time for good news

Hello, friends...we thought as you're in the midst of the holiday season you might enjoy some good news.

James had a CT this week and as the doctors compared his last CT (done in May) to this CT, they noticed there was no change. That is, there is no progression of disease. Seven months, and no growth of cancer...despite the fact that lung cancer is one of the fastest growing cancers out there. We are elated.

And slightly confused. I actually said, "That's WEIRD, right, Dr. Einhorn?"

Dr. Einhorn's only explanation is that James is not a smoker.

So for now, James will continue as he is and will not take any medications or treatment for cancer. As it turned out, we did get the new cancer drug from Pfizer (in the mail...twelve thousand dollars worth of drugs dropped off on our porch, no less), but Dr. Einhorn asked that James not start taking it. As he explained, "I wouldn't actually be able to tell if it's working or not, since your cancer is not progressing."

James's next appointment is not until the middle of February, which is nearly an eternity in cancer world.

in other news...
*James had an absolutely fabulous trip back home. He was busy morning to night every day, and had countless opportunities to share with believers, unbelievers, and seekers. He even had the chance to enjoy a visit from an old classmate who flew in from Beijing for two days just for the chance to see him. Needless to say, James came home tired, but also deeply encouraged and strengthened by his time.

*The last two weeks we have had a full house, hosting James's father, siblings, and their wives. We have had so.much.fun. Everything from a visit to Fair Oaks Farm to see commercial farming in America to Black Friday shopping, and everything in between...so much really good Chinese food, killing chickens at my parents' farm (more than once!), celebrating Thanksgiving twice, our girls playing games with their aunts and rough housing with their uncle, lots of laughing, a leaking faucet, someone (me) forgetting to run the dishwasher, learning how to use American tech like a waffle iron and the garbage disposal, decorating the Christmas tree, bonfires, late nights, and more shopping.

Our family has truly loved their time here and have joked more than once about not wanting to leave. They do wish they could stay longer. We hope this will be the first of many trips...

Sadly, we'll be packing everything up today and heading home tomorrow morning. I will fly with them (I got my passport & visa back just this week) and will stay a week. I'm looking forward to lending a hand at the restaurant and hope I'll be an encouragement to our staff. I think everyone at home in Indy will be mildly depressed by what will feel like an empty house. It has been a very, very good last couple of weeks.

Thank you so much for your prayers...we believe God hears and answers...
love,
~james and kristen

giddyap

Hello, Friends!

Hope you all are doing well as we quickly approach the end of the year. For us it feels a lot like sliding into home plate. Or, like we're on a merry-go-round that is spinning a little too quickly...we would appreciate prayers for God's sustaining power and grace in our lives, and that even in the midst of all the craziness of life, we might be at peace.

*Last Wednesday, James's family traveled to the US Consulate in Sichuan ( that's "Szechuan" for all you Americans) to apply for visas to the US. Thankfully, they were all granted a visa.  (Thank you, HRC, for making it so doggone easy to enter the US these days!) We are so excited for them, and really looking forward to their time in the States. (Of those traveling, only one has ever been out of the country.)  They'll be staying with us and, together with our family, generally causing a scene on the scale of My Big Fat Greek Wedding in our neighborhood. I'm thinking about painting the Chinese flag on our garage door just so everyone around knows we are that family. James is contemplating whether or not we could roast a sheep over our backyard fire pit, and whether the HOA would notice.

*James is buying his flight ticket today (Monday) for his flight to China (Friday).  Yes, we know it is kind of last minute. Sometimes, that's how we roll...and sometimes, that's just what life allows and we have to roll with it. James will be in China for just over 2 weeks. He will return the week of Thanksgiving with his family.

*James's health continues to generally improve. I often tell him that he is the world's first asymptomatic stage IV cancer patient. James is coughing less and is even able to run for short bursts. He told me that his lung capacity feels much improved and "less blocked." He is still taking Synthroid for his underactive thyroid. We don't know if that is a permanent condition, or if it will reverse itself with time (since it was medically induced). Lately we suspect that he is overdosed - we are praying his thyroid can be checked before he leaves the country.

Is James being healed? Is he being given life and health despite progressing cancer? We don't actually know. We do not know what God is doing, other than the obvious sustaining & giving of life...and we are okay with that. We are indeed very, very thankful. We would appreciate your prayers for his upcoming trip, that it would be fruitful, and that he would have strength to keep a daily schedule jammed with meetings, pastoring, preaching, counseling.

*The drug James's doctors have been working to approve has been, not surprisingly, denied by our insurance company. Although the drug has been used successfully to treat colon & breast cancer, it does not have FDA approval for use with lung cancer...so insurance considers that "experimental" and has denied it. James's doctors continue to contest that decision with reams of medical evidence. We are finishing up an application to Pfizer directly as another means of procuring the drug. Either way, we are relaxed. We know that God is most definitely not limited by insurance companies. As Job once declared, "For He will complete what He appoints for me, and many such things are in His mind."

*James continues to have opportunities for ministry here. He has been writing articles for a Chinese devotional that is distributed to Chinese Americans and the house church network within China. Within a day of publication his articles often have over 30,000 views. He has also been able to preach at a local Chinese church and is often asked to share at others. He is relishing these opportunities, and we are enjoying fellowship with our Chinese brothers and sisters (including getting to host a few for dinner last week!).

*Tomorrow I will apply for a passport renewal and then visa so that I may return to China with my in-laws at the end of their trip. I will spend the majority of my time back in China working with our restaurant staff and giving them support where needed as we quickly approach the holiday season. (Hello Dali friends - I will see you soon!)

*And in my little corner of the world...this past spring I helped a chef test recipes for an upcoming cookbook. I found out my name will be listed in the credits (along with many others, LOL).  I'll let you know when it comes out - it will be delicious! More importantly, I am working on a digital Bible study for kids for Advent (specifically, on the promises of the Messiah and their fulfillment in Jesus) that will be launched before Thanksgiving. Let me know if you want details!

I think that about wraps up the crazy. I foresee a lot of days of me in a ballcap in the coming weeks. And coffee.  A lot of coffee.

I hope your coming days are filled with bonfires, marveling at the changing seasons, taking deep breaths of cool air, and candy (the good kind).

Thank you (thank you!) for your many, many prayers.
Love,
~james and kristen

the new and unexpected

Hello Friends - I have a few moments of quiet around the house before I head out, and realized that now is as good a time as any to give you an update.  Two major things have happened since we last wrote...both new, and both pretty unexpected.

1. We bought a house. Yup, it's true! Just a few months ago, this was not at all on our radar and even as we considered it, we didn't actually think it would be possible.  But here we are, in our own place. 

Weird. 

And good. 

And completely unexpected.

Several of you have already done so much to help as we transition, and saying "thanks" really minimizes the gratitude we feel. Just the same: thank you. Most days (all days?) we are pretty overwhelmed by His goodness and kindness to us in the midst of all this. We heartily welcome visitors, and look forward to lots of hosting in the future. If you're in the area and need a place to eat or lay your head or grab a cup of coffee...remember us! (Did you know that in China, dropping by without warning is perfectly normal and socially acceptable? So if you do that here, we promise we won't think you are weird. You might even be speaking our love language.) 

Do we still hope to return to China one day? Most definitely. Pretty much every day. To be honest, buying a house in suburban America when you actually want to live and be and minister and raise your kids somewhere else is a very odd experience. If nothing else, though, these feelings keep us very grounded in the reality that this is all very temporal, and that one day it is all going to burn...so we don't have to get overly attached to any one place. This world is not our home, yet it is my Father's world. So we will live and grow and be and enjoy where He has us. 

2. About a week ago, we got a call from Dr. Einhorn with results from the genetic testing that was done on James's cancer. Initially, everyone thought that in the rare chance that there should be a mutation, it would be one that could be treated with oral chemo. As it turns out, ever the oddball patient, James didn't have those...but he has a newly discovered mutation that they would like to treat with a very new drug that is not chemo. It is considered targeted therapy, which means the drug goes after cells with a certain genetic makeup to keep them from reproducing. 

Weird.

And good.

And completely unexpected.

We met with the doctors last week and heard about how they discovered it, how they tested James, why they think this drug might work, and what they expect as the outcome. To be clear, even in the best case scenario, no one there feels that this drug could actually save James's life. The best they are hoping for is that it would stop progression of disease. Doctors and researchers have not yet seen it cause remission for lung cancer, and the doctor said that even if James did go into remission, his chances of surviving are still slim to none. 

Huh? 

My best guess is that the doctor means that based on statistics, most lung cancer patients don't make it five years. (Which is the marker they use to measure "survivability.") So they can't speak with any certainty about this being some kind of new miracle cure.  That being said, most lung cancer patients are 70-something lifelong 2 pack-a-day smokers who already had compromised health. So...maybe not the best pool for statistics on survivability?

