The connection between Hodgkin’s Lymphoma and COVID-19

In 1666 an Italian physician named Marcello Malpighi published the first known description of Hodgkin’s disease, documenting a progressive disease of the lymphatic system which would ultimately invade the spleen leading to death. More than 150 years later the English physician Thomas Hodgkin would describe the disease in much greater detail – an accomplishment for which the disease would come to bear his name. These men did not fully understand the disease they are credited with discovering, but they both knew it was an invariably terminal illness. For nearly 300 years doctors were increasingly able to identify the disease, describe its progression, and inform parents of this disease’s predominantly young victims that it was a terminal illness. The one thing doctors could not offer was a cure.

As a parent who has lived through the hellish nightmare of hearing your child has been diagnosed with a deadly, if usually treatable disease, I can only imagine what it must have been for centuries of parents before me who were told no treatment was available for their child. The desperate cries of those past parents begging God for a cure ring loudly in my ears.

The bombing at Bari, Italy where Nazi warplanes sank 17 Allied ships and clouds of black smoke tainted with mustard gas led to at least 1,000 casualties.

During WWII, German bombers attacked a harbor of Allied warships at Bari Italy and in the process destroyed a US ship carrying 60,000 lbs of mustard gas. A large number of American and allied troops were exposed to the gas, causing severe health issues and death. Doctors caring for the affected soldiers noticed a marked suppression of their immune systems and the first seeds of a cure for Hodgkin’s lymphoma were planted. For the next 20 years doctors experimented with variations of mustard gas and its derivatives in search of a treatment for Hodgkin’s lymphoma. This research led to some of the first forms of chemotherapy and, although cures for Hodgkin’s lymphoma remained elusive, it made the path to a cure seem achievable. In 1963 the medical world reversed their long-held view and declared Hodgkin’s Lymphoma should be considered a curable disease. Later that year the first chemotherapy trials would commence with 43 Hodgkin’s patients. The trial was concluded 3 years later with 35 of the 43 patients remaining in complete remission. 50 years later a refined version of this same chemotherapy was the mechanism by which my son would be cured when he was diagnosed with Hodgkin’s lymphoma. God had answered the cries of centuries of parents for a cure, but in His own timing. Through a tragic and serendipitous circumstance, God provided science with just the knowledge needed to find the cure. I became the beneficiary of those past parents’ prayers, those suffering soldiers, and the brilliance of scientists who pressed to find and refine the chemotherapy Drew would receive as a cure for his cancer.

Don’t let them put that poison into your son

When Drew began chemotherapy, a few of my closest friends arrived and filled the role of Job’s friends in my life – they loved me and were hurting with me over Drew’s diagnosis. They were true friends who meant well, but they came to offer poorly informed and badly misguided advice. Their requests were all the same – they were advising me to get Drew to stop his chemotherapy treatments. One friend put it bluntly, chiding me “Don’t let them put that poison into your son.”

The 4 chemotherapy drugs Drew received every other week over a period of 6 months

Their reasons were varied and most were so disconnected from reality they don’t deserve repeating. Yet they are repeating. The same lack of perspective and common sense which had people thinking Drew would be better off without chemotherapy is the same absence of coherent thought which has people avoiding the COVID-19 vaccines. The reasons people presented for why Drew should stop chemotherapy were all demonstrably false. Literally every reason I have heard articulated for not getting vaccinated against COVID-19 is also logically flawed or demonstrably false. But unlike Drew’s treatment, where opting out would have health consequences only for himself, opting out of the COVID vaccine is really about the consequences of that decision for others.

Hodgkin’s lymphoma is a blood cancer. It is a cancer specifically of the white blood cells called lymphocytes which make up a part of the body’s immune system. Cancerous lymphocytes with mutated DNA reproduce, grow to many times their normal size, skip their normal pre-programed cell death, and eventually choke the body’s lymphatic system to the the point of fatality. In order to treat Hodgkin’s lymphoma, a person’s immune system has to be largely destroyed. Killing off all of the lymphocytes (both normal and mutated) lets the immune system reset and rebuild itself with new and healthy white blood cells. This is what the chemotherapy treatment for Hodgkin’s lymphoma accomplishes. Other blood cancers like leukemia and other forms of lymphoma are similar in this regard, and the standard protocols for almost all cancers will result in some level of compromise to the immune system during and in the months after treatment. For Drew, we were told even a common cold could be dangerous. We were also told his cancer treatments would wipe out his immunity to other illnesses like chicken pox, measles, etc. On one hand you have a 19 year old who still wants to have some amount of life. Still wants to see his friends. Still wants to go out and have a nice dinner on an evening when he is feeling well. Still wants to go watch a soccer game. On the other hand you have parents who are trying desperately to cure their kid from one terminal illness while avoiding something truly ridiculous like successfully treating his cancer only to see him lose the battle to something as benign as a common cold.

A mutated lymphocyte – the Reed-Sternberg cell of Hodgkin’s Lymphoma

I have no interest in experiencing COVID-19 simply because I hate being sick, but I am not really fearful of it. At least by one online calculator’s estimate, my chances dying after contracting the virus are 1 in 179 or 0.557%. That’s a long ways off from the 100% death rate of Hodgkin’s and is not something I am overly concerned about. And this is one of the most common arguments I hear for why people don’t want to get vaccinated – they just aren’t too worried about the virus being consequential for them. If this is how you are feeling, I would ask you to consider getting vaccinated for the sake of everyone else. That’s why I chose to be vaccinated. There really are people out there who need you and I to do this. People who cannot be vaccinated themselves. People who don’t have an immune system which makes COVID just a minor inconvenience or a just a week of not feeling well. People for whom COVID is a real threat. People like Drew was a few years back – just trying to survive cancer and undergoing a treatment that compromises their immune system. For these people, the COVID-19 vaccines are an answer to prayer. Facing a virus which poses a real danger to them, but unable to take the vaccine due to their own fragile health. The vaccine is still their cure for the COVID-19 virus, but only when you and I are willing to take it.

I received the first dose of the Moderna vaccine a couple weeks ago, picking up a dose from someone else who missed their appointment.

For all the other reasons people are avoiding getting vaccinated…

  • The vaccines are experimental and did not get the usual testing before being approved
  • The vaccines have caused deaths and are not safe
  • “5G chips” are imbedded in the vaccine
  • Bill Gates is using the vaccines to gain global control
  • Big pharma is using the virus to enrich themselves
  • The vaccines contain cells from aborted fetuses
  • You can get COVID-19 from the vaccine
  • The vaccine is the mark of The Beast
  • etc

If you hold any of these views, I encourage you to step back from whatever sources of information you have been relying on and get a fresh perspective from trustworthy sources. Peer-reviewed sources. None of the above reasons will hold up as a reason not to be vaccinated when they are subjected to any kind of a logical cross-examination.

