Love your liver

I must admit that I’ve never been a big fan of liver. Maybe it goes back to having to eat it as a child, once even cleverly disguised as country fried steak (no amount of breading and gravy can hide that distinctive taste). The only way I can stomach it is all jazzed up as pate.

Image: Wikimedia Commons

While I may never love liver, I am learning to love my own liver. I never gave it much thought until I was diagnosed with metastatic breast cancer. Then I began to understand just how important this strange looking organ is as I watched various numbers on my lab reports start to go haywire this past summer, things on my comprehensive metabolic panel like alkaline phosphatase, ALT, and AST. What followed was a series of tests to try to figure out what was going on: a liver biopsy, an MRI, a PET/CT, and a triphasic CT. The PET/CT and triphasic CT finally revealed the presence of metastatic liver lesions.

This would explain the sudden weight loss, the inability to digest my food fully, the presence of repeated plural effusions and ascites. Within a span of days I went from walking four or five miles a day to barely being able to walk up the stairs. It was scary stuff. Add to the physical issues the fact that we were also moving to a new state and had to get a house on the market and packed up. Yikes!

Fortunately my new oncologist wasn’t overly worried and felt that the chemo we already had planned to address the rising cancer markers would also address the liver mets. And if it doesn’t, he told me, there are other ways to address them. So while what was a minor bump in the road turned into a pothole of sizable proportions, it is nowhere near the end of the road. My markers have come down significantly after only one cycle of Abraxane, and my liver numbers are stable or dropping. Whew! Come on little yew tree with your bound protein molecule, do your thing to bring this body back into balance.

Image: Wikimedia Commons

What’s the point of this post? Learn to love your liver now–before you are diagnosed with liver mets and/or stage four cancer. Begin an anti-cancer lifestyle now and take care to the best of your ability of your body for you are fearfully and wonderfully made. Whether you love liver and onions or despise the stuff, well, that’s your call.

Check out these facts about your liver and read more about this fascinating organ here:

  1. Largest glandular organ – Our liver is the largest glandular organ of the human body and the second largest organ besides our skin.
  2. Multifunctional – Our liver simultaneously performs over 200 important functions for the body. Some of these important functions include supplying glucose to the brain, combating infections, and storing nutrients.
  3. It contains fat – 10% of our liver is made up of fat. If the fat content in the liver goes above 10% it is considered a “fatty liver” and makes you more likely to develop type 2 diabetes.
  4. It stocks iron – Our liver stores important vitamins and nutrients from the food we eat and stocks them up for when we need them later.
  5. Detoxifier – Our liver detoxifies the harmful things we take in like alcohol and drugs. Without the liver the body cannot process these items.
  6. Creator of blood – The liver creates the blood that circulates in our bodies. In fact, the liver starts producing blood before we are born. Without the liver there would be no blood and no life.
  7. It regenerates – Our liver has the amazing ability to regenerate itself, making liver transplant possible. When people donate half their liver, the remaining part of the liver regenerates the section that was removed.

Huh?

Amazing how beautiful hollowed out bones can be! Photo: Creative Commons

Some of you have wondered how things are with my health after my last post about similarities of life with stage four mets and life in the wake of pandemic. Actually, I’m still trying to figure out what’s going on. What’s a result of cancer? What’s normal aging? Why for the past three months have I had a few days each month where I run a low grade fever (between 99-100.7) ache like crazy, am mildly nauseous, and completely exhausted?

This much I know. My oncologist ordered a CT scan in April following three increases in a row in my CA 27-29 tumor marker. It’s not horribly high or anything, but it’s inching up there. The CT scan revealed the following about the state of my bones.

MUSCULOSKELETAL: Extensive metastatic lesions of bone again seen, exhibiting heterogeneous sclerosis, overall extent greater than before although it is noted that even successful treatment of metastatic lesions might result in greater sclerotic
conspicuity on conventional CT; scintigraphy can be useful for quantifying metabolic activity within. Mild inferior-endplate compression fracture of T7, new from previous exam, in association with sclerosis; no significant retropulsion.”

The radiologist providing the CT report noted “Increased extent of heterogeneously-sclerotic metastatic disease of bone, newly resulting in a minor inferior-endplate compression fracture of T7. Advise consideration of radionuclide bone scan or even PET to determine how much of this is metabolically active. No suggestion of developing metastatic disease in soft tissue.” So I had my first ever head to toe bone scan. And this is what it revealed…

FINDINGS: There is diffuse osseous metastatic disease throughout the axial and proximal appendicular skeleton with lesions identified throughout the skull, bilateral ribs, spine, pelvis, and femora.”

