This Made Me Laugh Today

p.s. James is doing great. 90 minutes of chemo really IS easier than 360 minutes of chemo. 

One Down...

Just a quick post before I hit the sack. James went through his first BIG round of chemo today with flying colors. We are so thankful that (most) everything went well. We were in the "infusion room" for a good 7 hours today, and got to know James's nurse pretty well by the end of the day (along with the cheery septuagenarian who "fought" James for bathroom visits). James enjoyed passing the time with one of our new friends, a pastor at church and former missionary to India. 

James was first prepped with pre-meds which include anti-nausea meds as well as a diuretic (the idea being that if we flush the kidneys with enough fluids, we won't experience renal failure while killing cancer). He then went on to receive liter upon liter of fluid & chemo. The nurse did comment on how great his port is working - yeah! Will be a big deal as he continues treatment as chemo is really harsh (understatement) on your veins. 

Lest you feel too sorry for him, when the nurse told us that he could have lunch brought in, his dear wife went and got him a steak dinner to enjoy while he sat in his recliner, which he thoroughly enjoyed. I did feel a twinge of guilt mixed with awkwardness though - I figure everyone else was either made ill by the sight and smell of his lunch, or...those further down the road were all thinking, "you newbie suckers! You will live to regret THAT choice." Fortunately for James, the steak has stayed down. No regrets.

Toward the end of the day, James did start to feel nauseous, which is not (yet) a side effect of chemo, but rather the side effect of the gallons of fluid in his system. He got really pale (perhaps only loved ones can recognize "pale" on an Asian) and nearly passed out. His vitals were checked a few times, he was given time to rest, and then was wheeled out of the hospital, too unstable to walk. After more rest at home, he bounced back to more of his normal self, calling home to give an update and then walking for about an hour. He has already been asleep for a few hours tonight...just in time to wake up and do this again tomorrow. 

Tomorrow will be -should be - much simpler as James will only get 2 hours of chemo. Far less fluids are needed tomorrow, so it should be a relatively "easy" day. Of course, I don't know how he'll wake up feeling in the morning which would influence how "easy" it is. He also has his first radiology appointment tomorrow.

As you pray for us, continue to pray for my family who are providing child care, meals, and support on a daily basis. While James was getting treatment today, family member A got a flat tire while visiting at the hospital, family member B came to fix said tire, while C stopped watching our kids to pick up the two first graders, meaning family member D quit work early to watch the other 3 kiddos. I can see that without prayer, this whole situation can quickly spiral into a level of insanity we aren't accustomed to. I can also say a genuine shout out to those providing meals - it is a ministry, for which we are truly grateful. Thank you all!

Lots of love & goodnight. 

~kristen

Care Calendar - A Guest Post

This post is written by our dear sister in law, Mandy Horn, who is coordinating a lot of the care for us Hes. She wrote specifically with our church members in mind, but asked that I post it to the blog to include as many of our friends as possible. 

Thank you for continuing to pray for James and Kristen along with our family as they begin cancer treatment! I promised to pass along a care calendar once we had a better idea of what the next few weeks hold. While we are still waiting for James’ radiation appointments, we have put together some initial needs, mostly meals. We will continue to update the calendar as we better know the schedule.

http://www.carecalendar.org/logon/193011 and enter 
the following information in the appropriate spaces:

    Calendar ID  :  193011
    Security code :  9557

Right now, we have meals set up for “the family” as a whole, which includes James and Kristen, Kristen and Steve’s parents, and Steve and myself. This allows all of us to more easily cover the other care needs (school, James’ appointments, child care, etc.) and rest on the heaviest schedule days (Mondays in particular). It would also be a blessing simply for us to get to eat and be together as a family. We know that is a lot of food…we have already had some families partner together to do a meal and that has worked out really well. For those uncomfortable cooking for a crowd, we are also easily able to use Costco or Meijer gift cards to pull together easy meals that don’t really require much on our part. Because we don’t live on the northside, we are happy to pick up meals or things at church so that you don’t have to get your passports to come visit us. J(Though it really is usually only about a 30 minute drive…)

Some of you have asked for ideas just on how to bless James and Kristen. Gift cards to Costco, Meijer, Target, Amazon, and Itunes are the easiest and allow them to get special treats for themselves or the girls. They would also love to hear from you and see you. As we settle into the schedule, they would love prearranged visits during some of their long hours at St. V's hospital.

Thank you so much for your continued support and love for our family. We greatly appreciate each of you.

