Archive for January 2012

Living Intentionally

January 24, 2012

When I was first diagnosed with colon cancer five weeks ago, I wrote about how our lives, like roads, can have familiar and “predictable” sections.  But God, for His purposes, sometimes sends us off the predictable into the unfamiliar [ Detour Ahead, Exit Now ].    I’ve been on those “unfamiliar” roads the last five weeks and I have written about frustrations [ GPS is Spinning], and the challenges of unanswered questions [ Unanswered Questions  and Solving a Maze ].

Two weeks ago my ulcer, after being somewhat hard-to-find, was found again.  Then last Tuesday I met with the surgeon in Buffalo and we scheduled surgery for next Thursday, February 2, to remove the cancerous part of my colon .

In the last few weeks, my life has become very “intentional.”  I have been very selective of what I have done in my waking hours.  Because the doctors have told me that I will be “out of commission” for at least four weeks, I have wanted to finish up as many important partially completed projects as possible.  I have also wanted to get everything ready and scheduled for those who are going to be speaking in my behalf at my regular speaking engagements.  And I want to select and gather the various books that I hope to read while I am convalescing.  And since it is winter, and we live in upstate New York, I have wanted to make arrangements for our home and cars so that as much as I can, I will have everything in place for my wife and youngest son to be “ready” for whatever weather we receive in the month of February [both Patty and my son have now had, and passed, “snowblower lessons” 🙂 ; and for the first time in ??? years, our garage is cleaned out and there is actually room to park a vehicle inside(!)].  All of this has only come about by God’s grace and by my being very “intentional” in how I have used each day.

Recently, however, I have thought a lot about “intentionality,” and about how we can be very motivated and intentional when we have a project deadline, a test, houseguests coming, or a vacation.  I can also imagine that a person with an awareness that he has a terminal disease, and probably limited time on earth, can also be very “intentional” in how he uses his available strength and days.  We prioritize that which is important, which we must “get done,” when we have limited time.  Several verses in Scripture have come to my mind.

James writes: “For what is your life? It is even a vapour, that appeareth for a little time, and then vanisheth away.”  (James 4:14)

In this passage I am reminded that all of our days are unpredictable. Therefore we shouldn’t presume to have or take any present or future day “for granted” – whether or not we have an upcoming “deadline.”   We may not have a tomorrow.

Paul writes:  I [appeal to] you therefore, brethren, by the mercies of God, that ye present your bodies [as] a living sacrifice, holy, acceptable unto God, which is your reasonable service.”   (Romans 12:1)

Paul reminds me that I am to be making conscious choices to present myself to God in ways that are acceptable to Him.  This applies every day, not just when I am highly motivated to accomplish some goals, or when I see my time “running out.”  All of my life is to be lived in such a way as to be pleasing in God’s eyes.

Jesus says:  “Therefore I say unto you, be not anxious for your life, what ye shall eat, or what ye shall drink; nor yet for your body, what ye shall put on. Is not the life more than the food, and the body than the raiment? Behold the birds of the heaven, that they sow not, neither do they reap, nor gather into barns; and your heavenly Father feedeth them. Are not ye of much more value then they? And which of you by being anxious can add one cubit unto the measure of his life? And why are ye anxious concerning raiment? Consider the lilies of the field, how they grow; they toil not, neither do they spin: yet I say unto you, that even Solomon in all his glory was not arrayed like one of these. But if God doth so clothe the grass of the field, which to-day is, and to-morrow is cast into the oven, shall he not much more clothe you, O ye of little faith?”  (Matthew 6:25-30)

Solomon writes:  “Let us hear the conclusion of the whole matter: Fear God, and keep his commandments: for this is the whole duty of man. For God shall bring every work into judgment, with every secret thing, whether it be good, or whether it be evil.”  (Ecclesiastes 12:13-14)

I am here reminded that while Jesus tells me that I am not to be driven by anxious worry, Solomon reminds me that ultimately it does matter how I live.

And so I am reproved, that while I have been motivated to live very purposefully, very intentionally, these last few weeks, and I have genuinely wanted God to use my present experience with cancer for His purposes, I really need to live purposefully, “intentionally,” in a way that is acceptable in God’s eyes, every day, not just when I’m staring at foreshortened days, an imminent challenge, a trial, a deadline, or an ordeal.

