding, so I was able to hug my parents and brother for the first time since December. It was also the first Mother's Day that all my mom's kids were in the same place with her for almost 5 years! It was very sweet and way too short. We'll be looking forward to another visit from my family in June for my dad's graduation with his BA from The King's College. So excited!


Finally, in the "babies" news, a lot of craziness has been happening. I'm taking far more meds than I'd like, but hopefully they will help us conceive anytime now. We had been working under the assumption that Dan's chemo treatments were to blame for our current infertility issues...but he is very close to normal! I, however, am the one to blame for things being so tricky :(

It turns out that I failed my glucose tolerance test because I have insulin intolerance. This is different than diabetes in that my body just makes a ton of insulin, but my cells won't use it properly so my blood sugar takes longer to normalize. This elevated insulin and glucose ratio throws off other hormones which has essentially kept me from ovulating for Lord knows how long. No ovulating means no babies. Because of this, the doctor started me on metformin to balance the ratios and bring my levels to normal. Also, I have had to change my diet around a lot. No white carbs, lots of fruits/veggies and protein, no caffeine...it's been "fun". Dan has been AMAZING about helping me stick to this diet because I get really sick if I don't. Many women  begin to ovulate normally just with taking the metformin, but the doctor wanted to throw a couple more punches.

After some more investigation, the insulin resistance is part of a syndrome called PCOS (polycystic ovarian syndrome) which is the most common reason in women my age for infertility. As one can probably guess from the name, I also end up getting pretty large and painful cysts on my ovaries. When the ovaries occur we have to put fertility treatment on hold for a month while a different medicine shrinks them. This has already happened once and is very frustrating.

(Yet, God knows what is happening in every cell of our bodies and knows the exact perfect timing of every need. Even if that means, we wait a long time for a baby or we never have one at all. As painful as that thought is, I trust that God has a perfect reason for His will and actions.)

My most recent cyst is gone (yay!) and I've added 3 new meds to my daily cocktail of drugs. The next few weeks (or months) will involve a lot of doctor appointments and waiting and ultrasounds and waiting and praying and hoping and waiting and praying some more. Dan and I are really praying that we are able to conceive with just medications helping us, so that we don't have to move to more invasive technologies. We would appreciate your prayers in this, too!

Oh, and the last bit of our update: a cat! We made the decision to get Toulouse a new friend to help him be less lonely and crazy. We are still holding out on whether or not this has actually worked, but it has been very entertaining. The new kitty is named Fleur de Lis (Dan's choice to keep with the "cats are French" notion in our home). She is 1.5 years old, very small, very spunky and very loud. She talks all the time. Poor Toulouse.

Prayer Requests:
* Keep the cancer away!
* Safe travels for Jes and Josh
* Good timing, successful meds and God's hand in helping us in the baby-making
* A quick recovery for Dan's hip surgery with NO COMPLICATIONS
* Remaining at peace in God's will :)

A real update!

We saw the oncologist yesterday to discuss the results of the PET scan. The doctor said that the results were fairly unimpressive and a little difficult to interpret (what a shocker). He said that he and the interventional radiologists at my hospital took a look at the scan and were surprised to not seeing anything "lighting up like a Christmas tree." There was nothing that looked scary or "screamed come get me." Also, they didn't even see the enlarged lymph nodes anymore.

There are still hazy, slightly brighter spots around the newest ablation site, above the liver and slightly above the diaphragm. The options for the spots remain: recurring tumor, infection, or scar tissue/post-ablation tissue.

We told him what the Stanford doc said after reading the CT (wait for 3 months, then check again), and he actually agreed. We'll be sending a copy of the PET to Stanford just to make sure this is the right plan. For now, there won't be any biopsying. Just "watching and waiting."

Dan also got the go ahead for his hip replacement surgery. The official date for that is June 28th. I better put in the paperwork to get work off now!

This has also been a busy week for me from the fertility testing standpoint. All of our labs and scary tests were finished today. Thank goodness. The glucose test was like drinking a whole bunch of concentrated snow cone syrup. I didn't think it was too bad until I got home and had a crazy sugar crash. Whoa. As for the other tests, don't ask. I'm sitting with a heating pad and a constant stream of Advil. "For ze babies!" So far, results are looking alright, though we won't know for sure until we meet with the doctor. That appointment hasn't been made yet.

