05.31.06
Less rumpled today
Just a quick note to say thanks for your prayers. I feel better today than I have in two weeks–I actually slept until after 7am. Thanks so much. It’s clear to me that the Lord heard you all praying.
Blessings, Al
05.30.06
Gamma knife coming up on June 6
We met with a neurosurgeon and a radio-oncologist today. The tumor in my brain will be treated by radiation instead of by surgery, even though the spot is highly accessible and would also be treatable by surgery.
The radiation treatment is called gamma-knife radiation—one-time, highly focused radiation on the tumor, with minimal to no damage for healthy brain tissue.
I will have the procedure on Tuesday, June 6 (one week from today). It is out-patient and I go home the same day, Lord willing. There are complications of later swelling and headaches. It is possible that surgery could ultimately need to be done.
Advantages are that it is non-invasive. Moreover, because it is done in conjunction with a very finely gradated MRI (claustrophobia is going to be a prayer concern!), it may turn up other small tumors as well that can be treated at the same time. The MRI is required in order to precisely focus the cobalt beams (201 of them all converging on one spot!)
I should be able to return to normal activities the day or so afterward.
It all sounds pretty good to us.
Decision points ahead:
1. What kind of treatment to continue now that the cancer has spread to my brain? (We will be having a whole-body CT scan ASAP to see how my lung tumors are doing. If they remain more-or-less unchanged, then we may try to find a way to continue the earlier therapy, even though I will no longer be eligible to participate in the clinical trial.)
2. Because the cancer has spread to the brain, should we follow the gamma-knife with “whole brain” radiation (15 days of radiating the entire brain to catch the metastases that are very likely forming, but haven’t yet grown large enough to see)?
As you can see, things are moving along, not in the directions we had hoped.
The last few days I have been a bit down and rumpled of spirit. Part of it has been the ongoing issue with the blood clot. Pain and lack of exercise, lying around with my foot elevated, are not a good recipe for feeling upbeat!
The good news is that my leg is less painful each day and I was able to walk for several blocks today from the train station to the hospital and back, my first attempt at anything more than basic back and forth around the house or for short distances in and out of buildings, etc.
Again, we always thank you for praying and for your support in all kinds of ways.
Blessings, Al
05.26.06
MRI results
One and all,
We just heard from our doctor at Penn, and the news is somewhat better than we had expected. After the CT scan report we assumed that the whole ~4 cm swelling in Al’s brain was probably melanoma. As it turns out, a lot of the swelling is just that–swelling. There is melanoma there, as we expected there was, but it is only one small nodule–12x14x16 mm.
Given that, the best course of treatment seems to be radiation rather than surgery, which is a bit of a relief. We will arrange for something called Gammaknife radiation, which uses scan-guided imagery to focus the rays only on the cancer nodule. The consultation with the neurosurgeon to talk about setting up that procedure will be next Tuesday. (I’ll have to say that our doctor at Penn sure knows how to make things happen. Within a short time of hanging up with her we had a call from the neurosurgeon’s office with an appointment already scheduled!) We’ll let you know more details as we find them out on Tuesday.
Meanwhile, they’ll use steroids to try to reduce the swelling, and that should make Al feel better (he’s been feeling pretty crummy the past few days–general headache and body pain all over).
We’ll also schedule another CT scan of the body to see what’s happening with the melanoma there. Officially the appearance of the melanoma in the brain marks the end of the PFS (progression free survival) period and therefore the end of Al’s participation in the clinical trial, although it might still be possible to get the targeted therapy and chemo apart from the trial if that seems indicated. All of that remains up in the air.
Thank you for praying; this is better news than we thought we would hear. The Lord is keeping us, and we are grateful. When I have time I’ll write more about how we’re all doing. (The short version of that is that our souls are doing very well. But I’ll fill out that picture when I have a chance.)
Thankful for your company on the journey,
Libbie
MRI results: Sometime this afternoon
I spoke with the research nurse that works with my oncologist. The results are in and the doctor will be calling sometime this afternoon. Will post the results as soon as we have them.
Blessings, Al
05.25.06
Graduation Day at Westminster Seminary
Today Westminster Seminary graduated more than 125 students. Herb Lusk, pastor of the Greater Exodus Baptist Church in Philadelphia, received an honorary doctorate and was the keynote speaker (the address was excellent!) I was thrilled simply to be there and to be part of the ceremony. (Just days ago it seemed possible I might not be able to make it.)
One of my tasks was to read the name of each of the graduates as they walked across the stage to receive their diploma. There really is nothing more thrilling than to see the success of your students. Students probably don’t realize how precious they become to their teachers through the years. What a bittersweet process teaching can be–forging strong bonds and relationships with students, knowing full well that in a few very short years we will be sending them out of our lives. Perhaps forever. It’s like raising children, only on a much shorter time cycle.
