November, 2005

Monday, November 28th.  Tonight I updated the information in the section on Christie's Current Treatment.  Here it is:

On Friday, November 18, Christie had a modified radical mastectomy.  After her surgery, the pathologists analyzed the tissue and lymph nodes removed during surgery to determine how far the cancer had spread and what treatment will need to be considered.  The results showed that Christie had another, larger tumor in her breast that had gone undetected.  For that reason we give thanks to God that our son or daughter in utero made a mastectomy the only option, since it was exactly what was warranted by the progress of the cancer.  The tests also clearly showed cancer in three of the seven lymph nodes that were removed.  All of these features taken together put her cancer at Stage II.

These lab results indicate that Christie will need to receive six doses of chemotherapy.  They will commence on December 16th.  The chemotherapy will be administered every three weeks.  Over the  years, these specific types of chemotherapy have (amazingly) been used on pregnant women with no adverse effects on their babies.  That is what we are praying for.  After the chemotherapy is completed, she will start a regimen of Herceptin, which is an antibody that inhibits the growth and division of cancer cells.

Now, here is the rest of today's thoughts:  Over the past several days, Christie's shoulder has begun to swell considerably and is quite uncomfortable.  We are visiting the surgeon again tomorrow afternoon to have him decide how things are progressing.  We also worked to begin a series of appointments with a physical therapist to assist her in gaining back the full use of her arm.  Thankfully, Christie has been sleeping fairly well.  What a gift sleep can be.  If you are a parent you know exactly what I am talking about.  I never knew as a teenager, bachelor, or young married man how privileged I was as a member of the class of human beings who could sleep at will.  How many years of nights did I waste in reckless, thankless slumber, never realizing that just being able to close one's eyes and doze for an uninterrupted chain of hours is one of the good and perfect gifts that comes down from above.  How many naps did I actually take and enjoy to the fullest when I was young?  O, my wasted youth.  After our first baby was born, my eyes were (as you might guess) opened in both the metaphorical and literal senses.  Now, several children later, I usually do not forget to be thankful for those nights that have the look and feel and duration of real sleep.  In fact, there have been times when sleeping actually seemed more compelling than other normally premier attractions like eating or reading.  I never thought a person could thirst for sleep, but all mothers and fathers know it by experience. 

Last night, my wife and I spent a while constructing some schedules for the Turnbull kids' school subjects and chores.  Naturally, Dad and kids are going to absorb (and have been absorbing) the many responsibilities that Mom carried everyday.  I had a briefing with the troops at 0800 hours.  They were willing and cheerful and have been adjusting not only to this new schedule, but also to every bump and change of direction that this situation has introduced with great fortitude.  I am quite proud of them.  Of course, they have their moments of feeling overwhelmed by everything, but they have acclimated so well I have to conclude that many of you have been praying for them and that God is answering their parents' prayers that this trial will allow them to see and know and trust God like they never could otherwise.  Thanks again for praying for us.  Please pray particularly that my wife's shoulder will heal and that we would all be prepared for the hardships that come with chemotherapy.  Whom have I in heaven but You? And besides You, I desire nothing on earth.  My flesh and my heart may fail, but God is the strength of my heart and my portion forever. --Psalm 73:25-26

Here are two pictures captured this afternoon as our son submitted to his first ride in a girl-drawn sled.

Saturday, November 26th.  We really want to find out if this baby is a girl or boy, because we are overready to give the child a name.  That will be a break from tradition since we have appreciated the suspense and anticipation that not knowing brings to the last stages of being pregnant.  (I personally don't know what it is like to be pregnant, but I have been around a pregnant lady for many years.)  Our three-year old has related to us repeatedly that this baby is actually "Olivia."  That is a great name but it might not fit a boy.  Besides, it seems obvious that this baby needs a very meaningful and heroic name.  If you had to endure your mother's surgery and chemotherapy while you were being formed in her womb, you would have already conquered much by the time of your delivery.  It seems inappropriate and lacking in dignity to allow a baby who is the companion of so much of my wife's suffering to be called "him or her."  It is akin to Paul having to call Timothy  (his fellow-sufferer for the sake of the gospel) "that guy."  Therefore, we are keen for the day when we learn if "he or she" is "him or her" and we can bestow a fitting name on this  young Turnbull whose very life will be an evidence of the strength that God gives to the people He makes. 

