We Love Karen

December 2009 MRI comes back clean!

2009-12-06T21:45:00.000-08:00

For those of you who keep an eye on the blog for periodic updates, Karen had her most recent MRI last week and the great news is that it came back clean again. She has a 6 month follow-up and then another MRI in a year.

Thank you all for your love and care for Karen. We are happy to know that so many others are rejoicing along with us.

Can you believe it has been more than three years!

January 2009 Update

2009-01-15T11:46:00.000-08:00

We got good news and then even better news yesterday. Karen's scans have not changed since the end of radiation more than 24 months ago! That's the good news.

The even better news is that the doctor said that normally if any change was going to take place we would have seen it in the first two years. We appear to have reached a new point in this whole journey where I think we can rest more easily about our future, at least in so far as the cancer is concerned.

I do not want to presume upon God's mercy or his plan, but I truly expect to have a long and fulfilling life serving our Savior Jesus Christ ALONG SIDE my beautiful bride. God may choose to alter this plan, and I am confident that many more interesting twists and turns are ahead, but my heart will rest easier after yesterday's news.

God was good two years ago when we all thought Karen had been issued a sentence of death and he's still just as good today. I hope that those of you who are going through trials of your own will cast your cares on Christ now in the midst of the trial and will remain faithful regardless of what trials or joys may be brought before you.

God's mercies are truly new (and surprising) every morning.

2008-06-18T16:50:00.000-07:00

The results are in from the latest MRI. We met with the Radiation Oncologist and he said that things continue to look great and that there are no changes from 7 months ago. He said He is very happy and it goes without saying that we are as well.

Thanks to all who continue to lift Karen up in prayer. God has demonstrated His faithfulness in wonderful ways the past year and a half.

Thanks be to the God and Father of our Lord Jesus Christ who has blessed us with every spiritual blessing in the heavenlies!

2008-02-02T23:12:00.000-08:00

Just a quick update.

Karen had an appointment with the Endocrineologist and the results are expected and good. The thyroid medication is working well and though she may need to adjust it a bit we can definitely see the difference in energy levels etc.

Thank you all for your continued prayers!

2007-11-20T14:54:00.000-08:00

Good News!

The results are in and Karen's liver has freckles. Essentially little bundles of blood vessels. Nothing abnormal and nothing to be concerned about. Needless to say we are very happy and very thankful.

We were also able to get Karen the needed Thyroid medication and so She is looking forward to beginning to feel energetic for the first time in a long time.

We will be placing this new news onto the ever growing heap of blessings we have experienced over the past year.

Thank you again for your ceaseless prayers on behalf of Karen.

I think we'll begin our Thanksgiving tonight :)

2007-11-19T12:50:00.000-08:00

After the appointment with Dr. Massullo last week he ordered a panel of blood work to be drawn in large part to verify the status of Karen's endocrine system (pituitary, thyroid etc.). This is a concern primarily because Karen's pituitary gland was radiated during her treatment and that tiny little gland acts as the control system for the rest of the endocrine system.

Karen's OBGYN called this morning to tell her that some of the levels that had been way off in the past were now very close to the normal range. There was (as usual) a significant caveat. It appears that Karen's thyroid may have pooped out.

I chatted with Dr. Massullo's colleague and he said that this can be very easily treated with thyroid medication. Anyone have any thoughts on this?

We'll discuss this with Dr. Massullo tomorrow at the same time we get the results from Karen's Liver MRI.

I'm hoping the new year will mark the transition into normalcy. No more "interesting" changes. All Hum Drum on the health front is the news we're hoping for.

In the meantime thank you all for your faithful prayers.

Dave.

2007-11-14T08:30:00.000-08:00

We just found out that the next MRI will be this coming Tuesday at 7:45AM. This one will be a 45 minute long concert with audience participation. Karen will get to hold her breath in harmony with the MRI machine as instructed by the director (AKA technician). It promises to be a marvelous marriage of man and machine. Something akin to a blend of "Stomp" and synchronized swimming ... but without the water ... or the throngs of smiling people ... or the applause.

As always we are thankful for your prayers as to the result of the MRI.

A new update will be forthcoming on Tuesday.

2007-11-13T20:32:00.000-08:00

This morning a subtle feeling of anxious anticipation mixed in and out of the normal momentum of the day. As any parent can relate, there is enough activity in a home with small children to keep ones attention from settling too long on oneself. However, I did catch my heart jumping periodically throughout the day. Thoughts of the unknown darted into my mind every so often alighting momentarily on all of the “what if” scenarios that seem to crop up each time we are about to meet with Dr. Massullo.

In the end, though, Karen and I had a very pleasant appointment with Dr. Massullo this afternoon. As you may recall from the previous MRI the tumors appeared to have diminished entirely in Karen’s brain and though there was some residual tumor left in her spine these had diminished to a varying yet significant extent.

The results of the most recent MRI showed that trend continuing. At this point there is no noticeable tumor left anywhere in Karen’s brain or spine save for some irregularities in her mid spine. These spots could be dead tumor tissue or scar tissue, but the most important fact to note about the spots is that they have not grown at all. We are hoping that these are simply bits of scar tissue that are the result of the radiation.

There was one “twist,” however. The radiologist did note more spots on Karen’s liver than on the previous MRI. Because the MRI Karen just received was intended to focus on her spine, only a small portion of the liver was able to be seen on these images. So Dr. Massullo consulted with a radiologist and agreed that in order to rule out any potentially bad news he would order an MRI of the abdomen with special attention to Karen’s Liver.

Spots on one’s liver are not terribly uncommon and could be a number of uninteresting things such as what Dr. Massullo called “blood blisters”, or it could be groups of blood vessels, or scaring from the radiation etc. All of these things would be benign and not life threatening. On the other hand there is an extremely rare chance that the cancer could have spread outside the central nervous system. The chances of this are very rare but for our sake of mind he is trying to schedule the MRI for tomorrow.

If, as we suspect and hope, the MRI of Karen’s liver shows nothing to worry about then Dr. Massullo will have Karen’s next MRI scheduled for six months from now and we’ll just have a quick phone call in 3 months to update him as to how she is feeling.

We thank you all for your continued prayers on Karen’s behalf and continue to be ever thankful for the unimaginably longsuffering love you have all demonstrated toward Karen over the past year.

We’ll be sure to update you all when we get the results from the next MRI (hopefully tomorrow).

2007-10-23T09:40:00.000-07:00

This is a stealth blog. Karen doesn't know that I am writing it. Maybe she'll never know ...

But I was praying this morning and recounting the faithfulness of God to me over the years, a fruitful and encouraging exercise for those who belong to the "I Am"; the loving God of history. I was remembering God's faithfulness to me given my original identity in the fallen man Adam and his grace in giving me a new identity in Christ. I then took a short walk through some of the key points in my life all the while amazed that God would choose to set his affection and blessing on a such a man.

It was when I came to the moment that I first met Karen, and realized how young I was when God introduced me to my future bride, that my gratitude toward my Heavenly Father welled up and I needed to share God's goodness publicly. He blessed me with my greatest blessing outside of Christ at such an early age! I didn't have to struggle with the loneliness that so often accompanies the years long search for a suitable companion. Not only did I not have to wait long, but the quality of her character astounds me each day I spend with her.

I am realizing more and more just how wonderfully puritanical Karen is. I say this because unlike most of modern Christianity which is no longer on "speaking terms" with these important fathers in the faith, I have come to see that one of their many laudable characteristics was their sincere desire to weed out sin in their lives. They wanted nothing hanging about within the closets of their heart that would interfere with their communion with Christ. They were more willing to recognize sin, repent of it, and bear with one another in their weakness than any other branch of our Christian family tree of whom I am aware.

Karen exhibits this Godly desire on a daily basis. I have never encountered another woman who so sincerely and thoughtfully desires to hone herself into a tool fit for Christ's use. She is continually working to love me and the children more, even as I seem to be getting more difficult and crotchety each day. She nevertheless sincerely desires to be a blessing to us and to our church family. I only wish that more men were blessed with this kind of a woman. The Christian home could then truly be a wonderfully peculiar thing at which the world could marvel.

Karen has always frowned at the name of this blog. It is, I admit, a bit odd when you are the object of the name. But, as for me, I really do love Karen.

The One Year Anniversary

2007-09-14T09:46:00.000-07:00

Yea though I walk through the valley of the shadow of death, I will fear no evil, for you are with me; your rod and your staff, they comfort me.
Psalm 23:4

O Lord, you are my God; I will exalt you and praise your name, for in perfect faithfulness you have done marvelous things, things planned long ago.
Isaiah 25:1

It was exactly one year ago today that I found Karen unconscious on the floor of our home. Since that moment our lives have become a public testimony to God’s faithfulness. Though God’s holy character alone is enough fodder to feed our praise for an eternity we are grateful that God chose to use our family this year as an object lesson in the marvelous way he cares for his people.

What a comforting thing to know that the events of the past year were no accident of blind history and that our future has been marvelously planned from long ago. As we stand on the precipice of an unknown future we have no fear for what he has planned for us because by the blood of Christ our future is found in the palm his pierced hand.

How forgetful and ungrateful we would be if after the many examples of God’s faithfulness to us this past year we forgot to rest in God’s promises to us. We ought not to forget that,

He was faithful in placing Karen under the care of the best doctors in the nation
He was faithful in surrounding us with loving family and friends in the darkest hour of our life
He was faithful in increasing our faith rather than allowing us to become self-centered and bitter
He was faithful in showering us with people willing to give of their time and resources.
He was faithful in protecting the hearts of our children.
He was faithful in turning a sentence of death into a life of hope.
He was faithful in using Karen’s pain and suffering to bring life, hope and change to others.
He was faithful in bringing Karen out of surgery able to talk, sing and wow the doctors with her mathematical prowess.
He was faithful through seven weeks of terrible radiation.
He was faithful to bring us wonderful news after every MRI.

This list is but a short summary of all that could be recounted of Christ’s faithfulness to our family. I look forward to the day when God will gather all his people together before his throne where we will be able to sing an inexhaustible list of his praises with abandon and without distraction. Until that day we are satisfied with the glimpses that God has given us into the wonderful way he loves us and we sing his praises, though feebily, with sincerity and thankfulness.

“Praise and glory and wisdom and thanks and honor and power and strength be to our God for ever and ever. Amen!" Revelation 7:12

P.S. please be in prayer for Karen's next MRI in mid-November

2007-07-13T23:05:00.000-07:00

I'd like to make this entry more lengthy and interesting, but my extra time this week has been limited. I just want to let you all know that my MRI and follow-up appt. with the radiation oncologist doctor on Tuesday and Wednesday went well. My head still looks clear, and the multiple spots on my spine are even more faded. My white blood cell count is back up to normal, and I have regained about 25% of the weight I have lost.

The doctor was delightful and full of hugs and smiles this time. I think he probably has to give bad news to his patients far more often than such good news he has given me. My appointment in the radiation office was a delight, as it has been for the last 6 months. He wanted me to come again for MRI and follow-up in 3 months, but I talked him into 4. I don't have to go back until November!Although our current schedule seems busier than it was a year ago, it is nice to mostly be back to normal living.

The continuous prayers, support, and encouragement bring tremendous amounts of joy and thankfulness to the Lord.

2007-06-27T22:43:00.000-07:00

I am full of joy to declare that after consistant long-term improvements and plenty for which to be thankful, today is the 6 month mark of time passed since my last day of radiation treament on December 28, 2006. Perhaps it is my imagination, but it feels like things are getting more and more back to normal. My weight is coming back to a less bony point, I haven't been quite as constantly thirsty, my ears are slightly more clear, my hair is growing enough for people who only see me weekly to make lots of comments (although I still have some bald spots!), and many more tiny bodily functional problems that seem to be gradually fading away. It is a relief to think of that difficult treatment being that far behind me. I am working hard again as a pianist and vocalist (and regular jogger!), trying to build up important habits and skills in this earthly existance. Far from least importance, I am constantly reminded of my need to improve in training and educating my 3 precious kiddos.

Today I will be getting yet another blood test, followed by an MRI on July 6th, followed by a follow-up appt. with my radiation doctor. I am anxious and interested to hear his input on my progress!

July will be a challenge because my husband will be out of town for most of the next 3 weeks. The children have plenty of activities as well that will keep things busy, and I need to set a joyful example for them in the midst of that. Please pray for my dear hubby's safety and for my own wisdom while we await his return.

Continuously, I thank the Lord for His tremendous blessings on and gifts to us!

2007-06-06T22:10:00.000-07:00

It has been about 6 weeks since our last posting, and the things to report have been much less significant. I am thankful to be back in nearly full gear with the busy schedule we have had (and will continue to have!). I still struggle with my energy on some days, but that can't slow me down too much. Since the last update, I have experienced a few interesting medical things:

Nutrition specialist to gain back some weight - I haven't been back to the same doctor scale yet, but I do think I've gained back about 25% of the pounds lost, and I've been working hard at building more nutritional intake.

Rehab Psychologist and speech therapist - Those were fun, but unnecessary and very expensive! Thankfully, my thinking process has been very little impacted, except for a bit of a struggle with names and word memory. They gave me exercises to help kick my brain back into gear.

Gynocologist - My last blood test in April showed that there are some extremely low counts in certain areas. This reminded me that it had been almost 3 years (since Sophie was born) since I visited the OB/Gyn, so we took care of that too. Most of the girly tests came out normal, but following the appt. I was sent for a bone density test. Of the six risky factors toward Osteoporosis, I qualify for five of them. There is one part of my spine that has slightly deteriorated, and I was determined to be at the bottom of the scale at risk for future Osteo conditions. Their advice was to take Calcium and exercise every day, which thankfully I'm already doing.

I'll be having another MRI in about a month, followed up by the usual appt. with the Radiation Oncologist.

Our family schedule seems to have gotten busier and crazier than ever lately, but it is full of many blessings. The Lord teaches me things in the midst of my anxiety and experience every week, and I am constantly shown my own areas of weakness and sin on which I need to repent and improve.

I was pulling some weeds in the garden yesterday and enjoyed viewing all of the new growth on plants that were sent following my surgery last September. I can't tell you how frequently I am reminded of the joys and graciousness you all have provided in the months since then. The incredible amounts of prayers are a humbling delight.

Thank You Lord, for Your continuous love and provisions through our dear ones!

Love,

Karen (KP)

2007-04-25T22:40:00.000-07:00

I was supposed to be on a business trip today and so this was going to be Karen’s solo trip to the oncologist to review last Friday’s MRI results. My brother Steve, however, is always the dutiful and doting brother, and was kind enough to accompany Karen to the appointment. This appointment turned out to be one of the most encouraging to date.

Karen’s radiation oncologist normally sees people who are dying and and so the news he often has to deliver is done so in somber tones. Today, however, her appointment ended with him hugging her . . . and not letting her go for quite some time. If all the chipper hugging wasn’t enough to clearly communicate good news,what he actually told Karen did the trick.

