Welcome, new stent!

Sandy had an ERCP today at Wesley to replace her stent. The "old" one did not have any problems, but doctors had agreed to replace each stent after 8 weeks of use. Everything went well, and Sandy ought to be home tomorrow morning.

Thanksgiving is in a few short hours. We are thankful for many things, including the past three months of life. We're thankful for crazy text messages, thanks to autocorrect. We're thankful for faithful friends, provision, and more than enough opportunities to develop and strengthen our character.

Sandy could choose to complain about yet another ERCP and another stent, another stay in the hospital, another round of lab work, IV pokes, and hours without food or drink. She could choose to complain about decreased energy and stamina or the mild nausea she has experienced since beginning chemo. She could complain about the few hundred pages of math tests she has to grade, not to mention upcoming final exams.

But she isn't complaining. Sure, she has rough moments; she'd be the first to admit her weaknesses. However, she is choosing to be thankful. She is thankful this ERCP and stent happened before a blockage occurred. She's thankful for a great team of doctors and nurses. She's thankful for the reminder that food and water are a blessing, and thankful that she has been able to continue working, visiting friends and family, filling up the car with gas, grocery shopping, vacuuming, cooking, and washing dishes. She is thankful for the continued opportunity to invest in lives of college students, including the chance to encourage them as she grades tests.

In an attempt to follow her lead, I'm choosing today to be thankful for many things that are not quite how I would have planned as well. I'm thankful we have a neighbor who helped bandage our dog's leg, thankful the blanket that disintegrated in the washing machine did not break the washing machine, thankful I have friends who gladly offer to help when I take on more than is reasonable, and thankful my kids chose to watch an educational movie…even if it is loud enough for people to hear a mile away.  I'd better sign off and take care of that last one :)

We wish you a wonderful Thanksgiving. Remember to give thanks! It's a choice we all get to make :)

2nd day of chemo coming up!

Sandy has her second day of chemo this week. So far she has felt reasonably well - fatigue and some nausea, but both very manageable. She has discovered some fun new teas and candies that help with the nausea. I'm waiting for her to find a tea or candy to help with fatigue :)

We are headed into the holiday season - somehow, Thanksgiving is only a week away! There is so much for which to be thankful. Cancer has highlighted all of the things we hope and pray we don't lose, but at the same time, we realize that those are the very things we are blessed to have in the first place. It seems silly, and downright wasteful, to spend today grieving a potential down-the-road loss when we can instead celebrate having those things right now.

Sandy has enjoyed being back in the classroom these past few weeks, and she is gearing up for everything that comes with the end of a semester. Glad to be back in the church choir, she is looking forward to the annual Christmas program on December 14 and 15. She would love to see you there!

We wish you all the most blessed Thanksgiving! Let the baking begin!

Long overdue update...

Did you know that life doesn't slow down when you have a blog to update? Things just keep going and going!

Sandy feels great today! Sometimes it's hard for her to believe she has cancer because of how well she feels. And for that we are extremely thankful. She is gearing up to return to the classroom on Monday; she looks forward to being with her students again, investing in them as she's done for many, many years.

Thursday she had a portacath put in, which will allow the chemo to be administered every two weeks without needing to mess with an IV. It was a more invasive procedure than she had anticipated, but it went well. She was impressed and encouraged when her surgeon prayed for her before beginning. Due to her surgeon being called in to help with those affected by the plane crash at the airport, her procedure was delayed several hours. Rather than being frustrated and impatient, Sandy was thankful that she wasn't dealing with something as tragic as the crash. A few weeks ago, while talking to some friends, she learned of a couple going through a difficult separation. Her text to me pondered whether her situation is easier to deal with than a broken relationship. It's all a matter of perspective. Having peace in relationships, and knowing that heaven awaits, greatly diminishes the fear and sadness surrounding challenging medical news.

Several times, Sandy has commented that she feels so very loved. She has voiced that she wishes every person could feel as loved as she feels. The outpouring of cards, emails, calls, and hugs has been quite overwhelming - in a good way! Wouldn't it be great if we all made it our goal to act in ways that cause others to feel loved - every day? Offering a smile or a kind word, a helping hand or a meal, just might provide the strength that person needs to face difficult things. Kindness is an investment with an outstanding return.

