Another good MRI

We ventured back to UCLA on a rainy Wednesday for Susan’s scheduled MRI, suspecting we’d have a good scan since she’s had no symptoms of tumor trouble. We were not disappointed. Compared to November’s scan, her tumor is stable. Again. I think this is Susan’s 6th or 7th MRI without tumor progression dating back to 2009. When Dr Lai matched it with prior ones including her hemorrhage event in January 2009, he called her progress “incredible.”
 

We’ve learned to hold a doctor’s comments in check because it’s easy and unwise to project outcomes from such remarks, whether good or bad. But we’re genuinely encouraged that Susan’s tumor trend has been so positive for such a long while. Her brain cancer is not cured – it’s not even in remission – yet as long as this pause lasts, she gathers more resources for the next battle. She did have another urinary tract infection develop last week, and so began another course of antibiotics amid the reminder we still need to deal with the kidney stone that’s throwing off bacteria. Her next urology follow-up will be in February unless we need to step it up.
 

We’re so thankful for her current progress, for a good year overall, for the help we’re getting constantly from every direction, and for our peace and strength that are obviously God-given. As we look to the New Year, we know 2011 is infused with another gift borne of the Lord’s powerful support: hope.

Steroid taper continues

Aside from often-daily bouts with headache that require rest and pain meds, Susan continues to do remarkably well on her lowest dose of Decadron in at least the last 18 months. Headache is common as her body adjusts to less of the oral steroid and needs to jump-start its own natural production. But the fact that she’s been free from tumor or other problems for months means we can pursue this effort as far as possible. It also gives her a chance to shed the influence of side effects like bone loss and diabetes. We’ve learned to be ready for setbacks, but become more hopeful with the progress as time goes on. She’ll be back at UCLA before the new year for her next MRI and tumor update – but symptom-wise, things look good.
 

Today’s Brain Tumor News Blast from the Musella Foundation highlights research co-authored by Doctors Leia Nghiemphu and Linda Liau, Susan's UCLA neuro-oncologist and neurosurgeon. Their team’s 2006-2008 clinical trial study of 70 new GBM patients showed improved progression-free survival when treated with a regimen of Avastin (Bevacizumab) and Temodar (Temozolomide) following radiation therapy. Susan was not part of the study, but she's had each of these treatments during her course of treatment at UCLA.
 

Get the story: Journal of Oncology, Dec 2010 

While the clinical trial did not advance overall survival, it nearly doubled progression-free survival from 7-8 months to nearly 14 months. Such gains may seem small – but to me the study reveals the intensity of the battle as specialists try to find better ways to help GBM patients survive this devastating disease. That the study’s overall survival rate was 14 to 21 months makes us all the more grateful for Susan’s survival and good condition at 42 months. We’re also proud of the work her doctors are doing and glad she’s being helped by the best of the best.

Tumor stable again

It's been about a year since Susan's last tumor progression and the beginning of her latest chemotherapy.  The good results since then extended her MRI intervals from 6 to 8 weeks and led to last week's scan and oncology visit.  The good news continues – her tumor was stable once again.  We're so thankful. The scan shows more swelling near the tumor site; but that's to be expected since we're tapering her steroid once more and are down to about 1mg daily of Decadron.

There's been little development on Susan's kidney stones or other urology issues, so the holding pattern continues. In fact, much of our life seems to be a holding pattern. Her brain cancer has not advanced, nor has it healed. She's made a phenomenal amount of physical and cognitive improvement especially compared to 2007 and 2008, but remains encumbered and far from normal. We're still at peace with the situation and trust God with the outcome. In a moment of reflection about her progress today, Susan said, "I'm getting better – slowly, but I'm getting better. Who knows what God has planned for me? I'm going to find out."

We had a wonderful Labor Day weekend in the mountains and enjoyed perfect weather in the forest at Angelus Oaks. Susan was able to relax on our new deck, join friends at the annual potluck, and felt well enough to venture up the road to a party at the Gebb's. We're supported on all sides by loving family and friends, and we're grateful.

