Tears

This is another one of those posts that I don’t know how to start, other than to just say it.

Last Thursday, Mar 9, following another CT scan, we met with our oncologist to review.  He told us what we already knew, or at least strongly suspected - that the chemo was not working, the cancer is spreading, Kate’s body could not withstand further treatment, and there are no other treatment options.  He recommended that we switch to focusing on treating her symptoms and spending time with the kids and loved ones.

We’ve known since December that this is an aggressive cancer, but we had hoped that the chemo would be effective and buy us a lot of time, or at least some time.  After a scan in January and just before chemo started, he told us that it’s progressing much faster than expected, and he and all his colleagues were stumped as to why.  Note that this is the pre-eminent Appendiceal Cancer expert at what is widely accepted to be the best cancer hospital on the planet, and he was stumped.

His team explained that if chemo was effective, we’d know pretty soon just by observing her pain and other symptoms.  Kate’s pain has been increasing steadily since October, and the chemo didn’t have any effect on that trajectory.  Given what we saw with her symptoms, we expected this news and agreed with his assessment and recommendation to switch to hospice care.  He didn’t give a time frame, because truly no one can but God.  In the most general terms, he told us ‘weeks to months’, but that’s as much of a guess as it is experience or science.

So as of Thursday afternoon, Kate transferred from MD Anderson to Houston Hospice as her primary care team.  She’s home, and hospice nurses visit regularly, though we’re still her primary caregivers.  She can go into their inpatient care center if needed, but the goal is to keep her at home as much as possible.

We continue to pray for the intercession of Fr. Margil that God would heal Katie.  We know that He will heal her, though it looks like He is planning to heal her in heaven, and not here on earth.  In addition, I've been praying to St. Joseph, patron of the departing.

Oh St. Joseph whose protection is so great, so strong, so prompt before the Throne of God, I place in you all my interests and desires. Oh St. Joseph, do assist me by your powerful intercession and obtain for me from your Divine Son all spiritual blessings through Jesus Christ, Our Lord, so that having engaged here below your heavenly power I may offer my Thanksgiving and Homage to the most loving of Fathers. Oh St. Joseph, I never weary contemplating you and Jesus asleep in your arms.  I dare not approach while He reposes near your heart.  Press him in my name and kiss His fine Head for me, and ask Him to return the Kiss when I draw my dying breath.  St. Joseph, Patron of departing souls, pray for us.  Amen.

Many have asked me how I'm doing.  If you know me well, you know that I'm mildly Type-A (heavy sarcasm).  I like to know what's happening, develop a plan, and execute the plan.  God has been very clear with me these past days - there is no plan.  There is very little I can do to prepare (or help her prepare) in any meaningful way.  There is only today.  There is only the gift of another day, another hour, another minute with Kate by my side.  My prayer has been that He give me the strength and wisdom for today.  I don't need to worry about next year, next month, next week, or even tomorrow.  My calling is to live my marriage today.  It's to be the best husband, father, son, friend, employee, and man that I can be today, at this moment.  Please don't take that to mean that I do it well - I still need lots of prayers just like everyone else.

In this season of Lent when we practice turning back to God, perhaps He's asking the same thing of you.  Perhaps all we ever need is the strength and wisdom for today, to spend our energy on today, on the people we're with, on our calling today rather than what our calling may be in the future.

As difficult as this news is, we feel peace with where we are right now.  There are, of course, good days and bad days, but through it all we know that we are where God wants us to be.  We've looked into alternative treatment options; Kate and I agreed that we'd rather spend her last days enjoying time with one another, the kids, and our friends and family.  As you can imagine, time here at home is precious.  Kate is sleeping more these days, but still awake most of the day.  She needs a lot of her day just to do the things that you and I take for granted.  Visitors have been such a blessing, but it's a tough balance between seeing friends and spending time with me and the children.  Most days, she'd rather not take any visitors and just spend it with us.  It's been such a blessing to spend so much time with my best friend these past days, and I'm truly grateful to God for this time.

Thank you all so much for journeying with us this past year.  We feel the strength and support of your prayers.  Your generosity has been overwhelming.  We love you all, and are honored to have your attention and your prayers.  Please continue to pray for us - we will need your prayers more and more over the next days and weeks.

May God abundantly bless you.

Home Again Home Again

Whew! 

Well it's been quite a week.  Time in the hospital is always such a challenge - navigating the specific symptoms for which Katie is being treated, meeting a bunch of new doctors and other specialists and learning how they fit in with the overall plan of treatment, deciphering how a particular hospital stay impacts plans for chemo, trying to spend some time with the kids and finding the best way to communicate what is happening to them, not to mention all the work that our parents do caring for the kids while we drop everything to be in the hospital.  It's a lot to work through.  

As much as it's a challenge, though, we always meet such incredible people there.  I couldn't possibly tell you about all of them here, but I'd like to tell you about a couple.  Katie may tell you about a couple more because she's so much better at stuff like this than I am.  I'll call mine Steve and Stevia.  