Here’s the synopsis:

There continues to be no sign of Cancer in Karen’s brain
The upper spine has not shown any signs of growth
The tumors on her lower spine continue to shrink
We may continue to see shrinkage as her body flushes the dead cells out of her system

Interestingly the radiation oncologist said that he would have expected the cancer to start showing signs of growth by now if it was going to start at all. I would like the nuero-oncologist to confirm this assessment but we are nevertheless very thankful for the wonderfully encouraging meeting today.

On the hair-front it turns out that Karen’s “reverse Mohawk” is perfectly explainable, and though the nurses today assured her that her hair will not be like it was before radiation, the stripe itself should go away.

The next MRI will be in about 2.5 months. Until the next post we thank you for continuing to present Karen before our Heavenly Father in prayer.

2007-04-22T21:50:00.001-07:00

Thanks again to all who continue to ask for updates and bring on blessings with your prayers! There isn't a whole lot new to report, but the MRI on Friday went well. It was even shorter than 3 hours this time, and I managed to sleep through a good portion of it. I'll be meeting this week again with my Radiation Oncologist to get a report and check in with him about my physical changes. I'll be getting weighed again too and seeing if my new diet additions are helping me to physically stabilize. On this coming Friday, I have a scheduled visit to a neuro-psychologist to investigate the surgery and radiation affects on my brain. For some reason I'm a little more stressed about that than I am about possibly finding more spinal spots. I'm pretty sure this week will go fine and smoothly though, and I continually thank the Lord for his work in me.

2007-04-11T22:24:00.001-07:00

Yesterday was our initial meeting with a nutrition specialist. I honestly didn't go to it with a very high hope and tried to keep an open mind one way or the other. Our meeting with Tinrin (her name) was at her home in a lovely Lafayette neighborhood rather than in her far away office in Berkeley, and she was recommended to us by our dear radiation oncologist. We discovered within minutes seeing the books on her shelves that she is a strong Christian, and she spent a wonderful 2 hours with us, half of the time talking about the Lord in our lives.

To make it even better, she didn't just throw generic diet info at me. She mentioned many familiar things, but she was looking at my most recent medical info, blood and MRI results, and she asked a lot about my daily life and eating habits. All of her recommendations were applied to what I'm already doing. She took into consideration the fact that I have my hands full with company work and full, busy days with the children as well as the type of eating I'm used to. She was clear about the levels of nutrition and vitamin intake I need according to my body's current state so that I can recover most efficiently from the intense radiation treatments I experienced. The next 3-6 months is most important to my full recovery of health and strength and it's great that she gave us mostly easy things to implement in our daily lives.

I did most of my new foods shopping at Trader Joe's today (there is a brand new one about a mile from our house!) and it's proximity makes for a great start to implementing things right away. I'll let you know soon how I feel.

I have another MRI test on Friday the 20th, another radiation doctor meeting the following week, followed by an appt. with a rehabilitative neuro-psychologist shortly after that to determine a baseline for my current memory and speech recall. Once we get through these next few adventures we may change our blog's name to something more family oriented and by God's grace give you only family updates.

Also, please pray for our dear friend John who has major Pancreas problem, possibly cancerous. He was rushed to emergency this morning, and he is scheduled for surgery and a long recovery next week.

2007-04-08T22:12:00.000-07:00

From Karen:

Just a quick update--my dear hubby scheduled an appt. with a nutrition specialist (referred by our radiation oncologist) this Tuesday morning so we can try to correct my continuous problem of losing weight. (I never in my life thought I would have this problem!) In the meantime, I keep trying to follow various advice I receive from many concerned. It's easy to not do well in that area when I'm scrambling around just to make sure my family's meals are provided for them. I need to work harder at planning more wisely on my intakes.

The Lord humbles me with things like taking my high singing notes away for a few days. (By the way--I never said "ME ME MEEE" in the shower!! It was more like eeee's oooo's and aaaah's. David wrote that paragraph.. :-P ) Today in the worship service, some of the melody notes just wouldn't come out. I must be careful to praise Him with my singing and to be patient with His changes in my body right now.

It's been about a month since my head fuzz started growing again, and it is VERY slowly improved. I still have a pretty thin area down the middle of my head that looks like a skunk stripe (hopefully I don't smell like one). Now that the weather is getting warmer, I'm trying to be patient for it to start looking a bit more normal again so I don't always need a hat or wig.

Despite all of these continuous small difficulties upon which I hope for improvement, we continue to hear of other beloved ones who are encountering major difficulties, illnesses, and challenges. It reminds us of our need to pray for many and to care for those around us who are deeply in need. We MUST remember how the Lord works through us in our struggles for His own will and glory.

Love Karen
--------------------------------------------------

From Dave:

I’ve been busy now that I am 100% back to work so I’ve had ideas for things to write on the blog but with no time to write them down they’ve remained ideas and eventually left my mind completely. Today, however, seeing as it is Easter and that we had the opportunity to simply chill at home after church today I got it in my craw to write a little something. That is one of the many blessings of resting from your daily work on the Sabbath, it gives you a chance to do what you would like to do everyday but simply don’t have time for. I love the Sabbath!

The familiar verse of scripture “What good is it for a man to gain the whole world, yet forfeit his soul?” found in Mark 8:36 has been coming to my mind a lot recently but in the context not of riches but of our health. When you are faced with physical challenges it is easy to fall into the trap of making your physical health the most central part of your life and thoughts. But for the Christian our physical comforts or even our physical well being and health are not the penultimate goal for each of us to pursue.

God's word is clear that though the world he created originally was “VERY good”, that due to our sin the world we see around us today (including our own bodies) are only a dim reflection of the garden world that he originally created. There are still many good things to enjoy around us, but the Christian knows that the ultimate and unnatural end for each of us is the grave. No matter how organic, or genetically modified, or raw, or cooked, or balanced, or Atkins our diet may be, the results of our sin will lead us to the grave.

This is just as true when I consider the wonderful answered prayers regarding Karen’s own healing. God has been faithful, has heard our cries and yours and has seen fit thus far to bring health and vitality progressively back to Karen’s body. In the ultimate analysis, however, what would it profit Karen to gain all of this health now (the whole world) and yet in the end to stand before her creator and to hear “depart from me for I never knew you” (to lose her soul).

For the Christian our hope is not in temporary and partial healing that God brings today through medicine, doctors, healthy diets etc. Our hope is in the total healing that Jesus Christ purchased for his people once and for all in history when he conquered sin and death in his resurrection. Those who God has been gracious to call to himself have not only been granted a reconciled relationship to God and have not simply had their sins washed away, we also have the promise of the resurrection. This is an oft overlooked and undervalued reality to our salvation. One day the work Christ began on the cross will be completed when our bodies are fully restored and every mark and stain of sin in the creation is totally washed away.

I doubt Karen or I will still be alive for Christ’s 2nd coming and so I expect we will die and our bodies will return to the dust. But this reality holds no fear for us because we know that this life is not the end, and heaven is not the end either. We have the hope of the resurrection and the contented expectation of a world renewed and in which we can worship our Heavenly Father “walking with him in the cool of the day” for all eternity. (Genesis 3:8)

Happy Easter, Happy Resurrection Day.

2007-04-02T12:52:00.001-07:00

Sorry that it has been so long since we updated everyone. Our last few weeks have been so busy, and with my energy slightly improving each week, it's been easy to forget to keep our beloved friends and dear ones updated. You continue to be amazingly kind and generous to us with your love, prayers and generosity, and we can't be thankful enough!

Just a quick update on my progress: Due to the shock my body has taken from both the surgery and especially the radiation I have continued to lose weight these last few months, even though the rest of me seems to improve, especially my energy levels. I am starting to look pretty boney and my tiniest clothes are falling off. We don't have a scale at home (I've never liked weighing myself), so I used one while we were at my brother's house yesterday. I've lost another 5 lbs since my Feb. appt., and my total weight lost since November is about 15% of where I was in September. I certainly didn't mind losing some of my flab, but it's starting to get concerning. (People are noticing more b/c my Spring clothes are only 2 layers, in contrast to my 4 or 5 layers of bulky Winter clothing to stay warm!)

I'll be keeping better track of my food intake (which I thought had been sufficient up to this point) and meeting with the radiation doctor again at the end of this month. I'll have another (lengthy) full MRI appt. on April 20th and will touch base again around that time.

Thank you as always for your support and prayers. So very much appreciated!

A last minute addition to this entry before I send it off to the printers ... I seem to have gotten my full vocal range back. I surprised myself in the shower this morning with a chorus of loud "La La Las" and "Me Me Mees." This is an answer to prayer over the past few months and something I am really excited about.

2007-03-09T00:02:00.000-08:00

As you may recall, just before I started radiation I had a CT scan of my abdomen to make sure that there wasn’t cancer that had spread outside my brain and spine. The only thing that turned up that the doctor commented on was a tiny spec on my lung. This is common and was unconcerning, but just to be careful we did another CT scan today to take a look and make sure that nothing had changed. It turned out that the experience was very uneventful. The injections of “contrast” into my blood stream did cause a hive to break out on my eyelid which was weird but also not uncommon. It went away after a few minutes and the rest of the experience doesn’t deserve much comment.

A radiologist compared today’s scan to the one done in November, and the comparison shows no concerns about the little spots on my lungs. Our nuero radiologist called them “scars” and said that they could have been caused by pneumonia, bronchitis, or an allergic reaction sometime in my past. Either way it is nothing related to my cancer and not a concern at all. I also found out that I have a freckle on my kidney, which it turns out is not abnormal in women.

As usual, we are so thankful for the support from you all, and primarily, we continually praise the Lord for His goodness and all that is teaching us through this time.

Other than these now infrequent scans and office visits, things are about the same around here. Just working at getting my energy back, hoping to have some hair before Spring arrives and it’s too warm to wear all these Winter hats anymore, =) and anxious for my 6 month date (March 14) so my driving and scheduling can get more back to normal. We'll have another MRI toward the end of Apil and will be sure to keep you updated between now and then.

Continuously appreciate your love and prayers.....kp

2007-03-01T23:06:00.000-08:00

Would have loved to have an update for you, but someone accidentally cancelled my CT Scan appt., which we discovered when we arrived there in Walnut Creek. Grrr.... We'll have to drive out there again next Thursday morning. =P

All three kids got a bad cough this week, and today Hannah has a fever too. I'm praying I can avoid this one--that last cough I had was just miserable, and I'd love to steer clear of it!

I found a good scripture and short devotion this morning that was a great reminder to me:

For to me to live is Christ and to die is gain ... having a desire to depart and to be with Christ which is far better.
PHILIPPIANS 1:21,23

IF I were annihilated this moment, I should bless God for having been allowed to live. Far more, if I were to have to toil and suffer in this sorrowful but glorious earth-life through unnumbered ages, and the sorrow and suffering continued to bring the living life with it that it has brought, I would gladly accept sorrow and suffering here on earth. How much more, then, when I expect, and am sure, that a very few years more will place me with these precious life-powers in a world fitted for highest life, with life intensified, and all the pure great life of ages gathered there, besides those whom I have dearly loved. EDWARD THRING

2007-02-25T21:15:00.000-08:00

This week has been filled with more blessings, at least in terms of slightly improved energy for me. I had to experience a couple long days alone with kids because of David's busy days away at work, and I managed to make it through the challenge okay.

I called the DMV and found out that there is nothing special on my record, which is also good news! I'll still be a good and obedient girl and not drive before March 14, the 6 month anniversary of my original ER visit. I can hardly wait! Last night was the last time I had to take my anti-seizure medicine, which I was slowly weaning off of (by doctor's orders) over the last couple of weeks. This means that as of today I am drug free!

This Thursday, March 1, I'll be heading in for another CT Scan to check out the little spot on my lung they found last October (which probably is nothing).

Hard to believe the first two months of 2007 are almost completed, and we can do nothing but continue to thank and praise the Lord for His tremendous blessings and providing for our family.

Love, Karen

2007-02-20T21:46:00.000-08:00

Not a whole lot changed the following day (Wed. Feb 14) at our second doctor visit (which was another really wonderful one), except he felt it would be important to do another MRI in 2 months rather than 3 months, just to keep a closer eye on the spinal chord spots that are still there. I had a blood test the same day to check on some of my other slowly recovering symptoms (thyroid etc.) resulting from the radiation treatment, and we had no response back from that (which is a good thing!) Even though my energy still takes dives on some days, we're able to function pretty normally as a family each day. (I sure am anxious to drive again soon, though!)

On an interesting note, we got our new Blue Shield quarterly premium bill last week, and the amount had increased by 50%! We're perfectly willing and ready to pay it, especially to make sure our coverage continues, but for the interest of it I called the insurance broker who originally helped us sign up for it. Turns out the increase is because David turned 30 last month!!! Well, at least it's not my fault. (hee)

Thanks as always for your blessed prayers and support. We continue to be so very thankful.

2007-02-13T22:46:00.000-08:00

Hello Everyone!

We have good news. Actually, to be precise our Nuero-oncologist said that the MRI results are "REALLY Good."

When the doctor reviewed the scan of Karen's brain he said that the radiation had done such a good job that he couldn't see any tumor in the scan. That is not to say that the cancer is totally gone, but the fact that he couldn't locate any is certainly something to thank God for!

In addition, most of the tumor that was in her spine has either reduced so that it is also unable to be seen or there is only residual left where there were pronounced nodules previously. There is only one nodule of any significance left and we are hoping that this will continue to reduce over the next few months.

Needless to say we are very happy and thankful. We are thankful to the doctors who have done such an excellent job, to all of you who have so consistently endured along with us, and to our God who has chosen to answer our petitions by continuing to heal and strengthen Karen. She continues to remain in his fatherly care, and he can use her as he sees fit, but at this moment we are all smiles.

In three months we'll go back in for another MRI to see how things are looking then. If the progress continues to be good then we'll probably only need to do MRIs every 6 months. This is a lot better than the 8 week interval we originally expected for the first year.

More good news is that the Doctor gave Karen the OK to start tapering off of her anti-seizure meds which means at the end of next week she won't be taking any medicine.

It also looks like we only have a few more tests to run as baselines to refer back to in the future and Karen hopefully won't even need to have blood drawn for a long time after that.

There's some other little stuff, but suffice it to say we are thrilled and thankful for Karen's current prognosis. Thank you all again for your faithful love and friendship!

2007-02-12T21:23:00.001-08:00

Just a quick update about the latest. I did get my cysts removed last week! It was so easy in comparison to the last 5 months of events that David and I chuckled quite a bit throughout the quick process. I'll be getting the stitches out this Wednesday afternoon.

The MRI on Friday evening was a breeze, even though it lasted about 3 hours. It's not the most fun thing in the world, but it's rather relaxing compared to the head/face smashing that was my daily radiation for 7 weeks. David and I are anxious to see our doctor at UCSF tomorrow to show us the results.

We'll be sure to let everyone know right away what the update is tomorrow night. Thank you so much for your loving support and prayers, as always.