If I heard correctly, they have been using this drug for about 4 months, though longer for breast cancer patients (where they have seen the most positive outcomes). It is experimental in the sense that they don't yet have enough data to know expected outcomes for lung cancer patients. If I could go back to that appointment, I would have told the doctors that whatever they are expecting as the outcome, they should most of all expect that James's cancer will not react in the way they expect. Whatever happens, we can be sure that God is going to have this go the way He will have it go. 

The team at IU is working hard already (before we even met with them, actually) to procure this drug for use on James. (Prayer request number one, I guess.) They expect it to take 3-4 weeks. The next step will be for James to meet with Dr. Einhorn and perhaps do another scan to get a new baseline. As James gets treated with this drug they'll need to compare new scans with old ones to see if and how it's working. So maybe James will start treatment in November or so? 

In the meantime, James is working with friends of ours to help several of his family members get visas to come this way towards the end of November. If things go according to plan (ha!), our family will get visas, James will return to China in November for a few weeks of work and ministry, and will return to the States with his dad, three siblings, and two sisters-in-law. I personally look forward to seeing them all here, especially James's dad who is 74 this year...first flew on a plane when James and I were dating...and has never been out of the country. Amazing. And I'm sure Haoping, our niece, will enjoy getting to see her parents. We will all enjoy some really, really good Chinese food from our family.

As I sign off, allow me to share a story from the doctor's office. Neither James nor I often get the opportunity to share our faith with the doctors and nurses we come in contact with, though we seek those opportunities out and get excited whenever they present themselves. Last week, as the doctors explained things to us, and how we could call often to check on the status of getting the drug, I got the sense that they most commonly deal with patients who are in a state of desperation. Desperate for answers, desperate for a cure, desperate for efficiency, desperate for hope, desperate for life.

Yet there we were, not feeling any of those things. Through your prayers and God's grace, we have peace with where God has us, and perhaps more importantly, peace that God has us. He's got this completely under His control. Circumstances have rarely gone the way that we have wanted them to go, and yet we have tremendous confidence that nothing is happening to us that is not sovereignly orchestrated by our loving, all-powerful Father.

That's a pretty sweet spot to be in.

And so, in response, this is what I was able to say to the doctors treating James

I just want you to know that we are not going to do that [call repeatedly until we get the drug]. We are happy to use this drug, but my husband will not live or die based on whether we get this drug our not. My husband's life is in God's hands. No drug or lack of drug will extend his life or cut his life short. Nothing will cut my husband's life short. God has the number of his days, and we have already seen how He has sustained him. You know James should not be here, yet here he is. We have three young girls, and we most definitely want him to live. But that is not up to us. So we'll wait to hear from you.

That was a pretty good day.

Until next time...
lots of love & thanks,
~james and kristen

the post I didn't want to write

I have a confession to make.

Last week, James had a PET scan and we got the results.

I could have hopped on here and updated you all right away.  But I didn't, because we wanted a couple of days to process. And then we had a three day weekend which meant we were super busy doing a whole lot of nothing. And, so long as we're being honest, I didn't write to tell you because, well, how do you tell people your husband has cancer (for like the fourth time)?

Actually, James has always had cancer. But at different points along the way the treatment has been deemed working, he's gotten better, he's been declared well, the symptoms fade...and so we all start to feel like maybe this trial will come to an end sometime soonish.  But every time the cancer is actually still there. Given enough time, the cancer shows up in a measurable way.

And so it is this time.

When we saw Dr. Einhorn last week he told us the news we had actually suspected: James is not responding to immunotherapy.

Why not write right away? Because telling people the news they dread to hear is an uncomfortable, crappy job.

But here we are.

And now you know.

The good news is that the radiation appears to have obliterated whatever massive tumor was growing in his hip. (Yeah!) James is no longer on pain meds, no longer favors that hip, and...he actually ran last week, for the first time in two years. (Granted, it was just minutes of chasing Michaela around the yard, but still...running!)

The good news is that James remains off of his inhalers because his cough is diminished/diminishing.

The good news is that the cancer in James's lungs and lymph nodes remains localized and fairly minimal, especially considering that he's not really been treated for nearly a year.

The good news is that James, me, and the girls are not the same people we were two years ago.

Two years ago, on August 30th, we received the diagnosis that James had non-small cell lung cancer...and it felt like an atomic bomb was going off in our lives. We watched, pained, as the word "cancer" started to mushroom and seemingly destroy everything in its path. Everyone sees the upward explosion, but the billowing cloud on the ground that mercilessly devours everything around it was what we felt.

Two years ago, I stifled a sob when we realized that surgery would not be an option.

Two years ago, I wept when the doctor told us that James would need chemotherapy and radiation.

Two years ago, tears streamed down my face as our plane descended toward the hard road of doctors visits, potent drugs, physical pain, and the uncertainty of my husband's future.

Last week, on August 30th, when Dr. Einhorn gave us the diagnosis, we listened, we asked questions, and we left his office.

There was no detonation

no explosion

no tears.

In its place, there was hope. There was confidence. There was peace in the midst of a really (really) uncertain future.

And you might suspect that the point of all this is to say that trials make you stronger. Or to speak about how faith can grow through pain. Or maybe, cynically, to say that after you've been through everything we've been through, you can get to some kind of elevated consciousness where you stop feeling the weightiness of the bad news you've just received.

But you'd be wrong.

A few lines back I said that we are not the same people that we were. But that is really an oversimplification.

Actually, we are the same people. We are still the same weak, fearful people with faltering faith that we were two years ago.

Every morning, we wake up uncertain of the next step, uncertain of who God is, feeling anything but peace...and God graciously, faithfully pulls out the paddles and resuscitates our hearts with His love.

These last two years have given us glimpses of His goodness. At each and every turn of this precipitous journey, we have seen Him come through for us, often in astounding, miraculous ways. We have never been more assured of who He is: faithful, loving, sovereign, the God of all grace. We know that He alone has the power to give and sustain life. Because of this, we can have great hope that He will sustain us.

We have not changed. But we have been given eyes to see Him more clearly, and that makes all the difference.




and now, the brass tacks...
*at this point, James has limited treatment options. Since last November when James's tumors were genetically tested, some new mutations have been discovered which would allow James to be treated with oral chemotherapy. Dr. Einhorn sent James's tumor samples off to be tested for these "new" mutations. It is not likely that he has one, but those who do typically respond very well to the oral chemo.

*James is doing well these days. It's funny (in a way that has made me laugh out loud more than once this last week) when I think about all those months when he was being "treated" by immunotherapy that so many of us remarked how good James we looking, and how James was getting better. His symptoms are actually decreasing, and he's feeling really good. But we know the immunotherapy isn't working based on the PET.....so to say we don't know the outcome is an understatement.

*over the last week, we have spoken to several people, and the question that only a few people have dared to ask (though everyone wants to) is - how much time does James have left? Not surprisingly, Dr. Einhorn doesn't know, and isn't making any predictions. (Because for all his brilliance, he's still just a man.) Dr. Einhorn described James's cancer this week as "unusual" and "bizarre." Which means that they've never really had a patient like James. He's outside the statistics, outside the "if this diagnosis, then that treatment" formulas. For the first time since we've met him, Dr. Einhorn has stopped saying anything definitively.

We do know that very few people make it out alive from a stage IV lung cancer diagnosis. We also know that James's cancer is localized and progressing slowly. No doctor can predict how quickly it will progress. No doctor can predict what God will yet do. And, thankfully, no disease, no cancer, no doctor can undo what God has planned. The diagnosis is indeed grim. But it's just a diagnosis, merely a statement of what is. If these last two years have taught us anything, a diagnosis is not a definitive predictor of the outcome. (Because if it was, by all accounts, James would already by gone.)

So by all means, pray. You're not off the hook yet! May God be gracious, may God heal, may God lead us through any dark days ahead, may God receive all the glory for all that He's doing in this.

Blessed be the Lord, who daily bears us up.

Our God is a God of salvation, and to God, the Lord, belongs deliverances from death.

~Psalm 68:19-20~

With love & thanks,

~james & kristen

seven hundred thirty days ago...

Two years ago this week James and I were boarding a plane and heading to Thailand. 

A mere four months prior, we had opened The Foreign Wife after months actual years of planning; countless hours of cooking (the fun part - unless it's a fail, and then it's the worst part); recipe development (hello, metric system!); renovations largely involving two women (myself and our manager) whose combined hours of previous training, relevant experience, and watching renovation shows equaled maybe one; training a staff to cook and bake in an entirely different method, mode, and culture with ingredients they'd never heard of, to a flavor palate they'd never tasted, to a standard of consistency that surely convinced them I was neurotic; learning to deal with customers who are mostly a fun lot, until they berate you for your lack of skill, poor standards, and miserly approach to food and customer service because you forgot the bacon in the Caesar salad (Huh?). 

