Infusion Schedule

I got a call from Kaiser as I was riding in an Uber to the Dallas Fort Worth airport informing me of the schedule of my immunotherapy infusions: Friday, December 3, Thursday, December 23, and Friday, January 14. All will begin at 1:00 and take the rest of the afternoon. Many times immunotherapy has little or no side effects because it stimulates the immune system. This is quite different than chemotherapy which poisons the cancer cells even more than it poisons the whole body. So my prayer is that I will be in the majority who have little negative effects.

The radiation oncologist and have a meeting Monday morning to discuss the radiation treatment for the larger melanoma spot in my brain.

In the meantime, Sherry and I are having a great time with Donn and Susan and Elizabeth and MIchael here in Kansas City. Donn and I went to the Chiefs game after church yesterday. Here is a taste of what we saw. You will hear Donn loudly in the background!

Cancer Treatment Prep – Updated

Last week’s surgery, MRI, and oncologist consult left me with the understanding that I have two types of cancer: Bladder (which has been removed) and metastatic Melanoma with nodules in every lobe of my lungs, two places in my brain and apparently in my liver near my gall bladder. Most of the nodules are quite small. The doctors keep telling me how rare it is to have two types of cancer at the same time.

I continue to marvel that the blood in my urine led to a CT scan which providentially revealed the nodules in my lungs. Otherwise there is no telling how much they would have grown to produce symptoms. Early discovery means small nodules make for much more effective treatment.

Dr. Frager is the radiation oncologist who will be supervising the radiation treatment on the larger nodule in my brain. We will meet on Monday, Nov. 29 to set up that process.

The strike against the Kaiser system was averted so I am expecting a call today or tomorrow from the oncology folk to set up the immunology infusions (opdivo and yervoy for all y’all curious folk). Each treatment will take about 4 hours and be done every three weeks. After four treatments there will be a scan to check the effectiveness.

My big question is what will be the side effects of the two treatment modalities. Since they vary widely from person to person those life impacting questions are unanswerable for now.

A challenging thing is explaining to people that I have no cancer symptoms at all. I sleep well, feel normally strong, and am enjoying a full and fulfilling fife of family and ministry.

The great anticipation is removing my catheter in Wednesday’s follow up visit with Dr. Burt to check on the success of the bladder cancer removal. There will be great rejoicing when I am once again living a bag free existence! UPDATE: The catheter is extricated and I am now free. Dr. Burt confirmed that the bladder cancer was lowgrade so he does not see any need for any chemotherapy or other stuff – just have a look every 6 months in case it recurs.

UPDATE: I am headed to Ft. Worth for Evnagelical Theological Society where I will lead the “Evangelicals and Women” session. It will be outstanding. But three of the five presenters cannot be present because of international travel restrictions, so I am taking portable equipment to bring them in by Zoom. Then to Kansas City to meet Sherry and hang with Donn, my son and and his family for Thanksgiving. While we are there, we will go to Topeka to visit Sherry’s uncle and also to visit Quentin Heights Elementary School where I did 5th and 6th grades back in the mid fifties!

The Schedule for My Week

Sunday: Drive up to get outdoor nurses station for the COVID test required for my surgert with the nurses working in the rain. The nose swabbing briefly interrupted me doing deep spiritual work with a friend who has been hurt in a life event.

Monday: I will get a call somewhere in a day full of appointments letting me know what time to report on Tuesday. UPDATE: We check in at 9:45. For sake of my stomach this is not a good time. With an 8 hour no food order it will be a long time for breakfast.

Tuesday: My gall bladder extraction surgery will compete with teaching (by Zoom) my Boise Leadership Cohort and leading (by Zoom) an evening Q&R with the Leadership Development team at Reach Church, Kirkland. I am hoping the team can get a picture of my cancerous bush for me before they remove it. The surgery will be under full anesthesia out patient with no incision. Dr. Burt thinks it is early so the surgery and the chemo injection at the wound site will be the end of this cancer. UPDATE: The surgery is done and I am home, 5 1/2 hours after we left. Dr. Burt had to go deeper into the bladder wall to get all the cancer out so I had to come home what a catherter which is VERY annoying. Other than that I am doing well. Starting my day with 2 hours with the Boise Cohort before the surgery was a joy. I really shocked them when I joined after the surgery, but no longer as teacher.The is food and sleep in my near future! BTW, I did ask about the picture. I don’t yet know if he remembered to take it. Hope so. I will get the biopsy analysis when I meet with him next week.

Wednesday: A day full of faculty meetings and such. We’ll see how much I am up to doing. David (our son) and Zach will be with us for supper and bunking before their final Converge class.