2007-02-02T23:33:00.000-08:00

Sorry it has been so long since we updated you all. This past month has gotten busy with plenty of work stuff going on for both of us. There haven't been too many interesting updates about me, except perhaps that our whole family got really ill a couple of weeks ago and it hit me pretty hard. I am very slowly recovering from the 7 weeks of radiation treatment. I am completely bald (with minimal hair yet growing in), my voice (which was only whisper for a couple of weeks) comes back in a tiny bit more each day, my weakness still slows me down but gradual improvements are noticable week by week, and I'm still pretty dehydrated and drink water like crazy.

However, I do have so much to be thankful for. I have prayed often that the Lord will restore my singing voice and asked for humility in my ability to worship and praise His name again, and although it's very slow, He gradually restores it. My ability to think through things has improved quite a bit since September. I am able to function pretty normally with our 3 children again on a day-to-day basis. HUGELY, I have been overwhelmed by the immense graciousness, dedication, and generosity of our family and dear friends who have continued to help provide for us. I generally am a huge thankyou note writer :-) but have failed this year to directly thank the many loved ones for the precious gifts and incredible help. We thank the Lord often for you all - so tremendously grateful!

There is more interesting stuff coming up in the next two weeks. I have two large lumpy cysts on my head which are completely unrelated to the cancer, but being bald is a good time to have them removed. (Feb 7).

Feb 9th 6:30 - 10 p.m. : Follow-up MRI (of several more I'll be taking throughout the year)
Feb 13th : Appt. at UCSF with neuro-oncologist to see results
Feb 14th : Appt. in Walnut Creek with radiation oncologist to further discuss results.

Both oncologists are quite interested in seeing the results of the MRI (as are we!). They are both experts in the field, and have decades of experience between the two of them. I'm certain the meetings will be worthwhile.

We do hope for your prayers for the results, that the cancer in my head and spine will have reduced to nothing or next to it. Even if it doesn't, we trust in the Lord's will and His complete grace in loving and providing for us. We have been truly blessed and rely on Him completely for our next direction.

Love, Karen

2007-01-07T22:08:00.000-08:00

Here's a quick update from Karen ...

Well, I've been struggling a lot this week with my cough, nose, difficult sleeping, and my back being more in pain each day from the coughing. Finally went to the doctor yesterday and had an emergency Xray squeezed in at 4:30 on a Friday afternoon! It was a possible cracked rib, lung problem, walking pneumonia, who knew. The great news is that I am normal inside, and I got some antibiotic for brochitis. They're not positive that's what I have, but I've been coughing nonstop for over a month, so it should help that. Got some other good coughing and nose medications too. I didn't feel any better last night, but I sure was happy! I slept a lot better, but my back and now my sides are still killing me. Hopefully I can loosen those up by moving around a bit today.

More good news--my voice is coming back! Just a tad bit more each day, but at least I can talk a bit now. I'm anxious to be able to sing again. Thank you all so much for your love and support.

Love, Karen

2006-12-28T17:03:00.000-08:00

We all traveled up to Grass Valley where Karen's parents live and had a very nice Christmas all in all. As it happened, however, Christmas seems to have marked the lowest point in how Karen has felt since treatments started.

The good news is that today was the last of Karen's treatments and since yesterday she has been feeling a bit better each day. I've seen her smile more today than I have seen in far too long. Thank you all for your fervent prayers and steady affections. We are eagerly looking forward to Karen getting her voice and energy back. It looks as if she is headed in the direction of health.

I'll fill you all in early next week as to what the next steps are. We know there are MRI's, blood tests, and appointments but aside from that we will need to talk to both our John Muir and our UCSF doctors to determine the details.

We hope you all have a very happy new year!

2006-12-21T08:55:00.000-08:00

Hi everyone. I just wanted to ask you all quickly for prayer. Karen, as you well know, has not really complained once during this whole process but last night her throat was so sore she was having a lot of difficulty even swallowing sips of water. She even sent out an email this morning asking for prayer for her throat which means she is truly concerned. Please pray that as we inch closer to the end of the radiation that her throat gets no worse and is able to heal quickly.

I spoke to the Radiation Oncologist today because Karen asked if we could postpone today's throat treatment. He said that at this point one more treatment will make no difference to her discomfort and that it is better that we just get it done and out of the way so she can heal. He will be providing some stronger pain medication today which he said should help.

Thank you all for your continued prayers on her behalf.

Dave

2006-12-16T20:58:00.000-08:00

Give thanks to the Lord, for he is good. His love endures forever. Give thanks to the God of gods. His love endures forever. Give thanks to the Lord of lords: His love endures forever. To him who alone does great wonders, His love endures forever. Who by his understanding made the heavens, His love endures forever. Who spread out the earth upon the waters, His love endures forever. Who made the great lights-- His love endures forever. The sun to govern the day, His love endures forever. The moon and stars to govern the night; His love endures forever.

Psalm 136:1-9

If our perspective were limited to the discomforts that Karen experienced each day, then this week we would have had reason to fear the future. As would be expected this far into her treatments each day gets just a little bit harder than the day before. The ‘sunburn’ on her head, neck, back and chest continues to deepen. What little hair she still has continues to dutifully fall out each day. The battle with her gag reflex is constant from the time she wakes until her head hits the pillow. By the end of the day her voice just sort of gives out and stops working except for muffled whispers.

However, (and that is a very important conjunction) God has been gracious to give us a better perspective. The daily discomforts are not all there is to Karen’s story, and even in the midst of these pains and discomforts God still provides her with everything she needs to make it through each moment.

To talk this way runs the risk of sounding like trite Pollyannaish optimism. That really is not our perspective at all. The perspective that Karen and I have been given is earthy and uncomfortable on the one hand and satisfying and glorious on the other hand. As with much of the Christian view of things, life is full of perfectly fit together paradoxes. These aren’t irrational leaps of faith, but a salty realization that as creatures we don’t know everything and we won’t be privy to all the answers even in Glory.

So we are left with that rushing anxious sense that we are falling through life, but not toward the unknown. We are falling into the hands of Christ our redeemer. Trusting in him is not irrational it is the most sane decision anyone can choose to make. And this trust extends not simply to the saving of our souls for eternity but also to the daily ordinary earthly concerns that make up most days. So I hope that what might sound like a “make the best of it” optimism can instead be understood in light of this greater context.

First, we are encouraged by the knowledge that with the close of each treatment we are another step closer to concluding the whole process. There is an end in sight. Furthermore, we found out on Friday that rather than an additional eight days, Karen only has to do an additional five. The extra three treatments might sound trifling, but no one would want to get punched even one more time than necessary and the same goes for having radiation pointed at your body.

Secondly, we are reminded every so often that the diagnosis and prognosis three months ago was dire and that God has already demonstrated his fatherly care in continuing to provide us with healing and a steady diet of good news. Things could be a lot worse, they appeared that way in the beginning, and we are glad that that was not the path God chose to have us walk right now.

Finally, we know that God is orchestrating this situation for his own good purposes. Though we don’t know why he needed to ordain things to come to pass exactly this way we are satisfied knowing that it is his hands that are fashioning our story.

We are very thankful that her last day will be the 26th of this month and that her complete healing can then begin. We are also looking forward to finding ways to bless you all. I shake my head in amazement daily at the truly remarkable generosity that you have all shown to us. I really do hope you all know how thankful we are for you. I know that you do not desire to receive anything in return for your kindness, but it will be nice to find ways to bless you all as the weeks, months and years wax on.

2006-12-08T22:48:00.000-08:00

Sing joyfully to the Lord, you righteous; it is fitting for the upright to praise him. Praise the Lord with the harp; make music to him on the ten-stringed lyre. Sing to him a new song; play skillfully, and shout for joy. For the word of the Lord is right and true; he is faithful in all he does.
Psalm 33:1-4

It is true that God is faithful in all that he does. We are thankful that this week began and ended with him demonstrating his faithfulness to us with answered prayers.

The week began with what we thouhgt would be another 4 hour MRI. As we prepared for the MRI we were concerned that Karen continue to have the terrible coughing and gagging during the MRI that have plagued her for the past few weeks. We were also concerned that laying on her back for all that time would be extremely painful particularly for her head which is very sensative right now. So we prayed, as many of you were as the week began.

I was surprised to get a call from Karen a full hour and a half before she was supposed to be done. Somehow the MRI technician was able to get her in and out of the machine in two and a half hours. Better yet Karen only coughed once and her head felt good the whole time.

The week ended a few hours ago as we recieved really good news from the radiation oncologist Dr. Massullo after he got the results of the MRI. The tumor is responding extremely well to the radiation. The tumor in Karen's brain has not grown at all or moved into the cavity created by the surgery. Furthermore the tumor in her lumbar region has all but disapeared leaving only some residual scarring where the tumor was. There is only residual tumor left in her thoracic and cervical regions as well.

Needless to say, we are very happy and very thankful.

Thank you all for your consistent prayers.

2006-12-03T18:05:00.000-08:00

I just want to let you all know that Karen will be going in for another 4 hour MRI tomorrow (Monday). Karen will not be having her radiation treatment tomorrow. In light of the radiation she's been going through she's actually looking forward to haveing the day off. I guess that's why I haven't written to you all earlier about this.It's amazing how one's perspective can change.

Please pray that Karen will not cough too much during the MRI; given the sensativity of her throat right now the results of this could make a big mess in a multi million dollar machine.

Also please pray that her head will not hurt to much having to lay there for so long.

We continue to be ever thankful for your prayers and support.

2006-11-30T21:23:00.000-08:00

Karen is continuing to do well and her spirits remain high but that is in spite of the fact that she feels, as she calls it “puny” all the time. She’s running a discomfort marathon of sorts, punctuated by intermittent obstacle courses of gagging and clogged drains. The gagging is due to the radiation causing her throat to become very sensitive and sore. The clogged drains are due to the chunks of hair that are falling out through the day. Through it all Karen continues to be as steady as ever. I catch myself shaking my head in amazement sometimes. I'm not so sure I'd be so steady.

I did take some pictures to try to give you all a better idea what Karen experiences each day.

This is a picture of Karen after she's just gotten suited up before treatment.

This is a picture right after Karen took a shot of "soothing citrus" chloraseptic to help sooth her throat. That turned out to be a bad idea. She hasn't done that since.

This is a picture of the radiation machine. the big arm actually swings around to shoot at different parts of the patients body.

This is a picture of Karen laying face down on the radiation machine. The techs are maching laser lights that are projected from the walls with tatoos on Karens back and with marks on Karen's helmet. In this picture you can see the helmet that is locked onto the table. There are marks on the helmet on masking tape that show you exactly where the radiation is projected. You can also see one of the lasers on the far wall that projects the lines onto her back thatthe techs use to line her up with the machine.

After the treatment yesterday I took Karen out to a matinee. We went to see “Stranger than Fiction”. It’s the new Will Farrell movie billed as a romantic comedy. I personally thought that the movie was great. The characters were very interesting, the plot was creative and captivating, and the themes that the movie explored were very appropriate to what we are experiencing right now. The movie dealt with the question of tragedy in life. It made me think again about how we try to make sense of suffering.

As we explain the pains and discomforts that Karen is experiencing I hope that you are all putting these things into context in at least two ways. The first is that it is important to see these things in contrast to what Christ had to suffer. What he suffered he did so willingly as a righteous man., What we suffer we do so as guilty men who in our hearts beat our chests and ask “why?!” deceiving ourselves that we deserve better than what we’re getting.

Secondly, we must appreciate that this pain and suffering is part of the great story of history that God is breathing out over time. All of its comedy as well as its tragedy are perfectly placed. He is the master author and we are the characters that he loves. That he loves his people means that the tragedy is not capricious, mean or pointless. That we are characters means that we are his creation and we are not privy to know all the reasons why he has written our particular parts the way he has. We can be confident, however, that for those who love him, when we are finally able to look back at the whole story we’ll see that each part of the plot was necessary to make it truly beautiful.

2006-11-23T11:58:00.000-08:00

Again I saw something meaningless under the sun: There was a man all alone; he had neither son nor brother. There was no end to his toil, yet his eyes were not content with his wealth. "For whom am I toiling," he asked, "and why am I depriving myself of enjoyment?" This too is meaningless-- a miserable business! Two are better than one, because they have a good return for their work: If one falls down, his friend can help him up. But pity the man who falls and has no one to help him up! Also, if two lie down together, they will keep warm. But how can one keep warm alone? Though one may be overpowered, two can defend themselves. A cord of three strands is not quickly broken.
Ecclesiastes 4:7-12

I know that I've been slow to update the blog this week. Last week went quite well, but the past three days have really begun to show how progressively more difficult the radiation will be. One of the nurses compared radiation to a bruise that is hit each day. The first part of the treatment is not that noticeable but as the radiation continues to hit the tissue it becomes more and more sensitive and the effects become further pronounced.

While the Zofran has taken the bulk of the nausea away, this week nausea has continued to haunt her and she’s never felt quite right. That culminated last night in the sink (if you catch my not so subtle inference).

This morning she’s doing better in that regard, but the new symptom that popped up on Sunday was a chronic sore throat. This is not, as some of you may be guessing, a result of a suppressed immune system. In fact, the radiation should not (and has not to date) had any significant impact on her white blood cell count. The sore throat is due to the radiation being given to her spine that reaches through to the soft tissue in her throat and makes it feel like she has a perpetual cold.

Her hair is still hanging on though. The only potential precursor to her losing her glory is that her scalp has started to feel tender and itchy.

So let’s sum up …

Nausea
Chills
Fatigue
Sore Throat
Headache
Dry Mouth
Itchy and sensitive scalp

If I didn’t know better I’d diagnose her symptoms as the perfect storm of a flu, a cold and dandruff. At least this is all temporary.

There has been some good news this week. The 2nd opinion pathology report came back yesterday and the good news is that the Mayo Clinic pathologists concur that the cancer is indeed Tanycytic Ependymoma. We are thankful for that because it means that we are still dealing with a typically manageable cancer.

Also, Karen had her teeth cleaned recently because radiation can induce an environment conducive to cavity creation. I am proud to announce that she came away with a clean bill of dental health.

In the midst of the chronic discomfort that Karen is experiencing all of this is made bearable as we see God’s grace extended toward us daily in your love and generosity. Your love toward us was astounding when this all began happening, but more than two months later you continue to stand by us and it’s this consistent care that gives a fullness to the concept of “long-suffering.” Thank you all for your continued prayer and support.

2006-11-16T10:59:00.000-08:00

“Oh give thanks to the Lord, call upon his name; Make known his deeds among the peoples. Sing to him, sing praises to Him; Speak of all His wonders. Glory in his holy name; let the heart of those who seek the Lord be glad”

1 Chronicles 16:8-10

There are many reasons for us “to give thanks to the Lord” not the least of which is that today was another good day for Karen. Compared to this past Thursday when the thought of six weeks full of days like that one was too much for Karen to bare, today was an utter joy.