Solving a Maze

January 16, 2012

The last couple of weeks have been interesting.  It has been very much like trying to figure out a maze on paper.  With a pencil one tries different paths and then finds that one after another, each path seems to be taking you to a desired end, but instead leads you to the same place, a dead-end.  In diagnosing medical conditions, doctors need to rule out improbable causes from probable ones.  It is interesting when you are the patient.  Each test could lead to an answer to the puzzle of what’s wrong with you.  As you go through each test you weigh all the “what ifs,” both good and bad, for what that test could reveal.  You don’t want to become too “invested” in the results of any particular test because you know that another test could invalidate any earlier conclusions.  This is the maze that I have been living for the last couple of weeks.

Many paths have been tested; but the results have been inconclusive.  After my colon cancer was diagnosed on December 15 I had a CT scan to see if the cancer had spread to other organs.  Good news, it hadn’t.  Then a second pathologist interpreted the biopsy.  Bad news, confirmed, it was cancerous.  Then I was given a blood test to see if there were any indications of cancer.  Good news, there weren’t.  Then I had another (abbreviated) colonoscopy. Good news(?), the ulcer was not found.  Then a PET scan.  Good news, no cancer found.  Then I was given a DNA test to see if the biopsy was someone else’s.  It was mine.  The sequencing of all these tests was giving the impression that there definitely was cancer in my colon on the day of colonoscopy #1 (December 13), but the cancer seemed to be off the radar from then on.

With each test, I couldn’t help but “imagine” what results (a) versus (b) could mean.  Naturally I was thankful for every result that indicated “no cancer.” But the seeming contradiction between the initial diagnosis and the follow-up tests was hard to reconcile.  On December 15 I became aware that God telling me it was time for a detour from the predictable (see “Detour Ahead, Exit Now,” below).  My mind was racing, thinking of all the ways my life could go with a cancer diagnosis – Metastasis? Chemo? Radiation? Surgery? Numbered Days?

First I wondered about metastasis and very numbered days, then I wondered about errors, “Whose biopsy was it?”  “Did the doctor make an error? Or the lab?” Then I wondered if God might have healed the cancer.  The result of every test could have been (a) versus (b) and it was hard to not reach premature conclusions whenever a test result came back.  I was wrestling with the questions, “God, what are you doing?”  “What’s going on?”  “God, have You, in fact, healed me? Or have You not, and would I be foolish not to pursue the recommended medical advice?”  “Or if God really had healed me, would I be foolish to let them remove one side of my colon, as a precaution, ‘just to be sure?’”  [I certainly didn’t like the last idea at all!]

I knew that when King Nebuchadnezzar threatened Shadrach, Meshach, and Abed-nego with death they acknowledged that God could deliver them miraculously, if He would so choose, but they didn’t know if God would (Daniel 3:17).  Similarly, I knew that God could have healed my cancer after it was first diagnosed, if He wanted to, but I didn’t know if He had.  Many people were praying for me, and I would imagine that some were praying for God to heal me.  However, from the beginning of this journey it has been my prayer that God would do according to his will with the result, not necessarily of my healing, but rather with the result that He would be the most glorified by what He would choose to do in my life.

I knew that the Bible recorded that God used hardship in the lives of many of his servants for his purposes, even though his purpose was often hidden from the view of the particular servant.  I wondered what God was going to do in my life.  Would I know his purposes?  I had many questions, and no idea of what the doctors were going to conclude, or if God was doing something miraculous, or where God was leading.

However, last Friday (January 13) I had colonoscopy #3.  It was a full colonoscopy, and myRoswellParkdoctor was able to find the ulcer this time.  After the procedure she said, “I found it, it is small, and that is good – but it needs to come out.”  Then, all of a sudden, it became clear to me that the other “paths” in the maze, some of which had appeared to be very appealing, were dead-ends.  God now seems to be showing me, “This is the way, walk in it.”  So, in this I will rejoice and continue to pray that God will do what He will so that He might be the most glorified.

“Yet I will rejoice in the LORD, I will joy in the God of my salvation.”