For me today was special because I had the opportunity to give the charge to the graduates. Again, I cannot say enough how grateful I was to the Lord to be able to do it–even having to sit on a stool, with my clotted leg propped up. Sort of like having a fireside chat in the den or something. I was grateful that the Lord kept the pain in my leg at manageable levels. And the help from so many was just overwhelming. The president even wheeled me down the aisle and up onto the stage.
Afterwards I had wonderful conversations with graduates and alumni and parents. Gift upon gift for me.
Just wanted to share the joy of the day, undimmed by other circumstances in my life. In fact, other circumstances added something to the joy of the day! God is good.
Blessings, Al
05.24.06
No MRI Results until Friday
Just spoke with Lydia, the research nurse for our oncologist at the University of Pennsylvania, and she told me that due to a significant backlog at our local hospital where I had the MRI (Abington Memorial) the MRI has not been read and will likely not be read until later tomorrow (Thursday). Because I will be at Westminster’s graduation in the afternoon and at my daugther, Eowyn’s, 9th grade formal photo-shoot afterwards, we will not be able to get the news until Friday sometime. We will let you know then.
This news is not stressful. We are patient. It will be what it is. Meanwhile, we will enjoy the events of tomorrow.
Blessings, Al
05.23.06
MRI is done!
The hospital called early to say they had a slot open for the MRI at 8:15pm. Why wait?
Prayer and sedation helped and I felt no fear this time. We have the films and the official results will be in tomorrow. We’ll let you know.
I am now on blood-thinners. Still no pain reflief, but it’s coming, we believe.
Generally I feel like I’ve got some bad virus. Hopefully we will see the turn of a corner.
Thanks for your prayer!
Blessings, Al
Doctor’s visit 5/23/06
Just an ever-so-brief update from our doctor’s visit this morning:
Al will have an MRI of the brain tonight at ~9pm, and results from that should be in sometime tomorrow, clarifying what the swelling is in brain is–melanoma or something else. Until then, it is premature to make plans for evaluation or treatment, so there is not much to report.
If you read this before tonight, please pray for Al, who dreads having an MRI more than any other procedure he’s had so far. He suffers from claustrophobia, and the thought of being stuck in that tiny space for 45 minutes gives him nightmares. This time they’ll give him a mild sedative, and that should help, but I know he’d appreciate your prayers for preserved sanity as he goes through it.
We’ll let you know more after information comes in and decisions begin to be made tomorrow.
It’s been a pretty emotional few days, and we value and depend on your support shown in so many ways. Thank you so much!
Libbie
05.21.06
Blood Clot [Part 2] and Something More
Well, as you know from reading the previous blog, I was in the hospital with a blood clot in a vein in my right leg. The clot is between my knee and groin, but most of the pain is in my calf and ankle where there is swelling and discoloration—the blood cannot return in the way it needs to.
In cases like mine, the normal treatment has two parts—
1. preventing clots from traveling to the lungs or heart by inserting a filter into the main vein found in the abdomen (the inferior vena cava) to catch “wandering” clots and hold them until they can be dissolved by the body.
2. dissolving the clot by administering blood thinning drugs.
The filter was successfully placed, but I was unable to take the drugs to thin my blood. While several things could prevent me from taking the drugs, the presenting reason in my case was that there appears to be a swelling in the front part of my brain on the right side. Doctors will NOT administer blood thinners if there are anomalies in the brain.
The swelling in the brain was discovered through a routine CT scan of the brain on Saturday morning to verify that there was nothing wrong with my brain, and they could therefore eliminate brain issues as a reason for withholding the blood thinners. The doctors were surprised to find the swelling, because they had said in advance that they didn’t expect to see problems, given that I didn’t have any symptoms.
A CT scan of the brain is much less accurate than an MRI. Therefore, the CT scan is not conclusive, but it does show something that wasn’t there in my February MRI. This means I am looking at another MRI very soon. I meet with my oncologist Tuesday morning for my regularly scheduled meeting, so the swelling in my brain will be a major topic of discussion.
What could the swelling mean? As my grandfather used to say, “It’s just my orneriness coming out.” Or, it could be that the CT scan was simply inaccurate. Or, it could have something to do with the drugs I’m taking to fight the cancer. Or it could be the beginning of a tumor indicating melanoma has spread to my brain, something that is very typical in cases of melanoma. We just don’t know at this point, but you can see the cause for concern.
This swelling could affect my motor function (on the left side) as well as my personality (I could use improvement in this area, but I don’t think this is the kind of thing that works in that direction). But we don’t even know for sure what it is or that it is what it seems to be.
So prayer requests:
1. That, one way or another, this swelling would be nothing.
2. The pain in my leg from the clot (they have been able to do nothing to treat it) would abate and the clot would dissolve.
