I have called.

In response to encouragements to call my doctor, I just called him. He said that since I haven't experienced anything since Monday, we will wait and see but to let him know if I have another episode.

Rough Week

I got up on Monday and started to prepare to go to school. While in the shower my nose started bleeding.  No big deal. Soon after I was hit by a wave of dizziness and shortness of breath. I dropped to me knees to keep from falling. When it passed over I assumed it was just a one-time episode and proceeded to continue getting ready for school. While drying myself after the shower I had a second episode and dropped to my knees again. When it subsided I pressed on to get to school. While getting dressed I experienced a third episode and decided not to go to school. There were no more episodes and I felt fairly normal by midday. While yawning and stretching that morning, I felt a rib on my left side pop out and back in. This left me with a sore left side that felt like a muscle pull. As the week progressed, a couple of places on the middle of my chest felt like pulled muscles as well. By the end of the week a spot on the right side of my rib cage felt like it had a pulled muscle a well. To go along with all this was a feeling of "creakiness" in my hips and lower back. It was just a soreness similar to the day after a workout. None of these were debilitating but were multiple sources of irritation. This was the week of Parent/Teacher conferences. Therefore I, thankfully, was relatively inactive Thursday and Friday. I will say that sometime late this week one of my daughters asked me why I was walking differently. I'm blogging while my family is at church. I don't miss church very often but a restful and  uneventful morning was quite appealing. I was still able to talk to God this morning and hope to meet with my brothers and sisters in Christ next week.

What's Up Doc?

This week I met with my nephrologist (kidney doctor). I had not met with him since Thanksgiving. He also was pleased with my latest numbers. He spoke of a procedure that has been successful in returning kidneys to normal function if they fail to by themselves. I found that comforting to know. He also said because of the rarity of myeloma, there is not a large body of data to refer to when treating it. Information is constantly being added from the various cases. Daily I continue to feel fairly normal. My doctor doesn't even ask how I'm doing anymore. God was able to get me through our musical Annie without missing a beat. The students didn't miss a beat either and put on a great performance.

Spiritual. When this all started my daily readings were in the book of Kings. One of the main points of this section of scripture is that God rewards obedience and punishes disobedience. I spent a few times confessing to God things that came to mind. My theme verse was "Search me, O God, and know my heart: try me, and know my thoughts: And see if there be any wicked way in me, and lead me in the way everlasting." (Psalm 139:23-24) Now my daily readings are in the book of Job. (God's timing is really interesting). Now I am reading Job with much more depth and insight. I am nowhere near Job's situation but can relate a little bit. Also it gave me balance from Kings in that not all circumstances can be traced to our level of obedience with God. Since before the myeloma I have been attempting to memorize John 14-17 so that I can quote it in one sitting. This has been a great theme to have flowing through my mind and spirit. John 14:1 has been especially relevant. "Let not your heart he troubled: ye believe in God, believe also in me." Verse 27 of the same chapter is similar. "Peace I leave with you, my peace I give unto you: not as the  world giveth, give I unto you. Let not your  heart be troubled, neither let it be afraid." God has given me the method (faith) and the tool (peace) needed to keep my heart untroubled and unafraid. Thanks be to God that this is what I have been experiencing. Please pray for wisdom as we are continually faced with both small and monumental decisions. Thank you.

My First Side Effect

On Monday I started new chemotherapy which my doctor preferred. It required me to take aspirin as well. The aspirin serves as a blood thinner as a preventive for blood clotting. On Wednesday morning as I looked in the mirror to prepare for school I noticed that I had more forehead than usual. As I was leaving for school, my fedora sat about an inch higher on my head than I was accustomed to and felt quite tight. I asked my family members and they did not see a difference and no one noticed at school buy by the time I got home it was quite noticeable. My daughter Michaela thought that I had lost hair. The hat had given me an incredible hat ring. My forehead gave me a look that made me feel like putting a couple of bolts on either side of my neck (think about it). I felt as fine as any other day but my family encouraged me to stop the pills until after I consulted with the doctor. He said to go to the emergency room if it worsened but otherwise to come in the next morning to be checked. It didn't get worse and by next morning the swelling had sunk to my eyebrows. Thursday was a day that I was noticed the most by others. "Did Velda smack you in the face?" is an example of a few comments that I received. Friday the swelling had sunk to my eyes which did seem to be noticed as much. When I was checked Thursday morning I brought the aspirin with me. The nurse read the container meticulously and discovered that there was a warning that it could cause facial swelling. Who reads the  warning labels on aspirin! So it looks like aspirin is out. Their guess is that it was retention of wate. I am to resume the chemo pills on Monday with a prescription blood thinner.  I still am feeling great and continue to lead a life pretty close to normal for me. I would like to reiterate from the last blog that the numbers seem to have turned a corner in the right direction. Now they need to plummet precipitously (i.e. decrease very rapidly). Thank you for praying.