Habakkuk 3:18

Decision Helping Questions

January 8, 2012

It is now expected that the results from a DNA test on my biopsy will be back the first of next week.  Until then I am in a waiting pattern.  When the results come back it is possible that I will be faced with a difficult medical decision with no clear-cut obvious direction to go.  A couple of times I have asked a wise friend for suggestions of questions to ask doctors at difficult decision points, such as this.  The questions that have been suggested to me have been very helpful and I have decided to share them.  I have reworded them so that they all refer to a “treatment” or “procedure.”  This could be major or minor, in-patient or out-patient surgery, or some other treatment plan.  Feel free to use one or more of these as a starting point if you have to talk to a doctor about a difficult medical decision for yourself or a loved one.

As a pastor I have met with many families who have had loved ones facing decisions about medical procedures and treatment plans.  Sometimes the families have been well informed of their options, sometimes they have not.  Some have done exactly what the doctor has recommended; some have explored other possibilities, and taken slightly different routes.  Neither is necessarily right or wrong.  I know that I want to be as well informed as I can be before I make major medical decisions.  I certainly want to encourage others to be as well informed as they can be too before making (sometimes) irreversible decisions.

Regarding the current situation:

  • You may want to begin your discussion with your doctor by saying something like:  “I hope to learn from you my medical condition and its prognosis, along with all the possible treatment choices and your recommendations for which of them to do and in what order.”
  • “Do you already have all the information you need to make those determinations, or will you want any other tests?”
  • When the doctor discusses your prognosis, both in terms of the underlying disease and in terms of specific courses of action, ask him/her to please put numbers on the probabilities.*
  • “What are the risks, statistically, if I do have the treatment you are recommending?”
  • “What is the range of effects I might experience if I don’t have the recommended treatment?”
  • “What are the treatment alternatives, and their respective risks?”
  • “What might happen if I don’t do anything?”
  • “What are the risks, statistically, if I don’t do anything?”
  • “When and how might I become aware of physical effects?”
  • “If you do the recommended surgery (or procedure), what are the possible ‘surprises’ you might find, and their probability?”
  • Before any surgery or extensive treatment program it is often considered to be wise to get a second opinion from a specialist not affiliated with your doctor (in other words, not his/her partner, or in the same medical group).
  • Your meeting may end with your being faced with a decision on what to do and where to do it.  It may be helpful to make it a rule to try to never make medical decisions without having a chance to talk privately, without medical personnel present, with your spouse or other family member(s), or close friend(s).  Where possible, it would be good to have at least an overnight period to discuss and ponder, but that can’t always happen.  You almost always can go into another room with your spouse or family members or friend and talk (and pray) privately and then come back and give your answer.
  • A question to ask yourself:  “In which decision is it worse to be wrong?”

Regarding post-treatment:

  • “What effect will this procedure have on my future overall medical condition?”
  • “What effect will this procedure have on my lifestyle (for example: diet, exercise, mobility, health, etc.)?”
  • To the doctor:  “Based on your experience, do you already know what the probability is that I will be needing any particular treatment following the surgery (e.g. chemo, radiation, physical therapy, etc.)?”
  • To the doctor:  “What, if anything, can you tell me now about those post-surgical treatments and their impact, frequency, duration?”

Neither I, nor the person who gave me these suggestions, is licensed to practice medicine.  Hopefully these questions will help you get helpful information for your decision making process from those who are.

“The fear of the LORD is the beginning of knowledge: but fools despise wisdom and instruction.”
Proverbs 1:7


*  Please note that statistical probabilities are never “guarantees.”  In asking doctors about statistical probabilities you must understand that no doctor can guarantee any particular outcome and any statistical probability could be way off in any individual situation.  You must carefully weigh the answers you receive against ALL of the other options.

Joni Eareckson Tada

January 3, 2012

When I do aerobic exercises at the gym I usually listen to an MP3 of some conference lecture, or occasionally I read magazine or journal articles. When I went to the gym today I wanted to be sure that I could hear my cell phone if I got a call from a doctor or the mechanic who was working on my car. Consequently, instead of the iPod, I pulled a couple of magazines out of my gym bag before heading to the stair-step machine. It has been quite a few months since I’ve read any articles. The magazine I “happened” to pick up was the October 2010 issue of Christianity Today. It had been left folded open to pages 30-31. As I glanced down I saw that the article title was, “Something Greater Than Healing,” an interview with Joni Eareckson Tada.