Ok. Back to medical stuff :)
One reason bile ducts can become clogged is because of sludge removed by the liver from the blood. Since only one side of Sandy's duct is open, it is especially important that the sludge remain thin. Have you ever prayed for thin sludge?  You're welcome for this fine opportunity!  Another reason her duct could become clogged would be if a tumor grows around the stent and squeezes it shut.  This round of chemo is given the job of stopping further growth. She will have six hours of chemo every other Thursday starting next Thursday. Several people have expressed concern with this course of treatment, since choosing chemo is basically choosing to put poison in your body. And perhaps, in 50 years, people will look back and wonder why anyone was so foolish to do so! What we know is that for now, at this time, in this circumstance, chemo seems to be the best option, as well as the option that Sandy feels peace in pursuing. She is not "happy" about it, or really looking forward to it, but she feels it's the path to walk at this time. There are many instances in life when the right path to take is not crystal clear. We have to pray for wisdom, seek council, weigh options, and trust that God is bigger than statistics or our mistakes. I'm not saying that God is a trump card that allows us to do whatever we want! But He sees our heart, knows our motives, and always has the goal of drawing us closer to Himself.

Thanks for your continued support. From this point on, the plan is to update the blog about every two weeks, unless new things come up to report. Please continue praying for healing, peace, strength, and courage to face the unknown.

Looking Up

Tonight I told my daughter to go into the bathroom and put toothpaste on her toothbrush, and that I'd be there in a minute to help her with her teeth. When I arrived in the bathroom, I found her sitting on the counter.

Me: How did you get up there?
E: I climbed!
Me: What did you climb on?
E: The toilet and then onto the counter.
Me: Did you step on the toilet paper holder again?
E: No! I didn't do that. I just put my knee on the counter and got up here.
Me: Do you think that was dangerous? Or not dangerous?
E: Not dangerous. Well, when I was climbing and I was looking up, it did not seem dangerous to me. When I looked down, then it looked dangerous.

While this first struck me as amusing, it was as though God tapped me on the shoulder and showed me the truth in her statement. Was her actual journey any different depending on where she looked? Was the presence of danger different when looking down? No. The situation remained unchanged. The difference was in her perspective - her chosen place to fix her gaze. When she was looking up, everything was fine.

This encounter (on a counter…haha) reminded me of the story in the Bible when Peter started walking on water toward Jesus. As long as Peter's eyes were on Jesus, Peter was walking on water. As soon as Peter's eyes left Jesus and focused on his surroundings (middle of a large body of water during a storm), he began to sink. The water, the storm, Peter's sandals, his natural ability to walk or sink - none of those changed. They weren't the deciding factor. All that mattered is where he placed - and kept - his focus.

You probably know where this is going :)

How well Sandy weathers this storm will depend solely and entirely upon where she fixes her gaze. I'm not saying her healing is dependent on where she focuses, but rather that her peace and joy depend upon it.

A friend sent me a text today with Isaiah 26:3
"You will keep in perfect peace those whose minds are steadfast, because they trust in you."

It isn't our job to keep ourselves in perfect peace. Our job is to keep our minds steadfastly on God, trusting Him. God promises, then, to keep us in perfect peace. Whenever peace begins to wane, we can look up.

Because, remember, things don't seem so dangerous when we're looking up.

MD Anderson visit

Plans aren't any fun if they don't change, right? Sandy's plan was to be in Houston at MD Anderson through early next week. However, Wednesday, after meeting with the first (and only) doctor, she found out she just needed to have a few tests run as kind of a baseline marker. The treatment was already determined, seemingly before she even arrived. In some ways, that is a blessing, because the prescribed treatment is nearly the same as what she heard from the KU oncologist, and it's nice when experts agree. In other ways, it was a bit frustrating because she had hoped for several options from which to choose.

