Saturday, February 27, 2016

February 2016 Update

Hello everyone! Forgive me for not keeping all of you up to date for the past year or so.

Many of you know I've recently had some new health issues come up, and I'll do my best to catch you up here.

LAST YEAR

First, a fly-by of the past year and a half. My last update was in September 2014, when I began my new chemo regimen - maintenance Decitabine. Every 6 weeks or so, I went to my home clinic for a couple hours for five consecutive days. This chemo was much less toxic than my first regimen, and I went straight to work after getting my dose of poison. Thankfully, my treatment really didn't affect my work schedule at all. Most weeks, I preached the Sunday after receiving five straight days of chemo, something that would not have been possible the year before.

Throughout that year, I traveled to Houston regularly for bone marrow biopsies. (That's really the only way to monitor the effectiveness of my treatment.) In my last update, I explained about Minimal Residual Disease (MRD), and how they measure it with a process called Polymerase Chain Reaction (PCR). For the entire year, that number didn't change. It stayed at 0.01, barely hanging on, taunting me, reminding me that I was not through with this whole cancer thing. Honestly, I just resigned myself to the fact that it wasn't gonna change. I had done almost two years of chemo to no avail.

My doctor had told me that I would do this new regimen for one calendar year. I began my first round  on September 15, 2014, and snuck in my 10th round on September 14, 2015. After my levels rebounded, I headed to Houston for my next bone marrow biopsy. A few days later, I went through the obligatory process of logging into my account and checking my test results. Lo and behold, it changed! "No morphologic evidence of AML detected by Real Time PCR." I didn't know what to say! I emailed the doctor just to make sure I was reading it right, and he confirmed that this is what we've been hoping for. It was just such a good gift from God, that at a point when no more treatment was an option, He gave me this report. I went back in January 2016, and it was still clear. Yay!

LAST WEEK

Those clear reports really changed our whole perspective. For the first time since 2013, I began to live with the assumption that I was going to live a normal life. We began making longer term plans, dreaming about the future. One night a couple weeks ago, I went into the kids bedrooms while they were sleeping and thanked God that I was going to watch them grow up. My trips to Houston no longer carried dread about what we might find out; instead, they were just confirmation that I was still healthy.

I'm gonna be candid here. Men have testicles. End of biology lesson.

A few months ago, I noticed a change in my left testicle. I had noticed changes there before, and had actually consulted my doctors about it back in 2009. Tests were run, and I was assured that everything was normal. Dealing with something like leukemia has a way of causing you to neglect other health concerns. Like, "I'm doing chemo. I'll deal with this later." One day last month, I went with Karen to an ENT appointment she had, and the Urology desk was next to hers. I went over and made an appointment on a whim. She told me to come back the following Tuesday.

The following week, I showed my urologist what I had found. He ordered a testicular ultrasound (always a fun experience!). Afterward, he informed me that it wasn't a cyst. His gut was that it was cancerous. "I'd just take it out," he said. "We would know more after that." I honestly wasn't very phased. After Leukemia, testicular cancer didn't seem all that daunting to me (it has like a 98% cure rate in most cases). More of a nuisance than anything.

That afternoon, I emailed my doctor's team in Houston. "Off-topic question," I said. I explained what we had found and why my doctor here had suggested. He wrote back within five minutes (not a normal occurrence). "This isn't off topic! I strongly suggest you come to Houston for tests. We need to rule out the possibility that this is a leukemia relapse."

My heart sank when I read that. But I felt confident in a few things: 1) My bone marrow was normal at the molecular level. How could this be AML? 2) This thing had been hanging out for a while, and I hadn't noticed much growth. My tumors from AML grew at an alarming rate. 3) My brother had testicular cancer a few months before I got diagnosed in 2013. If your brother has testicular cancer, you're 8X more likely to get it.

With all that in mind, Karen and I went to Houston feeling pretty confident and at ease. I had labs drawn, got to have another ultrasound, and then saw the doc. From the start, we feel like they've been preparing us for the worst. He knocked down all my theories as to why this wouldn't be leukemia. He said that it could present as a tumor outside the bone marrow even if my bone marrow was 100% healthy. He said there is no "normal" when it comes to these things.

