Turning Point

hello dear friends...

we have had quite the past few days - long story short, james caught the flu which has given him some really high fevers...which was diagnosed as a "normal" flu (and not some whack-ball stuff from china) when the county health department came to our house...which then meant that james was not able to see his oncologist to get the results from his CT.  (the oncologist basically said, "you can't come here. you're too sick.")

yowza. 

so today, while we wiled away the hours at the urgent care (apparently they turn no one away - ha!), the oncologist called us to tell us the results which left me completely stunned and in shock.

james does not have cancer.

his scan looks (in the words of the oncologist) amazing, beautiful, really great, definitely different, unbelievable...nothing is worse, and everything is better. the largish mass that was remaining on the last scan is shrinking. there are a few remaining sections of inflamed lungs, but hugely decreased. the oncologist even used the word "gone" more than once to describe tumors, inflammation, etc. he sounded as high as a kite elated. he said "unbelievable" a couple of times. 

i told him i was just shocked because i thought for sure he was calling to say james had cancer. he said he was very happy to disappoint me with the news. 

james does not need any further scans (according to the oncologist) for another 4-6 months.

we will be following up with the pulmonologist & surgeon in the next few days to see what can be done with his symptoms.  (who knows but that will also include a GI guy looking at his esophagus....james didn't have GERD before cancer.)  ask that we have clear leading & direction as we continue to pursue james's total healing. 

in the meantime...feel free to join us in shouting the news from the rooftops. =)

we know this news doesn't mark the end of this whole journey...but we are thankful for the part you all played in praying for us, encouraging us, and keeping us focused on the goodness of God. i can only assume you'll keep it up until james is totally healthy. 

New Symptoms, No Diagnosis (Yet)

James is still in China, and started complaining of some new symptoms:
*difficulty swallowing & a sore throat
*chest pain
*back pain that's worse at night, when lying down.

He had been on prilosec, a drug for acid reflux. He doesn't normally have acid reflux, but between large doses of prednisone and radiating a tumor that's close to his esophagus, the doctors thought it a good idea. So while in China, he ran out and his symptoms - which sound a lot like a really bad case of acid reflux - returned. 

His symptoms could also be related to radiation - like if, say, we radiated a tumor adjacent to your esophagus and then (no one is saying it quite this way) burned a hole in your esophagus. Damn.  Oops.

Back pain could be related to sleeping on really terrible Chinese beds.

Or you know what else this all sounds like? Lung cancer. 

But there is no way to know for sure what is causing any of these symptoms, which may or may not be related, without some thorough diagnostics. So James is scheduled for a CT on Tuesday (less than 12 hours after he gets back in country) and then a follow up with the oncologist on Thursday. The oncologist will be able to prescribe next steps, whether that is chemo or a scope of the esophagus, or some different meds. Or something else entirely that only people who have actually been to medical school would know to do.

The good news is that this bumps up James's scan by a couple of weeks. (Originally we were waiting until the end of March for a PET/CT.) If it's a tumor, we will know, and can quickly get started doing whatever we need to do to get rid of that. If it's not a tumor, we can do whatever tests need done now to start getting James well. Yeah! 

For the record, no one is saying it is definitely a tumor. In fact, the oncologist said we could follow up the CT with any of James's doctors, which doesn't make much sense if you're thinking it's a tumor. (Would YOU go see a pulmonologist to deal with a tumor?)

Since scheduling those appointments, James has started back on prilosec, and has seen a reduction in some of his symptoms.  Except his back is in fairly constant pain, I think, and eating has become extremely difficult. (He ate a banana yesterday which turned out to be horribly painful.)  

So just in case you thought that was an exit ramp coming into view on the horizon...you were probably wrong. 

Needless to say, getting James well from all this, even if it is not new tumors, seems like a long haul. 

James, otherwise, is doing great, buoyed by a great visit at home - being loved on by dear family while fed the food you most enjoy is a powerful mental/emotional health boost. Beating all his brothers at cards - like he always does - brings a lot of joy. And, because it was the holidays and people have time, he was blessed with wonderful interactions...hours and hours and hours of conversations in his native tongue...with his family, friends, and ministry partners. As he said yesterday, "It's just physical pain, so I'm okay."

While we wait for next Thursday, please pray
*James will start his journey home on Sunday, arriving late Monday night. Ask for God's lovingkindness to be on display through the kindness of strangers. Based on his flight history since diagnosis, American flight attendants don't deal kindly to coughing passengers, even when they say "I have lung cancer." May God be gracious and allow him a great journey back.
*God's miraculous healing - may James experience a decrease in symptoms (a sudden decrease would be great, IMHO).
*Our continued faith in God's goodness, no matter the CT results. Together with that, pray for our willing, joyful submission to His will. Life as we want it is great, but life lived as He plans it out is best, and our greatest joy. I don't want to go kicking and screaming and dragged down this path.  But sometimes I am. Because God is gracious and ever-patient. 

Thank you, friends! You're the best & we love you! We'll let you know something when we know something. 

Here's a (Good) Thought

This year, I've been taking full advantage of the local library...not only checking out a slew of books for the girls (especially the younger two as we've started doing very basic 'preschool' at home), but also being careful to utilize the "hold" option so I can get the really good Christian books that are scattered throughout the county library system. If we wind back our lives to "normal" we normally live in a place that does not have a public library, nor does it have (perhaps more obviously) a Christian bookstore. So we're left to what can be found among our community of foreign friends, and more likely, what is available on Kindle.  But buying books to support a healthy reading habit can get pricey.  So...needless to say, landing in a place where there is just about every book you want to read...for free...even though it is a public, government institution...this is an amazing privilege that we should be taking full advantage of, friends!!  I find that the less screen time I allow myself, the more time I have to read. Shocking, I know.  And way more enriching.

So...sorry for the long lead in.  I wanted to share this thought.  It's a gem...and also puts words to why it is difficult for people like James and me to come back to the States for an extended period of time, much as we love everyone here. While we understand why we are here, and God has blessed us richly while we have been here in a multitude of ways, AND God has been gracious to allow us to minister to people here, we are still away from what we have been called to do - to reach Chinese people with the good news of the Gospel. That's hard. And it should be.

"We were made to live with no less a drama than the spread of God's eternal reign. We need adventure. We need purpose. We need the adrenaline of stepping out of our comfort zones for a purpose higher than our own well-being. We need all of that, desperately, and we need it to matter for eternity, not just for a moment or for our bank accounts, our pleasure, or our reputations...Nothing else can substitute for kingdom life, because that's how God created us."

Gary Thomas, A Lifelong Love

Okay, yes, this is in a marriage book - a great one.  He goes on to say (just in case you wanted a random, unexpected, kick-in-the-pants reminder about your marriage...)

"In Christian circles, we do a disservice if we try to "fix" marriages without first proclaiming the necessity of fixing our lives on this magnificent obsession, the kingdom of God. I have no desire to offer five steps on how to be a little less miserable in your marriage as you live a substandard, selfish life that isn't set on the spread of God's work." 

Yowza. There we go, friends. Now go out and have a great weekend!

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!

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...

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

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!