Yep. This is pretty much the entire report from the bone scan I had a couple of weeks ago. Well, duh! Oh, and the radiologist did note that “There is bilateral renal function.” Thank goodness! But that’s it for the report. I was confused. Even after meeting with members of my oncology team yesterday and talking with my oncologist later by phone, I’m still not 100 percent sure what’s going on. Like “doubting” Thomas, unless I can see on a screen how many parts of my skeleton light up like a Christmas tree, I will not be satisfied. Yep. I’m pretty big on visualization.

An example of sclerotic breast cancer metastisized to the pelvis. Not me.
Photo: James Heilman, M.D. Wikimedia Commons

The good news is no soft tissue or organ involvement. This is what we want to hear for sure. The not so great news, the “huh” news, is about the spread of the metastatic lesions, or mets. To me, with all my former-English-teacher-word-parsing, Dr. Googling, obsessive record-keeping, limited scientific knowledge, and attempts to stay fully connected to my body, this news feels unsettling. In looking back to the CT results from September 2018, only a few potential lesions were noted. Now we’re using the word “Extensive” to describe the situation? Hello? How extensive are we talking here? Instead of termites, this house has cancer.

My oncologist, however, seemed nonplussed. No need to change treatments or anything just yet. This bone scan gives us a baseline from which to work. The compression fracture will not repair itself, but guess what? There’s GLUE for that! And radiation if the bone pain becomes too difficult to bear. In fact, she suggests I go ahead and consult with a radiation oncologist.

And still, Rob and I shake our heads and say, “Huh?” What do we really know from this? Not as much as we’d like for sure. How do you plan a life around such generalities, devastating losses, and small victories and joys? What about travel since, I’m classed as high risk for COVID-19? What if we don’t travel? What potential losses might there be?

It appears that the cancer is continuing a slow, steady progression in my bones. So far there is no soft tissue or organ involvement. This is a marathon, not a sprint. I’m going to have to be more careful to avoid putting stress on my bones. At some point I will become a fall risk. I wish I could figure out what’s going on with these bouts of fever and total malaise. But for now, overall, things are pretty good, and I have much for which to be grateful. And I am grateful!

What has cancer taught me recently? A little planning is a good thing; too much planning is a waste of precious time. There’s much more living to be done than hours in a day. Letting go is awfully hard, but it’s the only way to experience life in the moment, to seize the day, and experience every precious atom and molecule spinning and dancing. Don’t look back with regret or nostalgia. The past tense lens, for any of us, does not offer a clear, true view. It is clouded by emotions, fear, longing, and rationalizations. Loving God and loving neighbor is plenty enough to focus on without any religious wars or theological conundrums. The Christ is too big to get caught up in our petty little control wars, too vast to be hampered by our desire to control the divine impulse. Let God be God and hang on for the ride. Life is precious. Most things don’t matter much at all: people do, justice and fairness do, being satisfied with enough matters, and love always wins.

I’m learning a lot from my teacher Cancer. Some of the lessons are so hard, but I wouldn’t miss the aha moments and the wisdom offered. I wouldn’t trade one second of this precious life, and yes I pray for many more years–I’m only human, after all. But I just don’t know, and I’m not going to let that spoil the party. We’ve got some serious living to do, my friends! Thanks for stopping in. Take care. Stay safe. Love all you can with all you’ve got. Live. Really live.

COVID-19, Cancer, & Change

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Novel Coronavirus SARS-CoV-2, NIH Gallery, Creative Commons

Here in central Pennsylvania most businesses have or are preparing to lock their doors. Essential services like grocery stores, pharmacies, and gas stations are still open and  populated by gaping holes and apology notes on shelves that once stocked toilet paper, cleaning supplies, bread, milk, eggs, and the ever-popular hand sanitizer. For many people life has taken on the surreal appearance of something between a snow day and a scene from a bad movie. It’s no wonder. We humans don’t do change well.

As I pondered the disruptions and strangeness of this unseen menace, it struck me that the physical distancing and suggestions pertaining to COVID-19 avoidance aren’t all that different from life with ongoing cancer treatment. For those who regularly adjust their lives to the whims of a compromised immune system this IS pretty much life as usual. Sure, for those of us who live and thrive with metastatic cancer and other immuno-suppressing conditions, we’re usually the ones making the determinations about what’s safe for us, which crowds are worth the risk, what the potential health-trade-offs might be, and making sure that hand sanitizer is always nearby. In short, you get used to it. It becomes a new normal. You learn lessons from this life and from your own rogue cells. You adapt–if you want to live.