 Friday, November 25th.  I was thinking yesterday about all of the reasons why we should give thanks to God on Thanksgiving.  One of the most significant is that we get to be together.  It might be just me, but as I get older, the more simple, mundane things that are a part of each day--things like sharing a meal together as a family--show themselves to be actually some of the greatest gifts of God.  And it is partly tragic that those daily things are the very blessings we often skip when it comes to genuinely giving thanks.  It should be obvious that we did not skip thanking God for the honor of being together as a family yesterday (or today).   My mom did a first-rate job in hosting our family and my sister and her boyfriend for dinner.  Mom, if you are reading this, thank you.  By the way, Kenny introduced all of us to an ancient Chinese secret.  For truly delectable mashed potatoes (called Mashies by our third daughter) add an entire head of cauliflower to the potatoes when you boil them, then mash them up together.  You may be a skeptic (as we all were) but we our palates were given a meteoric ride through the milky way galaxy at light speed by those potatoes.  If you have a mind, you have to try them. 

One of the other reasons we have been thanking God is that He has done something quite unusual during this pregnancy.  In each of the previous seven pregnancies, Christie has been exceedingly nauseated for the first four or five months.  This feature has made her eagerness to mother more children even more admirable.  Some women waltz through pregnancy.  Christie has to climb uphill through it.  But she does so very steadfastly.  Anyway, in a suprising shift, she has experienced almost no nausea this time.  Now if you were used to feeling like throwing up every day for months on end as standard procedure, and then you didn't, it would be somewhat startling.  It was actually alarming.  That is why she requested an early ultrasound, because she concluded that if she was not nauseated, something must be wrong with the baby.  However, several ultrasounds (as well as all of the other classic symptoms) have shown that she is very pregnant and that the baby is growing as he or she should.  So, our conclusion has been that Jesus Christ has once again shown tender-kindness to my wife in the midst of a difficult situation.  That is another remarkable thing for which we directly thank God.   

Wednesday, November 23rd.  It might sound trite because we have stated it so often, but we are really grateful for you all who are praying for us. We really mean it.  Thank you. 

Of all the afternoons in November thus far, this was one of the biggest.  At the first appointment with Dr. Pitts, he and Lisa (who has always treated my wife so professionally and compassionately) performed an ultrasound on the baby.  It was a great show.  We were naturally very enthused to see his or her heart beating and we were able to see that baby seem to be preparing for an upcoming fight in the boxing ring.  See the action shot of young Turnbull to the left, taken just today! 

Our meeting with Dr. Monson was very informative and we were once again thankful that he has been our surgeon and advisor over the past few weeks.  If you need some kind of organ removed, he should be your first call.  Subsequent to examining Christie's stitches, etc. he declared that she was healing splendidly.  Thanks be to God for that.  Then he spent lots of time thoroughly explaining the results from the pathology report.  (I, personally, was thankful that we did not have to wait longer than today to get that report.)  The lab results showed that the one lump that had been discovered and biopsied was actually the smaller of two tumors.  The other had been undetected.  Dr. Monson expressed emphatically how grateful he was that she had had a mastectomy.  If she had not been pregnant, then the normal treatment would have been to remove the lump and do radiation or chemotherapy.  That means if she had not been pregnant, that she would be walking around today with a cancerous tumor.  What many may consider a complication to cancer treatment (that human being in my wife's womb) is actually the person God used to force the very kind of treatment that was best for both mother and child (and husband and children, and family and friends).  One could label that serendipity or one could recognize the kind, sovereign hand of our Creator in the midst of this difficult situation. 

Dr. Monson went on to articulate that Christie had many examples of precancerous tumors throughout the tissue he removed in surgery and that, most significantly, several of her lymph nodes were cancerous.  That was the most weighty feature of the report.  It means that it is within the realm of possibility that cancer cells have at least traveled to other parts of her system.  This puts her breast cancer in a much more serious stage than earlier assumed. Our doctor spent a great deal of time with us answering questions and explaining details.  Thank you, Dr. Monson, for your superior service to me and my wife.  Strangely, Christie was relieved by this report; she was bracing herself for even a more advanced appearance of growth to the cancer.  Not surprisingly, I was fairly flattened by the news.   

Our meeting with Dr. Smith, the oncologist, was quite informative, especially in regard to the details of the planned treatment.   Her dedication to helping people with cancer is evident in her thorough knowledge of her field.  From her we learned what duration and effects the chemotherapy would likely assume and had so many questions answered that Christie was again relieved. 

