The Chicken or the Egg?

Which came first, the chicken or the egg? 

Which comes first, chemotherapy or surgery? 

When you are going through a process like cancer treatment, you don't necessarily know what others have done or why.  You don't know that you are doing something different.  You assume everyone has done the same thing.  

When I went to see the plastic surgeon who will be doing my reconstruction, he indicated that he generally sees the patient for surgery before the chemotherapy has been done. 

Two weeks ago at a coping with cancer class, I heard several women say that they had surgery first. Actually all of them that I heard from said they had. I was asked why I had chemotherapy first, and I could not think to articulate at that moment all the reasons why. 

I began to write about it but then set that topic aside.  

Last night I was asked by another couple, who said that they had been asked by others, so I decided to revisit the topic. 

Why did I do chemotherapy first? 

First, doing chemotherapy first would allow for clearer margins for the surgery. When surgery is done, they want to ensure that they remove all the cancer and that there are no stray lines.  They want to know that they have cleaned the body out. Chemotherapy allowed for shrinking of the tumors to allow the surgeon to clearly see the margins.

Second, my body was stronger to handle the chemotherapy. Some have been amazed that I have handled the chemotherapy so well. While the greatest reason for this has been all the prayer support, it is aided by the fact that my body was not already weakened by surgery.  I have gained weight, which surprised some people, but this is actually common with chemotherapy for breast cancer.  While I have lost almost all my hair, I still have most of my eyebrows and eyelashes, which is not common with my chemotherapy drugs. My strength and ability to bounce back from treatments has been better than expected. 

Third, chemotherapy before surgery allowed us to see that the chemicals were actually doing their job. If we had removed the tumors first, we might not have known that the drugs were having any effect. Instead, the doctor was able to tell that the tumors were shrinking to the point of having nothing to really palpate toward the end of treatment. 

Fourth, chemotherapy was going to be required if the cancer was in the lymph nodes. At the time that we started chemotherapy, we did not know for sure that it was, because we were still waiting on results from the lymph node biopsy. When we got the results, it confirmed that we made the right choice because the cancer had begun to spread to the lymph nodes. 

In conclusion, there was no scenario where my oncologist was going to feel comfortable with me not having chemotherapy.  For my surgeon's sake, she could have done it before chemotherapy, because she is just that awesome, but the clearer margins will hopefully make her job easier.  Personally, doing chemotherapy allowed me to use my best strength for what could be the most taxing and gave me peace of mind that the chemicals were not going into my body for no reason. Over time, it was revealed to be the best and wisest decision for me.  

So....

Why a bilateral mastectomy if the tumors have already shrunk? 

The first surgery option is a lumpectomy, where they merely cut away the actual tumors. In my case, more than one tumor and their spacing in different areas of the breast meant there would be too much cut out.  Thus it would make more sense to go straight to a mastectomy. 

 

While choosing to just have the infected breast removed was an option, there was still a ten percent chance that the cancer could come back in the other breast.  I am thankful that I was able this time to get to the doctor overseas, who had wisdom to know I needed to get the tumor taken care of as soon as possible. I cannot be certain that I would get to a doctor next time before it spread even further.  So having a bilateral mastectomy seemed to be the best route to prevent a reoccurrence that might have more complications and would take us away from overseas service yet again. 

That couple that I was talking with last night helped to confirm that decision for me. They were serving overseas when she had her first breast cancer diagnosis. She had been treated with radiation and moved on. Five years later, she was diagnosed again. At that time, she had a bilateral mastectomy. She, as with so many other survivors, has been so encouraging to me, but her husband has also been a great help to prepare Rich for his duties once the surgery occurs. Yes, bilateral mastectomy is the way for me at this time. 

Bad Situations, Good Results

Another title could be, "Yes, I am Human," because this is about some very real emotions, which are not always reliable and have to be worked through to get to truth.

Have you ever had someone frustrate you so much that you do something you should have done anyway?  Today I apparently needed a fresh look at my situation, but I did not like how it came about.