In the passage above the Psalmist tells us to “make known his deeds among the peoples”. It’s natural for those who are familiar with the history of how God has been saving and protecting his people throughout history for grand images to come to mind when we think of “his deeds.” The parting of the Red Sea and Esther’s rescuing of Israel from holocaust are beautiful pictures of how God extends his grace to those he loves. The chief picture of God’s great love, of course, was demonstrated when he sent his only son to suffer the indignities of the cross and ultimately to die, not for his own sins, but for those for whom he loves.

It is interesting, however, that the “deeds” of God are not restricted to those of magnificent proportions. God is at the bottom of even the smallest of events that takes place. As the Psalmist says elsewhere:

“Where can I go from your spirit? Or where can I flee from your presence? If I
ascend to heaven you are there; If I make my bed in Sheol, behold you are there.
If I take the wings of the dawn, if I dwell in the remotest part of the sea,
even there Thy hand will lead me and thy right hand will lay hold of me.” Psalm
139:7-10.

I imagine that for some people the idea that we are unable to escape God’s hands might sound threatening or dangerous or like our rights to autonomy are somehow being violated. But for those who God has graciously called and who rest in Christ’s work on the cross, the idea that there is no place we can go to escape from God’s hands becomes a comfort. What child would want to run from the loving arms of a protecting father?

It is remarkable to consider that all the things God has done for Karen, though seemingly small in the grand sweep of history, are in reality some of the many wonderful deeds that the Psalmist commends us to “make known … among the peoples.”

“Let the heart of those who seek the Lord be glad”

2006-11-14T23:21:00.000-08:00

The urgency of crisis has long since passed and has been replaced by the more subtle reminders that pop up at intervals throughout the day reminding us that life is moving forward but doesn’t look normal at all. The extremes of crisis make great fodder for writing and are also a sure fire remedy for writers block. Not long before Karen’s emergency I joked that the best artists are malcontent and deeply troubled. The tension in a life full of darkness and struggle tends to force one to confront the difficult subjects that the normal person rarely thinks about amidst the many distractions that lay within reach of the typical modern.

I don’t believe that I have ever been a malcontent and I don’t possess any allusions that this blog will find itself on a shelf next to any great author. I do, however, understand how a crisis can arouse in a person a sensitivity to these deeper themes. Now that the sense of crisis is gone, though, I find that the words don’t flow quite as easily.

So as we were chatting at dinner tonight about how things are going I asked if she would say a few words to you all. So here goes.

-------

My dearest husband has made quite an impression on you all (and me too!) with his delightful writing abilities. Mine aren't nearly as entertaining, but here goes...

I am really grateful that the radiation treatment only takes between 10 and 20 minutes now, rather than the 30+ minutes during the 2 days of preparation that were so intense they left me in tears. It’s getting easier now to make it through the daily struggle because the time with my face smashed on the table has been getting shorter as the days go on. I work hard to keep my focus elsewhere during the radiation. By occasionally closing my jaw I can move the pressure on my face from one part to another. Swallowing is also difficult so as the machine moves from one field to another I do my best to swallow a bit.

I also try to make the time pass by counting during each portion of the radiation treatment. So far it appears that I can count to around 30 for each side of my head and around 60 for both the top and bottom of my spine.

The best part is that when it’s all over my forehead and cheeks have large unattractive red indentations that remain prominently displayed for about an hour afterward. Thankfully the office is filled with a delightful and loving group of doctors, nurses and technicians. Yesterday I was getting really anxious as we drove to the appointment. I thought for sure I’d need to take some anti-anxiety medicine in order to make it through, but surprisingly after I got to the radiation center the staff there were so loving I was able to make it through without drugs and it was the easiest time yet.

Overall I'm happy to say that today (Tuesday) is the first day since I started on Thursday that I haven't been feeling pretty yucky. I can only hope that each of the next several days are like today...I want to let you all know how amazed I am by your devotion, prayers and generosity. Endless thank yous to you all!

2006-11-09T20:53:00.000-08:00

Today was Karen's first radiation treatment. The actual treatment went much better than the planning session yesterday. The primary reason for this was that it was much shorter.

Karen decided not to use the anti anxiety meds that the doctor had recommended that she try because she really wasn’t anxious about the procedure and it hadn’t helped the day before. Instead she tried a Vicadin to try to cut the pain a bit. In the end she doesn't think the vicadin helped so my guess is that tomorrow she'll be goin' hippie and not using any drugs at all. Actually, I guess that means that she'd be goin' anti hippie ... now I'm confused. Do hippies use drugs or not? Do they avoid legal drugs and only use illicit substances? Maybe they avoid drugs developed by corporations and stick to cottage industry “remedies.” In any case, since tomorrow’s procedure should be even shorter she doesn’t think she’ll need anything for the pain.

Unfortunately, a few hours after we got back from the hospital Karen started feeling really nauseous and got progressively worse as the day dragged on. She got many of the symptoms of a flu: vomiting, headache, chills, fatigue etc. When things didn’t get better on their own I called the radiation folks and asked them what we should do. They were really great and got a prescription sent over right away to our pharmacist. The good news is that the stuff that they prescribed is the best anti nausea medicine available today and that it worked really well. The bad news is that they only prescribe 2 pills at a time and the cost for each pill could provide your local yuppie (not to be confused with hippie) with fresh brewed Starbucks for about five weeks. (No joke).

I have to say, that at least for tonight it was worth the cost. Karen almost immediately felt better and as of about two minutes ago only had a light headache. She even ate the grilled cheese sandwiches I made for dinner! If that isn’t evidence of her dramatic turn around then I don’t know what would be. :)

As always thank you for your continued prayers.

2006-11-06T07:14:00.000-08:00

But because of his great love for us, God, who is rich in mercy, made us alive with Christ even when we were dead in transgressions--it is by grace you have been saved. And God raised us up with Christ and seated us with him in the heavenly realms in Christ Jesus, in order that in the coming ages he might show the incomparable riches of his grace, expressed in his kindness to us in Christ Jesus.
Ephesians 2:4-7

I’ve been told that many of you have been tapping your fingers impatiently on your desks waiting for an update on Karen. I am sorry to have waited so long but a lot happened this week and so I wanted to wait until we got to the end of it to let you all know what is going on.

On Wednesday we went to the initial consult with the radiation oncologist in Walnut Creek (John Muir Medical Center) where Karen will be getting her radiation treatments. This location is much closer to us than UCSF and was highly recommended by the team in San Francisco. Our radiation oncologist there has been in the business for decades and is very experienced and self described as “pedantic.” He said this is a good trait in a radiation oncologist considering he’s going to be pointing radiation at Karen’s head and spine and could paralyze her if he doesn’t pedantically plan the dosage and angles.

This appointment, as most are, was punctuated by many periods of waiting. As I’d forgotten to bring some reading material I was entertained as we moved from room to room by the different reading material that was made available in the form of thousands of magazines. As we entered another waiting area I reached over and started rummaging through one of the stacks. I quickly passed over “Vogue” and “Bay Area Mother” and picked up “The Economist.”

On of the articles that caught my eye (to no one’s surprise) was a feature on a very successful executive who had been diagnosed with terminal cancer and who, together with his wife, co-authored a book about his experiences over the next 6 months until his death. I’ll admit that I didn’t have the opportunity to read the whole article, but what I did read got me to thinking. This admittedly successful man handled his cancer and his imminent death with what anyone would call a kind of calm and purpose. However, I was primarily interested in how this man turned to meditation as a means of calming himself and remaining focused as he entered his last days of life.

This interested me because it got me to thinking about how Karen has viewed her “spirituality” in the context of her cancer. Meditation, as I understand it is practiced by most westerners today, is primarily about clearing ones mind and focusing one’s attention on a specific thought. I asked myself, “what was this man focusing his attention on? Did the object of his meditation really matter? Was all that mattered that he found it helpful? How does his experience in turning to meditation compare and contrast with how Karen is dealing with her own cancer?”

These series of questions reminded me of something I wrote early on in the blog as I wrote about faith. I talked about how the most vital part of faith is what you are placing your faith in. As I read about how this very successful, driven, thoughtful executive turned to meditation the fundamental question remained the same. What was he meditating ON? What was the object of his meditation?

John Calvin talks about something similar in his Institutes. In chapter 4 he is discussing how the natural and inescapable nature of man is to smother and corrupt their knowledge of God. Unless God reaches down, interferes in our lives, and changes our hearts, no one would want to seek after God to discover who he is as he has revealed HIMSELF. In this context he writes:

“Indeed, vanity joined with pride can be detected in the fact that, in seeking God, miserable men do not rise above themselves as they should, but measure him by the yardstick of their own carnal stupidity, and neglect sound investigation; thus out of curiosity they fly off into empty speculation.

They do not apprehend God as he offers HIMSELF, but imagine him as they have fashioned him in their own presumption.

When this gulf opens, whatever direction they move their feet they cannot but plunge headlong into ruin. Indeed, whatever afterwards they attempt by way of worship or service of God, they cannot bring as tribute to HIM, for they are worshiping not God but a figment and dream of their own heart.”

As I think about the many things God has done for our family I am utterly speechless. By his grace he has showered his mercy on our family and opened our eyes that we might see him as he has revealed himself. Karen and I thank him that he is continuing to wash away the residue of our own presumption, speculation and stupidity. We know that he is using this time of struggle as a means of refining us so that as we meditate on his word, THE Word, our meditation has the express purpose of bringing into more vivid focus the awesome character of our saving God.

When the doctor finally met us in the conference room, most of the information he gave us was basically the same as what the radiation oncologist in SF gave us. It was interesting, though, to see the nuances of difference in the way he presented the info and what bits he gave us that the other specialist didn’t. I also cracked a smile when toward the end of the meeting he asked us if his plan was different in any way than what would have been prescribed at UCSF. I guess I shouldn’t be surprised at this friendly professional comparison. All in all the meeting went well and Karen was in good spirits.Thursday we drove to San Francisco (UCSF) to have a CaT scan done of Karen's chest, abdomen and pelvis. Our Neuro Oncologist ordered up this CaT scan as a conservative precaution to make sure that the cancer had not spread to the rest of Karen’s body. The CaT scan was a totally different experience than the MRI. It was extremely fast and she didn’t even have to disrobe. I don’t think she was in the machine more than 10 minutes from start to finish. The good news is that we got a call from the doctor yesterday and after reviewing the CaT scans there does not appear to be any cancer in her body except for her brain and spine. No surprises there.

Though Wednesday and Thursday were filled with lot’s of doctors and nurses they were both pretty easy days. Friday’s appointment was of quite a different character. We went back to John Muir for the radiation "planning session." This became another one of those moments that drives reality home regarding how hard the next 6 weeks are going to be.

The purpose of this appointment was to get her body oriented in the machine. They had her lay face down on the bed of the radiation machine with her face pressed against an apparatus used to hold her head still. A plastic mold was form fitted to the back of her head to additionally secure her body from moving. Her head, was thus, squeezed in a kind of vice grip.

Unfortunately this important and necessary apparatus used to prevent her from moving, squeezed her face so hard that it was almost unbearable. It was all she could do to keep from breaking down into tears because of the pain. The physical pain was only made worse by the mental strain of trying desperately not to cry for fear that if she did she’d move and mess the process up and she’d have to stay trapped in this device longer. So Karen fought back the tears and tried her best to bear up under the pain.

I had no idea this was going on in the room next door. I was content to have my attention bounce back and forth between my book on President Andrew Jackson, the “Today show” that was playing on the TV above me, and the small sea of seemingly happy cancer patients that surrounded me. I was not all that concerned that Karen would be in discomfort because every indication we’d been given up to this point was that the process would be painless.

Apparently the pain that Karen experienced is unusual. The technicians explained that it was due to the fact that she has so little “padding” on her body. The technicians tried to encourage her by praising her for how easy it was for them to “find her spine.” I guess the obesity epidemic in the U.S. has real implications on the ability of radiation technicians to efficiently do their job. So as the moments elapsed Karen tried desperately to control her emotions. As the process came to an end Karen finally broke down into tears as the technicians informed her that though the future sessions would be shorter, that if the first session was painful they would all be just as painful.

As I looked up from my book and saw her walking toward me the first thing I noticed as she entered the waiting room was how pink and puffy her face looked. I furrowed my brows quizzically trying to process what that actually indicated. Had she simply fallen asleep or had she been crying? Then I noticed her eyes. It wasn’t really the fact that they too were pink and puffy that clued me in. Honestly, they acted for a moment like the proverbial “windows into the soul” I could just tell as I looked into them that something was really not right.

The pain had triggered the weight of reality to further press down on her and this produced more tears, I think, than the pain did. Waves of emotion passed over her throughout the rest of the appointment but the storm did calm as the day progressed. Mike and Michelle flew in that morning to spend the weekend with us and their arrival provided the perfect distraction to help Karen put the morning behind her.

Before we left the appointment, our doctor informed us that next Wednesday will be the follow-up planning session. This will entail Karen laying on that same contraption while they take Xrays of the exact locations on her brain and spine that will be radiated. This is a dry run that will allow the doctor to see the precise location where the radiation will go. He’ll be able to further refine the radiation plan including dosage and angles to make sure the plan is perfect before they actually start the radiation treatments the next day. Please pray that this goes quickly because it could drag on and every moment in that contraption is truly agonizing.

Also, as I mentioned in a previous blog entry, our oncologist is having the pathology of the tumor reviewed again. He wants a second opinion to confirm tanacytic ependymoma. Thus he has sent the sample away to Mayo Clinic to be reviewed by a totally new set of pathologists. We won’t hear back on this for about another two weeks.

In the mean time, as Karen begins radiation next week, we ask that you continue to pray for Karen. Please pray for the pain she experienced while being strapped down, for effectiveness of the treatments and for no long term side effects.

2006-10-28T22:51:00.000-07:00

Only be careful, and watch yourselves closely so that you do not forget the things your eyes have seen or let them slip from your heart as long as you live. Teach them to your children and to their children after them.
Deuteronomy 4:9

Karen and I were extremely happy with ourselves Thursday afternoon. We worked very hard to get to our 3:00PM appointment with the radiation oncologist on time. In fact we got to the appointment early! This was quite a feat considering that on the way there we had to drop Hannah off at ballet, deliver paperwork to one of my customers, drop my Mom off at her house, and then brave the traffic into San Francisco.

We were quickly humbled in our short lived triumph, however, when the gentleman who checked us in informed us that we were actually late to our appointment. By 2 hours! Our appointment was apparently at 1:00PM … oops ... my bad. Fortunately they were willing and able to see us.

As anyone who has gone to a doctor’s office will be intimately aware, even the most efficient and well oiled doctors offices still make you wait for inordinately long periods for the doctor to arrive. Maybe making us wait for their imminent arrival is a scheme developed generations ago by some of the first physicians to generate a sense of suspense and to make the doctor feel important. Or, maybe they’re all just bad at staying on schedule. Or, maybe there’s a lot of inconsiderate patients who arrive two hours late to their appointments and throw the doctor’s immaculately conceived schedules off for the whole day. In any case, we knew that at least in this one case we deserved the long wait and so we passed the time dutifully and without one word of complaint until the doctor arrived.

