Naked

Tough. Strong. Brave. Courageous. I’ve got this. I can handle it, after all, I have a very good life. I have absolutely no reason to feel sorry for myself.

And then…

Intimacy.

I stand undressed before my husband. He hugs me as insubordinate tears flood my eyes. Does he realize that I don’t want this, yet I desperately need this? Subconsciously I avoid intimacy with him. It’s too painful, it releases bulging emotions that I try to keep zippered shut. Emotions so strong I can’t speak, the sobbing is so hard, so deep.

Fear. I feel fear. Fear of what I want with all my heart. Fear despite our desperate precautions, because pregnancy could mean death for me, or our baby, or both.

I look down at my swollen body, twenty-five pounds heavier now than before chemo and steroids began pulsing through my veins. My face is shaped like the moon. Curves are where straights should be. Scars litter my abdomen. Sweet round breasts with soft nipples are replaced with long jagged indentations. I feel so unfeminine, so unattractive, so undesirable. Ashamed.

Choking, I attempt to explain to Jamie, but he stops me.

“Sweetheart, I want you. These scars are our scars; monuments of what we’ve been through together. I love you, and…

Baby, you still light my fire!”

He loves me. He has seen my vulnerability, sensed my insecurity, and covered my shame with his acceptance and love. He lives his vows with integrity, to love me in sickness and in health. We both grow stronger because of his love.

Maybe you don’t have cancer, but most of us don’t get through life without hurt. We put on our game faces, convinced that we have ourselves and our lives under control, trying to deny the naked truth that we are weak, limited, vulnerable. Things happen that we cannot control. Maybe you lose a house or a loved one to a wildfire or earthquake. Maybe your spouse or significant other walks away and never looks back. Maybe indescribable evil hurts you, or worse—your child. Maybe you’ve made choices that hurt yourself or others, and you feel ashamed. Maybe you’ve decided that God doesn’t exist, and just when you’re desperate you cry out to Him, and then you feel ashamed again. He doesn’t worry about that. He has made a commitment to love you in sickness and in health, and He has already died to show you that He will keep His word to you at all costs. It is His joy to cover your shame with His love! God loves you more than you can comprehend, and He wants you.

"'Later I passed by, and when I looked at you and saw that you were old enough for love, I spread the corner of my garment over you and covered your naked body. I gave you my solemn oath and entered into a covenant with you, declares the Sovereign LORD, and you became mine.” Ezekiel 16:8

Side Effects, from the experience of a patient

Side effects. You all know about them. You can read a generic list. But how does that look, really? Let’s go in the order that this patient feels them after the infusion.

First is the pain: headaches, body aches, joint pains like I’m old, and muscle pains. I’m talking charlie-horse in any part of the body at any time day or night. I walked two miles one day—which doesn’t seem like much but right now is huge—and when I got home my muscles all tightened at once and I had to crawl up the stairs to my room. Thankfully it ended there and I was able to carry the full hamper of dirty laundry downstairs and do what we moms do without ceasing.

Next is insomnia. Not good when one has small children. Who also don’t sleep all through the night. So maybe it works.

Nausea at the most inconvenient times. Constipation. Like can-anyone-do-a-colonic kind of constipation. Like your prescription anti-constipation medication isn’t working.

Then the steroid kicks in, and it’s aggression. I mean like if-anyone-is-hurting-my-little-sister-I’ll-fly-to-her-state-and-beat-them-with-my-broom-right-now kind of aggression. The kind of aggression that makes my husband say to my kids, “You know Mommy just had steroids, I’d do what she says.” Like the kind that makes me lose all I’ve gained in my effort toward patience with my children’s whining and my husband’s stubbornness. Yeah, it’s not pretty. But on a good note, I can accomplish a lot!

Rash! An unsightly, painful rash on my face (which looks a lot like acne but isn’t), and sometimes cold sores on my lips. A constant rash on my chest and back. The back rash is so itchy that it drives me to distraction and sometimes I unintentionally scratch it until it bleeds. Thankfully it's turtleneck time of year!

Vision. I’ve always had excellent vision. Before we went to Malawi in 2012, both eyes measured 20/15. Now I have to hold my books out at arm’s length to even begin to decipher what those letters are.