Thursday: Normal activities will be spaced around a noon time MRI of my brain to see if the melanoma has metastasized there. The PET scan from a couple of weeks ago showed three metabolic hot spots (bladder, gall bladder and lungs) but it can’t differentiate cancer hot spots from thinking hot spots. So the MRI will answer Sherry’s burning question: “Does Gerry have a brain in his head??”. UPDATE: I have scientific proof – there is a brain in my head. Sherry’s follow up question came post MRI: “Is it functioning?”

Sherry will join me at 3:30 for an oncology consult with Dr. Mashru. He will give us a full layout of the melanoma in my lungs, immunology treatment with schedule and possible side effects. This will be a big relief to my “plan my life” personality! UPDATE: The MRI showed that there are two melanoma spots on my brain. This is not surprising since when melanoma moves brain, lungs and liver are common spots. They will do radiation on one of them. Immunotherapy for all the nodules, brain, lungs and the spot by the gall bladder. Schedule for treatment will be determined soon. I will do a full post after I digest the ream of information I have now. Sherry is “on pause” and I am still living God’s word to me: “this is not the end. Keep on with what you are doing.”

Friday: I will teach my all day Leaderhship Cohort theology class followed up with supper with Tim Dalrymple and Tucker Fleishman, third year cohorters flying in from Chicago and Las Vegas for their class.

Saturday: All day elder “attack” at Grace. It is really a bi-annual major strategic planning session.

Lung Cancer Follow Up

Dr. Corcoran called this afternoon (Tuesday Oct. 26) in between surgeries to give us the follow up on Thursday’s biopsy. That he would make time in a busy afternoon shows the commitment to proactive care which I deeply appreciate!

He confirmed what we expected: it is metastatic melanoma. The BRAF studies which will indicate responsiveness to immunotherapy are pending. He is referring me to the same oncologist who saw me when I had the melonoma diagnosis 6 years ago for follow up work. That adds a fifth doctor to the care team along with who know how many other medical professionals.

The bladder cancer extraction is scheduled for Nov 9. There will be a biopsy of that seemly unrelated cancer. The gall bladder cancer is on hold right now waiting on the other two biopsies. How there can be three different cancers at the same time is baffling to everyone! The melanoma is the bigger issue at this time but all three cancers need treatment.

Sherry is up mostly up but also down sometimes. On the down side, she finds that she can’t concentrate, but not really anxious about me. We are enjoying the husband/wife growing old together with strong family and friend connections a lot.

I am doing fine. No symptoms at all. Same grumpy old guy who believes God is saying, “This is not the end, keep on with what you are doing.” I find there is a LOT of wonderful things that I love doing with and for Jesus that are fruitful and fulling.

I will follow up as more information comes to light.

Bladder Cancer Extraction

We had everything pointed to Sherry taking me to the Surgicenter at 2:00 today (Monday) for Dr. Burt and team to remove the beautiful but dangerous little bush in my bladder. However, I just got a call (9:30) from Dr. Burt that pneumothorax makes anesthesia unsafe, so surgery will be postponed for a couple of weeks.

It’s odd to have this much cancer in my body but no symptoms or discomfort at all. That along with a positive medical prognosis and God’s word to me, “This is not the end. Keep on with what you are doing” leaves me in a good place, sleeping well and doing what I love.

Julie Vawser sent me the song Aaron Keyes – Sovereign Over Us for meditation. I highly recommend it for everyone.

Lung Biopsy

Sherry drove me down to the early check in and soon the prep team was doing IV, monitors and such. They wheeled me into the same room where the first CT scan discovered the cancers and the very friendly efficient team went to work, doing the scan to find the best place to take the nodule sample. The doctor came in and the process began. I could not see what was happening, much as I wanted to. Then I heard the doctor say something about inserting a chest tube. His pre-op discussion alerted me that I had developed a pneumo-thorax, which is air between the lung and chest wall. That can happen when they insert the needle to get the stuff for the biopsy. He sucked much of the the air out and they did an x-ray to check – more news to come.

The doctor just notified (3:00) me that the pneumo-thorax is small, but still present. So they will continue the suction through the night which means I will be spending the night here. There is some discomfort from the chest tube but other than that I feel fine. Doing the breathing machine to promote the full inflation.

Teaching Prayer and Providence with Todd

Right now (Thursday afternoon), I am co-teaching the Providence and Prayer class with Todd Miles at Western doing it by Zoom in my hospital gown!