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Metastatic breast cancer in pleural fluid, Ed Uthman, Creative Commons

Hopefully, for most of us this time of social distancing (I prefer the term physical distancing. It feels more accurate.) will come to an end in a couple weeks or maybe more. For many of us this feels like more of a major inconvenience than a life-altering threat. We’ve had no choice in changing our patterns. Yet, we still have so much choice and abundance around us. I hope that we all avoid the temptation to hoard, that we take this opportunity to care for our neighbor in both small and great ways–like not buying out an entire shipment of Lysol spray to hoard just because you have the resources to do it. How much Lysol can one family go through in a month? It’s simple. Use what you need. Share what you have. Consider others. Treat others as you wish to be treated. Love lavishly. Be creative. Use this time to examine and perhaps reorder your life, your goals, your hopes, your plans.

Pay attention to others. Pay attention to everything around you. Listen to the silence. Look at the stars. Marvel at your breathing. Did you know that you breathe more than 23,000 times per day? That adds up to about 8,409,600 breathes each year. Talk to those with whom you are sheltering during this time of COVID-19  distancing. Learn about your family and friends. Play an instrument. Cook. Sing. Take a walk. Garden. You have so many possibilities.

Importantly, care for others. A lot of people will be hurting because of this time of distancing. There will be great economic disruption. Please continue to support the non-profits you value. If you are part of a faith community, please give generously either online or by mailing a check. Support local businesses that have online ordering right now. Make extra donations to your local food pantry if you’re able. Check on elderly neighbors and single parents who may have no way to pick up items they need. Above all, love lavishly.

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Live and love lavishly! Image: Kate Fisher, Creative Commons

May you celebrate many ordinary and extraordinary moments today, living in the here and now like it’s all you really have. Wisdom, cancer, and other teachers know that it truly is really all that any of us have. This one precious moment. Live it for all it’s worth!

Of course, I’m still holding out for that day when we find NED (no evidence of disease). I know it’s possible. I know people who have experienced this radical healing.

UPDATE:  I haven’t written much lately because I’ve been too busy living. I highly recommend it!  My December CT scan showed no progression of disease. This is really good news! I remain on the oral chemo regimen of Ibrance and Letrazole. I augment these meds with a lot of supplements, Frankincense and Myrrh, vegan diet with no processed sugar, alcohol, and very little processed foods period, along with other complimentary treatments like yoga and far infrared-ray saunas. I still live with a lot of aches, back pain, and fatigue, but every day is gift! Thanks for following along. It means a lot to have your prayers and intentions.

 

Thoughts While Waiting

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Today was my six month CT scan. You’d think I’d be used to such tests by now, but I always feel a queasy creep of anxiety stirred with a spoonful of fear about the “what-ifs.” Sure, I know better than to play the what-if game, but some days it’s easier said than done. I felt that “creep” this morning as I waited for the scan, and I’ll probably be a little bit agitated until we meet with my oncologist for the results. Inquiring minds want to know. Actually, the truth is that inquiring minds crave control. Cancer will teach you a few things about control–or the lack thereof.

A CT scan is no big deal really. Mine are always done with contrast dye, so I spend an hour and a half downing a Big Gulp size drink to help me light up better. It’s not unpleasant stuff, and the time goes fast. The folks at the UPMC imaging center are all helpful and kind, and they go the extra mile to answer questions and explain processes. Today the nuclear medicine tech even made me copies of all four scans I’ve had there, and because the CD I’d brought wasn’t big enough he burned them to two of CDs they use that also had the viewing software. Why would someone want copies of her computed tomography images, especially someone who isn’t trained in radiology?

As a visual learner, it simply gives me an odd sort of peace knowing that I can have this intimate look at my body as it works to live and thrive with Stage IV mets. It is an odd feeling knowing that some of your own cells are giving immortality their best shot while killing the host (me) in the process. You see, cancer cells don’t want to die, and they’ll do just about anything, including borrowing energy from healthy cells, in order to feed and grow and outwit apoptosis. The average adult human loses between 50 and 70 billion cells a day due to apoptosis. Cell death is supposed to happen in this circle of life, but cancer cells rebel. My apologies for the oversimplification of the process, but it strikes me as odd  that these greedy cells want to defy death, even if it means killing everything else in the process.

We are not meant to be immortal, at least not housed in these amazing yet fragile bodies. We are not, no matter how much we think we are, in control of much that has to do with our lives. All of us–yes ALL–have an expiration date, but we are a death avoidant culture. We’ll go to great lengths and lots of expense to pretend that death isn’t really a thing, or at least that we have control over it. Until we don’t. Until someone we love dies too soon. Until we watch our beloved parents living our their last years, months, or days. Until we face the stark reality of death ourselves–perhaps in a serious car accident or through a terminal medical diagnosis.

