Two Doctors and a Nutritionist

Wednesday included an extended visit to the Seattle Cancer Care Alliance—Fred Hutchinson site. Marilyn and I had an appointment with Dr. John Thompson who is the expert in immunotherapy for kidney cancer. We had a good conversation with the conclusion that my type of kidney cancer is papillary cell sarcoma. This is the less common kidney cancer occurring in 8-10% of cases. It is not responsive to immunotherapy so the protocol for treatment is to have scans every three months for the first year to determine if it has metastasized in another location. Then it may be treated with surgery or radiation. There is a 50% chance that I won't have a recurrence of the cancer in the first year. I'm shooting for those rather favorable odds. Next we met with Dr. Celestia S. Higano to discuss my prostate cancer. She is one of the most gracious and delightful persons one would ever want to meet. She suggests radiation therapy for the prostate and lymph nodes in the abdominal area. I asked why surgery wasn't an option. Her answer made sense. Major surgery depresses the immune system and the type of cancers I have thrive in those conditions. I will arrange for radiation here in Bellingham Then we met with a nutritionist who helped us determine the proper amount of calcium and Vitamin D supplements for my diet. My hormone therapy with Luperon can be a cause of osteoporosis so we want to keep the bones strong. She also counseled exercise and an appropriate diet. During the morning I had a blood draw, received my flu shot, and a three month Luperon injection. We left with a sense of appreciation for the cordial and welcome treatment by all the staff at SCCA. My questions were answered and I feel that I am a full participant in my treatment. Strangely, the information I receive isn't particularly disturbing. It is an accurate report of what is happening in my body. I am grateful for that information and feel wonderfully supported by friends, the prayers of many, and the deep consolation of the Holy Spirit. The journey continues to be interesting and eventful.

Ordinary Time

It shocks me to see how long it has been since I made an entry on the blog. All I can say is that the days have been busy and blessedly uneventful. Those seasons in the liturgical year which are not major festivals are called Ordinary Time. That has always struck me as containing great wisdom. Our lives are mostly lived in ordinary time and we should be grateful for that. We can't sustain celebration or misery for extended periods without wearing out. We need ordinary time and the grace to be grateful for it. NEWS: Our son Martin is visiting his sister Dani, her husband Charles, and his nephew James in Singapore. Martin has a daily record with pictures at his blog. I hope you will check it out. It's great to travel to exotic places from one's computer. Tomorrow I visit the Seattle Cancer Care Alliance to consult with a renal oncologist on any further steps which might be helpful in addressing the kidney cancer. Then I see Dr. Higano who is the regional expert on prostate cancer. There is always a little anxiety about the possibility of discovering something negative, but I am the kind of person who needs to know what is happening in my body so I welcome such consultations. I'll report later on what we find out. In the meantime, I hope you all are enjoying ordinary time.

Back In the Pulpit Again

Today was my first opportunity to preach following sick leave and surgery. The congregation was gracious in welcoming me back. Martin, Christine, Ron, Jeni Allie and Nicole all came up from the Seattle area to provide family support. They sat in the balcony where I could see them very well from the pulpit. I must say that it felt very good to be involved in leading worship once again. Through my illness, I think I only missed one Sunday in attending worship. Against my family's protests I was determined to be present three days after being released from the hospital. Somehow, the need to give thanks and praise to God became of primary importance to me. It is hard to express the value of such a loving community of support through an illness. My sermon addressed the text for the day which was the story of Jesus healing ten people with leprosy. I sought to tie the experience of healing into my recent journey. The sermon is posted on the web site of the First Congregational United Church of Christ. In the afternoon we had a leisurely lunch celebrating the birthdays of son-in-law Ron and granddaughter Allie. It was a full and very pleasant day. Marilyn and I took a mile walk around the neighborhood in the late afternoon and snacked on leftovers for supper.

Back to Work

October provided my opportunity top return to work as a member of the pastoral team of the First Congregational UCC I eased into work since Friday, October 1st and Monday, October 4th were days when the church office was closed. I assisted in a memorial service on Saturday, helped serve communion on Sunday and was in the office from Tuesday-Thursday. I find myself getting a little tired physically at the end of the day, but am excited to get my mind around the daily concerns of church administration and sermon preparation. I will preach for the first time on Sunday. The lectionary text is the healing of ten lepers. One returns to thank Jesus. To receive a text on healing after my surgery and recovery is a blessing and I am working hard to incorporate some of my experience into the analysis of the text. I have been fighting off a cold and this morning my voice is a basso profundo. I hope I'll have enough voice tomorrow to make it through the service. After church we are hosting a birthday dinner for granddaughter Allie and son-in law Ron. I don't really need to talk much then, just be available with smiles and hugs. It is a joy to step back into the pastoral shoes. I realize that I have missed that milieu during my days of rest and recovery.