So even if you have no interest in getting vaccinated for yourself, I am asking you to get vaccinated in fulfillment of the command to love your neighbor. Do it for the kid down the street and for the elderly woman you will run across next month in the grocery store. You and I getting vaccinated for those who don’t have the luxury of being able to to get the vaccination to protect themselves is the ultimate act of love. But if you need some selfish reasons, there are plenty of those to consider as well. Get vaccinated so you won’t get COVID. Get vaccinated so we can get the government and all their rules off our backs. Do it so schools and churches and small businesses and travel and sports and concerts and everything that makes up our life can return to us again. Unless there is a reason why you can’t, please just go get vaccinated.

A postscript: There really may be a direct and important connection between Hodgkin’s lymphoma and the COVID-19 vaccines – more than just the philosophical and moral connections described above. The mRNA technology used in the Moderna and Pfizer-BioNTech vaccines is the first successful application of a new medical technology which has been described as one of the greatest medical advancements of the past 100 years. The same mRNA mechanism that lets these vaccines train the immune system to specifically target the SARS-CoV-2 virus can and is being used in trials to train immune systems to specifically target cancer cells. Using mRNA in this way may result in a cure for cancers that is as simple as getting a vaccination. This has the potential to end the need for chemotherapies, providing more effective cures with little to no toxicity to the body. In this way, there may be a very real and tangible link between Hodgkin’s lymphoma and COVID-19.

Go Ye Into All The World – Nicaragua by Drew Hale

I still remember the waves of reality that crashed over me the first weeks after arriving in Nicaragua.  I walked through the halls of our university, saw hundreds of students in need of salvation, and realized the fear of rejection and judgment is just the same here as it is when walking campuses back home. I set foot in my first barrio, saw the desperate poverty of a typical Nicaraguan family, and realized my coldness of heart is just the same here as it is when passing by the homeless and hurting on the streets of Seattle. I grew more comfortable with my Spanish, began to preach simple gospel messages, and realized the strength and prevalence of the temptation for pride is just the same here as it is when sharing a message in the Clearview Gospel Hall. Day after day, I have been impressed by the struggle to consecrate myself to the Lord’s work, to answer the call He has laid before me, and to avoid disqualifying myself from the works He is ever preparing for me.

Read Drew’s full post at A Daily Devotion at the link below.

Source: Go Ye Into All The World-Nicaragua – a daily devotion

I don’t blog anymore, but…

This light momentary affliction is preparing for us an eternal weight of glory beyond all comparison, as we look not to the things that are seen but to the things that are unseen. For the things that are seen are transient, but the things that are unseen are eternal.  -2 Corinthians 4:17-18

 

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Drew and Jordan head off to catch their flight

News on this blog, both good and bad, has revolved around cancer. With Drew’s illness now a more than two years behind us, I’ve been happy to retire from the ritual of ‘blogging’ and let this site stand as a testament to something God brought our family though – something historical. The problem with this thinking is that God doesn’t work in finite or constrained ways, and certainly not for the sake of momentary blessings or for the creation of historical records.

Our God is eternal and He sees things in a forward-looking, eternal context which none of us can fully comprehend. When God does something, it is from the perspective of eternity. As such, the blessings of Drew’s cancer likely exceed the blessing of his healing. In both cases, those blessings are not limited to a list of things God accomplished in the past. God, who sees the end from the beginning, is working in us all on an eternal scale. He brings about what may seem to us like a momentary circumstance and sets in motion things which will last forever.  This is why Paul can write “This light momentary affliction is preparing for us an eternal weight of glory”.  More and more, I am seeing Drew’s experience with cancer in this light.

Devoted readers of this blog will recall that shortly after Drew completed chemotherapy, he disappeared down to Nicaragua for 5 weeks. That trip may have looked like an escape – a nice vacation after a long, stressful ordeal. In reality, Drew’s visit to Nicaragua was some of the first evidence God had been working in Drew on a scale far beyond the cancer. God was molding and re-shaping the inner man in ways that made Drew more useful to God and more willing to serve. As parents, we long to develop this servant character in our kids and go to endless lengths to bring it about, yet we shrivel at the thought of God working this out in ways that are uncomfortable or scary. I am learning every day how little I trust the Father who loves my children more than I ever could!

In this you rejoice, though now for a little while, if necessary, you have been grieved by various trials, so that the tested genuineness of your faith—more precious than gold that perishes though it is tested by fire—may be found to result in praise and glory and honor at the revelation of Jesus Christ.  – 1 Peter 1:6-7

We continue to see God working out His eternal plans in and through Drew. Yesterday morning we dropped Drew off at YVR in Vancouver BC, where he boarded a plane that took him back to Nicaragua. He plans to spend the next year with eight other young men, becoming fluent in Spanish and working as an evangelist missionary in this remarkable and needy little country. I hope you will join me in lifting Drew and the other young men up in prayer, asking God to keep them safe and healthy, and to fill them with every spiritual blessing while they are in Nicaragua. But more importantly, pray that God will work out His eternal plans in and through these young men, for His own glory.

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5 of the 9 men headed to Nicaragua.  From left to right, Austin Milne (BC), Carter Macfarlane (SK), Jordan Smith (BC), Drew Hale (WA) and Austin Joyce (MI). Not pictured are Johnny Marin (BC), Jared Kenworthy (WA), James Joyce (ON) and Amos Chiasson (ON)

I have no plans to become a regular blogger again, but I have learned that one of the young men in Nicaragua is blogging and I will certainly re-blog his posts on this site.  If you wish to follow Carter Macfarlane’s blog directly, it is linked below.

Thanks in advance for supporting Drew and the other young men who are serving the Lord in Nicaragua.

Jut

Well the first stop on the trip to Managua is coming to a end. My time in Seattle WA has been great! The Hale family have been absolutely incredible, from steak suppers to the log cabin in the moun…

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Source: Carter Macfarlane’s blog – Just about to head out!

