Entries by Robert N. Yale (41)
Melissa's surgery tomorrow; Chemo round 8 review
Well, a lot has happened since my last post. I had the pleasure of accompanying Melissa and Raegann to her first haircut, which was a lot of fun. It was just a trim, but one of those milestones that parents love to experience.
Last week, Melissa's physician also discovered a 6cm cyst on her right ovary. Tomorrow, Melissa will have laparoscopic surgery to remove the cyst. While it is unlikely that this cyst is malignant, it is always a possibility. We are hopeful that the surgery will go very smoothly and that she will require only minimal recovery time.
Chemo round 8 was similar to round 7, but with each passing round, the side-effects are a bit stronger and take a bit longer to recover from. With round 8, the neuropathy (nerve sensitivity to cold, in my case) was so severe that I couldn't even walk around on the cool tile floors in our home without feeling like my feet were being assaulted by a vengeful horde of needles. As the time has passed, the severity has lessened, but is still quite impactful compared to previous rounds. The nausea was present at times for the first few days after the chemo infusion, and the fatigue lasted through last Friday. By Saturday, I was feeling nearly normal again, so we got a babysitter for the kids and Melissa and I enjoyed a lunch/shopping date together.
Round 9 will be my last round of chemo on this particular regimen (Oxaliplatin and 5FU). On August 11, I will be back at MD Anderson for CT scans, and on the 12th I will meet with my oncologist to find out about my options for second-line treatments. It's possible that the gene testing of my cancer has revealed genetic anomalies which may qualify me for a clinical trial. It's also possible that I will instead go on a different chemo regimen.
Apprehension grows as each of these appointments near. The questions loom - has the cancer spread, remained stable, or retreated? Will the second-line treatment be effective? Will the second-line treatment provide the hope of longer-term survival, or just a short extension? With all of these questions, we remain confident in the goodness of our God and content with His plan for our lives, however long they may be.
Thanks to all of you who continue to pray for us. Please remember the following requests in the coming days:
- That Melissa's surgery will go as planned, that recovery will be quick, and that the cyst will be non-malignant.
- For peace in the lead-up to our next visit to MD Anderson.
- For unexpected effectiveness of the current and second-line treatments
Chemo round 7 review
Last week, our best friends from Ohio came to visit us for several days. It was such an encouragement to both Melissa and me to get to spend some quality time with old friends, to be "normal" for a few days, and to have some fun together in the DFW metroplex. Never underestimate the restorative powers of time with good friends.
Because of the Independence Day holiday, my regular Monday chemo appointment was delayed until Tuesday. Round 7 proved to be more difficult than the last few rounds. Once again I experienced the awful nausea and fatigue that weakens the body and saps the psyche.
Over the last few rounds, I've learned to expect an emotional breakdown that directly coincides with the worst day of chemo symptoms. When your body is so physically weakened, it's easy for your spirit to be weakened as well. It is in those moments when hope is hard to find.
I am fortunate to have a wonderful partner who understands this, and who holds me in the most difficult moments, reminding me of the Ultimate Hope that we have outside of ourselves and the messy world we inhabit.
I have only two more rounds of this chemotherapy regimen. August 11 I will return to MD Anderson for new scans and discuss my second-line treatment options with my oncologist. I remain hopeful that the genetic testing of my cancer will open up clinical trials or other treatment options that may more directly target the disease in my body.
Thank you again for all of your prayers. Please continue to pray for the following:
- That my remaining chemo treatments with Oxaliplatin and 5FU will continue to be effective.
- That the genetic testing of my cancer will reveal promising options for targeting the cancer more directly.
- That the second-line treatment will be effective at slowing the cancer and extending my life.
Chemo round 6 review; Days in the pit
We had a wonderful time celebrating Father's Day. My parents were here visiting from Washington State, so Melissa and I took both sets of our parents out to a Brazilian steakhouse for lunch - first time for both sets of parents. We took lots of Father's Day pictures with the kids, and had a great time!
On Monday, I spent the day in the chair receiving chemo infusion #6. With this round, it seems that the fatigue was as severe as it's ever been - I spent most of the day on Tuesday and Wednesday, and part of the day Thursday resting or sleeping. Part of it is fatigue from the chemo drugs, part of it is fatigue caused by the anti-nausea meds that I've been prescribed to help with the side-effects.
The nausea meds did their part, and I didn't have any significant nausea or pain with this round of chemo, which was a blessing. I generally have no appetite in the days following chemo, so I eat very little. By Thursday, when I feel good enough to eat again, I have to take it slowly as I introduce food into my system again.
Today was a rough day, emotionally. After receiving the good news from MD Anderson that the chemo is working, you'd think that I'd be excited about my prospects. The difficulty is that I only have three more rounds of this chemo regimen; after that, we have to find something else and hope that it works. It has been tough to face the reality that the rest of my life will likely consist of chemo treatment after chemo treatment until the available treatments run out or stop working and the cancer kills me. It was especially hard today, thinking about Raegann's 2nd birthday next month, and Matthew's 4th birthday in August, knowing that those might be the last birthday celebrations I share with my children.
Sometimes it takes a phone call from a close friend to drag you up from the pit. Today, I received one of those calls when I needed it the most. The wisdom my friend shared was this: "Do not sacrifice today between the twin thieves of yesterday and tomorrow." It is so easy to waste your energy mourning the lost dreams of a future that will never be, reliving past triumphs that won't be repeated, or wallowing in the regrets of old failures that cannot be undone. In truth, today is all we ever get - use today with purpose. I so needed to hear this advice today and be challenged to live it.