And things were going, well...great! 

Except that James could not stop coughing. He had given up preaching on Sundays, and really much talking at all because he could not speak more than a few sentences without a coughing fit. As we transferred planes on our way to Thailand he actually laid on the airport floor to try to get some relief for his back pain as weeks of an uncontrolled cough made sitting in a molded plastic chair unbearable.

Except that a round of antibiotics and consistent use of an inhaler did nothing to improve the situation. 

Except that James had done a CT that showed a collapsed right middle lobe.

Except that James had done a bronchoscopy in China that told us that "something" was "growing" in his lungs. 

Ever the optimist, I expected to find that James had some weird virus or fungus. I thought, you know, worst case scenario we were dealing with TB. 

Other than James's back pain, we were kinda sorta looking forward to a few days' break in Thailand. We hadn't been on so much as a date in years (yes, actual years - no judging!), and one of our friends said that hey, sans kids in a foreign country, it would probably feel like something of a second honeymoon. 

Within days, James had blood tests, another chest xray, another bronchoscopy, an MRI, another CT, a PET scan, a bone marrow biopsy, and a lung function test. We saw multiple specialists multiple times: a pulmonologist, a thoracic oncologist, another oncologist, a physical therapist, a surgeon, and even an infectious disease doctor.  We learned to bow and sawadee-ka our way into the good graces of numerous Thai nurses. We got prescriptions filled at the pharmacy - mostly for pain (those worked) and for James's cough (those didn't). 

When we weren't trying to sustain ourselves on the free crackers and juice boxes at the hospital between appointments, we frequented the Thai shops, enjoyed several great Thai meals, took ambling walks in the neighborhoods surrounding the hospital, and even found a fabulous little Italian place where the owner liked to sing Italian opera (loudly) in front of his diners.  (Because, why not?!) 

But mostly, we waited. When we first arrived in Thailand, no one, least of all the doctors, thought James had cancer. When we first arrived in Thailand, we thought we'd have a few days off, get some answers, fill a script, and go back to life as planned. 

But then, the results...

A hypermetabolic pulmonary mass in the right lower hilum, causing collapse of the medial segment. There are hypermetabolic mediastinal lymph nodes along the paratracheal, precarinal, and sub/post carinal (right paraesophageal) and probably hilar (obscured by the aformentioned mass) stations.

AKA - Stage III Lung Cancer.

And so began the last two years of our lives, where we have learned what words like hypermetabolic, mediastinal, neoplasm, and malignant mean.



I mean, what those words really mean.

What they mean is physical pain, weeks of suffering, the opioid class of drugs you never thought you'd need, sleepless nights, anesthesia, surgeries, hospital beds, ER visits, calls from the doctor, calls to the doctor, long hours on hold with hospitals, billing offices, and insurance companies, needle pricks, IV bags, radiation, lines at the pharmacy, weight checks, blood tests, intravenous drugs, PET scans, CT scans, more needle pricks, more radiation, waiting for results, and being asked every three weeks about your past/current tobacco use.

Of all the things on the list, I wish I was making that last one up.

Those words have also meant innumerable kindnesses from friends, precious hours spent together as a couple, tears in public, and conversations about life, death, and love with our girls.

They've meant all kinds of prayers, in all kinds of ways, from all kinds of people - from elders at churches to strangers in the store - prayers for healing, prayers of lament, prayers of faith, and pleading prayers for mercy.

They've meant always having a story to share about how God is real, God is present, and God alone gives life and numbers our days.

They've meant finding strength to persevere,

hope against some really (really) horrible odds,

joy in the midst of sorrow,

courage replacing fear,

gratitude among the rubble of loss (so much loss),

and life in the face of death.

Those few words have meant - more than once - that when things seem really, really dark...God is actually working a miracle.

There's been a lot packed in to these two years.

And we wouldn't trade them for anything.

Thanks for coming along, friends.
~james & kristen

august and everything after

Hi All - Sorry for the long silence over in this little corner of the internet. So we fell off the face of the earth for the summer, but the good news is that the views are spectacular! 

I hope to write a few more posts in the coming days (but those of you who know me can shrug those off, "promises, promises..." and then be pleasantly surprised if I actually come through, teehee!). 

Since I last wrote, here's a few highlights...

1. James just completed 5 treatments of SBRT radiation to his hip on Friday. Ever the unusual patient, James's pain actually increased on this treatment, though yesterday and today he has been able to have several hours pain free. (I think this is a good sign, as we've learned that cancer pain comes and stays...it doesn't comes & go.  It's possible that the pain he is now feeling is the effects of radiation and not from the tumor.) We are hoping and praying that as the days pass post-treatment, his energy will return to previously high levels and that the pain will stop completely. There's also the possibility that even though doctors only radiated his hip that this treatment can have a synergistic effect with immunotherapy, actually increasing immunotherapy's effectiveness.  Also, James is off of his inhalers and coughs pretty minimally now. Wow - how did we get here? 

James's next CT scan will be sometime this month...I'll be sure to keep you in the loop on that humdinger.

2.  We are now a family of six! We returned from China with our 16 year old niece, Haoping, who will go to high school here in Indianapolis. She starts school in just a few days and has been busy back to school shopping, getting immunized (ouch!), enrolling in classes, eating American food (which she says is much better than her Uncle James led her to believe!), and acclimating to air conditioning. Hat tip to all the large families out there who manage to seemingly effortlessly stay on top of the lives of their children ranging in ages from preschooler to high schooler. It's an impressive feat, let me tell you! (After this last month, the only reason we might still be functional is because we don't have middle schoolers in the mix - ha!)

3. We had an absolutely wonderful summer back home in Dali. We had fabulous weather (siiiiiigh), too many ice coffees to count, hours of fabulous conversations connecting with locals (yeah for my brain that quickly recovered my Chinese!), incredibly blessed (and delicious) weeks spent in the restaurant kitchen, swimming with friends, a week spent relaxing with James's extended family in the village, perhaps the best tiramisu in the world (come to The Foreign Wife!), got drenched in the pouring rain, and....everything in between. I think one of the girls favorite parts was getting to go to the corner store on their own to buy bubble gum, ice cream, and various other sundries. It was a whirlwind of a trip with very little downtime for either James or me, but it was very, very good. God truly blessed the weeks that we had, and we saw Him accomplish and do things in those short weeks that many times we would wait a year or more to see. 


4. Our restaurant did something of a relaunch the last week I was in Dali. Our staff has new uniforms, we installed a new China Town style sign out front that glows in your sleep, our menu was updated and reprinted with heaps of new dishes, staff assignments were realigned, we hired a couple new staff members, we sent out an advertisement via social media that got 18,000 views in the first 24 hours....and naturally got wind in our sails from being all together again. By the time I left everyone was feeling recharged and excited, and proud of the work they do. (They know how to make Italian pasta from scratch! What's not to love?!) Not surprisingly, our July sales were the highest they've ever been. Exciting stuff. 

5. We are looking for a place to live. With the addition of our niece + the uncertainty of our time here in Indy (will it be another year? another two? three? ten?), we have started the house hunt. Kind of exciting and definitely overwhelming in it's complexity. The cultural differences are absolutely astounding and either make you laugh or make your head spin. But it's all good, and we are thankful. 

As always, thanks for your love & prayers that continue to bless and sustain us. Since our return to Indy we are finding grace to persevere through this season of our lives. In the last couple of weeks, James has had some of the worst pain he's ever had, and many nights of disturbed sleep. After our time in China it feels like a real setback, and is all things scary and depressing all rolled into one. But we find that as we draw near to Him, He strengthens us so that we do more than plod. Some days it feels like a plod (and that may be all you have the strength or energy for), but if you can just look up...you see there's just so much to be thankful for. 

Enjoy this beautiful day...
~james & kristen

moving forward in faith

Hi all - thanks for checking in with us again! I'm sorry that between the technology issues and the pace of life we've kept up over here, our postings have been few and far between. Nevertheless, James made it back to the States on Monday, and yesterday (or today, depending on where you are in the world) (Wednesday) James had his PET scan and a review with the doctor. Dr. Einhorn was away at a medical conference, so James was seen by his colleague. (Just to forewarn you of the coming pronoun change.)

I'll first share her observations & then the conclusion.

She noted that James is doing really well and looks really good. He's put on some weight (not surprisingly!) which is noted a good thing in cancer world. I was able to mention that his energy levels are way up even from two months ago, and that his cough is generally improved as well. She felt that overall he is doing great and looking quite healthy. She was really pleased with his overall condition.