Pursuing the good

It’s been 18 months since I wrote my “final” post on this blog. I was eager to write it. In some symbolic way, I thought writing it would make the experience of Drew’s cancer something that happened to us, rather than something that was happening to us. 12814054_10153312324136854_3070108378577092007_nWhat I have learned since that last post is that the experience of Drew’s cancer changed us in significant enough ways that it will always be with us. I have also learned this is not necessarily a bad thing. The fallout of the experience is very visible in our home, if you know what to look for. In various ways, the experience changed us all. In small ways, little by little, I am learning to see the good which has come as a result of Drew’s cancer.

Our family doesn’t talk  much about Drew’s cancer anymore. Usually only after he visits his oncologist, and even then the conversation is limited to “What were your test results?” and “When is your next visit?” We don’t really talk about the experience of Drew’s cancer at all. Maybe someday we will. I can’t speak for the others in the family, but thinking back on my fear and anxiety during Drew’s diagnosis and early treatment is still very distressing for me. Those experiences were genuinely traumatic and the memories of those early days still feel like wounds. Maybe all of us are in the Hale household are in the same boat, as there isn’t really anyone in the family who brings up Drew’s cancer without a reason. And the person who brings it up the least is Drew.

It is because of this last fact I was so surprised to learn Drew had posted about his cancer on Instagram today; his post was a little celebration, marking 2 years since his final chemo treatment.  This milestone had slipped past me unnoticed, which is both good and bad. HLA doctor reviewing Drew’s case would think of this anniversary in terms of statistics and be satisfied Drew is moving past the period of highest risk for relapse. I confess, I still occasionally “relapse” myself, and return to this way of thinking. More and more, however, I see our experience with cancer as something done for us. Done for our family, for our good. I have not yet reached the point where I can thank God for Drew’s cancer, but I am beginning to appreciate and acknowledge the good which has come as a result of our brush with Hodgkin’s Lymphoma.

In the month after Drew began treatment, I read a short book titled  “Don’t Waste Your Cancer”. I blogged about it at the time. The book challenged conventional thinking with ten points to help a person see their own cancer, or the cancer of a loved one, in a healthy way. The author (a Baptist pastor) wrote the book for his family on the eve of surgery for his own cancer. The book forces the reader into a new perspective about cancer. Here are the ten points made by the author:

  1. You will waste your cancer if you do not believe it is designed for you by God.
  2. You will waste your cancer if you believe it is a curse and not a gift.
  3. You will waste your cancer if you seek comfort from your odds rather than from God.
  4. You will waste your cancer if you refuse to think about death.
  5. You will waste your cancer if you think that “beating” cancer means staying alive rather than cherishing Christ.
  6. You will waste your cancer if you spend too much time reading about cancer and not enough time reading about God.
  7. You will waste your cancer if you let it drive you into solitude instead of deepen your relationships with manifest affection.
  8. You will waste your cancer if you grieve as those who have no hope.
  9. You will waste your cancer if you treat sin as casually as before.
  10. You will waste your cancer if you fail to use it as a means of witness to the truth and glory of Christ.

At the time, point #3 was what I needed and #1 seemed very hard to swallow. Now, as I see the blessings begin to flow out of the cancer experience, the truth of #1 & #2 are powerfully impressed upon me. Do I really believe this experience was designed for our good? Designed in a way to make Drew a better man? Do I believe the experience was tailored for Drew so the “tested genuineness of his faith” might glorify God? Do I believe the same for myself?

Blessed be the God and Father of our Lord Jesus Christ! According to his great mercy, he has caused us to be born again to a living hope through the resurrection of Jesus Christ from the dead, to an inheritance that is imperishable, undefiled, and unfading, kept in heaven for you, who by God’s power are being guarded through faith for a salvation ready to be revealed in the last time.

In this you rejoice, though now for a little while, if necessary, you have been grieved by various trials, so that the tested genuineness of your faith—more precious than gold that perishes though it is tested by fire—may be found to result in praise and glory and honor at the revelation of Jesus Christ.  – 1 Peter 3:7

In March, Drew graduated from the University of Washington. Other than the two quarters of school he missed for treatment, he graduated right on time – just 1 month after his 22nd birthday. At present, Drew is working hard and saving up his money, with plans to spend the next year living in Nicaragua, working with missionaries in this very needy country. He has told me on more than one occasion about a new and growing burden to share Christ with others. When I get up in the morning, I often find Drew has beat me up and is parked at the dining room table studying his Bible. For Drew, the lessons of his cancer are being acted on – Drew is permitting those lessons to change him. He is embracing his cancer experience in a very present and positive way – letting God work through it to change him.

Now no chastening for the present seems to be joyous, but grievous: nevertheless afterward it yields the peaceable fruit of righteousness unto them who are trained by it.   -Hebrews 12:11

I am thankful and personally challenged by Drew’s new energy for God. What a loss, if God intended the cancer experience for his good, and somehow he had missed it. The title of John Piper’s little book may be trite, but I believe it touches on a powerful idea – Don’t Waste Your Cancer.  Indeed. Drew has seemingly made the most of this hardest of chapters in his life. Even as I thank God for His workings in Drew’s life, my prayer is that the same can be true for me.

Putting a bow on cancer

Happy New Year everyone.  2014 was quite a year for us and I’m relieved tell you it’s ending on a terrific note.  Drew continues in remission with truly no lasting effects from the cancer or the treatment he’s been through.  He is still undergoing regular scrutiny for any recurrence (currently every 3 months and soon every 6 months), but this is routine and the doctors are extremely pleased with how he is doing.  Drew returned to the University of Washington in September, pulling down the best grades of his college career, answering the question of whether or not he was going to suffer from something the doctors can’t test for, but call chemo brain.  What seemed impossible to me a year ago has in fact happened; in virtually every way I can think of, Drew is healthy and has returned completely to life as normal. God truly has been merciful to us.

This will be my final blog post on the Anchored in Hope site.  The site was always a means to an end, and I am relieved to be concluding it with positive news about Drew’s health.  It is an unspeakable blessing that I can wrap things up in this way.  There are a few stories and thoughts I hope to share with you further down in this post, but first I want to say thank you.  If you choose to skip the rest of what I’ve written below; please know we are deeply appreciative of your care for Drew and for your prayers over this past year.  We were blessed through this ordeal to have friends around the world who stood by us and prayed with us for our son.  I cannot thank you enough for your words of encouragement, the verses you have shared, for meals which were delivered, for visits at the hospital, for gifts to brighten Drew’s day, for letting us crash out at your house and go ice fishing, etc, etc.  You proved over and over that you cared, which is something I will always treasure.  Thank you!

