Wednesday, February 18, 2015

James and the Reunion

For the past several months, James has anxiously been awaiting an opportunity to return home to see his family and to assure them that though he is not cured nor finished with treatment, he truly is okay. We have had tremendous compassion for his family, who we can only assume have been feeling hopeless in the face of James's diagnosis, grieving the imminent doom of their brother, and saddened by their inability to do anything to help from such a great distance.

This month, James finally got the go-ahead from his radiologist, oncologist, pulmonologist, and surgeon that he would be fine to return home for the holidays. (The holidays? Oh yes, the biggest celebration in the world is coming...Chinese New Year.)

Here's an excerpt from an email I received from him tonight, which brought me tremendous joy. I know that many of you have been praying specifically for James's family, that God would be at work in their lives through James's cancer. Be encouraged, and please keep praying for them. 

So I made it home yesterday, and I am definitely glad I'm here. All my family are so anxious to see me, it reminded me of the first time you came to the village. When they saw me, my eldest brother immediately ran to me and hugged me and lifted me up. Third brother was stunned to see me doing so well, and he goes "Nobody would think you are an ill person at all, I have been wasting all my emotions." He just could not believe what he saw. Third sister-in-law said, "When we saw you on screen you always looked pail and puffy, we were just worrying about you." And everybody goes on and on. I have never seen them getting so excited. [Kristen's interjection - if you know Chinese people at all, I can assure you that James is not exaggerating.] 
 
By the evening time the whole house was crowded with relatives and family friends. In front of 40-50 people I was able to share with them about how the Lord led me through this journey, they attentively listened for about an hour, many of them were weeping. 


I am just so glad to be here. 

James

Continue to pray - James needs sleep & he mentioned that his cough is worse than when he was here just a few days ago. Could be a mix of lack of sleep, an arid environment, dust, smoking...cancer.  (wink.)  I am sure that James will have many, many opportunities to speak with family and friends. Pray that he would be strengthened and would take advantage of the opportunities given him.  Thanks, all - you're fabulous!

Tuesday, February 17, 2015

The Pulmonologist, A Major Problem, Next Steps, and a Flight

James made it to the pulmonologist last week, which turned out to be excellent, if not without a little drama. This pulmonologist is an internal medicine doctor who has worked in critical care for decades...and is definitely not okay with James coughing like he's been doing.  

"I heard you from the other room [examining another patient].  You don't exactly have a subtle cough going on there."

He spent a good 30 minutes with us, trying to get read into the total picture of James's health history which we certainly appreciate - not all doctors have that kind of time - but we know that helps with diagnosis. 

Some of our conversation was somewhat amusing.  
Dr P: Have you been checked for histoplasmosis?
James: No.
Me: Oh, well, see, that's one of the things we initially thought this was since, you know, 30-something non-smokers don't get lung cancer. [Grin.]
Dr. P: [Chuckling] Riiiiight. [Writes up lab order to get that checked.]

Then later on, Dr. P is explaining to us that lungs don't have pain receptors but rather, they have cough reflexes. Thus, when there is something irritating the lung tissue, we don't feel pain. We just cough. So perhaps there is something [else] in James's lungs that is causing the cough.

Dr. P: When you did your bronchoscopy, did the doctors mention anything about blockage?
James: Well, there was the tumor that was blocking my lung that made it collapse.
Me: I think once the doctors saw cancer, they just went with that. 
Dr. P: Ooookay.  

And then, a less amusing portion...
Dr. P: Did the doctors share your CT results with you?
James: Yes.
Dr. P: Did they tell you that you have a blood clot in your chest?
Us: [Eyes wide, mouths agape] Nooooo.
Dr. P: Well, I'd encourage you to get that checked out [with the surgeon who placed the port].

So that was kind of how our week went last week.  

Actually, our week went really well.  Other than thinking through the possibility that my husband could die from an anuerysm or a stroke rather than cancer (the location of the clot was in his port, so if one of those things did happen, it would be death via the cure).  Strangely, James and I were not worried at all. We did think about how it might mess up our plans for the next few weeks, but otherwise were kind of like, "Whatever.  Let's go find out what's next."

Maybe getting diagnosed with a highly fatal the deadliest form of cancer does that to you. You can get news of a potentially fatal blood clot and think, "Oh, something else that could kill me but probably won't. Won't it be interesting to find out what they do to fix this?!"