P.S. I am sorry I didn't take pictures (but not very sorry).

"Overall, going in the right direction"

Those were the words of my doctor after our review of the labs today. There are 4 indicators that he referenced. These numbers show improvement by decreasing in value because they are measuring the disease.The most important one stayed the same. We had hoped for better but at least it didn't increase. I will not give you technical terms (e.g. Beta Z M) but quote the numbers. These are all changes since the last month. One decreased from ~33,000 to ~14,000 which is an improvement of 55%. Another decreased from ~10 to 5.7 which is a 43% improvement. Most encouraging is that the kidney indicator dropped from 2.8 to 2.4. This 14% drop in a month indicates that my kidneys are responding (Yeah!). We asked the doctor what the goals are and he said that they have to  return to normal. Even with these improvements I am a long way from normal (some of you may assert that I was never normal in the first place). Yesterday I started the new cutting edge chemo and the doctor is hoping it will accelerate this good trend because it needs to move faster. He is still "amazed"(his word) that I am not sick. He is glad of the level of nearly normal activity that I am able to maintain because he believes it is a key to my health. With my blood count up, I am feeling really well. I may start riding the bike to school again.

Spiritually. Sometimes circumstances make it easy to praise God. Velda and I (as well as our doctor) were pretty upbeat today. We felt like we have made it over a hump. Velda provided the verse for this blog entry. Jeremiah chapter 33. In verse 3 God says to "Call unto me, and I will answer thee, and show thee great and mighty things, which thou knowest not." Many Christians have found comfort in this verse. We as well as many of you have been consistently calling and will continue faithfully. Thank you all. Later in verses 6b and 7 God says "Behold . . . I will cure them, and reveal unto them the abundance of peace and truth. And I will cause the captivity of Judah and the captivity of Israel to return, and will build them, as at the first." God has provided me and my family with an abundance of peace and we are putting our hope in Him to build me back up as I was at the first.

Gaining Understanding

I am beginning to understand why the reports I get can seem to conflict. The nurses check my lab reports to make sure that my blood levels are good to take the chemotherapy. My blood levels have been improving since the lowest point in October. In fact all my blood levels have now either reached normal levels or are very close. So the nurse gave me a good report this week. The hematologist (blood doctor) checks on the disease. I see him about once a month. The level of my blood is not an indication as to how the chemo is affecting the disease. Therefore the doctor's report may not follow suit. I will see him this Tuesday. I haven't seen my kidney doctor for awhile because treating the myeloma is first priority. As a result I haven't much to say about how my kidneys are doing because it hasn't been addressed. Hopefully my entry next week will be more illuminating.

Spiritually. I just listened to a talk on "Agents of the Impossible". The speaker started by stating that we are people with impossible situations. I heartily agreed at that point. He then stated that we are surrounded by people with impossible situations as well. This helped me see that even though I have some difficult things to face and God is infinitely interested in my situation, it is not all about me. I must still focus on how to be an agent for God in the lives of the people around me. That is my first priority.