Then the tumor markers in my blood started coming back. Testicular cancer would elevate these levels. Leukemia would not. One by one, they came back normal. In other words, it's not likely this is testicular cancer. Our hope began to fade. The doctor explained that the only way to get an accurate diagnosis would be to biopsy the tissue. They'd do a PET scan to see if there were any more tumors (there weren't!), but the only way to biopsy the tissue would be to remove a testicle.

So yesterday, I had surgery in Houston. It was surprisingly easy. I feel a bit sore, but good overall. Now we wait. If the pathology reveals that I have indeed relapsed with AML, we will begin preparing for a Stem Cell Transplant. This has been a dreaded scenario since Day One for me. A transplant is a difficult and risky procedure, but it is the most effective way to treat leukemia. But over the past week God has settled my heart, and I'm even ready for this.

I've been reading Tim Keller's The Songs of Jesus as part of my daily devotional, and it has ministered to me deeply. Yesterday, before my surgery, the reading was on Psalm 31. Verse 15 contains the phrase "My times are in Your hands," and it replayed in my mind all day yesterday. No matter how confusing or discouraging my circumstances are, God is sovereign over them. I trust His goodness, His wisdom, and His love for me and my family.

I am deeply moved by your concern for me. Thank you for following my story and for remembering me in prayer. I am not alone. That makes all the difference.

Monday, May 18, 2015

Resection

This is the 9th of a series of posts chronicling Chris' battle with Acute Myeloid Leukemia.

*It's been quite a while since I posted anything. I'm picking up where I left the story off in the post called "The First Couple Days." Feel free to skim that post if you'd like a refresher. As always, thanks for reading. 

GOING PUBLIC

That Sunday morning (October 20, 2013) I stood up in front of our church and told them what I knew, which wasn't much. Basically, I had some type of cancer growing in my abdomen and on my back, and that the doctors were waiting for some more information before they could decide what I had. I had been told it's "probably either a lymphoma or sarcoma," and I relayed that news to the congregation. I was honest - I told them I was scared, but that I believed two things beyond any doubt: God is strong, and God is good. 

Some people came to me after the service and told me how relieved they were to hear that it was a lymphoma, because those are super-duper treatable. (This was encouraging news at the time, but would haunt me in the coming months once I found out that I did not have a lymphoma - or really a sarcoma for that matter.) 

Someone else told me about a website called chrisbeatcancer.com. That afternoon, while the whole family was napping, I watched a video on his homepage. That ten minutes was a very important moment for me in my treatment, and one that I would recommend to anyone facing any type of cancer. God used that guy's testimony to bring comfort to my soul, and to help me breathe a bit deeper about the whole process. 

When I met with Dr. Osafo on Tuesday, he updated me on my condition. He said that the biopsy revealed the cancer to be a myeloid sarcoma, which is a tumor that sometimes presents itself alongside acute myeloid leukemia, a cancer of the blood. What perplexed him is that my bone marrow was clear, so I wasn't showing other symptoms of leukemia. He suggested that they perform a resection of my terminal ilium (they'd cut out a lot of my small intestine), let the doctors get more information about it, and then we move forward with treatment. 

I was speaking regularly to one of my best friends from college named Jason Mizell who also happens to be a surgeon specializing in abdominal cancers. I know, right? Jason actually went through medical school with Dr. Byrnes who was operating on me, so Jason was able to call him and then translate all the doctor speak for me over the phone. Jason told me that leukemia isn't usually treated with surgery, but with chemotherapy, so he was confused as to why I would take that route. But when he heard that my pain was such that I could not eat or function, he understood and agreed. We scheduled my surgery for Thursday, October 24. 

Throughout that week, my stomach pain came back in waves. It would spike, I would vomit, and then it would subside again. I called Dr. Byrnes numerous times that week asking if he would go ahead and admit me, as my pain was often unbearable. On Wednesday, he finally did. I would undergo surgery the next morning, but wasn't nervous or even concerned. Because Dilaudid. 

SURGERY

On the morning of my surgery, Dr. Byrnes came in and gave me the run down of what they were going to do to me. He reiterated that this surgery would not cure my cancer, but would buy me some time to get to MD Anderson and take next steps. He hoped to perform the procedure with a scope, but that could only happen if the tumor was pretty localized. If the cancer was widespread he would need to "open me up," which meant make an incision that looks like a big question mark around my naval. This option would be much more painful with a much slower recovery. 