In middle school, I had a teacher that made completely chauvinistic remarks. (I will not say what school or his name, since I think he still teaches there.). It provoked my friends and I to say that we would succeed in order to prove him wrong. Yeah, maybe that was his plan, but it agitated us into it rather than inspiring us. 

When Rich and I as a young married couple began feeling called to serve overseas, we went to talk to a consultant who worked with a company for overseas service. Instead of inspiring us and helping us to know what we needed to follow where we felt God leading, he caused me to doubt my salvation at most and the legitimacy of my baptism at the least. It lead me to reflect and seek clarity on my conversion and baptism, which was good, but the reason I got there was not pleasant. 

I have had lots of excuses for not going bald in public, since we shaved my head. 

I am using head wraps and scarves because that is what I am used to overseas. 

People are uncomfortable enough with me in a scarf, so I don't want others to feel uncomfortable. 

Et cetera, et cetera.

But deep down, 

I was thinking of the woman who went out to lunch with her husband, and the waitress called them "gentlemen."

I was scared to look too manly, I.e. look like my brother, who is a handsome man but not who I want to look exactly like. (One of my children said they did think I looked like him at first.) 

Et cetera, et cetera. 

On the other hand, I have been encouraged by some amazing women who have walked this road before me. One even saying that she was told to say, "screw it," to those who had issues with her being bald. She said she could not say that, but she was told to think it.

Today a comment was made that brought me to tears, heaving ugly tears.  It does not really matter what was said or who said it.  Unfortunately, I will be hearing them in my mind for a long time. (Even when you forgive, the hurt does not easily go away.)  I wanted to say some really nasty things to and about the person who hurt me.  However, as Ecclesiastes 3:7 says, there is "a time to be silent, and a time to speak." There in my emotion was not the time to speak.  I wanted to slap someone, and I don't mean a Gibbs' slap. As Aunt Em from The Wizard of Oz said, "I've wanted to tell you what I've thought of you, but, well, now, being a Christian woman, I can't say it."  I finally got to the "I'll show them" phase, which is the point at which I touched up my makeup and posted the picture of me for all of Instagram and Facebook world to see.  I really should have done that a long time ago, like my husband wanted me to do.  I did not like the situation that brought me to that moment, but I am so glad I did it! 

As I worked through the four stages of grief as a result of this offense, I came to a full acceptance of the situation. 

Yes, I am bald!

Yes, I will be having a surgery in less than two weeks that will remove my breasts! 

Hair and breasts do not define who I am! 

I am a child of the One True King! 

I am beautifully made in His image! 

I am an Overcomer, just like every one of my sisters who have battled this terrible disease!  

No matter how many times you hear, "this is the one to have if you are going to have one," or how many survivor stories you hear, the very real threat of losing one's life when you see others who have not won their battle does not go away. 

I am mortal! Maybe I will beat this cancer and live a long life. Maybe I won't. But either way, My God is the One True King and my life is in His hands! 

Waiting Well

Waiting. It is not a strength of most humans. The phrase "wait for the Lord" is used eleven times in scripture. The first time it is used follows the phrase, "why should I." Most of us have asked that at one time or another.  "Why should I wait?"  Many have asked specifically, "Why should I wait for the Lord?"

Let us look at how things worked out for some people who did not wait for the Lord. 

Let us start with Abraham. God promised to make his descendants like the stars of the sky while he still did not have one child. After waiting for years, his wife suggested the use of her maid as the vessel through which the blessing would occur, and he went along with it. Within his home, it created great strife, which continues today in the descendants of this man. God gave him the son He promised twenty-five years after the promise, but not without consequences. Waiting is hard! 

Our second example is Joseph. God gave visions of grandeur to Joseph, who subsequently shared these visions with his siblings and parents. For the life of me, I cannot figure out why his brothers did not like the idea that they would one day bow down to their younger brother. (Wink wink) Joseph then suffered being sold into slavery at the hands of his brothers and then imprisonment after being falsely accused by his employer's wife. God fulfilled the vision, but the road to it was not easy. Waiting is hard!