So I will spend a few days waiting and wondering, and trying to not give too much energy to worry. What will be will be, and I really don’t want to borrow trouble from tomorrow. No matter the results of this scan, I will move forward trusting in healing and wholeness, savoring each precious day of life, and learning from my cohort of rogue cells. I still have a whole lot of living to do, and I am grateful for all of you who are journeying with me. Your cards, notes, calls, visits, and other tangible signs of support and solidarity help keep me strong.

Do me a favor, please. After you read this, go look at your body in the mirror. Most of us are overly judgy about what we see, but remember that you are fearfully and wonderfully made–and dearly loved by the Creator of all that is. Thank your body for being the vessel that holds your soul and mind and for carrying you this far on the journey. Take care of you as best you can, and give thanks for the wonderful creation that the human body truly is–even those rogue cells we call cancer. We are, each one of us, a small miracle.

My thoughts while waiting aren’t all doom and gloom and cancer-related. In fact, I’m doing a lot of writing these days and trying to stay as healthy as I can. Yep, I’m still chugging those green smoothies! One of the joys of life recently is our new cat (and my new muse), Zoey. Here’s a cute cat picture for a happy ending!

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Reflection on my first “Cancerversary”

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About this time one year ago, I was headed home from a church council meeting when I received a call from “Unknown.” On a hunch I pulled over and took the call. It was my primary  care physician–bless her–with the news I had already been steeling myself to receive. “Your biopsies were positive,” she said.

Yep, my old teacher cancer had returned after 14 years, metastasizing to my rib, back, hip, peritoneal and lung fluid (ascites). My very kind and thorough doctor promised to try to get me in with an oncologist in whom she had absolute trust, and she did. Within a couple of weeks I was receiving “palliative” chemotherapy every week (talk about a sobering turn of events). Taxol knocked out the problem with the ascites in short order, and to-date the existing lesions have remained stable with no new spots present on this summer’s CT scan.

Today (September 20, 2019) I celebrate this strange sort of anniversary, my first METS “Cancerversary.” It’s been a strange year indeed, with changes, losses, and a new measure of normal that has included:

  • Going from pink hair to no hair (but cool hats) to salt-and-pepper wavy hair,
  • Transitioning from working 50-70 hours a week to medical disability (I prefer to refer to it as my unplanned sabbatical),
  • Grieving the loss of the pastoral vocation that I truly love (at least the way I’ve been accustomed to ministering to others),
  • Trying to figure out what to do with myself now that I’m living in what my oncology team graciously refers to as “retirement,”
  • Watching myself age about a decade in twelve months,
  • Slurping more green smoothies, eating more salads and beans, and drinking more anti-cancer tea than I’d ever thought a human could consume,
  • Learning a new “normal” thanks to a variety of chemo side effects,
  • Discovering that multi-tasking and grossly overstuffed schedules are highly overrated,
  • and learning that, yes Sharron, our bodies really do have limits and if you push it too far for too long there will be a price to pay.

Yes, there’s been a fair share of loss and grief and pain in these last 365 days. But the yucky stuff will never get the last word in my life. There have also been some amazing gifts and “aha moments” during this trip around the sun with cancer. Here are a few highlights:

  • The very first thing I do every morning before my feet hit the floor is say “Thank you, God, for another day of life.” And I MEAN it with all my heart. Life is so precious and fleeting and beautiful. We need to celebrate every single day.
  • My beloved husband and I have found ways to spend more quality time together and savor every moment that we can squeeze out of each day.
  • Relationships with family and friends have taken on new poignancy, meaning, and vitality. I love and value you all SO much!
  • Emotions and chronological time are like amusement park rides–just hang on and prepare for change. Nothing lasts. Not pain. Not sadness. Not fear. Not joy. Not even the present moment (which is the very best place to be, I’m learning).
  • Cancer is not a death sentence. It’s a LIFE sentence. You learn while living with cancer what it means to savor life and appreciate everything. (Well most of the time. There have been a few moments that just plain suck.)
  • Creation is absolutely amazing. If I want to hug a tree, I will hug that tree for all I’m worth. I’ll smile at and speak to strangers. I can spend an hour just watching our new cat and marveling at how brilliant she is. I thank the plants before harvesting their bounty in our garden. So much of life takes on a brighter hue and vibrancy when you realize that we all contain the imprint of the universe and the breath of the Creator’s Spirit. Everyone matters and is beloved. Realizing and embracing this will change your life–trust me on this.
  • Hope is real. Attitude matters. Naps are bliss. Love wins.

So cancer, my teacher and companion, happy first anniversary. I can’t say that you’re my number one choice for how this life thing is going to play itself out, but here we are. So thank you for all that you’ve taught me this year about appreciating people, creation, and the present moment. Thank you for finally getting me to grind my overworked gears to a screeching halt so that I can finally listen for the Spirit’s whisper and divine direction. And, thank you for teaching me how to live better and love better. Yes, thank you.