Clearing infection, stable scan

Susan’s lab tests early last week were positive for a urinary tract infection, explaining her recent slump.  We coordinated with her infectious disease physician, who meets the highest standards of care we've come to expect at UCLA, but is someone we’ve come to know too well over the years.   He prescribed an antibiotic that seems to be working well, given Susan’s gradually improving symptoms.  We’re relieved to learn there wasn’t something more serious afoot since a UTI is relatively easy to knock down. 

Wednesday found us back at UCLA for Susan’s scheduled MRI scan.  Gratefully, her tumor is unchanged once again, so the CCNU evidently has been working.  We had an unhurried visit with her oncologist, Dr Nghiemphu, discussing plans for her steroid taper, the possibility of having chemo next week, and her treatment schedule once we’re done with CCNU.  Susan’s recent series of blood tests show her platelets are low and trending lower, so she went for more labs on Friday.  If her counts improved, she may have her last dose of CCNU next week; otherwise, she'll be done after five doses. 

Susan spent an extra hour in the MRI scanner on Wednesday for a research study using MRS, or magnetic resonance spectroscopy.  This is a term that can make you feel really smart for a moment while you say it.  The sample of her brain tumor tissue taken in 2007 shows she has a genetic mutation that occurs early in the formation of brain tumors and seems to indicate a positive response to therapy and positive prognosis.  Susan’s neurosurgeon and neuro-oncologist asked if she would participate in their study since they’re searching for a non-surgical way to detect this genetic alteration in others during the early stages of brain cancer treatment.  They know she has it, so they’re experimenting with MRS hoping they can see it.  This extra scan not only was useful in their research it was a useful complement to Susan’s PET scan last year that will help the neuroscience team know more about her tumor.
 

We’re thankful as ever for good MRI results, great care on all sides, and for God’s never ending faithfulness for us.

Good results again at UCLA

We’re thankful once again for tumor stability following Susan’s MRI and oncology visit yesterday.  Dr Nghiemphu showed us several areas on her scans that indicate the tumor is unchanged, although we could still see last year’s blood clot as well as increased scar tissue compared to prior scans.  The blood clot may not completely disappear even though it’s much smaller than after the hemorrhage in early 2009.  The scar tissue may be the result of surgery or, more likely, Susan’s radiation treatments in 2007.   Neither the clot nor the scar tissue seem to be a big issue.  We’re glad the tumor has remained stable.
 

Since her blood counts have not fully recovered from January's chemo, we’ll wait a week and get another blood test before proceeding with her 5th dose of CCNU.  Her platelets did double to 85k from the low we saw in week 4, but they need to be much higher.  We’re also monitoring white counts and liver function that have become cautionary.  All told, this may be her last dose of CCNU since we’ve had to lower it by 20% the past few cycles and going much lower becomes ineffective against tumor growth.  Dr Nghiemphu said a full treatment is six doses anyway – and we’ll be getting most of it on board.  After that, we'll wait and watch.
 

We’re making another run at getting Susan off steroids, and will reduce her Decadron from 2mg to 1mg every other day as long as headache doesn’t become a problem.  We enjoyed another lunch at Jerry’s Deli in Westwood after Susan’s appointment courtesy of some loving friends.  We remain ever grateful for God’s faithfulness and for the support and care we receive on all sides.

Chemotherapy, Round 3

Yesterday was co-pay mayhem following Susan's blood draw at UCLA at 7am, MRI at 8am, and oncology visit at 9am. Then we winged it down to Torrance for her dermatology exam and back up to Westwood for an infectious disease follow-up. The only actual infectious disease I noticed was LA traffic. So much schlepping in one day – I ought to have my skin examined. Wait, we did that. The schedule worked out perfectly until our first appointment. It took longer than usual and cramped our timing. Thankfully, the other two doctors accommodated our delays. We pulled into our driveway by about 5pm with Susan mostly nap-less and dog-tired.