To make a long story short - we went to the surgeon's office and made an appointment for the following day. (Which actually freaked out some people we told: IF A SURGEON GOT YOU IN TOMORROW, I THINK THIS IS A MAJOR PROBLEM.)  I remained convinced that it was either something that could be easily resolved or just nothing.

As it turned out, we are happy to report that it turned out to be nothing. James does not have a blood clot in his chest, inches from his heart, brain, and lungs. Yeah! 

And we had a really great conversation with the surgeon. ("You look good, James. Do you feel good?") And then an awkward moment when we had to tell him why we were visiting (despite already telling his nurse that upon arrival). Needless to say, the surgeon nearly ran out of the exam room to re-check James's CT. 

The blessing of getting to see the surgeon, though, (other than the no-clot diagnosis) was that he was able to lay out his perspective on next steps. His hope is that James will qualify for surgery at the end of March and that at that time he will surgically remove James's right middle lobe, the site of the initial tumor. If James has that removed, chance of recurrence is reduced by 20%. Sounds good for someone in their 30's. (Of course, less than 2% of people in their 30's getting lung cancer sounds pretty good and we all know how that turned out!)

We do not know yet what next steps will be. 

But it's nice knowing a potential next step. 

Other highlights...
*James does not have histoplasmosis. 
*James is back on prednisone & will remain on it until his end-of-March PET scan. (The pulmonologist really wants to see what happens & looks forward to comparing his scans.)
*James is now using an inhaler. This, together with the prednisone appear to be helping.
*James is now back home with his family in China! He left on Sunday and arrived yesterday. I'll post more (from him) soon. 

Geesh this is a long post. How do we pray?
*Thank God for the pulmonologist and his desire to get to the bottom of James's coughing. 

*Thank God that whether or not the pulmonologist really did see a clot, twenty-four hours later, James did not have one. (We really don't know what happened - was the first doctor confused or did James get healed?  Either way, we figure that God does not get enough credit on a daily basis for keeping us alive. Give Him glory & praise.)

*Thank God that James is healthy enough to return home & that he went with the blessing of all of his doctors. 

*Ask that these meds would work, and that James would be restored to full and complete health. 

Thanks!  More to come...



Friday, February 6, 2015

Back to Square One. Sort Of.

There's been a longish silence over here...mostly because there is not much to report, because for the most part, James's situation has not changed. 

He's still coughing. 

A year is a long time to cough. Even if you have cancer. Or maybe especially if you have cancer. (I mean, people who smoke cough for years and years and apparently it's not that bad.)

So we've gone back to James's doctors to see what can be done. Perhaps a lot. Or perhaps nothing. We are descending into prescribing allergy medicine (just in case there's any post-nasal drip?) and antacids (just in case there's some sort of acid reflux that James is not feeling?) This feels a bit like a descent into quackery, since both doctors believe quite strongly that James's cough is caused by radiation. But at the same time "we" don't want to stay on the one thing that has shown itself effective - prednisone - because of potential long term adverse affects. 

As one of them said yesterday, "We're good at what we're good at. We can keep trying stuff, but I'm not sure we'll fix it, and you're just going to get annoyed."  (Now that sounds like an appropriate diagnosis! Ha!)

The good news is two-fold. (You were starting to think there wasn't going to be any, weren't you?)

First, if you take the long view, James's cough is definitely better. Better than when he first started treatment (no comparison) and even better than before he started this last, most recent round of prednisone. The overall trajectory is heading towards health and wellness. Awesome. 

Second, James has been referred to a pulmonogist. We started this whole journey with a pulmonogist, so maybe this is a good sign, like when you return to start you win the game?! We can only hope. 

The appointment is next Tuesday, so please be in prayer for the doctor, that he would have wisdom in dealing with James's lungs. What James is experiencing is all within the realm of normal, but some relief in the form of healing would be a wonderful, longed for blessing.

Thank you all for your continued prayers for James and for us. Your concern and kindness are such a great source of encouragement to us! We are being given grace and faith in this time of waiting, and we are thankful. Let's all keep on, in hopeful, expectant faith that the God who has done great things will do many more, and will bring this to completion. 

Be strong, and let your heart take courage, all you who wait for the Lord!
Psalm 31:24

Wednesday, January 7, 2015

A Critical Distinction

"Does this outfit make my butt look big?"  

Have any of you ever asked that question?  Or worse, have any of you ever been in the position to need to answer that question?  


If so...thanks to our oncologist...we now know the perfect answer: 


"Not bigger, just more prominent."


In all seriousness, that's what the oncologist told us about James's one tumor that did not shrink. "No, no, it's not necessarily bigger, it's just more prominent."