KU Med Center

On Thursday, December 27 our family took a trip to Kansas City mainly to have a consultation with the KU Med Center staff about my upcoming bone marrow transplant. We took the whole family and tried to make a fun day of it. Velda and I dropped off the children in Crown Center to spend Christmas money while we were at the Med Center. It was not exceptionally eye-opening but added a little clarity. We as well as many of you have wondered how the transplant works. Let me elucidate. I will be given a hormone that the body normally produces to encourage stem cell production in the bone marrow. I will given so much that my body will over-produce them. The bone marrow will then kick out the excess stem cells into the blood stream. At that time the staff at KU will draw some of my blood and separate the stem cells and freeze them. Step 2: now they will subject me to intense chemotherapy that will kill everything that remains in the area of my bone marrow (i.e. good cells as well as the malignant ones). I will be left with no living bone marrow. Step 3: is to put back into my blood stream my own stem cells. They will swim to their home in the bone marrow and start replenishing the bone marrow. It is about as complex for me as giving blood. It can be an outpatient procedure. My doctor will be Siddhartha Ganguly. Dr. Gangluly and Dr. Beck (Salina) have stressed the need for my kidneys to return to full functions. The myeloma cells have adversely effected them and are causing complications to the whole process. I believe that is why I have what is known as multiple myeloma. My kidneys have been "myeloma-tized". If the kidneys don't respond, the simple three step process becomes more involved. I won't go into those details at this time. I am suffering from information overload and I don't want you to be inflicted as well. The plan is to continue chemotherapy for 3 more months. During that time I will have a 2 day visit to KU and  5 day visit for the purpose of analyzing the effectiveness of the chemotherapy. At the end of March I will go for the bone marrow transplant and will have to stay 30 days. It takes that long for the bone marrow to be restored. I have weekly labs in Salina to monitor the effectiveness as well. They are on Wednesdays. On Thursday I have a consultation with the nurse-practitioner or Dr. Beck to interpret the lab results for me. Because I went to KC this past Thursday I have no updates on the latest labs. The routine will be restored next week at which time I will divulge the results of possibly 2 labs. After the appointment we picked up our children and had a meal at Grinder's West in the 18th and Vine district of KC. The whole day lasted from 9AM when we left Salina to 9PM when we arrived back home.

Spiritually. In Matthew 6:24-34 the King James Version uses the phrase "take no thought" three times. Modern versions use phrases like "don't worry" or "don't be anxious" but this is one time that I think the KJV got it right. Jesus didn't speak english when he was on this earth. This makes it important to catch the meaning as well as the nuances as well. The word means to focus your thoughts in such a way that it has a negative effect on your mental state. Let me illustrate. I was one of the smallest in my class in elementary school. If a bigger boy were to tell me that he was going to pound me after school, it would be good cause for me to worry. If I were to focus my thoughts on my impending doom the worrying would most likely escalate. This type of thinking is what Jesus is telling me not to do in this passage. So what am I to do? In the same passage Jesus tells us what to do. Instead focusing on things that will cause us to worry He redirects our focus to our heavenly Father. Let's go back to elementary school again. When this guy threatens me I should allow my mind to take in all the facts. I should remember that my father is picking me up after school. When I am waiting after school for my dad, I will take note of the bully and possibly his friends but not to the point that I can't see my 6 foot 3 inch 240 pound father getting out of the car at the same time. I am in a situation where the temptation is to focus on the wrong information. The key to avoid worry is to take in all the information and to factor in God and His promises.

Roller Coaster

Physically. What a ride! Last week things looked good. This week the numbers were bad. My doctor is "concerned" but not "panicked" (his words). The shot/pill combination I'm using is not the optimum he would like to use because it takes a while to get the newest meds. He proceeded with an older combination because he had it on hand. The newer meds are on the way. I am to use the older meds until they arrive. Estimated time of arrival is mid-January. I go to KU Med Center this coming Thursday(12/27). I will update after that visit which is primarily about a bone marrow transplant but could also influence what meds I use. When the doctor first walked in the examining room he asked somewhat facetiously "Why aren't you sick?!?" He went through his routine questions to see if I have any symptoms of the disease. None. He went through his routine questions to see if I have any side effects from meds. None. I feel pretty normal. Long days do drain me so I have cut out evening musical rehearsals. I barely made it through the Winter Concert last Monday. I was literally weak in the knees as I was directing the last song "Silent Night". Otherwise I can  put in a normal day. One good note, at the request of my lovely wife Velda, my meds have been adjusted to be more proactive about my anemia. Now, hopefully, I will not have to have an occasional blood transfusion when my tank (a.k.a. red blood cells) gets too low.

