Monday, March 24, 2008

It has been three months since my diagnosis of breast cancer. My journey continues. It is not a path I would have chosen; I suddenly found myself here one day. Now I am surrounded by a great company of fellow travelers, some have been here before themselves, others, though they are not compelled to walk with me, have chosen to do so, lending their support to me by prayer and encouragement.

I have met many courageous women whose footprints still impress the same ground I now walk. I have heard their stories of suffering, faith in God and answered prayer. They have impressed my heart and bolstered my hope.

God graciously brought me through the first surgery I needed February 14. He more than answered our prayers. Now I face yet another surgery, to remove more lymph nodes, in hopes of making sure all cancer is out of my body. The PET scan I had beginning of March indicated there was no spread of cancer outside the area of the breast tumor. Pray with me this aggressive cancer, if there are yet cancer cells multiplying, stay put and the surgery effectively remove all trace of them.

I am realizing the war against cancer involves battles not only to kill the present cancer, but battles of taking steps medical science knows to make sure it does not recur in the future. This will involve chemotherapy, other drug therapies and radiation, following the upcoming surgery. In all these please pray for wisdom for my doctors and strength for me.

My surgery is scheduled for Thursday April 3. Even if you get this late, your prayers are urgently needed and deeply appreciated. I believe that since God lives outside Time, which is mind-boggling for us to grasp, your “late” prayers are not really late. Time is for our benefit, not God’s.

This surgery will be more involved and demanding. I will likely stay overnight in the hospital, I will have a drainage tube for a period of time, may more likely need pain meds after surgery, and will have to do exercises to rehab/maintain range of motion, etc. I will have new demands on me to do and not do certain things in relation to my right arm to avoid lymphedema (swelling of the arm and area affected by removal of the lymph nodes/system).

Please pray with me about these issues and that I will get over the cold I have had the last two weeks. My concern especially is coughing when I need to have anesthesia (they insert a tube down my throat to introduce the anesthesia) and related issues.

God has continued to take my fears and anxieties as I bring them to him, giving me in exchange just what he promised: his peace. I live each day as it comes, rejoicing in God’s goodness, my wonderful family and many friends, and daily strength.

Self-chastising thoughts come up sometimes of “why didn’t I catch this sooner, be more attune and assertive about the breast lump”, but I take myself in hand and remind myself the “if only” and “what if” questions do no good. Fretting only leads to sin. I refuse to look back. I cannot go back in time (good old time) and change anything I did or didn’t do. There are only two right and productive things I can do: I can learn from this experience, move forward and determine not to repeat it but do the right thing for my own health from now on, and the other is to turn to the Lord who is gracious and merciful, full of compassion and forgiveness, seeking his mercy to bring me through this dark vale. These I am doing daily.

The scriptures, God’s words to us, sustain me daily. They are our life. They bring the only light to this dark path. Your love and concern and prayers accompany me and encourage me, like that cloud of witnesses the author of Hebrews writes about.

I pray God does mighty things in answer to our prayers, not just for my sake but for yours, that the faith of all of us might be built up and strengthened, so we all might be more like Jesus and bring joy to our Father’s heart.

Monday, March 17, 2008

March 17, 2008

Sometimes you just need space to breathe. That is what I felt on Monday, March 10, when I saw the surgeon again and we talked of the need for more surgery to remove lymph nodes. Fear came to taunt me (as he talked about “cleaning out” the lymph nodes) and I called a halt to the decision I had made to go ahead with this surgery. I needed to find out more information about the surgery and lymphedema, and I did.

Through the goodness of several long time friends and many new ones, I was able to learn a lot more about the realities of lymph node dissection (surgical removal of these lymph nodes), and life with lymphedema (swelling related to removal of lymph nodes) or the possibility of it. I also called the American Cancer Society and was able to get more information from a medical perspective.

I cried out to the Lord for direction (here we are again). I know there was cancer in both of the two lymph nodes taken out in the initial surgery, and there may be more and they do have to come out. But what I was hearing from the surgeon deeply concerned me. I asked God to let us know what to do by the end of the week.

Friday I had an early morning appointment with the oncologist (the doctor who would oversee the chemo therapy). During his hour and a half with us we learned a number of things, one of which is that he doesn’t like to do chemo therapy until all the surgery is taken care of. The most significant thing he said though, was when he began to describe the Tiers of lymph nodes. Today they only remove tier 2 and/or tier 3 lymph nodes, but never tier 1. I never knew that. I asked about the surgeon’s meaning when he described “cleaning out” the area, and the oncologist was sure he meant the same thing that had just been described to us, and indeed, after a phone conversation between the oncologist and the surgeon, right there as we waited, that very thing was confirmed.