The big down side is no visitors – not even Sherry. Maybe even worse, I am in a room with a VERY noisy roommate. šŸ¤¢ But lunch came and it was good. Sherry brought my back pack so I can do some work and update this blog.

Noon Friday update: I have had two x-ray’s to check the pneumothorax. It went from 9 mm yesterday to “Prior trace right apical pneumothorax is not definitely identified.” So the suction tube is clamped and another x-ray coming. If it’s good the chest tube will come out. If that’s good, then I’ll be released

Friday evening update: I passed the pneumothorax test and was soon out of the hospital, finally able to put my wedding ring back on. Thursday night was the first night since March 22, 1968 that I have not worn it. I can see why hospitals need to keep patient’s valuables out of their care, but I don’t have to like it!.

So I am at home watching Nicole play tenor sax in the Oregon State Marching band via live stream. And very glad to be felling fine with no lingering effects of the unexpected events of the last two days.

Cancer Update

The new news is that it looks like the Melanoma has made a new home in my body. I made a video of the journey of discovery to give context to the journey. I will add new ones as we continue the diagnosis and treatment. For those curious ones (like me!) there is a screen shot of the CT scan here.

The bullet points are (1) blood in my urine led to a CT scan that showed a beautiful, but cancerous bush in my bladder. It will come out on Monday afternoon, Oct. 25 and be biopsied; (2) strange stuff in the CT scan prompted a second contrasting CT scan of my lungs that confirmed “multiple bilateral lobular solid pulmonary nodules/masses of varying sizes in all lobes”; (3) a PET scan showed most of my body is “unremarkable” (my new favorite word!) and three “hot spots”: bladder, lungs and gall bladder; (4) an early morning needle biopsy of my lungs will be taken Thursday, Oct. 21; (5) Dr. Corcoran will review results with us Tuesday afternoon, Oct. 26. (6) Hopefully, the biopsies will explain what is perplexing everyone: why do I have three apparently unrelated hot spots in my body?

When I had the Melanoma before, I laid out four principles to guide me: (1) When I go to the past look for lessons, not regrets. It is easy for me to shred myself for what I did/didn’t do; (2) in the present build plans based on what I actually know so I can act wisely and responsibly rather than feeling helpless; (3) the future is where the “what if’s” are. Satan dwells there. Don’t dwell with him; (4) Jesus is in the present, look for Him. Like the bush in Exodus 3, He is easy to miss.

Thanksgiving 2020

There is so much to be thankful for today. Sherry and I celebrated a half century plus a quarter decade of marriage at Depoe Bay last month. Even with all the COVID restrictions we had excellent food, great weather, and wonderful views. One trip was down to Cape Perpetua Lookout. I took a trail walk from Devil’s Churn Lookout down to the Spouting Horn where the Pacific rages high, arranging for Sherry to drive down and meet me at the visitor center, only to discover that it was closed. I did a lot of checking before discovering her back at my starting point . . . not that there were a lot of options along Highway 101! I remembered another walk up the narrow canyon inland from the spouting horn where a close friend decided to explore near the rift and almost got washed away by a big wave.

Health is a point of thankfulness in COVID days. None of our family has been hit with anything, not even a cold. Family relationships are strong. Joy lost her senior year events, including her lead role in Grease and involvement in state music and drama events. But she decided to join Ecola Bible College, which still meets at Cannon Beach Conference Center. Her work scheduling is done by Cyndee, herself an Ecola alum, actually doing my class there so long ago. Grateful for God’s intervention that brought us together. Donn brought Elizabeth and Michael out in August so we could hang. Unfortunately COVID meant cancelling our plans for Thanksgiving in Kansas City. We will do family time via Zoom, a very 2020 thing!

Western Seminary is having its largest enrollment ever and my Leadership Cohorts and the new Master of Applied Biblical Leadership are both growing quickly so my teaching load is enormous. We have two cohorts each in Portland and Costa Mesa plus a new on beginning in Boise next term. I get to hang out and pastor a most exciting group of men and women through that work.

My role at The Bible Project continues. In addition to my board role, I was leading the staff in what was initially called “Happy Hour with Gerry”, times to explore theological questions in an open dialogue format. That all went by the wayside with COVID, but the work of the Project continues to grow. It is stunning that views of our videos have exceeded 200 million. We have at least 10 videos in 18 different languages and 55% of our views come from outside the United States! And then there is the blog and the podcasts.

I did two weddings and continue to be a pastor to pastors and a help for the hurting.

Aynsley & Nicci

There is so much more I could add to this list of gratitudes but this is enough for now

Living in a COVID-19 world

This is a COVID-19 first: I “preached” today’s sermon at GraceĀ from my family room to a camera and Jim. It’s the new way in a “Stay home; Stay Healthy” ordered world. Later this morning I will watch myself preach from that same room as part of our 10:45 service. It’s a very strange world.