Ever in His loving care,

~Mandy 

Prepped and Ready

James has spent this week getting prepped for cancer treatment. On Tuesday we met with the radiologist who first expressed sympathy for James's diagnosis and then continued to be upbeat about James's treatment. (Truly a special breed of people who are a) brilliant enough to be doctors b) compassionate enough to deal with cancer patients and c) "odd" enough to be upbeat and positive among people who are often scared, depressed, or even, sometimes, dying.)  We all had a good laugh together when the power went out. The three of us were sitting in complete darkness while we waited for the doctor to get out his phone-flashlight. I told him it made us feel really at home to have the power go out and that we'll remember our "China-moment" with him for a long time. 

James came home from that appointment marked up with Xs all over his chest, back, and stomach and special instructions printed in bold on his discharge notes, "DO NOT WASH OFF MARKINGS." (I am still trying to imagine the special kind of person that reminder/rule was written for.)  

The radiologist will finish mapping out James's tumors early this next week (not to be a jerk to radiologists, but this is apparently a very complicated process...shows how daft I am), and then James will be scheduled for those daily treatments.  James will have at least 33 radiation treatments. The radiologist believes that thankfully, James will not have symptoms from radiation until about half way through. After 20 treatments, the radiologist will reassess (via CT) and determine how much more radiation James needs.

Yesterday James had his port placed for chemo and blood draws.  It involved two small incisions in the upper left corner of his chest. The port is placed under the skin with tubes feeding into his veins.  Right now it's just a big bulging lump under his chest, but starting Monday, it will allow for quick hookup to chemo and keep him from having IVs put in, or having to be poked for routine blood draws. It is very painful, though James is not one to complain.  He seemed to be doing so well this morning that I asked, "Does it hurt?"  He responded, "How could it not?!"  Good point. 

We continue to be thankful for all of your prayers and emails, daily reminders of God's grace to us in this time. We are all trying to adjust to this new normal - not only of spending a great deal of time at the hospital meeting doctors, getting poked, sliced open, or drawn on, and/or drinking bad coffee with bad TV...but life in America too. So much has changed that it's truly hard to believe that just a month ago I was drinking genuinely delicious coffee in our restaurant made by our staff while my kids played with their toys in our house with their friends. Most days it feels very hard on most of us to have given all of that up, at least for the time being. We find ourselves continually surrendering ourselves to God and His plans for us, trusting Him to bring very real good out of this bizarre and difficult season of our lives. We know He will and wait expectantly to see more of Him.

Heading Towards Treatment

I apologize for the delay in letting you all know the latest.  I know that many of you are praying daily for us and knowing the latest helps you pray more effectively. Thankfully God is outside of time, so you can "backorder" some of your prayers now.  Ha! It took me a couple days to a) get some sleep and b) figure out the best way to keep everyone updated across various churches, time zones, states, continents, languages, et cetera!

It has been about a month since we first started planning our trip to Bangkok which led us to James's initial cancer diagnosis. Throughout this whole process, God's hand has been so evident, especially in who we see for treatment. It was true in Bangkok and has continued to been true in Indianapolis. Orchestrating who we see has been one of God's many kindnesses to us, and it brings us great peace. From Dr. Yongyudh, the Chinese pulmonologist who had dinner with us so we would "feel at home," to one of the top thoracic surgeons in the nation performing James's lymph node biopsy, to the nurse who was a former missionary to India...these are not coincidences. They are planned events, orchestrated by God's great lovingkindness. We are thankful.

Thanks in great part to your prayers, on Friday we saw Dr. Niraj Gupta, an oncologist and our new best friend. Dr. Gupta's approach is a perfect fit for us - he is incredibly compassionate while at the same time on top of the latest research in oncology. He is also not overly cautious in terms of giving James a lot of restrictions ("play with your girls!" "go for a run" "eat what sounds good to you"). Not having to second guess yourself ("Is this going to kill me?") will be incredibly freeing. He stated that we will be treating James's cancer in an "aggressive and expedited" fashion. Like all the other doctors, he commented on James's great overall health and strength, which naturally influence what one is able to endure. So here's the plan (it's a doozy!)...

James will have chemotherapy together with radiation. All previous doctors have said, "and probably radiation." We are truly thankful James will get radiation together with chemo, because that gives the best outcomes with this type of cancer. Chemotherapy is on a 3 week rotation (1 week, every day, and then 2 weeks off.)  Four of the six chemo infusions will be about 90 minutes; 2 of them will be 4.5 hours.  Radiation treatments will last for approximately 15 minutes every day for the next 5-7 weeks. After the 5-7 weeks of chemo/radiation, we will wait for 2 weeks with neither chemo or radiation and then check on the state of James's cancer. And then we go from there.