In 1967, at age 17, Joni was severely paralyzed in a diving accident and has been living with quadriplegia ever since. For the past ten years she has been living with chronic pain. Last year, at age 60, a month before the article was written, she was diagnosed with breast cancer. Today, January 3, 2012, I appreciated all of what Joni had to say in a way that I wouldn’t have a month ago. Here are some excerpts from the interview.

——————————————————————————————–

CT: How has your perspective on suffering and healing changed since your breast cancer diagnosis?

Thankfully, it hasn’t changed at all. You examine Scripture again and follow every passage regarding healing. I did that with my quadriplegia, and I did that again 10 years ago, when I embarked on a whole new life of chronic pain. Just a month ago, getting diagnosed (more…)

Unanswered Questions

January 2, 2012

I am very thankful that since my last post God has enabled me to get done what “had” to be done before several deadlines, and I have been able to spend time with my family in Pennsylvania.  Prostate cancer has been ruled out by the blood test last Tuesday and the specialist in Syracuse has said that an aneurysm found during the CT scan does not need any intervention (and will only need to be checked every six months).  However, my colonoscopy on Thursday was unsuccessful in marking the ulcer for surgery and raised a number of questions.  Simply put, the doctor couldn’t find the ulcer.

Unfortunately, from my perspective, we haven’t been able to communicate with the doctors because of two “phone tag” situations just before everyone went home for a long weekend.  In retrospect I “wish” I had made additional provision so that the doctors’ offices would have been able to reach me.  As it now stands I really don’t know what the doctors are thinking or planning.  I was still under anesthesia when I last spoke with my doctor after colonoscopy #2 last Thursday, and that doesn’t facilitate clear-headed communication.  [After my first colonoscopy the doctor and nurse had told me not to drive, or make any major decisions, or change my will during the balance of that day!]  Patty and I remember parts of what the doctor said, but do not know “where we go from here.”  I believe it is possible that the doctor may not have looked deep enough for the ulcer (even though she went twice the distance that it was supposed to be), or it may be that my biopsy got confused with someone else’s (which is now being checked through the DNA), or it may be that the surface of the ulcer somehow “healed over,” or maybe the ulcer itself is healed.

In fairness to the doctor, I am probably confusing some of what she said, but from somewhere within my foggy still-anesthetized mind I believe she did say something about removing that “side” of my colon.  Tomorrow morning I am supposed to have a pre-op appointment in Buffalo with the surgeon who would be doing the surgery, but I have many unanswered questions, I can’t talk to the doctors and I am not comfortable with the idea of anyone removing “one side of the colon” when the doctors do not appear to be sure that that is where the cancer is (or was?).

So, today, how do I deal with my “unanswered questions?”  I am frustrated with myself for not having handled provision for phone communication differently last week – even though what I told the “check-in” staff on Tuesday made the most sense at the time.

I can’t help but think about the various times in my life when I “wish” I had done something differently hours, or days, or weeks before.  I think, “If only I had . . . ,” things would be different now.  But what about God?  Where is/was He in all of this?  Couldn’t He have somehow prompted me to have made a different decision last Tuesday?  Couldn’t that have eliminated my current frustration if I had been able to speak to the doctors (or nurses) last Thursday and/or Friday?  Yes, it certainly could have.  But since I believe that God is good, sovereign, all powerful and all knowing, I have to conclude that He has a purpose in allowing this chain of events to unfold in this way.  Quite frankly, I’m not very happy about it.  I don’t like having unanswered questions about procedures that could significantly impact the rest of my life.  I wish I knew what was going on inside my colon and why the doctor couldn’t find the ulcer.  I don’t know how this will unfold, but for now, I must instruct my soul to remember that God . . .

“He is the Rock, His [work is] perfect: for all His ways are [right]:

a God of truth and without iniquity, just and right is He.”

Deuteronomy 32:4