3. That we would have faith and not fear in the face of these newest developments.
It has been difficult for our family. I think that we had been encouraged by response to the treatment so far, and this has hit hard.
It’s hard for me to think of potential impact on my mind and general affect. I don’t like the thought of being a burden or treating people with anything other than kindness and love.
In faith we remain where we have been throughout this ordeal: God’s faithfulness and love endure. He is the Lord. He is good. We may be confused, but our eyes are on him. He will fulfill his loving purposes for us.
Blessings, Al for all the Groves
05.19.06
Blood Clot
Just a quick note of update:
Today we found out that Al has a blood clot in his leg (apparently both the cancer and the treatment can sometimes increase the risk of that, as I understand it). He spent most of the day in the hospital, and the doctors placed a nifty filter contraption in his vena cava that stays there for life and catches any clots–present or future–that might break loose and head for places where they could be deadly, like the heart. We are thankful for medical advances and for great doctors and hospitals nearby.
Tomorrow the doctors at Abington and Penn will decide whether anti-coagulants would be a good or a bad idea with the lung tumors. Please pray for clear wisdom for them.
Plenty else going on. Becky is home for 48 hours for a wedding. (Poor girl. It seems that every time she comes home one of us ends up in the ER.) Alden’s soccer team just folded, so the members are suddenly scrambling to find other clubs to play with. Some of Eowyn’s friends are caught in major teenage girl drama. And I’m trying to get a couple of papers written. It’s not dull around here, anyway. We are finding that God is a solid rock and a still point in the midst of the whirlwind, for which we are repeatedly grateful.
This is brief and without a lot of detail; maybe we’ll write more medical details later. But now that I’ve tucked Al in and written this, I’m going to fall into bed myself.
Thanks for walking with us!
Libbie
05.15.06
Flotsam and Jetsam
Well, the combination of travel, busyness and tiredness is a recipe for failure to blog. Let me correct my silence with scattered news.
HEALTH NEWS: Not much new to report. Mostly I feel fair to cruddy most days. My stomach doesn’t like anything, even water, although my taste buds still appreciate good food. Cramps and constipation have become my continual companions. (Sometimes I think I sound like some old geezer listing his ailments.) My next doctor’s visit is May 23, but no major tests prior to that visit. My next CT scan is mid-June. If I follow true to form with others in the same experiment, these tests should show tumor shrinkage. However, at some point, in the undetermined future, the tumors will begin to grow, and there will be little that can be done. (Éowyn is writing a paper on melanoma for her biology class and taught us this term that she ran across: PFS. It stands for Progression-Free Survival, which is the period of life- extension between the beginning of the treatment and the point at which the tumors begin to actively grow again. We’re grateful that so many are praying for lots of it!) My feet burn, but not so seriously that I cannot function. I must be careful to get off my feet regularly, and that helps reduce the problems. I am able to exercise to a certain extent, for which I am most grateful!
LIFE’S-LITTLE-JOYS NEWS: I was able to teach for two days at the end of the semester (May 4-5). You cannot know how thankful I was to be there to do it and to be relatively able to do it! An answer to prayer. (I had to prepare for those lectures because I did something new this year, and that is one reason I didn’t keep up with the blogsite in that period.) My next younger brother (Warren) came from California for 36 hours to visit. A real shot in the arm. Shared life experience is special medicine—a word and a simple gesture was enough to remind us of hilarious moments from our childhood, and we laughed till we wept all over again! Had a very nice retreat in Cleveland with some Christian friends from college. Our son Alasdair (who went with me to Cleveland) and his wife Lauren were here a couple of weeks ago to look for a house. They found one in East Mount Airy about 15 minutes from here. They move in July and will begin seminary in September. Rebeckah is also moving back to this area after her graduation in June. It will be wonderful to have them all nearby again! We have had a number of other visitors (too numerous to list) from all over—including a visit today from some dear friends who now reside in Jerusalem.
STATE-of-the-SOUL NEWS: We have settled into the middle part of the race. Most days now seem ordinary. We can sometimes almost forget that cancer is there lurking somewhere. Cancer has not meant that the Lord has let up on me in the pruning process. I am finding that the Lord continues to deal with my heart issues—unkindness, believing less than the best, etc. The good news is that God leads me into repentance. It’s just that I seem to need to be repenting all the time these days! I have been reading the psalms most mornings. God uses them to speak to my soul and keep me sane. It is my intention to begin to post some of the fruit of this meditation on the blogsite.
Our friends Charles and Ann Clayton reminded us today that the most important thing for people who are suffering to know is that they are loved. We certainly know that we are loved—by God and by you all. How blessed we are. That we are given the gift of seeing this more clearly is worth the present suffering.