Per the scan, all the tumors in his chest are stable. There is one spot that was a little brighter than before, but not enough to worry about yet. His hip, however, continues to light up strongly with no improvement. In fact, it is a bit worse than before - though whether this denotes tumor growth or inflammation (15 hour plane flight, anyone?) is impossible to discern. 

She observed that James is definitely favoring his hip, making sure that he doesn't do too much to cause additional pain. She was not comfortable with him continuing like this. She also doesn't like the possibility of tumor growth.

So, the plan for now is to continue on with the immunotherapy. She felt that James needs more time, and that given that his overall health is improving & that the tumors are stable is proof enough that it may be working. Yesterday was his 5th dose, so he's only been on this for 3 months. I get the sense that they were expecting a fairly immediate result, but as James's cancer never acts the way they think it should, I am not surprised. And I am also thankful that we're not pulling the plug on immunotherapy yet.

Additionally, given James's age, energy level, and the reality of present cancer she has recommended that James start radiating his hip. She doesn't want any tumor growth and they know (as much as they "know" anything related to James's cancer - ha!) that radiation will help with pain. Different than before - where radiation was daily for over a month - this will be a once a month treatment between immunotherapy treatments. For all I know, this may kill off the tumor there...though they haven't said that. (Personally, while I believe it's a tumor there, I am not fully convinced that it's lung cancer in the bone...since it doesn't act the way it's supposed to and they've never biopsied it.) Who knows but that radiation may be a means of His grace to bring healing. We can at least pray toward that end. 

So we move forward. As I said, we are both thankful that James gets more time with the immunotherapy. James was feeling less then thrilled about radiation, but I believe that since it's not daily nor concurrent with chemotherapy, his experience with it this time will likely be radically different than before. We are both genuinely thankful that James had such an incredible month here in China, impacting so many people in such a short time.  We give thanks that James's health is improving, and that the cancer is stable. As I told the doctor yesterday,* I think that is counted as a win in the world of cancer.  

We both feel strongly to continue to move forward, one day at a time, trusting in God's loving care. We are called to believe and to trust in who He is, and that His plans for us are genuinely good, even when things don't go exactly the way we want them to. (See Tim Challies, "God Doesn't Owe Us a Happy Ending.") So for today, we have grace to believe that God is faithful, and He will sustain us to the end (1 Corinthians 1:8,9).

Thanks, as always, for your prayers! (And for reading what seems to be a very dry blog post!)
~james & kristen

*Yes, I talked to the doctor via James's WeChat app - there I was, stumbling out of bed at 12:30a.m. like a drunk housewife, trying to put coherent thoughts together while simultaneously trying not to wake everyone in my house. I am sure I made quite a first impression! 

how he's really doing

So many of you are so faithful to ask us how James is really doing, and as I've not updated you on his situation in a couple weeks...this post is for you. Your faithful prayers mean so very much to us...what an incredible blessing it is to walk this road with you all, to be lifted by your prayers, encouraged by your love, and strengthened by your faith.

The last week of May James saw Dr. Einhorn, and at that time was not feeling all that great. In fact, his hip pain was getting stronger and he ended up asking for prescription pain killers in anticipation of things worsening while we're away (and being away from the good drugs!). Naturally, that really concerned Dr. Einhorn who promptly contacted our insurance company...and got a PET approved for the week James returns.

Dr. Einhorn was careful to remind us that he's been "doing this for 40 years" and that he doesn't make a diagnosis based on symptoms. I think, though, that everyone had hoped that the hip pain would be gone by now. Since his bones will "never" be right again, as you can't grow new bone, it is impossible to know whether the pain is from cancer that just won't die (and is growing?!) or from the compromised nature of his bone. He also has intermittent pains in his chest - is it new tumors or the effects of coughing and radiation?

Naturally, cancer patients take any kind of pain quite seriously (as do their doctors) and after months of pain, treatment, and being a patient, it is probably difficult to objectively evaluate if your health is improved or worsening. (Is that twinge of pain new cancer? Is it back? Am I actually dying?)

So a PET is the best way to know what's really going on.

Since we've been back, James's pain has not gotten worse, and some days its been better. His cough also seems to be descreasing...especially in light of how many hours he daily spends in conversation. There were times where he couldn't speak more than a few words without coughing. But now he is able to speak for about as long as he wants before coughing once, and then continuing on. (As I write, he's sitting just across the room, sharing the Good News with a small group of people and has been speaking for at least 10 minutes with nary a cough!)

And I personally find it remarkable - being the optimist I am - that all those hours on the plane (15 hours, just for one stretch!) did not leave James completely incapacitated for several days after deboarding. In fact, he seemed to handle the travel as well (or better) than I did. It was only a few months ago that his hip pain kept him from traveling a mere 4 hours. So, improved, right?

Also, James's energy levels seem markedly better than even a month ago. I have watched as he divides his day studying, in hours of conversations with people, up and down multiple flights of stairs, playing with his girls, carrying them and letting them climb all over him, et cetera, et cetera...all without a nap, all without wearying until the end of the day. This would have been impossible even a month ago.

Of course, it's been enjoyable to see everyone comment on how healthy James looks. Everyone here is amazed at how strong he is, his coloring, his energy, his hair. Definitely not your typical cancer patient!

So - there's lots (in my humble opinion) to point to an improving state of health, that the immunotherapy drugs are working.

But...there's pain that won't go away, and there's so many opportunities for fearful thoughts to creep in. Short of (another) miracle, immunotherapy is the last resort for James. If this drug doesn't kick it, and God does not show mercy, James will not make it. There's nothing else that can be done.

So...as you've always done, and continue to do...pray. We know that nothing can alter God's purposes, and that His plans will stand. May His will be done, and may we have strength and faith to joyfully submit to all that He has for us. 

Thank you.

made it...alive!

Well hello there...it's been a while, hasn't it? Excuse the delay, but between the time warp of the last week and the difficulty of getting onto just about any US website here...it's taken a bit of time to write an update. But here we are.
Back home.
Wow.

(I feel like we should throw in a "Thank You" and "Amen" in there too.)

Here's our life in bullet points...

*We have LOVED getting reconnected to people here. In fact, as I write, the girls are all down the street at the lake with one of their old local friends (and his mom). We have spent hours of time in conversation with people already, and are savoring every bit of time with them. The connection that we feel to people here (and they to us) is such a precious treasure...what a gift "reunion" is.
*The girls have adjusted fabulously! Thank you for your prayers in this regard. They all have various degrees of memories from this place, but they have slid back into life here like fish to a stream. It's been a joy to behold.
*Something else fun for the girls - June 1st was Children's Day, and business at the restaurant that night was booming. The girls - especially Lydia and Michaela - whole-heartedly plunged into restaurant work, bussing tables, charming the locals, entertaining their kids, and even helping wash the dishes.  They were awesome! Every time I think about them working, I can't help but laugh at the stereotypical nature of it all. ("I went to school, and then during holidays I worked in my parents' restaurant." HA!)
*The mountains here are just so beautiful. There they are, every day, at the end of every street, outside every window of my house, firmly, stoutly jutting into the clear blue skies...I missed the mountains. (Strangely, gratefully - we haven't had any difficulty adjusting to the altitude - yeah!)
*This last week we've spent a fair amount of time getting settled into life here - our lives even before James's diagnosis were a bit hectic, and then added to that our hasty departure...so you might imagine we didn't leave our home in the best of conditions when we left. I will say this - it's amazing what kind of deep feelings of "home" result for me by de-cluttering my house and getting rid of all the old things. (Think flour, toothbrushes, torn clothes, broken toys...) I am sure if any of you ever had a summer home or cabin on the lake you can understand...if you multiply it by about 100 times the dust! (How does dust get inside cabinets and drawers?)
*"Home" also feels like making your family breakfast out of the kitchen you helped design - a first for me this morning. We've already been here a week, so it felt like a major accomplishment! That my precious (read: imported) stand mixer and oven still work are small miracles that I do not take for granted.
*James invited all the local shepherds to our restaurant last night to treat them dinner, encourage them in the work they do, and to reconnect to local work here. I think they spent about 4 hours together. When I woke up this morning, I found myself marveling that God has truly rejuvenated him and given him strength for the tasks before him. What a joy!
*Also not taken for granted - James preached last weekend and will preach again tomorrow morning at his local fellowship. I can't help but be reminded that in the weeks leading up to our departure to Thailand nearly 2 years ago, James had given up preaching. He was too sick, coughing too much, and had all but lost his voice. Immeasurable riches of His grace in kindness...
*As I've driven around town, I can't help but notice how much has stayed the same. Things aren't just vaguely familiar...so much is nearly exactly how we left it. (But not the local Walmart - it's been remodeled and is an absolute disaster.) It's been fun, too, to walk into places and be recognized by the shop keepers and restaurant owners. Lots of good conversations reconnecting with locals.