Drew and Ray in La Conner, WA

Drew and Ray in La Conner, WA

On New Year’s Eve, one year ago today, the headline on Drew’s Caring Bridge site read “Preparing for chemotherapy”.   Four days earlier, we had received confirmation of Drew’s cancer; the result of a biopsy performed on Christmas Eve.  The 2013 holiday season had been a brutal sequence of one sucker punch after another and my head was spinning when I wrote that post at the close of the year.   I remember wanting to be hopeful and trying to convey hope in what I wrote.  After all, the doctors had told us Drew’s was a very curable cancer, we had access to the best medical care in the world, we had friends providing endless support and encouragement, and we had a God who promised to never leave us.  Despite it all, writing hopeful words felt hollow to me. Inside I felt empty and utterly alone; lost in a very personal, un-sharable despair.  Deep down I was terrified this disease would rob me of my son.

A few weeks later, updates were transitioned from Caring Bridge to this WordPress blog and part of setting up the new blog included creating an “about” page for the site.  I recall writing about my plans for the future of the blog, hoping it would be a temporary endeavor.  Still, I hedged my bets against a harder road, just in case things didn’t go as smoothly as I wanted…

If I get to choose the future of this site, I’ll provide updates here on our family’s battle with Hodgkin’s, then shut it all down in around 6 months when Drew is completely healed and I no longer have anything to write about. Should God have a different path planned out for our family, with His help I’ll attempt to keep the updates flowing here.

As I read back through my writings in the first couple months of Drew’s sickness, I see the evidence of my faltering confidence everywhere, even as I was trying to write upbeat and encouraging updates for family and friends.  Re-reading them now makes my heart hurt to recall how lost I was in test results, statistics, medical research, and the details of Drew’s disease.  I simply refused to lift my eyes to the hills where I would find my only real help.

I will lift up mine eyes unto the hills, from whence cometh my help. My help cometh from the LORD, which made heaven and earth.
-Psalm 121:1-2

Finally, on February 28, God turned me around.  Using a book that came out of left field, a hunting memory, and an unexpected verse from the Psalms, God completely changed my perspective.  God must have figured I had wallowed in despair long enough and it was time to steer me back to Himself.  The verse re-centered my faith and my focus toward God rather than the mechanisms and means of men:

Some trust in chariots and some in horses, but we trust in the name of the Lord our God.
-Psalm 20:7

God was teaching me even as He was healing my son.  Especially meaningful was the lesson that God is good, His actions are just and His plans are right, regardless of how I might see things.  It was hard for me to concede Drew had another Father who cared for him infinitely more than I ever could, whose plans were infinitely better, and that stepping aside to let this Father carry out His will for Drew’s life was what was required of me; a painful surrendering of my definition of a “good” outcome by acknowledging God’s will was unquestionably right, no matter what direction that path might take.

From February through the end of Drew’s treatments in June, I enjoyed real peace, despite the fact my son was fighting cancer.  Don’t get me wrong, there were still many anxious moments.  However, I took solace in the fact God was in control, rather than worrying His plans for Drew might be different than my own.  Along the way, the good news came in waves: Drew suffered relatively few side effects from chemo, and certainly none of the really bad ones.  In April he received a perfectly clear PET scan at the midpoint of treatment, then another clear scan in July after treatment was complete.  We rejoiced as each milestone flew past with success, celebrating results which were truly as good as we could have ever hoped.  At the end of treatment, Drew was in complete remission – there was no remaining evidence of cancer. Walking out of the oncologist’s office with those scan results was a victorious moment.

Two months after treatment ended, Drew was off having an adventure in Nicaragua and I was doing his chores for him; dragging the garbage down to the curb on a clear summer night.  Without warning, in the middle of my driveway, a crushing wave of fear came over me that was so powerful and unexpected that I just stood in my driveway and cried.  In an instant I was again terrified of cancer taking my son from me.  Remission means something different than “cured”.  The careful monitoring which follows treatment becomes a painful reminder from the doctors there is a very real chance the cancer could return at any moment.   Cancer is a thief in a thousand ways, but robbing a person of that feeling of triumph and finality and closure after successful treatment has to be one of the cruelest.  Instead of a victory, remission suddenly felt more like a delicate cease-fire with a still-dangerous enemy.

Perhaps it was because surrender meant not being in control and I have a need to be in control. Or maybe it was because there on the driveway I wavered a bit in my belief that God’s plan was good, no matter what that plan was.  Whatever the case, the good news which had come so effortlessly over the past many months simply became too good for me to accept.  In that moment I un-surrendered myself in order to start fighting for Drew’s health in my own strength again.  So, instead of the relief I enjoyed in July and August, by early September I found myself tortured by recurring waves of panic, waiting for remission to disappoint. I resumed pouring over medical studies and the details of Drew’s cancer, trying to decipher science’s cryptic methods for predicting the probability of recurrence. Waiting for the cancer to reappear and break its fragile truce.

I’ve mentioned in past posts my good friends Ryan and Tanya, whose daughter Browyn has been fighting a protracted battle against Leukemia for nearly two years.  This fall Browyn received a new transplant and by November, for the first time in a year, was receiving truly promising news – news that her body was accepting the transplant and that the Leukemia was not showing any signs of a return.  In late November Ryan wrote a Caring Bridge post expressing the difficulty of accepting a successful outcome.  In that post, Ryan articulated emotions I instantly related to.  He had put his finger on something I was experiencing, but had not quite understood.  Ryan wrote…

“This continues to be the defining trial of our lives.”

“Why is it, then, that I can’t just let go of my reservations?  Why must I fight against this current grace, waiting for the other foot to drop?”

“Pray for us, dear friends, that we’ll have the courage to give in to this grace, to live without clouds of fear, and to enjoy days like today full of the promises He’s given!”

I know it will seem odd to say this, but surrendering to the success of Drew’s cancer treatment and not living in fear of what the future might hold has been a difficult challenge.  To realize I was not alone in this was helpful, even as I hated to think of my dear friends wrestling similarly with accepting grace in the good health of their own child.

So again I find myself re-learning the lessons of last January – The lesson God uniquely had for me in Drew’s cancer:  That I might realize God is good, that His actions are just and that His plans are right, regardless of how I might see things.  That these truths are so absolute, I do not need to fear what the future might hold.  I know that for Drew the lessons were something different.  Something tailored to his need.  And for Kathy, the lessons were different yet again.  Our magnificent and benevolent God orchestrated circumstances in just the right time and in just the right way to fulfill His purposes in each of us, including working in the heart of this often-wayward son.