All my classroom teaching and weekend speaking until at least mid-May has been cancelled. Elizabeth’s two week school trip to France to live with a French family, followed by a week where Donn and Susan would join her for their own tour is off. We were going to bring Michael here for the week. Cannon Beach Conference Center is closed so Cyndee is beginning a four week furlough. Joy’s senior year was going to have a lot of thespian activity, including a state convention, several performances, capped by a starring role in Grease. We still have slim hopes for Grease. A lot of loss. None of these are exceptional.

Thankfully, my job is still way more than full time so my income is not impacted significantly – and Uncle Sam if going to send us $2,400 relief check, if I read the news correctly. I am thinking about how best to give that away.

I got to help cancer patients yesterday morning by donating platelets again. It is a two armed process which is very strange after many one armed blood donations. My Ortega’s blanket from Chimayo, NM and my Urbana curve helps keep me warm. Laying still for three hours and not moving my arms for most of that time (needles in both elbow joints restricts movement!) left me really stiff and exhausted, which isn’t the norm. But a good night’s sleep and I am back to normal.

There are lots of ways to help beyond my normal pastoring and counseling which are now limited to phone, Facebook live, and Zoom. We did take out from one of our favorite restaurants as a way to support them in their time of shut down dining room.

Budapest – Final Ponderings

We left the Curry House and Phil Metzger snapped this picture of us: him, me, Sherry, Christina, Ryan and Terry. The laughter here was typical of our lunch. That laughter was more around the marvelous things God is doing than the goofing around that was also rampant. I have to say Sherry and I were going to treat the group in thanks for all they had given us. Terry responded by choosing a cash only restaurant – and we had already given away almost all of our Hungarian Flourins so we were not able to accomplish our goal. I am a long term relationship person so there is a certain pain to meeting so many marvelous people knowing that I will never see most of them again in this life.

Heading Home

We did our packing and went early to bed, knowing our early morning departure meant there was a 3:30 am alarm set. I woke to do a bathroom visit and saw the message that our flight was delayed by 25 minutes which set off my travel anxieties stemming from a short layover in Amsterdam. We got to the airport in plenty of time only to get a note from the checkin machine to see the service desk. The kind lady notified us that the delay meant we could not make the Amsterdam connection so we would need to be switched to another set of flights. In my mind, I saw my carefully chosen seats disappear to be replaced by center seats for the 10 hour hop to the west coast. My imagination proved true. Worse than that our wheel chair assist also disappeared for our Paris connection so Sherry had to make the long walk to our departure gate with very tight time constraints. Had not another kind woman helped us get wheel chair passage throught the passport control, we would not have made the connection. Fortunately our 39F and 40F seats were with amiable seat mates who were understanding about “excuse me, please” and I could reach up and touch Sherry from time to time.

Reflecting on our time

I was deeply impressed by the power of the Golgota (Calvary) movement in Central Europe. Not only is the gospel preached powerfully and worship done in very lively ways, the church very intentionally reaches out to marginalized populations like the Roma (Gypsy) people, drug addicts, as well as orphans and widows. Part of my commission was to lay groundwork for reaching into the growing LGBT community in a country where they are legally excluded. The transforming power of Jesus is at center of life.

Expositional preaching typifies Calvary everywhere. It is done well here and there is a deep commitment to equipping young preacher/teachers to continue the Bible centered work. I knew the Americans would be doing that, but was excited that those from Central Europe were also deeply committed to exposition along with equipping and empowering younger leaders.

When I teach I usually pack my time with challenging material, both intellectually and applicationally. In my first session, I found that the leaders were eating it up with rapt attention and insightful questions. The challenges of translation were eased by very high level translators who could comprehend quickly and translate naturally. They were quick to ask clarifying questions to confirm understanding.

My ending thought was “when can I get back here?” Maybe that is why the keys to the flat still in my pocket when we went through airport security (!!!!!)

Arrival home

Sherry Atkins fetched us home from the airport, stopping at Panda Express to get some supper for our exhausted selves. We did some unpacking and a few “gotta get it done” things. I was able to make it until about 8:00 before I fell into bed for a 12 hour sleep. Sherry was coming a bit later but had a coughing spell and was slower but also had a renewing 12 hour sleep. I was renewed enough for a Saturday trip to give pastoral help in a most challenging situation. Happily God moved powerfully. I am deeply grateful to be a minister of the gospel in Hungary as well as Western USA.