Starting early November, Sandy will have one 6-hour day of chemo every two weeks. The reason to wait until early November is so that she is six weeks past her surgery date; certain chemo drugs can interfere with the healing process, and she needs to be at full strength for this next leg of the journey. Treatments will be here in town. At this point, she will travel back to Houston in three months for another round of tests/scans to look for changes. Since none of the earlier scans detected the tumors, the most the scans will reveal is whether the tumors have grown. At Monday's KU appointment, Sandy learned that the KU Tumor Review Board doctors had reviewed slides from scrapings taken in late August here in town, and found there to be cancer cells. That news was both surprising and not surprising - finally there's a confirmation of the presence of cancer, yet questions remain why it was not determined the first time the slides were reviewed. It seems that pathology is not necessarily a black and white science.

The best way to tell if treatment is working is by how Sandy feels. So far she hasn't had a great appetite, and she's still fairly fatigued. We keep reminding her that the nearly foot-long scar on her torso points to why she's not at 100% yet! She had a major surgery, and recovery takes time.

Medically speaking, there is not a cure for bile duct cancer. Medically speaking, the best scenario is for the continual chemo to hold the cancer at bay, keeping it from spreading anywhere else or blocking the open duct. Medically speaking, the outlook is not so great.

Boy are we glad we are not limited to what medicine has to offer! There have been many numbers thrown around the past few weeks, many statistics about this type of cancer.  But there are numerous factors that affect patient outcomes, and even more than that, we serve a really big God.

Both the KU doctor and the MDA doctor agree that Sandy ought to feel well enough to continue working while receiving treatment.

I'm calling this journey a blessing in disguise. God promises it will work for our good, but right now that "good" is so well disguised that the blessing part is nearly unrecognizable. That doesn't change the fact of the blessing, however.  We'll just keep looking.

Road Trip!

Tomorrow (Thursday) Sandy has a follow up appointment with the surgeon in Kansas City. Next Monday she will return to Kansas City for an appointment with an oncologist. And next Wednesday (15th) she and Rod will travel to MD Anderson in Texas. They will be in Texas at least through Monday, October 20. She is thankful for the opportunity to have her case examined by a team of experts, who will all work together to formulate the best possible plan.

If you know of fun activities to do in Houston, please let Sandy know via text, email, or comment on this post. They will have several days of "down time" - and neither of them are accustomed to that!!

Today was a pretty good day, though Sandy was tired - due primarily to being up since 4am. One of her favorite parts of today was sharing a piece of homemade poppyseed cake (made with homegrown and freshly ground poppyseed!) with a friend who stopped by. The most disappointing thing about today for her was losing all three rounds of the card game Phase 10. Those grandkids are ruthless!

:)

Please pray for miraculous healing, wisdom for everyone involved, safe travels to KC (twice) and TX, peace, and fun memories. Thank you for being such a consistent support during this season.

Pretty good day

Today was a pretty good day! Sandy felt well enough to attend the funeral of a friend from church this morning, clean out her freezer this afternoon, and bake a cake this evening! She had to take breaks, and she is tired, but we are thankful for the many ways her days look like they did several months ago. I convinced her to let me take a picture of her before she changed clothes after the funeral - she's looking great :)

Rocks and Sunrises

Sandy visited the nice employees at Wesley's ER again on Thursday morning. Some IV pain medication relieved her intense abdominal pressure, and she returned home. At an appointment with a Wichita oncologist Friday morning, she learned that the pressure is a result of the tumors, and will likely return from time to time. Now that she knows the cause, she can take medicine at the onset of symptoms. Her incision is healing nicely; it is much less warm, less red, and less swollen. She is somewhat surprised by her lack of stamina, though we keep reminding her that her body has been through quite an ordeal these past few months, not to mention the emotional roller coaster that doesn't seem to have an exit. Appointments next week in Kansas City are still on the calendar; Sandy is eager to have a plan in place.