For me, those pieces of information changed everything. I had no fear or heavy sense of oppression. I felt I probably did not need a second opinion about the surgery.

Was I mistaken to have fear and reverse my decision to go ahead with the surgery the previous Monday afternoon? No. We do not have all knowledge. We must make the best informed decisions we can. I did not feel my information was complete. There was too much I did not know and needed to pursue answers. I needed “space to breathe”, or rather, time to think and learn more.

And as to fear; fear will come. It is how we deal with it that is important. I went to the Lord (Phil. 4:6), recognizing the fear and anxiety rising up in me. I cried out for help, wisdom, direction, knowledge. I turned to my most trusted confidante and wise counselor, my husband Randy, and we talked and prayed. His insights and encouragement helped me work through a very difficult situation. I sought out others I respect for their counsel, especially those who have gone through these same waters. I continued to seek sound medical advice.

It is agonizing going through the trial, feeling the suffocating fear, the desperate need. But God has proven himself once again compassionate, and faithful to hear our prayers. He gave the information we needed. He gave it within the timeframe I asked.

This St. Patrick’s Day I call the surgeon’s office to proceed with getting the surgery scheduled.

Tuesday, March 11, 2008

my choices for treatment

 I saw the surgeon yesterday and he gave me two options: 1) chemo therapy then surgery to remove more lymph nodes (because cancer was found in the two nodes previously removed), or 2) surgery first and then chemo. I opted for surgery first because I thought I might be stronger now, rather than later considering the MG 

myasthenia gravis)

However, this surgeon (who has done an excellent job with my first surgery) believes in removing the lymph nodes ("cleaning out" the area, as he puts it) and that is a controversial issue. Other good doctors do not believe the same way, are more conservative about taking out lymph nodes. We do not know how many lymph nodes are cancerous.

I know my surgeon wants to remove all possible cancer cells in the lymph nodes, but to remove all lymph nodes almost guarantees that I would have to live with lymphedema (swelling of the arm and chest area) the rest of my life, due to lack of a lymph system in that area to remove fluids, with attendant pain and other debilitating factors, to a greater or lesser degree. Removing fewer nodes gives me the possibility I won't have lymphedema.

When I went home after my appointment, having signed a paper stating I would agree to the surgery, I had no peace, only fear. This fear and anxiety intensified as I read medical articles related to the removal of lymph nodes and lymphedema. The decision I made would be life altering. I may have a better chance of removing all the cancerous cells, but I would very likely live with pain and debility the rest of my life. I needed time to consider my options.

I have reversed my decision to have this surgery first and informed the doctor's office. Now we move to chemo therapy, giving me a chance to do more research and get a second opinion as to the surgery.

This has been a wrenching decision! Though I can be objective and assertive when it comes to advising others, I find it very difficult to do the same thing for myself. I tend to defer to "authority" figures and doctors to me are authority figures. I think it has alot to do with the fact that my dad was a doctor, and that we were raised to respect all persons in authority. This is not a bad thing, but when it comes to choosing what is best for my own medical care, taking responsibility for it, this can be a hindrance.


Your prayers are needed as much as before! If you have experience with this issue, please drop me a line. I will be gathering as much information, even anecdotal information, as I can in my decision making process. I need wisdom for seeking a second opinion from a surgeon. There is also the issue of insurance approving whoever I go to. I don't know if my insurance would approve of me going outside the Loma Linda system to seek treatment since I have begun with them. And I am not unhappy with Loma Linda per se. They are doing an excellent job. I'd prefer to stay with them.

I need wisdom and guidance. The only thing I know to do with certainty, is to seek the face of the Lord, who promises to give just what we need.

Pray God continue to hold at bay any cancer spread, to contain it and by the chemo therapy eliminate it. Pray God give the oncology team (including the neurologist for the MG) wisdom in selecting my chemo drug "mix", suitable to eliminating the cancer as well as mixing with the MG drugs I'm on. Pray I remain strong during chemo therapy and have a minimum of side effects. Every kind of stress weakens me and could become life-threatening.

You are part of my "life-line" and I deeply appreciate you!

Jacque




Thursday, March 6, 2008

March 6, 2008

Hello friend,

Yesterday I was given the results of the bone scan and the PET scan which were done over the past week. The PET scan showed no evidence of cancer activity in any other part of the body. This is very good news, praise the Lord. Our prayers are being answered.