Alright, I think we're going to try to get off the couch long enough to grab some dinner. Thanks for all the prayers and well wishes!

Praises:

- Dan's PET scan didn't look crazy or all lit up!

- Dan's hip replacement is scheduled

- All of the fertility tests are done (for now)

Prayer Requests:

- A good plan from the fertility doctor

- No more cancer!

And it begins.

Cancer/CT/PET scan news:

Nada. The PET scan is still tomorrow, we won't know anything until next week most likely when we meet with the oncologist down here on Wednesday.

Baby news:

We met with the fertility specialist for the first time today. Whoa. Our heads are still spinning a bit from all of the information.

The doctor seemed kind and extremely intelligent with all kinds of awards and plaques covering a wall of his office. Even better, there was a whole wall full of babies he has helped bring into the world. He is very logical and realistic, though optimistic. He took our histories, asked a hefty amount of VERY PERSONAL questions, scribbled lots of notes and described to us the process of fertility treatments.

Dan asked me to use the same analogy the doctor used with us, so I'll try to paraphrase as well as I can: over the next few weeks, we will gathering all of our 'cards' (information, stats, etc.) through tests and monitoring. Once the 'deck' is ready, we'll meet with the 'expert card player' (the doctor) to help us play the best 'hand' with the 'cards' we've been given.

The doctor made it clear that he is not going to be making "something impossible possible, but something improbable probable." We liked that, especially Dan, who has recently taken to thinking like an economist. Math teachers.

As it stands with the information we have now, the doctor has given us fairly impressive odds of having children. Yay! Even with the chemo-induced low numbers, the doctor said that that alone would not prevent us from conceiving naturally. Which led to him thinking that maybe something is going on with me. (Or, he said we just have incredibly unlucky timing!)

Somehow, with all of the focus on Dan's cancer and treatments and the well-known probability that chemo reduces fertility, we never stopped to think that maybe I was contributing to this whole lack of baby issue. Well, Dan did, but he thought it wasn't likely. So, now that that door has been opened, we are a step closer to finding any possible problems and fixing them. Which also puts us a step closer to becoming parents!

The not-so-fun part of the appointment was going over The Plan. Lucky for Dan, most of his part of The Plan is done for now. Unlucky for me, I have a lot to do in the next couple weeks. We'll spare you the details, but if you find me to be a little moodier or grumpier than usual in the near future... sorry. X-rays, blood work, glucose testing, ultrasounds, scary needles going scary places, etc.

Dan keeps reminding me (in a faux French accent): "Iz for de bebe!"

Anyway, once all these tests are done, we meet with the doctor and decide upon the next steps of The Plan. This will include a cost-benefit analysis, too. I hope I don't fall over after hearing the final numbers!

We found out today that my insurance will cover 50% of all the diagnostic work which is FANTASTIC news. This is very rare. Thank you, LORD. That being said...the next 2 weeks alone will be around one of Dan's paychecks. God will provide.

We left feeling encouraged and more optimistic than we have felt for a long time. I'm not expecting a pregnancy to be right around the corner or anything, but I no longer feel that it is a never type of situation. This is a big blessing.

Praises:

1. Insurance coverage

2. Good timing with tests

3. Jamie made it back from Israel safely

4. We feel optimistic!

Prayer Requests:

1. Dan's PET scan tomorrow...let it show nothing lighting up or abnormal at all. With God it IS possible :)

2. Grace in scheduling all of my tests next week.

3. Clear results and wisdom for the fertility doc to help us make a plan.

4. Patience and peace as we wait.

5. NO MORE CANCER!

6. Success in starting a family.

7. Oh, and Dan has a cold that he'd really like to get over soon.

The non-news update.

We haven't blogged because we haven't had any news. Ugh.

No PET yet because insurance took forever to authorize it. It finally got scheduled for this Thursday (3/15). As a reminder, the PET scan may not clarify things as much as we'd like. Since the test shows increased of metabolism, so things with high metabolic needs will light up. Types of things that light up include: tumors OR infections. Good grief. Anyway, depending on how much things light up, the oncologist and interventional radiologist decide what to biopsy. Only a biopsy will actually tell us what is going on and that is several weeks away.