So many people have called us this week and prayed for us and provided meals and written cards.  We are very unable to answer them all, but are thankful for every gesture.  Please pray with us that we would trust God everyday, as each day comes, and that our kids would see God's goodness and His excellence, even through (and because of) this difficulty.  We know that we have this treasure in earthen vessels that the surpassing greatness of the power may be of God and not from ourselves (2 Corinthians 4:7).   

 Tuesday, November 22nd.  Thank you again for praying for Christie.  She has struggled with increased numbness and swelling near her shoulder, but she has not had to take any medication at all for the entire day. 

We look forward to tomorrow.  While our kids get to spend lots of time with their Aunt Cathy (who has simultaneously telecommuted to work and helped our family motor along smoothly), we will be in Wenatchee for three appointments.    First, we will have an ultrasound to see how the baby is doing.  This is the first ultrasound since the surgery and we are eager to know how young Miss or Master Turnbull is getting along.  Second, we will meet with Dr. Monson who performed the surgery and he will assess Christie's recovery and remove some bandages.  We think and hope that he will also have at least a preliminary pathology report to discuss with us.  Of course, this will be definitive in terms of knowing how extensive the progress of the cancer is.  The comforting thing is that God already knows how extensive (or not) the cancer is.  He is working out His plan in our lives and He only asks us to trust Him.  Behold, God is my salvation, I will trust and not be afraid; for the Lord God is my strength and song, and He has become my salvation (Isaiah 12:2).  Our third appointment is with the oncologist, Dr. Smith (not to be confused with the famed doctor friend of Will Robinson).  I assume we will also be discussing the report with her. 

A highlight of the day for Christie and me was sitting in the dining room watching our son eat.  Only a child's parents can find deep pleasure in simply watching that child consume apple slices and Cheerios.  At one year-old, his greatest tricks have mostly to do with eating.  Actually, he can also play the piano quite well, only with some adjustments to normal technique.  He usually plays standing up on the piano bench.  And, he does not obey the normal rules of tonality.  It is almost as if he has no real concept of key.  Hmmmm.  We have a new appreciation for the simple pleasures of being together and being with our children as they grow. 

Monday, November 21st. Besides a few really satisfying naps throughout the day, Christie had lots of time with her family.  Several highlights of the day included clean hair, more substantial meals, fewer Tylenol, and playing the piano.  That's right, Mrs. Turnbull played the piano . . . with both hands! To her husband, the rapidity of her recovery seems incredible, and being able to play the piano three days after surgery appears certifiably miraculous. 

The oldest Turnbull girl has been spending several evenings a week in rehearsal for Leavenworth Summer Theater's production of It's a Wonderful Life.  Proud of her daughter, Christie wanted me to include the link to the promotional for that play on the Leavenworth website.  Here it is:  http://www.leavenworth.org/  Just scroll down to see an action photo of her as George Bailey's daughter. 

The funniest thing that happened today occurred this afternoon as I was working at the couch in my office.  Christie was sitting next to me and our three year-old was playing a computer game for children.  As I was attempting to concentrate on my work, the "musical" background for the game was making work a bit like trying to split wood without an axe.  I began whispering my complaint to my wife through clenched teeth: "I suppose every child's computer game has to be accompanied by annoying sounds."  In an unusual moment of withering severity and acerbity, my wife skewered me with the following reply: "Any man who listens to Herb Alpert  should be comfortable with odd noises." I was temporarily paralyzed.  Odd noises?! Did she not realize that Herb Alpert and the Tijuana Brass were responsible for producing some of the highest expressions of culture in the late 60's and 70's?  Doesn't she know that Herb was the early seventies?  I am tempted to roll my eyes, but then I remember that my wife may yet be experiencing some vestigial effects from the anesthesia.  Someday she will come to see the profundity of my musical preferences.  At any rate, it was a great day and one marked by increasing strength and that is a gift from God. 