The bone scan, however, did show abnormalities, in parts of the spine and sternum (bone which connects the rib cage in the front) which may or may not be cancer related. Since I have been on prednisone for many years and it has caused some osteoporosis (I have been on and off Fosamax, to build bone, for several years; currently off), this may be related to bone loss. I also have severe degenerative disc disease so the abnormalities may be related to that, too. As to the sternum, I have had two thymectomies (a surgical removal of the thymus gland as a treatment for myasthenia gravis) in which they had to break the sternum to get at the area where the thymus gland lies above the heart, in order to remove the thymus. The doctor and I both feel the abnormal reading in that area is most likely related to that scar tissue. Anyway, the X-rays I had yesterday will help the doctor determine these things. Pray for no cancer!

The not so nice news is that I will be going back to surgery to have more lymph nodes removed. The surgical date has not yet been set. I see the surgeon again on Monday, March 10, at which time he will tell me the results of the spine X-rays and get a surgery date set. I will update as to surgery date when I find out that information.

As I thought about the news that there is no evidence of the cancer spreading beyond the lymph nodes, I remembered that I had asked the Lord to slow and contain the spread of the breast cancer cells when it seemed that there was delay after delay, week after week. I was diagnosed on December 20th and my first surgery date, to remove the breast tumor, wasn’t until February 14, nearly 2 months later!

The waiting was difficult when I considered the “enemy” within, that being the cancer cells and tumor, the “headquarters” of these cells (I have an invasive form of cancer). I felt there were enemy forces advancing inside my body, deviant, destructive forces as real and deadly as human military forces with guns and bombs. I just wanted the enemy “headquarters” and foot soldiers OUT of my body!

The enemy can come in many guises. His ultimate goal is to destroy God’s possession. Peter warned us against our enemy, the devil, who prowls around like a lion seeking prey to devour (folks, this is total annihilation!). In this case Peter is warning us to live our lives “self-controlled and alert”, to stand against the devil.

Sometimes the devil attacks us unawares and not because we have failed to guard ourselves (and I am not saying that I do everything right and “have arrived”! By no means! I am a traveler and learner in The Way of Jesus). In these situations, like Job’s situation, we must throw ourselves on the mercy of the Lord for deliverance. Job struggled excruciatingly and though I would not put myself on the same spiritual plane as Job, I do feel the enemy is attacking me through physical disease.

This is not the first time I’ve been attacked in the body, but it feels more “deadly” than other attacks, because of the nature of cancer. One can live with the ups and downs and even the life threats of a serious chronic disease, and to this day I have, and am alive by God’s grace and mercy. He has delivered me from the “jaws” of the enemy many times. But one cannot live with cancer indefinitely. It must be eradicated. This is the battle I am now engulfed in.

War is not nice or desirable most of the time. But there is a place for it. I have declared war on my enemy, the devil, and so have you by your prayers for me.

In this war we show no mercy and take no prisoners. In my mind this is not just about “me”. Yes, though I am being accused by Satan, the accuser of the brethren, before the throne of God, it is also about the reputation and renown, the glory, of the King. Every attack against God’s creation is an attack by Satan against the Person of God.

Paul says, “(God’s) intent was that now, through the church, the manifold (yes, the manifold, the multi-faceted :) wisdom of God should be made known to the rulers and authorities in heavenly realms, according to his eternal purpose which he accomplished in Christ Jesus our Lord. In him and through faith in him we may approach God with freedom and confidence” (Eph. 3:10-12). And on that authority we approach the throne of grace. And I bow to the sovereignty of God whom I love and serve. May he be glorified in me.

We have a dear friend and co-laborer in the Kingdom who is fond of saying, “Perspective is everything.” We concur. Putting things into a bigger perspective, believing that to be the will of God, infuses me with life and hope in the humanly hopeless situation I find myself. “With man this is impossible, but with God all things are possible” (Matt. 19:23-26). If in this text Jesus was referring to man’s salvation, the greatest feat of God, how much more should this apply to all other life situations we encounter, such as healing of disease (see Luke 2:9)?

I am thankful for modern medicine and technology, for good and knowledgeable doctors, but my hope is ultimately in God whose “pleasure is not in the strength of the horse (modern technology), nor his delight in the legs of a man (his knowledge and abilities); the Lord delights in those who fear him, who put their hope in his unfailing love” (Ps. 147:10,11).

By God’s grace I will make my stand here, in the fear of the Lord, hoping in his unfailing love. Thank you for standing with me and encouraging me in this place.