To conclude, some reflections on Nehemiah 9 from the lectures I gave at the end of the semester:
Nehemiah, who led Israel during the return from Exile in Babylon, prayed a most amazing prayer in the ninth chapter of the book of Nehemiah. After all that Israel had experienced in Exile and during a period when the rebuilding of Jerusalem hardly resembled the glory of Zion which Isaiah had spoken about, he remembered and praised God as an awesome God who created all things and who redeemed his people according to his covenant promise. He rehearsed Israel’s history in his prayer—their covenant unfaithfulness and God’s covenant faithfulness. He accented and repeatedly mentioned God’s COMPASSION! Nehemiah had seen judgment and oppression. He continued to see problems in the community of faith. Yet, he extolled God’s compassion, even when Israel behaved in the most depraved of ways towards him. He came to the end of his prayer crying out to the Lord, the Lord who had in compassion heard the groans of his people many times before. He cried out to say that God’s people had become slaves in their own land—the miracle of deliverance from slavery in Egypt to settle the land of Canaan, and now this. His final word in the prayer: “We are in distress.” A plea for help. There was still sin in the midst of the people. The reason for God to judge yet again was as great as it ever had been. And God answered the prayer with the greatest expression of compassion ever, although not in Nehemiah’s lifetime. He sent a deliverer who dealt with the sin in the midst of his people, a deliverer who dealt with the real enemies: sin and death caused by that sin. In Christ, we see the answer to Nehemiah’s prayer. No more threat of judgment because Christ has been judged in our place. How God has answered Nehemiah’s prayer! But not in the way or timeframe in which he had almost certainly hoped.
I am in distress. But that is not the final word in my prayer. I live on the other side of the cross and the resurrection, that toward which Nehemiah looked from a distance. For me the final word is not distress, but hope in the one who has raised me from the dead and changed me into a new creature in Christ.
05.02.06
Crowned at last!
Thank you for praying–my tooth has a crown at long last! I honestly think the dentist was as relieved and excited as I was. I’m in a whole lot of pain right now, but I am SOOOO thankful!
After the first two and a half hours and 4 unsuccessful shots it looked as if this was going to be a repeat of the last attempts. But the dentist decided to give it 15 more minutes and one last shot, and lo and behold the area got decently close to numb. I still had sensation in the tooth, but it was pain I could live with (not that raw drilling-the-nerve kind of pain), so we went ahead. She could tell I was pretty nervous when she started drilling without it being fully numb, but it ended up being okay. And the job is done! Hallelujah!
I got to thinking about it. Last summer when I had a different tooth crowned, the jaw got fully numbed, and I remember vividly the exquisite sensation of non-feeling, knowing that I could just relax and lean back on that cushion of numbness that would protect me from pain. (With my history of problems with Novocain I was dancing dances of praise to God inside while I sat quietly in the chair.)
It struck me as significant today that we had to proceed without knowing whether or not, or to what degree, the pain would be there. I couldn’t necessarily count on the protective cushion of Novocain.
Recently it seems that the Lord has been calling me to walk in lots of situations that feel more like that: not knowing what will lie ahead with Al’s cancer and what the details of that will be like to go through; sticking with my the seminary course I had signed up for this spring and having to take that one week at a time, not knowing whether I would in fact be able to finish it or not; wondering what life will look like if/when Al is not here anymore–will I finish my degree at WTS? Will I need to find a job right away? Which one? etc.
These are uncomfortable lessons in living one day at a time and trusting things to the Lord. I’d rather have all my proverbial ducks in a row, sitting where I want them–or at least where I know I can find them. I’d like to know specifically what hard things lie ahead so that I can prepare for them, since I generally like to err on the side of being over-prepared for things. But the Lord is setting my path through lots of unknowns that will probably include painful things, and all he will let me know ahead of time is that he is and will be right there with me as I walk that path. And that is enough. It’s not the “enough” that I might think I need, but it is enough in his economy, his way of doing things, his love. Which means it is definitely enough.
I’d rather have had the comfortable assurance that I wasn’t going to feel a thing under the dentist’s drill. And I’d rather know that whatever lies ahead won’t really be too agonizingly painful. But the Lord knows better. If those things were true then I wouldn’t need to trust him or depend on him so much. And while I might prefer that, it would be my great loss.
He is gracious to lead us through hard places where we have no other options but to put our shaky little hand in his and hold on tight, knowing that there may be scary things on the road, but that he’ll guide us safely and protect us well.
So, I’m thankful–not only that my tooth is safely on the other side of the drilling, but that the Lord gave me a concrete reminder that I can (and have to!) depend on him.
Thank you so much for praying even for this recent little subplot in our lives. We treasure your love and support more than we can say.
Libbie
05.01.06
Another attempt at crowning…
A very quick request: tomorrow (5/2) the dentist is going to try again to crown my tooth. Please pray that this time the anesthetic will work.
Thanks!
Libbie