Third came Moses. God's people had been enslaved and had been crying out for deliverance. God sent Moses to be born in the midst of this and provided a way for him to be saved from death. Forty years later, Moses tries to take on the role of defender of the Israelites by killing an Egyptian. He marveled at the fact that the Israelites he encountered did not understand that he has there to save them. He fled for his life to the wilderness where he became a shepherd for forty years. Then God called him to deliver His people and gave instructions as to how it was to be done. Moses tried to make excuses as to why he could not do it. A very different man from the one who tried to deliver by murder. God had work to do in Moses' life. Waiting is hard! 

These examples are not the only ones, but you get the idea. Now of the eleven uses for the phrase "wait for the Lord," seven are found in The Psalms, which were written by David. David was by no means perfect, but he does show us how to "wait for the Lord."

Saul was king in Israel and yet he disobeyed the Lord. Because of his disobedience, Samuel was sent to anoint the next King. The Lord told Samuel to anoint David, a shepherd boy. Once this was done, the Spirit of the Lord left Saul, who began to be vexed. Saul sent for a boy to play the harp for him, to soothe his spirit. David was brought to do so. David did not tell Saul that he had been anointed but rather served the king. When Saul and the Israelite army went to battle, David went back to his family and cared for the sheep. David's father sent him to the battle to take food to his brothers and bring news from the front.  David heard Goliath taunt the army of God and  volunteered to go fight. As a shepherd, David had slain a bear and a lion to defend the sheep, and he was confident that God would help him to fight the giant as well.  David had the victory that day, which also lead to the hand of Saul's daughter in marriage and friendship with Saul's son. Saul grew jealous of David and sought to kill him. However, David would not lift his hand against the king, though he had more than one opportunity to kill him. David sought to "wait for the Lord" even when his life was in danger. 

The last three uses of that phrase, "wait for the Lord," are as commands found in the book of the prophet Isaiah. Isaiah prophesied many things regarding The Messiah and His coming.  After the prophets spoke, God seemed to be silent and the people waited 400 years for the Promised One.  Then when Jesus did come, He was not what the people expected. Jesus was also very concerned about waiting until His time had come. As Luke 2 shows us, He knew He was to be about His Father's work, and yet He lived in subjection to Mary and Joseph as His parents. 

I have found myself waiting a lot lately.  I wait for the next treatment.  I wait to find out results.  I wait with preparation for surgery.  I wait for us to return overseas, and it gets harder every time our time to return gets pushed back by this treatment process.  Waiting is hard! However, God will fulfill His promises and plans if we will but wait for Him. 

We Do our Part. He Does His.

Last Thursday was one of THOSE days. My morning had been a little busy but good. Then William had come home without his sweatshirt or his coat, meaning he was going to have only a small jacket to wear the next morning. I got back home with William from the dentist before Rich made it home from Mariama's guitar class, so I got started on dinner. Unfortunately, I did not do it the way Rich had planned, so he was disappointed and I felt bad. Since Mariama had some issues making right choices on Wednesday, I felt like I had to follow her around to make sure she made right choices. Every time Rich and I tried to shake off the frustrations, something else would happen to aggravate us again.  One of those days when none of it is really bad, but the combination just makes the day hard. 

Then it was bedtime. It is probably my favorite time of day, because we get to talk with our children. I was working on putting the girls to bed and walked by William's room. I was shocked to find him reading a book, not that I was shocked to see him reading a book, but rather shocked that he had already finished reading His Bible. I asked if he had already read his Bible. He said he had but my gut told me differently. I asked if he had really read or simply skimmed. I just kept looking at him. He said that he could look back over it. He then admitted that he had only read the section headings.

I was so upset! He had lied to me! He had disrespected me! He disrespected God! 

After taking my shower to settle down, I went back in William's room to talk with him. He apologized and confessed to having read only the section titles for a while now. Once again, my heart was broken, but it made me feel better that he confessed and that he asked for forgiveness. Then the conversation got deeper....