Steve walked into our room Monday evening as Katie, my sister Christina, and I were watching an episode of Parks & Rec (Season 2, "Kaboom") on Netflix.  We paused, Steve recognized the show at once, and we struck up a conversation.  He recognized some holy candles (Providential Co.  You should definitely check them out) we had in the room, and we asked if he was Catholic.  He Non-denominational Christian, but he ran into them at a design conference he was at and picked up a few because "it's so hard to find good contemporary Christian design."  Steve is an architect, he's roughly our age, and he lost his first wife to sarcoma a little over six years ago, not long after they were married.  He's Christian and seems to be very involved in his faith, and one of his favorite theologians is Catholic, though I can't recall the name right now.  We exchanged information and will very likely meet up in the coming weeks.  I don't doubt that he'll be a blessing in our lives.  Meeting him was one of those moments where you just know that God brought people together, and regardless of whatever other fruit comes from the encounter, it's a reminder that God is at work in our lives, and that's perhaps the best comfort.  

Stevia... well... that's a terrible name, and actually an artificial sweetener.  Let's switch that to Stephanie.  Much better.  

Stephanie and Katie hit it off immediately.  Stephanie has a 15-ish-month old daughter who has the biggest, cutest cheeks ever.  We threatened to kidnap her and eat her cheeks, but we probably won't follow through.  Scheduling and all.  Stephanie and her husband tried for 10 years to have their daughter.  They spent more money than I'd care to say, and 5 months into her pregnancy, she was rushed to the hospital, where they told her that she was losing the baby (I forget what specifically was wrong), and they'd have to take her out.  Stephanie knew better, and told them that she was NOT giving up her child.  Doctors said that she'd have to spend the rest of her pregnancy in bed with her legs in the air if she had any hope of carrying her daughter to term.  Stephanie didn't hesitate.  Kate, of course, encouraged her to have more children and recommended they look into NaPro Technology and the Creighton method, as a NaPro doctor is very likely to be able to help them have more children with a lot less time, money, and effort.  Stephanie was excited to hear about NaPro and said she'd look into it right away.  And again, God brought people together.  We'll probably never know whether Stephanie and her husband pursued NaPro or had more children, but that's not really the point, at least not right now. 

The point is that God is at work.  I'll say it again because I need to hear it again.  

God is at work.  

Our God is not a God who sits by an watches.  He is not a God who simply suggests.  He is not idle.  God is at work in our lives - every day, every hour, every minute, every second.  Our creation stories tell us that we're made in His image, and He made us to work - to tend the garden.  As any gardener will tell you, tending a garden is hard work.  So if we are made to work and we are made in His image, then God must be a God who works.  Note that the command to tend the garden comes before the fall.  We're not doomed to work because of our sin; we're made to work because it is integral to our being.  The fall made the work toil, but work is inherently good.  

God is placing you in situations at work and at home, with your friends and acquaintances.  He is introducing you to new people and placing problems in your inbox that you are uniquely suited to solve.  He is working for you and through you.  May our eyes be opened to His work that we may recognize it, and may we be strengthened at His table and with his word that we may have the courage to follow where He is leading us.  

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On the medical side, it looks like Kate was dealing with a few things when we went into the ER late last Tuesday night (Feb 21) - dehydration (again), acute infection / sepsis (that's a new one), and opioid toxicity (also a new one).  

First, the dehydration: as I hinted at last time, Kate received a lot of IV liquids in the hospital, and they seem to have helped a lot.  Doctors did decide to give her two units of blood, though the transfusion didn't have the instant-energy effect that we were led to believe it might have.  As a result of all the liquids and the transfusion, she's looking a lot better than she was when we went in, which is really nice to see.  The dehydration is primarily a result of her ileostomy.  She has a shorter overall digestive tract than before, and the small intestines aren't designed to absorb water - that's what your large intestines are for, among other things.  The small can learn to adapt, but dehydration will likely always be a challenge, despite Katie drinking five to six 24 oz glasses of water a day.  

Regarding the infection, doctors found that she had Pseudomonas, which is a nasty bacteria that is pretty rare in the normal population, but not uncommon for advanced cancer patients with compromised immune systems.   Luckily, it's treatable with antibiotics, so we should be in the clear on that, though I'd ask you to pray for it to clear up just the same.  This does present a bit of a wrinkle when considering the chemo regimen, as the chemo she's on suppresses her immune system and makes her more susceptible to infections, which require week-long stays in the hospital, which delays chemo.  It's not unforeseen, but it's a frustrating loop.  Please pray for wisdom for us and our doctors and we move forward on this.

Finally, Kate had been experiencing some other symptoms as a result of opioid toxicity - aka pain killer side effects.  Her hands were intermittently shaky when she'd try to perform fine-motor tasks like texting on her phone or writing.  Her thoughts were frequently cloudy, the drugs made her very drowsy, and she may have had increased pain that wasn't directly from the cancer.  These symptoms can all be traced back to the pain killers.  We learned a bit more about the pain meds she's on during this hospital stay.  It's a bit of a long story, but suffice it to say that we've switched around her meds and these symptoms have largely subsided.  We're still working with the pain docs to get the dosing right so her pain is at a manageable level, but it looks like we may be able to get that sorted out in the next couple of days.  

Kate was discharged yesterday Feb 28, and we are very happy to be home.  Please continue to pray for her increased strength and continued recovery.  

God's blessings be on you, and may you have a blessed Ash Wednesday.