That said, I still have a lot of living and learning to do, so let’s blow out the anniversary candle, raise high the glass of green smoothie, and keep on keepin’ on. L’Chaim!

(Photo: Jens Comiotto-Mayer, Creative Commons. Thanks!)

 

So long for now, Sergeant Spatula

Spatchy in specs

Today marks the end of an era. For the first time in almost 17 years, I find myself without a furry companion. We lost Pete more than two years ago, and today we said goodbye to our beloved pastel calico cat.

Sergeant Spatula came into our lives just after my first cancer surgery more than 14 years ago. We were living in upstate New York where I was a pastoral intern when my friend and my daughters conspired to bring this palm-sized bit of fluff and sass into our lives. She was born to one of Crazy Cat’s litters (yes, that was really her name) in friends and parishioners’ dairy barn, and complaining vociferously from her flea bath she entered our home (well, actually the Methodist Church’s parsonage) and hearts to stay.

Sergeant Spatula

Affectionately known as “Spatchy,” the Sergeant received her name and rank from my daughters, who were evidently in a military kitchen implement naming phase. Life with Spatchy was quite an adventure. In her first year she managed to pull down the Christmas tree, bolt outside during a storm and climb some 30 feet up in the neighbor’s tree, and regularly perform acrobatics by climbing pants legs and curtains. She could open doors and cabinets and drove my mother to distraction with her uncanny knack to know just where mom wanted to sit and beat her to it. She was, however, cute and cuddly, and that covers a multitude of feline misdemeanors.

Although she loathed the pet carrier, she was a stalwart traveler, moving from New York to North Dakota to Tennessee and finally to Pennsylvania. She put up with the indecencies heaped upon her out of pure love for her humans, allowing herself to be carried like a baby, wrapped up like a kitty burrito, dressed in humiliating Halloween costumes, and have her nails clipped to try (mostly unsuccessfully) to prevent the shredding of my husband’s leather sofas.

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The cat definitely had the proverbial nine lives. In North Dakota she ingested 18 inches of decorative ribbon with wire edges. Several hundred dollars, a long car trip, and an emergency surgery later, the Sergeant pulled through and came home with the pictures and ribbon retrieved from her gut to prove it. In Pennsylvania she was accidentally sprung from the back porch during  a package delivery. For three weeks we posted signs around our small town, followed up on every lead, put food out near potential sightings, and refused to believe that she had become coyote snack. To our great joy a skinnier but relatively healthy Sergeant Spatula turned up chilling on the den sofa one morning.

Despite her combat-themed name, she was a lover not a fighter and claimed not one mouse kill to her name. The chipmunks tormented her through the glass storm door, and so did the neighbor’s cat, Hugo. We are fairly sure, however, that she had a secret crush on him but was simply too proud to admit it. She also served as sermon inspiration and writer’s muse, usually by plopping her corpulent self on top of my keyboard.

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For the last several days she was clearly not herself. She hid her illness quite well, something the vet tech said cats were prone to do. After the ribbon incident in North Dakota she was always a picky eater, and she was aging, so we tried a procession of new foods with varying success. For the last 48 hours all we could get her to eat were a few bites of chicken baby food and vanilla ice cream.

A trip to the vet revealed advanced kidney disease with no real option to prolong her life without additional suffering, so we made the difficult decision to not allow her to suffer for our sake. That wouldn’t have been fair.

The staff at Colonial Park Vet Clinic deserves a shout out. They were wonderful and helped make her transition as smooth and easy as possible, and they honored our grief so very well. I am grateful to them.

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Why all this fuss about a cat? If you’ve never had a beloved animal companion, I’m not sure I can explain it. If you have loved and lost a fur friend, you know exactly what I mean. In fact, this old world would be a whole lot better if we loved each other like our animal companions love us. We have so much to learn from them.

Thank you, Sergeant Spatula, for the joy and laughter you brought into our lives, for the love we shared, and for the lessons you taught us. You are already so deeply missed.

Receiving the Cancer Participation Award

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Hi friends! It’s been a while since I’ve written anything, but I’m back today to share with you the news that I have received the decidedly average Cancer Participation Award*. What is that, you may ask? Well, let’s put it this way: I had hoped at my most recent oncology check-up to find myself in possession of a first place award (i.e. news that my cancer had gone into remission). No such luck! Even though I’ve trained hard

  • drinking pond scum,
  • jumping on my mini-tramp,
  • eating enough salad, legumes, nuts, and seeds to make me feel like a Chia Pet,
  • praying/meditating,
  • practicing yoga,
  • and sweating to the oldies in the far infrared ray sauna (oh, wait–I AM the oldie thanks to the prune-shriveling and estrogen-blocking effects of letrozole),

my estrogen positive metastatic stage IV breast cancer is still present and accounted for and hanging out in my rib, spine, and hip. Woohoo!