None of us know how our lives will turn out. We have ideas and plans and dreams. Sometimes those ideas and plans and dreams come to fruition, sometimes they don't. For me, it is often too easy to forget that God's plans are always better than my own, even when it doesn't seem like it at the time. James Chapter 1 discusses the idea that experiencing trials leads to wisdom. I have found over the past several months that you learn things through trials that you simply don't learn any other way. So, although I wish this trial was not mine to experience, I am finding joy in the wisdom that I gain in these times.
We continue to covet your prayers for my health and our family. Specifically,
- That my remaining chemo treatments with Oxaliplatin and 5FU will continue to be effective.
- That the genetic testing of my cancer would reveal promising options for targeting the cancer more directly.
- That the second-line treatment for my cancer would be effective at slowing the cancer and extending my life.
Follow-up at MD Anderson; Plan going forward
On Wednesday afternoon, Melissa, Matthew, Raegann, and my in-laws (Phil & JoLinda) made the 4 1/2 hour trek (read: 6 1/2 hours with kids) from Dallas to Houston for my appointments at MD Anderson Cancer Center. On Thursday morning, the family went to the Houston Zoo while I went in to the Mays Clinic for blood work and CT scans to see how the chemotherapy has been working to slow the progress of the cancer.
This afternoon, I met with my medical oncologist at MD Anderson to hear the results. As we had been hoping and praying, the chemo has been effective so far. The primary tumor in my stomach has significantly decreased in size, and all of the metastases to the lymph nodes have seen either slight improvement or have stayed the same. No additional spread of the cancer was detected by the CT scan, which is really good news. We are so thankful to all of you who have been praying with us for this result.
Although the chemo has been effective thus far at slowing the progress of the cancer, my body will only be able to handle a maximum of seven more rounds of this particular chemotherapy regimen before oxaliplatin and 5FU toxicity becomes a concern. For this reason, during this appointment, we discussed the options for the second line of treatments. My oncologist prefers not to go beyond 9 rounds of treatment with the oxaliplatin and 5FU regimen, so I will be continuing for four more rounds of chemo and then returning for more scans at MD Anderson in August.
At that time, it will be necessary to switch to a second line of treatment to continue to hold the cancer at bay. While I was down at MD Anderson, I was able to enroll in a clinical trial process to identify potential genetic mutations and expressions that may allow more targeted treatment of my cancer. Tissue from my tumor biopsy will be subjected to genetic sequencing to look for any of 146 different mutations that may provide options for more directly targeting the cancer or attempting immunotherapy treatments to unleash my own immune system to fight the cancer. In August, I will find out the results of the genetic testing and will discuss with my oncologist the various clinical trials and immunotherapy treatments that I may qualify for.
In many ways, this weekend was bittersweet. Sweet, because we know that the chemo has been effective thus far at slowing the cancer. Bitter because we know that in two months, we're back to looking for alternative treatments to continue fighting this disease. I continue to cherish the days that I have with my beautiful wife and sweet children, recognizing that each day with them is truly a gift not to be squandered.
Going through all of the poking and prodding and scans and tests and treatments that come with being a cancer patient makes one incredibly aware of the impermanence of life. For me, it has made me value the people around me so much more. I hug my kids more often, tell my wife I love her every chance I get, and remind myself of the sacredness of my relationships with my family and friends.
Thanks to all of you who are walking with us on this journey. Your presence in our lives is encouraging and enriching.
If you are also praying for us, please remember the following:
- Praise that the chemo has been effective so far.
- That the remaining chemo treatments would continue to be effective.
- That the genetic testing of my cancer would reveal promising options for targeting the cancer in the second-line treatment.
Four days until follow-up; Chemo round 5 review
Over the past two weeks, I've felt better than I have in more than three months. My energy levels have been higher, I've been able to eat more normally, and for the most part, I've been free of any other pain or symptoms.
Chemo round 5 came and went. I experienced the usual fatigue (although not as severe as previous rounds), but only had minimal pain and nausea. One side-effect I've had with every round of chemo is an extreme sensitivity to cold things. Usually, about 30 minutes into my infusion, the sensitivity begins, causing pain when I touch cold things, and making it feel like I'm drinking broken glass if I drink something even slightly cool. For some reason, with chemo round 5, I didn't experience this side-effect, so I've enjoyed drinking cold beverages and eating ice cream again this week!
Since I'm not teaching this summer, I've been using my regained energy to spend more time playing with my kids, who continue to bring me such joy. Both Matthew and Raegann will have birthdays this summer (4th and 2nd, respectively), and Melissa and I are excited for those coming celebrations.
For Melissa and I, the last few weeks have been somewhat odd. Melissa explained it this way: "In the same day, I'll spend time looking at neighborhoods and houses to move into [with Rob], and I'll also spend time looking for jobs in case I need to be the primary breadwinner for our family." We are hoping for the best, but planning for the worst, which makes every plan more tentative than it otherwise might be.
On Wednesday, we will travel to Houston for my end-of-week appointments at MD Anderson. On Thursday, I will have blood work and CT scans, and on Friday I will meet with my gastrointestinal oncologist for a follow-up. In this appointment, we will find out whether the chemotherapy is working. Here, there are three possible outcomes: 1) The cancer has continued to spread; 2) The cancer has stayed the same; 3) The cancer is shrinking. Of course, we are hoping and praying for option 3!
We are so thankful for all of the friends, family, acquaintances, and strangers who are praying for us. This week, please remember the following requests:
- For unusual efficacy of this chemotherapy against my specific cancer.
- For good news from the CT scans on Thursday.
- That we will have peace with whatever the report is from MD Anderson.