William said that he he has been struggling and has been asking God for help, but he does not feel like God is answering. I tried to help him see some answers that I knew about already.  I also reminded him that God promises, "seek and you shall find, ask and you will receive, knock and the door shall be opened." God promises to answer but we must first seek, ask, and knock. We cannot expect God to answer, but not do our part, basics such as reading His Word. That is like a farmer expecting a field to produce a crop without going to sow the seed (or a man asking God for work but not sending out resumes or getting out to apply). We have to be obedient to what we know to do. God is ready to answer.  However, we might not be hearing if we are not reading His Word, or maybe He is answering in a way we do not expect. 

He began to see my point.  Then it was time to pray before bed. I asked him to pray first, and then I would. He confessed to the Lord and kept asking over and over again if God could forgive him. I let him finish his prayer while I stepped out to grab my Bible.  I turned to 1 John 1:9. "If we confess our sins, He is faithful and righteous to forgive us our sins and to cleanse us from all unrighteousness."  When he finished praying, I read this verse to him. Then I talked with him about what it means to confess.  True confession involves admitting our sin (be it doing what God has told us not to do or not doing what God has told us to do), understanding why it is sin, and desiring not to repeat that sin again.  So if we truly confess, then we can be confident that He forgives us because He is faithful and He keeps His promises. We do not have to wonder if He can or if He will, for His promise is there. What a comfort! What joy! What confidence! 

Friday was a new day and we enjoyed God's mercies, which are new every morning. He still had to suffer consequences for yesterday, getting out in the freezing cold to go to school without his large coat, but thankfully yesterday's unrighteousness was washed away. 

Today, I got the pleasure of taking William to school and sitting in on their chapel time. I recalled the above story as we sang "There is a Fountain." 

"And sinners plunged beneath that flood lose all their guilty stains." 

Surgery and Reconstruction

To reconstruct or not reconstruct, that is the question!

(Warning: content may be uncomfortable for some readers.)

I would be lying if I said that I have never even faintly considered breast augmentation of any kind. After nursing three children for a year each and gravity taking its toll as I get older, I actually debated a few years ago on whether it would be something I would want. (Not to mention, living where it is so hot, that any extra piece of clothing I can eliminate would be a relief.)  However, I came to the conclusion that I could not in good conscience have that type of surgery while trying to teach my daughters to love how God created them and their bodies. In addition, they are two of the three reasons why my body does not look like it used to, right? I also felt it was not prudent financially. 

This July at my yearly physical is when the tumors were detected, and I was subsequently diagnosed. This was the same doctor who delivered both my girls. Two years ago at my checkup, this same doctor asked if we were done having children. I said we were. I had also been eating right and exercising, causing me to be the fittest and thinnest I had been in a long time. This doctor told me I should tell my husband to get me new breasts, since the children had taken mine away. (I texted this suggestion to a friend of mine who asked if I told the doctor to tell his wife to get him a new brain.) I knew that I had already privately been through this debate myself and was able to dismiss it.  

Now two years later, I am fighting breast cancer and looking at a double mastectomy to make sure that all the cancer is removed and to reduce the chance for it to return in the other side. As a result, I am looking at breast reconstruction. While I know that having breasts does not define me as a woman, I do like having a feminine figure. I also know that my husband would love me either way, with or without breasts.  

This week as I prepared for my appointment with my plastic surgeon, I began to debate which option would be best for my ministry and God's glory.  Does God even care what I do about this? Would not having breasts but my husband still loving me be an opportunity for greater testimony as I return to West Africa? How can I think of something so "frivolous" when I am already so blessed medically compared to the options for the women where we live? Through the insight of my friend I mentioned earlier, I realized that most of the women would not even understand. It is not like they are going to see them anyway.  For those that might understand, if they knew the option was there, they would probably wonder why I did not have it done. I drew the parallel for myself along the lines of air conditioning. The people there do not have it because they cannot afford it, but they think we are crazy if we do not have it. (Much simpler subject I know but still a topic of debate among coworkers.)  If I have air conditioning to help me sleep to function better in ministry, then why not have reconstruction for my own mental well being to enable me to function better? The downside is that it possibly pushes our return to the field out a little farther. I was so not happy about this, but my husband reminded me that it is not my timing, but the Lord's. I was less than grown up in my response to him, but he was right. 