Yes, despite all of this life-with-cancer training and healthy living the results of my July CT scan show absolutely no change from the January scan. That is good news, right? Yes. It means there is no progression to sideline me. I give thanks for that. But, typical human that I am, I had hoped for more.

“Is this the best we can expect?” my beloved spouse asked my oncologist as she stared intently at the monitor on which my latest results were displayed.

“Yes,” she said. And then she paused. “Well, no. I would have liked to see some regression with this protocol.

“But this is still good news,” she added. “And we have lots of tools yet at our disposal.”

Drat! Not even the second place award of some regression. Sigh.

Clearly my friend cancer still has a few things to teach me. Maybe I’m a slow learner? Perhaps this chemo cocktail is not the right one for me? Whatever the case, I’m still here and raising my glasses of pond scum and herb tea in the air. It’s been less than 11 months since I received that fateful phone call from my family practice physician, and I am most definitely not ready to throw in the towel on this precious thing we call life.

The downside? I won’t be able to return to work/ministry at the end of August. I still need to continue the focus on wellness and mind/body/spirit health and work faithfully with my oncology team. I need to listen and watch for the Spirit’s movements and design for my life. I need to live every precious moment to the best of my ability–not taking one second for granted.

Yes, I will take that cancer participation award and do so gladly. I have a lot more living to do, and I look forward to sharing the journey with you. Your prayers, intentions, beautiful cards and remembrances, calls and encouragement mean the world to me. You help keep me strong. Thank you for that. No matter how this journey ultimately plays out, cancer will not have the last word. It is my belief that thanks to The Christ, death has already been defeated for all of us. And that’s some very good news.

So, beloved and faithful team, here’s the cheer of the day in honor of the preciousness of life. Keep your eyes, hearts, and hands open. Be surprised by joy. Don’t despair. And…

Two, four, six, eight: Participate! Participate!

Life’s too short to let it fly past.

Get in the game; make each day last!

Two, four, six, eight: Participate! Participate!

*The medal is for illustration purposes only. It’s from the 2000 Chickamauga Battlefield Marathon. I won second place for my age division that year. The marathon I’m training for now is life, and there is indeed joy in the journey (pond scum and all)!

Remember that you are (star)dust…

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Ash Wednesday held new meaning for me this year with the stage IV cancer diagnosis. I’m six days in to my unplanned medical sabbatical (what I prefer to call my time on medical disability), and it’s been sobering to observe my body finally coming off of the adrenaline high that kept me going for far too long. This day has given me the permission to speak truth: I am tired. I am weary. My body needs this time of rest if there’s any chance to recover, heal, and hear those magic words “No Evidence of Disease.” I won’t get there by depending on myself or any imagined “super hero” abilities to defy death and appear magically in control.

“Remember that you are dust, and to dust you shall return.” These are the powerful and painful words my friend and colleague said as she marked my forehead with ashes this morning. I deliberately chose the quiet chapel service at the church she serves because I needed safe space to experience this moment in a new way, in the shadow of dis-ease and with the words “terminal” and “palliative” still ringing in my ears.

Don’t get me wrong; I’m not throwing in the towel. I’m not crying “uncle” to the cancer cells. Not a chance! What I am doing is entering the season of Lent by acknowledging that the shadow of death is just over my shoulder, and my hope lies in God and God alone. But this is true for all of us. None of us is promised more than the present moment; we just choose to live like we have an unlimited span of life ahead. We can wipe that cross off our foreheads, but we can’t erase the truth of it.

Yep, nothing like Ash Wednesday and a cancer diagnosis to set the record straight. This is also a powerful gift to carry into the 40 days of Lent. Without this journey to the cross, without death, there can be no resurrection and no promise of real and lasting life. Only by walking the road to Jerusalem with Jesus and looking unflinchingly at death is there lasting hope or reason to live for something beyond oneself. This is the only path to the risen Christ.

Death will come for all of us–sooner or later. Deny it all you want; it won’t change the truth of it. Every day is a gift of God. Every breath is Spirit-infused. All of creation is held together in Christ. Or, as Eugene Peterson so beautifully renders this idea in The Message (Colossians 1:18b-20):

“From beginning to end he’s there, towering far above everything, everyone. So spacious is he, so roomy, that everything of God finds its proper place in him without crowding. Not only that, but all the broken and dislocated pieces of the universe—people and things, animals and atoms—get properly fixed and fit together in vibrant harmonies, all because of his death, his blood that poured down from the cross.”