It sure feels like this all came out of the blue, out of nowhere. But it's like driving on a winding mountain road, going around a string of bends, and suddenly seeing a huge rock in the middle of the road. The rock had been there for some time, but it was only now that you saw it. Even if the rock just now tumbled down from the top of the mountain, onto your stretch of road, it wasn't out of nowhere - the rock had been part of the overall scene long before you took notice of it. Or it's like walking through an unfamiliar house at night, turning on one light at a time as you enter each room. The furniture in each room was there when you first entered the house, but it was not until the light came on that you saw it. This cancer diagnosis has been part of Sandy's life story since God wrote her story many years ago. It is only now that the time has come to walk this section of the journey. We can walk it in despair, or we can walk it in confidence, trusting the author. We are promised a good ending…and we are promised God will gently encourage us if our definition of "good" needs some adjusting!

We often say we wish we knew what was going to happen in the future, or we wish we knew for what purpose something was happening - what is the bigger picture? But do we really want to know? I think what we're actually saying is that we want to know the good things that will happen, the things that bring peace and joy and happiness, the things that make the world seem right again. However, in March, if we had known that Sandy would be diagnosed with cancer in September, would it not have been exceedingly difficult to enjoy these past few months? Wouldn't we have begun a mourning process, not knowing what would follow the diagnosis? We would have lost out on many great memories, or at best, experienced them with bittersweet emotions. Similarly, while in some ways we'd like to know what the future holds from this point on, how would it help? If it is not what we want, we'd be sad or angry (or both) starting now! If it IS what we want, we might wonder why any further pain is needed when healing is the outcome - not to mention we would have much less reason to lean into God and His promises.

I know what will happen in the future. Are you ready for this? :)  Sandy will continue choosing joy, holding tightly to hope, sharing her contagious optimism with others, and living her life to glorify God.

We can focus on the rock in the middle of the road, or we can look around and notice the beautiful scenery. We can continue driving around the twisting roads in fear of the next big rock, or we can drive in anticipation of the next amazing sunrise. The journey is not in our control, but how we experience the journey is up to us.

By the way, I vote for the sunrise.

Results of Tumor Board Meeting

Yesterday the Tumor Board discussed Sandy's case. They decided that she needs to be treated as having bile duct cancer, even though all pathology reports have come back negative for cancer. Based on what the surgeon saw and felt during the Kansas City surgery, they feel that it is cancer. There is not yet a "next step," though we imagine there will be options presented to Sandy at her October 13 appointment with a KU oncologist.

Please continue praying for healing - may the tumors simply disappear! Also pray for wisdom for the doctors and a clear direction to go from this point on.

A friend reminded me today that while it is easy to become enmeshed in medical terminology, diagnoses, treatments, and statistics, our hope is only to be in the Lord. So we pray that He directs the minds of the doctors, opens and shuts doors, and continues to flood us all with peace. Regardless of what tomorrow holds, we want to live today to the fullest. There's no sense in missing out on today's blessings because we fear what is around the corner.

Another little ER visit….

Just to keep things interesting, Sandy's body decided to have a fever this weekend, adding a rash to the mix earlier today. Her Wichita doctor - the one who has continued to be available to her via text, even on weekends, told her this evening to go to Wesley to check out the fever and rash issues. She was, of course, reluctant to go, but at the same time, glad to find out what was going on. It was a surprisingly short visit, as far as ER visits go; she was discharged around 9pm after some IV meds and a script for a new prescription. Her voice sounded strong tonight, and she was in pretty good spirits.

There are so many things to be thankful for, including that she lives in close proximity to the hospital!

Tomorrow, Sept 29, is National Coffee Day…I doubt Sandy realizes that, but if she did, she would be more than happy to celebrate all day long!  When you drink your coffee tomorrow, think of Sandy, pray for healing, and do something to bless someone around you - just as she does every day :)  It would be fun to collect stories, in the comments below, of things you did in her honor on National Coffee Day!

Peace Be Still

Sandy asked me to convey to all of you how grateful she is for all of the cards, calls, well-wishes, and prayers. Knowing that a vast army of people are standing with her brings immense comfort.