At the conclusion of treatment, Drew stated he would not trade the experience of cancer and the six months of treatment for any other six months.  I’ve never asked him what value he found in the experience or what it taught him.  I figure he’ll tell me if and when the time is right.  If he never does, that’s just fine; I’m certain the lessons were important and will help shape the man he is going forward.  For me it seems God is underscoring His lessons for me by going over them with me twice.  Perhaps if I share them here, I’ll be less likely to forget them again!

So, with a ton of gratitude I bring this blog to a happy conclusion. You faithful readers who endured these ramblings are truly something special… and probably have bad taste in reading material.  The vast majority of you never commented, but the hundreds of blog hits after each new post betray you… I know you are out there and that you suffered though these many posts.  More importantly, I know you suffered with us through our family’s trial this past year and for this I will always be grateful.

Jut

I waited patiently for the LORD; and he inclined unto me, and heard my cry. He brought me up also out of an horrible pit, out of the miry clay, and set my feet upon a rock, and established my goings. And he hath put a new song in my mouth, even praise unto our God: many shall see it, and fear, and shall trust in the LORD. Blessed is that man that maketh the LORD his trust, and respecteth not the proud, nor such as turn aside to lies. Many, O LORD my God, are thy wonderful works which thou hast done, and thy thoughts which are to us-ward: they cannot be reckoned up in order unto thee: if I would declare and speak of them, they are more than can be numbered.
-Psalm 40:1-5

Overdue ramblings à la carte

It has been 116 days since I last posted a real update. The four intervening months have been eventful and there has been plenty of news to share along the way, but with the end of summer and the resumption of school and work for all of us in the Hale household, I simply haven’t found the time and emotional energy it takes for me to write. Now, as I contemplate writing about the many things I would like to share, I’m slowly coming grips with the fact there is simply too much; my mind is filled with a thousand thoughts and I’m imagining an update that would be impossible for me to write and even worse for you to read. The consequence of all this is going to be a rather incoherent collection of abbreviated posts, stories and ramblings, served up à la carte style. Suffice to say, there is much more I would like to share.

Drew takes in the sunrise on Timberwolf Mountain in the Cascades

Drew takes in the sunrise on Timberwolf Mountain in the Cascades

I’m proud of my son. From the moment he was diagnosed with cancer until today, Drew has been unflinchingly brave in the face of a dangerous diagnosis and a daunting treatment regimen. Untreated, the mortality rate for Hodgkin’s lymphoma is 100%. The best available treatments for Hodgkin’s are themselves dangerous, and invariably include a lot of things you would never willingly put inside you. For Drew, treatment included cytotoxins, glycopeptide antibiotics, antineoplastics and alkaloid antimicrotubules, all fancy words to describe families of drugs which attack cancer cells without regard for how much havoc they wreak on the healthy parts of the body. During the six months of treatment that followed diagnosis, I worried ceaselessly about the possible outcome of Drew’s cancer, as well as the possible consequences of the chemotherapy drugs we were using to treat it. Drew is a very smart guy and none of these possibilities were lost on him, yet I never once saw Drew depressed, discouraged or troubled by his diagnosis or his treatments. I can only imagine how much worse the struggle might have been for Kathy and I if Drew himself hadn’t been so quietly confident through it all. Cancer and its treatment tested Drew’s mettle and I’m very proud of how he handled this great challenge in his life.

I was blessed with an opportunity to see Drew at his best. During treatment, Drew didn’t want to talk much about his cancer or how the treatments were making him feel. When we did bring these things up, he would often ask us to change the topic. Where Drew avoided talking about it all, he didn’t avoid the grueling task of dragging himself into the infusion lab and receiving his chemotherapy. In the final months of treatment, Drew was physically ill just from the psychology of walking into the infusion lab. To his credit, Drew turned his face into the headwind of his treatments, asked for a barf-bag and silently let them hook him up to another round of toxic chemo drugs. On one occasion Drew’s infusion nurse (Denise) commented on how impressed she was with Drew and how well he was handling the treatments. I apologized to her that she was not able to see Drew at his best, lamenting that she had never seen the truly happy and outgoing guy he is. Denise explained to me that the ABVD chemotherapy regimen Drew was receiving is one of the most difficult cancer treatments a person can undergo. She also said she had given chemo to men two and three times Drew’s age who had shown far less resolve and toughness as they went through the difficult treatments. Denise told me she was quite certain she HAD seen the very best of Drew, BECAUSE she was able to see him undergo chemotherapy. It doesn’t take much these days, but I teared up a bit when Denise told me this. Reflecting back on Denise’s words, I also feel blessed to have seen the character of my son revealed in the face of great adversity. I realize now I did get to see his very best as Drew underwent treatment for his cancer.

Drew declined radiation therapy. This was a difficult one for me. At the end of chemotherapy, Drew met with his regular oncologist as well as a radiation oncologist to discuss the possibility of following up his chemotherapy treatment with radiation therapy. This radiation treatment was not without risks, but statistically it would improve Drew chances of a lasting remission by around 4%. They offered him three weeks of daily involved field radiation on the largest tumor in his chest and left the decision up to Drew. After weighing up the pros and cons of radiation therapy (for about 5 seconds) Drew told his oncology team he would not undergo radiation therapy and that he was done with treatment. As his dad, there was a huge part of me which was thinking “Let’s throw every weapon at this disease that’s attacking my son!” It was hard to sit back and let my adult son make his own treatment decisions. Agonizing, in fact. 4 months later, I can now see the bravery and wisdom of this decision and I couldn’t be happier with it. His remission is intact and he subjected himself to none of the consequences radiation may bring.

Drew and his oncologist Dr. Matt Lonergan celebrate a good checkup

Drew and his oncologist Dr. Matt Lonergan celebrate a good checkup

Drew is not looking back. After chemotherapy, Drew resumed his normal life as quickly as humanly possible. Maybe faster. After taking almost two weeks at home to recover from his final chemo, Drew spent 10 of the next 13 weeks away from home, camping in Canada, relaxing in Idaho, fishing in Montana and living with missionaries in Nicaragua. He did come home for two weeks in the middle of it all for a blood test and to have his chemotherapy port surgically removed. Other than that, within two weeks of finishing treatment, Drew had put it all in the rearview mirror and moved on.