Spiritually. It is hard to maintain our theme of rejoicing in our trials and glorying in this sickness. There are two reasons for this. First, this is not a natural reaction but correct for followers of Jesus. Second, because I don't feel sick, my sickness is not at the forefront of my thoughts. Because I can perform my normal duties each day, I get up and think about what I need to do for the day. The sickness is an afterthought. To correct this, I took Velda out for a date night after my appointment today and when we returned home I led our family in our theme song (Psalm 3:3-4). I have many friends who are keeping up with this episode in my life. Those of you who are followers of Jesus can help me. Instead of telling me that you have heard the unfortunate news, try saying that you have heard the great news of the opportunity that God is giving me. (Romans 5:3-5; 8:28, II Corinthians 12:7-11a, I Thessalonians 5:16-18, James 1:2-4) I also would like all of you to quit telling me that I can beat this. If that were true then when this is over I would proclaim to the world "Look what I've done". I have no plans of fighting this. I plan on putting myself in a position to allow God to do the fighting for me. When this is over, whether I live or die, I plan to say "Look what God has done!" If you don't start responding correctly I will correct you like a wrong note from a singer. Gently first but increasing in intensity if repeated. I look forward to further interaction with all of you.

Update: 12/16/12

Physically. I had to have a blood transfusion this week because I had become to anemic to receive my chemotherapy shot. My first transfusion was the day before Thanksgiving. This time I was asked to cut back on my activities. No other part of the lab work was revealed to me at that time so I have no update on what is happening on the inside. I felt a little draggy last weekend but was not alarmed in any way. I still feel good enough to maintain normal activity but I'm cutting back on my evening activities at school. This happens to be my busiest time of the year so if I can make it another week I will be on winter break and can catch up on rest and relaxation. Still no serious symptoms from the disease or side effects from the chemotherapy.

Spiritually. This week I was going to share on Luke 18:1-8 and it turned out to be the subject of my sunday school class today. Christ said that the purpose of this story was "that men ought always to pray, and not to faint". In the story the widow banged on the unjust judge's door until she got satisfaction. I told God at the beginning of this in October that I would be banging on the door but tapered off as life got back to business as usual. I cannot allow this to happen again. I hope to continue to bang on the door. The good side is I have a benevolent parent who will respond speedily. I learned today that "speedily" does not mean "right now" but that the process when started will be quick. It is like communism in Russia or the Berlin Wall. They stood for a long time but when the process started they were both disassembled quite quickly. I have to prepare myself for a possible lengthy time of crying out to God day and night if He decides to bear long (verse 7). On another point. I appreciate all the sentiments of prayer and support for me. I want to also encourage everyone to hold up Velda just as diligently. I believe she has the greater burden. In addition to maintaining our household, she has been to every chemotherapy treatment, lab, consultation etc. She is taking notes at these as well maintaining a notebook for every document that we receive. I have received comforting cards, emails and notes. Would you consider sending Velda something similar? Sometimes we will be standing together and a person will say they are praying for me. Will you turn to Velda and say the same thing to her?

How Am I Doing?

Physically. This is one of the most difficult questions to answer. I feel just about normal aside from a couple of sleepless nights from side effects of the medications. This question is really about what is going on inside of me. I can only tell you what the professionals are telling me. First of all my oncologist said that if he didn't have it in black and white in front of him that I have myeloma he would think that I was a healthy person. I am not suffering from any outward ill effects. He also has never had myeloma detected in this early a stage in his career. I have had 2 chemotherapy treatments. They are on Thursdays. I have labs before each one to see if the chemo is working. The nurse looked at the lab report before my second treatment and said a lot of things that boiled down to "good". Things so far are moving in the right direction.

Spiritually. This summer I taught a class on God's grace. One of the lessons was on II Corinthians 12:7-11. The themes of this passage are that God's strength is made perfect in our weakness. Therefore we are to take pleasure in sickness that the power of Christ may rest upon us. I taught this lesson and it looks like I am now in the lab trying it out as a practical application. We made a cake to celebrate this condition and have instituted a theme song as well. Along these lines I would like to state that I cannot fight this. God has made our bodies into incredible healing machines. We have discovered over the years more and more of God's ways which enhance the healing process. I am depending on God to control how my body reacts to treatments. God can also reach down and heal outside of the realm of the normal physical universe which I also am hoping He will do. Either way I am a spectator as I watch God work. My main involvement is to follow the directions of the professionals around me and most importantly to pray. More on prayer later.