It is good to be home. We're savoring every bit of time here, and feel that even though we are busy, these weeks will be quite restful to us.

Do continue to remember us - of course it's impossible to be here, doing the work we do, without encountering spiritual opposition - it comes out in feelings of fear, discouragement, and being generally overwhelmed by the work that needs to be done. ("Where do we start? Will it even make a difference? Is real change possible?") Yes, we are loving being back, but it is not all rainbows and kittens. There are real people with real problems. There is a western restaurant with nary a westerner to help run it. (wink) And there is a local church comprised of many young believers that is trying to move forward in faith without a shepherd.

So ask that God would continue to fill us with faith, strength, wisdom, and courage for the days ahead. May He redeem the time we have, and may He be glorified.

Thanks for remembering us...
~james, kristen & the girls

grab your things...

Back in the days of college, when God gave me a great roommate with much cooler music taste than me (Thank You, God), we inevitably approached school breaks with hyper enthusiasm, giddy excitement, pure exhaustion...and Peter Gabriel. It's funny the things you can remember (or funnier, perhaps, the things you do not) - but I have sweet memories of packing up my things in the dorm while belting out along with Mr. Gabriel - Grab your things, I've come to take you home...

Oh, the days of the repeat play function on a CD player.

And so, here we are...officially on our way, with tickets purchased (gulp) and visas in hand (yeah, FedEx!). And, of course, not a thing packed. 

We leave in a week.

As it turned out, James will be in China for 4 weeks, while we He girls hang out for 6. The hospital in Thailand perhaps could have procured James's drug, though only with weeks of red-tape and without any kind of guarantee. We are all quite content with how things turned out, and these days, with James feeling so much better, we believe that he can likely return for other trips in the not-so-distant future without a problem. (Something that's not always been possible over these past 2 years!)  

As you continue to pray for us, pray that God grants us a trip that is refreshing, that God uses us to minister to others, and that He opens doors for continued, future ministry. 

James will spend the majority of his time in Dali, but will be doing some travel/ministry around the province as well, so ask that God protects him and keeps him strong! He will have his next infusion the day before we leave - please ask that God prevents any and all ill side effects while we're traveling/away from good medical care.

I will spend a fair amount of time at The Foreign Wife, cooking up a storm, teaching the staff, drinking more Italian coffee than probably wise, and trying to discern (with James & the staff) the best way forward over the next year. (Added bonus - I now know how to make mozzarella!)

And of course, the girls - may God be gracious to our girls who are at various stages of remembering China and their Chinese. (Lydia started giving Caroline Chinese lessons this afternoon. She grimly reported, "Yah, it's not going well.") (Yes, Caroline - the Caroline who first came to the States exclusively speaking Chinese. That Caroline.) 

At least we all still love Chinese food. 

Now I'm off to do a long list of things that doesn't include packing (yet). Thank you all for your support and prayers! We hope we'll get the chance for an update or two while we're away as well. 

(Nitty gritty details for those of you still reading - the girls' last day of school/James's last infusion day is May 25th. We leave at 9am May 26th and will arrive home the morning of Sunday, May 28th.  Giddyap.)

hey cancer - you're losing!

Hi Friends...

Here's a bit of good news to start your day - James had a CT yesterday and from the best of Dr. Einhorn's ability to discern, James is responding to treatment. (Insert sound of party horn here.)

In an ideal world, our insurance would have listened to our doctor's clinical evidence which necessitates a PET scan...but we don't live there...so a CT it was. Unfortunately - or I guess fortunately, depending on how you see things - James's cancer in his chest is only at the cellular level, which means a CT cannot pick it up. So the only thing that Dr. Einhorn was able to say definitively is that James's cancer is not worse. (No new tumors, no new growth, no progression of disease.)

We take that as a win. 

Had we access to the PET, we might have even better news...like, "Oh, by the way, all those cells that were cancerous are no longer there." Or some such glory. But we are indeed very thankful that between the CT results and the fact that James's symptoms are decreasing, Dr. Einhorn can conclude that treatment has been effective.  

So we continue on. James had another infusion yesterday and will continue to receive them every 3 weeks.

In other really great news, this all means that we get to head back to China for a bit of time this summer. This is not a permanent move back, of course, but we will get to visit for at least one month.

James's ever-so-kind and well-connected doctor has gotten in touch with his old friend/former colleague Dr. Theera...the onocologist in Thailand who first diagnosed James...to find out the availability of the drug in Bangkok. (Insert gleeful humming of "It's a Small World" here.)

If - and it's a big IF, people - the drug is available and it's being used in the same way (i.e., to treat lung cancer), James could get treated once in Thailand before returning Stateside which would extend our stay for a couple weeks.

That would be remarkable.

Over the next couple weeks as the girls finish school and James continues to improve (right?), we'll be busy prepping to return...visa applications, booking flights, brushing up on our Chinese, and all that good stuff.

We so appreciate your prayers through all of this, and give thanks for your patient endurance along what has turned out to be a long stretch of road. Thank you for journeying with us.

So be truly glad. There is great joy ahead...

1 Peter 1.6 (NLT)

                                   

thankful

Early Tuesday morning I woke up to the sound of James's snoring. That's a fairly uncommon occurrence around here, though whenever it happens, my immediate, extreme annoyance is the very common result. 

Not this week, however. 

After a few half-hearted attempts at flopping on the bed to "reset" my husband back to silent slumber (does that ever work for you? It does me!), I laid awake and felt...grateful. 

James is doing really, really well on the immunotherapy drug. In general, his hip pain is decreasing, his cough is decreasing, and his energy is way, way up. In fact, I am almost to the point of feeling embarrassed (the good ol' Chinese bu-hao-yisi variety) to use the valet parking at the hospital or to walk in to the cancer ward looking so good. I am guessing that most people in the waiting room at this point don't know which of us is sick.  

So there I was, lying in the (noisy) dark, offering up a simple prayer of gratitude and thanksgiving to God. Just a simple prayer of thanks that He has sustained James's life thus far, eased his suffering, and been gracious to us. 

And then I realized how long it had been since I had offered up a prayer of thanksgiving to God. 

Does that ever happen to you? You're in the midst of going through a struggle, or grief, or pain, or fighting for your life, or actually just trying to make it through the line at the grocery without losing it...and in the midst of all that there are a lot of prayers for God's help and mercy. Lots of prayers that sound like a little kids' incessant demands for assistance. 

Show up. Now, please.
Give us favor. 
Heal this.  
Let this go the way we want, and may what we want & You want graciously align.
Please do something.
Make it stop.
HELP!!

I think all those prayers are really good prayers, and that God is honored in our childlike (or childish) asking for His help more than in our bullheaded determination to work things out on our own.  



But sometimes...certainly more often than I am prone to do...we should stop and just say Thanks. 

Thanks for showing up
For doing more than we ask or think
For strength
and grace
and life in the midst of all this.

And just for fun...here's a photo - a testament to how the Lord has truly carried us this far! James posted this to his WeChat account this week, and so I am reposting it here. We are thankful, and in awe of how God has done more than merely keep James alive. He has given him life, rich and full (and strong!). He has very graciously answered so many of our prayers! Let's continue on in expectant faith, looking forward to what God will yet do.

 

Happy Easter!

Over the course of these last two years, one of the most disarming things that I repeatedly say to doctors is, "James should be dead, and yet here he is." It seems strange to me that in a cancer ward people would still be so hesitant to talk about death, so I am always kind of surprised that everyone else is surprised to hear me so openly make that statement. (What, you mean every other wife doesn't refer to her husband as "a dead man walking"?!) But seriously, friends, are we denying the reality of our own mortality that much, that in the face of infusion tubes, wheel chairs, feeding tubes, massive amounts of costly drugs, pale, bald people who have been stripped of nearly everything that marks "life" and "living" - could we really spend so much as an hour with any one of these patients and not realize that even if they "beat" cancer, that they are going to die, that we are going to die? 

Let me let you in on a little secret - just in case you didn't know - if you are alive reading this right now, it won't always be this way. You are going to die. But don't feel bad. I will too. 

Yet today is Easter Sunday, the day we celebrate the most wondrous event in the history of the world. Jesus, the Son of God, who bore our shame, our debt, our sin; who died the death we should have died; who was buried, and descended into hell...this Jesus was raised to life. The power of sin is broken, the curse has no power over me, and my sin can no longer separate me from a holy, righteous God. Death no longer gets the last word. In fact, one day, that which is mortal is going to be swallowed up by life...and we will actually live forever. 