Actually, because UCSF is a teaching hospital it is usually the lowly neophyte med student who sees you first. They ask preliminary questions and do standard neurological tests the result of which will then be delivered by the student to the doctor in an academic version of the “telephone game”. It’s during this preliminary examination that the med students practice their textbook bed side manner that always seems a bit awkward when applied in real life. I must say I wonder sometimes if the sympathetic nods, grunts and other gesticulations that these med students make are truly genuine and if the almost eager interest in our case stems from a deep seeded concern for our well being or from an eagerness to finally be working on a real person. In spite of my natural suspicion I do believe that our med student that day was one of the genuine ones and so I was entertained as I always am as he went through his regimen of neurological tests that they use to asses general gross motor function.

The reason I always get a kick out of watching these tests performed on Karen is because she is in a word, competetive. I hold my breath in anticipation just waiting for the look of surprise and maybe even stifled fear each time a new doctor performs this test for the first time and says “push against my hand as hard as you can with your leg.” As soon as that simple command is issued the doctor and his chair (regardless of size, weight, or position) are promptly catepulted a foot or so back from his or her starting position. It is also immediately followed by a subtle look of satisfaction on Karen’s face.

After the med student was done with his tests and questions he left the room to consult with the doctor who eventually came to talk to us. I must say that I really liked her. She was very clear and descriptive about what Karen should expect from the radiation. In fact, she was extremely generous with her time considering that we arrived at 3:00 and she is usually gone by then. When all was said and done she stayed with us until 6:00PM.

She even scavenged the halls for a laptop on which to show us on the MRI scans where the tumor is located on Karen’s spine. If you look at the picture below you can see the yellow arrow pointing to the spinal cord (a black cord running up and down the MRI). The green arrow is pointing to the white cerebral/spinal fluid just to the right of the spinal cord. This bright area should run up and down the whole spinal cord and should appear to be consistently white. As you can see in the scan, however, there is a significant presence of a grey discoloration (I have two red arrows pointing to some of the grey areas to give you some perspective. The grey areas are the cancer and as such should not be there. Given the significant presence of cancer, you can now see why the doctors agree that it is really important that they radiate this stuff right away.

The good news continues to be that ependymomas typically respond very well to radiation. According to the radiation oncologist treatment is considered successful when the tumor stops growing. Their expectation is that radiation will probably prevent Karen’s tumor from growing anymore and may even shrink what is already there. This, as always, is not a guarantee or a certainty, but it is what they expect to see given how ependymomas typically respond.

The doctors want the radiation to begin no later than two weeks from this past Thursday. Once it begins the sessions will go for six weeks, Monday through Friday, and will last between 15 and 20 minutes. This will be a more aggressive radiation than what they originally intended because the ependymoma has demonstrated that it is more aggressive than initially believed. The first 2/3 of each session will be a mild dose of radiation spread consistently over the whole brain and spine. The last 1/3 of each session will be a more powerful dose focused on the areas of Karen’s brain and spine where there is significant tumor presence.

The potential side effects that Karen may experience during treatment are:

Fatigue. This will progressively increase through the end of the therapy. It should not be to the point of incapacitation, and she can be as active as her body will allow her, but the doctor did say that help around the house will be important.

Hair loss. The radiation oncolgist assures us that she WILL lose all of her hair. This is because her whole head will now be irradiated. It will start to grow back about two months after radiation is over.

Decreased blood count. A decrease in red blood cells, white blood cells or possibly platelettes could occur. If this does occur it will not be to the point of immuno-suppression, but because a decrease is a serious possibility her blood will be monitored weekly to make sure that her counts don’t dip to low.

Skin dryness. Her skin will not be burned and there will be no pain involved, but her skin may become dry. This can be addressed by a simple skin lotion.

Nausea. Because her spine will be getting radiation some of that radiation will go through her stomach which could cause nausea. In order to prevent the discomforts of nausea the doctor will provide anti-nausea medicine from the start to avoid any potential discomfort.

The potential long term radiation side effects are:

Short term memory difficulties. This would manifest itself years down the road. Examples of this could be not remembering all the numbers in a new phone number, or needing to write down a grocery list rather than committing it to memory.

Hormonal regulation problems. This would be caused by potential damage to the pituitary gland which regulates hormones like estrogen, and cortosal. There is about a 40% chance that sometime in the future (between 2 and 40 years from now) her pituitary gland could have trouble producing hormones in the proper amounts. This could be easily treated if it becomes an issue and with yearly level checks they should be able to monitor the levels and respond accordingly.

Fertility problems. Because of potential long term damage to the pituitary gland the hormones that control fertility could be impacted. This could make it difficult to conceive if the needed hormones are not provided in sufficient amounts.

Vision, motor function, balance and language should all be unaffected by the radiation.

2006-10-24T21:20:00.000-07:00

There are good days. There are bad days. And then there are days like today, somewhere in between, when you are forced to recognize that each new day may take you round a corner that changes your perspective yet once again. We are blessed that the bulk of the past few weeks have been filled with really good days. In terms of Karen's healing things continue to get better each day. Today, however, wasn't terrible but it wasn't good either.

Dr. Prados called this afternoon because he'd had a chance to review the MRIs. When I took his call I actually didn't think that there'd be much to tell. Dr. Prados first asked how Karen's back was feeling. I thought he was just being nice, but it turns out that he was asking because after reviewing the MRIs he found a number of cancer spots on Karen's spinal cord. He thought the pain she had been experiencing in her back and thighs may have been caused by the cancer he'd just discovered there.

I don't know if this is the actual cause of her pain since the pain has totally disappeared, but regardless, I had to inform Karen of this new and disappointing news. I took her outside while the children occupied themselves with "bear and the big blue house". I wanted to speak freely without fear of little ears picking up on words and emotions that so often get misunderstood and mixed up in their young minds. I also wanted to give Karen a context in which she could respond in whatever way came naturally to her. In the end she received the news like one would expect who knows her well.

She didn't cry for herself. Tears came to her eyes when she thought about having to tell her beloved parents the bad news. No one likes to deliver news that you know will disappoint or cause fear especially when you are delivering this news to people who you desperately want to please and whose joy is so closely tied to your own. So as she asked me questions about my conversation with the doctor and heard my answers in response, tears gently rolled down her face.

The tears came not because of the additional discomfort she'd have to undergo with a more aggressive course of radiation or the additional thoughts of uncertainty that seem to attach themselves to this kind of news. The tears welled up because of the mental picture that formed in her mind of delivering this news to her parents. At that moment the first images that filled her thoughts were the sadness in her mother's face and the concern in her father's voice that would inevitably greet us on the other end of the telephone line as the news was delivered.

In the end, however, it is important for us to remember that the prognosis is basically the same as it has been since the beginning. So any sadness we feel isn't fear or dread for the future. It's just a mixture of the disappointment that anyone would feel after getting this kind of bad news mixed with some apprehension about what the radiation treatments will really be like now. The answer to the last question will be a lot clearer after our meeting with the radiation oncologist on Thursday.

What we know at this point is that Dr. Prados found between 7 and 8 cancerous "nodes" on her spine in both the thoracic and lumbar regions of her spine. He also found what he called a "sheet" of cancer on the backside of the same part of her spinal cord. All of these areas appear to be on the surface of the cord rather than in the center, which is a good thing.

This new finding changes the recommended treatment. Initially the recommendation was a focused treatment at the precise site of the tumor and we could do it now or wait. Now that the cancer is in both regions they are not recommending any kind of wait, in fact they are seriously recommending that we do the radiation treatment right away. In addition, the radiation treatment will not be a localized treatment, rather, radiation will be applied to the entire brain and spinal cord. The reason for this more aggressive approach is that now that we know that the cancer has spread the chances of microscopic cancer cells existing in other parts of the neurological system is pretty high. By radiating the entire brain and spine they will be taking any of these unseen little buggers out of commission.

Additionally, because this cancer has manifested so uniquely they are going to take some additional precautions. The first is that Dr. Prados is going to have the pathologists re-diagnose the tumor. Because it spread, which is unusual, he wants to confirm again that we are really dealing with an ependymoma. He said that the pathologists will not like this but that it is important that this get done.

Also, though he's never heard of it happening before, he wants Karen to get a CaT scan to rule out any masses other places in her body. He said that this kind of tumor is not known to spread into other areas of the body but he wants to make sure that this general understanding is verified in Karen's case.

Also, Dr Prados said that if the tumors in her spine were to start growing the first kind of symptoms would most likely be numbness in her limbs. If the tumor were allowed to progress she might experience weakness in her limbs. If the tumor were to progress to a significant degree then she might experience some motor control difficulties.

The good news is that ependymoma of the spinal cord responds just as well to radiation as ependymoma in the brain and the prognosis at this point is not much different than it was before. It just means that the radiation process will be quite a bit more exhausting and that we have some additional areas of her body to which we must now be attentive moving forward.

Thank you all for your continued prayers. Days like today are made so much easier knowing that so many people are continuing to lift Karen up in prayer.

2006-10-22T19:51:00.000-07:00

"The Lord God said, "It is not good for the man to be alone. I will make a helper suitable for him." ... Then the Lord God made a woman from the rib he had taken out of the man, and he brought her to the man. The man said, "This is now bone of my bones and flesh of my flesh."
Genesis2:18, 22-23

Today Karen had her follow-up MRI. Our Neuro Oncologist sent us to an MRI center in San Francisco because there were no openings for another month at UCSF. She had 4 scans done, one brain scan and then one each for the three sections of her spine (Cervical, Thoracic and Lumbar). For those of you who don't know what an MRI is like here's a little taste. The MRI machine is a huge electromagnet that has electricity running through it at all times and is extremely loud. So loud, in fact, that you have to wear ear plugs when you are in the machine.

Imagine the sound of a fax machine hooked up to the sound system at an AC/DC concert, mixed with a jack hammer being used 6 inches from your head, punctuated by R2D2 screaming and the obnoxious banging of woody woodpecker hopped up on steroids.

Here’s a picture of an MRI machine for those of you who has never seen one.The patient lays down on the bed which then moves the patient into the right position in the big donut shaped electromagnet. At that point the concert begins.

In addition to the obnoxious loudness, one of the main discomforts of the traditional MRI machine is that it is extremely claustrophobic. Each scan takes between 40 minutes and an hour, and while you are being scanned you can't move at all. If you move while the scan is taking place you don't get a gold star and a smiley face from the MRI technician. In fact, he has to do the scan over again.

Laying in bed may sound like an easy task considering we spend about eight hours each night slumbering away, however, there are a few important differences. The biggest difference is that while we may not be aware of it we are constantly moving throughout the night, sometimes violently (very violently as many wives can attest who have been accidentally socked in the nose in the middle of the night by her husband’s wayward elbow).

Additionally, it is very unusual for someone to get four scans in a row. "Very unusual" means they’ve never let anyone do it before. In fact, the radiologist almost didn’t let Karen do it. He actually sounded annoid that Karen even wanted to atempt the feat and skeptical that she'd be able to finish. That is a really long time to lay motionless in a loud enclosed space. In the end all the scans took more than four hours. I don’t think many people could have done so well in this unusual MRI marathon. To lay motionless for that long is more like something you’d have to do to become a Samurai warrior or Army Ranger sniper, not when you are a 5 foot 4 inch mother of three.

After the MRI was over I took Karen to Kincaid’s. This is the restaurant where I first told Karen I loved her, and we’ve shared a number of other great moment’s there since then. It’s located in Jack London Square (Oakland) and sits right on the water over looking the Marina.

As I sat across from Karen sharing a quiet moment and a glass of a refreshing California Riesling, I was trying to synthesize all the thoughts and feelings that kept popping in and out of my mind. For a while all I could really focus on was her striking blue eyes. That, by the way, was one of her features that I remember thinking a lot about the first few years we were getting to know each other.

Finally it dawned on me what the idea was around the edge of which my thoughts had been flirting. It wasn’t a totally new thought to me. In fact it was an idea that I’ve considered a number of times before. But the truth of the idea stood out more starkly and clearly than when the thought had come to me in the past (this often seems to be the case when the same idea is seen in the light of a new experience).

I realized afresh how different I am after being married to Karen for 8 years and how different my life is today because I chose to marry her and not someone else. To a significant extent I am the man that I am today because Karen is my wife. God has used her as the biggest and most important instrument in my life to sharpen and mold me. I am very thankful for the life that I have been given and Karen is responsible for much of the life I am now enjoy. I shudder to think what my life would be like were she not a part of it.

In Genesis we are told that God made Eve to be a helper suitable for Adam. She was to fit him perfectly in his calling to subdue the earth to the Glory of God. It is not enough to realize that women are suitable for men in a general sense. It is also central that we realize that each particular wife, given to a particular man, has been given because she is specially suited for him, to be a helper in his God given calling. Not only has Karen been a great help to me in terms of my secular vocation, God has used her in my life to mold and shape me as a person, so that I am more effective in all of the callings God has placed before me. I look different, talk different, listen differently, think about things differently, have different priorities and in so many other ways am different than I would have been had I married another woman. She fits me perfectly, better than a hand and glove, because unlike a glove she makes my hand so much stronger, more efficient, more tender ...

Because of Karen I have learned how to be decisive, I’ve come to appreciate that the small things are actually big things, she’s shown me what it looks like to passionately desire God to remold us into the image of Christ, I’ve been privileged to observe first hand what it looks like to live a lifestyle characterized by endurance, I’ve seen and received by association the blessing that accompanies a good reputation and I know what it feels like to walk into a room and feel honored to be seen with someone truly special.

It also says something about Karen that for the most part the changes God has wrought in me through her occurred not because she’s talked a lot about them, but because I have seen these attributes modeled in her life. I could write for quite some time listing the many things that I have learned from Karen and I know that there are many more ways she has effected me that I am not even aware of yet.

One of the reasons I look forward to growing old with her is that I am confident God will show me many of the other numerous other ways that God has already shaped me through her. Though a residue of vanity in me groans when I imagine the wrinkles, back problems and various invasive and undignified probing that accompanies growing old, I am in the last analysis really looking forward to getting old and saggy with her. I know that each day that I am blessed to fall asleep beside her, that is a day that I am made a better man because of my time with her.

2006-10-11T19:31:00.000-07:00

"I thank my God every time I remember you. In all my prayers for all of you, I always pray with joy because of your partnership in the gospel from the first day until now, being confident of this, that he who began a good work in you will carry it on to completion until the day of Christ Jesus. "

Philippians 1:3-6

Here's a picture that Chris and Wanda Kersey graciously took two days ago. You can see how great she looks!

Karen and I continue to be overwhelmed by the unending cascade of generosity that you continue to shower on us. It is truly hard to articulate how utterly thankful we are for everything that each of you has done for us. Thus we are left on the horns of a dilemma.