Her MRI revealed slightly more new tumor growth than in August, confirming her need to begin a third round of chemotherapy, so she begins oral CCNU (Lomustine) tonight. We spoke at length with Dr Nghiemphu about Susan having a biological agent called XL184, but were put off by its similarity to Avastin with the potential to cause another hemorrhage. We might have decided otherwise if the new tumor tissue were faster-growing and had lots of blood vessels in it, but we think CCNU will handle the need at this time. XL184 sounds promising for high-grade tumors since it cuts off blood flow like Avastin, plus it inhibits certain chemical receptors involved with the cancer. I deeply respect Dr Nghiemphu's approach in making recommendations like these. She informs and explains, and outlines potential benefits and risks - but since an outcome is so uncertain, she stops well short of dictating a treatment. Instead, she invites us into the push/pull of a complicated decision until we arrive there together. The quality of her care is so good – and gives us confidence and peace of mind in the process.

Our dermatology and infectious disease excursions came about because Susan developed two suspicious sores about two weeks ago. They emerged quickly and had too many cancer-like symptoms for my comfort, especially since Susan had a pre-melanoma removed about 5 or 6 years ago. Thankfully, they've already begun to heal and evidently were not caused by anything internal, although their origin is unknown. We walked away with a really good antibiotic cream from the dermatologist and the availability of the ID doctor at UCLA in case we need him.

Lord, sometimes I'm tempted to ask why we have to walk this road of suffering, but I hold back. I know "why" is a mystery on this earth. It may not matter in Heaven. This road is crowded - I'm sure if I knew how many were making their way along, I couldn't bear it. Some people have it way worse than we do, so how can I complain? Some people's whining seems louder than the size of their troubles; but if they've reached their limit, how could I tell them to be quiet? It's better not to compare.

I remember the days before disaster struck. Susan and I were a team in marriage, as parents, in ministry, and in life. Our activities were intertwined in the fullness of those pursuits while the years tumbled out too quickly for us to notice – date nights, anniversaries, soccer teams, kids club, slumber parties, homework, bible studies, dramas, choirs, board meetings, work days, ski trips, the occasional doctor visit, and lots of fun along the way. How quickly life got up-ended! Our game board got turned over; and many things I thought were permanent simply fell off. I didn't know life could be so basic. Alive. Today. Each other. You. At times, it seems that's all we've had. Mostly though, we live somewhere in the middle – date nights have become doctor appointments, that sort of thing.

We grieve at losing the life we had and we grieve the absent promise that life will return to what it was. But what's surprising is that life still offers fulfillment and satisfaction. We have hope, joy, and peace, thanks to you. Somehow, we understand everything is ok. And we know you better. Knowing you provided for us while things were going well was nice, but having you provide for us while we suffer is phenomenal. There's something about your comfort now that tells us you love us, but in a way we couldn't notice until so much had been taken way.

Lord, you know we just met some new friends who learned their son had a brain tumor when he was just ten months old. That was their on-ramp to the road of suffering. You know our other friend just found out he has cancer after his surgery last week. That was his on-ramp. You know about my co-worker's friend whose 22-year-old daughter just died in a 405 Freeway car crash, leaving a toddler without a mom. Her family quickly merged onto the road of suffering. There are so many people on this road – in fact, I'm pretty sure every person on earth will take one of the on-ramps at some point. It's hard, Lord. Upheaval. We can't know why it happened or how it will turn out. And there's no off-ramp in sight. But you know all these answers – why the suffering, how it will turn out, where the road leads; and you choose to keep them hidden from us. That's ok, really, because you know what's best for us. Please help me to focus on you and not our circumstances. Help me to trust you with the mystery.

Looks like more tumor

With the results of Susan's Dopa-PET scan on Friday, it appears she's experiencing tumor growth and will need to restart chemotherapy in the near future. Dr Nghiemphu wants to match the PET scan with Susan's last MRI for a better review; but she believes the scan confirms a new area of tumor near the midline and ventricles. She'd like to see the results of next week's scheduled MRI before we decide on a treatment, most likely another type of chemotherapy. In March when we discussed the potential for tumor recurrence, she said there are a number of chemotherapy drugs she believes will be effective for Susan's combination of Grade III/Grade IV tumor cells. Since we've gotten beyond the first and second lines of treatment of Temodar + radiation, then Avastin + CPT-11, it seems we're venturing into an individualized mode where you find something effective and stay on it as long as it works. Thankfully, Susan is a brain tumor survivor who has taken as long as two years to reach this point.