May we rejoice today, as every day, that Jesus lives. We serve a risen Savior. He is our rescue, and in Him is Life. So this is not just James's story, or my story, but a truth for every one of us who has put faith in Jesus -  we are dying, yet behold, we live (2 Corinthians 6:9). Thank You, Jesus. 

can you go 10 rounds?

We spent much of yesterday at the hospital, and had the distinct pleasure of seeing how a very large hospital with dozens of doctors, nurses, and support staff, and hundreds of patients that has also fully transitioned to digital records manages care when the computer system shuts down.  Fun times! Lucky for us, actually, not much changed, though we did get to skip one step of check-in, so actually maybe for us it worked better. Ha!

We met with Dr. Einhorn and got the results. James does not have the rare genetic mutation, which means he qualifies for the immunotherapy drug pembrolizumab. (Say that three times fast!) The idea behind immunotherapy is based on the fact that cancer cells have "immune inhibitors" which act like a barrier, preventing your white blood cells from responding to your cancer. They are unable to attack the cancer cells, even though they recognize it as a foreign body that needs killed off. Immunotherapy drugs break down the immune inhibitors, while boosting your body's immune response, which allows your body to attack the cancer cells, and in many cases, kill off the cancer. It is the newest advance in cancer care, and pretty state of the art stuff.

The Plan
James had his first dose of "pembro" (as the insiders call it) yesterday afternoon. It is an IV infusion that takes about 30 minutes...or 2 hours if a nurse can't find a vein. Not that we're speaking from experience or anything. (Ouch.) James will receive these infusions every 3 weeks for one year, which translates to 17-18 doses...a few more than 10 rounds, but not bad! Throughout the year, Dr. Einhorn will be monitoring James through blood work, x-rays, and (hopefully, if insurance doesn't hate us) PET scans.

The Hope
Dr. Einhorn used the word "remission" yesterday, which was really encouraging! We had no idea this was possible apart from a miracle. But yes, over the past few years doctors have seen patients with other cancers use immunotherapy drugs, experience remission, and be effectively cured of their cancer. Unfortunately (or fortunately, however you want to look at it) - this drug is so new in the world of lung cancer that they don't know yet if the remission will "hold." That is, does lung cancer go away only as long as you use the drug, or can you actually be cured of lung cancer? Is remission of even a few years possible after a year of immunotherapy? They don't know, and they know that thus far, nothing has really been that effective for most lung cancer patients. But based on what they've seen with other cancers, they are tentatively hopeful.

Additionally, doctors have seen that patients who have the PDL-1 biomarker respond the best. That is, the higher your percentage of PDL-1, the more likely pembrolizumab is to reduce/eliminate tumors, and the more likely it is to allow you to live longer without progression of disease. With James being a 90% percent match - one of the highest they've ever had - this is all very good news. Needless to say, Dr. Einhorn expects this to be very effective for James, and is expecting he'll experience remission.

The Needs
Okay, so I know this is what you wait so patiently for...you wade through all my mind-numbing (quasi) medical mumbo jumbo to find out how to pray. Thank you! You are so kind. And here you go.

*There is a small risk that James's immune system will be over stimulated, resulting in any kind of "itis" you can imagine (hepatitis, colitis, gastritis, our old friend pneumonitis, etc.). Pray that this does not happen. They have medical ways around it, but better if we don't have to endure that, IMHO.

*James broke out in a rash today. Apparently not too itchy, but it is a direct (common) result of the pembro. Fun times! Pray that it goes away, and that it isn't something he has to deal with every time.

*James's hip is causing a significant amount of pain these days. Dr. Einhorn expects James to feel the positive effects of the pembro in 4-6 weeks, which would mean a reduction of pain. May this drug be a means of God's grace, effectually working in his body, graciously bringing health, healing, and life. And if God would show James mercy in allowing the drug to work faster than it's "supposed" to, well, we would not be surprised...but we would be very grateful.

*Dr. Einhorn has been so kind to be mindful of the fact that we would rather be back home in China. He brings it up just about every time we see him. He has offered to go above and beyond in some ways if it meant that we could return. While we don't currently have plans to return to China long term (we are far from out of the woods), we are hopeful that we might be able to have an extended visit over the summer. To me, sitting where I am right now, this is little more than a dream. But you can pray for that, and we'll see what God does.

God is at work. God is good. And this is far from the end of the story.

But you knew that already, didn't you?
Thanks for hanging in there with us for the long haul. We'll get to the end of all this one day, dear friends, and not only will our joy be that much deeper for all the hardship and sorrows we've endured, but we'll all be better for it.

To God be the glory.

I Hate Your Rotten Guts

Okay, so last time I said that the latest report from the oncologist made us feel like we were on a roller coaster. Actually, I think it feels more like this.

LIFE AS SKYDIVING 
while screaming "I HATE YOUR ROTTEN GUTS!!" to cancer, pain, suffering, and death. 

We spent most of our day at the hospital yesterday, perhaps the last time we will need to do that for awhile. We had asked for prayer that the results would be conclusive, and I think God graciously answered those prayers. Here's a summary. 

What We Found Out

*James had two severely restricted airways. The pulmonologist said it is "classic" radiation damage. The airways were "pinholes" too small for the bronchoscope to enter. In one, the pulmonologist was able to inflate a balloon and open it up. Time will tell if it will stay open. In the other (which leads to the right middle lobe), he was able to insert and inflate a balloon, but as soon as the balloon was removed the airway went back to its original size. The pulmonologist also stated that the airway leading to the right middle lobe is so constricted that it will possibly close off completely, resulting in James losing his right middle lobe. Thankfully, if and when that happens, that is the smallest lobe of your lungs, so...you live.  

*The pulmonologist saw no visible tumors. (Yeah! Good news!)

*Pathology was at the bedside and as the pulmonologist was removing tissue samples for biopsy, they found cancer cells. (See above picture for how we feel about that.)

*The conclusion is that James has a recurrence of lung cancer, which is completely likely and, in many ways, expected. There is a reason they track you every 2 months after they think you are in the clear: this crap is aggressive and is likely to recur. They assume that James's hip is metastasized lung cancer. 

Where We Go From Here

*Tissue samples will be sent for genetic testing for one more (rare) mutation. If James does have this mutation, he will start a daily oral chemo pill. The results of this test will take about 2 weeks. 

*Assuming he does not have this mutation, James will start the immunotherapy drug pembrolizumab on March 23rd. This is not chemotherapy, but a relatively new drug that was recently approved for use with lung cancer patients. It is given intravenously once every 3 weeks. Most patients tolerate it very well (ie, much better than chemo) with very few side effects. For those of you who are really interested in research, James does have the PD-L1 biomarker.

How Are You Guys Doing? (No, Really...)

We know that if you're reading this, its because you love & care for us deeply, so we know that this news will be met with sadness, grief, and maybe even anger. I think this is valid, and I think you should let God know. 

To be quite honest, after the doctor's appointment last week James and I both ended up wrestling with God with where this journey seemed to be heading. By the weekend, though, we had both willingly submitted to His plan and were able to pray, "Not my will, but Yours be done." We are very much perplexed, but we do not despair. He has graciously given us His peace.

I think one of the greatest joys of my life came yesterday when I was reflecting on this "sudden" turn of events. I realized that when the doctor called me over to that little glass room in the basement for a consult, I didn't feel that my world was imploding. The word "cancer" came off his lips, and I could accept it. The first time James was diagnosed, we felt lost. We were shocked, stunned, and grieved to the core. Cancer came into our lives and had us in a choke hold. Or maybe it was trying to drown us. This is not to say that God didn't meet us in those times. He did, and He showed Himself present and merciful in some really spectacular ways. 

But this time was so very different. Our future remains incredibly unclear, with all sorts of unknowns. My parting words to the doctor yesterday first expressed my gratitude, and then I said, "So James lives to die another day. That's true for each of us." I don't think I expected the sobering effect that would have on him. Yet if there's only one "gift" of cancer, it is that it makes you incredibly aware of your own mortality. James is going to die. I am going to die. You are going to die. It might not be today, but it is going to be one day. And when all this temporal rubbish passes away and we live in the true reality of the "eternal glory in Christ Jesus" I know we won't be sorry. Not for one millisecond. 

So yesterday it was with joy that I realized - I have changed. God has changed me. I can look cancer in the face and say that I am not afraid. I can look at all the loose ends that are my life, and be at peace with where God has me. I can see all the unanswered questions, and see that I have an opportunity to happily trust Him. I can joyfully accept this path, and I can willingly submit to all He has for us. We do not feel our lives are screeching to a halt, imploding, or spinning out of control. James actually said he was "encouraged" that things weren't as bad as he thought they'd be. We have hope. Hope that is real and sure. This is not the end. And even when death comes...and it will...that is not the end. 