Niiiice.  May not get you out of hot water if you say that to your inquiring friend or spouse...but apparently in the world of cancer, this is a critical distinction.  


Like the radiologist, James's oncologist believes that James's cough is from radiation-induced swelling.  (Though he admits that this is really just his best guess.)


Additionally, he believes that it is entirely possible - perhaps likely?! - that the tumor that is "more prominent" appears larger because everything in James's chest is a bit inflamed. He is hopeful that at the end of March when James has his PET scan that we will not see a growing tumor.  He was also careful to point out - "Well yes, this one appears bigger, but did you know that the one right next to it is significantly smaller?"  He took this as a very positive sign that the one which appears bigger (aka "the growing one") is also actually shrinking.


(We did not delve in to discussing cancer at the cellular level during our time together, but I took everything that he said to mean that the cancer tissue can be inflamed just as James's lung tissue is inflamed.  This is not the same as growing/dividing cancer cells. Which is very good news if that is indeed what is happening. Inflammation. Prominence. Not growth.  I'll take it.)

For now, though, there is nothing for us to do but wait. As optimistic and positive as the oncologist is, there are still a lot of unknowns. James's cough is markedly better (yeah!), though far from cured. (So keep praying!) And based on their experience, the doctors believe James will be healthy soon, but that assumes that the coughing, the remaining tumors, and the inflammation all go away. 


James does not need any other chemo or radiation at this time. 


And as for surgery, though in November the oncologist was leaning strongly towards James having surgery, after today's visit he said that things are looking "excellent" and that for now we should not be thinking about surgery.  Doesn't mean that it won't ever be needed, but to do it now would be in the realm of overzealous/unwise. 


Long story short - we left today feeling encouraged and hopeful. And while we would love to have all this behind us; to see James healthy, well, and cured; to be back in China in our home, with our friends, work, and ministry...for today, for right now, we are at peace knowing that God is at work, that He has us where He wants us, and that He is carrying us through this. His grace to us continues to amaze us, strengthen us, and fill us with great hope. Truly, we serve a good God.  For all that God has allowed in our lives over these past months, He has also allowed us to draw near and see Him more clearly than ever before. We are so grateful. 


And can I end this post on a shout out to all of you? (Sure I can. It's MY blog!) You have been so faithfully thoughtful and kind to us. I can barely remember my own doctor's appointments, much less someone else's. (Kudos to me for not missing any of James's yet. Seriously. I'm impressed with me.)  (Ha!) (Okay, only half joking there, but only because a huge part of the credit obviously goes to James.) Yet there are so many of you who have truly taken on our burden as one of your own - so perhaps it seems only natural that you would remember to ask about how it's all going since we had such-and-such the other day. You have remembered us in our sometimes feels like an eternity long periods of waiting. You keep praying, and you keep asking. Naturally. But it's anything but natural.  It's a bit odd, really. It's amazing. And wonderful. And it fills our hearts with good things. Thanks for loving us so well!

Sunday, January 4, 2015

Guest Post on Giving

Hello friends! We want to thank you for your prayers and support as James and Kristen continue through cancer treatment. We know that our God hears and has been very present, even on difficult days. We are grateful for His sustaining hand and His provision of such a wonderful body of believers. Kristen and I remark all the time how we can’t imagine people going through this situation without the Lord or His people.

As we head into the New Year, many of you have asked about special giving for the He family. Their financial needs will obviously be above their normal support in order to cover deductibles, the increased cost of living Stateside, and continuing ministry in China.  Their sending organization, Global Outreach, is not set up to transfer special giving to trusts or other funds that are typically used in cases like this. As such, the He’s sending church, Harvest Bible Chapel North Indianapolis, has arranged for a fund to administer special giving for them during this time.

For those who would like to give toward the He’s need, checks can be made out to Harvest Bible Chapel North Indianapolis with “Missionary Benevolence Fund” in the memo. The He’s name does not need to be on the check. The He’s normal support can continue to go to Global Outreach.

Harvest’s mailing address:
9675 E 148th St. STE 200
Noblesville IN 46060
 
If you have any questions, please feel free to contact me (ph.: 317.654.9836, 
e-mail: mandybhorn@yahoo.com) or Kristen.
 