There is relief in understanding what's wrong since Susan has slipped below her fine form of month or two ago and the burden on her system has become more evident. There's hope in anticipating the next level of treatments will do their work to help her and that God may heal her by any means. And there's comfort in knowing that God has us in the palm of his hand, just as he has all along our brain tumor journey. I find these words from 1 Peter 1:6-7 especially encouraging – Peter praises God for our living hope, for our inheritance, and for God's protection, and then writes:

In this you greatly rejoice, though now for a little while you may have had to suffer grief in all kinds of trials. These have come so that your faith — of greater worth than gold, which perishes even though refined by fire — may be proved genuine and may result in praise, glory and honor when Jesus Christ is revealed.

Our help is not in gold, or medicine, or even in our faith itself. Our help is in the name of the Lord. I can't say it any more plainly – we trust him.

More infection, persistent weakness

This is a rare Sunday morning when Susan and I stayed home from church. She has headache and abdominal pain and needs to rest. Days like this seem to come and go more frequently and interrupt Susan’s otherwise cheerful spirit and initiative. Her funk was more intense a week ago on Saturday when I became convinced infection had returned. I spoke to Dr Leia about Susan’s confusion, weakness, and pain (but no fever), so she prescribed another round of oral antibiotics and suggested we get some labs done in a few days. We still had some Cipromycin on hand from last time and were able to get her started without having a prescription filled. By Tuesday, Susan’s response was mixed – improved memory strength, and mental status, but with periodic slumps in each area. On Wednesday, Dr Leia ordered labs for blood and urine and extended the Cipro course to seven days. The lab results showed slight infection, a reasonable fact since five days of antibiotics knocked it down some. Right now we’re stumped about her persistent symptoms and realize there are several factors at work, as always, like the effects of her hemorrhage, infection, or possible tumor progression. We’ll know more about all of it this week when we go back to UCLA for more labs, an MRI, and a visit with Dr Leia.

Tomorrow will be our 24th wedding anniversary. We got married in 1985 between the winter and spring quarters during my first year after transferring to UCLA. I was sort of an oddball student since I commuted to campus from Bellflower, wasn’t involved in activities there, and was married by my 22nd birthday. After I had proposed to Susan in 1984 (at Tommy’s in LA so she wouldn’t expect it), we didn’t want to wait until summer of 1985 to get married, so UCLA’s calendar determined the date – Saturday, March 23, 1985. I rushed out of my last final exam on Friday to make it to our wedding rehearsal that evening. I think I got a “C” on that one and felt satisfied I had a good excuse in having my thoughts on bigger things.

As I said to Susan the other day, twenty-four years is almost a long time. Next year will be our Silver Wedding Anniversary, which is a year later than almost a long time. In late 2007, someone generously and anonymously gave us a gift certificate to stay at the Surf & Sand Hotel in Laguna Beach, a perfect thing to bank for a special occasion like our 25th. But since one of us has a malignant brain tumor, shouldn’t we use it now? You know, “carpe diem,” and all of that? We decided to wait and have something to look forward to. She’s made it this long.

The Word of God is so much my food for life. I need it for guidance, strength, counsel, and to slap me out of foolish thinking. During this season of Susan’s illness, we’ve had our lives emptied of things we thought were important and even indispensable. With life becoming more basic and undistracted, I realize how temporary we are, how small our efforts can be, how quickly we exhaust our strength, and how little we truly understand. This truth came alive recently as I read and rested in Isaiah 40, a passage that has great importance for me. In huge contrast to our lot, verse 28 says,

“Do you not know? Have you not heard? The Lord is the
everlasting God, creator of the ends of the earth. He will not grow tired or
weary, and his understanding no one can fathom.”

Wow. My life is but a breath on this planet – but he’s the everlasting God. I can produce nothing that will last, really – but He’s the creator of the ends of the earth. I’m often wiped out by 9pm – but he will not grow tired or weary. I don’t know what our cancer journey means, why it’s happening, or how it will turn out. But I am getting to know God better. His goodness is overwhelming, and His understanding no one can work out, think through, or comprehend.