None of us makes it to Easter without the painful reality of Lent. We need that ash cross to tattoo truth smack between our eyes. But here’s the thing: we are not just the dust you dump out of the vacuum bag into the rubbish bin. We are stardust. We are inextricably linked to one another, to all of creation, and to the Christ.

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As my friend marked that ashen cross on my forehead and said those somber words, I took courage and comfort in knowing there is so much more. Cancer may strip me of all my illusions of security, invincibility, and layers of self-defined identity and worth, but it will never have the last word. That belongs to God, and here is truth for me–and for you, for all of us: “Remember that you are the stuff of stardust, and to stardust you shall return.”

(Photos: sblezard and Gianni, Creative Commons License. Thanks!)

 

 

Hair Today. Gone Tomorrow.

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Today’s topic is about chemo and hair loss, although there’s a whole lot more going on than just the demise of my dearly beloved fierce pink tresses. The real subjects are attachments, fear, and letting go–three much more powerful issues that affect not only those in cancer treatment but pretty much all human beings at some point in life.

I went through the whole hair loss thing with the first cancer experience. Taking what measure of control I could, I had my head shaved and sent the ponytail to Locks of Love. It really didn’t bother me that much that I can remember. Perhaps it was because I was sure it would grow back, AND I’d have the added benefit of an outrageously expensive but effective perm. (Note: You have to look for the small bright spots and opportunities to laugh when dealing with cancer or any other life-threatening medical condition.)

Ready for chemo in 2004 with a pony tail for Locks of Love

This time felt different. Perhaps it was the difficulty of letting go of that brave, bright color my daughter so lovingly applied to my hair–a hot pink badge of courage. Maybe it was the comments from folks that this time my hair might not grow back like it did a decade plus ago; after all we’re dealing with long term treatment now as opposed to a once and done experience. It could be the reality of just one more indignity and loss of the illusion of control. After pondering the situation for a couple of months and getting used to my rad baldness and wardrobe of really cool hats, I think it’s something more–something that affects virtually all of us. That something is the power of attachments and the fear of letting go.

You see, the initial tears and sadness of having my beloved shave my head have given way to acceptance and even a kind of love for my bald look. It’s sassy. It’s real. It doesn’t try to pretend that my shorn skull is a fashion statement rather than a side effect of chemo. It’s not, in short, a cover-up of all that’s happening in my life. And therein lies the dilemma.

I am now quite okay with my bald pate and the many lovely, quirky, and precious caps and hats that so many friends and family have made and/or given (I treasure your love and care. Thank you!). Yet sometimes I wonder if I’m becoming too attached to the present state of being. You’d probably never know I am living with stage four cancer if it weren’t for a shiny noggin (and the persistent fatigue). After all, bald IS beautiful, and I’ve embraced rocking the look.

My Buddhist friends will say that nothing lasts. The Buddha teaches that almost all of our struggles–anxiety, anger, sadness, frustration, grief, worry, despair, etc.–all stem from one source: being too tightly attached to something or someone. Jesus had a few things to say about attachments and possessions, too (Check out Mark 10:17-31, Luke 6:32-36, Luke 12:15, Luke 14:33, Luke 15:11-32, Luke 18:18-22, Matthew 5:1-7:29, Matthew 6:2-4, Matthew 6:19-25, Matthew 16:24-26, Matthew 23:25-26 to get started. Pastor, teach thyself!).

I can understand how past attachments may have contributed to my present state of dis-ease, and I confess that for me letting go is definitely not as easy as I would like for it to be. I also know I’m not alone. If it was easy to let go there would be far fewer struggles and pain. We humans are not experts at holding loosely to our lives, possessions, and relationships. Sure, some things are easier to let go of than others, but we all have our “sticky stuff” that prevents us from being truly free.

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To learn to let go of attachments takes intention and practice. Whether you choose prayer, meditation, or some other discipline, the important thing I’m learning is to be gentle with oneself in the process. My most difficult attachment is to the value (both real and perceived) of my vocational life. I’ve been taught to work hard, to work until the job is done, and to do the very best work possible. Unfortunately, a good teaching has become over time both a coping mechanism to avoid dealing with past pain in my life and an attachment that is detrimental to my overall health and well-being (not to mention that of my loved ones). I could definitely take a regular seat in an Overworkers Anonymous meeting!

And here’s the thing: There is no badge of honor for working oneself to the bone, to ill health, or to death. My friends, don’t wait for the death part to figure this out, no matter what attachment(s) to which you may be clinging with ferocity. Learn to let go while you have the choice and opportunity. Do it better than I have done until now. Don’t wait for cancer, heartbreak, or other life altering event to stop you in your tracks and force you to learn. Oh, and rock your wonderful self just as you are. You are enough. You are beloved! It’s okay to let go and be you.