Sunday, November 20th. It would be hard to express how encouraging it is to be a part of the Body of Christ.  If not for other followers of Christ, the weight of this situation would be quite crushing.  For example, the people of our church, Cornerstone Bible Church, have spent so much energy getting things in place to help us on a weekly basis when and if chemotherapy begins and to see that the members of this family will not be nightly subjected to the culinary horrors produced by Dad in the kitchen.  As another example, the families in the Co-op where I teach in Wenatchee have provided the resources and avenue for getting weekly grocery items.  Additionally, my wife has received daily encouragement from friends and family across the country who are praying for her, and even from some people she has never met!   So many are being so generous with their prayers and time that we realize we are part of something much bigger than just cancer.  We see again that the greatest honour a human being can have is to be a recipient of the mercy of God and to be one of His servants and part of a story that is longer than our lifetimes and much more significant than our immediate comfort. 

Over the course of this day, Christie's discomfort has gradually decreased and she was able to stop taking the pain medications and just resort to Tylenol (this is not an advertisement; we actually used Safeway's generic acetaminophen [this is not an advertisement for Safeway, either]. It's not that we don't like either Tylenol or Safeway, it's just that we are not secretly receiving sponsorships from any pharmaceutical companies.  Christie is strictly an amateur drug user.)  At any rate, she is doing so remarkably well that we are thanking God for her great progress.  Thank you for praying.  Spending many hours with her children and sister and husband made this day a welcome change since she left for the hospital on Friday. 

Saturday, November 19th, 10:00 p.m. Yesterday was, naturally, a big day for our family.  Christie and I left early in the morning for Wenatchee as Aunt Cathy (Christie's sister)  was firmly and cheerfully established in the house as the Aunt-to-surpass-all-Aunts in caring for her nieces and nephew.  The preoperation preparations went smoothly with the exception of starting the I.V.  As though part of a subtle conspiracy against her equanimity, her vein collapsed in her wrist and so the nurse had to (according to the fateful phrase) "try again."  My wife looked at me with the look that a young goose gives to its mother as it is going with the farmer to "get ready" for Christmas dinner.  I tried to comfort her by talking about our son's recent antics.  It didn't quite work.  She knew I was trying a not-so-subtle distraction ploy I read about in one of my undergrad psych texts.  But she did ask me to pray, and the second attempt at the IV was very successful.  Shortly afterwards, Dr. Thomas, the anesthesiologist, came in to discuss the surgery and to spend some time praying for us.  That was a great reassurance.  Then Dr. Monson spent some time explaining in very clear and cogent terms what he was going to do.  I think the thing I like most about Dr. Monson is how much time he takes to teach his patients and to answer any questions they have.  He is outstanding, and not just as a teacher, thankfully. 

Meanwhile, there were so many people in our church and many friends and family members praying for us. I can't really believe it.  It is almost perplexing to consider why God would be so gracious to the people in this family by making us the point of so much prayer.  One of the things I can figure is that it is a sign of how God has mercy on human beings because He is actually rich in mercy.  That word "rich" is not just a stylistic textual enhancement.  It is the truth.  God is, in truth, rich in mercy.  And one of the great privileges of going through this trial that God has appointed for us is that we get to see the depth of the riches of His mercy firsthand.  I am sure that must have been at least part of the reason Paul rejoiced in his sufferings. 

Back to the surgery--while Christie was sleeping her way through the procedure, I was waiting in the aptly named "waiting" room.  Five of our best friends came to pass the time and pray for me and my wife and read from Isaiah and John.  It was excellent time.  After about an hour and a half, Dr. Thomas' nurse came to say that the mastectomy had gone very smoothly and that they were going to have time to put the "portacath" in for the chemotherapy.  Both portions of news were very welcome and what we consider direct evidence of God's kind answer to much prayer.  If they had not had time to put in the portacath, Christie would have had to have another surgical procedure and we are eager to avoid too much of that kind of thing for the sake of the youngest Turnbull.  (This summary is becoming a novella.  I must be more concise!)  Later, both Dr. Thomas and Dr. Monson came out to the waiting room to confirm that my wife (and baby) were doing well and that the surgery had been very successful.  Praise be to God! 

It was another hour and a half before Christie was out of the recovery room and in her hospital room.  It was, as you can imagine, great to finally see her. One of my favorite parts about my wife's appearance is her classic Finnish forehead.  I like it when she wears headbands, but early in our marriage (when she used to wear them) I made too big of a deal about how beautiful she looked and she got embarrassed and will rarely dare to wear one. Anyway, her hair was swept back, like a graceful wave retreating from a sandy shore and there was that elegant forehead.  Anyway, you can imagine, that I kissed it.  The romantic feeling that animated that kiss was, however, not fully appreciated by the recipient.  Not fully coherent, she gave me a sort of weak smile.  I interpreted it in the best possible way and proceeded to get her rendition of what she could recall of the morning.