Along with joint and muscle pain is a lack of coordination. My son's Pogo Stick? Bad idea. I’m pretty much limited to activities that keep my feet on the ground, or swimming. Thankfully there are a lot of options!

Nosebleeds, and large bruises.

Reflux, like do-they-make-fire-extinguishers-for-throats kind of reflux.

Runny nose, ears that painfully pop driving up and down the mountain. Every time.

How could I forget exhaustion? I do most everything about half speed.

Hair thinning, nail ruining, skin aging.

Bloating!

Weight gain (for me) because of the large amounts of steroids, and because the chemo has caused me to develop hypothyroidism.

Depression and anxiety. It keeps me awake at night, solving problems of how to protect or evacuate my children in the event of a natural disaster, or other anxious thoughts. It always lifts on day 11 of my 21 day cycle, just like clockwork.

What is the most difficult, though, is what’s called “chemo brain.” I had a conversation with an acquaintance that we had not seen for several years. He lives in another part of the country, and was in California for a conference. His name is Alex, his first child is Daniel, and he has a much younger daughter. Another acquaintance that we know is also Alex, also has a first child named Daniel, and has a much younger daughter. While both are from the same country outside of the states, Alex and Alex look very different! When speaking to Alex, I confused him with Alex, and asked about Alex’s wife when I meant Alex’s wife, and so you see, it was very confusing. It wasn’t until I said, “So Daniel is about Jedidiah’s age now?” that I realized that I was speaking to Alex and not to Alex. Oh dear. It was really quite difficult, and I just couldn’t pull it together. I briefly thought to tell him that remembering has become a challenge since I’ve been on chemo, but I didn’t for two reasons. 1. In the off chance that he doesn’t know, I didn’t want him to feel sorry for me or to feel uncomfortable, and 2. I would then feel obligated to explain to nearly everyone with whom I have a conversation, because it happens all the time.

This is how tough it is. Yesterday Jamie was hanging some pictures for me while I was preparing supper. I saw the salt shaker was empty and went into the pantry to get the refill salt. I opened the door, stepped in and right at that very moment Jamie chose to ask, “Hey, can you come look at this for a minute?” I said, “Um, sure, just a minute” as if I were doing something. But I wasn’t, because just like that I had no idea why I had walked into the pantry. I stood there, thinking, stretching my brain until my head literally hurt, and just when I was sure I’d pull a muscle, I remembered, “Salt!” I grabbed it from right in front of me, put it on the counter, and went to look at the picture.

New Fight Song

Dear Family and Friends,

Thank you for your prayers. If we ever needed them before, we need them now.

I'm sitting here with the drug Kadcyla dripping into a port in my chest, going through my internal jugular vein, into my heart, and from there to my body. In an attempt to gain the upperhand on the cancer growing inside me. In an attempt to remain on this earth longer to be the wife I want to be to Jamie, and to be with and for my children as they grow.

We met with the oncologist this morning. She gave us good and bad news. The good news is that the Kadcyla has rendered the nine centimeter liver mass inactive, as well as several smaller masses.

The bad news is that there are several new small tumors in the liver, a different large tumor has grown to seven centimeters, and the lung tumor has grown. My oncologist said that usually cancers don't gain, but they lose specific receptors. In this case, my cancer was already estrogen and progesterone negative, and HER 2 positive, so her suspicion is that this clone dropped the HER 2, making it triple negative. She also said that these resistant clones usually develop after a person has gone through multiple lines of chemotherapy, and for some reason the cancer in my body has developed a clone earlier than is expected or common.

I can tell her the reason. I know, and have known from the beginning of this diagnosis, even when it was Stage 0 five years ago, causing us to leave Malawi the first time. "For our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms." Ephesians 6:12 This battle is not about me, and it is bigger than me. I do not have the evidence of victory in my body, but I am ready to speak. I am ready, by God's grace, to do what He wants me to do. With His power, and His help.

Today they drew my blood for genetic testing, and a liver biopsy follows in about 10-12 days. My next infusion on November 12 will be a different chemo combination. My oncologist told us that results of a phase three trial of a new immunotherapy drug for TNBC (triple negative breast caner) were published yesterday. It is expected to have FDA approval by the end of the year.