MRI, hydrocephalus, Avastin

Yesterday’s UCLA visit brought some much-needed good news. Susan’s MRI revealed enlarged ventricles that indicate the build-up of fluid in her brain – hydrocephalus. While that’s not good news alone, it might mean adjusting the shunt that was implanted last fall for the same condition could bring relief from Susan’s terribly weakened state. The last adjustment brought quick and dramatic improvement and months of relief. But tumor progression apparently can change conditions in the brain and cause a return of hydrocephalus in some cases. I am waiting eagerly for the consensus at tomorrow’s brain tumor board meeting when Dr. Nghiemphu will present Susan’s scans and her opinion to the other neuro-oncologists and neurosurgeons. Perhaps Dr. Bergsneider who implanted the shunt can make the adjustment soon.

Yesterday’s MRI also showed a big decrease in brain swelling, more good news. It looks like two treatments of Avastin have been effective. But there’s no definite reading on tumor growth right now since they’ll need to see a series of scans without swelling for a meaningful comparison. At least we know there are no new tumor sites. Susan had another Avastin infusion yesterday, but skipped the CPT-11 chemotherapy this time since its side-effects may be complicating her symptoms. She’s still extremely weak, tired, and mentally slow, needing full-time custodial care. We’ll have a wheelchair delivered tomorrow to help with mobility and hope we won’t need it for long. With so much muscle loss from steroids, she’ll need to work a while to get her strength back. Meanwhile, we’re doing a fast decadron taper to 6mg from 8mg this week and to 4mg next week. Susan’s whole ordeal recently has been puzzling since there can be several possible causes for her weakness – tumor growth, decadron, chemo, or now hydrocephalus. We hope for some action and relief, and soon.

I’m coming to know the challenges of dealing with acute long-term care needs. They’re emotional – there’s the pain of seeing your loved one in a compromised state. The challenges are physical – lifting, transferring, bathing, dressing, and doing them over and over again. It’s a grind. The challenges are psychological – the routine pressures of daily life do not stop just because your helpless loved one needs what they need when they need it. The pace of both worlds is hard to reconcile and the contrast is enormous. The challenges are spiritual – waiting on the Lord can seem to be endless when your circumstances intensify. I identify with the Psalmist who cries out, “How long, O Lord? Will you forget me forever? How long will you hide your face from me?” But somehow, God meets our needs everyday with peace for emotional pain, rest for a weary body, strength for a troubled mind, and His presence when hope has yet to be realized. This is so hard – and God is so good.

A trip to Colorado, new chemo begins

Tue 05/27/08
We returned from a terrific visit to Colorado where we attended the wedding of our niece Heather Romberg and her new husband Nathan Tebedo. They had a beautiful courtyard ceremony overlooking a picturesque valley near Palmer Lake in Monument CO. Lexie and I had the privilege of singing our first duet together at their reception. Susan had a bit of a trip-buster brewing on Thursday afternoon due to swollen ankles that raised the concern of blood clots. After a hastily-arranged ultrasound revealed no clots, she was cleared to travel. The swelling is caused by her high-dose steroids.

The whole weekend was another great family event that reunited Rombergs, Shipleys, Underwoods, and others, including lots of young and young-adult kids. We also had some precious time with Susan’s cousin Kelly (O’Toole) and James Dykema and my cousin Stephanie (Joeckel) and Gabe Arcuri. Colorado’s stunning views are everywhere and an obvious reason why so many want to live there, although my uncle Ray Joeckel said he moved from CO to CA after forty years because you don’t have to shovel rain.

I took part in a couple of “how’s it going?” conversations concerning Susan’s condition, one with Dwayne Underwood at Brian & Nancy’s and another with Stephie and Gabe on Sunday at their home in Brighton. Dwayne happened to be in LA the week after her first surgery at LB Memorial and spent many hours over several days in attending his lifelong friend. My cousin Stephie and Susan are both breast cancer survivors and share a special kinship in their experiences. It was good to be connected with them again. We’re so grateful for their love and support.

