Thursday, April 30, 2009

When the News Isn't Good

My grandson, who always helps me smile

Cancer. That was the word I heard from the respiratory doctor two weeks before the urologist asked, “May I speak straight?” When we gave permission, he bluntly declared, “You have kidney cancer.” A few minutes later after we’d agreed on laparoscopic surgery to remove the kidney, he continued—just as bluntly—“Good. You have so much belly fat, I’d have trouble cutting through it all if you chose open surgery!” (Yes, I laughed, but I shot daggers at him with my eyes. It was okay for him to be straight about my cancer, but definitely not about my fat, belly or otherwise.)

After the news, we prayed we’d be in the 10% of people who find out that, contrary to a doctor’s preliminary diagnosis by sight, the tumor isn’t cancerous. But I was in the other 90%.

The next step was the pathology. For the next two weeks, we prayed—along with family and loved ones around the world—that the pathology report would not show a “bad” cancer. (Is there such a thing as a good cancer?) But on April 22, the doctor announced the unwelcome news: although I was now cancer free, as far as he could tell, the cancer that had been removed was a cancer with high rates of metastasis. “I wish we’d caught it sooner,” Dr. Morita said with regret in his voice. There was no joking around in this visit, no talk of belly fat, just the facts. It was as if the wind had been knocked out of his sails.

But there was good news, too. My blood levels were nearly perfect, surprising the doctor greatly. Additionally, my energy level was the best it had been in months, the incision was nearly completely healed, and I was the picture of health, Dr. Morita commented—except that a highly metastic cancer had been taken from me.

My next step is a combination PET/CT scan that will be done here in Tokyo on May 8. Bernie and I will then travel to the States carrying those films, a CD-Rom of all the test results from everything that has been done so far, and even the microscope slides from the pathology, on loan from the hospital here. I am absolutely amazed at the cooperation we’ve received in helping us seek a second opinion (in English—everything so far has been in Japanese). Assuming there is no metastasis at this time, we will return to Japan and I will begin a lifetime monitoring/maintenance program. However, if there are signs that cancer has found a new home in my body, I’ll begin drug therapy in Indiana with the goal of transferring my regimen back to Japan as soon as possible. With that treatment completed, I will enter a maintenance program here.

Obviously, where we are today in thinking and planning is not where I wanted to be when I wrote the last blog. So what do you do when the news isn’t good? This question popped into my mind as I lay in bed two nights after G-3 first became part of a new vocabulary of medical words I never knew before. How grateful I am for the answer that came instantaneously in the form of the title of the thirteenth book of international stories I complied and edited just last year: Yet, I Will Rejoice.

The Old Testament prophet Habakkuk declared, “Though the fig tree does not bud and there are not grapes on the vines, though the olive crop fails and fields produce no food, though there are no sheep in the pen and no cattle in the stalls, yet I will rejoice in the Lord, I will be joyful in God my Savior” (Habakkuk 3:17-18, emphasis added).

Contemplating Habakkuk’s words, I realize that life’s circumstances change daily. Sometimes this means that the news we receive isn’t what we’d hoped for—sometimes it is even downright bad. But bad news doesn’t change God. He is the same yesterday, today, and forever (Hebrews 13:8) and he has promised never to leave me or forsake me (Hebrews 13:5). Therefore, I will rejoice! Even when the news isn't good.

Sunday, April 19, 2009

Telltale Signs

After surgery, visiting a lovely Japanese park with my sister--
following doctor's orders for a daily walk

The coughing started sometime last September. Not that it was any big deal. When I talked with the doctor about it as a precautionary measure in October, I could only estimate when it began. “It’s probably allergies,” he responded easily after listening to my lungs, looking in my throat and ears, and noting that Indiana was in the vice-like grip of an especially horrible season for allergy sufferers. Since Bernie and I were headed out to visit churches in Colorado and Oregon, he added, “It’ll probably clear up when you get out of Indiana.”

Only it didn’t. As we looked at returning to Japan in November, following our three-month home assignment, I visited the doctor again. Although the doctor still was not concerned about the coughing, he agreed that treating me more aggressively could eliminate the increasingly aggravating cough and at least ease my mind. He prescribed a heavy-duty cough syrup that brought on a spasm of uncontrolled coughing when I saw the price, gave me an inhaler to sample in case this was asthma related, and ordered an x-ray of my lungs. I was satisfied and happy when the x-ray was clear, and I returned to Japan confident that everything was fine, even though both the syrup and the inhaler did nothing to alleviate my coughing.

In fact, the bouts of coughing were becoming more frequent. In December, they were joined by heaviness in my chest—at times, pain—when I exerted myself to walk up a hill. Gradually, my energy began to flag as well until the January day I began crying as I spoke with my father on the telephone. “Dad, I’m just so tired,” I admitted to him. “I can’t seem to do anything without resting, and I don’t have time for these daily naps and this lack of energy. I’ve got two book deadlines on me, and I’ve just got to keep going.”

What would a girl do without her father—even a girl as old as I am? I’ve been married 33 years to a wonderful, loving, and caring husband, have been blessed with two children of my own, and love to “talk” with my 15-month-old grandson nearly daily via Skype. But at that moment, it was my dad who picked me up, brushed away my tears, prayed for me, and comforted me as all loving daddies do when their little girls trip and fall down. Never mind that he was half a world away in the United States.

But still the coughing didn’t stop. Finally, when the books were off to the publisher, I began a month of weekly visits to a respiratory doctor. Gradually, using x-rays, strong antibiotics, and bronchial patches, he eliminated all the usual: pneumonia, bronchitis, whopping cough (making a resurgence here), and asthma. Yet the coughing continued. In fact, it was getting worse even as my energy was dangerously low. Blood work showed anemia and a highly elevated CRP (C reactive protein, whatever that is). Something was definitely wrong, but all we could see were telltale signs. Two weeks before a sonogram of my left kidney finally brought the diagnosis, Dr. Yamamoto told me carefully, “I think we are dealing with something very difficult.” In Japan, where the word cancer can hardly be whispered for the impact it carries, I realized immediately what he was suggesting: there was a strong possibility that we were dealing with the dreaded disease.

Today, two weeks after my hospitalization, I am at home resting, less one kidney, and awaiting the pathology report in three days. Amazingly, my coughing ceased the day after the surgery (and maybe even sooner, but I don’t remember much about my recovery time in ICU); I no longer pant when walking up the slight inclines Tokyoites call hills (there’s a reason this area is referred to as the Kanto Plains); and my energy level is returning (hence the fact that I’m at the computer to begin to unravel some of the jumbled and even incoherent thoughts that crowd my head).

Although the untangling of my mind and heart is going to take a while, I’ve already exceeded my self-imposed one-page blog limit. So for today, I’ll let it go at this: I am overflowing with gratitude for telltale signs that led me to a good doctor and a good hospital and for the amazing care that I received there. But most of all, I have been buoyed on the wings of the love of friends and family—and especially the family of God—from all over the world. I am speechless with wonder for I know I have done nothing to deserve this outpouring of love. In fact, as the emotions well up in my heart, I realize I have seen the invisible God. His name is Love (1 John 4:8).