Another Visit to SCCA

Friday, Marilyn and I drove to Seattle for an appointment at the Seattle Cancer Care Alliance (SCCA). Having treated the kidney cancer, it is now time to pay attention to the prostate cancer. My appointment was with Claire Works, Dr. Higano's nurse practioner. We reviewed my blood panel and found that almost everything was in an excellent range. The exception was my creatinine lever which was 2.1. This is a measure of renal function, so it is an important check on my remaining kidney. My last score was 1.8 and they would like it to be 1.5 or lower. It is affected by hydration so I am on a regime of drinking lots of water this week and having another blood panel on Friday. I hope that will lower the score. Dr. Higano suggests that I have an appointment with the renal oncologist to see if any follow-up on the kidney cancer is called for. In addition she has arranged an appointment with a radiologist oncologist to consider treatment for the prostate cancer. One thing I appreciate about the SCCA is that they are meticulous about following every diagnostic option and providing regional experts in each field of cancer care to provide their input. I am grateful for this because I'm a person who needs to know a great deal about what is being proposed and why it is recommended. I want to be a full partner in making informed choices about my care. I hope I don't become a pest to the medical community with my many questions. It appears that the next months will be dotted with various tests and consultations, all of which will give the doctors and me a better understanding of my physical situation. At the same time I will be working to strengthen the spiritual dimension of this process of healing and I still covet your prayers.

A Pause in the Journey

Last Friday, October 1st, I had an appointment with my renal surgeon, Dr. Takayama at the University of Washington Medical Center. It was a check up six weeks after my surgery. Dr. Takayama is a very personable individual with a reputation for being somewhat conservative in his medical practice. That is just fine with me. Marilyn and I had scheduled a cruise to Alaska long before these medical conditions were discovered. The cruise was to begin about four weeks after my surgery and I was feeling pretty good. I thought it would be a nice way to continue my recovery. I mentioned the idea to Dr. Takayama and encountered a stone wall. . . . He said that complications were possible for during the six weeks following surgery and that a complication to my surgery would be beyond the medical skills of doctors on the ship or in Alaska. He told us that he received frequent calls from Alaskan doctors who were treating people in crisis. "You can go to San Francisco or Los Angeles," he said, "there are plenty of doctors there. But you don't want to have an emergency in Alaska." So we cancelled out trip, feeling very badly about the companions who were traveling without us. Fortunately our tour guides had recommended cancellation insurance and we should have a refund of the cost of the trip. On Friday Dr. Takayama seemed very pleased with the work he had done on my body and indicated that my healing was progressing very well. He signed an approval for me to return to work which I have already done. I intend to watch my energy level and work a 40 hour week which is ½ to 3/4 the usual work week for clergy. I think it will go well. My visit with the doctor also reminded me that I am at a way-station in this journey and there will be many medical adventures ahead. As the doctor put it, I have an advanced form of kidney cancer which has been treated through surgery. We will have CT scans every three months to look for any spread of the cancer. No further treatment is indicated unless there is indication of new tumors. On the other hand I have an advanced case of prostate cancer which now needs attention. After seeing Dr. Takayama, Marilyn and I drove over to the Seattle Cancer Care Alliance (SCCA) at Fred Hutchinson to deliver several vials of blood and other body fluids in preparation for an appointment next Friday with the nurse practitioner who works closely with Dr. Higano, the prostate cancer specialist. Last August I received a hormone shot which more-or-less puts the prostate cancer to sleep for a time. I suspect that Friday I will learn about the next steps in treatment. Although I don't look forward to further medial intervention, I am fully aware that my first hospital visit and surgery in August literally saved me from a serious, and perhaps fatal, problem from the renal tumor. I still receive each day as a gift from God and literally am buoyed up by the prayers and concerns of so many friends and members of congregations I have served. This means that the future, whatever it may bring is to be received with gratitude.