So when I realized that once upon a time...not so very long ago...I struggled to do any of these things, I rejoiced with deep gratitude in my soul. God has changed us, is changing us, and will continue to change us. For His greater glory. Amen and Amen. 

But Please Pray

Okay, so we are feeling emotionally and spiritually bolted together today, but that doesn't mean we don't covet your prayers. We need them now as much as ever. Our faith, peace, and joy are inextricably tied to your prayers for us. 

*Thank God that James's cancer seems to be progressing slowly/slower than normal. One thing that Dr. Einhorn had told us pre-PET scan was that if James's hip was cancerous, there would be multiple bone tumors at this point. But there aren't. Just the one. And no visible tumors in the lungs. Praise God.

*Ask for God's continued "intervention" in our lives. I keep thinking how none of this has gone the way doctors expect/have expected. Pray that that continues, for God to continue to miraculously override the typical path, and that God will use all this "confounding of the wise" to bring glory to Himself. 

*Ask for God's deliverance. I have no idea what that would even look like at this point...what does healing look like when you're set on a path of drug therapy that does not stop until your cancer stops responding? Do you get to a point where you've been doing so well for so long that they decide to see what happens with no treatment? I have no idea. But let's not lose heart, resigning ourselves to the typical outcome (ie, death). I want James to live. Jesus came to give us abundant life. So let's pray for that. 

*Pray for God's clear guidance over the next days, weeks, and months. Where should we live? (Continue with my parents? A house? An apartment? A large-ish box?) What should we do? (Work? Ministry? Sit around for extended periods of time?) What should we drive? (Please something different!) What should we do with our "life" in China? (Sell it? Store it? Keep it? Move it?) How do we manage a restaurant and ministry now that it seems clear we are not returning any time soon? (Uhh....)

*Pray for our girls - who do not yet know their Daddy is not yet well. I hear lots of people talking about praying James is around for them, and healthy for them, for memories of him, and all that. Those are good, fine prayers, and you can continue to pray them. But pray most of all that through all of this, no mater what happens, that this would drive them to God where they can find the love of a perfect Father. May they come to love and trust Him, even through this. No. Matter. What.

Thank you. You're awesome.

And unless you're cancer, I don't hate your rotten guts.

the roller coaster ride of our lives...

James and I spent the day at the hospital and came away feeling...um...with mixed feelings.

Long story short: the results of James's PET are inconclusive. As Dr. Einhorn says, the PET can tell you about the presence of something, but it can't tell you what it is.

Step one is to procure the images from previous scans so that they can clearly compare what is (or isn't) happening with James's hip. I guess until now they've been working with reports from the scans rather than actual images. When IU radiology has a chance to look things over, they will give us their opinion on what is happening with his hip. If the latest PET image is brighter (indicating higher metabolic uptake) or larger (showing growth) then they will conclude "cancer." We expect to have results on that by Friday (March 4th).

Step two is to have a bronchoscopy. This will be scheduled for next week. This just got scheduled as I am writing for Tuesday (March 8th). The pulmonologist we met with today specializes in lung malignancies, so I believe we are in good hands. He says that based on the images he saw today he cannot determine if James has a recurrence of cancer or if it is effects from radiation.  (Apparently the whole radiation thing can last a very, very long time. James is still within the window of normal for length of time for symptoms/fallout.) Sadly, he did not mention anything today about a laser (Dang!), but we did talk about using a balloon. (Cool, but less so.)  We expect to have preliminary results from that on Tuesday.

Step 3 would be to determine - in the event that James has cancer - if James has a mutation. There is one final, very rare one that hasn't been tested for. In the (unlikely) event that he tests positive, he goes on an oral medication that is well tolerated and tends to keep the cancer at bay for....a bit.

In the event that all else fails, Step 4 would be to begin immunotherapy at the end of March. James is one of the closest matches they've ever had in terms of potential effectiveness, so Dr. Einhorn believes that should we need to go this route James is looking at (a few) years.

SO...I know, friends, a lot to take in. Not really what we were expecting to hear either. Didn't think you could die from a roller coaster, did you? In the meantime, we again ask you to do what you do best - pray. Pray that James experiences peace and joy in the midst of discouragement. Pray against fear and lack of faith on our part. Pray that God will use all of this - ALL.OF.THIS - for His glory. We know so little...but what we do know is that God is sovereign, He IS using this for His glory, and that everything He does in our lives (everything!) passes through His almighty, tender, loving hands. We (feebly) trust, and He leads, comforts, and (abundantly) blesses.

*thank you*

while you were out being awesome...

Hi Friends!

Sorry for the longish silence over here.

But silence is nice sometimes, right?


Right.
(You're welcome.)

Since I last wrote, James returned home just in time - before the real weeping and gnashing of teeth started among we He girls. Keeping everyone emotionally "up" when daddy is away is a full time job, let me tell you!

James came back with a respiratory bug which got knocked out with a z-pak. Last year at this time he had just returned from China and spent a week in the hospital with the flesh-eating bacteria. So we take this as a win. #grateful

He had an absolutely marvelous time back home. He spent oodles of time with his family, ate copious amounts of delicious food (sigh), and was able to strengthen local Christians with his testimony of God's amazing mercy. He also had the joy of seeing several locals decide to become J*followers for the first time. We are rejoicing!!

In terms of a health update....with the respiratory bug we did end up getting a bonus (unexpected) visit to see Dr. Einhorn, who said that James's lungs continue to look great (whew!), and that he'd like him to meet with their team pulmonologist this week. Apparently, there is the possibility of treating James's lungs with a laser, to correct the damage from radiation. Cool! (And crazy weird!!)

Please be remembering us this Wednesday as James has a PET scan. We are asking for a good scan that shows James to be disease free, and maybe some additional data on what is going on in his hip. He still has pain where there was cancer/not cancer. Dr. Einhorn feels strongly that the pain is musculoskeletal in nature, so I guess we'll find out! At least we hope so...

We will get the results of the scan on Wednesday, and we'll also meet with the pulmonologist guy with the cool laser. We are trusting that God will use this week as part of the restoration of James's health. May it be so.

Now I'm off!
Picking up the girls from school, enjoying some early SUNSHINE, homework, dinner, laundry, and all that.
Thanks so much!
~james & kristen

and he's off!

This less than flattering photo was taken while we waited for breakfast at Cafe Patachou (swoon!) at the Indianapolis Airport this morning...but hopefully serves as a good reminder to pray for James as he heads home today. James got off without a single glitch, which we do not take for granted!

In the days and weeks to come, please pray
*for kind and compassionate flight attendants. We understand the reason to be twitchy around Asians with a cough when you're traveling internationally...but there is no need to be rude. Unfortunately, that hasn't stopped some flight attendants from displaying a total lack of courtesy. (Yes, even when they knew he was a cancer patient! But let's not make my blood boil...)

*for James to continue to feel healthy and well. May he be strengthened to take full advantage of every opportunity that he has to meet with people, enjoy good food, fellowship with local believers, and relish time with family.

*that God's Spirit would work unhindered in the hearts and lives of those who know James, those James will be speaking with...I expect James to have the opportunity to speak personally to well over 200 people in the 3 weeks he's there. May God be glorified as James shares the story He has written!

Thanks, friends! I look forward to sharing updates as I get them, and I know you join with me in joyful expectation to hear about all that God does with James' time at home.

For from Him and through Him and to Him are all things. To God be glory forever! Amen.

~Romans 11:36

Best Books from 2015

Do you read? And when I say, “Do you read?” I mean, do you read more than your Facebook, Twitter, And Pinterest feeds? More than emails and blogs? Like, you know, actual books? If you don’t you should, and you know you should. (Keep reading - that’s the extent of my guilt trip.) If you do read, chances are you might be looking for something to read. Here are my “best” books from 2015...they weren't necessarily published in 2015, but they're the ones that had a deep impact on me, the ones I enjoyed the most, the ones I imagine I’ll go back to reread one day. (They're in no particular order.)

Run With the Horses, Eugene Peterson – this is Peterson’s reflections on the book of Jeremiah, a book that is rarely preached, but is rich in truth just the same. Jeremiah as a character study is absolutely fascinating, and Peterson gives great encouragement for living out one’s calling to the hilt.

Encounters with Jesus, Tim Keller – James and I will probably always remember 2015 as “the year of Tim Keller” as we read just about every book of his we could freely get our hands on. This was one of my favorites – it’s originally material Tim put together as sort of a seeker’s Bible study/apologetic for the Christian faith based on the life of Christ. His reflections and insights are superb. Highly recommended.

Walking with God through Pain and Suffering, Tim Keller – this tome is absolutely astounding. If you are in a season of pain or suffering, this book will undoubtedly speak to your heart...especially once you get past the first part on worldviews of suffering (fascinating in its own regard and worth reading, nonetheless, however). Keller’s insights on the problem of evil in view of Christ are fabulous.  Expect to be deeply encouraged.