We are confident of God’s perfect provision for James and Kristen in all areas of their lives and for James’ healing. Please continue to pray for them; for wisdom and peace as they look at next steps, for strength and grace to walk those steps well, and for God to do more than we could ask or imagine here and in China during this time. We know this time is not by accident and will result in His great praise. Please thank Him with us for what He has already done and will do yet.  We are taking a deep breath and heading into the new year knowing that the One who loves us deeply is sovereign over every day to come. We pray you have the same hope and confidence. 

Happy 2015 friends! 
~Mandy Horn

Tuesday, December 30, 2014

Mixed Review

We are in the middle of celebrating family Christmas, so it is a bit of a challenge to write in the midst of all the crazy. At the same time, I know that you all are anxious to hear what the latest is on James, so I will write something - maybe a little short, but hopefully I can minimize the disjointedness somehow too. 

For the last two weeks James's cough has been getting increasingly worse, to the point that he now sounds as bad as when he first started treatment. Going into his latest CT scan we really had no idea of what to expect. Based on his previous, positive scan, we were fairly confident that it wouldn't be worse than, say, hearing "you have inoperable lung cancer" for the first time....but no confidence that things would actually be improved.

Long story short, James's radiologist said the scan is a "mixed review." James has a very bad case of "pneumanitis" which sounds kind of made up, but is basically inflamed lung. In James's case, his lung is inflamed from radiation. The doctor believes very strongly that James's cough is no longer a result of cancer. Awesome news. 

James will be on a crazy large dose of prednisone over the next few weeks to take care of his pneumanitis. James's first thought was "oh my, I'm going to be eating like a cow again." My first thought was, "oh my, he's going to blow up like a hippopotamus." Yeesh. Please pray that the symptoms are manageable and that it really does take care of his cough. It would be wonderful to have James be back to his quiet self again. 😀

As to his cancer, James has no new tumors (awesome!!) and all of James's tumors are in the process of death/dying/disappearing. Yeah! Except one. Boo. But the doctor reassured us, "Well, it's only grown a few millimeters." (I'm not really sure how that is supposed to be reassuring, but I guess points for being kind.)

Next step for us? We will have a follow up appointment with James's oncologist, Dr. Gupta, next Wednesday. He has had a fairly aggressive approach to James's cancer, but we don't know what he will recommend. Perhaps surgery. Perhaps more chemo. Perhaps just waiting until James's PET scan at the end of March. 

In the meantime, we are very, very grateful for how God has carried us thus far, and we are thankful that we can rest knowing that He will continue to be faithful. Thank you for your faithfulness in continuing to care for, pray for, and remember us, even in the waiting. You are a blessing and have comforted and encouraged us in more ways than you know. Thank you.

Wednesday, December 10, 2014

Good News

So I am China these days...I left Sunday & arrived on Tuesday. I came with the purpose to check in on everything, make corrections or tweaks as needed, and to train my staff on a few new dishes to optimize the holiday season.  (The biggie is learning how to roast a turkey.) I also hope to be an encouragement - James and I never want our staff to feel abandoned, even if our personal lives are up on end at the present. 

In short - everything is going really, really well.  I am so impressed with our staff - they are a truly remarkable group of people.  (How well do you think you'd do if James taught you how to make Kung Pao Chicken and then left you for a few months? Do you think you'd continue to nail it on the flavor, or would it start to taste like American Chinese take-out?)  Over here at The Foreign Wife, everything tastes right, everything looks good, everything is (still!) immaculately clean. It's incredible.   

It's been great to get to reconnect with our staff too.  They are some of our best friends here, and I think they've enjoyed hearing how we're really doing. It goes without saying that they are anxious for our return. 

And then, since I am here and James is there...I got an email from my husband.  I'll let him share his good news in his own words. He speaks a lot about his cough - for one, because it's an incredible nuisance (and something he's put up with for nearly a year). For two, when we asked his doctors if his cough would go away, they both responded "We hope so." (Apparently when it comes to lung cancer, asking if the cough goes away is akin to asking, "Am I going to be healed?")  

I am doing well. I feel these days my health is getting better everyday. Coughing is getting less every day and much less violent and I'm coughing much shorter. Last night, for the first time, I woke up without coughing, It was a very weird feeling. Eventually I coughed of course, but it was short and light. Yesterday I played basketball and in a few minutes I was out of breath, but this morning when I woke up I felt like I have much more energy. I took Michaela and Caroline out to walk and I chased them, didn't feel any problem to breathe at all. Today I coughed so much less than any other days. I feel God's complete healing is at hand. I'm very excited and encouraged about it. 

Thank you all, again, for your many, many prayers on our behalf. We believe that God is hearing them and is working great things on our behalf as a result. Thank you.