Note: Need somewhere to start? Check out Leo Baubuta’s blog post “The Zen Habits Guide to Letting Go of Attachments.” He offers five practices you may find helpful.

 

 

Marathon (cancer treatment) Training

Athlete running road silhouette

I know there’s been a long (truly unintended) digital silence here. I’ve started a few posts, but I’ve simply lacked the energy and dedicated writing time to finish them. What I have learned is that cancer treatment for stage four metastatic breast cancer is definitely more like a marathon than a sprint, and training/treatment/healing is a time-consuming and “all-in” effort.

Last Friday we met with my oncologist to review a recent CT Scan after three months of IV chemotherapy with paclitaxel (Taxol) and denosumab (Xgeva). The news is best described as cautiously optimistic, and my oncologist seemed pleased with this report. While my hope is to hear those words “radical remission,” we are not there yet. The good news is that all the ascites (fluid build-up containing cancer cells) in my peritoneum is gone, as is the pleural effusion in my right lung. My liver, which had been somewhat questionable on the first scan now appears normal. It’s good news that the lesion on my tenth posterior rib shows post-treatment effects. Go little yew tree, go! (Note: Taxol is derived from the Pacific Yew Tree.) It is a hopeful sign that there is no growth in the other lesions or in the two lung nodules, and that there are no new lesions or nodules.

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Photo Credit: By Cancer Research UK – Original email from CRUK, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=34333556

 

(Note: Skip the next paragraph if medical/pharmaceutical details put you to sleep. I’m learning to speak a new language in order to understand my treatment and condition.)

The new plan  is to switch my chemo cocktail to palbociclib (Ibrance) and letrozole (Femara) to address the cancer cells from another angle. I’ll still keep taking the monthly denosumab shot, which is a RANKL inhibitor that helps keep the cancer from breaking down my bones. Palbociclib is a reversible small molecule cyclin-dependent kinase (CDK) inhibitor that blocks certain proteins in the cells (specifically cyclin-dependent kinase (CDK) 4 and CDK 6). For hormone positive breast cancers like mine this can help stop the cancer cells from dividing and making new cells. Letrozole blocks the enzyme aromatase–used to convert androgens into estrogen. The end result should be a reduction in the number of cancer cells produced and the size of my lesions and nodules. If I’m lucky, it will help push me toward radical remission; however, there’s a lot more that goes into that process. Like my previous chemo cocktail, there are some pretty unpleasant probable and possible side effects (boo!). Given the choice or side effects or not living as long, I’ll take my chances on the side effects and keep addressing the situation with complementary therapies, wrapped in some serious prayer.

(Non-medical/pharmaceutical readers should begin reading again now.)

Complementary therapies that I am using include aforementioned prayer, meditation (aiming for at least 30 minutes per day), monthly spiritual direction, exercise (yoga and walking),  hyperthermia treatments (daily far infrared sauna sessions), some aspects of the Gerson protocol (not juicing yet–doing green smoothies instead), supplements (Transfer Factor) and dietary adjustments (raw as much as possible, as green as can be, mostly organic, avoiding processed foods, sugar, oil, and alcohol). Depriving cancer cells of the sugar they love and need to replicate, and using heat because cancer loves a cold environment are two key elements of my complementary therapies. The hardest thing for me so far is getting adequate rest because I am still working full-time in a demanding vocation that I absolutely love. Finally, I’m trying to look at cancer as a teacher rather than an enemy. That’s why you won’t hear me use the words “fight cancer.” Instead I’m trying to embrace the reality and learn from this difficult teacher.

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The first Sunday in the parish sporting my “new look.” Folks have been amazingly supportive and adaptive–right down to the youngest (who is about to put a band-aid on my head in this photo.)

 

Yes, this is not a sprint. I remind myself that it took time for my body to get in this situation. I was first diagnosed with stage II/III breast cancer in 2004 and declared “cancer free” in 2005 (a false truth–more on that later), so I had a good long run without the influence of cancer as teacher and companion. Now it’s back, and it’s going to take a total surrender to my own will and a willingness to learn and be in new ways to experience healing.* I’ve laced up my trainers and am ready to keep up the work of living with this condition, learning from this teacher, and  seeking healing and radical remission.  I am so grateful for your many expressions of kindness, care, encouragement, and love. Above all I am thankful for your prayers that keep me lifted up when the going gets tough (and it does some days).

*I use the word “healing” rather than “cure” deliberately. Healing is a much richer and holistic notion that includes mind, body, and spirit.