I woke up a few hours later and was told that I had a huge incision that looks like a question mark around my naval. I was woozy, but remember there being a really somber atmosphere in the room. I have a friend named Debi who is a surgical nurse and was in the room when they opened me up. She has told me that my procedure was her darkest day as a nurse. When they looked inside me, cancer was everywhere. No one expected it to be as widespread and advanced as it was. They were shocked that any food had passed through my intestines at all. Dr. Byrnes removed about two feet of my small intestine, which was the most affected portion. But he said that there was still lots more cancer, and that it would grow quickly. (Debi also told me that the cancer was green, which has been an interesting fact throughout this whole ordeal). 

I didn't care about any of this at the time. All I cared about was the large tube running from my stomach out my nose that drained blood for the next two days. Is that the only way to drain a man's stomach these days?! 

The night of my surgery, the nursing staff got pretty concerned. I was so doped up on pain meds, my heart rate and breathing were dangerously low. I think I was breathing 6 times per minute. At one point I remember waking up to the nurse standing over me calling my name to make sure I was still breathing at all. They had a little mini-conference in the hall, and they they gave me some pain-med-reversal drug from the pit of hell, and it brought all my pain out into the light. I was miserable. I begged my nurse to give me a pain killer, but she was of the drill-sergeant variety and was waiting for my blood pressure to reach a certain point. Even though clouded from the anesthesia, I remember the pain. I just felt so tired of hurting. 

Looking back, I wish I hadn't had the surgery. Sure, the pain from the tumors was ridiculous and in a few days it could've killed me. But I started chemo two weeks later, and the tumors vanished almost instantly. This procedure is a very difficult one to recover from, and I was no different. Had I known then what I know now, I would have rushed into chemo treatment and bypassed the surgery.

But in the midst of suffering, we generally can't see that far ahead. I couldn't know at that time what I know now. So when we're in the valley, hemmed in by mountains on all sides, all we can do is keep walking. Not every step we take will be the best one. But still, we keep walking. By God's grace, He can use even our failures to make something beautiful. 

Friday, September 12, 2014

A Brief Update: September 2014

I'm taking a break from telling the story of my battle with Leukemia. I'd like to let you know what's going on today. 

The past 10 months have been pretty difficult for my family. But we've been blown away by the faithfulness of God manifested in our community. So I wanted to take a moment and thank you for traveling this journey with us. When you're hurt, or scared, or anxious, it makes a huge difference to know that others are standing with you, experiencing those same things. And we've felt that all along the way.

For those of you who have been walking this road with me, I want to let you know where things currently stand. So here goes...

Back in July, I finished my last of seven rounds of intensive chemotherapy in Houston. This was the same regimen I began back in November. I entered remission in December, after just one round of chemotherapy. But treating leukemia is difficult. Sending into remission is relatively easy; keeping it there is not. So the final six rounds are to "kick the cancer while it's down."

A bone marrow test in August showed that I am still in remission. There is no active cancer in my body. There is a very sensitive test they perform on my bone marrow called a "Real Time PCR" test. PCR stands for "polymerase chain reaction." They extract some marrow, and let it culture in a lab for a few days. If a certain protein is created, I have what is called "Minimal Residual Disease." In November, when I had active leukemia, this protein number would've been 100%. In December, it was 0.08%. In February, it was up to 0.19%. Then in May, 0.01%. Almost nothing. The goal was nothing.

This most recent PCR test showed the protein number to be 0.03%. So it isn't gone. Honestly, I was pretty bummed when I heard the news. This number means that I am probably more prone to relapse because that protein is present. It means that chemo wasn't completely successful to accomplish what we had hoped. This "minimal residual disease" does not necessarily mean my cancer will come back. But scientists have reason to believe that it means I am at an increased risk. This type of testing is all very new, and I'm fortunate to be a part of it.

Therefore, on Monday I'm beginning a new type of therapy. It's called "Maintenance Therapy," and it's basically a really light chemo dose still designed to chase down those last few cells that are creating the protein. I will be treated in Ruston, which is a blessing. A round is five days of treatment, an hour a day. I'll repeat that about every four weeks, up to 12 cycles. My doctors have told me that I will probably not notice any side effects. I'm hoping to work full time this year, which I'm really excited about.