Over the course of the afternoon and evening we (the nurses, doctors and me [as junior assistant]) tried to fine tune her medication to get ahead of the intense pain in her shoulder and arm.  I have to confess that the nurses didn't quite give me the kind of credence that someone who has watched as many episodes of "Emergency" (starring Randolph Mantooth) as I have obviously deserves.  I know what Ringers Lactate means! Hey! I may be a layman, but I am an educated layman!  People are nurses, too!  That pain was worst in the middle of the night, but one very clever nurse realized that some ice packs might give Christie some relief.  They worked, and she actually got some substantial sleep last night.  Every small and big blessing like that warrants praise to God.  We thank Him for providing expert, professional nurses and doctors to care for us. 

We were able to come home this evening and see six children who missed their mom (and Dad) very, very much.  Aunt Cathy and "Gramnda" Turnbull had done a great job of caring for them and it was so deeply satisfying for Christie to get to hug them, even if just with one arm for now.  Over the course of the day, my wife's pain has drastically abated.  Thank you again for presenting your requests to God for her sake.  We have an appointment scheduled with the oncologist on Wednesday and we should learn then what the extent and status of the cancer is.  That is the next big juncture.  But tonight we can look back and realize that God mercifully shepherded us through a hard stretch of  this trial, and He did so with great faithfulness and in such a way that we got to experience His kindness. 

 Thursday, November 17th:  Tomorrow morning (at 8:30) Christie will undergo her surgery.  We are thankful to have such a professional and concerned surgeon and to have our anesthesiologist friend involved in tomorrow's procedure.  The surgery will involve not only a mastectomy, but also the removal of some additional lymph nodes.  Before the surgery is over, the doctor will "install" a port in Christie's shoulder to make it more feasible to administer chemotherapy later on.  Of course, the insightful moment for us will come in the middle of next week when we learn what the pathology report shows about the extent of the cancer in the tissue and lymph nodes.  As God is willing, it will be small. 

From the Scriptures we know that God made us and knows the number of our days and the purpose of those days.  This truth feeds our minds with hope and our souls with comfort during what would otherwise be somewhat unbearable anticipation.  Moreover, God gives us other, more urgent things, to fill our attention besides fretting (as we are sometimes wont to do) over possible outcomes: Shout joyfully to the Lord, all the earth.  Serve the Lord with gladness; Come before Him with joyful singing.  Know that the Lord Himself is God; It is He who has made us, and not we ourselves; We are His people and the sheep of His pasture.  Enter His gates with thanksgiving, and His courts with praise.  Give thanks to Him; bless His name.  For the Lord is good; His lovingkindness is everlasting, and His faithfulness to all generations (Psalm 100).  Thanks very much for praying! 

Tuesday, November 15th:  Christie made another journey to Wenatchee today to have an echocardiogram.  The superior results from this scan showed that her strong Finnish constitution and beauty extends even to the very core.  She received this test in order to ensure that she might take one of the newer treatments specific to the Her2neu cancer type. 

When she returned, she found that her daughters had concocted a fruit salad for dinner that combined heretofore uncombined fruits in a montage of flavor that raised dad's eyebrows.  It was all motivated by pure love and a desire to "serve Mom by making dinner."  Regardless of the leftover cherry juice found on the floor and cupboards, it shows that Christie is already getting good care from her family. 

Monday, November 14th:  Today Christie had an appointment with Dr. Pitts, our very trustworthy obstetrician.  A new ultrasound showed the baby doing well and at about nine weeks.  He also plotted the date that Christie's pregnancy will enter the second trimester.  This allows us to set a target for the commencement of chemotherapy.    Dr. Pitts talked through some aspects of the surgery with my wife, which was very heartening.

It is good to give thanks to the Lord, and to sing praises to Your name, O Most High; to declare Your lovingkindness in the morning, and Your faithfulness by night . . . For You, O Lord, have made me glad by what You have done, I will sing for joy at the works of Your hands.  --Psalm 92:1-2, 4

For the word of the Lord is upright; and all His work is done in faithfulness.  He loves righteousness and justice; the earth is full of the lovingkindness of the Lord.  --Psalm 33:4-5