On the one hand, all the words we come up with aside from “Thank you” risk sounding trite or insincere. And yet on the other hand a simple “Thank you” seems to run the risk of sounding weak and obligatory.

As we approach the one month mark since we first rushed Karen to the ER, please know how much we continue to covet your prayers and appreciate your generosity.

Here are some current updates on Karen:

We have our next two appointments scheduled and approaching fast. Karen will be going to get her post operative MRI next Friday the 20th. She'll actually be getting 4 MRIs. One of her head, and three of her spine. She’ll be in that machine for about four hours with a couple of “stretch breaks” in between each scan as they change the "coil" (whatever that is). These people talk to you like everyone speaks the same techno-babble that falls from their lips.

The following Thursday we'll be going back to UCSF to have an interview with the radiation oncologist. They'll use the MRI results from the week before to determine their suggested course of radiation treatment. Our nuero oncologist will also look at Karen's spine to determine if the ependymoma has traveled to her spine through the cerebral fluid. This is rare but happens occasionally. During this meeting we'll be able to ask the radiation oncologist all the specific questions we'd like about the radiation therapy itself.

Also, Karen’s been experiencing pain in her thigh and back muscles. We were wondering what the cause of this might be but our oncologist and pharmacologist were stumped. After about 2 minutes on Google, however, my sister in law found a great article on the side effects of the steroid that Karen is taking. Apparently this medication (among its many side effects) causes a depletion of potassium which in turn can cause cramping and muscle pain, ergo … she’s eating bananas. Anyone know what the side effects of bananas are? On second thought I’d rather be ignorant on that subject.

We’re thankful that Karen’s last day taking the steroids will be on Saturday.

2006-10-07T22:16:00.000-07:00

As I glance over at Karen throughout the day I can't help but smile as I consider all that God has been doing over the past few weeks.

Karen could have died that Thursday afternoon that I found her unconscious on the floor ... but God preserved her
The tumor could have been inoperative ... but we were blessed to have been provided with a skilled surgeon
She could have had a stroke after the surgery ... but she came through perfectly
The tumor was supposed to be terminal ... but it turns out they were wrong
She wasn't supposed to be able to talk after the surgery ... but she sang and played the piano at a wedding last night

One of the Psalms that she sang last night was Psalm 128A. The words to the last stanza of that song are:

"And may you see Jerusalem's good all days on earth you dwell. May you your
children's children see, and peace on Israel."

Because the prospect of Karen actually seeing her children’s children had been so poor only a few days before, the great news we received on Tuesday made the blessing that accompanies seeing your grandchildren a truly sweet picture. Coming out of the meeting, however, it wasn’t this picture that was on Karen’s mind.

As I’ve said before Karen is currently at a real disadvantage. It often feels to her like everyone around her has a better understanding of what’s happening than she does. Trying to wrap her mind around this whole situation has been like trying to envision what you look like without the benefit of a mirror to help. You have to rely on everyone else’s description of reality and thus the details in your mental picture remain fuzzy.

So, I’ve been trying my best to help nudge her along as we all endeavor to come to terms with what this all means. In part this has taken the form of summarizing what the doctors are saying and what each bit of information means for her future.

Karen didn’t need my nudging on Tuesday, though. As we sat in the car and began preparing to drive home she told me that she was finally beginning to understand that this cancer was something that she’d have to live with the rest of her life. Silly as it might sound, until this last appointment she had imagined that after the radiation she could simply put this chapter of her life behind her and move on … cancer free. She never even considered that she’d have to get periodic scans, or the possibility of recurrence.

I was glad that she was coming to terms with the long term consequences of her cancer but I also wanted to make sure that after such a positive meeting her focus was in the proper place. I didn’t want her focus to be on radiation or MRIs or recurrence etc. Instead I wanted her to focus on what Dr. Prados kept repeating in our meeting, that Karen should plan on a long and happy life.

I struggled to summarize this message in a way that would create a clear mental picture on which she could set her mind’s eye. After a few moments it finally struck me and I told her gently, “Karen . . . You can plan on seeing your grandchildren.”

A smile of contentment spread across her face. The tears of peace that welled up in her eyes told me clearly that all the inconveniences that might accompany her cancer really don’t matter in comparison with the great joy she will experience when she sees on the face of our first grandchild the special smile that grandchildren reserve only for their grandmother’s.

2006-10-04T17:42:00.000-07:00

I thought you all might be interested in seeing a before and after MRI scan:

The left image is before the surgery and the right image is after the surgery. You can think of the image as if it were taken by a camera near Karen's feet looking up through the bottom of her brain. The mass was about 5 centimeters in diameter.

The right arrow points to the white object which for the most part represents the tumor.
The left arrow is pointing to the left ventricle. The ventricles are the dark areas in the middle of the brain. There is one on each side of the brain and they should be symmetrical. As you can see from the left image the ventricle on the right side is being compressed.

After the surgery the ventricles were more symmetrical after the pressure had been released and it's pretty obvious that a lot of that tumor had been removed.

You can also see in the picture on the right the swelling that took place after the surgery on the side of her head.

2006-10-03T21:54:00.000-07:00

Dear Family and Friends,

I do apologize that it has taken me until now to get this update out there. I tried last night but fell asleep and tried today but work got in the way. So here are some of the most important bits of info we learned during our meeting with the oncologist last night. If you all have additional questions please let me know.

Dr. Prados confirmed that Karen's tumor (funny to call it "Karen's tumor" like it's a piece of clothing or a good idea) is indeed a Tanacytic Ependymoma. As the doctor said, it's never good to have a tumor, but if you do get one this is the kind you want to get. This is considered a low grade (grade 2) cancer, slow growing and typically responds extremely well to radiation therapy.

It is also a rare kind of tumor. For some perspective Dr. Prados told us that UCSF is one of a handful of "tumor centers" in the nation so they see a lot of tumors in a year. In fact UCSF sees a total of 3 or 4 tumor patients a DAY but they will only see about 15 to 20 ependymoma cases in an entire YEAR. Only about 150-200 cases of ependymoma occur across the nation in an entire year.

Aside from this being a relatively uncommon tumor he could say that the majority of adults (85-90%) with an ependymoma have "long term success." He gave an example of an ependymoma patient that he treatedwhen he first came to UCSF in 1985 who he just saw recently and who continues to do very well. That’s 20 years later and still no problems.

Also, let me give you a sense for what he means when he says it is “slow growing.” If the tumor was left alone and they didn’t do anything to it, it might be three or more years before any growth was even detected in scans or by symptoms. In fact, the accepted practice for ependymoma patients for whom they believe they have removed all of the tumor is that they don’t even recommend radiation therapy at all.

Even in Karen’s case where they know they didn’t get all of the tumor, they said there is no urgency to starting the radiation therapy. The reason for this is that there is no known difference in outcome between those patients who do radiation right after surgery and those who wait until scans or symptoms indicate significant growth. In terms of our options, the doctor said the choice is up to us, and that the only real question for radiation has to do with the timing of when we begin.

Some of you may be asking why one would want to wait to do radiation. The reason has to do with the effects of radiation on the brain. Although they are recommending a very low level course of radiation that will be focused specifically on the area of the tumor, the radiation can still have an effect on the abilities controlled by that part of the brain.

The short term effects of radiation are typically fatigue, as well as dry skin and possible hair loss at the spot that is experiencing the radiation. But this will go away after the radiation is done. The long term effects, however, could be subtle effects on short term memory. This is due entirely to the fact that the part of her brain where the tumor still resides is the area that facilitates memory. If the radiation did effect her memory it would manifest itself in things like difficulty remembering a new name. He said it would probably not be noticeable to anyone else, and that “she might have to rely a bit more heavily on her blackberry.” All in all even the worst case scenario regarding side effects would be nothing more than an inconvenience easily overcome.

Important to note is that he also said that if she did experience some subtle deficits in memory that this would not be something that she would get back. Damage like that to the brain doesn’t heal. This is the reason to wait for radiation. In waiting you put off these potential problems a year or two more. So Karen and I will have to weigh the options and make a decision, do it now and get it over with or do it later and put off the potential inconveniences. I’ll give you one guess which way Karen is leaning …

Many of the questions that you all asked had to do with radiation. It turns out that though Doctor Prados is an expert Neuro Oncologist, we really need to address most of those questions to the Neuro Radiologist. We’ll be doing that when we meet with them.

Some of you also asked about how much of the tumor was left in Karen's brain. Well, there is no precise answer on this. The reasons for the imprecision are numerous. Some of the reasons include the inability to exactly distinguish where the tumor begins and ends. Also, the MRI, though very good, just doesn’t provide the level of detail necessary to find the edges even if they did exist. In answer to this question, Dr. Prados said that most surgeons would have gone in and only done a biopsy. Our surgeon, Dr. Parsa, was one of few nuero surgeons who could have resected anything, let alone the significant amount that he ended up removing. The take home message on this … we got the best results you could possibly hope for in this situation and the rest should be controlled by radiation.

In the next few weeks Karen will be getting an MRI of her head and spine. At that time the swelling and other effects of the surgery should have gone away so they can get a good look at her brain as well as her spine. They are checking her spine because this kind of tumor can sometimes travel through the cerebral fluids down into the spinal cord. The MRI will help to determine if this has happened, though there are no indications that we ought to really be concerned about this.

On another note, I did ask about the genetic nature of ependymomas and whether we should be concerned about our children or Karen’s brother getting this disease. Dr. Prados said that the factors that need to be present in order for this to be a realistic concern do not exist in our case and that no risk exists of transmission.

In terms of lifestyle issues here are some of the things that Karen can and cannot do:

She CAN

Walk
Be left alone
Bend over
Drink alcohol in moderation
Do pretty much anything that she want’s to as long as it doesn’t hurt

She CANNOT

Drive for the next 6 months (legally because she had what may have been a seizure)
Jog until her head no longer hurts (about 2 weeks more)

Her our the Next Steps:

Karen will be getting an MRI of her head and Spine in about 2 weeks
We’ll meet with the UCSF radiologists regarding radiation therapy
We’ll determine when to start radiation
We’ll get recommendations from UCSF as to what radiation centers they would recommend in our area.

I hope that this satisfies some of your curiosity. Like I said in the beginning, let me know if you have any other questions at this point.

Questions ...

2006-10-02T08:47:00.000-07:00

As we prepare for tomorrow's meeting with the oncologist I thought it might be interesting to see if any of you have questions you think we should ask the oncologist.

I won't be responding to these questions on the blog, but I thought you might have insites that could help us in our meeting tomorrow. Feel free to post the questions and we'll use the ones we find the most appropriate for the meeting.

2006-10-01T23:47:00.000-07:00

I know it has been a few days since I have posted. I suspected this would happen. For those who may have been impatiently waiting for an update I do apologize.

The good news is that my lack of posting is a good sign. It means no major changes have occurred and that life is settling into a generally comfortable routine. Karen continues to improve everyday. We measure this by the number of pills she has to take at each meal. She’s down from 25 pills a day to 11. She did tell me tonight, though, that unlike the fast, pit-stop kind of healing that she is used to, this time the healing is "going really slowly." I don’t mind slow. If that philosophy worked for the turtle why shouldn’t it work for Karen.

Since she got her staples out on Tuesday the incision has continued to improve. The redness is basically gone, and it is starting to take on a more normal appearance. She wore her hair down today for church and you couldn't tell she had any incision except for about an inch near the beginning of the incision on the top side of her head. You wouldn’t have even noticed that unless you really looked. You can ask anyone who saw her at church today and they'll tell you that she looked great! Considering her condition 14 days ago I continue to be amazed at the healing God has provided.

In fact, today was a really wonderful Sunday. Karen was able to make it through the whole day and whereas last week she had a hard time grasping the content of the sermon, this week her comprehension was a lot better. Pastor Walker preached from Acts 12 on prayer. Given the events that spawned this blog, prayer and its importance in the life of a Christian has taken on a much more vivid reality than ever before.

It really has been a blessing to watch our God, who at the same time he’s busy upholding each molecule in the universe, take the time to bend his ear to the supplication of his saints and touch Karen’s mind and body in answer to your cries on her behalf.

2006-09-27T17:18:00.000-07:00

Proverbs 16:33 "The lot is cast into the lap, but its every decision is from the Lord."

I'm beginning to notice that Karen is definitely more tired toward the afternoon and early evening. I know that many of you are slapping your forehead and saying "duh! What else would he expect to see after major surgery", but I have always admitted that I am slow on the uptake when it comes to things like this. For Pete's sake, when we were dating Karen had to tell me THREE TIMES that there was no future for our relationship before I finally understood. Fortunately she was wrong :) but the point is still the same. I often need the obvious to be hammered into my head a few times before I see how obvious it really is.

Aside from the fatigue, however, Karen is doing remarkably well. She was noticeably more energetic this morning and when my Mom called she commented that it sounded like the old Karen.

I am also pleased to announce that Karen has now reached a real milestone in her growth as a patient. She actually passed up a fun opportunity this afternoon realizing (without help) that it might be a bit much for her at this point. Usual she only acquiesces after receiving a volley of "No" missiles from me and any other family and friends in the vicinity. This was momentous for her because it is the first time I can recall that I've heard her admit without "help" that she might need to rest. For Karen this is an epiphany of the 1st degree. When I heard her turn down the opportunity my jaw dropped, my eyebrows raised in astonishment, and for a moment I may have glimpsed a cartoon 'thought cloud' form above her head announcing that she finally realized that when you have brain surgery you really should slow down a bit.

As Karen continues to improve I've also been thinking over the past few days about the whole idea of odds and percentages. I'd like to think I am pretty tenacious in my pursuit of consistency. Whether it is in the context of politics, theology, or beer, I like to think that I'll be consistent in how I apply arguments, even to the point of having to make uncomfortable changes in beliefs or behaviors.

So as I was reflecting on the hurricane of emotions that was last week, I am pressed to apply my argument about odds and percentages consistently. As you may recall, I was significantly impacted by an article by John Piper called "Don't waste your cancer". For those of you who are interested you can read it here. (I'd encourage everyone to take a look. It's short but powerful).

In this article John Piper talks about the ten ways that a Christian can waste his cancer. In particular the third point struck me to the core. I think it had such a poignant impact because at that moment I was battling with the words of the surgeon after he had come down to talk about what he'd discovered during surgery. The words

"98% fatal ... Terminal ... 98% fatal ... Terminal ... 98% fatal ... Terminal ... 98% fatal ... Terminal ... 98% fatal ... Terminal ..."

kept pressing in on me. I knew that God could heal Karen but I also knew that these percentages were not pulled out of thin air. They were real and I had to come to terms with the reality of the situation.

When I read the following words, however, it was like a kick to my rear (uncomfortable but effective) ...