Please continue to pray with me. I'm asking that God would completely heal me, that the protein number would be 0.00%. I'm trusting in His strength, in His wisdom, and in His goodness.

Also, please pray for Karen. I'm convinced that this journey has been much more difficult for her than it has been for me. She's an incredible wife, and an incredible mom. Pray for her strength and peace.

Finally, pray for our kids. I'm hoping that this whole ordeal is a tiny blip on the radar of their childhood memories. That they always remember a healthy dad who was present with them. May they see in their dad someone who lives by faith, and may that faith take root in their souls as well.

Feel free to use the comments section for any questions you may have. I'll do my best to answer what I can here. 

Sunday, July 20, 2014

The First Couple Days

This is the 9th of a series of posts chronicling Chris' battle with Acute Myeloid Leukemia.

The first night of sleep after finding out you have cancer is not a good one. Counting sheep apparently works better than counting scenarios. Friday morning arrived slowly, as I tried to digest the new reality of my world. I have cancer


Life-shattering news aside, I really didn't sleep well. My back was aching, and I didn't know why. I walked into the kitchen and asked Karen to massage a knot. She started to, but then stopped abruptly. She didn't say anything at first, and lifted up my shirt to inspect more carefully. "This isn't knot," she said. "It's a lump." 


I ran to a mirror, and there it was. On the right side of my back, just below my rib cage, it looked as though someone had surgically implanted a racquetball under my skin. My heart sank. Karen and I told each other that it could be anything, but I knew what it was. I had no idea what was happening inside my body, and I had no control over it. Looking back, it's still amazing to me that I never noticed the lump before I found out I had cancer. 


On the bright side, I already had an appointment scheduled Friday morning with an oncologist. What are the odds?! Karen and I made the same drive to the clinic that we had made one week earlier, this time under very different circumstances. We checked in at Dr. Byrnes' office, and he walked us down the hall to meet the oncologist, Dr. Osafo. Originally from Ghana, Dr. Osafo has become somewhat of a fixture in Ruston, cycling and saving lives. He is a man with no enemies. 


I love Dr. Osafo. There haven't been many times in my adult life when I was truly terrified; this was one of them. But he gave me and Karen a sense of confidence and calm, to know that there are actually people in the world who could help me. I had been living in a cloud of worry and sadness for the past 18 hours, but Dr. Osafo was upbeat and happy. It's amazing what simple kindness can do for someone in need. 


Dr. Osafo told us we needed to do a bone marrow biopsy. This guy had my trust, so it didn't seem like a huge deal when he turned me up on my side and shoved a huge needle to the center of my hip bone. He said he extracted some marrow from my hip, but it felt like it came from my toes. That marrow would help us nail down a diagnosis. 


The bone marrow results would come in on Monday, and Dr. Osafo asked us to come back then to move toward a treatment plan. Before we left, I asked, "Dr. Osafo, I don't know anything about cancer. How serious is this?" He answered, "We have to assume it's very serious." 


That weekend happened to be Louisiana Tech Homecoming. My brother Patrick's family were coming in town for the festivities, which turned out to be a huge blessing. Rather than sit around and worry all weekend, I would be watching my kids play with their cousins, attending a football game, laughing, and being with family. 


The football game was cloudy and cool. I sat in the cold metal stands, feeling detached from the noise and activity around me. I thought about how much time I had spent at that stadium. Sitting in section DD, Row 35 with my mom as a little boy. (Dad was always working at football games.) Through those awkward adolescent years, I'd run to the far corners of the bleachers and sit with friends, far away from the shackles of authority and oversight. In college I switched to the East Side, where we'd stand through the whole game and scream our heads off. Now we had progressed back to the Old People Side, as Karen and I tried to wrangle kids of our own. I wondered if this would be the last season of Tech football I'd see. (If you watched last season, you know how great a tragedy that would be.) The thoughts, and the breeze, brought a chill to my core. The shivering accentuated the sharp pain in my back, which was never far from my mind. 


After the game, we took Jude and Owen down to the field - a treat they only get at these rare daytime games. They love seeing the turf up close, standing on the logo, looking back up into the seats, dreaming. I had sat for three hours looking at the life through my eyes. It was good for me to see it through theirs. We threw the ball, chased each other, fell down...