I am not despondent, though the temptation is there. We talk too much of the power of evil, too much of things that hurt. That gives them more power in our lives--minds, bodies, relationships. Jesus told us, because somehow we forget, "In this world you will have trouble." John 16:33 He wasn't trying to scare people. He knows what can happen down here. Life can be tough; it can hurt beyond words. He doesn't want it to be that way more than we don't want it that way. "But take heart! I have overcome the world." John 16:33 Praise God for the victory! Let us speak of His love, His promises, and the hope we have in HIm, for by His stripes we are healed. By the pain He endured in this world, we can be whole. Let us choose wisely what we let ourselves think and speak. I choose to sing the mighty power of God! He is the one who gives me life.

Please, friends, never turn your back on the only One who can help you in your time of deepest need, the One who is with you through the hurt. It makes no sense. He didn't escape pain while He was here; you can't expect to either.

Please pray for me to do all that I can to help my body fight this, to focus, to persevere, to not give up! This is the truest fight for my life I have faced, and I want to give it the best I've got in me. With God, all things are possible!

We love and appreciate you all very much, more than you know! We thank God for each of you in our lives. Your prayers and support strengthen us. Thank you.

Not Afraid

“I am not afraid to die from cancer” said my beautiful, young, healthy wife.  Recent scans and discussions with oncologists had brought one of these discussions back around, “I just worry about my children”. 

It has been just over two years since Shallena was diagnosed with advanced breast cancer.  A diagnosis that changed our home, our job, our future, our security, our finances…pretty much everything in the material world.  While at different steps we have been given very different prognoses – from months to decades – one thing was clear: its worse now than it has ever been before.  While the facts forced our mortality to weigh upon us, the reality of our situation felt different this time. 

There have been many bumps in this road.  The first bump came after her first diagnosis of breast cancer in 2013.   It scared us more than the medical community thought it should have, as it was “only DCIS”—breast cancer stage 0.  We eventually recovered, and surgery gave us another chance at life. Then the second bump came one week after our baby Caleb was born – breast cancer stage 4 with liver metastases.  This was a big bump because it meant our life as we loved it would have to change.  We gave up (very unwillingly) our mission, our home, our pets, etc…and moved back to the United States.  The third bump was when chemotherapy stopped working.  We decided for a “chemo holiday”, but we were really not inclined to go back to toxic treatment as it had been very hard on Shallena, and had destroyed her quality of life.  The last, but most recent bump was a few weeks ago when we learned that the cancer had come back more aggressive than ever, with large metastases in the liver which were already causing dysfunction. 

Each bump brings its own cycle.  We feel sad, discouraged, we start to reorganize, make a plan, and then go forward with hope.  Its like riding a roller coaster, which is not really my thing. 

As we have talked together during this time of reprocessing, a few common themes have crystallized for us:

1.        We have been blessed.  I could not list in 50 pages the number of blessings that we have received going through this experience.  From new friends, to new mentors, to prayer partners, a new job with new colleagues, a new house, new pets….God has been faithful to us and while we would not wish this situation on friend nor foe, we have been blessed through it.  Thank you to so many of you who have been part of that blessing.  We miss our mission in Malawi, but we accept this transition with all the opportunities that have come with it.

2.       The power of death has been broken.   The discussions between my wife and I are different these days – as you may expect.  The other night she told me, “I’m not afraid to die -- I will just go to sleep until Jesus wakes me up”.   It was simply spoken, but when the truth like this is spoken by the favorite person in your life, it has a different kind of power.  For me it was a reminder that as a Christian my eggs cannot all be in this basket I call planet earth.  If we are part of that long lineage of the faithful, then we are “pilgrims and strangers on the earth” Hebrews 11:13, looking for a better land.  I fear that in a land of relative security and plenteous material wealth, it is easy to forget that this fallen world is not home.  At times – times when we least expect it – God allows the unthinkable to help remind us that heaven is where we belong.  I can tell you today, we’ve never had more eggs in the heaven basket, and it is a blessing.  I thank God from the bottom of my heart.