3. You will waste your cancer if you seek comfort from your odds rather than from God.

The design of God in your cancer is not to train you in the rationalistic, human calculation of odds. The world gets comfort from their odds. Not Christians. Some count their chariots (percentages of survival) and some count their horses (side effects of treatment), but we trust in the name of the LORD our God (Psalm 20:7). GodÂs design is clear from 2 Corinthians 1:9, ÂWe felt that we had received the sentence of death. But that was to make us rely not on ourselves but on God who raises the dead.Â The aim of God in your cancer (among a thousand other good things) is to knock props out from under our hearts so that we rely utterly on him.

I realized even before reading this that God is not bound by odds. He messes with the so called experts all the time and leaves them scratching their heads wondering what part of their calculous went wrong. But somehow the way Piper communicated this truth at that moment really provided me with a peace that carried me through until we got the news the next Thursday that Karen's cancer was not what they expected in the beginning. Her chances were now extremely good.

NOW FOR THE MOMENT OF CONSISTENCY

If I was not to put my hope in odds when it was 98 to 2 against Karen, should I now be putting my hope in odds when they are suddenly reversed in her favor? I'll admit that the good news did lift an enormous burden from my back and I finally felt myself breathing again. Nevertheless, at the moment the good news was delivered did I slip back into the trap of trusting in my odds rather than our Heavenly Father who seems to really get a kick out of frusterating the odds? I think I did to some extent.

Don't get me wrong. I am thankful for the new and promising prognosis. This is surely an answer to prayer. But I am reminded that I am required by the 9th commandment to be consistent in my thinking and more importantly to be consistent in my fidelity to Christ. My physical life remains in his hand, my spirtual life still rests in his finished work on the cross. Were do the odds come in then? I guess 'Odd' in this situation really should only be used to describe Karen's husband, and not her chances of survival. I'll leave Karens' future in bigger and beter hands than mine.

2006-09-26T22:50:00.000-07:00

A number of people have asked that we post a picture of our whole family. Funny thing is ... after searching high and low I was not able to find many pictures with all of us. I did find one, however, that we took when we were on our trip to Oregon.

I'll give a special prize to anyone who can tell me what device is pictured in the background (residents of Redmond, OR are not eligible).

2006-09-26T22:16:00.000-07:00

Karen got her staples out today. All 51 of them. For those of you who are interested it was painless. Karen said it just felt like someone was tugging on her hair. We had our regular family doctor do the removal around the corner.

The devise to the right is the staple remover. For those of you who would like one of your own you can purchase one for $8.80 or a box of ten for the low low price of $61.90.

Next Tuesday the 3rd we have an appointment with our Neuro Oncologist. He'll have the final pathology report back then and will use that to determine their suggested course of treatment. He's already said that for Ependymoma's they usually just suggest a 6 week course of radiation therapy.

We continue to value your prayers. Though the diagnosis and prognosis appears optimistic at this point, the road of recovery certainly is not over. Thank you for your faithfulness in lifting Karen up to our Heavenly Father.

Matthew 7:-11
Ask and it will be given to you; seek and you will find; knock and the door will be opened to you. For everyone who asks receives; he who seeks finds; and to him who knocks, the door will be opened.
Which of you, if his son asks for bread, will give him a stone? Or if he asks for a fish, will give him a snake? If you, then, though you are evil, know how to give good gifts
to your children, how much more will your Father in heaven give good gifts to those who ask him!

2006-09-24T17:42:00.000-07:00

We're at home now with Karen's parents (Gordon and Mary) enjoying a beautiful Livermore Sabbath's rest. Worship was wonderful. I was struck particualrly by the words of one of the Hymns ...

Great things He hath taught us great things He hath done
And great our rejoicing through Jesus the Son
But purer and higher and greater will be
Our wonder our transport when Jesus we see

It always bother's me when I notice how frequently the focus of my praise centers on all that God has DONE for me rather than all that he IS. He'd be worthy of praise even if he'd never done one thing for me. Don't get me wrong, though, I am thankful that he saw fit to extend his love in my direction. I am also thankful that the outlook for Karen is now so good. I just know that to a great extent my praise can be so self centered and fair weather.

I liked the words of this song because it starts out by recognizing God has done great things, but it ends where it ought to, in recognizing that ultimately our joy will simply be in seeing Christ face to face on the day he calls us home.

Great things He has Done!!!

Dave

2006-09-23T08:39:00.000-07:00

The kid's are on their way back home. Kevin (Karen's brother) and Tacy have been so great during this whole time. In fact it has been truly amazing the way all of our friends and family have been so helpful and supportive. Thank you all!

Proverbs 17:17
A friend loves at all times, and a brother is born for adversity.

Proverbs 18:24
A man of many companions may come to ruin, but there is a friend who sticks closer than a brother.

We are really looking forward to the kids being home. Josh has a soccer game today and KP (Karen) really wanted him home so he could play his vital role as nose picker and space cadet.

I am very interested in how they will do today. The first game was a slaughter (we lost), the second game they only lost by two, and last Saturday they tied! I like the trajectory :)
GO BULLDOGS!!!

If extrapolation were appropriate in this situation I'd be confident Josh would bring home a win today, however, we're talking about six year olds here. Oh yeah, and we're not supposed to be keeping score.

On another note ...

Karen and I are really looking forward to worship tomorrow with our church family. There is nothing quite like worshipping corporately with the people of God. I love to hear the voices of God's people raised in joyful song. What a day it will be when there will be nothing separating us from Him, not time, or distance, or distraction, or this body of sin, just pure unobstructed adoration amidst a countless throng of saints.

Revelation 7:9-12

After this I looked and there before me was a great multitude that no one could count, from every nation, tribe, people and language, standing before the throne and in front of the Lamb. They were wearing white robes and were holding palm branches in their hands.

And they cried out in a loud voice: "Salvation belongs to our God, who sits on the throne, and to the Lamb."

All the angels were standing around the throne and around the elders and the four living creatures. They fell down on their faces before the throne and worshiped God,

saying: "Amen! Praise and glory and wisdom and thanks and honor and power and strength be to our God for ever and ever. Amen!"

I guess each Lord's Day is something of a rehearsal for that great day. I hope that you all will be joining with us tomorrow, wherever you are in the world, as we ready our voices for eternity.

2006-09-22T18:08:00.000-07:00

Here's an update from our Pastor regarding our fellow church member Bob Gibson ...

We wanted to update all of you regarding Bob’s surgery so that you know how to continue praying for him and for Jane. Bob ended up having to have a quadruple, not a triple bypass. He’s out of surgery now and doing “well”. He’ll be in ICU for 2 ½ days, Lord willing, and in a regular hospital room until Thursday. Jane is weary, but relieved that the surgery went smoothly. Keep praying for them as Bob begins the lengthy recovery process!

2006-09-22T12:24:00.000-07:00

I have a new prayer request for you all. Some friends of ours from our new church just found out a few days ago that he needs a triple bypass. He is actually in surgery right now.

I am excited that I have the opportunity to share this with you because I know you are faithful in your prayer. Please lift Bob Gibson and his wife Jane up in prayer.

Dave

2006-09-22T09:49:00.000-07:00

I am amazed at God's faithfulness. Karen woke up this morning and for the first time since surgery had oomph in her voice. It's is wonderful to hear energy back in her voice. I have so much to be thankful for. God has been gracious and given us the desire and hope of our hearts.

I was thinking about the idea of hope yesterday. It's a very prevalent theme in conversations from doctor's, friends and anyone else you come into contact with in these situations.

"You have to have hope." We are told and say to ourselves. It does seem, in fact, to be the cardinal and unforgivable sin in situations like these to take hope from the one suffering.

That got me thinking, however, about what we mean when we say this. (We so often say things without thinking through what we mean). Hope, after all (like trust or faith) is only as good as the object in which it is placed.

I am convinced that there is such a thing as vain hope. This is an empty hope. Hope for hope's sake. Or hope in something that is really not powerful enough to do any good at all (our own goodness, our inner strength, the skill of doctors, the love of those around us). Even hope in a good outcome is no place in which to put our hope. After all, none of us are promised tomorrow.

This is not the kind of hope that Karen and I have been given over the past week. By God's grace our hope has been placed in an object more solid and immovable than the universe itself. The Rock of our salvation, Jesus Christ.

As I looked in scripture at the whole idea of hope I was struck by how consistently we are shown that the key to hope is placing it in the hands of our redeeming God. Take a look at just a few of the verses that show us in whom we ought to place our trust ...

Psalms 31:24 Be strong and take heart, all you who hope in the Lord.

Psalms 33:18 But the eyes of the Lord are on those who fear him, on those whose hope is in his unfailing love,

Psalms 33:20 We wait in hope for the Lord; he is our help and our shield.

Psalms 130:5 I wait for the Lord, my soul waits, and in his word I put my hope.

Psalms 130:7 O Israel, put your hope in the Lord, for with the Lord is unfailing love and with him is full redemption.

Psalms 147:11 the Lord delights in those who fear him, who put their hope in his unfailing love.

Isaiah 49:23 Kings will be your foster fathers, and their queens your nursing mothers. They will bow down before you with their faces to the ground; they will lick the dust at your feet. Then you will know that I am the Lord; those who hope in me will not be disappointed."

Jeremiah 14:22 Do any of the worthless idols of the nations bring rain? Do the skies themselves send down showers? No, it is you, O Lord our God. Therefore our hope is in you, for you are the one who does all this.

Jeremiah 17:13 O Lord, the hope of Israel, all who forsake you will be put to shame. Those who turn away from you will be written in the dust because they have forsaken the Lord, the spring of living water.

Lamentations 3:25 The Lord is good to those whose hope is in him, to the one who seeks him;

Micah 7:7 But as for me, I watch in hope for the Lord, I wait for God my Savior; my God will hear me.

1Peter 1:3 Praise be to the God and Father of our Lord Jesus Christ! In his great mercy he has given us new birth into a living hope through the resurrection of Jesus Christ from the dead,

1Peter 3:15 But in your hearts set apart Christ as Lord. Always be prepared to give an answer to everyone who asks you to give the reason for the hope that you have. But do this with gentleness and respect,

I thank God that because of his grace toward us, Karen and I know in whom our hope is found. I pray that from now on, if you have not done so before, you will all think carefully when you use the word hope and will ask yourself in what object that hope is placed.

2006-09-21T18:31:00.000-07:00

Great News!

We got a call from our NeuroOncologist a few minutes ago and he informed us that they believe the tumor to be a very rare variant of an "ependymoma." This would be a class 2 tumor rather than the very aggressive class 3 or 4 that they were expecting to find.

These tumors are very receptive to radiation and the prognosis is good. No Chemo therapy should be needed.

I'll fill you in on more details shortly but wanted to get the good news out right away. We have a lot to be thankful for tonight!

Dave

2006-09-21T11:42:00.000-07:00

Karen Just played the piano and we sang some Psalms together. It was really nice to hear her voice and see her fingers gliding across the keys. Here's the words to one of the songs that we sang in preparation for the Brown/Bush wedding ...

How blessed all who fear the Lord and walk within his ways. You'll eat your labor's fruit be blessed, and prosper in your days.

Your wife will as a fruitful vine within your house be found; Your children will as olive plants your table gather round.

Behold thus shall the man be blessed who truly fears the Lord! The Lord from Zion grant to you His blessing and reward.

And may you see Jerusalem's good all days on earth you dwell. May you your children's children see and peace on Israel.

2006-09-20T17:20:00.000-07:00

This is a very strange process. You never really know when the gravity of this situation has actually sunk in. I've been trying to assess where Karen is at in terms of her really understanding her condition. While we were on a walk earlier she told me, without my prompting, that she doesn't think she really gets it yet. I think she's right. She has not had as much time as we have had to really let this all sink in. She has not allowed herself to think to far into the future yet, which is fine for now. "Baby steps" as I was told once by a goldfish wearing hypochondriac.

I do worry about Karen and how she will handle the full weight of her new reality as it sinks in. Maybe the epiphany will come tomorrow when we hear the results of the pathology and get a prognosis. She is strong, stubborn, (her faith is much stronger than mine) and I know she will process the information just fine. But I also hate to see her scared and hurting.

In the past I have often said what a comfort it is to look back at our own lives as Christians and to see the many troubles and times of uncertainty that God has brought us through. The path that God has cut for each of us through history is fraught with these hills and valley's and we never in our wildest dreams would have written the story line God has penned for us. But what a drab uninteresting and lifeless story our lives would be if we were the ones writing it.

Then I think of the history of God's people through the ages. I think of the Israelites as they were being delivered from Egypt and how quickly they turned their backs on the God who had just saved them. Yet God was gracious and demonstrated his mercy and let them drink from the rock. I think of the church in Corinth in the 1st century and the way they had so quickly fallen into sin. Yet by the second letter Paul wrote to them God had proved faithful to forgive and bless them once again.

Karen's life, and the lives of all the saints through history are a testimony to the beauty of the story of redemption that God has been weaving since the first day He made His promise to send one who would crush the head of the serpent.

Clearly, the symphony of Karen's life has entered a movement with a distinct minor key, but as long as we are driven to Christ by these minor chords then her pain, and ours as those who love her, will not be wasted.

2006-09-20T11:28:00.000-07:00

Karen is getting better each day. She woke up this morning asking for pain killers though, because she slept great but that meant she didn't take any pain meds in the middle of the night.

She's feeling better now, had her 'Kicks' (apparently not just for kids), her morning cup of coffee, and paid our quarterly tax bills. That might sound to you like an odd combination of stuff but is quite normal for Karen.

Tomorrow is the "Tumor Board". This is where about 25 experts on brain tumors sit around all day and review a few tumor cases. They'll look at Karen's scans, review the pathology of the cancer, and assess which forms of treatment will be best given the specifics of Karen's situation. Please pray for good results from Pathology and great options for treatment.

We'll we're about to watch the second season of 'Lost'. I know, I know, but it's not our fault. Mike and Michelle (Brother and Sis'n'Law) got us hooked when they gave us the first season on DVD. You know how it is. In times of crisis like this you find out what is really important to people :) I'll let you know what happens to Walt.

Dave

2006-09-19T13:04:00.000-07:00

We're home!

I am currently sitting next to Karen and Michelle on the couch while Karen crunches an apple in my ear. 5 days ago this probably would have irritated me. Actually I'm sure it would have irritated me. After the past few days it now sounds like a chorus of angels. (Michelle's crunching on the other hand still irritates me).

I am finally able to show Karen the blog first hand and she is really overwhelmed and touched at your outpouring of love and expressions of sympathy.

Karen has given me permission to post a picture of how she is looking, but it may be a day or so before I do.

Thanks again to everyone. The next big news will come on Thursday or Friday when we find out exactly what kind of cancer it is and then begin to develop a treatment plan.

I'll be talking to you all again soon (probably later tonight).

Dave

2006-09-18T22:47:00.000-07:00

Just a quick post before I go to bed. This should be our last night here at the hospital. Karen has been up and walking. Actually doing laps around the building. Don't get the wrong impression, she's not going very fast but she is walking. I accompanied her on one of those walks around the 8th floor hand in hand. I can't tell you how special I felt walking through the halls with my bride on my arm. I felt like the way I did as we walked down the aisle on our wedding day after being pronounced "man and wife." I knew she was gorgeous then and I felt the same way tonight. The goofy look on my face was a testament to that fact.