Dan wrote to his doctor up at Stanford who has been with us through every piece of Dan's cancer journey and sent a copy of the CT scan. The doc said he is "cautiously optimistic" about the results. He obviously can't tell what everything is just from a picture on the screen but said that the lymph nodes were actually present on previous scans (surprise?). Also, he said that the liver is looking pretty good to him. The only thing that bothered him was the area on the lung. He is fairly comfortable saying that it doesn't look like metastasis, but was sure to tell us he cannot be positive.

So, cautiously optimistic is our motto for now.

In other news, tomorrow we meet a new doctor...the fertility specialist. It would have been nice to tell you that between the last post and this post that we don't need this doctor's advice, but alas...It will just be a consultation and discussion of financial expectations. Hopefully, the doctor will shed some light on our options and give us some hope in the area of starting a family. Since loans are paid off, we won't be waiting long to start the early stages of treatment. It's still strange to think about what will be involved (medications, tests, invasions of privacy, etc.). Even a little scary, to be honest.

One step at a time!

Prayer Requests:

1. PET scan that shows NOTHING lighting up

2. Biopsy results that show NO MORE CANCER

3. A good doctor's appointment tomorrow...one that gives hope and excitement!

4. Provision for financial expectations of fertility treatments

5. A baby with our good looks, Dan's intelligence, my communication skills, Clifford confidence and the Howen musical abilities! Ha. (Or, just the baby God wants us to raise for Him)

6. Peace and hope and peace

7. A stronger, even healthier marriage :)

Not what we were expecting

I haven't had to write a blog post like this for a while. Since November of 2009, actually. A blog post in which we report something other than good news.

We returned a couple of hours ago from Dan's follow-up with the oncologist (Dr. S). Unfortunately, the CT results were rather difficult to interpret. A few things were clear:
1. There was some shrinkage of the ablated area in the R lobe of the liver (good)
2. There are some shady areas in the liver and R lung that could be either post-treatment changes or new tumor growth (could go either way)
3. There are 2 enlarged lymph nodes that have not been seen on CTs before. One is in the chest by the lungs and the other is down closer to the diaphragm and intestines. (bad)

If all the questionable areas are just Dan's body recovering from the ablations and infection last summer, we just have wait and keep a close eye on it. However, if any of them do represent new tumor growth...well, that's a whole different story.

The only way to tell the difference is to biopsy the areas that are suspicious and see what's there. The most disconcerting areas at this point are the lymph nodes as that is a very common first site of spreading disease. So far, Dan has not really had much cancer growth in his lymph nodes. They actually removed several nodes during his Whipple and found no evidence of cancer at all. Thus, seeing these new lymph node swellings is not promising.

The oncologist was quick to get to action and called one of the interventional radiologists (IR) at our hospital to re-read the CT scan. The IR doc who looked it over said one of the lymph nodes is too close to the intestine to biopsy safely and that he wants some more information before he biopsies the other lymph node or the problem area of the liver.

Dan will be having a PET scan next week to see what (if any) of the areas are active "hot spots", meaning if any of them are metabolically active and growing. With that information, the IR doctor will be able to take a biopsy of the most active spot. We'll meet with Dr. S in 2 weeks to discuss the PET results and the next steps.

While Dan and I are trying to be calm and hopeful and optimistic about these findings being inconclusive or just inflammatory, we are also having to be realistic. Dr. S stated today that if Dan's cancer has returned, he would most likely send us back to Stanford to meet with Dan's original oncology team for options. Chemo would most likely be the first step, though other radiation or treatments could be discussed. My favorite line today was when Dr. S said that he wanted Dan to get the same treatment as all the billionaires (Swayze, Jobs, etc) going to Stanford--and he'd try to make that happen.

In being completely honest, recurrence has always been a possibility. The whipple got most of the cancer, but the surgeon had to leave some of the dead tumors in the liver. The ablations should have taken care of most of the liver tumors and insured their deadness. Yet, micro-tumors are very difficult to target without systemic treatment (chemo). Dan's last chemo treatment was in April of 2008, so the tumors have a long time to do a little sharing elsewhere in the body.