What's life for if not for living?


Saturday, July 12, 2014

Finding Out

This is the 8th of a series of posts chronicling Chris' battle with Acute Myeloid Leukemia.

Thursday, October 10

"Hello?"

"Chris, it's Dr. Byrnes."

"Hi, Dr. Byrnes. Thanks for calling."

"We finally got your biopsy results in from the reference lab. Again, I'm sorry it took so long. I don't have very good news. Basically what we know is that it's some form of cancer. The lab identified your tissue as either a lymphoma or a myeloid sarcoma, but we'll need to run some tests to know exactly what type of cancer we're dealing with. I need you to come to my office tomorrow morning at 8am, and I'll walk you down to meet the oncologist, Dr. Osafo. We'll start answering questions tomorrow."

"Ok, thanks for your help, Dr. Byrnes."

"Bye."

I hung up the phone, and just sat there. It's funny the things you remember in those moments. I was on the white recliner in my living room. It was a bright afternoon, and the sunlight flooded in through the blinds and bathed the room in light. I remember the peaceful whirring of the ceiling fan over my head. I have cancer. For the next few days, that was the thought that I simply couldn't shake from my mind. Is this real life? I had a thousand questions, but honestly, I didn't really feel like doing much research on the subject. I have cancer.

I should tell somebody. News this big isn't something you should keep to yourself. Karen was gone picking the boys up from preschool; besides, I wanted to tell her face to face. So I called my brother and told him. Then I called my dad. I told them what I knew, which wasn't much. I don't remember many specifics of those conversations. I was in shock.

A few minutes later, I heard the garage door opening. How do you tell this kind of thing to your wife?  This new reality was going to impact her life more than it would my own. I met her in the garage as she pulled the car in. She stepped out, and knew in an instant that something had happened. The kids were still strapped into their seats.

"The doctor called."

"And?"

"It's cancer."

I think we hugged for a minute. It's a really significant thing, but one that is easy to overlook: whatever we were walking into, we would walk into together. That changes everything. We pulled the three kids out of the car, unpacking them into this new reality of our lives. Karen tried to tell the kids that we just found out that Daddy is really sick, and the next phase of our lives would be different and challenging. They wanted a snack.

I wanted to tell the guys at church. So I drove to the office and asked all the staff guys who were there if I could talk to them for a minute. I can't remember who all was there. I think Skin, Len, Jeremy, Jason, and Sutton were there. Maybe Slate.

"Well, it's cancer."

I watched as the news sunk in. Me having cancer would impact these guys nearly as much as it would my own family. I was transitioning into an expanded leadership role at church. Sunday morning was my primary area of leadership. I was going to preach half the time, and lead worship half the time. I would mentor Sutton as he discerned the next steps for his life. These guys weren't thinking about how my absence would impact their plans, but I was. I thought about how thankful I was to have a group around me as strong as this one.

Skin was the first guy to say something. He's the best pastor I've ever known, in the sense that when you're walking through something, you really feel that he's with you. All he said was, "We're all terminal." Three words. I'm not even sure why those words comforted me. Looking back, they don't seem all that profound, or all that comforting. But in that moment, he took the fear I was dealing with and reminded me that we'd all face it at some point. I wasn't isolated. I wasn't alone. I was just like everyone else. It was a powerful thing for me. We prayed together and then I went home.

That night I had a phone conversation with my primary care doctor. Jake is a friend as well as a physician. So when he heard the news, he gave me a call. He knew I was scared, and he knew that there weren't many questions that had answers. He gave me some clarity about lymphomas vs. sarcomas. I asked him which one I'd rather have, and he said, "I think you'd prefer a lymphoma." Uh oh.

"Am I looking at chemotherapy?" I asked.

"Probably, but your oncologist can tell you for sure."

"The next phase of my life is going to be pretty difficult, isn't it?"

"I would think so. I'm here if you need anything."

"Thanks Jake."

I went to bed, full head and heavy heart. I stirred most of the night. Each time I woke up, there was an optimism, a sense of relief that maybe this nightmare had ended. Then the fog would clear and I'd realize this is my life. I have cancer.

About halfway through the night, I began to be bothered by an aching in the right side of my back. Great. I have cancer, and I slept funny and have a sore back. Insult to injury.