Her incision is rather impressive! And we can only see the stitches in the skin, not the many stitches through the layers underneath the skin. There is still a small area that is numb, and her system is not fully functioning as she'd like. Pain has been more of an issue today, though she has had moments of feeling pretty ok. Tonight she began to feel badly, in some ways similar to how she felt before the bout with sepsis - we were all watching her closely, and thankful to see that her temperature did not continue to rise. There is definitely a concern about the current stent becoming blocked and/or infected. 

Many of you have been waiting to call Sandy, as requested when this blog began. She said it is ok for people to call her, though when she is resting, or playing UNO with a grandkid, she won't answer.  While you may want to ask a million questions about how she is doing, it is also great to have one or two topics ready to talk about with her. She is the same Sandy she was before this journey began, though it is easy to begin to feel defined by a diagnosis. 

Please pray for a swift recovery from surgery, absence of infection, quality rest, and peace - especially when she begins to feel worse, worrying another trip to the ER will be required.

Our kids have listened to various scripture lullaby cds since they were born. Sometimes I think the songs are more for the adults than the kids! One song in particular feels like it gently washes peace over us every time it plays. It is called Peace Be Still, by Scripture Lullabies, Volume 3.  Below is a link to listen to part of the song, followed by the lyrics.

Jesus did not suggest that the winds and waves stop in Mark 4:39 - He commanded that they stop. In the same way, God does not merely suggest that we might want to consider being still (Psalm 46:10) - He commands us to be still! How in the world are we to be still with so much going on all around us? How can our hearts and emotions be characterized by still waters when everything around us is going crazy? Only one way - choose to focus on truth. The truth is that God operates outside of human time. While He certainly cares about each of us and our life circumstances, He also sees the bigger picture that we cannot see, at least not on this side of heaven. When God promises to work all things for our good, we assume that we will see and recognize the "good" during our lifetime, and that the "good" will align with our definitions of good. But God doesn't say that part. Do we trust Him and His love for us…regardless of what we can see with human eyes? Can we fix our eyes on Jesus at all times, including when all of life is going well and when it is all falling apart? We cannot control much of what comes our way, but we can choose where we will look.

Our prayer for YOU is that no matter what twists and turns are part of your life's journey, you will choose to look at Jesus, and quiet your hearts so you can hear Him gently reminding you of His love.  He alone knows the ending, and He assures us it is good.


Peace Be Still
http://www.scripture-lullabies.com/shop/home.php?cat=253

Waves are crashing all around

Thunder roars as rain pours down
I am so afraid

There's no shelter I can find
My heart pounds as waters rise
Hope is far away
Then I hear You say

Peace be still
Peace be still
There's no need to worry
Peace be still

Fear has taken hold again
I can feel it closing in
I know You're here

And even now I hear your voice
Through the storm and through the noise
All my fears fall away
When I hear You say

Peace be still
Peace be still
I will calm Your storm
Peace be still

Home again!

Sandy was dismissed yesterday evening and is now resting at home. Well, she's supposed to be resting! She is not to lift anything over 10 pounds for six weeks…that will take some major self-discipline for her! Just when we think we know what is going on and what is next, things change. Tests continue to be inconclusive. Below is an update from Rod:

"After some discussion between the surgical team and members of the Oncology Department, no consensus was reached as to the appropriate next step.  As a result, the case has been referred to the Tumor Review Committee which will meet on Tuesday to review the records and formulate a plan for the next phase of this journey.  The Committee is composed of experts in many fields:  surgery, oncology, pathology, radiology, anesthesia, etc.  While "hurrying up to wait" was not the desired result of this week's disappointments, we look forward to a defined path for further treatment."

We hope you have a great weekend!

It's Raining

Sandy's epidural was removed, her bowels are starting to work again, and her fever, while still there, is lower than yesterday. The surgeon came by today with some additional information. This type of cancer is referred to in Classes more than Stages. Hers is Class IV because of involving both the right and left sides.  People do not necessarily begin with Class I and move progressively up to Class IV. He didn't see a reason to go outside of Wichita for oncologist appointments or treatment, if any are deemed beneficial. Looking back, he said that had we done surgery six weeks ago, there would likely not have been a different outcome. Perhaps there would be a different outcome had surgery been done six months ago, though Sandy didn't have symptoms six months ago, so there was no way to have known.