Drew pauses from a paint war while working at a kid's summer camp in British Columbia

Drew pauses from a paint war while working at a kid’s summer camp in British Columbia

Drew and Ray float the Madison River in Montana

Drew and Ray float the Madison River in Montana

Drew arrives in Nicaragua for a stay with Kyle and Alison Wilson

Drew arrives in Nicaragua for a stay with Kyle and Alison Wilson

I won't ask Drew about this photo since Dr Lonergan told him to stay out of the jungle and to avoid mosquitos

I won’t ask Drew about this photo since Dr Lonergan told him to stay out of the jungle and to avoid mosquitos

Drew with Mark and Brenda as he prepares to leave Nicaragua

Drew with Mark and Brenda as he prepares to leave Nicaragua

God gave Drew’s body superhuman resilience. When Drew returned from Nicaragua in late September, the oncologist wanted to see him for a blood test and to examine him for any problems resulting from the chemotherapy drugs. After examining Drew and testing his blood, the oncologist told us he could find absolutely no evidence that Drew had ever had lymphoma OR that Drew had ever received chemotherapy. The oncologist told us this was truly unexpected, quite remarkable and a superb outcome; there is not one lingering side effect from his treatment.

They are monitoring Drew very closely for a relapse. Other than getting special permission to be in Nicaragua for 5 weeks, Drew continues to see his oncologist very regularly for blood tests, physical exams and for scans of his chest. At his late September exam, Drew’s oncologist ordered a fresh CT scan for October 15, he had a blood test again on November 6 and has another blood test and a PET scan planned for mid-December. The December PET scan will (nearly) mark the one year anniversary of when Drew began his treatments. Drew will continue to see his oncologist for blood tests every 3-6 months and periodic CT and PET scans for another two years, at which point they will likely reduce his visits to once per year. Like many types of cancer, the longer Hodgkin’s remains in remission, the less chance there is of a recurrence. Hodgkin’s is a bit unique in that the likelihood of a relapse actually increases with time for a period, with a peak at around 18 months from the start of treatment, after which the likelihood of a recurrence drops off very quickly. Drew will pass this 18 month mark next June.

Drew and Dr Lonergan review the results of a CT scan

Drew and Dr Lonergan review the results of a CT scan

Drew has absolutely no anxiety. As he has been all along, Drew is not living in fear of his cancer or filled with anxiety over the possibility of it returning. So much so that Drew completely forgot to go to the appointment with his oncologist on October 30 to get the results of his October 15 CT scan. Kathy and I may still get anxious about what these scans might reveal, but Drew has simply moved on.

Drew’s cancer remains in remission. We did finally get the results of that October 15 CT scan on November 6 and the results were terrific. It was a CT scan only and not a PET, so they were only looking to see if the lymph nodes were changing in size. Drew’s tumors are all stable in size or shrinking. The largest of the tumors, which was about size of a baseball last December, is now shrunk down smaller than a hockey puck. The doctors feel confident Drew remains in remission, but will continue monitoring these lymph nodes for activity and growth.

Perfectly clear lungs and no lymph node growth :D

The October CT scan – Perfectly clear lungs and no lymph node growth 😀

So much stronger than a year ago. Last year at this time, we did not know Drew had cancer, but he was already pretty sick. In November 2013 Drew and I had gone elk hunting near Yakima and Drew found it difficult to keep up with me (his out of shape 44 year old dad) and his (in much better shape, 68 year old) grandpa in the rugged terrain. We all knew something wasn’t right, but we never could have imagined it was something serious, let alone cancer. This year the three of us went elk hunting again and Drew showed his dad and his grandpa just how fit a 20 year old is supposed to be compared to men two and three times his age. I had no chance of keeping up except when the boy had some mercy on me.

Drew near the top of Timberwolf Mountain

Drew near the top of Timberwolf Mountain

Timberwolf Mountain

Timberwolf Mountain

Off on an adventure with his dad too tired to keep up

Off on an adventure with his dad too tired to keep up

Awaiting an unsuspecting elk

Awaiting an unsuspecting elk

Drew’s hair is spectacular. When he completed chemotherapy, Drew announced he would be growing his hair out into a magnificent mop of blond. We were all actually quite curious what his hair might look like after chemo, since they had warned us hair can change color and or texture with the kind of chemo he received. Perhaps it’s just one more example of the resilience his body has demonstrated in other ways, but Drew’s hair grew back thick full and blonde, looking just as it always did. He must be satisfied with the outcome, as he announced just tonight he’s ready to get it cut.

The dust has (mostly) settled. Drew returned to school at the University of Washington on September 28 and is already approaching the end of the term. He is studying hard, getting good grades and looking for a part-time job. On weekends he’s sneaking off to Canada to see Rachelyn or heading down to Centurylink to take in a Sounders game. As far as I can tell, his life in virtually every way has returned to normal. The rest of us have returned to our usual routines as well, but I can’t say things have fully returned to normal. For Kathy, and I, I believe the trauma has taken a toll and our recovery is going to take longer. While it is true that Drew has completed treatment and is now in remission, Kathy and I have each found the experience left us with some very real wounds. Kathy lost a truly beloved grandmother on the same week as Drew’s cancer diagnosis. With the cancer diagnosis already in-hand, I do not believe Kathy let herself grieve the loss of her grandmother last December. One day shortly after Drew finished treatment, I walked into the bedroom and found Kathy sitting on the bed weeping. I asked her what was wrong and she said “I just really miss my grandma.” Margit would have been Kathy’s closest friend and confidant through Drew’s cancer, making the loss particularly acute. It was gut-wrenching for me to realize she had postponed her grief for 6 months while Drew went through treatment. Grieving postponed is still grieving, and I felt terrible that my wife was suffering through the loss of her grandmother alone, long after myself, other family and friends had moved on.

For me, the struggle has come in a different form. In late summer I began feeling overwhelming waves of anxiety, frequently accompanied by tears. These were events of truly paralyzing fear, with no rational cause. For a very left-brained and rational guy, I am not at all comfortable having a mind that’s filled irrational emotions. After talking to others who have had similar episodes after a traumatic experience, I realize now these were panic attacks likely resulting from something akin to PTSD. By the time Drew returned from Nicaragua they were becoming infrequent and less severe to the point where it has not happened to me now in over a month. Time may not heal every wound, but I’m grateful it seems to have helped this one.

I know that Danielle, Amanda and Tessa have each had their own private struggles as our family went through this. For Amanda, she said simply through tears the other night this has been the worst year of her life. Indeed.