All of us (including the doctors) have been hoping that Dan's cancer is dead and that the spots we see are just dead tissue. That is still possible, but the oncologist made it fairly clear today that the enlarged lymph nodes are directing us away from that possibility.

So, what now? We wait for the PET scan results and then wait for the biopsy results. We probably won't have a plan of attack until the end of next month in all reality. Until then, we are praying and trying not to go into panic mode (as if Dan could ever be in panic mode!).

We are also going ahead with our plans to see the fertility specialist. Some may see this as unwise giving the current situation, but if Dan does have more chemo, we may lose any chance to have children of our own. Also, we do not know the future and want to live in the present. We are both anxious to begin a family and are not going to let the new "what ifs" get in the way of our plans. Trying to have a baby in the midst of this is our way of remaining hopeful and trusting God--the only One who knows the number of our days.

As for how we are doing emotionally, we're okay. I cried a little, switched into nurse mode and tried to educate Dan on what Dr. S meant, started dinner, vacuumed and filed. (I process bad news by staying busy--so I guess we could thank Dr. S for the clean house we are now enjoying!)
Dan took it all in, asked questions, interfaced with our parents and prayed with me. He is still as optimistic and calm as ever. We're okay.

Please join us in prayer. We need it. Thanks.

Prayer Requests:
1. More conclusive results from the PET scan (disappearance of tumor activity would be great!)
2. Wisdom for the doctors.
3. Ease of scheduling for appointments and procedures
4. No cancer cells to be seen in any biopsy results
5. Peace and hope for both of us and our families
6. An encouraging meeting with the fertility specialist
7. PRAY FOR REMISSION IN THE NEAR FUTURE
8. God's healing hand to touch Dan

Restless hearts

No, this is not a post-Valentine's Day let-down blog.
(I actually had an amazing Valentine's Day! I worked, so we couldn't go out to celebrate or anything. BUT Dan had plans for the day. I came home to a house full of good-smelling candles everywhere, French toast cooking in the kitchen, chocolates on the table (from Dan's classes) and the most beautiful bouquet of red and white tulips waiting in the bedroom. We sat in our PJs, ate dinner by candlelight, exchanged love letters, and snuggled. I mean honestly. It boggles my mind that this guy loves me like he does.)

On to the real purpose of this entry: my own restless heart. I am not restless out of unrequited love or disappointment. My heart is restless out of fear and worry. This is the opposite of what God has called me to be. I have always been a self-proclaimed worrier, but I really need to work on this sinful part of my character. Yes, worrying is sinful. God knows all and loves me perfectly. Worrying says I do not trust God or think Him big enough to handle my life. Yikes.

God reminded me of this today during devotions. I read Streams in the Desert everyday, and today's writing hit home. Here's an excerpt--a poem by Edith Willis Linn:

Dear restless heart, be still; don’t fret and worry so;

God has a thousand ways His love and help to show;

Just trust, and trust, and trust, until His will you know.

Dear restless heart, be still, for peace is God’s own smile,

His love can every wrong and sorrow reconcile;

Just love, and love, and love, and calmly wait awhile.

Dear restless heart, be brave; don’t moan and sorrow so,

He hath a meaning kind in chilly winds that blow;

Just hope, and hope, and hope, until you braver grow.

Dear restless heart, repose upon His breast this hour,

His grace is strength and life, His love is bloom and flower;

Just rest, and rest, and rest, within His tender power.

Dear restless heart, be still! Don’t struggle to be free;

God’s life is in your life, from Him you may not flee;

Just pray, and pray, and pray, till you have faith to see.

Awesome. What do I need to do? Trust, love, hope, rest and pray. That's it.

Instead of thinking that Dan's oncologist won't speak to me at work because Dan's CT was bad, perhaps the doctor is just busy! (duh)
Instead of imagining that Dan and I are in incredibly in love because we won't have a long marriage to enjoy it, maybe we are just blessed with an amazing love story!
Instead of dwelling on the "what ifs", maybe I should just praise Him for what I have now.
Instead of waiting for the other shoe to drop, perhaps I should just keep walking on the path God has us on.

Oh, Lord help me to trust you more and more.