Because the tumors cannot be removed, and chemo/radiation are unlikely to benefit, inserting the metal stent to hold the bile duct open is the only "solution." Further tests or scans might reveal if the tumors grow or spread, but because they did not show up on previous tests, we can still have an all-clear test despite the presence of cancer.

Sandy will not have any doctor mandated restrictions on her activity level - she can do whatever she feels able to do.

Specific prayer requests: continued healing from surgery, including eradication of infection; miraculous healing of the tumors, with zero additional growth or spread; stamina both physically and emotionally; wisdom for everyone involved as we proceed from here.

Release day could be tomorrow, though Friday is more probable. Once she is home, we will let you know what she is up for or if there are any additional ways to help.

Last night I suddenly remembered I had promised to make cookies for a friend who was coming to mow Sandy's yard - and I know this friend will not be happy to read that I still felt it was important to keep my promise, all things considered! However, since I was up with a fussy kiddo anyway, I decided to mix up the batter. Then it rained most of the night, fully saturating the ground, making it necessary to postpone mowing…and making it unnecessary to have fresh cookie dough in the refrigerator! While my first thought was rather grumbly, I quickly remembered that we had just been talking about the need for rain - and here it was! While the rain messed up one plan, it served a greater purpose.

I remember praying, as this ordeal began this summer, that no cancer would be found. And it wasn't, for the longest time. I prayed that she would not need this very invasive and complication-prone surgery. And as of Monday, she didn't. Yet looking back, in some ways it could have been better if cancer HAD been found earlier, or if the surgery WAS possible and needed. It seems like this diagnosis is in no way good. And yet, we don't know the whole story. We don't know what God is up to, though we do know it is for the good of those who love Him. We also cannot see all of the prayers, some of which have been prayed for years, that are being answered in and through these circumstances. Nor do we know how the future will reveal answers to today's prayers. All we know is that it is raining, and some of our best laid hopes and plans are seemingly messed up. I want to encourage you to remember that rain serves a purpose. Some of the most beautiful skies, some of the freshest air, some of the most peaceful moments and lovely blossoms come after a rain - because of a rain. Perhaps we can, collectively, lean into this rainy season, looking with expectation to the future, where God's love and blessings will continue to shine.

Hopefully minor setback

Sandy was again pleased as punch to receive coffee and clear liquids today! However, late this afternoon her temperature rose to 102. Some blood was taken and sent to culture; results ought to be back tomorrow. They started her on an antibiotic for now, until they learn which medicine will best fight whatever is going on. Because this occurred so soon after surgery, it is likely the infection was present before surgery, perhaps leftover from last week's bout with sepsis. Thankfully Sandy (and Rod, her #1 advocate) knows what to watch for this time around, so it did not get as bad as last week.

Coming home will be Thursday or later. Nothing further has been decided about how to proceed from here. Thanks for the continued support.

Surgery Update 9/22

After beginning the surgery, doctors were very surprised to find two areas of cancer. Multiple tests, biopsies, etc from the last few months all came back clear, making this an unexpected discovery. If cancer was present only in the left bile duct and left blood supply, or only in the right bile duct and right blood supply, doctors could have surgically removed the cancerous side. However, cancer was found in the left duct and the right blood supply.  This combination is inoperable.

 

You probably have two main questions - how is Sandy doing, physically, with healing from this operation? And what next?  Sandy is in recovery from surgery, which was much less intensive than originally planned. She is awake but still coming off the anesthesia. She may be released Wednesday or Thursday.

 

At this point there is a bit of a scramble going on as to what to do next. There is word of a clinical trial with a combo of radiation and chemo at Mayo. All of the doctors who have been involved in Sandy's care will discuss options and come up with a plan in the next several days. It sounds like there is an option to insert a metal stent that ought to last longer than the previous ones have lasted, though that has to be done endoscopically (as with all previous stent placements); it couldn't be done during today's operation. While it would be great to have a longer lasting stent, it does not take care of the cancer; it merely addresses a symptom of the cancer.  