The worst year? Of course, but perhaps also the best. Because of our circumstances this past year, we have appreciated the preciousness of life, the love of family and friends, and the nearness of God in ways we never could have without the experience of Drew’s cancer. It’s impossible to call it the worst year without also acknowledging that God does all things well and that He does all things for our good. Whatever way I choose to look at it, I have a great deal to be thankful for this coming Thursday*!

Thanks for your continued interest, care and prayers for Drew and for our family.

Jut

*For those of you reading from outside the US, November 27th is the holiday Thanksgiving Day in America

Green blood and other good things

Sitting in a coffee shop in Bozeman, Montana, I saw a little sign that I probably related to a bit more than I should. It said:

I have CDO.
It’s similar to OCD, except all the letters are in alphabetical order… as they should be.

For me, my obsession has been Drew’s blood numbers. Hodgkin’s lymphoma is a blood cancer and blood tests offer a small (as in tiny) window into understanding the nature of the disease and into how well the body is responding to treatments. As soon as I understood this, I became obsessed with every detail of Drew’s blood test results.

By my count, Drew has had 39 CBC blood tests since early December, roughly one per week. In early January, I began recording the results of these tests on an excel spreadsheet; 22 numbers in a nice column for every test, each number counting a different component of the blood. If a number was in the normal range, I colored it green. Borderline numbers I colored orange. Abnormal numbers were red. At the time of Drew’s diagnosis, 15 of the 22 counts were abnormal, so I colored them red. Just 5 were green. By the time Drew had his first chemo treatment, just 3 were green. Quite frankly, these early numbers told a discouraging story. They indicated “systemic” disease, which often means it will be less responsive to treatment.

I tried to stop thinking about the numbers, but I couldn’t. I obsessed over them, and faithfully added each fresh set of test results into my spreadsheet… where I would stare at them, study them, cross-reference them with research papers, and generally waste time on them which I could have spent with Drew. I won’t hesitate to call it a sickness; it was without a doubt the most unhealthy preoccupation of my lifetime. This lasted until late February, when God mercifully gave me relief from my great anxiety regarding Drew’s numbers. Literally overnight, I realized God didn’t need good numbers to heal my son. I stopped obsessing about the numbers… but I did keep updating my spreadsheet after each new blood test 🙂

Two weeks ago Drew had a blood test which showed a low platelet count. Platelets are the clotting component in blood. This low count caught me completely off guard, as Drew’s platelet count was one thing which had been consistently normal through all of treatment, so why would they drop after chemo was complete? The oncologist didn’t have an answer either, so we scheduled one more blood test to be done jut before Drew would head off to Nicaragua. I asked you to pray about this low platelet count and several of you told me you were praying.  It’s safe to say we shouldn’t be surprised by good results.

Ask, and it will be given to you. For everyone who asks receives. Which one of you, if his son asks him for bread, will give him a stone? If you then, who are evil, know how to give good gifts to your children, how much more will your Father who is in heaven give good things to those who ask him!
-Words of Jesus in Matthew 7

As inexplicably as they had dropped, Drew’s platelets have bounced back to normal. Thank you for you prayers!

The only other time I asked you to pray specifically about a blood count was in a May 14 post about Drew’s neutrophil count. You prayed and the result was much the same; a medically inexplicable response in his neutrophils. It’s impossible for me to ignore these responses to prayer in Drew’s blood counts.

Way back in February, I left God in charge of ALL of the numbers, so I cannot be surprised by the results. After inserting the numbers from today’s test into my spreadsheet, for the first time since this whole ordeal began, Drew’s blood counts came back all green – every single one of them.

I suppose in one sense, like Drew’s blood numbers, life in general has returned to normal. Drew has spent the weeks since competing treatment fishing, rafting, hiking, swimming, playing in a beach volleyball tournament, hanging out with Rachelyn, etc, etc. He’s even procrastinating ordering books for the fast-approaching fall quarter at the UW, which means he is doing all the “normal” things you would expect from a college junior in August. Yet today, Drew got up in the wee hours of the morning to have coffee with a man he hadn’t seen in years – someone who texted him almost daily in the months following his diagnosis, encouraging Drew and telling him he was praying for his healing. Now, Drew finds himself less than 48 hours away from leaving to visit a missionary friend in Nicaragua for 5 weeks – a trip he had talked about taking since he was a junior in high school, yet somehow after staring cancer in the face, he has decided to make the trip a reality.

It’s abundantly clear to me that this the new “normal” won’t be anything at all like our life before cancer. As far as I’m concerned, that’s just fine.

Photos courtesy of Jon and Rach Photography

Promises kept

Late last Saturday we returned home from two solid weeks of gloriously relaxing family vacation. There were no treatments, tests or appointments. We didn’t have any reason to talk about cancer, which meant there was no need to awkwardly tiptoe around an elephant sitting somewhere in the middle of everyone’s psyche. For the first time in more than 7 months there were no dark clouds hanging out somewhere on the horizon and I was able to relax as if I did not have a care in the world. It felt amazing.


The consecutive weeks away from all routine and obligation afforded a rare opportunity to reflect on the past 7 months and to realize how blessed we are. God did not promise us an easy path, but He promised He would not leave us alone through our darkest hour and He has certainly lived up to this commitment. There were agonizing moments, for sure, but God became our refuge and He mercifully always gave us more reasons to hope than to despair.

When I consider what could have been for our family… learned as I see what others have been through and in some cases are still enduring… our family’s experience almost seems unfair in its brevity and reasons for optimism. For my friends whose path has taken them through a much longer and deeper valley, God has used Drew’s cancer to augment my empathy for your circumstance and to energize my prayers for your deliverance. I cannot see into the future for my family or for yours, other than to know God will be there, and to know this is enough.

Be strong and courageous. I will be with you. I will never leave you or forsake you.
-Joshua 1

On the Monday after our vacation, Drew returned to his oncologist for a blood test. All of his blood numbers have returned to normal now that the cancer is gone and the last traces of the chemo drugs have left his system. The only exception to this is his platelet count – something which had miraculously remained normal throughout chemotherapy – these have dropped below normal, meaning Drew has slightly compromised clotting.


Drew’s platelet count was not low enough to prevent him from having his “port-a-cath” surgically removed on Tuesday, which was a huge relief to Drew. He hated having this piece of hardware inside him, I think for both practical and for psychological reasons. The removal surgery on Tuesday went well, even if the doctor had a bit of trouble getting him to stop “leaking” from the incision in his chest – a result of his low platelet count.