If I step back and analyze my feelings for a moment one part of me says that I am blinded by love, but the rest of me knows how cute she looks with those silly pigtails they gave her before surgery.

For those who haven't seend her yet she has little pig tails randomly placed all over her head with rubber bands. Probably the best description I could give you to help you build a mental picture is that it looks like my spazzy two year old daughter Sophie somehow got ahold of a bag of rubber bands and absolutely went to town on Mommies hair with the help of that WWF wrestler from the 80s that adorned himself with those useful little office supplies. She really is cute.

Surgeons do a great job on brains, not so much on hair.

Maybe I'll sneak a picture and post it later ... I may need to slip a few more vicadin into her tapioca for that to happen.

Dave

P.S. I know she is getting back to normal because as she was walking with me around the floor she looked up tenderly into my eyes ready to whisper what I can only assume would have been some confession of abiding love for me when she promptly walked straight into the corner of a wall. I was obviously concerned considering she just had brain surgery and her skull is currently held together with staples. So I asked her if she was OK and she said without missing a step "Yeah, it would have happened on any normal night at home.'

It's good to have her back :)

2006-09-18T16:16:00.000-07:00

A couple of hours ago few family and friends were sitting in a waiting areas just around the corner from Karen's room when Karen came waltzing through the door. (Well, now that I think about it, it wasn't really a waltz it was more of a waddle.) Either way it was a truly beautiful sight to see.

She's improving consistently each day and the doctors are very happy to see her phenomenal progress. Right now we are both very encouraged. We'll meet with the head of neurooncology later today and he'll give us an overview of how things will work over the next week or so. I'll try to remember to update you all on that info later today.

As I was reading some of your recent posts I found tears welling up in my eyes. Your words are so profound and encouraging and I can't help but be moved by them. I noticed, however, that though I am sincerely moved by your words and hope to hear many more, it has been the words you have quoted from God's word that truly stir my soul. Though what you have written is so eloquent and beautiful, there is nothing like the voice of my Heavenly Father. His words are so perfectly bitter sweet. No sugar coated cliches will do for the Lord of Hosts. And like any child, I long to hear the truth from my father. The truth that sends my heart soaring with gut wrenching joy.

Praise God that he has revealed himself so clearly to us in his precious word. I will pray today that as you open your Bible tonight you will be struck more than you have ever been before by the words that confront you on each page. You won't find the words of a self help guru. You won't find chicken soup, or any other kind of poultry for that matter. You won't even find great advice and nuggets of truth. What you will find etched in every word of every page is THE Truth who became flesh. The Truth that sets us free. The Truth that is so often painful until we remember that it was the Truth who was wounded so that we would not be.

How glorious it will be after we have been refined in the fire to look back and see the master artisanship of God as he molded us and shaped us into the image of his very own son. I hope that you will find that kind of life in the words you read tonight and I will pray that God's words will change you as I can feel them changing me.

Dave

2006-09-18T08:52:00.000-07:00

I want to thank you all again for your love and concern. I just want to let everyone who is interested in coming out to visit know that you may not be able to visit with her if you do. I want to make sure that she gets her sleep. That is really the best thing she can do to get better at this point.

If you want to come and show your support, pray with us and for Karen that is fine for now. We'll all have to play it by ear.

Keep in mind that you can respond to the blog and I will eventually get her the message.

You can also send emails to welovekaren@hotmail.com.

Thanks everyone.

2006-09-17T23:03:00.000-07:00

I think today begins the start of a new phase of this saga. Karen was moved down to the regular recovery rooms and is now out of the ICU. Her current status is truly amazing. Less than 24 hours after brain surgery the doctors have told us she can go home tomorrow if she feels up to it. That is certainly a far cry from our original fears that she would not even be able to talk.

She essentially has no negative results from the surgery itself. That in itself is an answer to prayer that we are happy to receive.

As we begin this new chapter I think we're moving from some of the more acute challenges to the longer term challenge. We'll be meeting shortly with the oncologist and will begin the longer process of fighting the cancer that is still in her.

As I try to comprehend what this means and what it will look like as we move forward, I am confronted with at least one huge reality ... I am not in control ... and neither is Karen. This is a really hard concept to grasp for both of us. The whole idea that we have to rely on other people for help is not easy for either of us to acknowledge.

Everyone hopes that if a tragedy like this one strikes they will have the kind of support that we have experienced the last four days. But it isn't until the offers of assistance begin pouring in that you realize how odd it is to actually be on the receiving side of compassion. People like us do not like to admit that we need help. If I'm being honest I'd have to say that it is much more comfortable to be on the other end. When you are the one that is giving you feel a sense of control over the situation. In our current situation we are being offered help because we truly couldn't do this on our own. It's downright humbling.

I can't help but draw a comparison in my mind between this situation and the Christian message. After all, fundamental to the message of Christianity is the reality that we are all dead in our sin. We are all separated from a loving relationship with our Creator because our sin creates that insurmountrable rift between us and a holy God. We all have a fundamental need to be reconciled to the God who created us and sustains each and every molecule of our being. In short, we desperately need help.

And like our situation with Karen's cancer, the answer is not in trying to conjure up the strength you need by looking into the recesses of your own heart. But by God's grace we get to a point where we realize that we need to rest in someone else's efforts. We need to rely on the strength that comes from God's heart as that was historically expressed in him sending his only Son to die on the cross for the sins of his people.

What a humbling thing to realize how truly weak that we are. And then to remember what our Heavenly father tells us,

"My grace is sufficient for you, for my power is made perfect in weakness." Therefore I will boast all the more gladly about my weaknesses, so that Christ's power may rest on me.

I thank Him for showing me my weakness. I thank him that I now have no choice but to trust in his strength and to remember that his hands are much much bigger than mine.

2006-09-17T22:54:00.000-07:00

I do hope you'll forgive me for not updating this sooner. Today was a good day but a busy one.

Karen is continuing to do well. She's really really happy to see each one of you who has had a chance to visit. For those of you who can't come and say "Hi" in person please know that many of your blog responses have been read to her. I will also be making sure that when she is able she has a chance to read each and every one of the responses you have all left. I look eagerly throughout the day for each of your posts and have found them all very uplifting.

Dave

2006-09-17T12:09:00.000-07:00

Karen is doing well.

She should be moved out of the ICU and down to a regular floor this afternoon. The doctor said that she could go home tomorrow if she is up to it but it may be Tuesday. We'll see.

As for talking to her and the kids, that has gone well. I'll fill you in on how that happened later. Karen now knows that she has cancer and that the doctor had to leave some of the tumor in. She's teary but I am glad she's not trying to "be strong".

We'll be talking to the oncologist sometime in the next few days about what kind of radiation and Chemo regimin she'll need to undergo.

We will be able to do the treatment near our home. As the doctor says, they call the game plan from UCSF and it doesn't matter who the quarterback is.

Thank you all again for your prayers. Please continue to pray. The road ahead will be long and hard.

Dave

2006-09-17T07:44:00.000-07:00

Karen made up a song years ago for the kid's that we sing on the Lord's Day. That isn't unusual for her, it seems that every activity in our family has some little song to go with it. Funny now that I think about it that though she was a musician she never thought herself much of a song writer and yet her little ditties are attached to almost every item in our house and activity we do together.

You can't hear the tune right now but the word's are short and sweet ...

"Happy Lord's Day, Let's prepare our hearts to go to church and worship the almighty God."

I hope that you all have a sense of awe and thankfulness this morning as you enter corporately into the throne room of God and meet him in worship this morning.

She asked again in her stupor that I make sure you all go to church this morning. It's always been very important to her that His people not neglect the worship of their God. After all, those who share the bonds of Christ share the same gracious bonds that she wears. When you worship this morning you are worshipping with her. Sing loudly.

Please pray that I know what to say to her when the time comes and that I know what to say to the children.

I love you all.

2006-09-17T07:35:00.000-07:00

Karen had a Good night and is improving. Praise God.

2006-09-16T22:06:00.000-07:00

Well...I have been able to see Karen tonight and considering all that she is going through she is doing extremely well. She is recognizing faces and is obviously happy to see her friends and family who have come to visit. She is also able to verbalize, though with some difficulty due to her anesthetic stupor and swelling induced aphasia. For those of you who don't know, aphasia is the inability to come up with the words you are looking for to express a thought. I think this is related to a phenomenon that most mother's experience after chasing their small children around the house all day.

I am encouraged, but for now I am trying to learn to take things one day at a time. I may need to make the increments of time even smaller as we move forward, but for now a day at a time seem reasonable. As for tonight, I can go to bed truly content. I have seen my bride and she's as beautiful as ever. In fact, some things have not changed all that much. I mean, she's sleeping with her mouth open right now, but as those who know her well can attest, that is not much different than a normal night.

I can also go to bed knowing that I have an essentially endless line of loved ones who really want to help. That's certainly a bit of knowledge that many people will never be blessed to experience. And most importantly, I know that God's promises are as true right now as they were on Wednesday.

Good night for now,

Dave

2006-09-16T17:18:00.000-07:00

Karen is on her way out of the operating room. The surgeon was able to tell us that the tumor was malignant and he was unable to remove all of it because of where it was placed. The next 24 to 48 hours are critical in terms of potential acute problems. The prognosis in these circumstances is typically not good. We do find some hope in that we are in the right place in terms of the most cutting edge treatments, some of which have been very effective.

Please continue to pray. The battle is just beginning.

Please do not spread this information to anyone at this point. I want to keep you all updated but also want the information to be accurate. Send them to this site if they are interested in an update. Accurate information will be useful to you so that you know what to pray for, but we all need to be careful. Acciidentaly spreading false information could be damaging.

We really do covet your prayers and need them now more than ever.

To God be the glory,

Dave

2006-09-16T16:31:00.000-07:00

The doctor has just informed us (through Barbara) that they are closing up. That means that we are about an hour away from completing the surgery. She is continuing to do well.

Thanks for all your prayers. Please pray that the tumor is benign and that her mind and body respond well to the surgery.

2006-09-16T15:31:00.000-07:00

Update: The nurse shift changed and so the new nurse (Barbara) called to let us know that she will be responsible for updating us.

Karen is continuing to do well.

2006-09-16T13:57:00.000-07:00

I just got a call from the O.R. (Operating Room). The nurse said that everything is going well. She was in good spirits and went under the anesthesia perfectly. They have begun the inscisions and will call us again in about an hour.

Dave

Go to church tomorrow ... She's not giving you a choice

2006-09-16T13:44:00.000-07:00

I almost forgot to tell you all; before Karen went to surgery she told me that she wanted you all to go to church tomorrow. It is his day after all :)

For those of you who belong to a Bible believing church it will be a great time to worship our God who Karen loves and who is lovingly guiding the surgeons' hands even as I write this.

For those of you who do not belong to a Bible believing church this is the perfect time to go to church, crack open your Bible, and hear the good news about the God who condescended, became man, suffered the death on the cross, bore the penalty of the sins of his people, rose to new life three days later, and who, though he reigns over all of creation, still has concern for each hair on Karen's head.

Love,

Dave

Update as of 12:00PM

2006-09-16T13:18:00.000-07:00

I accompanied Karen to the Operating Room at 12:00PM where we were able to meet with the two surgeons. Everyone so far has been really great (Nurses are the best!).

The good news righy now is that the head surgeon says that he expects her to be no worse than she is right now in the long run. This is actually really good because she is doing really well. You wouldn't know she had a 5 centimeter mass in her cute little head if it weren't for the pictures.

The back side of the tumor is located near the speach center of the brain so this is where they are going to spend most of their time. The rest of the tumor is located in a part of the brain that is much easier to work in so they expect that part of the surgery should go faster.

The surgery should take about 6 hours. I'll let you all know how things are going as we find out. Thank you all for your prayers.

We love you all.

Update as of 9-16-06 9:30am

2006-09-16T09:18:00.000-07:00

David called me and asked me to give a preliminary update.

Karen is scheduled to go into surgery in the late morning or early afternoon. The doctor is currently working on another person, and they are waiting for him to finish.

The doctors won’t know much until they begin and are able to make an assessment. The affected portion of Karen's brain controls speech and comprehension.

At this stage there is nothing we can do but pray. And that is no small thing. Rather than a last resort, prayer is our first and most powerful recourse. Rather than mere individual emotional catharsis, it is our gate into the audience chamber of the Most High God, who lovingly and sovereignty ordains whatsoever comes to pass and upholds all things by the power of his Word. David asks all of our friends and family to labor in prayer for Karen because he understands its importance and power. What a blessing and privilege He extends to us, that we can cry into the ear of our Heavenly Father, who through the mediatorial work or our Lord and Savior, hears us as beloved friends and children. What amazing grace He extends to us that we can exchange our burdens for His Peace. If we ask our Father for a loaf of bread, will he give us a stone? Surely, He who has Karen's name engraved on the palms of his hands will not suffer her to loose one hair from her precious head apart from His most loving will. Let us remember His promise that our prayers avail much, while echoing the words of our Savior, "Nevertheless, not my will, but Thy will be done." Amen

David wanted me to list some specific items to remember in your prayers:

Pray that Karen would have peace, be encouraged and comforted.
Pray that God will guide the hands of the Doctors and give them wisdom.
Pray for friends and family members, that they would also have peace and wisdom to know how to best assist.
Pray for the recovery. Even after a successful operation, she will still have to endure the fatigue and hardship of recovering from brain surgery.
Pray for successful rehabilitation.
Pray for yourself, that the testing of your faith might develop perseverance.

We will keep you posted as events unfold. Thank you for your prayers

-Mike Gregg

Just in case...

2006-09-16T00:03:00.000-07:00

David had hoped to log in and post an update, but the poor guy had been up at least close to 36 hours when I talked to him. I hope he's getting some sleep right now.

I will write what little I can until he has the chance to provide better information.

Last I heard, Karen is scheduled for surgery Saturday at noon. Her MRI had at that time not been reported to have shown any real news for better or worse.

I know that's not much but I am fearful of posting anything inaccurate.

Pray, pray, pray,
Steve

Why this blog is here.

2006-09-15T20:01:00.000-07:00

This blog is for the friends and family of Karen and for David to keep their loved ones updated on her progress and condition.

In order to make this blog easy to access it is public, so I ask that you please not post ANY personally identifiable information such as full names, addresses, phone numbers or similar information.

I'm sure any and all prayers and comments will be greatly appreciated. Karen is blessed to have so many godly and loving people in her life. I hope that this site will be a blessing to you and David and Karen's family.

Please pray that the doctors will have wisdom as they diagnose Karen's condition, that David, Karen and their little ones will be at peace, resting in our Lord and Saviors grace. Please pray that Karen will be spared pain and that God would grant her healing mercies and full restoration to her role as a loving wife and mother soon.

Steve (Brother-in-law)

And we know that in all things God works for the good of those who love him, who have been called according to his purpose. Romans 8:28