Praying the Bible, Donald Whitney – a short read, but a must-read for anyone who wants to improve as a pray-er. Think how-to book combined with godly counsel from a deeply Christian man. Dr. Whitney was one of James’s seminary profs, and we can honestly say that he lives what he writes (so anything you find by Whitney is bound to be very good).  

In the Land of the Blue Burqas, Kate McCord – this book was recommended to me by a friend of mine, and if you haven’t read it yet, I’d encourage you to do so. I was struck by Kate’s ability to counter Muslim thought and culture with Christianity and the teachings of Jesus, and was challenged to grow in my ability to do the same in the context of my ministry. One caveat - it was a little hard to discern just how or when or if she ever asks her Muslim friends to make a commitment to following Christ...or if she only ever asks them to “consider” what Christ is saying & who He said He was.  But I understand that I don’t live or minister in a Muslim context...nor am I bold enough to write about it even if I did...so I am willing to hold this critique lightly, recognizing that her book may not explicitly describe her ministry in full.  Excellent read, especially if you want to understand Islamic thought and culture.

Seeking Jesus, Finding Allah, Nabeel Qureshi – Another one recommended by another friend of ours. This is a book that is hard to put down once you start reading, so buyer beware. Nabeel writes of his path towards faith in Christ. I was most struck by how similar his story of faith – and the barriers he had to work through - is to that of the intellectual Chinese, and the cultural barriers they encounter in coming to Christ. Loved it.

The Day the Crayons Quit, Drew Daywalt – quickly became a “classic” in the He family, one that we return to over and over again, especially when we need a laugh. (And when do you not need a laugh?) What is funnier, orange and yellow crayon arguing over who is the true color of the sun, or naked beige crayon too ashamed to come out of the box? Please hurry to your library to check this out if you’ve not read it yet.

The Hardest Peace, Kara Tippetts – Okay, so not one I would recommend you read when you or a loved one is maybe, possibly dying of cancer. But wow, what a testimony to how one can go through pain, suffering, and loss with deep faith. (I still remember my friend saying, "WHY?!  WHY would you read that right now?!!!!!!") Beautifully written. Expect to cry. More than once. Read it any way.

Unicorn Thinks He’s Pretty Great, Bob Shea – I think technically the first time we read this was 2014, but we’re sneaking it on to this list because...there just aren’t enough books in the world that make you laugh out loud. This is one of them, and one that we He girls return to again and again. Taste my cloven justice!

Galatians, A Journal and Doodle Bible Study, Kari Denker – I worked my way through Galatians this year, and thank God for the way He used this study to root out remnants of legalism that have long been lurking in my heart. Doesn’t get any better than the Word of God, folks, and this is an excellent way to study it. (As long as we’re on the subject, I’d also heartily recommend “Galatians for You” by...shock, surprise...Tim Keller as well.)

The Biggest Story, Kevin DeYoung – I read just about everything Kevin writes, and this is his writing at its finest. The whole story of the Bible in a fairly succinct, theologically rich, sometimes hilarious story that your entire family should read and reread.

What about you? What did you read last year that taught, encouraged, inspired, or convicted you? Let me know in the comments below...

short and sweet

Hello again - just about to shake off some winter chill with a short run, but before I do here's a brief update on James.

He had his port out on Monday, and just as we all had prayed, he came out of anesthesia superbly. In fact, it was his best surgery recovery to date. Thank you, friends!

I had expected to get a chance to speak with the surgeon, and while he did give me an update on James post-surgery, it was only the briefest of conversations. He actually seemed like he had forgotten who we were. (I know! I was as shocked as you are!)  

On the other hand, I did get to talk at length with the surgery care coordinator about many things that God has done over this past year plus, starting with bringing me back to the surgery waiting room so soon...when there were definitely times I didn't even know if we'd ever be back. We continue to be in awe, and are so thankful when God gives us the chance to share with someone and we actually have the words to say that encourage, strengthen, or inspire. 

God has been so gracious, and we can testify that He has faithfully carried us every step of the way. Thanks for being here to cheer us on. 

Continue to pray for God's healing for James, for a continued reduction of his cough, for pain from surgery and this last year of cancer to subside, and for James to feel, well....WELL.

All for now...be sure to check in later this week for other fun stuff like book recommendations and my new recipe faves from 2015. (Fingers crossed!)

A Man, A Plan, A Scan...China

Hi friends! Trusting that you had wonderful, bless-ed holidays and, like me, have sufficiently dug out of the new year haze to feel more hopeful than overwhelmed. James had an appointment with Dr. Einhorn this week which gave us greater understanding as to what just happened. And, we have something of a plan!  Exciting times ahead for sure.

James remains disease-free.
When we asked Dr. Einhorn how they made this determination, he graciously responded with a chuckle and a, "Well, that's a fair question." Apparently, once you've had cancer, in a sense you never really have a "clean" scan. Because of previous tumors, because of scarring, because of necrosis (one of my all-time favorite medical words!) there are lots of causes for "blips" on a PET which need to be monitored but do not warrant further treatment.

Instead, oncologists look for "progression" of the disease which looks like new tumors or growth of previous tumors. James has none of this.

James does not currently need further treatment.
If you recall, last summer James had two spots that showed up on his PET scan which then led to more chemotherapy. One, a lymph node, and the other, a spot on his hip (ilium). The lymph node in and of itself was not enough to warrant chemotherapy, as it was considered one of those typical "I had cancer in the last six months" blips. The bone, however, was understood to be metastatic lung cancer which needed immediate attention.

Yet Einhorn's team knows the following about squamous lung cancer - only in the rarest of cases does it metastasize to bone, and, as Dr. Einhorn remarked, "would that everyone's metastatic cancer responded so well to chemotherapy." That is to say, the tumor in James's hip really shouldn't have responded the way that it did. It is so unusual, in fact, that they remain unconvinced that it was ever actually a tumor. (On the other hand, James & I believe that it was, and that God miraculously intervened. Choose your worldview, and the interpretation of events will follow, I suppose.)

So, with the hip tumor "mysteriously" gone, James is considered disease free and thus no longer needs treatment.

Important Next Steps
1. On Monday, January 11 at 10:45, James will return to his thoracic surgeon to have his port removed. This is a huge milestone.  I am sure it will feel a lot like freedom. Pray that James comes out of anesthesia quickly (this is usually a struggle), pray for healing without complications, and pray that we'd have the opportunity to testify to the surgeon, Dr. Freeman. A Christian colleague of his described him as an honest, ethical man who is otherwise lost. May God's dealings with James speak to his heart.

2. James will be allergy tested on Tuesday...he is currently on an asthma inhaler & it has helped tremendously with his coughing. We believe that James has allergies, and think that having allergies on top of compromised lung function (due to scarring from cancer, chemotherapy, and radiation) may be contributing to his cough. It will be interesting to get a perspective from another discipline within the medical community...we've been encouraged that James was actually able to run a few hundred feet a couple times this week after being on the inhaler. (Something he's not been able to do in over a year!)  Continue to pray for complete restoration & healing.

3. Dr. Einhorn will continue to follow-up with James every two months this year. However, he understands our desire to return to China and has no problems with us returning as long as James continues to have clean scans. He would like to get James to the summer, so whether that means we return after May's follow up or wait until after July's follow up is yet to be determined. Einhorn seemed comfortable with both, though of course it all depends on how James is doing. Pray for wisdom, and pray that we would perceive and follow God's leading.

4. In the meantime, James gets to return home to celebrate Chinese New Year with his family. It will be a joyous celebration, no doubt. Pray that God would work mightily among his family and friends, that they would be humbled and give glory to God, and that the Spirit would use James's testimony to convict them of righteousness and judgment.

5. James will have a full-body PET in March to check once more on his hip "tumor." We may never really know what that was...but maybe the PET scan will give them some helpful information. James does have occasional pain there, and while he is awfully young to have arthritis, that is one possibility. Pray that God continues to heal this area...or that doctors can determine what it is to treat it accordingly.

6. For the long term, James will continue to be monitored by Dr. Einhorn. Every four months for years 2-3, every 6 months for years 4-5, and every year after 5 years. Dr. Einhorn has several "international" patients that he monitors, and is completely comfortable getting scans from James from overseas. Interestingly, Dr. Theera, the oncologist who first diagnosed James when we were in Bangkok, Thailand, was once a colleague of Dr. Einhorn's at MD Anderson. It is possible that James will return to Bangkok & Dr. Theera for at least some of his future scans.

As this is turning into a lengthy post, I won't say any more but to thank you all again for all the many, many prayers on our behalf and to say that God continues to be gracious. James is regaining strength, hair, and eyebrows...and we are thankful.