The low platelet count is not critical and the doctor expects it to recover soon. However, because Drew is leaving the country in a couple weeks and will be gone for more than a month, the oncologist has scheduled one more blood test on August 12th, just to make sure the platelet count is rebounding. We’re praying these counts are on their way back up, rather than getting any lower.

The longstanding promise of going fishing was fulfilled on our recent trip; Drew and I spent many days fishing Idaho’s Lake Pend Oreille for bass and Montana’s Gallatin River for trout. We mostly reeled in empty lines, but we didn’t get skunked. And catching fish wasn’t the point anyway… we were fishing! This was the blessing. Miles from anywhere, soaking up sunshine, breathing mountain air and appreciating all that God has done.



I suppose it may be an odd reaction to the events of the past 7 months, but the experience of Drew’s cancer has been a catalyst for my faith, reassuring me of God’s presence and of His goodness. Our fishing trip notwithstanding, it is God who has faithfully kept His promises to us. If you have never known Him, I want to attest to the fact God is real, God is near, and God is good.

Praise the Lord, all you nations.
Praise him, all you people of the earth.
For great is his steadfast love toward us,
and the faithfulness of the Lord endures forever.
Praise the Lord!

-Psalm 117

PET scan results and what’s next

Six months ago, I declared my plans for the future of this blog, at the same time leaving some wiggle-room for God to take us down paths I did not want to think about.

If I get to choose the future of this site, I’ll provide updates here on our family’s battle with Hodgkin’s, then shut it all down in around 6 months when Drew is completely healed and I no longer have anything to write about. Should God have a different path planned out for our family, with His help I’ll attempt to keep the updates flowing here.

When I made that statement, I was quite honestly terrified of what lay ahead for Drew. It is a horrific thing for a parent to contemplate the death of their child, yet those were the thoughts which unceasingly tormented me in the weeks immediately following Drew’s diagnosis. My faith was weak. I failed to appreciate what Drew recognized right away; God’s mighty hand was anything but absent; He was beginning a new work.

Drew shared this verse with me shortly after his diagnosis and has made it his own ever since:

For I am about to do something new. See, I have already begun! Do you not see it? I will make a pathway through the wilderness. I will create rivers in the dry wasteland.
Isaiah 43:19

Today we shook hands with Drew’s oncologist and don’t have plans to see him again until late September. Drew’s Tuesday PET scans were spectacular! There will be no further treatment for Drew, just close monitoring to make sure the Hodge does not rear its ugly head somewhere down the road. A picture is always worth a thousand words, so please enjoy some great visuals of what God has done:

This is Drew's PET scan from last December, with the bright area indicating active cancer

This is Drew’s PET scan from last December, with the bright area indicating active cancer


Here is the same scan with colors added to make sense of it all

Here is the same scan with colors added to make sense of it all

Now, 6 months of pleading before the throne of grace has changed the picture in a most dramatic way. Here is the exact same image from Tuesday’s scan:

No metabolically active cells visible on the scan

No metabolically active cells visible on the scan


And Tuesday's scan with colors

And Tuesday’s scan with colors

There remains a 5cm x 2cm mass of scar tissue where the largest tumors had been and these are pressing his trachea slightly to the left. Otherwise, he has been completely (physically) restored to the pre-cancer Drew. Even the remaining scar tissue is expected to continue shrinking and slowly resolve itself over the next year or so.

Drew leaves the oncologist’s office after getting the official word his treatment is complete

Drew may have been physically restored to his former self, but spiritually God used this experience to change him. When his chemo treatments were completed, he posted his thoughts to Facebook, including gladness for having gone through this experience.

As trying as the last 6 months have been, I can honestly say I wouldn’t trade them for a different 6 months if I had the chance.

Drew's Facebook status on the day of his final chemo treatment

Drew’s Facebook status on the day of his final chemo treatment

At Anvil Camp 1 last week, Drew stood up in front of 200 campers and staff and shared how God had worked in his heart through his experience with cancer. It was powerful and it reminded me once again of the lesson in this experience for myself – to lift my eyes above every circumstance and trust my God for the work He is perpetually doing in my life.

For the moment all discipline seems painful rather than pleasant, but later it yields the peaceful fruit of righteousness to those who have been trained by it.
Hebrews 12:11

For all of the prayers and kind and encouraging words you all have shared with my family over the past six months, I want to say thanks. I cannot express how much your support has meant to Drew and to each of us. Please keep praying for us!

On Sunday, two glorious weeks of family, road tripping and fishing adventures will begin. When we return home, Drew will have his port removed, then depart for around 5 weeks with a missionary friend in Managua, Nicaragua. Drew believes hair grows faster at the equator, so we’re supportive of the trip! He’ll return in September for a routine check with his oncologist, and just in time for fall classes at the University of Washington. It might seem like things are returning to normal, but I’m happy to report that none of us will ever be the same after this experience.

Jut

A final PET scan

Killing time while Drew undergoes PET #3

Killing time while Drew undergoes PET #3

We’re wedging a busy week of tests and appointments between vacations this week, and right now I’m sitting in the waiting room while Drew undergoes his third (and hopefully final) PET scan. The multi-hour scan is even more tortuous for Drew, who has to fast on a sugar/carb-free diet for 24 hours, then sit perfectly still (not even moving his eyes) for an hour+ immediately before the scan, as they give his body time to metabolize the radioactive sugar they have injected into his bloodstream. This scan will give us a final look at whether there is any cancer active in his body. We don’t expect there will be, as his last PET in April showed all clear.

We will get the results of this test tomorrow when Drew meets with the head of radiation oncology at Evergreen. This meeting will make a final determination regarding any need for radiation therapy. For Drew’s stage of Hodgkin’s, chemo followed by about a month of radiation therapy is the standard treatment protocol. I have real conflicted emotions about tomorrow’s decision. Part of me knows God has done an amazing thing in Drew and has healed him. Another part of me knows that statistically, people who get radiation therapy after chemo have ~4% higher long-term cure rate. Like every day over the past 6 months, there remains a battle between the part of my brain that is good at math and my heart which has placed my every hope in God.

On Thursday, we will meet again with Drew’s regular oncologist. We will review the results of this PET scan, and (if all is well) make plans to get Drew’s port removed. On Friday, Drew will receive a battery of immunizations in preparation for living a month in Managua, Nicaragua with an immune system that’s a bit battered from 6 month of chemotherapy.

After this week of necessary tests, consultations and procedures, (and barring any detour for radiation therapy) we will be leaving it all behind to become full-time fish slayers.