 

This is definitely not what we had hoped for. However, a few things remain unchanged. God is big. God is good. God has a plan that is not thrown off course by today's development. The enemy comes to steal, kill, and destroy - not just in matters of life and death, sickness and health, but also in each moment. But He who is in us is stronger - so we do not have to succumb to fears or run-away worrisome thoughts. We can choose joy, choose to see blessings, choose to enjoy each of the easy-to-overlook blessings that constantly surround us.

 

Please keep praying for healing, wisdom, quick recovery, fresh perspective, and peace. Just as we did not anticipate this seemingly downward turn of events, neither can we know what direction things will go from here. God is still in the miracle business!

The Big Day

Today is Sandy's surgery. She checks in to the Kansas City hospital at 12:00. We don't anticipate having anything to report until late afternoon or early evening. The length of surgery depends on what they find when they get inside, as well as how complicated or easy everything turns out to be. We will update the blog as soon as possible once there is news to report.

Home!

Sandy was released from the hospital this evening. Never before have real clothes felt so good :)

Please continue to pray for the stent to remain unblocked, for the infection to completely go away, and for her to quickly and easily finish preparing to be somewhat out of commission for the next several weeks.

Out of MICU

Sandy was moved to a regular (non-ICU) room late Tuesday. She's ready to break out of there and go home! Perhaps after a few more hours of IV antibiotics they'll let her leave. This morning she was given clear liquids, for which she was extremely excited! The person delivering her "food" was surprised at her eagerness for "just" clear liquids. The fact that coffee counts as a clear liquid might explain part of her excitement…!  Later in the day she was able to eat other foods, and is off all food restrictions now. Surgery is set for Monday.

MICU at Wesley

We are thankful that Sandy is feeling better today - not great, but much better than last night. Her labs came back showing bacteria in the blood, and she had the symptoms of sepsis. It is a good thing she went to the hospital rather than waiting! Sandy's doctor completed the ERCP (http://www.nlm.nih.gov/medlineplus/ency/article/007479.htm) to replace the stent early this evening. When the "old" stent came out, it was apparent that the infection was from the area of the stent. She has an IV for fluids and another one for antibiotics. They took her back to the MICU at least until tomorrow. Tomorrow a decision ought to be made regarding a new surgery date. Please pray for the infection to go away, the stent to remain unblocked, surgery to happen soon, and for Sandy to find joy and strength in the midst of disappointing news.

Unexpected ER visit

Sandy spent the weekend doing normal activities - attending soccer games to watch grandkids, spending time with a friend, and hosting the monthly family lunch at her house today. She noticed some itching start last Friday, causing concern that perhaps the stent was becoming blocked. Tonight she suddenly began to feel awful. After a gentle reminder that the reason her doctor gave her his cell phone number was so she could contact him for things like this, she sent him a text. He replied that she could either go to Wesley tonight or go to his office in the morning. Thirty minutes later, continuing to feel worse, dad drove her to Wesley.

After an hour of multiple nurses struggling to find a vein for the IV, they decided to admit her for the night. Due to a rising fever, she will be in ICU for right now. Whether or not this affects surgery Thursday remains to be seen. Please pray for healing, comfort, encouragement, and peace. This is really wearing on Sandy. She's been working hard to prepare for her substitute, as well as figuring out all of the details that need handled in the upcoming weeks. God has a plan in this, it just feels overwhelming right now.

Surgery scheduled

Sandy's appointment with the surgeon in Kansas City went well. She feels confident about his ability to perform the surgery, which has been scheduled for next Thursday afternoon (Sept 18). She will stay in the hospital for 4-7 days before returning home.

The surgeon does not think she has cancer. However, the solution for benign bile duct strictures is the same as the solution for bile duct cancer, so this surgery is needed regardless of the underlying issue. They won't know for sure if it's cancer or "just" a stricture until surgery is completed. During the surgery, once the stricture is located, they will determine how much, if any, of the liver needs to be removed.