While we were in Colorado on Saturday, I received a call from Floyd DeBoer letting me know his wife Joanne’s brain cancer has continued to advance. She is on hospice care and may pass away any day. Floyd thanked me for our calls and visits and wanted to let me know how much they helped Joanne and him. He said she’s sleeping most of the time and not able to communicate much. He said even in this state she’s still here, and he’ll miss her terribly when she’s gone. We prayed together on the phone and I hoped we could see her at least on more time. Susan and I were able to visit them tonight, meet some of their family and pray together. We were so impressed to see how Floyd is trusting God with the outcome and how the peace of Christ is present with them for strength.

Wed 05/28/08
This was a big day scheduled for Susan at UCLA with a 7:30am MRI, a 9:00am blood draw, a 9:30am neuro-oncology visit, and an 11:00am chemo infusion. The day went well overall with good MRI results and a smooth chemo infusion. The nurse couldn’t get any blood return from Susan’s new port catheter, so we had to revert to a stick in the arm from the phlebotomist – a point of confusion for Susan since the reason it was implanted was for blood draws and infusions. We were told that once in a while a new catheter doesn’t work properly the first time. Later, a nurse got it flowing both ways, so we should be in good shape for next time. The good news from our visit with Dr. Nghiemphu is that the tumor has not grown since over the past month. The high-dose decadron has done its job to counter swelling, but it’s only a stop-gap measure until the CPT-11/Avastin therapy begins to work.

The chemo infusion is quite the process – saline to flush the line, heparin to prevent clotting, Zofran for nausea, and then a bag of Avastin followed by a bag of CPT-11. The whole deal takes about 3 hours. We were told to watch for possible side effects like bleeding and high blood pressure with Avastin and nausea and severe diarrhea with CPT-11. Both drugs can lower blood counts because the production of blood in the bone marrow gets suppressed. Fewer white cells (neutropenia) compromise the immune system and can lead to infection; fewer red cells (anemia) can increase fatigue; and fewer platelets (thrombocytopenia) prevent clotting and can lead to bleeding. Now we appreciate how mild the side effects of the oral Temodar were. Aside from the fact that it cuts off blood flow to tumors, one thing I like about Avastin is that its generic name (bevacizumab) reads about as easily backwards as it does forwards (bamuzicaveb).

In a surreal moment on the 405 freeway near Culver City, John McCain and I waved at each other today. Traffic was crawling on both sides of the freeway as we moved southbound in the left lane at about 4pm. I saw a CHP motorcycle escort creating space in front of some vehicles across the low wall in the opposite northbound lane. Knowing McCain is in LA today, wondered aloud to Susan if it could be his motorcade. I lowered my window and we slowly passed several CHP and dark sedans filled with serious-looking men in suits. In a moment, as we paused next to a Chevy Suburban without darkened windows, I found myself exchanging glances with the candidate behind our respective sunglasses. I waved at him. He waved at me. Then we moved along. A charter bus brought up the rear of the procession. Only in LA, I guess.

We were so saddened to get an email from Jayne Nord today saying Jeff’s brain tumor has continued to grow in spite of the latest chemo treatments and there is nothing more the doctors can do. They are recommending hospice care for Jeff and have estimated his survival at a couple of months. This news just took our breath away. It’s just crushing. We love our friend Jeff and his wife Jayne and their children. We commend them to God while continuing to ask for a God-glorifying, miraculous healing if that’s His will. Even though heaven is far greater, it’s hard to accept the end of the fight for this life. We pray for mercy and peace.

A disappointing setback

The MRI today did not bring good news. The scan showed significant brain swelling in the left frontal cavity where Susan’s tumor was removed that has pushed the left hemisphere across the midline. That explains why she’s been struggling so much. Dr. Nghiemphu showed us the views done with IV contrast where there’s a lot of contrasted area in the cavity on the left and the “remaining” tumor site on the right, explaining it’s probably tumor resurgence. She said the amount of change over the past six weeks is cause for concern.
While we could push to get Susan on a clinical trial like the brain cancer vaccine/immunotherapy at this time, the doctor would like to see her begin treatment with a chemotherapy called CPT-11 plus a biological agent called Avastin. Avastin was developed for colorectal cancer and has been found to cut off the blood supply to brain tumors. It’s been approved in the USA and is still in late clinical trials elsewhere. The CPT-11/Avastin combination is now the most common 2nd line of treatment for brain tumor recurrence and is the same one our friend Jeff Nord is having now. Since it’s an intravenous program, she'll have infusions every two weeks at UCLA beginning in a couple of weeks once it’s approved by our insurance company. We're hopeful the Avastin will do its thing to cut off the blood flow to her tumor and we’re hoping to see relief of symptoms in the next few days as she goes back on the anti-swelling steroids for now.