3.       No fear.  Part of one of my most recent blessings was to spend a week in Michigan with a group of returning missionaries.  I felt the connection from the start.  It will always be a special event in our memory.  We shared our stories of miracles, providential leading, unresolved conflict, and personal pain.  Every missionary has that list.  One day I was eating lunch with some new friends, and as we shared our stories I felt a sense of God’s presence.  One of them was a pastor who had been working in the Middle East.  He ultimately had to return home because of a malignancy which had caused the loss of a limb.  The other one was a pastor who had actually gone to the mission field (in Central America) at the same time as us.  His wife was suffering with a neurodegenerative disease which has left her in a wheelchair and completely dependent on others to care for her.  There we sat –  three broken and crippled missionary families that had to come home due to unexpected serious health conditions – on the outside looking very much like the enemy was winning.   But on the inside….I’ll never forget how I felt on the inside as we all shared our mutual experience.  It had been hard, and we all had uncertainties about our future on earth, but we were all gaining a depth of peace that could not be challenged by the unexpected chaos of this world.  In some way for each of us, it had already happened.  Despite the difficulties, loss, and insecure earthly future -- together we were waiting for God to do exactly what He has promised and work all this together for good.

I’m not going to say that we thank God every day when we are living in the details of this experience, but overall – when we step back and look at the trajectory of our lives – we thank God for what He has done in these experiences.  We are walking through the valley of the shadow of death – but it is here that we get saved and God teaches us to fear no evil.  I fully believe that when I stand face to face with my Savior, that I will thank Him for the valley of the shadow of death.  He is teaching me to fear no evil. 

4.       Two Years.   I can’t count on one hand the number of times in the last several weeks that Shallena and I have been overcome with gratitude for the last two years we have had together.  You may know that two years is the average life expectancy for a woman diagnosed with stage 4 breast cancer, and so by now out of 100 women who had been diagnosed with her problem, fifty would not still be alive.  What can we say?  We have traveled the United States seeing friends and family.  Shallena has been a wife and a mother, and for most of the time (except the six months on chemotherapy), she has felt, looked, and acted very healthy.  Many of you have told me how good she looks, and I couldn't agree more!!  We are so grateful for that time, and we are very aware that it could have been different.  We are hoping for more miracles, and at least 20 x 2 more years, but we also realize that we cannot only ask and take from the hand of God.  We also have to come back and say thank you.  Thank you, Lord for the wonderful last two years of life with Shallena.  She is a wonderful gift to all of us, and we treasure every day we get!

5.       Help.  We continue to ask for help.  I am tired of it, and feel like most of you are probably tired of hearing it, but the truth is, we still need it.  Thank you for those who lift us up in prayer.  Thank you for the notes, messages, cards, phone calls and every other communication that has lifted our spirits.  Many days the clouds of discouragement have been swept away by a ray of light that has come through your care and concern for us – pointing us again to the King, and away from the raging sea.  Thank you to the scores of you who have brought us food, gift cards, advice, and even money to help out in our transition.  You have carried us, and over and over again, we have felt the miraculous provision of God through you.  But today I would like to ask for a little more help – maybe a different flavor…

Since our unexpected return from the “mission field”, we have felt that this struggle is bigger than us. That we do not fight against “flesh and blood”, and that we are caught in the middle of a great controversy between good and evil.  We especially felt this come into play when we had to leave Malamulo Hospital where we felt like the kingdom of heaven was advancing.  So, as we feel the loss, we are determined that this battle is not lost for the kingdom of heaven.  What I am requesting is that you join together with us in this great controversy against the kingdom of darkness.  How can you do that?  First and foremost by surrendering your life to Jesus and following where He leads.  This is always a victory for the kingdom of heaven as you cross over from darkness to light.  If anyone has questions about how this happens, I would be honored to share with you.  Second, once you have given yourself to His kingdom, then live by the raw counter-cultural principles of the kingdom of heaven – forgive somebody who does not deserve it, love your enemy, apologize for something you did, live generously, and practice reflexive grace.  The enemy is busy wreaking havoc in our world, it is time for us to be busy advancing the kingdom of heaven in our own lives.  We will together ask for God's miracles to continue in Shallena's life -- but today I am also asking that His miraculous grace will take over mine so that in the middle of this dark valley the enemy's cause is worsened for the destruction He has tried to sow.
  
"Who can separate us from the love of Christ?  Can affliction or anguish or persecution or famine or nakedness or danger or sword?...No, in all these things we are more than victorious through Him who loved us." Romans 8:35,37.