Please continue praying for total healing, accuracy, precision, and wisdom for the surgical team as well as recovery nurses, and for a peace that passes all understanding. Sandy is waiting to find out how soon she can return to the classroom...so pray for her quick recovery and patience with her body!

At this time, there really aren't tangible needs to be met. Sandy is in good spirits and feels this is the best possible decision, all things considered. She is looking forward to teaching tomorrow, Monday, and Wednesday, before heading to KC on Thursday.

She has been overwhelmed (in a wonderful way!) by all of the cards she has received. Thank you for all of your support and friendship!

We have a plan…no we don't

Perhaps the most frustrating thing about this ordeal is that nobody knows for sure what is going on in Sandy's body, and therefore nobody can state with certainty the best path to take. Today's appt was rather uneventful in terms of new information, but ended up putting more options on the table once again - options that had been studied and set aside.  Sandy still has an appt next week Thursday in Kansas City with a doctor who has experience with this type of surgery. Early next week she will have an MRI. They are still looking for a tumor.  Of course we are still praying for healing! Please continue praying for wisdom and clear direction in the following areas:
1. What is the problem - cancer? Autoimmune pancreatitis? Something else?
2. It'd be great if everyone involved will come to an agreement on the best route to take.
3. No more missed work for Sandy until surgery, if that is coming up (many of her appointments have been scheduled during classes or meetings).
4. Deep peace, assurance of truth, endurance both physically and emotionally.

Sandy is extremely thankful for each of you. She is also grateful for the care she is receiving from her doctors and their nurses/PA/staff.  It is no surprise that she has found a place in each of their hearts - she is not just another patient to them.

Our Bible verse this week has been Philippians 4:13 "I can do all things through Christ who strengthens me." We have been filling in the blank as we strive to live out this verse:
I can ________________ through Christ who strengthens me.
I can choose thankfulness through Christ who strengthens me.
I can dwell on truth through Christ who strengthens me.
I can not fear the future through Christ who strengthens me.
I can be kind to my brother/sister even though he/she is really mean to me and deserves a consequence … through Christ who strengthens me.
(The last one may end up proving the immense strength of Christ…!)

We hope you have a great weekend!

Appointment scheduled

Sandy has an appointment with a surgeon in Kansas City next week. She anticipates they'll schedule surgery for the following week, but until she meets with the surgeon, nothing is definite. She will learn the results of the biopsy at her appointment on Friday with the doctor here in town. Thanks for the prayers!

Background

In the middle of July, Sandy began to itch all over. Nothing seemed to relieve the itching. That began a series of appointments with various doctors, numerous referrals and tests, and a lot of waiting. It was determined that she had a stricture, or blockage, in the bile duct. Doctors inserted a stent, which relieved the buildup of bile and the itching, but was merely a temporary solution. At one point, she traveled to Kansas City for a scan that doctors fully expected would reveal a mass needing to be removed. Nothing was found. Further tests indicated that she either had the beginnings of a cancerous tumor of the bile duct, or she had autoimmune pancreatitis. Doctors said that 90% of these cases end up being a tumor. Because of the similarities between the two possible diagnoses, they cannot rule out cancer. Since treatment for autoimmune pancreatitis would exacerbate a cancerous situation, it is not a great option to pursue. This type of cancer does not respond to chemo or radiation, making surgery the only - and best! option. Here is a link to an explanation about this type of surgery.  

http://www.hopkinsmedicine.org/liver_tumor_center/conditions/bile_duct_cancer.html#.VAEf5oyTyRs.email

Decisions about when, where, who, etc will likely be finalized this week. We will post as we have solid information to share. 

Due to the rarity of this type of cancer, the effectiveness of alternative treatments is unknown. Sandy and her team are diligently pursuing the best route. While many people have wonderful stories of eradicating cancer with non-surgical methods, each type of cancer - let alone each individual body -  responds differently. Please refrain from talking to Sandy about what has worked for others, as it quickly becomes overwhelming in a sea of already overwhelming options and decisions. You're welcome to email her daughters if you feel you have information that will be helpful. Thanks for your understanding!