So once again, as I checked in with my oncologist before my chemotherapy this week, he said all my levels were good and examined me for any sign of tumors. Despite much searching and pressure, he could not find them to measure them. My last chemotherapy is in two weeks, so he said scheduling surgery in four weeks would be great. It is currently scheduled for four and a half weeks, on December 9th, with my breast specialist who is the surgeon and with the plastic surgeon. I still have time to change my mind regarding reconstruction, but this is where I am at right now. 

Your prayers are much appreciated as we approach surgery and for peace as we get closer to it. I have never been in the hospital overnight, with exception to giving birth to my children, so this does cause some concern, in particular for being away from my children and any anxiety they might have. 

Neuropathy in The Body

"Peripheral neuropathy is damage or disease affecting nerves, which may impair sensation, movement, gland or organ function, or other aspects of health, depending on the type of nerve affected."

A common side effect of the chemotherapy medication I am on now is neuropathy. For some, it is more directed at the feet. For others, it may affect both hands and feet. For me, it seems to be more directed at my fingers. After the first round, the fingers on my right hand seemed to be numb a lot. After round two, it seems to be in my left hand as well, though not yet as strong as in the right.  

I looked up the definition stated above.  A spiritual analogy came to mind. 

We as believers are the Body. When the disease of fear or injections of negativity come into the Body, it often results in numbness, apathy within the rest of the Body. The parts which serve fail to sense the need and thus do not fulfill their tasks.  We must be vigilant to keep the Body healthy, so that we do not become apathetic. The origin of the infection within the Body may deny its responsibility for the inactivity of the hands and feet, however we must all as part of the Body beware of how we are causing neuropathy in the extremities. It can be easy to point fingers, but we must examine our contribution or lack of it. We must be going out beyond the Body in the shoes shod with the Gospel to those still needing to hear the Good News. We must reach out our hands to the world hurting and in need. 

Yesterday in the morning cold of the race, both hands became so cold that I could hardly feel them at all. As they thawed, the numbness remained in the pads of the finger tips. Praying that the numbness in the Body will just be from the cold and will become active again as the Body thaws in the presence of the Light.      

I Hate School!

What student hasn't said that before? More specifically, what middle schooler, sixth grader even, has not said those words at one point or another? 

Last week, my daughter told me that her brother felt that way. I inquired of him whether that was true. He confirmed that he indeed felt that way. 

I expressed doubt about the truth of that statement. I told him that his teachers at parent-teacher conference said that he is an eager learner and one they can always count on to have the answers, in addition to being a joy to his teachers. So I asked again if it was true that he hated school.

He confessed that it was not completely true. Maybe he just dislikes school. Truth be told he mainly dislikes homework and struggles in making true friends. He said that every day is a struggle except Saturdays and Sundays. He looks forward from one weekend to the next. 

I told him that it can be easy to focus on the struggles and not see the good stuff. If look forward from one weekend to another, we miss the blessings of each day. I confessed that it could be easy for me to only look forward to returning to West Africa, but then I would miss all the blessings that God gives us between now and then. I told him that I have some really tough days, but even on those days, I find things for which to be grateful. (This conversation taking place on some of my worst post-treatment days.) 

The next morning as he got ready for school, I reminded him to look for the good things of the day. When he encountered a rough spot, think how he could change the situation, and where he cannot change the situation, he can change his attitude about it. 

This lesson sounded a lot like one we learned earlier in the year about enjoying the moments you have, because you may never have that opportunity again. However, maybe I needed the reminder as much as he did to keep pressing on and keep looking for the good things, especially on those really hard days. 

At the end of the week, while praying before bed, he changed in the middle of his prayer from "give me friends" to "give me more friends" showing he was able to be grateful for the friends he does have. This positive outlook was a step in the right direction.