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)