We've had the blessing of stable improvement for five months, so this turn is discouraging. This change is hard because it seemed like Susan’s stability might continue indefinitely. Today we were reminded how aggressive this type of cancer is. But God's presence is life-giving, His faithfulness protects us, and His gift of hope sustains us always. Just today, our bad news was tempered with two generous and anonymous gifts (one by mail, one by the church offering plate), some gift cards for dinner, and an offer from the drug company to pay for Susan’s Avastin if our insurance company won’t. We're so grateful for our church family and for the kindness of caring people. We are holding to God's unchanging hand.

Joy at church, at home, with improvements

Sun 03/09/08
Today was Super Soul Sunday at Emmanuel’s Noon Service, our annual celebration of worship in the African American tradition. Pastor Larry’s promise of a hand-clappin’, foot-stompin’, finger-lickin’ good time did not disappoint. We were privileged to have Pastor Rafer Owens of Faith Inspirational Church in Compton deliver the sermon at all the services. He greatly encouraged our church for the work we’re doing to lift up the City of Compton, confirming that the flame of renewal we were hoping to help ignite has caught on in the city. I wept to hear this man of God testify to the reality that the one American city that has symbolized violence, corruption and blight like no other has begun to turn. It’s real – over the next 40 years, Compton will move from being a byword to being a model for urban transformation. We are beginning to witness a move of God that will bring Him great glory.

Listen to Pastor Owens' sermon online: http://www.erc.la/staying-focused-on-the-road-less-traveled-luke-131-35-rafer-owens

Tue 03/11/08
Susan made dinner tonight – the whole meal. It was significant because we’ve needed to push further toward me doing less and her doing more. Many nights in the past I’ve just done the whole thing in the interest of time since it takes longer to teach and do than it does just to do. But last night I was busy and turned her loose to do the cooking. I had to help out only a couple of times. She made baked chicken breasts smothered in tomato sauce with cheese (call it pizza chicken), steamed broccoli, and a delicious romaine salad. It was a great meal and an important step in shifting our roles back into balance.

Tue 03/19/08
We had our 4th consecutive monthly trip to UCLA today for MRI and neuro-oncology clinic visit with Dr Nghiemphu. Great results! What we've been praying for - the tumor site across the midline got smaller since February. We felt a great sense of relief with her good news! As she continued, the doctor also noticed more swelling in the cavity where tumor was removed last summer. Both the shrinkage and the swelling are the effect of radiation, in her opinion, enhanced by the temodar chemotherapy. She said radiation effect can be progressively noticeable for up to a year and a half. We were all very encouraged by this MRI - certainly moving in the right direction. Aside from continued monthly chemo, Susan will return to the two-month MRI cycle, so we'll revisit in May.
On a cautionary note, Susan has developed an infection in her big toes, more so on the right foot. My guess it’s from ingrown toenails since her feet have been swollen from being on steroids. She’ll see the podiatrist tomorrow for treatment. Infections can be troublesome for cancer patients like Susan, as we’ve seen in the past. We continue to pray for overall healing.

We had a break of several hours between Susan’s MRI and clinic visit, so we ventured down Sunset Blvd and visited the Will Rogers State Park. We had a personalized tour of the home since there were only two other guests and had lingering comments from our guide, lots of time for questions, and a peek at the many lumps of chewing gum Will Rogers stuck under the table when he sat down for meals. Susan and I enjoyed our time together strolling the grounds, soaking in the springtime sun and fragrant breezes, and having fish tacos in Santa Monica for lunch. This was a memorable day.