To be honest, after hearing how overwhelming the initial oncology appointment can be, I expected Dr. Gupta to be very clinical and grim. He was not at all.  We laughed together several times and we were encouraged by his upbeat, confident outlook.

This week James will meet with the radiologist (who "just so happens" to be a friend of a dear friend of ours who has visited us in China) who will map out James's tumors so they can radiate them all.  (I don't know if I ever updated you all to say that James has several tumors, the largest two being close to ping pong ball size.) James will also return to the biopsy surgeon to have his chemo port installed.  "Real" treatment starts a week from Monday, on September 29th.

As you pray for us, pray that James would get some relief from his cancer symptoms. His cough has only gotten worse over the past month, he has back pain (lower back from coughing, upper back from tumors), and has killer headaches at night. Dr. Gupta is optimistic about these symptoms subsiding as James undergoes treatment (to be replaced by others, perhaps...but hopefully less painful ones).

Thank you, all!
The Lord your God who goes before you will Himself fight on your behalf, just as He did for you before your eyes, where you saw how the Lord your God carried you, just as a man carries his son, in all the way which you have walked until you came to this place.
                                                                                                                       --Deuteronomy 1.30, 31 

Clarifying the Diagnosis in Indianapolis

Writing from my parents' kitchen table. We made it safely back to Indianapolis a little over a week ago and are now mostly over jet lag. Since we've been back the girls have all been to the pediatrician, Lydia has started school, and James has had a lymph node biopsy (a fairly significant surgery).

The doctors were hopeful that James's lymph nodes would be clear of cancer, as 50% of the time they are benign (even though they look malignant on the PET scan).  Knowing the state of the lymph nodes is key as it not only diagnoses James's cancer stage but also dictates the treatment regimen he needs. 

The surgeon just called to let us know that, as suspected, James's lymph nodes are malignant. The biopsy results do not appear to have changed James's cancer staging.  They did biopsy lymph nodes from the left side and, thankfully, all cancer is contained to his right side and mid-line. The surgeon's office will put us in touch with an oncologist who specializes in lung cancer so that James can start treatment. He will need chemo and most likely radiation.  We will have a lot more questions answered when we meet with the oncologist. 

We are all doing well - we have expected "the worst" as we believe God is going to be most glorified in miraculously bringing James through this. We are thankful, though, that the biopsy doesn't appear to have changed James's cancer staging to a worse stage! =)

We so appreciate your prayers & encouraging emails. We do hope to start treatment sooner rather than later, so please pray towards that end.

If you're in the area, James (and I) are up for visitors - contacting us via email is a pretty effective way to get in touch. 

"This Adventure is About to Get Interesting..."

As James has said today, this adventure is about to get interesting. =)

We had several more doctors appointments today and were hoping to get a clear answer on where James should have surgery. Then we met with the doctors, and it became very clear what we need to do. James has been diagnosed with Stage 3a lung cancer. Surgery is actually not an option at this point, according to the doctors we are meeting with. James's best treatment option is a combination of chemo and radiation. We can be thankful that treatment is an option, even though it is not the treatment we expected or wanted.  (The surgeon drew a very fine line between where James is and where treatment stops. We can give thanks that we're on the right side of the line!)

We did receive some good news today - James's bones are free of cancer...his bone marrow looks great, which means he can handle the chemo. That was our last appointment today which was nice, since the previous three went from bad to worse. (I joked that we best stop seeing doctors, since each one told us something worse than the previous one!) Good to end on a high note. =)

James is in the process of getting all of his hospital records and will leave Thailand on Thursday morning. He will arrive in Indianapolis on Friday. I am leaving tomorrow, heading to Dali where I will pack up and pick up the girls. We are working on flights and hope to leave on Friday morning. 

I had a chance to skype briefly with the girls and as they were hugging each other, jumping up and down that I am coming home tomorrow...I then told them that when I got home we needed to pack up to go to America. Lydia said, "Oh, mom, thank you for planning a trip to America for us!" So they are excited. 

We don't yet have details regarding James's treatment plan, so it's hard to guess how long we will be in the States.  I am sure we are looking at months, anyway. We hope to start meeting with doctors next week (folks in Indy are working to track down a great thoracic oncologist & set up appointments). Treatment needs to start within the next two weeks.

I am sure your creative minds can think of many things to pray for regarding this whole situation, so I'll not write them out (and return to packing instead). Thank you for praying for us! 

We rest in the hands of our Savior and Father, who alone has the power to raise the dead.